Freedom, control, choice and empowerment
are all part of the modern discourse or rhetoric of health promotion. Every idea that starts with radical intent
becomes diluted as it becomes adopted and incorporated into the mainstream, and
the radicalism of the WHO’s original definition of health promotion being about
people taking control of the determinants of their health has inevitably not
occurred, as that way revolution lies! At the least however, social movements
have attempted to address the worst excesses of loss of freedom, dignity and
lack of control.
The film being shown at the moment, 12 Years a Slave, is perhaps part of the
retrospective imperative in our different political age that has enabled women
feeling able to speak out against their historical sexual abuse, and people of
African heritage pointing out the evils of slavery and its legacy. Much of the rediscovery of history has taken
place in the USA and is being told through popular media. The Butler for example, tells the story of a black butler who
served in the White House under eight different Presidents. It charts the
shameful treatment of black Americans in the twentieth century and
provides a backdrop to explore the civil rights movement. This film is based on the true-life story of
Eugene Allen; when he started to work at the White House, he had to use the
back door reserved for black people. He
lived long enough to see a black man appointed as president. In 1792 when the White House was built, 400
of the 600 labourers were slaves. Even in the early 1960s, John F Kennedy is
reputed to have ordered his aides not to allow Sammy Davis Junior, the black singer and musician, to be photographed with his white wife at a party at the White House,
it not being that long since inter-racial marriages were illegal. The legacy of slavery thus runs deep in the
US, yet of the 10 million Africans forced to the new world as slaves, only
350,000 went to what is now the USA.
Over a million went to the British colony of Jamaica and British
colonies took a total of about 25% of all slaves from the Atlantic trade. Given
that slavery was lawful in the USA from 1620 to 1865, much of that too would have
been under British jurisdiction.
12
Years a Slave is unusual in that the man whose true
story the film is based on, Solomon Northup, was firstly a free man who was
kidnapped and made a slave, and secondly, that he was literate and wrote a book
about his experiences. Once enslaved,
Northup had no means to free himself; he was 33 and lived in upstate New York
with his wife and children before he was duped. He was only freed by the white
former owner of his father. Few first hand accounts of slavery exist, although scholars
have turned up about 100 written between 1750 and 1865, and they serve as
powerful testimonies to challenge the mainstream histories usually written by
white men. The autobiography of the runaway slave Harriet Jacobs, is one
example. Harriet Beecher Stowe, the white abolitionist, made a huge
contribution with her series of Uncle Tom’s Cabin, which appealed directly to
the emotions of Americans about slavery. But there is nothing more powerful
than people’s own testimonies, highlighting, if it were needed, the importance
of literacy and of the written word being such a commanding medium for those
who are silenced, to use Paolo Freire’s terminology. The film has been made by
the young black British director Steve McQueen.
Whilst it’s instructive to learn about the
slavery of the past, what should concern health promoters today is the current
day slavery that we know exists. Modern slavery is clearly illegal and is
covered by a number of conventions such as the Slavery Convention of 1926, and
the Supplementary Convention on the Abolition of Slavery, The Slave Trade, and
the Institutions and Practices Similar to Slavery of 1956, plus the Universal Declaration
of Human Rights 1948, and the Convention on Forced Labour of 1930. Slavery is
where people are forced to work through mental or physical threat; being owned
by an employer; being dehumanized, treated as a commodity, bought and sold;
being physically constrained with restrictions on freedom of movement. By these
definitions, there are groups of people who are clearly modern slaves,
including those doing forced or bonded labour, child slaves, people who are
trafficked, slaves by descent, and people in forced or early marriage. In 2002, the ILO estimated that over 8
million children were slaves, 21 million adults were forced labourers, 55% of
them women, and the majority, 56% were in Asia and the Pacific. The
organization Anti-Slavery has more
facts and figures:
The group No More Slavery instructs how to take action, or as it says,
‘Empowering you to act’. (Yes that E word again!)
Like Solomon Northup, many modern day
slaves are tricked into their status as slaves. They are promised jobs or a
better life in some way. Desperate people are likely to take desperate measures,
but they can end up in a number of forced positions, whether that is as brides,
organ donors, servants, sex workers, or factory workers. The high profiles
cases, such as that in Lambeth, London in November 2013 where three women were
kept for 30 years and then made a dramatic escape, suggest that modern slavery
is rare, whereas if we go beyond these headlines, we can see that slavery
affects millions of people today, and some politicians and social commentators
claim that it will only get worse. Moreover, it’s close to home, occurring in
Europe, North America and other supposedly ‘developed countries’ with laws
against it.
Though much of its work has been on organ
trafficking, The World Health Organization has taken a cursory look at
initiatives concerned with the health of people who have been trafficked,
noting that much of the literature focuses on those who have been sexually
exploited. In this regard, this WHO’s report is useful: http://apps.who.int/iris/bitstream/10665/77394/1/WHO_RHR_12.42_eng.pdf?ua=1
It has also looked at child labour, itself
a contentious area, given the different social constructions of childhood and
the economic importance of children. The WHO distinguishes hazardous child
labour from other forms of child labour, and suggests that of the 250 million
children globally child labourers, 111 million are engaged in hazardous labour:
Is the epistemic health promotion community
fully engaged with the modern slavery issue? It’s surely one of the most
important health inequalities of our age and so obviously contravenes the values
embedded in health promotion of empowerment, choice and control.
