Ottawa Charter for Health Promotion: The Guerrila Update

November 9, 2016

NOTE: Images in this archived article have been removed.

Image Removed

This week’s dispatch from the field comes from Ottawa, where I spoke at a conference celebrating the 30th anniversary of the Ottawa Charter for Health Promotion — a brief, bold, feisty and visionary statement of public health principles that’s a must-read for anyone involved in food advocacy and people-centered food policy.

Got time? Reach the extended version of this newsletter 

It’s worth the sidetrip to the full column because there’s lots of important info that will help you understand the original Charter more deeply.

The conference was small and comfortable, with about 50 of us grouped around dining tables in a spacious room in the beautiful Canadian Museum of Nature, which I’d recommend to any meeting planner. About half the audience were relatively young professionals who needed a primer on the old days of the 1980s. The other half used to be young back in the day, but hadn’t lost any passion over the years. Some of the old-timers had just flown in from Charlottetown, where they prepared the PEI Health Promotion Declaration, which issued a call to build holistic health promotion into the UN’s Sustainable Development Goals and into an upcoming Shanghai world conference on public health.   

Three speakers in the first session talked about all the changes since 1986, when the Ottawa Charter was drafted.

Their speeches reminded me of how far ahead of its time the Charter had been. It named the issues of ecosystem health and sustainability, a year before the Brundtland Commission’s Our Common Future made sustainability a household word. The Charter was also up to date with today’s “bottom up” and “grassroots” and “empowering” approaches to change, probably because it was abreast of the concept of “people-centered development” — another phrase that seized the time in 1987, and was winning widespread support until it died without a trace in the early 1990s, as neo-liberalism and market-centered development became marching orders of the day. 

WHAT GOT INTO ME??

As I read over my notes on the conference, I see how my mind became gradually unsettled.

Mihaly Kokeny, former minister of health in Hungary and a leading actor at the 1986 conference, spoke in the opening session about how the bottom-up approach of the Ottawa Charter had been lost, and how the World Health Organization had become ambivalent about civil society, more concerned about following the lead of national governments.  “Social mobilization is key” to bringing about changes  in public health, he argued.

Also on the first panel was Sume Ndumbe-Eyoh from the National Collaborating Centre for the Determinants of Health in Nova Scotia. She argued that health promoters must recognize that health policy emerges from power struggles, making it necessary to confront corporate power, neo-liberals, and their “fantasy paradigms.” I thought to myself: maybe I’m in a fantasy paradigm thinking that the Ottawa Charter will ever be relevant in a neo-liberal era.

Ketan Shankardass — an officer with  Health Promotion Ontario which co-organized the conference, he teaches public health at Wilfrid Laurier University in Waterloo, while working  with the Centre for Urban Health Solutions at St Michael’s Hospital in Toronto — opened the second session, which dealt exclusively with food.

He described food as “the most modifiable determinant” of the major determinants of health. Such factors as income, housing and environment are not easy or even possible to improve on your own, but food leaves room for individual and group action. That’s why the Power of One to make a difference is so fundamental to the food movement. So food gives the opportunity to “push the boundaries” of what healthy public policy can do in the here and now, Shankardass argued.

I think he offered a fundamental insight into why food arouses the excitement of the younger generation, who want to take part in something meaningful that leads to real change on the ground. As I look back on my notes, I’m thinking his introduction must have filtered through my mind as an invitation to change my speech.

The first panelist was Tim Stephenson, who heads up Northern and Indigenous Programs for Food Matters Manitoba. He showed us a picture of rough and ready greenhouse built by the Cree and Dene peoples of Brochet, a remote fly-in community of 800 people in northwestern Manitoba.

The soil was poor, the climate was harsh, and the greenhouse looked makeshift – held together at the edges by hooks recycled from an old tossed-off trampoline. But people in the community were taking what control of their diet, and using the greenhouse as one way to grow their own fresh food – and to offer a practical alternative to the domination of a monopoly retailer, and thereby reverse the epidemic of diabetes caused by the low-quality food flown into the retail monopoly (ironically, with government subsidies).

I have to change my speech, I said to myself, and started scribbling as Irena Knezevic, a Carleton professor of communications started her talk.

Her theme was that change doesn’t happen because of tectonic plates that suddenly  smash and crash, but because of hundreds of modest interventions rooted in a community’s history. The problem, she said, is that the people who lead and support the hundreds of modest interventions by the entity known as “civil society” are unpaid or underpaid, and if civil society is to serve its function in people-centered food policy, their engagement needs to be supported, in some meaningful proportion to the resources commanded by established interests, all of which are relatively well-funded.

Well, whatever Knezevic said about tectonic plates didn’t apply to my head, as my prepared speaking notes crashed and smashed against my newly scribbled notes. 

