by Adanna Chukwuma
Successful movements to reverse health inequity will not be built by one leader but by a movement of leaders, each a champion in their own right at varying levels.
Growing up in a country run by the military deeply influenced my notion about leading change: national political leadership seemed inherently superior and potentially the most effective platform for dealing with the health disadvantage many Nigerians faced. Graduate study in global health reinforced my convictions. I saw that at the very root of avoidable health disadvantage was powerlessness – the deprivation of political power to demand accountability and the deprivation of resources to meet health needs. For as long as we stayed on the surface of the issue, content with strategies to redistribute health commodities and services, there would be no tension. However, I had chosen to take a dive off the deep end ensuring that everyone could be heard, that each person had the resources they needed, and that we could all live with dignity. In my mind, there was only one way to facilitate this goal: becoming the benevolent national political leader. I discovered I was wrong.
In one of the most profound experiences of my Global Health Corps fellowship year, I had the privilege of meeting Marshall Ganz. First a brief bio: Marshall is a senior lecturer in the Harvard Kennedy School, a veteran activist and a community organizer credited with devising the grassroots movement for Barack Obama’s 2008 presidential campaign. I sat in on a 3 hour long in-house workshop for staffers of MDG Health Alliance who were looking to apply community organizing principles to their work, aiming to accelerate progress on addressing global health challenges. Drawing from almost five decades of experience organizing communities around social justice issues, from the civil rights movement to labor unions, Marshall’s theory of change was at odds with mine and his method worked.
I was right about one thing though: at the root of health disadvantage is powerlessness. But could I, working alone, empower the disadvantaged? Unlikely. The truth is that the idea of the charismatic leader working in isolation to change systematic disadvantage, though appealing, is a myth. The powerful do not willingly let go of power so that movement to correct disadvantage rooted in powerlessness is often met with hiccups. Take one look at “Obamacare” and note that this innovative bill drafted to grant millions of Americans access to healthcare has been stalled so many times its entire survival is currently being questioned. I was thus starting off on the wrong foot by trying to take this on all alone and focusing solely on the issue. The place to start is not with the issue, the place to start is with the people.
Turning to communities for partnership in leading change acknowledges that the community understands their challenges and that together they can find the capacity to deal with these challenges. It is acknowledging that battles to correct injustice will often be hard and long. Sustainable change must then be championed by the people who are most affected and who will find the strength to stay the course, reshaping the dominant culture through collective action. Successful movements to reverse health inequity will not be built by one leader but by a movement of leaders, each a champion in their own right at varying levels. I looked to a partner organization to see this model in practice within global health. Partners in Health through PIH| Engage mobilizes organizers to work with communities in Malawi to counter health inequities by supporting health policy change, by educating others about critical global health issues and by generating resources to move forward on access to care in the country. My shift in paradigm was complete.
After the meeting, Marshall walked over and thanked me (Imagine that!!) for sharing my experience in leveraging social media to organize for action: I was part of a small team that led a 20000-man group on Facebook to mull over political issues and start or join rallies all over the country during the 2012 Occupy Nigeria protests. Rethinking my notion on leading change does not mean I am absolved of responsibility to address these pressing issues. It implies that rather than work for my people, I choose to work with them. I choose to help equip communities across Nigeria with the capacity to stand together, working collectively towards achieving health equity. It was an exceptional discussion, one I will remember for a long while.
Adanna Chukwuma trained as a Medical Doctor in University of Nigeria, graduating with several distinctions. Following medical practice in a variety of settings, She spent a year in one of the most deprived states in her country involved in health promotion and paediatric clinical services, for which she received community service awards from both the Nigerian President and the Executive Governor of Yobe State. She decided to further my understanding of health disparities and accepted an ExxonMobil International Scholarship to study for a Master of Science in Global Health Science in University of Oxford, graduating with distinction.
Adanna firmly believes that avoidable disparities in the experience of health can be addressed by multi-sectoral collaborative action on the social, economic and political factors that shape the environments in which people live. She just completed a Health Policy Fellowship with Global Health Corps, a non-profit organization led by Barbara Bush, and was placed with the Division of Strategic Health Planning, in the City of Newark, New Jersey. Among other things, she served as technical lead on the 2010 – 2012 process evaluation of “Let’s Move! Newark”, the local adaptation of First Lady Michelle Obama’s childhood obesity prevention campaign.
She is currently a doctoral student in Harvard School of Public Health within the Department of Global Health and Population concentrating in health systems. She is also a Research and Communications Associate with Institute for Advanced Development Studies, recently ranked the top development think-tank in Bolivia. On completion of her doctoral education, Adanna aims to work throughout sub-Saharan Africa strengthening the capacity of national health systems to meet the need for care equitably.
Op-ed pieces and contributions are the opinions of the writers only and do not represent the opinions of Y!/YNaija.