The centrality of asking when does misfortune become injustice?
ALICIA ELY YAMIN
Toronto— Protesters holding a banner demanding housing for the homeless during the COVID-19 pandemic. Public Domain. Via Flickr.
We are pleased to present an adapted excerpt from When Misfortune Becomes Injustice: Evolving Human Rights Struggles for Health and Social Equality » .
The sweeping disruption of the COVID-19 pandemic has generated broad public concern with the connections between population health, health systems, and democracy, on the one hand, and between our neoliberal global order and the realization of health and other human rights, on the other. Students across geographic regions and disciplines—law, public health, nursing, sociology, gender studies, anthropology, and the like— are grappling with how to understand the suffering we ourselves and close friends and family are experiencing, as well as diverse people across our societies and the globe—and what are appropriate legal, political and economic responses?
These questions are not new. Having spent a career interviewing the loved ones of women who died in childbirth, and others who have died painful deaths in abject poverty, including from HIV and untreated cancer, I have come to believe that how we understand the relevance of human rights to health is inextricably shaped by how we understand individual versus societal responsibility for the drivers of disparities in health, and in turn what is misfortune versus injustice.
Even before the pandemic, it was clear that there was a need to disrupt our traditional strategies in human rights to address the drivers of scandalous inequalities across global health.
When we reexamine what it means to say that something causes someone’s illness or condition, we are forced to look at what produces certain distributions of power and privilege within and across societies. For example, is the cause of enormously disproportionate COVID-19 mortality among people of color in the United States really due to individual biological differences and co-morbidities? Or is it more accurate to understand them in light of structural dynamics and social determinants, such as unequal exposures as essential workers, and housing conditions, and poor access to public health and medical care in a marketized health system? When we call on ourselves and others to ask these questions, it quickly leads to de-naturalizing both the biological individualism of the medical and health fields and to questioning prevalent narratives about poverty, inequality, and population health which so many societies take for granted in our neoliberal world.
Even before the pandemic, it was clear that there was a need to disrupt our traditional strategies in human rights to address the drivers of scandalous inequalities across global health. So I wrote When Misfortune becomes Injustice » not as a traditional text but to encourage critical reflection about what is required of societies, and of our global governance, for diversely situated people to live lives of dignity , including effective enjoyment of health rights. In the devastation wrought by this sweeping pandemic, it has become even more essential for students grappling with these questions not just to learn a fixed set of skills but to assess critically how we got here in order to devise transformative ways forward, and to connect human rights to broader struggles for health and social justice, including climate justice.