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Not In My Backyard: Howglobalisation can be harnessed
to support local equality,inclusion and community
Fran BaumSACHRU/Public Health
Flinders UniversityCommunities in Control, June 2008
Local & globalexperience I willdraw on
Ideas, Principlesand Theories
New ways of thinking anagenda for a sustainablehealthy and convivialfuture
Practical Examples
Outline of talk1
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NIMBY
“Not In My Back Yard.” A term fora person who resists unwanteddevelopment, such asmanufacturing plants, prisons,power companies, or chemicalcompanies in his or her ownneighbourhood or town.
The New Dictionary of CulturalLiteracy, Third Edition. 2002.
Has negative overtones – selfishness butare there “unwanted developments” fromglobalisation that are bad for the health andwell being of communities? Can localaction overcome these? Do some aspectsof globalisation assist this local action?
Commission on the SocialDeterminants of Health
People’s Health Movement
Community Health My local Resident’sAssociation
Local & globalexperience I willdraw on
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Ideas, Principlesand Theories
• Dimensions ofglobalisation• Growing inequity• Empowerment ascentral to communitycontrol
‘Globalisation’ – impacts on localcommunities
• Global village– communications, travel and transport – easier, faster, more
connected– Fashions, culture, McCulture– health concerns: communicable disease, tobacco, etc
• Global economic integration– configuration of economic relationships, stocks and flows,
dynamics• Global regime of governance
– structures of economic and political control• Global Environment
– warming of atmosphere– degradation of natural environments– Good planets are hard to find so we are all in this together
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Globalisationmakes links muchmore evidentbetween globalforces and localcommunities
What is economic globalisation?
• Trade liberalisation, tarriff reduction,standards harmonisation and deregulations
• Growth in international trade e.g. 8.6% peryear from 1990-99
• Greater mobility of capital and increase intransnational investment
• Global institutions to regulate WTO, GATT,GATS
• Economy takes precedent overenvironmental protection
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Economic rationalism’s march continuesunabated
Where is the room for community,solidarity, conviviality, collectiveaction?
“When inequities become toogreat the idea of community
becomes impossible.”(Raymond Arons)
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Health inequities are stubborn
• Overall health improving in most regions ofthe world
• Health inequities appear to be increasing• Distribution of wealth is becoming less
equal• Inequity is bad for social cohesion and
well-being
“If people’s perception of theirhappiness is judged according to whatthey have relative to others, thensubstantial economic inequality is arecipe for widespread socialdiscontent”
“..the redress of economic inequality iscentral to the achievement of a goodsociety”Stilwell & Jordan (2007) Who Gets What? Analysing EconomicInequality in Australia
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CEO total cash remuneration &adult earnings
63:154,0803,420,5072004-05
47:143,4142,041,9212000-1
31:136,4941,148,4211995-6
18:129,198514,4331989-90
RatioFull time adulttotal earnings –private sector
AverageCEO
Year
Source: Stilwell & Jordan, 2007, p. 27.
Epidemiology of Inequality
• More equal societiesare healthier
• Leads to more justsocial policies
• Less crime morecohesion
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“The success of an economyand of a society cannot beseparated from the lives thatthe members of the society areable to lead… we not onlyvalue living well andsatisfactorily, but alsoappreciate having controlover our lives.”Amartya Sen (1999) Development asFreedom
•Material•Psychosocial•Political
EMPOWERMENT
0.8
1.3
1.8
2.3
2.8
High job control Intermediate job
control
Low job control
Rate
rati
o
Adjusted age, sex, length of follow up
+ effort/reward imbalance
+ grade, coronary risk factors, negative affect
Bosma et al, 1998
SELF-REPORTED JOB CONTROL AND CHDINCIDENCE WHITEHALL MEN AND WOMEN
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NUMBER OF MAZES SOLVED IN 15 MIN:INDIAN CHILDREN 11-12 YEARS
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3.5
4
4.5
5
5.5
6
6.5
High Caste Low Caste
Caste announced?NO YES
(Source: Hoff & Pandey, 2004)
Canada: Cultural ContinuityFactors
1. Self-Government2. Land Claims3. Education4. Health Services5. Police/Fire
Services
6. Cultural Facilities7. Women in
Government8. Child & Family
Services9. Traditional
Language useChandler & Lalonde (2008) Horizon 10,1, 68-72
Why some bands of Canadian Indigenouspeoples had higher rates of suicide thanothers
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Youth Suicide Rate by Number of CulturalContinuity Factors Present (1987-1992)
Rate per100,000
Number of factors present
0 1 2 3 4 5 6
140
60
0
120
100
20
40
80
Chandler &Lalonde, 2008: 71
Practical Examples:Shaping our own
backyards
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Example 1: Global resistance to
economic globalisation
based on local action
Solidaritybuilt locally
andstrengthened
globally
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Key local-global issues
• Privatisation of essential services – health, water, power• Corporate wealth and power – new feudalism which takes
power from local communities e.g. small farmers• Growing global inequity especially between rich and poor
countries• Environmental sustainability – global warming, pollution,
reduction of wild places. Development versus environment
Challenges to economicglobalisation are based on local
action
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Local groups
• Tell local stories of impacts of economicglobalisation
• Organise and mobilise• Link globally – the power of the internet• Inspire other movements in across the
globe• Share information
Global protest haltingaspects of globalisation
Social movements celebratedSocial movements celebratedvictory in 2003 when 5thvictory in 2003 when 5thMinisterial meeting of the WTOMinisterial meeting of the WTOheld in held in CancCancúúnn collapsed when collapsed whenthe developing countries, led bythe developing countries, led byAfrican delegates, walked out.African delegates, walked out.Through an unprecedentedThrough an unprecedentedalliance, backed by worldwidealliance, backed by worldwideprotests, developing countriesprotests, developing countriesachieved near equal footing inachieved near equal footing inthis week's meeting while richthis week's meeting while richcountries failed to impose theircountries failed to impose theirwill.will.
