The ongoing process of the self organisation of Health in Petralona (part 1).
Social Health Space of the Neighborhood Assembly of Petralona, Koukaki and Thissio
This text was the presentation of the event “health and self-organization”, which was held on Saturday, May 19, 2012 at the Polytechnic School of Athens, in the context of the overall presentation of the project of the social health space.
From Social Medical Centre to Social Health Space
Ever since the start of the Social Medical Centre in March 2009, its goal was to connect itself to the local neighborhood assembly. It became imperative for matters of health to be introduced into the arena of neighborhood assemblies.Because the health issue is too important to be left to the exclusive attention of the workers in that field, who may mobilise around this issue on a different level to the rest of society (eg.labour demands of medical practitioners etc).
Today, more and more attempts to create new social medical centers have appeared, as well as proposals in this direction. What this shows us, is that the Crisis acted as a catalyst in exposing the need for people to mobilise around this issue as a way of taking control of their lives. Presently, as the social contract has been breached, the attack on social welfare has disintegrated any notion of free healthcare that might have existed in the ailing system of health, by excluding more and more sections of the population.
We believe that social medical centers should not attempt to address these problems by filling in the gaps left by the state. On the one hand they should attack the existing reality and on the other hand, by building our counter structures we should invent in practice our vision of health in another world. They should understand themselves as a living cell of resistance and as such to be in a position to impact and be influenced by other social projects and counter structures, as well as neighborhood assemblies, grass roots trade unions etc.
The purpose of this event is the self presentation of projects involved in health and so that we can share our experiences, our mistakes, and learn from them. We do not present our experience with the belief that we have discovered the magic formula but so that we can share our experiences with other similar projects, exchange views and if possible set the groundwork for creating a network of projects that mobilise around health.
What follows is a short presentation of our experience:
During the revolt of December 2008, the “Assembly for Health” was created both by medical and non medical practitioners; the aim was to reflect and act on matters concerning health as a right, healthcare, free access to health care providers as well as labour conditions of medical practitioners.
In this direction, we symbolically occupied the reception desks* of two major hospitals, propagating “health for all” and free access for patients to the accident and emergency departments. At that time, the idea of a social medical center was spawned. It was a vague idea, full of questions and contradictions.
And so, we began to speak of the idea of “another health”, a notion that would subvert the role of the experts, that would breach the binary concept that people are either healthy or diseased. Alternatively, we envisioned an idea of health that would treat problems in a holistic manner and encourage the individual to actively participate and be involved in decisions that concern their life and body. In shaping these thoughts it was important for comrades who are not from the medical field to participate in the discussions, who along side the medical practitioners would put these ideas into action. The participation of the local community in the direction of self organisation and unmediated action was also important.
Since people who participated in the “Assembly for Health” also participated in the Neighborhood Assembly which took place around that time in Petralona, these two assemblies came together and decided to squat the abandoned building of ex-PIKPA, situated in Ano Petralona in April 2009 in order to house their desires. The squat was run by the Neighborhood Assembly while the Assembly for Health was ruminating on the idea of a social medical centre. The choice to squat was taken in order to stress the character of the project and to bring it closer to other self organised projects.
Social Medical Centre 2009-2011
During opening hours of the Social Medical Centre there was always an attempt to breach the dominant power relation between the expert (doctor) and the patient.
At the weekly assembly there was an effort to process theoretical issues regarding health as well as to give an analysis of current reality. For the purposes of providing advice a health practitioner would be present in PIKPA twice a week and would receive queries concerning health issues. There would be an attempt to give advice either on an individual basis by utilizing the knowledge of the health practitioners as well as our networks within public hospitals or collectively in the framework of the assembly.
At the same time the space would host talks on current health issues (e.g. Swine Flue). Contact with other collectives as well as with neighborhood assemblies from other areas of Athens was actively pursued with the aim to share information on developments in the field of health care and issues concerning the National Health System (E.S.Y.).The “Assembly for Health” published a pamphlet entitled “Looking through the crystal ball”, while in coordination with other neighborhood assemblies symbolic occupations of the reception desk in various hospitals took place.
Experience and reflection
The past two years have left an important stock of experience for the “Assembly for Health”; the shortcomings of the original approach to the issue became apparent. While it was considered from the very beginning that the creation of a Social Medical Centre would address and embrace first and foremost the local community of Petralona which could support the project, in reality the project was approached by mostly politicized individuals with a certain ideology and views. The local community on the one hand was not able to incorporate this effort, to embrace it and participate in its formation and on the other hand the “Assembly for Health” failed to approach the community effectively since it was not ready as well as did not wish to function as an autonomous unit of ‘experts’ on health. Hence, its rationale met the limits of the local society.
For one’s personal health, well-being and balance, the participation of the community as a whole is required without delegating responsibilities to others. And so the question of whether the Social Medical Centre would become integrated in the local community which would actively participate in its running in the spirit of solidarity, mutual aid, hope and a vision for another world, remained open.
Socioeconomic crisis-Social Health Space 2011
In light of new circumstances the “Assembly for Health” could not ignore the exclusion of thousands of uninsured people and the creation of a health care system is becoming increasingly privatised. This new political climate called for an escalation of action. The road towards the total collapse of Health has already been paved by the IMF and the greek State. At the same time various “Social medical centres” with heterogeneous characteristics began to spring up across Greece. Neighborhood assemblies are growing in number and gaining new momentum as well as promoting counter-institutions to support the concerns of our everyday lives. The “Assembly for Health” met for the second time with the neighborhood assembly of Petralona-Thissio-Koukaki. Since October 2011 a working group continues to run the project of the Social Medical Centre in the PIKPA squat, which was then renamed “Social Health Space”.
