September 2020


  1. Democracy “As If“
  2. Social movements as essential services
  3. Book Review: Reconstructing Democracy: How Citizens Are Building from the Ground Up by Charles Taylor, Patricia Nanz and Madeleine Beaubien Taylor
  4. Doctors can’t treat COVID-19 effectively without recognizing the social justice aspects of health

Democracy “As If“


More than a century ago, Hans Vaihinger formulated his philosophy “as if” to describe our willing choice to live in a world of logical contradictions. As we cannot reach our ideals  (e.g. a truly just society), we produce imperfect fictional explanations full of deliberate errors to fill in logical gaps and oversee the inconsistencies. When the fiction includes glaring contradictions, it requires a generous dose of irrational belief or outright pretense (“corrections”) on the side of the establishment as well as on the side of the people.  Our psyche seeks stability and cannot function without fictions. But the kind of “corrections” necessary to make a fiction appear persuasive depends on the type of fiction itself. Often, they can only be reconciled through illegitimate means, for example by transforming hypotheses into dogmas—as if becoming a because or so that. This is the simplest way to rid the system of tensions. But the more such corrections are used, the more complicity it requires of the receiver. 


From Ideology As If to Democracy As If 

Slovaks have lived through a number of dogmatic fictions in the recent past. The rigid Stalinist regime was discredited and loosened in the 1960s following Stalin’s death. The reformist communist leadership was looking to resolve many of the inconsistencies of Stalinism through their “socialism with human face” program. The Warsaw Pact invasion in Czechoslovakia in 1968 quashed the attempt, and with it, ended all hope of finding an equilibrium in the communist fiction without “forceful corrections.” One could either succumb to a new dogma of Normalization or abandon it and go into exile. 

Thereafter, a new dogma, “real socialism,” emerged. The normalization period in Czechoslovakia was described by Miroslav Kusý as a pretend ideology, “ideology ‘as if’”. Kusý was inspired by the title of Vaihinger’s book. However, if Vaihinger’s dichotomy were to be accurately applied, Kusý’s title should have been  “ideology ‘because.’” 

This “ideology ‘because” was introduced in a simple declaration by the General Secretary of the Central Committee of the Communist Party, Vasil Bi?ak, who said “real socialism is that which we have here!” The new dogma abandoned not only the attempts to humanize socialism but also the pursuit of socialist ideals as such. Instead, the leaders claimed that “real socialism” was better than the original communist utopia, trumping the Marxist-Leninist designs. 

The regime devised an Orwellian language to create an alternative reality. As Kusy observed: “Rising prices become the leveling of price relations, discrimination of citizens, equal in the face of the law, becomes the class approach, energy crisis becomes the objective challenge of intense growth, monopoly on information becomes freedom of information, right to freedom of religion becomes the religious retardation, right to political opinion becomes anticommunism…”

The language served as a thin veil—nobody was expected to believe these claims. People were only expected to manifest their consent and in return, they could live in relative comfort of the grey economy. Tacitly agreeing to this arrangement was, however, also morally corrupting. Citizens used the same kind of language to cover up frequent theft, shirking of duty, bribery, excessive drinking, etc. The mode of existence demanded that people turn a blind eye to corruption, discrimination and oppression of others, and that people practice self-centered uncare of the other. In his exposé of Slovak political behavior throughout the past few decades, Martin Šime?ka sees the indifference of the majority as the dominant thread of Slovakian history. Indifference towards the fate of the persecuted in the totalitarian regimes, indifference towards the members of religious, ethnic, gender, or other minorities persists up until the present. This indifference has been translated into an exclusivist notion of citizenship, which differentiates between “our people” and the others, who don’t quite belong and are not entitled to the same rights. 

The dogmatic fiction can only survive as long as the pretense is intact. It requires full cooperation—willingly suspending disbelief or at least turning a blind eye to the glaring contradictions. Thus, the pariahs of the dissident circles, who pointed out the lies of the regime were considered to be the mortal enemies of the regime and had to be silenced. Dogmatic fictions can collapse when enough people recognize and denounce the sham. 