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The Collapse of the 5th WTOMinisterial Conference Cancun
“The collapse of the Ministerial, following fromthat of Seattle for similar reasons, should servenotice to the rich and powerful countries of theinternational trade system that the time isrunning out for their narrow interests on the restof the world. It should signal the beginning of anew way of interaction in international affairsbased on a relationship of genuine and mutualrespect.” (Africa Trade Network)
Didn’t just happen in Cancun – built on work ofsocial movements around the world
Another world is possible…
The World Social Forum that began as an open space forreflection, democratic debate, formulation of proposals andfree exchange of experiences has become a process of seekingand building alternatives to neo-liberal globalization andcapitalism. All the events, regional and local, and thematicforums have an international dimension.
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Example 2: Global Commission
call for local action
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Commission on the Social Determinants ofHealth in a nutshell
• Put SDH oninternational healthagenda and encourageaction on them
• Improve health globally• Reduce health inequities
within and betweencountries
• Create social movementfor health equitywww.who.int/social_determinants/en/
Basic logic: what good does it do totreat people's illnesses .........
then give them no choice but to go back tothe conditions that made them sick?
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Commission on SocialDeterminants of Health
• Bringing people and organisations together tocreate a global movement
• Civil Society as partners in CSDH process –watch dogs and critical friends of the CSDH
www.who.int/social_determinants/en
CSDH Visit to Self
employed Women’sAssociationIndia 2005
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MAKING A DIFFERENCE TOPEOPLE’S LIVES: SEWA
• Vegetable sellers inAhmedabad
• Micro credit Vegetablewholesalers
• Legal right to sellvegetables
• Child care provision• Health care provision• Housing• Pensions• SEWA Bank
Closing the Gap in a Generation: Equitythrough action on the social determinants of
health (Sept. 2008)• Strong focus on health equity as sign of successful
society• Empowerment as crucial – economic, social, political• Will require reallocation of money, resources and power• Local social movement required to support shift
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Example 3: Save our planet
Local action
Western Coastal ResidentsAssociation (WACRA) Adelaide
• Many local groups around Australia taking actionon issues and building local community – manyof you in audience today!
• Tell story of a vibrant, lively active group in mycommunity that takes action on a range ofissues. Some examples ……– Unsuccessful protest against boat harbour and
catchment water outlet and their impact on coast– Community arts– Protecting Gulf St. Vincent– Electricity prices in era of privatization
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Proposed sea outlet at West Beach.The Advertiser 24/3/1998
West Beach: view north of pre boat harbour site.Observe the width of beach and the healthycondition of the primary dune. (1995)
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West Beach before the construction of the BoatHarbour. Note the width of the beach (1997)
West beach : Erosion and dune fencing damaged andwashed away after construction of boat harbour. 15/5/99
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West Beach Dune Fencing damage and Beach Erosion(15/5/1999)
West Beach Erosion: view north from the boat harbour.Note the reduced beach width, exposed drift fencing anderoded foredune. (May 1999)
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West Beach: sand dunes cut back even further than thewinter before. Note the dune vegetation and exposedroot system. The black pipe is dredging sand andseaweed from the West Beach Boat Harbour. 20/5/99
Community Campaign
• Awareness raising• Lots of media• Blockage of boat harbour building site – “tree” of local
people• Boat harbour and outlet built – monitoring of the impact
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Community Action: In Henley Square, the clock iscounting down the days prior to community action to stopthe Barcoo Outlet from being constructed. (Feb 2000)
Protesters join together to make a clear stand on the boatharbour issue. (1998)
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Community Protesters (February 1998)
The community blockade at West Beach. 20/3/1998
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Marked and unmarkedcars lined up at WestBeach yesterday tocontrol protesters,including the group onthe right.Advertiser 1/4/1998
Protesters are dragged away at West Beach.Advertiser 12/5/1998
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Resident Protest at West Beach, near the siteof the proposed boat harbour and BarcooOutlet. (Advertiser 22/3/1997)
A West Beachprotester is bundledaway by police.Advertiser 8/4/1998
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Protesters voiced their displeasure with state’s leaderby donning John Olsen masks. Advertiser 6/6/1998
West Beach: precious dunes gouged away. Jim Douglassaid the government refused to listen to warnings by itsown experts. Sunday Mail 4/6/2000
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Environmentalist David Suzukisays Australian stance isembarrassing.David expressed horror at plans by theState government to build a $10 millionboat harbour at West Beach.
