Place-Making For People of Small Means

Placemaking (or place-making) can be defined as, “the process of creating squares, plazas, parks, streets and waterfronts that will attract people because they are pleasurable or interesting...Being in places involves social encounters, immersion in the sights, sounds, sun, wind and atmosphere of a locale, and curiosity about the traces of thought, imagination and investment that have guided their construction and use over time. ” (Wikipedia, Placemaking.)

Another definition is, “An integrated and transformative process that connects creative and cultural resources to build authentic, dynamic and resilient communities or place.” (Toronto Artscape, Glossary.) I like this definition much better.

One of the challenges of this present time of economic contraction is figuring out how to make the places where we live into places that sustain us on a number of levels. This involves not only trying to create places that provide some or all of the essentials we need, but also creating places that encourage and promote a sense of community.

Some writers and thinkers have addressed this challenge, notably architects and urban planners from the “New Urbanist” movement. Their assumption has been that placemaking is primarily an activity reserved for governments, developers and other large entities with lots of resources to create well-designed, resilient communities from the ground up, or to re-fashion defunct, poorly designed communities into the sorts of communities that could be called good places to live. Things like redevelopment, transit-oriented development and gentrification come to mind when discussing the re-fashioning process.

The problem is that the money and resources for such a refashioning have already been largely blown in the United States. It's as if the nation collectively went to a store with $5 in its pocket, and blew the money on candy and soda instead of beans, rice and vegetables. Some key writers and economic analysts believe that the industrialized world in general, and the United States in particular, are in the early stages of a massive deflationary depression which will destroy the ability of large-scale entities like governments to do anything on a large scale.

It will therefore be up to ordinary citizens to make good places out of the places where they live. But there's another challenge, namely, that not that many of us own our own living places outright, and even now, not many can afford to pay for a place in cash. A deflationary depression will cause a drop in prices of assets like real estate, yet it will depress wages even faster. Such a drop in wages will make it hard for people who own “on margin” (that is, who owe money on the houses they “own”) to continue making payments on their debt, and it will turn many other people into sojourners without definite roots, as many young people in college and recent college graduates are now.

How can these renters - young people in college or recently graduated, and working poor people - make sustainable places for themselves in the places they rent? How can they make their neighborhoods into sustainable places? How can they engage in good placemaking?

In an attempt to answer that question, I interviewed Neil and Naomi Montacre, proprietors of Naomi's Organic Farm Supply in inner southeast Portland, Oregon. I first met Neil and Naomi during a tour of homes with backyard chicken coops in 2008. Their house impressed me, with its large chicken coop, its varied gardens, its “Hens for Obama” sign and a poster with pictures giving a guided tour of the place and their efforts. I asked them several questions about their place, the plans and steps they had taken in altering the place, and its impact on the neighborhood. In 2009, they added a greenhouse and more garden plantings. This year, they moved to a leased property of about an acre where they set up their store, and they continued with the activities and philosophy they had developed while living in their former house. In all these things, they took bold steps with property they were renting, to make that property a place that could at least partially sustain them.

In this week's interview, Neil talks in more detail about their activities with rental properties, and his philosophy regarding making good places out of the places where people live. The interview can be found at the Internet Archive, under the title, “Place-making For People Of Small Means.” There's also a video on Vimeo which shows a partial tour of Naomi and Neil's new location, as well as an interview with another renter in inner southeast Portland. The video can be found at Place-Making for People of Small Means, or you can watch it by clicking on the link below. Note how prominently urban agriculture figures in both examples of placemaking.

Place-Making for People of Small Means from TH in SoC on Vimeo.

Post-Peak Finance for Vulnerable Neighborhoods

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I am pleased to present another interview this week. The themes of today's interview are banking and local neighborhoods during a time of economic contraction. This week's guests are Scott Bossom, Vice President/Credit Administrator for Albina Bank (Martin Luther King branch) and Teri L. Karren-Keith, Vice President/Branch Manager, Albina Bank (Martin Luther King branch). They both graciously gave me an hour of their time for today's talk. Albina Community Bank is a locally-owned bank in Portland with a reputation for strongly supporting the local community, and especially minority neighborhoods.

In arranging for this interview, I sent Mr. Bossom a note in which I outlined my questions thus:

“I have three general areas of interest. First, there's the subject of the general future of finance in an age of economic contraction caused by the depletion of natural resources. Others have written on this topic (for instance, there's Gail Tverberg's work at http://www.ourfiniteworld.com/finite_world_issues.html and http://gailtheactuary.wordpress.com/2007/04/22/our-world-is-finite-is-this-a-problem/), but I'd like to know how banks view this issue.