David Ost, although harshly critical of Havel’s The Power of the Powerless, compellingly argues that the common workers or students, unlike the public intellectuals of the Charter 77, owing to their lack of connections, know-how, and public visibility can not resist the dogmatic fiction to the degree that elite intellectuals can. The masses do rise up and act politically, in the Arendtian sense, when a critical mass of the pariahs consolidates. The Revolutions of 1989 were rare examples of such a mobilization.

Since the collapse of the communist regime, a new, democratic, fiction has emerged. This fiction has been subject to contestation between competing visions: one based on human rights of individuals and communities, inspired by a forward-looking vision of a just society, and a dogmatic and exclusivist version of “democracy” which caters to “our people,” here and now. The latter democracy, the “democracy because” prevailed during the early years of independent Slovakia under the premiership of Vladimír Me?iar. Despite the rampant corruption, violent organized crime, and massive embezzlement of funds, many, intoxicated by nationalist populist promises, acquiesced to the Me?iar regime. Subsequently, the majority also acquiesced to the twelve years of the Fico government during which oligarchs gradually captured the state and the top public offices in government, judiciary, prosecution, and police through corruption, nepotism, and embezzlement. After all, the state inconvenienced “others”—the ethnic minorities, foreigners, journalists, LGBTQ+ communities, progressives etc. 

Supporters of Me?iar’s or Fico’s democracy either fully believed the fiction, or willingly took part in the transaction, propping it up in the name of the nation, tradition, and social security, shutting their eyes to the outright violations of justice and equality. The economic transformation after 1989 underscored these tendencies. The strong neoliberal pressures prioritized economic growth as the primary element of democratization. Transgressions against the rights of the excluded minority groups were legitimized in the name of the social and economic rights of “our people.” The populist governments simultaneously enforced neoliberal economic policies and neoconservative ideals of protectionism, traditionalism, and exclusion.

The “democracy because” does not like the vocabulary of human rights; rights discourse are depicted as either an imposition from the West, as “gender ideology,” or as a project of ethnic minorities to gain extra rights at the expense of the majority. The language, once again, distorts reality by instilling fear and resentment.


A ritual of rebellion

Recently, the national parliamentary elections (March 2020) were won by a coalition which rallied to end the state of capture and sweep out the corruption brought about by the Fico administration. That the “democracy because” was finally challenged en masse appears positive. However, the new administration is a hodge-podge of mostly conservative and populist forces. This administration started its tenure amidst the corona pandemic. It took fast and effective measures to keep the pandemic in check. Some of them, however, trampled the rights of several communities: members of the LGBTQ+ community were unable to seek reunification with families or loved ones should they be hospitalized; Roma settlements were forcefully isolated from the rest of the population (initially using the army forces), while not preventing the risk of virus transmission within the Roma community sufficiently. Reactions of the majority illustrated the exclusivist stance against the “other” in Slovakia—with many either praising the government for the early intervention in the settlements, failing to even notice any discrimination, or on the contrary, criticizing the government for the “excessive care” given to the Roma communities. 

While the decisions of the new government during their first 100 days of rule were veiled by the pandemic, gradually the lack of a vision, moral standards, and even of competence are now coming to light. Policies to systematically alleviate the situation of the most vulnerable are lacking. Instead, political leaders are using this time to carry out their conservative agenda. There are currently four bills in the National Council seeking to limit the rights to abortion (one from the pen of a part of the coalition, three from the circles of the extreme right-wing opposition). People with ultraconservative orientation are being assigned political posts requiring expertise in gender equality (e.g. at the Ministry of Labor) in the name of the protection of traditional families and values. The strongest Party of the Common People (O?aNO) announced that they will occupy the positions of the heads of the district offices and the prime minister has called for the vetting of the candidates by the public—asking the people to report any dirt they may have on the candidates, which, in his view, will somehow guarantee their expertise and non-partisan standing.

But the “so that-ism” of the current administration is best illustrated by the current case of the Speaker of the National Council B. Kollár, who has been accused of plagiarism in his master’s thesis. Despite the fact that in the past, both Prime Minister Matovi? and Kollár demanded the resignation of the previous speaker of the National Council, who was also accused of plagiarism, Kollár refused to resign and Matovi? went out of his way to defend him. Soon it turned out that Matovi? had to face an accusation of blatant plagiarism on his diploma thesis and an unsuccessful vote of no confidence in the parliament.  The mantra of “fighting mafia and corruption” has become the default justification for all government actions. 

