Questioning the Solution : The Politics of Primary Health Care and Child Survival

Questioning the solution analyzes why 13 million children still die every year from preventable causes and challenges conventional Primary Health Care and Child Survival Strategies. Too often, health and development planners try to use technological fixes rather than confront the social and economic inequities that perpetuate poverty, poor health and high child mortality. As a case study, the authors show how marketing Oral Rehydration Therapy as a commercial product, rather than encouraging self-reliance, has turned this potentially life-saving technology into yet another way of exploiting and further impoverishing the poor. The book explores the history of medicine and public health since colonial times and shows that health is determined more by the equity or inequity of social structures than by conventional health services. It reveals how structural adjustment policies and the globalization of the economy diminish the health and quality of life of vulnerable people, especially wom

David Werner, a biologist by training, has spent the last 30 years working to help poor farming families in the mountains of Western Mexico to protect their health and rights. Project Piaxtla, the villager-run program to which he has been a facilitator and advisor since 1965, has contributed to the early conceptualization and evolution of Primary Health Care. The three main books he has written and illustrated - "Where There Is No Doctor", Helping Health Workers Learn" and " Disabled Village Children" - are among the most widely used in the field of community-based health care and community-based rehabilitation. He has worked in more than 50 countries - mostly in the Third World - helping to facilitate workshops and training programs and as a consultant. David has received several awards for his groundbreaking work, including the world health organization's first International Award in Health Education in 1985 and the MacArthur "genius" fellowship in 1991. He is a founding member of the International People's Health Council and of HealthWrights (Workgroup for People's Health and Rights).

David Sanders was born in South Africa and grew up in Zimbabwe, where he qualified as a medical doctor. During the 1970's, he lived and worked in Britain where he specialized in paediatrics and later in Tropical Public Health. While there he was actively involved in campaigns to defend the National Health Service and in solidarity work with the liberation struggles in the former Portugese African Colonies, Zimbabwe and South Africa. He was also a founding member of ZIMA (Zimbabwe Medical Aid) and the "Politics of Health" group. In 1980 David Sanders returned to the newly independent Zimbabwe as Coordinator of a rural health program developed by OXFAM in association with the Zimbabwe Ministry of Health. He also initiated and helped develop a national children's supplemental feeding program and actively contributed to the reconstruction and development of Zimbabwe's health system. He joined the Department of Paediatrics and Child Health of the Medical School in Harare and later transferred to the Department of Community Medicine, in which he was a latterly Associate Professor and Chairperson. During this period, he was centrally involved in the restructuring of the Medical Undergraduate curriculum. In 1992 he became director of Staff/Student Development at the Medical School of the University of Natal in South Africa, where he became actively involved in health policy development with the African national Congress (ANC) and SAHSSO (South African Health and Social Services Organization). In 1993 he was appointed as Professor and Director of a new Public Health program at the University of the Western Cape, Cape Town, South Africa, which provides practice oriented education and training in public health and primary health care to a wide range of health and development workers. He is the author of the book, "The Struggle for Health: Medicine and the Politics of Underdevelopment", as well as several booklets and articles on the political economy of health, structural adjustment, child nutrition and health personnel education.