“Second, there's the subject of how economic contraction affects local communities. Specifically, what barriers are now appearing in front of people who want to finance projects? Especially, what existing hindrances faced by vulnerable communities are now being amplified by economic situation? How have big banks contributed to making vulnerable communities even more vulnerable?

“Third, what can local communities – especially working-class and poor communities – do now to finance necessary projects? How is Albina Bank helping these communities? And have locally-owned banks experimented with emerging approaches like establishing local currencies and microloans for small-scale businesses?”

These questions laid the groundwork for our discussion. During the interview, we talked about the current local economic picture, and whether that picture actually lines up with government and mainstream media reports of economic “recovery.” Scott and Teri told me of the weaknesses in the commercial real estate market, and the impact of resource shortages on the decisions of local banks. Terry voiced the opinion that our present crisis will not suddenly go away.

I asked point-blank, “What have big banks done to destabilize local neighborhoods?”, and we talked about the impact of predatory and discriminatory lending practices by big banks such as Bank of America and Wells Fargo. (For more on this subject, and on discriminatory pushing of subprime mortgages on minorities, see “Wells Fargo, Ghetto Loans, and 'Mud People',” “Race Discrimination Lawsuit Filed Against Bank of America, N.A.,” “Countrywide Sued For Discriminating Against Black And Latino Mortgage Buyers” and “Study Finds Disparities in Mortgages by Race”.) And we discussed the Fox News reports from several months ago, which blamed minorities and Federal anti-discrimination laws for the subprime crisis of 2008. Scott and Teri were genuinely surprised by this sort of reporting (both stated that they do not watch Fox), and wondered how Fox managed to create such a story.

(On a completely unrelated subject, it seems that Fox and spokespeople like Sarah Palin are now blaming the Deepwater Horizon disaster and Gulf oil spill on environmentalists and left-leaning members of the Federal government. In both the subprime case and the case of offshore oil drilling, the right-wing message is the same: “Oh, here, look at this mess that we've made. Only, it's not our fault! The mess has actually been caused by people trying to pass some semblance of laws designed to keep us from making a mess!” If lying made people rich...but then again, these people are rich.)

Regarding subprime loans, we discussed the fact that lenders deliberately presented a picture to potential borrowers that was not clear or full. Scott tied this in to credit card policies that are also deliberately made unclear, in order to insure that borrowers are liable to be penalized.

We talked about what vulnerable communities can do to become resilient and self-sufficient. Teri stressed the value of localism and supporting local businesses. Scott mentioned microloans and organizations such as Mercy Corps who provide guidance to small businesses. Both Scott and Teri agreed that there is a swell of interest in entrepreneurship and starting one's own business among people in the Portland metro area. I mentioned the rise of local currencies, which seems to be a new concept to those who are involved in traditional banking.

Lastly, we tried peering into the future of banking in an age of general economic contraction and collapse, and Scott and Teri shared their perspectives of what such a future might look like. Teri returned to a simple prescription for the survival of local banks in such a time: to focus on community relationships and actions that build trust.

A podcast of the interview can be downloaded from the Internet Archive at this address: Post-Peak Finance For Vulnerable Neighborhoods.

Repost - "Our Least Resilient Neighborhoods"

I've got another interview coming up this weekend, God willing. In preparation for that interview, I thought it would be good to mention “Our Least Resilient Neighborhoods”, a post I wrote several months ago. That post talks about the challenges facing neighborhoods in the United States in this time of economic collapse, challenges made worse in many cases by institutional policies of economic persecution directed against minority communities. It is a good preparation for this next interview which will explore of some of these policies further, as well as general financial issues confronting urban neighborhoods. It's a bit late in the day to be talking about some of these issues – I don't know how much can be done at this stage of the game. Nevertheless, it can't hurt to talk about these things.

Post-Peak Education - A Grassroots Teaching Model

I am pleased to present another interview for this week's post. This past Friday, I had another opportunity to visit Holly Scholles, founder of Birthingway College of Midwifery in Portland, Oregon. We continued our discussion of what post-Peak health care might look like, and then we moved on to this week's main subject – a discussion of post-Peak education. Holly is uniquely qualified to discuss post-Peak education, due to her experiences in founding a college, and as a homeschooling parent.

We discussed both K-12 and post-secondary education and how traditional educational avenues, both public and private, are being imperiled by the shrinkage of revenues due to our ongoing economic collapse. A surprising fact surfaced, namely that Oregon public higher education tuition fees are now nearly equal to fees charged by some of the private colleges in Oregon. (For more on rising tuition fees, see FinAid | Saving for College | Tuition Inflation and College Tuition: Inflation or Hyperinflation?, for instance.) Why are college and university fees rising at such a rapid rate? Where is all that money going?