“Because Fico” (the reminder that “if we lose, the previous cadres will be back”) is a formula used to counter all criticism and resistance. Unfortunately, it has also been picked up by the junior coalition partners of a more liberal democratic inclination; It is a feat of argumentational acrobatics used to  justify, for example, their abstention from the vote for the removal of the Speaker and the Prime Minister from their posts; the Members of the Parliament voted not to remove them.  This leaves us in a situation where the two of the highest political representatives in the country are accused of cheating and stealing  and the ruling coalition stands by them in the name of the fight against corruption, theft, and for the rule of law. The facts are plain for all to see, however, they are side-stepped and relativized, and downplayed through blackmail. 

In the 1950s, Max Gluckman published a famous socio-anthropological study of the rituals of rebellion among the tribes of Southern Africa. There, he described staged rebellions against the tribal kings in order to affirm the principle of openness and interchangeability of the tribal chiefs in their social structure. The rebellion served to reassure the community that the system is working, providing catharsis for social tensions, while paradoxically strengthening the status quo. The parliamentary elections of 2020 were in effect such ritualistic rebellion. The protests against corruption and murder of an investigative journalist that marked the two previous years, culminating in the presidential elections of a progressive female candidate Zuzana ?aputová, failed to deliver a critical mass that would lead a more widespread political action and change. The political parties that are aligned with the values of progressive liberal democracy did not meet the necessary 7% threshold and remained outside the gates of the parliament in the March election. The president, thus, is unfortunately an outlier rather than a symbol of the current Slovak politics. 


The Democracy As If

Liberal democracy, as a vision, and even more so as a political practice, is always an as if enterprise. It is dependent on dialogue, problem solving, reconciliation of countervailing principles, building of bridges among diverse interests and views. It values expertise and learning. It requires the public to have  skills that are learnt through education and political practice.  

“Factual truth,” Arendt writes in her essay on truth and politics, “is always related to other people: it concerns events and circumstances in which many are involved; it is established by witnesses and depends upon testimony; it exists only to the extent that it is spoken about, even if it occurs in the domain of privacy.” When the factual truth is purposely suppressed by the rulers “in the name of” some notion, it is a sure sign that the democratic practice has departed into the realm of dogmas.  

There are certainly islands of progressive political action in Slovakia within the fragmented and relatively weak civil society—the students who led the anti-corruption movement, the activists who protest the clero-conservative attempts to curb rights in the name of “traditional values,” the young people who willingly enter the state administration with intent to change practices within, teachers who change lives in remote areas for pittance, or those who are entering political parties, mobilized by these efforts. However, when the new administration, which ran on the call for a “decent Slovakia” condones the same practices that it advocated against and the majority of the public accepts it as normal, the prospects for moving away from a dogmatic quasi-democracy are bleak.


Dagmar Kusá teaches Comparative Politics and International Conflict and Cooperation at the Bratislava International School of Liberal Arts in Bratislava, Slovakia. 


By                 :               Dagmar Kusá

Date             :                August 17, 2020

Source         :                Public Seminar (

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Social movements as essential services


Social movements are changing with the pandemic and becoming increasingly important in protecting vulnerable people and stopping expoltation.

In an unjust pandemic world, social movements are essential services. But the question of how to transform a system under pressure is a delicate one. The scale of the need, the poverty, the lack of housing, the immune-compromised, the children and elders push us towards the state. Like social movements over the last few hundred years, movements demand more benefits, more space, and more resources. Such demands may paradoxically strengthen a system that helped to create racial, class and other inequalities. Without our usual repertoire, how can we ensure that the most vulnerable are included, while continuing our efforts to nurture the seeds of a more just, fruitful world?