They get the credit for building this butthey’re not around here 10 years fromnow when the citizens start adding upthe cost’ he said. It’s a totallyirresponsible way of doing things.
Dr. Suzuki said politicians andeconomists needed to understand thatnature should be respected first andforemost.
Advertiser 4/12/1997
Global Expert supported local campaign
Educated the community Exposed the lack ofdemocratic process Developed skills Friendships formed throughchallenges United our community Empowered people throughaction
What did boatharbour campaignachieve?
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Living Arts Festival 2007• The Mosaic Sea
Creatures• Henley Beach• Over 60 friends
and familiesinvolvedthrough theResidents’Association
Giant Squid Mosaic being placed
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World Environment Day, 2006
Protecting Gulf St.Vincent - local actioninspired by Global Event
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Spreading the message
Impact of electricity privatisation
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The community gathers
Getting the message
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Selling the story
Local environmental campaigns gainstrength from global movements
• Legitimacy from being part of global network oflocal activists
• Information sharing made possible by internet• Build grassroots support for global issues such
as anti-privatisation and environmentalprotection
• Locally builds networks and sense of community• Local leadership develops and strengthens
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Example 4 People’s HealthMovement- local servicesbased on communitycontrol and taking actionfor community as well asindividual health
People’s Health Movement• Global network of
people’s healthmovement formed in2000
• Secretariat based inCairo
• Country circlesadvocating for health asa human right, attentionto social determinants,community controlledhealth services andagainst privatization ofservices essential tohealth
http://www.phmovement.org/cms/
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PEOPLE’S CHARTER FORHEALTH (translated into 33 languages)
The Charter is built on theviews of people's movementsand organizations fromaround the world and wasfirst approved and endorsedat the People's HealthAssembly in Bangladesh inDecember 2000. It is theexpression of our commonconcerns, our vision of abetter and healthier worldand of our calls for radicalaction. It is a tool foradvocacy and a rallying pointfor the global healthmovement.
Health as a Human Right
• Health is a reflectionof a society’scommitment to equityand justice. Healthand human rightsshould prevail overeconomic and politicalconcerns.
• People’s testimoniesand academic analysisare crucial tounderstanding threatsto health
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Developing the People’s HealthCharter, Bangladesh 2000
Written through a year long global processof local groups feeding in to the People’sHealth Assembly
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Australians at the 2nd
People’s Health Assembly,Ecuador, July, 2005
PHM Right to Health Campaign
• Focus on theconditionsthat make forhealth
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Cape Town, South Africa
Building local understanding that health is more than health services
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Cross country solidarity – linking local campaigns
Alma Ata, 1978 WHO/UNICEF
The International Conference onPrimary Health Care calls forHealth for All by the Year 2000
Inspired a generation of healthactivists
Remains important inspiration forpeople’s health movements aroundthe world
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Global social movements offerinspiration……..
Dr. Halfdan Mahler, in Almaty, Sept 1998 20th anniversary of 1978Primary Health Care Alma Ata Conference
Community controlled healthservices
Central Australian AboriginalCongress
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Community health services – howthey could be……..
• Community health centres withlocal management
• Multi-disciplinary – individualas well as community health
• Citizens rather thanconsumers
• Debating where we spendhealth & well-being dollar forbest community healthoutcomes
• Ability to act on social andenvironmental causes of illhealth
• Collective rather than initialsolutions to local health issues
• Focus for local social actionand advocacy
• Supported by public sectorcommitted to empowermentand citizen’s voice
New ways of thinkingan agenda for asustainable healthy andconvivial future…someideas collectively wewill have many morethat need to be debated– many alternatives
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So please, allow this oldman in front of you to insistthat unless we all becomepartisans in renewed localand global battles for socialand economic equity in thespirit of distributive justice,we shall indeed betray thefuture of our children andgrandchildren.
Dr. Halfdan Mahler, DG Emeritusaddressing 61st World HealthAssembly May 2008
Inequities, Poverty & Neo-liberalism– part of natural order?
It is “not a preordainedresult of the forces ofnature or the product ofa curse of the deities.But the consequences ofdecisions which men andwomen take or refuse totake.”Nelson Mandela quoted in Heywood and Altman,2000, p.173
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New thinking for 21st century to createsustainable & convivial communities• Interventionist state – control market and
regulating threats to health and well being• Global governance for human rights and public
good• Create conditions for local democracy and
exercise of citizenship – public spaces to meet,debate, create futures, internet spaces whichallow global citizens to interact , protection ofrights of citizens to protest
• Support poor communities to develop skills andabilities with range of resources – part ofbroader inclusion strategy
Thanks forlistening
If you want to read moreabout these ideas…….
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