Department of Health Systems Management, Ben-Gurion University, P.O.B. 635, 84105 Beer Sheva, Israel.
Soc Sci Med. 2012 Mar;74(6):839-45. doi: 10.1016/j.socscimed.2011.07.018. Epub 2011 Aug 23.
In the context of neo-liberal retrenchments humanitarian NGOs have become alternative healthcare providers that partially fill the vacuum left by the welfare state's withdrawal from the provision of services to migrants and other marginalized populations. In many cases they thus help to build legitimacy for the state's retreat from social responsibilities. Human rights organizations play an important role in advocating for migrants' rights, but in many cases they represent a legalistic and individualized conceptualization of the right to health that limits their claims for social justice. This paper analyzes the interactions and tensions between the discourses of medical humanitarianism, human rights and political advocacy using the example of an "Open Clinic" run by an Israeli human rights organization as a case-study: In 2007 dramatically increasing patient numbers provoked an intense internal debate concerning the proposal to temporarily close the "Open Clinic" in order to press the government to take action. Based on protocols from internal meetings and parliamentary hearings and in-depth interviews, we have analyzed divergent contextualizations of the Clinic's closure. These reflect conflicting notions regarding the Clinic's variegated spectrum of roles--humanitarian, political, legitimizing, symbolic, empowering and organizational--and underlying conceptualizations of migrants' "deservingness". Our case-study thus helps to illuminate NGOs' role in the realm of migrant healthcare and points out options for a possible fruitful relationship between the divergent paradigms of medical humanitarianism, human rights and political advocacy.
在新自由主义紧缩政策的背景下,人道主义非政府组织已成为替代性医疗保健提供者,部分填补了福利国家从向移民和其他边缘化人群提供服务中退出所留下的真空。在许多情况下,它们有助于为国家从社会责任中退缩建立合法性。人权组织在倡导移民权利方面发挥了重要作用,但在许多情况下,它们代表了对健康权的法律和个体化理解,这限制了他们对社会正义的诉求。本文以一家以色列人权组织运营的“开放诊所”为例,分析了医学人道主义、人权和政治倡导话语之间的相互作用和紧张关系:2007 年,患者人数的急剧增加引发了一场激烈的内部辩论,即提议暂时关闭“开放诊所”,以迫使政府采取行动。基于内部会议和议会听证会的记录以及深入访谈,我们分析了诊所关闭的不同语境化。这些反映了对诊所多样化角色——人道主义、政治、合法化、象征性、赋权和组织——的冲突观念,以及对移民“应得”的潜在概念化。我们的案例研究有助于阐明非政府组织在移民医疗保健领域的作用,并指出医学人道主义、人权和政治倡导之间不同范式之间可能存在的富有成效的关系的选择。