Only a month ago, visible and vibrant protests filled the streets and the news. In Canada, indigenous communities and allies blocked roads and railways in support of the hereditary chiefs of Wet’suwet’en, reaffirming their sovereignty and challenging the legality of a natural gas pipeline across their territories. The legitimacy of the settler state and its extractivist economy was called into question. These movements held space, and reaffirmed connection to the land in ways that imagined a society beyond the state. Internationally, pro-democracy protesters in Hong Kong, Chile, and Turkey filled the streets, went on strike and clashed with police. In India, women held hands in widespread protests challenging the right wing citizenship laws that targeted and excluded Muslims.

As news of the virus spread, activists were faced with a difficult question. Should we cancel our plans? If we did, were we stepping back? But those veterans, particularly those connected to homeless, undocumented, prisoner and immune compromised populations argued that social solidarity required both physical distancing and mutual aid. We shifted. At one meeting planning a prison abolitionist conference, anti-racist activists explained it was unethical for movements building another world to ask people to travel and physically converge at this time. That doing so would be most likely to harm indigenous and Black communities, particularly prisoners or recently released folks. So, we turned away from the streets, and towards one another, arguing those who are most vulnerable, must be at the centre. The cancellations flooded in. Following the lead of the World Health Organization, the local, provincial and federal governments announced closings, cancellations and shutdowns.


COVID era movements: four models

Less than a month later, the streets are empty, nor can we have physical meetings, but social movement organizing continues in four modes. This organizing defends the needs of workers, it demands more from the state for the most marginalized, it disrupts exploitation and it provides direct support for vulnerable communities. Each mode holds contradictions within it – choices that can either reinforce inequalities or build another world in the shell of the old. We know that how we organize now, will matter in the future. This COVID era movement work varies by location and by history, as pre-existing movements, organizations and networks lean in. I’ll use examples from Toronto.


Essential workers

The first mode is led by workers deemed essential. In Toronto both formal unions and informal workers movements are demanding increased access to personal protective equipment. These include health care workers, truck drivers, first responders, and grocery store workers. The importance of these workers to the functioning of society has never been more apparent. Some have used this moment to flex their power – striking and holding work stoppages. On April 2nd, Canadian Union of Public Employee workers wore stickers “to protest a decision the government to give registered nurses a different level of protection than other professions, such as respiratory therapists, personal support workers and registered practical nurses.” These efforts, amidst the desire by power holders to maintain control, and legitimacy are likely to be successful. We see broad public support for these workers– from the nightly banging of pots to the crafty folks sewing masks, and the signs in people’s windows supporting letter carriers.

Workers have also been fighting layoffs and for compensation and financial support. More than 2 million Canadians filed for employment insurance in the last two weeks of March because of company shut downs. The government has rolled out the Canada Emergency Response Benefit (CERB) that supports some contract, and self-employed workers who have been affected, offering them $2000 a month for four months. Although these programs are intended to maintain the functioning of an exploitative economy, they are important victories that reflect the longstanding efforts of movements to expand the recognition and value of workers, and include gig and other precarious workers. They build on struggles to defend the public sector, gutted by years of neoliberal austerity. The recognition and resources given to these sectors right now are long overdue. However inequalities still exist and these programs and funds can end up further abandoning those most marginalized. Some are excluded from these benefits; those who had no job to begin with, migrant workers, student workers, or those who had no status. La lucha continua.


Defending the most vulnerable

Ensuring that the most vulnerable people are not abandoned is the second mode of movement activity. This includes prisoners, people in long term care facilities, non-status people, those on welfare and the homeless. In Toronto veteran anti-poverty activists who have fought for years for more, more affordable and better housing, shelter beds and supports for the homeless have, in the context of widespread public fear, have succeeded in getting the City to open up beds in community centres and hotels. They work to get more money into the hands of poor people, with emergency assistance to those on welfare. These movements organize online and drive phone and email campaigns that are making a difference to people’s lives.

Immigrant justice and health activists have succeeded in pressuring the Ontario health care system, so that hospitals will now see non-status people with any health care emergency without charge. This change has spread to other provinces. The Migrant Rights Network has succeeded in getting some financial support to some workers with temporary immigration status affected by the shutdowns. In the wake of a hunger strike led by immigrant detainees in the holding facility in Laval; No One Is Illegal, the End Immigrant Detention Network, Solidarity Across Borders, and the Migrant Rights Networks have continued their push to end immigrant detention, and indeed, they are succeeding in undermining the argument that these people must be detained, as many have been released in the past few weeks.

