Youth activism for health: taking the future into their own hands

In September 2019, Greta Thunberg, a 16 year old Swedish schoolgirl and activist, took to the stage at the United Nations Climate Action Summit in New York to tell the world’s leaders that they were failing to tackle the climate emergency.

She called them out for their “betrayal” of young people—the generation that has most to lose from their inaction.

In 2018 Thunberg had started school strikes, with pupils worldwide skipping class to demonstrate for action to prevent further global heating. Thunberg has since become a poster girl for the cause, inspiring millions of people of all ages to protest.1 The strike before the UN summit was estimated to be the largest climate protest ever, with over four million people marching globally.2 And polling in September showed that the public in seven out of the eight countries surveyed view the climate crisis as the most important problem facing the world.3

Increasingly, young people are taking their future into their own hands, frustrated by government inaction on issues that will affect the younger generation the most. Jamie Margolin and Nada Nazarin founded Zero Hour in 2017, when they were 15, to campaign about the climate emergency. Amy and Ella Meek, 16 and 13, set up a charity, Kids Against Plastic to fight single-use plastic. They have been joined and supported by many other young people who are fed up that those in power are constantly ignoring issues they feel strongly about. Social media has helped spread and amplify their message and coordinate action.4 Ahead of the UN climate change conference in December 2019, the UN secretary general, António Guterres, compared this youth leadership and mobilisation with government inaction, arguing that although the world has the means to tackle the climate emergency, politicians lack the will to make it happen.5

Healthcare too has increasingly vocal and influential young leaders. Take the Young Forum Gastein initiative6 run since 2007 by the European Health Forum Gastein, an annual conference of politicians, decision makers, and experts in public health and healthcare. The “young Gasteiners,” are aged 35 and under with a masters degree in a health related topic. They receive scholarships to speak or facilitate at the conference and become part of the health policy network. The global advocacy organisation Women Deliver runs a programme that supports advocates in their late teens and 20s worldwide to improve sexual and reproductive health and reduce gender inequality, with 700 participants from 138 countries since 2010.7 Women Deliver provides its young leaders with a platform at its conference, a digital university, grants, and workshops. Its alumni have had an impact. For example, law student Kobe Smith, 21, led negotiations on a new policy in Guyana to make it mandatory for schools to support young mothers to continue their education, and Humphrey Nabimanya, 31, repealed a national ban on comprehensive sex education in Uganda.

Experiences and skills that no degree provides Such programmes can provide young people with training and networking. Moa Herrgård, a former medical student and organising partner at the UN Major Group for Children and Youth (https://www.unmgcy.org/), which helps youth engage with UN bodies, says that such opportunities “give young people experiences and skills that no degree will give them. “They have to learn to deal with the frustrations and power dynamics of working with other leaders, which provides them with valuable skills for later life. “Young leaders understand how to work across cultures. They aren’t afraid of it.” Youth involvement can make organisations more inclusive and representative of the wider community.8 Young people bring innovative thinking because they have spent little time constrained by current systems, says Herrgård. But they need support to make sure their ideas are feasible. Their attitude and language can bring fresh approaches that move conversations on, she says. Pierre Cooke, a 19 year old health advocate and law student in the Caribbean region, recently represented Barbados at the One Young World conference in London, a global forum for young leaders across all sectors including healthcare. He wants youth advocacy to change society’s attitudes towards non-communicable diseases. Prevalent childhood obesity in the Caribbean inspired him to act. Policies made by adults often don’t resonate with young people, he says—for example, reducing sugar in fizzy drinks. Younger age groups often see such moves as authoritarian, missing the obesity reduction message. Cooke emphasises the need to consult with young people in policy making and to ask how this will affect them. A project led by youth advocates in Barbados asked schoolchildren to guess the number of teaspoons of sugar in soft drinks. They all substantially underestimated, but, Cooke says, participants engaged with the message because it came from other young people. Cooke also maintains that using social media is key to communicating to a younger generation. He suggests designing public health messages for mobile phones with attention grabbing images. “If you empower young people, they will take your message and run with it,” says Cooke. They can help spread the message to their peers, parents, and community. But they need to be equipped with the right knowledge and information. Being a young activist can take substantial effort. The International Federation of Medical Students’ Associations (IFMSA) trains medical students to participate in high level meetings, locally and internationally. It organises meetings before events such as the World Health Assembly to coordinate the messaging, prepare what the students will say, and plan how to get the best outcome. Although it takes time and training to plan and coordinate efforts, Stijntje Dijk, a sixth year medical student who has taken time out of her studies to be part of IFMSA, says that, “it is easier than you think, and every effort counts.” Dijk recounts how a member of the European Parliament told her that sending politicians letters really can change their opinion. The more the same message is repeated, the more MEPs are likely to hear what students are saying and adopt a cause, she says.

Youth engagement should not be merely a tick box exercise because it’s expected or seen as trendy. Donya Nasser, a youth advocate for the reproductive health non-governmental organisation International Planned Parenthood Federation told the 2019 Women Deliver conference in Vancouver that meaningful youth engagement means enabling young people to participate fully—not just allocating them five minutes at the end of a discussion.9 IFMSA’s Dijk says, “People don’t always take you seriously. They tell you to stop worrying.” The onus is on youth advocates to express a clear, considered, and specific aim. The risk of being poorly prepared is that students won’t be asked to participate again. “We’ve seen examples where students were chanting, ‘We have a right to be listened to,’” Dijk says, “But when a minister actually asked their opinion, they didn’t have one. They were too perplexed.” Meaningful youth representation means hearing a range of views, says Dijk. Writing in The BMJ in February, a group of young doctors said: “No single individual can represent all youth voices so including balanced gender and geographic representation with adequate involvement of vulnerable and marginalised groups is crucial.”10 Herrgård says that meaningful engagement from young leaders requires long term capacity building. They need time to learn strategic approaches, to assert themselves and be heard, and to grow from their mistakes, she says. Young leaders should bear in mind that they are representing a constituency, not just themselves, she says. Language and a lack of financial resources can be barriers to engagement by youth from some parts of the world, she says. Youth engagement can be limited also in countries that do not allow free speech. A medical student in Iran, who asked not to be named, told The BMJ about her climate activism, which she does with a “mixture of love and fear.” She spreads awareness of the climate emergency with her peers and encourages them to live more sustainable lives, but says she has to be careful “not to cross red lines.” She wants to attract students’ attention—but not that of the authorities. “I know what sensitises the system. I share only as much as the political climate allows me, as I wouldn’t want to risk my future or lose my freedom of speech.”

Can’t just leave it to young people Young people’s activism is heartening and inspiring, says Dijk, but it’s not their responsibility alone to solve all the world’s problems. “Politicians enjoy the image of supporting you. But it is not just about supporting the strikes, it is about implementing meaningful action. “Youth are the future, but this can be used as an excuse not to solve things now, to stop being accountable,” she says. Thunberg and other youth activists spoke to this ahead of the global climate strike on 20 September, calling on adults to join them: “To change everything, we need everyone . . . We’re counting on you.”11 It is time for us to listen and act.

Source: Bmj.com

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