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A Reflection on the Inclusiveness of International Conferences on Health and Social Justice

By Sabu K U
on October 3, 2018

It was a rainy night, as I made preparations to go to Bangalore for my visa verification interview. I had already postponed the appointment twice in the same month, because of the worst flood that affected our state (Kerala, India) in a long time. It had been difficult to find transportation anywhere, and I had been with the flood victims in the relief camps for most of the time, but it was already August 22nd and high time I attended the interview. I was planning to participate in the Fifth Global Symposium on Health System Research and the Emerging Voices for Global Health (EV4GH) workshop, conducted as part of the Symposium. Working with one of the most marginalized tribal communities in my state, I was thrilled with the opportunity to present their problems in an international forum and network with committed champions of public health from around the world.

In the past few weeks, I had experienced nature’s unimaginable fury, and seen the havoc she wrecked in the places and on the people I work with – the floods and landslides were truly a heart-wrenching sight to behold. Dealing with emotionally and physically battered people during that time, meant I was burnt-out on most days and unable to think of my visa application. Now that the water had receded and transportation had been restored, however, I realized that I might be forced to give up any hopes of attending the symposium and EV4GH, if I didn’t attend the visa verification interview soon. A friend working at the EV4GH secretariat also reminded me of this, informing me that the visa processing procedure typically takes 14 working days, and encouraging me to apply without any further delay. Just on the previous day, I had booked my appointment for the interview in Bangalore, eight hours away from my place of residence, and it was one hour before my bus was scheduled to depart. I was getting ready to leave when a knock on the door made me pause with my preparations.

I opened the door. The boy standing in front of me was completely drenched, and it was still drizzling outside. “Sir, Sharanya is not feeling well, want to take to the hospital, Bindu chechi is calling you”, said Akshay. Sharanya is a two and half-year-old girl child with severe undernutrition, from the Melekappumkunne tribal colony where I am doing my field study. The child’s parents are landless agriculture labourers belonging to the Paniya tribal community. The household had faced severe food insecurity for the last few weeks, as a result, mainly, of the heavy rain and flood that the district had experienced for many weeks, and had to depend completely on the charity of governmental and non-governmental agencies, which provided food during the floods.

Akshay is a 13-year-old boy from Sarala and Velli’s neighborhood,  and Sharanya is the couple’s only child. I called the boy to my room and tried to contact in turn, the ASHA worker, the Tribal Promoter, and the Anganwadi teacher from the place, but nobody picked up their phone. They were probably busy and overworked with the flood relief camps in the Panchayath, fortunately, this settlement had not been affected too much by the flood. In the end, I took an auto-rickshaw and went to the Kappumkunne colony.  Halfway through the journey, the road turned sludgy and we could go no further with the auto rickshaw, meaning that we had to walk the last one kilometer. On reaching the settlement, I found out that there had been no electricity for the past two days, only a few houses had lanterns, and most of the families were sitting in darkness. The sick child shivering with a high fever, was covered with woolen sheets, and the sobbing mother was sitting in a chair with her. Seeing me approaching the house, Bindu chechi (Sharath’s mother) came towards me with a lantern “Sir, my child will die in this condition, she is not eating”; Bindu chechi (elder sister) told me “Do something, sir. She is not responding to anything we say”. Sarala looked so confused and the child’s father was unavailable. Bindu chechi further added “what can she do sir? Her husband is not here. Since one month people in this colony have not had work. How can we go to the hospital without any money?” The households in the colony had been surviving during this monsoon season on food supplied by different government and non-governmental agencies as part of the disaster relief work, but to go to the hospital which is 12 kilometers away, they needed to pay for the night taxi. I informed them that the taxi was ready and they just needed to come to the hospital. Bindu chechi also volunteered to accompany the mother and the child to the hospital. With a lot of persuasion from both of us, Sarala finally got ready and we took the child to the taxi. On the way I paid the taxi driver for the trip, and also gave Sarala some money for any additional expenses the next day. My room was on the way to hospital and I alighted as we went past it.