In the midst of CoVid fears, prison justice activists like those of the Prison Justice Society and the coalition “Contain CoVid Not People,” have reiterated demands to improve conditions and release prisoners. They have succeeded in pushing phone companies to stop charging exorbitant rates to prisoners, and in the last few weeks, they, joined by more mainstream allies like the Ontario Lawyers Association have succeeded in getting the prison system to release many non-violent prisoners.


Disruption against exploitation

The third mode of social movement organizing disrupts exploitation. Toronto’s housing prices are some of the highest in the world and there is an active tenant rights movement which succeeded in getting a sign-on letter from many organizations and achieving a moratorium on evictions right now, and then turned to campaign for a rent strike. The tactic raises fundamental questions about the right to housing and became front-page news. One landlord advocacy spokesperson noted, “We have the concept that no one should worry about paying the rent. This has caused chaos,” While it is unclear how many people refused to pay rent, the idea of challenging such exploitative housing relations is circulating and building momentum. This will aid longer term struggles against exploitative housing.


Mutual aid, direct action and immediate support

The last way that movement activists have been operating is through direct action, and mutual aid to support those most vulnerable through food, care and supply runs. Sometimes called Caremongering – (vs. fearmongering), horizontalist movements have a long history of such efforts. One can think of how activists became central in Hurricane Katrina and Sandy efforts. However, the effectiveness of such initiatives attract those understand it as charity for the needy, rather than part of a longer term effort to build a more just society. Helping ones neighbours is a wonderful thing. But when one neighbourhood is homogenous and well resourced, and another is not, that charity may simply reinforce durable inequalities through opportunity hoarding. These tensions can erupt. When the Toronto Caremongering Facebook group that had been started by social justice activists with a strong anti-racist, anti-capitalist analysis, grew over 15,000 strong, they did.

On March 18th, Ghee Chopra, an administrator on the site posted:






















































I normally avoid reading statements in ‘ALL CAPS’, but joined hundreds of others in ‘liking’ its fierce poetry. Mutual aid projects have flourished in this moment – in some, but not all, activists are working to ensure that these efforts avoid building relationships that further marginalize and exploit.


Social movements in times of pandemic and beyond

We know that social movements are most likely to emerge and succeed at particular moments, when regimes is more open to challengers. Pandemics, like economic instability, war, or social unrest create such moments because powerholders are uncertain, making them pressurable by outside actors, including social movements that aim for more just social relations, but also to those who seek to close borders, exclude, criminalize and arrest.

Those voices of top down enforcement seem attractive to many when the numbers of sick and dead continue to rise. But such emergency orders will inevitably be used most frequently against those that law enforcement see as risky – people of colour and youth. They will condemn those without safe shelter, identification and resources – undocumented or homeless people, the sick, the old, the vulnerable.

But in a pandemic, no one should be left behind. Transformative, anti-authoritarian social movements play an essential role in building trust with each other, incorporating the most vulnerable, multiplying the possible ways of relating and making us less dependent on centralized power that has a historical tendency to abandon and exploit. As my colleague Cary Wu notes, “Public health crises stress public trust in at least four ways. Trust in fellow citizens, trust in politicians, trust in health care and trust in perceived outsiders.” Anti-authoritarian social movements can help to build trust. Because of the way that movements can redistribute and reorganize resources, and create the spaces and relationships that we need, we can challenge the dominant, top down mode of organizing social life.

With fear and anxiety rage, people look for things they can rely on. If anti-authoritarian social movements retreat, state approaches to social order gain more power, with dangerous consequences for creating just social relationships for the short and the long term. As James C. Scott warns, social order is not “brought about by such professionals as policemen, nightwatchmen, and public officials.” He reminds us that such state logics encourage us to trust top down authority, logics of control and criminalization. And they don’t work. Instead, working for the long haul, social movements recognize how society can work best for ordinary people, through building relationships amongst the people.

At their best, social movements play this essential role, building voluntary and trusting relations amongst one another – pushing the state to distribute its resources to the most vulnerable, so that we can build together. Social movements save lives, now and in the future. We must, as thinkers Chris Dixon like remind us, work within, against and beyond the existing system to ensure that when the pandemic recedes, we all flourish.


