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PREVENCIÓN Y CONTROL DE INFECCIONES INTRAHOSPITALARIAS

APRENDIZAJES ESPERADOS Y CRITERIOS DE EVALUACIÓN Módulo 5: SISTEMAS DE REGISTRO E INFORMACIÓN EN SALUD

MÓDULO 6: PREVENCIÓN Y CONTROL DE INFECCIONES INTRAHOSPITALARIAS

2.5.1 The placing of the non-modern in the modern

India‟s independence in 1947 from the British led to its inheritance of a large government machinery, a plethora of laws and a judiciary. Further, the nature of Indian modernity on the eve of its independence became a part of the larger contested vision of a future India amongst its political elite. On one hand was Gandhi whose vision of new independent India was far removed from the ideals of modernity24, on the other hand was Nehru, India‟s first Prime Minister whose dream was to develop a “modern” India. With Gandhi‟s death in 1948, the Nehruvian vision of modern India became the dominant paradigm of development for India.

24 I discuss Gandhi and his political critique of modernity in my first empirical chapter “Rights and

60 Nehru‟s political vision of India‟s modernity included notions of progress, the elimination of poverty through economic development in the form of large scale industrialization, and a transformation of “backward” villages for the new era of agricultural modernization. Following the ideal of a mixed economy, which combined private capital along with public sector investments, the Nehruvian era through its five year plans instituted the modernisation of Indian agriculture, central to which was the building of large scale fertilizer plants. Nehru, for example argues that the new industrialization would help India become modern. Nehru proclaims:

“Today, there is the powerful impact of the industrialized West, and India herself is becoming rapidly an industrial nation absorbing science and technology … In doing so she will shed many of her superstitions and past practices and develop a new dynamism, as indeed she is doing today. But I doubt very much if this change will result in her losing her individuality, which has been her traditional feature throughout her history”(Nehru, 1998 p. 189).

While Nehru wanted India to become modern – to shed several “superstitious” practices - he also wanted India to retain her individuality. Thomas Pantham argues that Nehru‟s vision of modern India was a not a blind commitment to the rationality of science and technology, and not at the cost of democratic politics (Pantham, 1998). Nehru‟s nationalism encompassed a commitment to civil and political rights as also to economic, social and cultural rights as Nehru suggests “We have been too powerfully influenced by the poverty and economic backwardness of India to think of political changes only” (Nehru, 1998 p. 191).

Nehruvian modernisation strategy was two-fold: that is, it involved both political as well as economic institutionalisation through government machinery. The aim was to govern the populations through a plethora of rural development programmes, education and health programmes, and by the enforcements of acts in relation to agrarian land reforms and the abolition of untouchability. All these were methods of institutionalizing constitutional rights: namely the civil, political and social, economic and cultural rights discussed in the third section. The institutionalization of Panchayati Raj25 institutions – through the “decentralization of authority and giving of greater power and resources to the village organisations” was a process of deepening democracy (Nehru, 1998 p. 191). This

25 Panchayati Raj refers to idea of „panchayats‟ or village councils which have the mandate of governing the

61 modernisation of India has continued to date and the opening up of the economy in 1991 is now integrating India with the global markets and capital (Prakash, 2009).

This Nehruvian model of modernity and its continuation through the globalisation processes has been critiqued by subaltern studies scholars who suggest that the idea of modern, in the context of India, produces a moral dilemma, as though there were some group of “people or practices or concepts” called “nonmodern” or “premodern” (Chakrabarty, 2002 p. xix). This raises specific questions in the context of India as Chakrabarty asks “How do we, for instance, characterize the intellectual worlds of the peasant and the subaltern classes who are our contemporaries yet whose life practices constantly challenge our “modern” distinctions between the secular and the sacred, between the feudal and the capitalist, between the nonrational and the rational?” (Chakrabarty, 2002 p. xx) To take this further, how do we characterise the worlds of those whose notions of rights may not always be decidedly modern? What place do we give to the moral economy or the subaltern world in our research which seeks to understand the making of disasters through the lenses of rights and entitlements?

