Neither State Nor Market: Communal Health Care In Rojava (Excerpted)


In Rojava, power is decentralized to the point
where neighbors make most decisions that affect them in a body called a “commune”. This is nothing like a “commune” in the US;
it is essentially a neighborhood assembly made of 100-150 families or so, and instead
of politicians deciding what norms should govern their community, they all do through
directly democratic structures. Each person living within the commune can
represent themselves directly within the commune assembly. The commune is used on a principle that most
of us know intrinsically: nobody knows what you and your neighbors need better than you
and your neighbors yourselves. Communes are linked together through elected
and removable spokespersons (again one woman and one man) to form a neighborhood council,
and neighborhoods are linked to form city councils, and so on and so forth. This is a bottom-up or horizontal system of
organizing society; the larger the area of administration a council has, the less power
it has. For example, in the largest city in Jazira
Canton, Qamishlo, there is a neighborhood called Korniş. In Korniş, there are 58 communes. Of these communes, three are Assyrian and
Armenian, three Arabic and 52 Arabic and Kurdish mixed. These 58 communes form the Korniş neighborhood
assembly, but the heart of power remains in the individual communes themselves. Women and young people also can and do organize
their own communes separately. The commune is made up of committees which
residents can sign up for. To name a few: women’s committee, youth committee,
healthcare committee, economic committee, safety committee (neighborhood defense groups),
and peace committee (transformative justice as first line of defense). Let’s go through the committees one by one. As I said before, the more knowledge is concentrated
into the minds of a few people, the more likelihood those people can create an oppressive power
dynamic over those who depend on them. For those living in the communes, access to
good healthcare is vital, especially in an area always under threat by hostile states
and fundamentalist groups. In such a situation, it benefits no one for
health knowledge to remain the domain of professionals. The people of Rojava see the dispersal of
this knowledge as the reclamation of traditional knowledge that had once been passed down through
women, but had been stolen from them by the state, guarded by powerful men, and sold back
to the people for profit. As Heval Azad, a member of the health committee
for Jazeera Canton pointed out: “The problem is that before the revolution
there was a deep connection between health and the power of the state. So we are building up a new system with a
new basis – trying to remove this connection. Health is one of the key areas which is represented
by specific structures and institutions in the new system. So the main aims for health in Rojava are:
To solve the problem of relations between health and power/ the party. To critique and rebuild the relationship between
society and doctors. To return ownership of health to society. “Everything is centered around [self-organized]
committees and if we organize around these committees the state will disappear.” So how is health knowledge and care decentralized
at the commune level? As I said before, the goal is to decrease
reliance on professionals whenever possible. To do this, each commune elects two heads
of the health committee (one man, one woman) who are trained by doctors. These co-chairs then train every commune member
who wants to learn in basic first aid and often even more advanced aid. This keeps valuable health knowledge from
being centralized and allows life-saving action to be dispersed. The communal health care model seeks to combine
the latest in medical technology and research with traditional, natural medicine without
discounting the value of either. In April of this year, Halanj village near
Kobani was reported to have achieved medical autonomy through their self-organization in
communes. Four of the communes in the village, together
part of the House of Communes, established a medical center for themselves and the surrounding
area. The villagers chipped in what they could to
buy pressure gauges, sugar testers and other medical tools such as sterilisers and syringes
to be stored in the village medical center. The role of natural medicine is encouraged
by education so people can learn about their own bodies and some communes are even coordinating
excursions for gathering herbs to start to get back the wealth of local knowledge that
5,000 years of state and patriarchal systems have attempted to destroy. From Qandil, a region of Iraq where Kurds
have formed some autonomous villages also under democratic confederalism, we have the
example of the village of Binare, where residents volunteer to plant and harvest the Sumac herb
together, taking what they need for themselves and distributing the rest to relatives and
neighbors. A resident, Amine Mehemed told a journalist:
“Sumac contains many healthy features. It is also used as a medicine for many health
issues. It is effective against high blood pressure,
it strengthens the gum and is very beneficial for children as well. But it should be only enjoyed in healthy moderation,
and not in abundance. It is also deemed a medicinal herb. It grows in almost the entire region. And it is also effective against diabetes.” An important aspect that cannot be overlooked
is women’s health needs and the ways in which women are organizing to meet them. Again, we can turn to Heval Azad: “the point
is to give people education [at the commune level] so that they can have the knowledge
and decide for themselves. In this education people are made to think
about for example, the consequences of having many children if you do not have any money,
and what the future might be like for your children. People are thus given the chance to decide
for themselves how many children they want to have.” Women can use this knowledge how they would
like and have easy access to birth control. The last crucial piece of the health committees
is prevention of illness in the first place. Heval Azad noted how states spend tons of
money on treating illnesses but don’t put the same resources into prevention. I’ll close this section with her words:
“[The state system] looks at society as if it is sick and needs to be cured, but it
is the system itself that is the illness of society.”

3 Replies to “Neither State Nor Market: Communal Health Care In Rojava (Excerpted)”

  1. The closing statement on the ruling system itself isn't what people disagree on, it's how it's changed that worries me. Could you imagine someone promising this and then suggesting force be used to achieve it? This is what I hear from political radicals in the West. They like the humanitarian or egalitarian appeal of communes. But they are quick to suggest force of violence to install it in their own society. Granted; many of the people debating communism or capitalism (fruitless debates) aren't exemplary characters. So let's hope Rojava is left alone and never toiled into the global discourse of politics. They did it peacefully. There seem to be many that lack that vision.

  2. I only discovered your channel a couple of hours ago, but the videos are fantastic. Well done comrade ✊️

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