By                   :               Lesley J. Wood

Date               :                April 30, 2020

Source           :                Open Democracy (         

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Book Review: Reconstructing Democracy: How Citizens Are Building from the Ground Up by Charles Taylor, Patricia Nanz and Madeleine Beaubien Taylor


In Reconstructing Democracy: How Citizens are Building from the Ground Up, Charles Taylor, Patricia Nanz and Madeleine Beaubien Taylor respond to the lack of public faith in the institutions of representative democracy by calling for a ‘bottom-up’ reconstruction of democracy at the local level, drawing on examples of local participatory democracy in action. While the book explores some inspiring initiatives that can have real and lasting benefits for communities and the capacity to solve local problems, Luke Bostian is unconvinced that such programmes alone can address the wider structural forces that jeopardise efforts to reconstruct democracy. 


Reconstructing Democracy: How Citizens are Building from the Ground Up. Charles Taylor, Patricia Nanz and Madeleine Beaubien Taylor. Harvard University Press. 2019.

On 25 May 2020, a protest broke out in Minneapolis, Minnesota, after the killing of a Black man, George Floyd, by a police officer. In the months since, the uprising has spread to dozens and then thousands of cities across the United States and around the world, many of which were met – as they had been in Minneapolis – by further police violence.

To put it mildly, the people marching in the streets do not believe that the police represent their interests, or that the elected officials who oversee the police will listen to community demands for change. In that sense, they are an especially dramatic example of the lack of public faith in the institutions of representative democracy that has been a subject of interest for scholars since at least the 1970s. A recent entry to this literature of concern is Charles Taylor, Patricia Nanz and Madeleine Beaubien Taylor’s new book, Reconstructing Democracy.

Taylor et al are right to be concerned about the state of democratic institutions, and public attitudes towards them, in Europe, North America and beyond. While their motivations and goals vary widely, groups as diverse as the Gilets Jaunes in France (whose internal diversity of backgrounds and ideologies is itself startling); the student protesters who erupted in Chile in 2019 in outrage over a transportation fare hike and eventually demanded a new constitution; and the Black Lives Matter movement in the United States all accurately believe that their ostensibly democratic governments do not represent or respond equally to the needs of all citizens. At the same time, an anti-democratic backlash, in large part a reactionary response to efforts towards racial equality, has helped sweep into power right-wing authoritarians in ostensibly democratic countries, including Brazil, Hungary and the US, and led to historic electoral gains for far-right parties in Germany, the Netherlands and elsewhere.

The authors of Reconstructing Democracy lay the fault for this crisis at the feet of neoliberalism. They argue that the crisis of democracy has arisen because neoliberalism has separated economic affairs from social relationships and led to the rise of ‘managerial supremacy’ in the way democratic governments carry out their business. This has, in turn, led to a decline in the ability of traditional institutions to solve problems and a large gap between what people want government to do and what political elites think it should do.

But Taylor et al’s diagnosis stops short of examining why neoliberalism rose to the world-hegemonic status it enjoys today or addressing the idea that it might have arisen because it serves the purposes of particular groups of people. As a result, their neoliberalism, as discussed in the book’s introduction, is something of a mysterious, agency-less boogeyman. In fairness, this is a slim volume and clearly not meant to be a thorough academic interrogation of its core concepts. But given the emphasis they place on neoliberalism as the problem, the book would have been stronger if they had unpacked it further.

So much for the diagnosis. What about the prescription? Having identified low faith in institutions, poor institutional problem-solving capacity and a wide gap between the public and elected officials, Taylor et al call for a ‘bottom-up’ reconstruction of democracy based on four building blocks: an existential shift toward ‘empowering consciousness of collective agency and possibility’; new inclusive solidarities and trust; opening new alleys to creativity, ‘creating breakout innovation’; and alignment of goals, knowledge and motivation.

