Juan Carlos Eslava C.
Public Health Department, Faculty of Medicine, Universidad Nacional de Colombia
Even though one tries to see the present situation calmly and disregard the fact that, like humanity, we have not left wars, hunger, exclusion and social inequality behind, the current age we live in leads us, too easily, towards pessimism.
As various sociologists and social thinkers have said, the world in which we live and the society in which we are developing has markedly changed. According to their diagnosis, men and women living at the end of the 20th and the beginning of the 21st centuries have been doing so aware that they are feeling the combined effect of three dramatic experiences: insecurity, uncertainty and vulnerability (or, put another way, a lack of protection).
Insecurity questions our social position, the ability to place ourselves within productive dynamics and the real exercise of our rights, uncertainty concerning a threatening future which forebodes us being thrown into confusion and a lack of protection making our bodies, desires and all our possessions become increasingly vulnerable.
Instability, therefore, becomes a characteristic of contemporary life, in spite of which the world is paradoxically perceived as being more opulent, freer and more fertile regarding possibilities. Precariousness has become a sign of the times, in spite of a display of social policies, the existence of state organisms responsible for guaranteeing social security and investing enormous sums of money in social care and rehabilitation programmes.
Work becomes more precarious and insecurity at work has made the life of millions of people become uncertain and their subsistence particularly doubtful; the instability of communal links has made support networks become more fragile and people's burden of solitude more distressing. Organisational forms' precariousness has led to the breaking up of the old links between collective interest and political action. The instability and weakening of the figure of the state has broken down defences regarding markets' overwhelming power.
It is thus not strange that individuals' options are plunging them into despair, cynicism or the frenetic and voracious search for their desires becoming immediately satisfied. If medium- and long-term security becomes lost and perplexity becomes the sole constant, the strategy of living for the moment without thinking about the future and, therefore, without assuming any responsibility whatsoever for the consequences of present acts, seems to be something understandable and almost reasonable.
Such unfolding panorama does not thus seem to be pleasing. However, it is the current scenario for public health, primary attention, health promotion, social medicine and all those diverse currents of thought in the sanitary field which fight for collective wellbeing and assume the social genesis of health and disease. Its task is thus not so much complicated but tortuous. It has to confront, if the worst comes to the worst, late modernity's perverse tendencies. This is a colossal duty which could become a thankless but necessary task.