The space is open twice a week for three hours in the afternoon and it is run by a weekly assembly of the working group for Health of the Neighborhood Assembly. During the opening times part of the space runs as a meeting place and part of it is specially formed for seeing to patients. The schedule of the “Social Health Space” is designed every month as a shift system for both the medical practitioners (pulmonologist, surgeon, orthopedist, G.P., otolaryngologist, and support group for mental health issues) and the non medical practitioners.
What is the objective of the “Social Health Space”?
1. Is it the organisation of a centre that provides a first point of contact for health care whilst trying to help people overcome the increasingly apparent failings of the National Health System?
2. Is it the spreading of our vision of an alternative notion of Health?
3. Or, maybe, is it the creation of a “therapeutic” community and an attempt to overcome the alienation amongst people?
History and life go on, there are no fixed solutions, only processes of collectively forming radical structures.
The project of the “Social Health Space” is comprised of different individuals from different backgrounds, different views on Medicine, Health or the system in general. Our availabilities and possibilities are clearly restricted for now; therefore our desire is to build a culture of participation and for that to be adopted by the local community, which has embraced the project up to a point. As people who participate in the project we are trying to listen to the demands of the local community and go on from there.
Four action lines for the “Social Health Space”:
1. Providing a first point of contact for Health Care as well as Advice. Of course, there is no possibility of prescribing medicine; however there is a strong chance of finding medicine for people who cannot buy it, through our connections with various comrades and other health care practitioners. (Equipment: Stethoscope, blood pressure monitor, oximeter, blood glucose monitor, otoscope, incident book and lately a cardiographer.)
2. Spreading knowledge – self education. First Aid and Reflexology seminars have been held at the “Social Health Space”, as well as a workshop on Reflexology. In order to configure presentations, the working group of the “Social Health Space” suggests alternative subjects to the Neighbourhood Assembly – so that the seminars reflect the interests and needs of the Assembly as much as possible. At the same time, there is a process of translating and editing the Botanology book of the Zapatistas, in order to spread the experience and traditions of the insurgent indigenous people of Mexico.
3. Sharing of information on current issues regarding the National Health System whilst exploring the possibility for a radical collective response.
4. Restricting the role of the expert with the aim of challenging the notion of the relationship between doctor and patient. The needs of the patient are first met in the meeting space by both medical practitioners and non medical practitioners. This collective approach reflects the idea that communication and solidarity can be the most dynamic response to health issues, given that we don’t consider health to be merely the absence of disease. Further more this particular approach gives us the opportunity to tackle the problem with a variety of approaches and perspectives, both professional and alternative. A discussion and a self help group on matters of mental health have also been created.
Experiences, Questions and Concerns
Through the “Social Health Space” new relations are formed between the people who support the project and those who come seeking advice. Health becomes an occasion for communication, for creating bonds and for collective management of our individual concerns.
Mutual relations which bank on and aspire to the sharing of experience, knowledge and finally a meaningful human contact.
Relations unmediated by money, by institutions, foundations, charities or ngo’s.
Relations built on the strive for self organisation and self direction. Relations that entice reflections and concerns. The exchange of services isn’t confined to the individualistic relationship between medical practitioner and patient but exists in and is embodied into the collective procedure. This helps the residents who visit the space to comprehend, to change their everyday life, their life as a whole inside the rotting capitalistic system which in its decadence carries away with it everything we have held to be true until now.
Premised on solidarity a new community in embryonic form is evolving where the struggle of “patients” and medical practitioners is common (not only for matters of health but for life in its entirety). And so the provision of health care does not become an act of charity or welfare but a self-evident act of solidarity in an effort to incorporate it into the wider social struggle. There is critical consideration of the role of the expert, not as to their technical skills and know-how but as to the authority that expertise and the disdain for the diffusion of knowledge give rise to.
The experience of a collective processes in dealing with health matters, through the creation of healing groups for the “ailing”, could prove to play a therapeutic role and to contribute to a great degree to their overcoming where feasible.
In this particular historical moment, a contradiction arises where on the one hand the exclusion and exemption of more and more people from health care is on the rise and on the other hand, demand for access to health care is growing since the number of uninsured people is increasing and the NHS no longer provides for them.
Some considerations. Health is an undeniable right. However, the “Social Health Space” at this point lacks the structure and the power to meet this challenge. Only through struggle towards the total overthrow of the existing capitalistic system can this be done, when we truly take back control of our lives.
What we desire is for the people with whom we come into contact to understand that self organisation of our everyday life is possible and to be able to envisage another world where Health equals physical, social, mental balance and harmony with oneself and the environment in a framework of community rather than individualism.
And so, as the need for creating new Social Medical Centers becomes apparent, the “Social Health Space” believes that this particular experience needs to and must be diffused into society.
Not because there are magic solution or absolute truths.
But as a tool for collective processes that can create each in its own way a vision of another world premised on a different perception of life where we truly take back control of our lives!
*Following the introduction of IMF policy a fee was introduced in all public hospitals. Access is conditional to paying at reception.
Social Health Space
of the Neighborhood Assembly of Petralona, Koukaki and Thissio.