Ghandi’s swadeshi – why not involve patients in this debate?

Ghandi’s “Swadeshi”, or local self-sufficiency, seems to be a philosophy that supports  liberal ideals. If specialist Hospitals are seen as a form of “mass production” then the local District General Hospital (DGH) represents the “local artisans” as described by Satish Kumar. (and in The economics of performance – chapter 35, p 418 in “The Case Against the Global Economy”). The problem is the increased mortality and morbidity associated with rural DGHs for complex problems at the edge of technology. There is a choice between having services locally, but with poorer results, or having them centrally with better results, but problems of transportation, inconvenience and access. Why not involve patients in this debate? After all, we consulted citizens on the complexity of the EU….

…Central to Gandhi’s philosophy was the principle of ‘Swadeshi’, which, in effect, means local self-sufficiency. Satish Kumar elaborates on this important concept. Kumar is a Gandhian scholar and also a thinker and activist in the tradition of E.F. Schumacher. Born in Bikaner, in Rajastan, India, Kumar was a Jain monk early in life, then joined the Gandhian movement and later, quite literally, walked around the world. He finally settled in England, where he is now the editor of ‘Resurgence’ magazine and runs the Schumacher Society, the Schumacher Lecture Series, and Schumacher College. He is also the head of Green Books, an ecologically oriented publishing company.
Mahatma Gandhi was a champion of ‘swadeshi’, or home economy. People outside India know of Gandhi’s campaigns to end British colonialism, but this was only a small part of his struggle. The greater part of Gandhi’s work was to renew India’s vitality and regenerate its culture. Gandhi was not interested simply in exchanging rule by white sahibs for rule by brown sahibs; he wanted the government to surrender much of its power to local villages.
For Gandhi, the spirit and the soul of India rested in the village communities. He said, “The true India is to be found not in its few cities, but in its seven hundred thousand villages. If the villages perish, India will perish too.” Swadeshi is a program for long-term survival.

Principals of Swadeshi

Gandhi’s vision of a free India was not a nation-state but a confederation of self-governing, self-reliant, self-employed people living in village communities, deriving their right livelihood from the products of their homesteads. Maximum economic and political power – including the power to decide what could be imported into or exported from the village – would remain in the hands of the village assemblies.

In India, people have lived for thousands of years in a relative harmony with their surroundings: living in their homesteads, weaving homespun clothes, eating homegrown food, using homemade goods; caring for their animals, forests, and lands; celebrating the fertility of the soil with feasts; performing the stories of great epics, and building temples. Every region of India has developed its own distinctive culture, to which travelling storytellers, wandering ‘saddhus’, and constantly flowing streams of pilgrims have traditionally made their contribution.

According to the principle of swadeshi, whatever is made or produced in the village must be used first and foremost by the members of the village. Trading among villages and between villages and towns should be minimal, like icing on the cake. Goods and services that cannot be generated within the community can be bought from elsewhere.

Swadeshi avoids economic dependence on external market forces that could make the village community vulnerable. It also avoids unnecessary, unhealthy, wasteful, and therefore environmentally destructive transportation. The village must build a strong economic base to satisfy most of its needs, and all members of the village community should give priority to local goods and services.

Every village community of free India should have its own carpenters, shoemakers, potters, builders, mechanics, farmers, engineers, weavers, teachers, bankers, merchants, traders, musicians, artists, and priests. In other words, each village should be a microcosm of India – a web of loosely inter-connected communities. Gandhi considered these villages so important that he thought they should be given the status of “village republics”.

The village community should embody the spirit of the home – an extension of the family rather than a collection of competing individuals. Gandhi’s dream was not of personal self-sufficiency, not even family self-sufficiency, but the self-sufficiency of the village community.

The British believed in centralized, industrialized, and mechanized modes of production. Gandhi turned this principle on its head and envisioned a decentralized, homegrown, hand-crafted mode of production. In his words, “Not mass production, but production by the masses.”

By adopting the principle of production by the masses, village communities would be able to restore dignity to the work done by human hands…….

Edward Goldsmith – Participating in Democracy

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About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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