2.5.2 The moral economy and the subaltern

The notion of moral economy suggests that socio-economic structures are affected by morality, conventions, norms and values: that is normative structures existing in society. They are part of the normative structures because they inform the perceptions of what is acceptable. In this sense socio-economic relations “are no exception, indeed they are structured by moral-economic norms about rights, entitlements, responsibilities and appropriate behaviour” (Sayer, 2004 p. 3). In places where subsistence economy is still predominant, as in our researched villages, the moral economy – the social arrangements – rights and obligations are informed by the subsistence ethic26 (Scott, 1976). Indeed, disasters occur at the times when subsistence is stretched and an inclusion of moral economy in this study also becomes important from that perspective. However, as discursive constructions these normative structures are also a pursuit of self-interest and power. Thus normative structures or the moral economy may not always advance the emancipatory or the progressive politics of the subaltern classes or the marginalised and may at times sustain the status quo. For example, as Kabeer shows, moral economy may

26 By subsistence ethic I refer to those contexts where practices and decisions are led by basic subsistence

62 also entail notions of rights and obligations arising out of unequal or hierarchical social relations as in the case of a patriarchal household (Kabeer, 2002). I therefore distinguish between notions of rights and obligations arising out of the moral economy and the critique of those notions and modernity as advanced by subaltern politics.

The concept of subaltern classes as used by subaltern studies represents an “agency of change” (Spivak, 1988 p. 3) and is “a name for the general attribute of subordination in South Asian society whether this is expressed in terms of class, caste, age, gender and office or in any other way” (Guha, 1988 p. 35). This means that although subordinated, the subaltern classes actively construct their worlds, are politicised and construct critiques of the world around them. In this thesis, I use the concept of subaltern classes as a contextually sensitive, and not an ascribed, concept to denote the active voice of the excluded groups, depending upon their positionality in the social relations at stake. I use the active voice of the socially excluded group as a key marker of the subaltern voice, following Boaventura de Sousa Santos who refers to the counter-hegemonic practices and their resistances to social exclusion by subaltern cosmopolitanism. Santos et al argues that “subaltern cosmopolitanism, with its emphasis on social inclusion, is therefore of an oppositional variety”(Santos & Rodriguez-Garavito, 2005 p. 14). Thus, for example, an impoverished landed person who migrates to urban areas in search of labour work after a

disaster, by his very status would become a voice of a subaltern in the city27. Similarly, a

complex play of identities, such as that of gender, class and caste may defy a singular or an

easy description of a subaltern voice along only one axis of oppression and exclusion28. A

counter-hegemonic discourse of what is „right and wrong‟ by excluded groups of former untouchables acts as a critique of the ways of living of the dominant castes in the village

constitutes the politics of the subaltern29. An analysis of the colonial world which bases

itself on a racial discourse of supremacy to legitimize oppression may call all those who

27

My empirical chapter “Disasters, Social Change & the Politics for Rights” engages with migrant labourers across castes, which form the subaltern voice in a city like Delhi, having had to leave their homes in search of livelihood after floods and erosion.

28 The empirical chapter on “In Heterogeneous Times: Disaster Responses in Post-Colonial India” attends to

the voices of the excluded groups, their construction as well as their critique of rights.

29 The empirical chapter on “Disasters, Social Natures and the Subaltern” shows how different castes grant

normative agency to the River Ghagra in such as way that it also entails a moral critique of the acquisition of wealth by the upper castes. Further, broadly, while all the castes view erosion processes and the solutions to the same differently; they also share an alternative human-nature associative paradigm. Thus such an alternative paradigm forms a part of the subaltern critic to the extent that they challenge a technocratic or a scientific view of proposed solutions.

63 are objectified and excluded as racially differentiated persons as representatives of the subaltern voice30.

Ashish Nandy one of the India‟s leading cultural theorists suggests a need for a public discourse that is “culturally rooted” to enable a “non-modern understanding of the civilizational encounters of our times” which could constitute the politics of the subaltern (Nandy, 1998 p. 256). Nandy suggests that the language of oppression in non-western traditions is expressed through myths: a self conscious selection of memories which rejects the modern idea of history, or a language of spirit which rejects the analytic categories of their oppressors as well as that of the modernity. Thus for example, a subaltern language which, within a mythic context, treats a river as an embodied spirit, can be decoded as a culturally rooted critique of modernity as well as of the oppressor31. Similarly, as Guha points out, the political assertion of their rights by the subaltern classes may take forms which are not based on constitutional or legal definitions, but which rely more upon “traditional organization of kinship and territoriality”(Guha, 1988 p. 40).