By this time, the bus I booked for the Bangalore trip had left, yet I could not postpone the visa appointment any more, as this is allowed only up to 24 hours prior to the interview. Unfortunately,  because of the flood, public transport buses plying this route had just restarted service that day and all the busses were crowded. In the end, though, I managed to secure a seat on a bus to Bangalore. Overworked for the last two weeks, and emotionally and physically exhausted, the sleepless night spent traveling on a crowded bus and the fact that this was my first time at a visa office, contributed to making me anxious. On reaching the visa counter, I was told that my application was in the expedited application category, and I had to pay another 8000 rupees, in addition to the visa fees I had already paid. This meant that in total, I paid around 16000 rupees (£168), which is roughly half of my monthly earnings. After having my documents verified and doing the bio-metric tests, I went back home in the hopes of receiving the visa. However, twenty-five days after submitting the application, I received the decision letter which contained a rejection of my application. The reason cited for the visa rejection was the insufficient balance on my bank account statement.

Arundhati Roy says in her book “The Ordinary Person’s Guide to Empire” that the concept of a ‘free world’ does not allow the free movement of people and their ideas across the national boundaries. Thinking about this, it occurred to me that it does, but only for the rich and their commodities. The opportunity to network with people from around the world, learn from an international workshop, and represent the voice of the marginalized people I work with were all denied with the rejection of my visa. Why? Because I belong to a lower income group from a lower- middle income country (LMIC)? Was it not enough that I had received a scholarship to cover the full cost of attending the symposium and the scholarship award documents had been submitted with the visa application? And what does this visa rejection mean? In reality, it shows that even if someone from an LMIC receives a full scholarship to attend such an international symposium, that person must also belong to an upper or middle-class family that is able to maintain a sufficiently high bank balance for the minimum three months that is required, in order to be granted a visa to attend such an event. This rejection also reflects richer countries’ stereotyped views of individuals from poorer countries as being illegal migrants who would try to overstay their visas and make a living in those countries. It is beyond doubt that India is still a low-income country with high levels of poverty, just as almost all other colonized nations across the globe, however, this poverty does not justify the universal stereotype that every poor person in an LMIC harbors thoughts of illegal migration. Despite the inclusive approach taken by the Symposium’s secretariat of providing opportunities to scholars and activists from low- and middle-income countries with full scholarships, other EV fellows from the current cohort faced the same problem on the account of their financial statuses. I have narrated my personal experience to show how despite the inclusive measures taken by the symposium organizers, attendance is still reserved for elites from low-income countries and the difficulties. I also wanted to highlight the barriers and challenges that scholars from LMICs must navigate through, in order to get access to international forums where they can get their voices heard. I believe that the voices of people reporting social injustice and exclusion should emerge from the very communities that face them. However, maintaining a policy of requiring that applicants have a three-month account balance which shows evidence of sufficient means of subsistence, as a crucial criterion for visa approval for conferences on areas of social justice, implicitly implies that a career in those fields is only acceptable for individuals from economically sound backgrounds. This cannot but point to the persisting nature of the discriminatory policies that developed countries currently follow, and the exclusion from international forums which discuss the equality and justice issues that people from LMICs face. During the “Fourth Global Symposium on Health Systems Research” conducted in 2016 in Vancouver, Canada, many scholars from the global south experienced similar difficulties in attending the Symposium and EV4GH, and this was brought into the attention of the health system research community. Inequalities in the participation of the fellows from the global north and south were also discussed and one of the suggestions put forth by the EV fellows to the conference organizers was to consider “ease of visa securing” as one of the criteria for selecting the host country for the symposium venue. Yet, here we are two years later with the same problem – by selecting the University of Liverpool, located in a high-income country, as the conference venue, the problem is yet to be addressed.


About Sabu K U

India Health Policy System Research Fellow 2021, Ph. D Scholar at Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India, Emerging Voice for Global Health Fellow 2020, Honorary Associate with Institute of Public Health Bangalore, India.
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