We didn't answer those questions in this interview, but we did discuss an alternative model: education that is relationship-based, small-scale, with reasonable fees charged by people who understand the concept of “enough.” Holly described an education system comprised of only four elements: motivated learners, able teachers (or coaches or facilitators), a good library and an environment conducive to learning. She stated that all these elements can be provided inexpensively.

She also described the organic process by which Birthingway started and by which it grew, and described how that process might happen for people in working-class neighborhoods who want to create local neighborhood classes and other learning opportunities for themselves and their children. We discussed a hypothetical example of a neighborhood whose members decide to start an urban farming class, and the process by which that class would grow – from gathering a library to attracting learners and other facilitators. From there we talked about the need for a revival of teaching of practical skills of the sort that have been lost due to reliance on technology and globalism.

We discussed many other things related to education, but these are the highlights. A recording of the interview can be downloaded from the Internet Archive at “Post-peak Education – A Grassroots Teaching Model.” As time permits, I hope to be able to post a transcript as well. (And I still owe you all a transcript of my last interview with Holly.) From the interview, it will be very obvious that a system that actually educates people is very different from what we have now, by and large, in the United States - a system whose purpose is mainly to institutionalize instead of educating.

I've got another interview coming up in the next few weeks. I can't say what it's about yet, but I think many of you will be very interested. Stay tuned...

Surviving The Hollowing-Out of the U.S. Tech Sector

This post is another “diary” post, as opposed to a more journalistic essay. It is also a midweek post, so I'll try to keep it short. There won't be many links, as I don't have time for exhaustive research, but I'll try to include a few relevant and interesting sources.

As I have said before on this blog, I am an engineer. The type of engineering I do involves generating plans and specifications for large-scale built structures and facilities, whether they be shopping centers, airports, rail terminals, military installations, or industrial plants. I have noticed certain trends over the years, trends which recently seem to be coming to a point of crisis.

For over fifteen years, large design firms have been outsourcing various parts of construction engineering and design. It started with CAD, and has by now grown to advanced engineering up through detailed design. The countries of choice for outsourcing are China and India. Most U.S. based major design firms now have design centers in India. (I won't name names here. I still have to live in this town.)

I know of a firm whose stock was highly valued over the last few years, and which had an impressive backlog of large clients, both military and industrial. However, the economic meltdown that began in earnest in 2008 dried up a significant portion of that backlog and of their client list. One example: someone I know was involved in designing facilities for an industrial metals mine which was operating in a region where concentrations of the metal in the ore had dropped to very low levels. In order to continue operating that mine, the operators needed a stable and relatively high price for their finished metal. The crash in commodity prices at the tail end of 2008 shut down the mine (and one of this engineer's projects).

This firm was typical of most of the large players – publicly traded, requiring constant dividend growth in order to promote increased share prices, and having a business growth strategy that often consisted of capturing market share by buying up smaller firms. 2008 was a year in which dividend growth and corporate growth were threatened by the global economic contraction. This company's management turned much more to outsourcing – in an attempt, I believe, to maintain profit and dividend growth. Meanwhile, several of their U.S. offices began to shrink.

Did the outsourcing strategy work as intended? That's a hard question to answer. The local office had regular meetings where employees were told that “although we're facing lean times now, the future looks bright!” And, “The company is doing well overall!” I think, however, that they may have missed at least one 2009 earnings target.

They began to rely heavily on outsourcing in order to boost profits and increase competitiveness in a shrinking market, but I think the best they have been able to do is to slow their own bleeding. One other problem they have is that because they are so large, their business model depends on securing long-term contracts with large clients. This is the only way they can profitably support their large cadre of middle and upper managers. Outsourcing was a way for them to lower their fees in order to win these clients while maintaining their revenue flows.

But the supply of large, stable clients with lots of construction capital is drying up. Or at least, that's what I suspect, based on what I've seen over the last year. This is a natural consequence of a contracting global economy, in which both private and government clients have become so heavily indebted that it is becoming clear that they can't repay their debts. This is something I knew about via the news and blogs I read (read the May 10 post from the Automatic Earth blog to see how this is playing out in Europe) – yet I hadn't experienced it as directly until my own work started drying up and the firm I worked for began to shrink. For I also worked at a typical large firm. The story I told you about one particular large firm applies to most of the major players, I suspect. And it goes to show that a person is not always confined to reading the news – sometimes he gets to live the news as well.

