The political position on public health has been dominated by the understanding that good and effective health care, to be found in modern systems of sanitation, health care and medicine needs to be provided for, to be delivered to people. Given that in a developing country context like that of India, most of it was out of the reach of a majority of the people, the provision of health care was also a significant part of the democratization process. The experience of providing health for the public however, particularly in India, whether through the state health systems or community health interventions by non-governmental organisations or people’s movements, has indicated more agency on the part of patients and ‘consumers’ than the traditional perspective allowed for. This paper will discuss what these experiences of agency are and what they indicate for policy and politics of public health. People/patients make choices of treatment regimens on the basis of a colloquial classification of disease and how soon they believe it can be treated or indeed, how much time they can afford to get better. On the other hand, those that have access to no primary health centres or modern medicines, put their faith in local healers that rely almost entirely on the local biodiversity for their sources. A large number of people routinely combine regimens as well, from common everyday conditions to very complex ones. All of this happens in an unmediated and unregulated manner, which limits the learning and exchange possible, simply the spaces for communication between different knowledges. Instead, the entire focus is on battling for spaces of power for each of them. This paper argues that a self-conscious politics of knowledge mobilization, recognising the agency of practitioners, patients and institutions of learning, is what is required. This will initiate a process of democratization at both the material and pedagogic level and possibly, a more democratic model of health for ‘the public”.
Dr. Madhulika Banerjee has taught mainstream courses in Political Science at the University of Delhi and has researched on its fringes, on the politics of knowledge for nearly three decades. She has a book, titled, Power, Knowledge, Medicine: Ayurvedic Pharmaceuticals at Home and In the World. This book explored how the knowledge system of Ayurveda, recast itself in the post-colonial period on the axis of industrial manufacture, state interventions and scientific research, questioning its perceived 'revival' in the late twentieth century. Interested in the manner in which the politics of knowledge has played a crucial role in shaping and transforming the discourse and practice of development particularly in the developing world, she is now trying to extend her analysis and arguments on medicine to those of knowledge in other fields of agriculture and water. She is also beginning a study on comparing political mobilisation using the politics of medical knowledge in Brazil and India, in the 1980s to the early twenty-first century.