At a time when the COVID 19 pandemic is still present, when the war against Ukraine, and not Ukraine as it is wrongly said, is flagellating an entire nation and causing collateral effects in practically the whole world, where the threat of totalitarian regimes jeopardizes fundamental values and rights, in which inequalities and lack of equity are the consequence of vulnerable populations… it seems that this does not invite much to talk about Health, even less to talk about it do so with a view to global celebration.
However, precisely because of this and because of many other factors, situations and events that occur daily in the world, but also locally, it is more than ever necessary to speak, analyze, reflect and debate of health.
Undoubtedly, the effects that the pandemic, war or inequalities generate on global health are sufficient reasons, but not the only ones, to stop, even for a day, to assess what a word means. that we all recognize and how little we know and appreciate. Only, as the saying goes, we remember Santa Bárbara when it thunders, and by analogy we can say that we remember health when we don’t have it or see the danger of losing it.
In any case, both the pandemic, war and inequalities, as paradigmatic examples against health, what they come to highlight is the fragility of health and the worrying lack of attention paid to it by politicians/organs, rulers, managers, health professionals and the general population.
Something like health that arouses so much consensus, in terms of the importance given to it, at least in appearance and in the discourse that is generated around it, and yet so much is neglected and even so mistreated in concerns facts or actions tending to promote, preserve or replace it.
It is therefore clear that it is not only a question of identifying health as a value, a right or an opportunity that is used opportunistically and punctually in the approach of speeches, positions or arguments to make convey a message in which its importance is clear, but in which it is never, or almost never, specified how health fits into the policies that support or at least found political, governmental, managerial, professional or social.
Thus, health is used, manipulated, manipulated and deformed according to the interest required in each case, as if it were a joker to try to complete the move that wins the current game at that that time. Whether it’s pandemic, war, or inequality, incorporating it where it matters most to complete the winning combination. It always ends up being a safe option.
But of course, what is actually used is not health, but the word with which it is identified, which in no way implies that we all understand in the same way what it means, or what it contributes, or what it determines. Because health is in itself an option, a responsibility, an opportunity, an illusion, a condition, a solution, a requirement, a need… depending on who or who uses it, the research, the interpreter, the analyze it, verbalize it, incorporate it, move it, coordinate it, manage it or even buy or sell it.
In a highly competitive society where immediacy, individualism and commodification permeate everything, health becomes one more consumer good with which to gamble on the stock market, do business, scare, deceive, speculate, blackmail, but very little to generate equality, tranquility, well-being, balance and solidarity.
We have all become, more or less, health traffickers.
From politics, by making partisan use of such a sensitive, transcendent and necessary issue in order to benefit from it, without this meaning that it is done according to the answers or bets that are made around or in favor of health public and community that require, but only as an element of marketing and propaganda with which to attract attention or obtain an advantage, whether political, social, corporate or personal, but very far from the real capacity of what means to have and be healthy.
From management to identify health as a good with which to obtain benefits in a rentier perspective far removed, in many cases, from health outcomes of and for individuals, families and the community, systematically confusing health with health as if they were synonymous when they are really antonyms or at least different concepts which are even managed in different ways and with different objectives.
From professionals because some do not even feel and even give up being health professionals, because they understand that their action is above focusing exclusively on the disease and its possible cure. Others because even by assuming, or at least not renouncing, their belonging to health, their activity is circumscribed to the disease or to the technique, doing so from a paradigm that is not theirs. and of which, moreover, they lose their autonomy and generate dependence and subsidiarity from other professionals. All of this leads to a professional reductionism that places them as health professionals, having renounced health, which only occupies an anecdotal or testimonial space. Care, on the other hand, is relegated to a residual and unscientific evaluation, neither identified nor recognized by the institutions, although it is valued very positively by the population, but which nevertheless finds it difficult to assimilate it to a nursing contribution. specific that generates health, self-management, self-determination and autonomy of care.
Finally, citizens because they identify that health is something to which they have and cannot contribute anything, that for this there are already health professionals who are the only ones with the competence to act when a health need is identified or perceived, which is not really such that it is assimilated to a demand for illness, a consequence of the health culture which, in this sense, has been transferred by professionals to the population, usurping all their popular knowledge and ability to make decisions about their health-pathological processes, generating a care-dependent and highly demanding population that is neither healthy nor caring.
Thus, health, like other fundamental rights such as justice or equity, is reduced to simple idealized and desired notions, but which are difficult to access on equal terms because of the context and determinants that exist in the present, which will determine clear differences both in access and in people’s perception of their own health.
Health must therefore be identified, in addition to being an indisputable right, as an accessible good regardless of all the factors that directly or indirectly clearly affect the possibilities of people to do so in equal conditions and results. .
For this, it is essential that health clearly moves the disease to the center of the attention of policies, management, professional care or the individual and collective responsibility of the population. Only by placing health as an objective and not as an expected or desirable outcome with which to do business or speculate, and from a direct participation approach, can we generate environments, populations and healthy contexts where health is part of coexistence and not just a one-off, anecdotal or incidental experience linked to assumed and stereotyped states of well-being.
Public and Community Health must acquire the leading role it unfortunately does not currently have, being subject to the rationalism and paternalism of health care models in which professionals such as nurses are made invisible or reduced to execution of delegated tasks of sickness assistance and with that nullified as fundamental health agents of health promotion from which to empower individuals, families and the community in health.
Continuing to celebrate World Health Day as a date to remember that it exists, but without there really being a firm commitment on everyone’s part to make it an indisputable reference for all policies, which represents a radical change in terms of its identification, approach, treatment, planning, accessibility, development and evaluation, will be reduced to one more date in the calendar of world celebrations which reminds us each year that there is ‘it makes less and less sense and is used, once again, as a propaganda showcase in which to stage recognitions whose sole purpose is to mask the shortcomings derived from the lack of necessary, desired and courageous decisions that place health as an objective to be achieved and not as a means to achieve ends that have nothing to do with the health of individuals, families and the community community.
Applause, like awards, lose all their value if they are not accompanied by actions that give real meaning to health, which citizens, professionals and the national health system itself really need.
Arguing with reality is painful, as Byron Katie2 says, admitting it without doing so is giving up trying to improve it.
From the Academy of Nursing of the Valencian Community we make a serious, rigorous and scientific appeal to global health as the only way to achieve the necessary balance that facilitates access to it from equality , equity and freedom, in a common effort to respect it. and not to make an interested use of it.
Today more than ever, HEALTH acquires a dimension beyond health and assistance. An integral dimension that gives meaning to life in any cycle, environment or vital context, regardless of social, cultural, religious or sexual differences, enjoying it in balance and coexistence as a common good that determines the individual and collective responsibility and not as an obligation imposed against the disease exclusively. As a value that must be defended and shared, promoted and respected, generated and maintained, desired and realized from participation and solidarity, ethics and aesthetics, technique and care, technology and humanism. It is only in this perspective, this approach, this commitment that it is worth recognizing and celebrating this World Health Day as a universal and accessible good and right.