Quite rightly, the authors write about the value of these building blocks being not only in their ability to help people achieve defined goals, but also to conceive and go after future goals. What they are talking about is building people’s ‘capacity to aspire’: their ability to create and navigate a ‘map of a journey into the future’ in which their rights are fulfilled and they are able to thrive, in the words of the sociologist Arjun Appadurai. In the authors’ view, these building blocks are to be used first and foremost at the local level, to help communities work together with government officials and the private sector to define and solve local problems.

The three chapters that form the bulk of the book are based around examples of local participatory democracy in action, mostly from post-industrial cities in the US, Germany and Austria that had become depressed through the loss of manufacturing jobs that had formed the backbone of the municipal economy. All are instances when citizens had to define the problem to be addressed, not just come up with solutions to a given problem.

Some of the examples are inspiring. Chapter Two describes the redevelopment of San Diego Market Creek Plaza, a neighbourhood development project in which two local organisations formed paid outreach teams to create a shared vision and then worked with residents to form small committees that planned and implemented the project. Community members were then able to buy ‘shares’ in the project in a kind of ‘public IPO’. This move to ensure that ownership of capital in a community stays in the community is commendable and remarkable, and the authors are spot-on when they write ‘for neighborhood revitalization to be successful, residents must own process and assets’ (my emphasis).

Unfortunately, the prescriptions are as much plagued by shallowness and lack of evidence as the diagnosis. Little evidence is given for the outcomes and impacts of these initiatives on people’s quality of life or on the inclusiveness of their citizenship. The authors contend that infrastructure projects can serve as a means to strengthen democratic participation, but readers are mostly left guessing at any long- or even medium-term impacts on the towns and cities where the examples take place. They claim that ‘institutionalization of citizen participation […] is an important step toward establishment of participatory democracy’, but leave it at that. While they argue that participatory budgeting, of the kind pioneered in Brazil in the 1990s, is qualitatively different from the open-ended initiatives they have in mind, to me it seems to provide a rich context in which to consider the implications of institutionalisation. And in fact, participatory budgeting research shows that institutionalisation of citizen participation is not a uniform process, nor is it monolithically successful or positive. For example, it can lead to the softening and co-opting of radical movements that are seeking substantial changes to the status quo.

On that note, for a book about democracy, the diagnosis and prescriptions are curiously apolitical and technocratic. The ongoing popular uprisings against police brutality in the US show dramatically that conflicts at the municipal level are often deeply political fights about who wields power over whom and how. And the protests show that those in power do not generally give it up willingly or without a fight. But Reconstructing Democracy does not address the radical, confrontational activism that has so often been the driving force behind meaningful changes to democratic processes and rights, or the systematic assault on government institutions that is a defining feature of neoliberalism. For all the times the authors acknowledge that the initiatives they have in mind require the willing support of people in power, they do not explain why those people should or will render such support.

Finally, there is the very rosiness of the portraits the authors paint. Not until more than three-quarters of the way through the book are any participants shown to express negative reactions to a participatory process. While the authors do acknowledge here and there some of the challenges to ensuring genuine and inclusive participation, they make no reference to the rich scholarly literature on this issue. What they are proposing – expert-guided action research and dialogue with local residents and government officials in poor and deprived neighbourhoods – has strong parallels with what has been a standard international development practice for decades, with mixed results at best.

The authors of Reconstructing Democracy are not wrong that the initiatives they champion can have real and lasting benefits for people and their relationship with their governments, and on the capacity of local governments to address local problems. But I have my doubts that such programmes will be sufficient to make a dent in the deep and large-scale problems – racism; the authors’ own focus, neoliberalism; voter suppression – that threaten to cut any effort to reconstruct democracy off at the knees.


This review originally appeared at the LSE Review of Books.

Luke BostianUniversity College London

Luke Bostian is a master’s student in Social Development Practice at University College London. Prior to beginning his graduate studies, he spent eleven years working in international development, most recently as Director of Policy and Partnerships for the Aga Khan Foundation, Pakistan.

Source               :                      LSE Blogs

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Doctors can’t treat COVID-19 effectively without recognizing the social justice aspects of health


Recent data shows that black, Latino, indigenous and immigrant communities are disproportionately affected by COVID-19, due in large part to the persistent legacy of structural racism – practices and policies that systematically benefit white people and harm people of color.

