60 SOCIAL SCIENTIST and, as one of its components, an alternative health care system, developed as its logical corollary. In th^ese countries, the very process of bringing about democratisation of the political system had led to serious questioning of the technological, social and economic bases of the health care system which was prevailing earlier. • In the case of Tanzania, where serious attempts are being made to promote democratisation at the grass-roots, the earlier health care system, which was inherited from the colonial rulers, is being subjected to close scrutiny. This scrutiny has already led to a shift in the allocation of resources from the urban to the rural, from the curative to the preventive and from the privileged class orientation of the services to those which are oriented to the underprivileged classes. In all these three instances, all sections of the community, pait-icularly the weaker sections, have been actively involved in the shaping of alternative primary health care services and in their implementation. Significantly, in countries where the process of democratisation has not made deeper inroads, there is considerable hesitation and often confusion in the formulations of alternative health care systems. The WHO publication describes two categories of cases. One category is exemplified by two oil rich countries. In both these countries, the political system has not allowed any change in the highly sophisticated, state subsidised curative services in urban areas which are accessible mostly to the privileged classes. However^ both these countries happen to have very dedicated leaders in the persons of G L Gonzales (in Venezuela) and Majid Rehnama (in Iran). Even within the stifling political constraints, they have been able to make significant innovations in the rural health services of their countries. However., it is still to be seen whether within the existing political climate the alternatives promoted by these workers will turn out to be viable. The other category is exemplified by Guatemala, Indonesia and India. In these three countries, not only has the process of democratisation not reached the underprivileged and the deprived sections of the population to any extent, but there has also been a conspicuous lack of leadership in the field of health care. This might explain why in all these cases inspiration for alternatives had been sought from the experiences of Christian missionary organisations.These experiences however, were based on programmes which had available to them disproportionately large amounts of resources(when compared to the very small population served by them). Further, they had workers who worked with a missionary zeal. These certainly are not reproducible «|4 they cannot be considered as alternative health care systems for the rural populations of these countries, Alternatives Formation of alternatives is thus wentially a political question. A crucial determinant of the nature of an alternative is whether there is