As I said, I worked (or more accurately, used to work) at a typical large firm. But I found myself at home twiddling my thumbs for several weeks this year, due to lack of work. By now I have become addicted to groceries and hot and cold running water, so I needed to find a way to support my habit. I discovered that while the large firms seem to be contracting in several regions of the U.S., there were small firms that were still able to find plenty of work. As I once said to a co-worker, “It's easier for a cat to survive on a diet of mice than it is for a grizzly bear.” All the elk and moose seem to be disappearing. I am now at a cat-sized (smaller) firm.

This firm's projects rarely exceed a few hundred thousand dollars. Many of them are in the $10,000 to $20,000 range. There's still a lot of work to be done for that kind of money. It's quick-turnaround, bang-it-out work – and it keeps me on my toes. Yet even this I do not expect to last, due to the ecological and resource constraints which initiated our economic contraction in the first place. I think the economy still has a lot of shrinkage left to endure.

Therefore, my eyes are still open to options. One such option is teaching. God willing, I will be teaching a quarter of a sophomore engineering class as an adjunct at a local college. This college also does research on renewable energy, so I'll have a chance to rub shoulders with some bright people who can educate me as to just what can and cannot be accomplished on a societal level with the renewable energy options currently available. I suspect that the application of renewables will involve asking hard-headed questions about what a particular energy source is actually good for, and whether certain applications need this source or whether they are better performed using more low-tech methods. In other words, I think that the next few years will force us to triage our industrial society and its living arrangements. I suspect that engineering in the U.S. will soon be mainly about designing small-scale systems appropriate for poor communities. The future, moreover, will belong to people who know how to do productive things, not to people who only know how to "manage." Those who can teach others how to do productive things will enjoy a special place in their communities.

By the way, if you want to read an article on the ethics of outsourcing U.S. construction engineering projects to other countries, check this out: “Outsourcing Affects Civil Engineers, Too.”

Watching The Well, Late March 2010

This month, it was announced that an island in the Bay of Bengal was swallowed up by the sea, due to rising sea levels caused by climate change. Five other nearby islands are also threatened with submersion.

This month, NASA scientists stated the very high likelihood that this year, 2010 could be the warmest year on record. FYI, 2009 was the warmest year on record in the Southern Hemisphere, and the second warmest year overall.

This month, the U.S. Federal Reserve announced the end of its program of buying U.S. mortgage-backed securities. The buying of these securities by the Fed was a major factor in propping up the U.S. financial system, and was quite possibly the single biggest factor in keeping American home prices elevated.

This year, the U.S. Energy Information Administration finally joined a chorus of official voices from official government and oil industry agencies who are saying that the world could start to see a decline in global oil production...right about now (actually, to be quite precise, starting in 2011). However, neither the EIA nor the U.S. government in general can yet bring themselves to say the words, “Peak Oil.”

This year, none of these pivotal stories has been covered in any meaningful way in mainstream American media. However, Scripps Networks have just launched a new “reality” TV show on their Travel Channel, called, “America's Worst Drivers.” Our media continues to lull us to sleep by petty distractions such as these, and many of us are as a mouse nodding off to the sound of the purr of a nearby cat. So few of us realize that the cat's jaws are about to close on us.

A Slightly Late Post, March 2010

To those who are just now joining this blog, I want to say a big “Thank you.” The Well Run Dry is a blog that deals with declines in the energy available to modern industrial society, the environmental destruction caused by this society, and its resulting economic contraction. It is partly a discussion of problems caused by energy decline, environmental degradation and economic collapse. It is also partly a calling-out of some of the rich and powerful people responsible for making our predicament worse than it need be. And it is partly a diary – how one man (me) wakes up to our situation and searches for strategies for coping with all of it. Hopefully in thinking of strategies I can come up with things that help all of you.

Normally, I try to post each weekend (Saturdays preferably, though sometimes I get a post in on a Friday night and sometimes I am delayed until Sunday afternoons). There are also times when I am able to publish two posts per week. This weekend I participated in a tree-planting organized by Friends of Trees, a Portland environmental nonprofit organization. Having recently purchased a very cool “hybrid” camera (one that records both high quality still images and high quality videos), I shot some videos of the tree planting, as well as short interviews with some of the staff. This weekend's post would have featured those videos, as well as a brief explanation of Friends of Trees and the impact of their efforts on building resilient neighborhoods.