From the Bronx and Queens, New York to the Mission District in San Francisco, to the Navajo Nation and black communities of New Orleans, Detroit and Oakland, the message is clear: COVID-19 highlights our societal failures at the intersections of public health, health care and social justice. If health inequities weren’t severe and oppressive enough, add on the layer of police brutality that takes black lives on a regular basis. No matter where we look, our system has continually devalued black bodies and lives.

As an interdisciplinary team of public health experts, physicians, medical students and critical race scholars, we believe that an important piece of the solution lies in physician training and knowledge of how societal factors affect health. Clinicians in training need to be grounded in the social determinants of health and critical race theory to prepare them for an ethical and effective pandemic response. We’ll explain why social justice is so crucial to medical education and the care of marginalized communities.


Public health, social justice and medicine

Public health promotes and protects the health of people and the communities where they live, learn, work and play. Traditionally, physicians study purely biological factors that only make up a small proportion of an individual’s risk of disease. Public health professionals study the social determinants of health – factors beyond our bodies that impact health. These include insurance status, access to health care, reliable access to food, safe housing, transportation, education, safety and equal protection under the law.

Social justice is central to public health. This is because research has shown that health disparities are created by social inequities. Public health experts understand that oppressive systems dictate which people have access to key resources that determine health. Racism and classism create conditions where people of color, those living in poverty and other marginalized groups have limited access to resources that impact health – the social determinants.

The social practices that created these gaps in health include redlining, a practice where lenders denied mortgages to eligible buyers solely because of their race. Therefore, black people and other people of color were denied the right of home ownership and upward economic mobility that millions of white people enjoyed. Redlining, now banned, was succeeded by gentrification, whereby middle-class white people come into urban areas and displace black people who have lived in a neighborhood for years.

Both redlining and gentrification perpetuate poverty in communities of color in America’s cities. As such, many black and low-income Americans live in communities where clean water for good hand hygiene isn’t guaranteed, and social distancing is near impossible in crowded homes. In this way, redlining and gentrification impact the racial inequities seen in COVID-19.

By improving social determinants of health, health care leaders can transform our systems toward adequate COVID-19 prevention, testing and treatment for marginalized communities. But without a critical race lens, experts will still get it wrong. They still might assume that racial and ethnic disparities exist because they believe that race is biological - a longstanding myth. Rather, they must confront how structural racism is a root cause of health inequity.

A strong example of social justice-oriented care is the work of pediatrician Dr. Mona Hanna-Attisha, who helped link toxic lead levels in Flint, Michigan’s drinking water with the high lead levels in sick children’s blood from Flint. Dr. Hanna-Attisha helped ring the alarm on the Flint Water Crisis, which sparked efforts to clean Flint’s drinking water. We believe a similar social justice approach is necessary for beating COVID-19.


COVID makes the case clear

Social justice and human rights are at the center of COVID-19. Therefore, they must be centered in clinician training. Courses on inequity and social justice are still optional in many medicals schools. Most of these efforts are student-run, underfunded or assigned to minoritized medical educators.

COVID-19 has revealed how looking at differences in health through biology alone is limited. It is not sufficient in addressing this pandemic. If people perceive inequities as inevitable, they resign marginalized communities to poor health outcomes. When health providers and the health system take accountability for our inequitable health care system, they can better serve patients and communities.

As practitioners, scholars and people from communities that are most affected by COVID-19, we see human rights as being at the core of our work. Social justice demands us to see people with their full humanity to ensure equity in and beyond a pandemic. Because so many affected by COVID-19 are navigating poverty, food insecurity, lack of housing, child care and insurance issues, physicians must develop a deep understanding and compassion towards all elements that undergird people’s health and well-being.


Editor’s Note: Bernadette Lim, Edwin Lindo, LaShyra Nolen and Max Jordan Nguemeni Tiako contributed to this article.


By                   :         Zoë Julian (Health Services Researcher and Clinical Instructor, University of Alabama at Birmingham)

                                 Rachel R. Hardeman (Associate Professor, University of Minnesota)

                                 Ryan Huerto (Family Medicine Physician, Health Services Researcher and Clinical Lecturer, University of Michigan)

Date               :          June 3, 2020

Source           :          The Conversation



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