Advocacy is a tool for health

PAUL R MARTIN

Queensland Health Minister Lawrence Springborg has placed a ‘gag order’  on non-government organisations he funds.  Any that receive more than 50 percent of their funding from the state government are now not allowed to engage in advocacy.

This would mean that Healthy Communities, if we were still funded by Queensland Health, would be barred from calling for marriage equality, an equal age of consent or better recognition of trans and intersex people.  It would also mean we would not even be able to provide links on our website to organisations like AFAO and the National LGBTI Health Alliance, because they engage in advocacy.

So what is advocacy and why is it important?

Community service organisations of all types (e.g. HIV, LGBTI, Aboriginal & Torres Strait Islander, neighbourhood centres, community nursing) see thousands of clients each year for all sorts of issues and ailments.  Over time, we begin to see patterns emerge of the underlying causes of ill-health.  It may be that residents of a neighbourhood come to see us because of diabetes, but the underlying cause is lack of access to fresh and affordable fruit and vegetables in their area, leading to overweight and obesity.

Few community organisations are in a position to directly do something about these underlying causes, so we speak to people, organisations and governments who can.  That’s called advocacy.

There is an often used story in public health to explain why advocacy is so important.  Two people are standing by a river and see someone float by drowning.  They jump in to save them.  Then they see another, then another.  They could easily spend all their time by the river rescuing people.  But one of them has an idea.  She walks up the river to see what’s happening, finds that a bridge is broken and fixes it.  Problem solved.  By working ‘upstream’ she has prevented people from falling into the river and needing to be rescued.

So much of our health system is focused on treating ill people downstream, while doing little upstream to prevent illness in the first place.  We can’t all fix the bridge, but we can all call on those responsible to act, via advocacy.

Advocacy is an important tool in the toolbox of health promoters.  Addressing the underlying causes of ill-health is more effective, less costly and saves people from getting ill in the first place.  Preventing health promoters from using the tool of advocacy is like walking into an operating theatre and telling the surgeons they are no longer able to use a scalpel.  It goes against our training, our professional guidelines & ethics and common sense.

By preventing community services from using advocacy, the Queensland government will not be fully advised of the underlying causes of ill-heath and what can be done about them.  In time, the health of Queenslanders will be worse of and thousands of people who needn’t have become ill or die will suffer.

Paul R Martin is the executive director of the Queensland Association for Healthy Communities.