Although I felt totally unprepared for what I was about to say, I was able to draw on some personal experience.

Back in 1995, I became well-known for a self-published bestseller that people loved for its  attitude, or ‘tude as we used to call it. The book was called Get a Life! How to Make a Good Buck, Dance Around the Dinosaurs and Save the World While You’re at it.

That was a ten years before social media — which feels like saying it was before the car was invented – but I decided to sell the book by using the new principles of “guerilla marketing.”

The primary principle behind  guerilla combat is to do a mental flip that turns disadvantages into advantages, advantages into disadvantages, and problems into opportunities. The powers-that-be had a huge army with lots of equipment, but the original guerillas were nimble and could hide in the mountains, where big equipment can’t be taken, the original guerilla logic went.

Today, our Big Food competitors have huge advertising budgets and powerful political allies, but their money can’t block integrity, authenticity, audacity, blood, sweat and tears.

Think craft beer, and how these micro-brewers are kicking Bud.

The greenhouse in Brochet, Manitoba, came from guerilla thinking, I said. The people of Brochet confronted long and cold winters and poor soil. But there was lots of compost, and the long days of northern summers gave plants as much sunlight as they’d receive during the longer growing season further south. True, ground in the far north retains winter cold until late in the spring growing season, but food can be grown on the warm soil of raised beds. And the distance that food has to be flown in gives local producers some protection from the lower price of production down south.

A snowball may not have much chance in Hell, but a snowball’s chance in northern Manitoba is worth a try.  

As it turns out, Tim interned with my friend, Shaun Loney, the king of mind flips, and the initiator of 11 social enterprises in Manitoba First Nations communities that learned to do the guerilla flip, which Loney calls “solutionary economics.”

It so happens I was just starting to write an article about Loney, so I immediately saw how Stephenson’s flipping mind worked.

Here’s approximately what I blurted: neo-liberal worship of global corporations and non-interference in public health and environment issues is so imbedded now that even a compelling and economically rational document like the Ottawa Charter won’t get much of a hearing, unless momentum is built in the community to propel the agenda along.

For the time being, I argued, we must innovate as much as possible on a low budget and without much backing, using peaceful guerilla tricks of the trade.

To my mind, cutting edge guerilla opportunities include massively expanded farmers markets, healthy street vendors, craft beer, social enterprises, collective buying clubs (see some fantastic examples in Turin), artisanal food products, local and sustainable food purchasing at universities, social media interventions. Hop on the wagon that’s already moving, build strength from the advantages made available by nimbleness, integrity and grit. Use each victory to build the confidence of an empowered community and whet their appetite for more.

The guerilla mindset to acting on the principles of the Ottawa Charter links nicely with the philosophy of actionism developed by Michael Sacco of prize-winning ChocoSol Traders, who brought Toronto his learnings about chocolate and community action from the Zapatista, and Zapatista thought leader Gustavo Esteva, who is Michael’s mentor.

In the tradition of Gandhi’s call to “be the change you wish to see” rather than passively wait for the establishment to change, actionism creates the change we want to see, often through social enterprises and demonstration projects. The same spirit animates Hypenotic, the company that produces this newsletter, and also promotes B corps from the side of everyone’s desks.

The conference ended the next day, after a masterful review of social determinants of health research by Connie Clement, scientific director of the National Collaborating Centre for Determinants of Health.  She argued for creating “space in the middle” by action-researching researchers who can act as conveners of innovators – an interesting space for peaceful guerillas to operate in. Food’s “power to convene” people is one of food’s virtues that lets it play such a key role in society, according to Welsh scholar Kevin Morgan, former chair of the first food policy council in the UK.

Dr Kokeny gave an overview of how the “political determinants of health” had become more of an obstacle to health than the social determinants, and encouraged people to focus on learning how to implement. “Knowing what to do is easy,” he said. “Implementation is the tough part.”

I believe that is one of the things we’ve all learned since 1986. Neo-liberal governments have shut down action much more than they have shut down research and policy, and that’s one of the reasons why peaceful guerilla methods need to be explored.

Ketan Shankardass gave the closing comments on behalf of Health Promotion Ontario. Be brave, he said, in response to comments from many speakers that the radicalism behind the Ottawa Charter was a tough sell. “Think about how to bring about guerilla health promotion projects.”

Will do!

Wayne Roberts

Dr. Wayne Roberts is best-known as the manager of the world-renowned Toronto Food Policy Council from 2000 to 2010. But he did lots before (see his Wikipedia entry) and has done lots since. Wayne speaks, consults, coaches, tweetslinks inFacebooks, and Read more.

Tags: building resilient food systems, food policy