Unfortunately, when I tried to upload the videos to Youtube, my computer kept disconnecting from the Web (and the upload process seemed to take forever), so I never completed this weekend's post. I am now looking into other video hosting sites like Vimeo or the Internet Archive. Hopefully, sometime before my next birthday I'll have those videos up on the Web. ;) I've also got to learn how to turn my videos into a more polished production... Meanwhile, if you want to see some other videos I recently shot, look up the “Portland Fix-It Fair” on Youtube. The Fix-It Fair is an annual series of workshops hosted by the City of Portland to promote resilient, sustainable neighborhoods.

I also have more interviews for you all to enjoy. One interview I did last week dealt with urban farming; I'll try to have the transcript up shortly. And I'll be writing a “diary” entry about coping with slow times at my company, and thoughts on appropriate strategies for people dealing with continued underemployment. Stay tuned...

A Safety Net Of Alternative Systems - Providing Community Doctors

Medical care in the United States is insanely expensive. According to several sources, medical bankruptcies account for 60 percent of all personal bankruptcies in America (even though most of those driven into medical bankruptcy have insurance). Moreover, American health care is very technology and drug-driven. This is by design, as American health care has become a capitalist growth “industry” whose masters demand continually increasing profits every quarter. As the global economy continues to shrink, and as the economy of the U.S. in particular continues its collapse, an increasing number of people and communities are being cut off from standard American health care. This trend will only worsen as the industrial economy continues to contract due to the depletion of natural resources such as oil.

Today's post consists of a transcript of a recording I made a couple of weeks ago of an interview with Rachel True, MPH, Academic Program Director for the Medical Education Cooperation With Cuba organization, also known as MEDICC. We discussed the work of the Latin American School of Medicine (ELAM in Spanish) in training primary health care physicians to labor in poor countries and communities, and how disadvantaged American communities could benefit from the initiatives of ELAM. ELAM is now offering scholarships to students from disadvantaged communities in the U.S., for the purpose of training these students as doctors, with the condition that these newly trained doctors be willing to go back to their home communities to help their neighbors. ELAM is a Cuban school which trains Cuban doctors – doctors who have earned a very high reputation for competence and skill. ELAM is therefore an important avenue for communities in the U.S. who want to build their own health care systems.

In the following transcript, my questions and comments are in bold type. If you wan to listen to the interview, you can find it here: “Internet Archive: Free Download: Interview with Rachel True of MEDICC”.

Rachel, what I'd like to ask first is the history and motivation behind the setting up of ELAM. Why did Cuba decide to set up this school? What are their goals? What are they accomplishing?

Cuba has had a very long history of international cooperation in the area of health and human resources for health. For many years they have sent their own trained doctors abroad to countries, mostly in Latin America, but also in Africa and other parts of the world, where they have collaborative and cooperative agreements in solidarity with those countries as they work toward addressing health disparities and the inequities in their own health systems, and addressing the shortage of health care workers in their own countries.

ELAM began as a response to the hurricanes Mitch and George, which devastated much of Central America in the late 1990's. As is often the case, Cuba sent a large number of doctors to the affected areas to address the disaster-related health care concerns of affected communities. Many of those doctors came back from those areas feeling that they had done the best they could, but knowing that when they left, there was no one to take over. They had been manning health posts in remote communities and marginalized areas in Central America where there was no doctor when they arrived and no doctor to take over when they left. So they brought that message back to the leadership in Cuba, saying, “We really need to develop a more sustainable response...we need to bring these countries further along in addressing the shortage of their own health care workers.” So the Cuban government decided to open ELAM as a school to train students from those countries, from Latin America and Africa and Asia to become the kinds of doctors that are needed to work in these remote areas.

The curriculum is offered for free. It is a six-year curriculum. They recruit from marginalized and poor communities with the understanding that those are the students most likely to return to the communities where they're needed most. The curriculum focuses heavily on primary health care, public health and prevention, which have been shown to have the largest impact, especially in communities with large infectious disease burdens.

Regarding primary health care, how does the training of Cuban general practitioners compare and contrast with the training of U.S. general practitioners?

I think that the training offered at ELAM is scientifically very similar to the training offered at U.S medical schools. However, at ELAM, family medicine, which is their basic primary care discipline, is offered as a seven-week block – or rotation – in five of the six years of medical school at ELAM. In the U.S., it is not nearly as well emphasized or encouraged. So in the U.S. the system tends to incentivize sub-specialty and specialized care, and the discipline of family medicine is actually having a very difficult time filling residency slots. I believe last year only 42 percent of residency positions for family medicine were filled by U.S. graduates. The remainder were filled by doctors of osteopathy and by international medical graduates.

So there's a real difference between the two countries in the way primary care is seen and prioritized and encouraged as a prestigious and worthwhile career path. I think that also, integrated into the Cuban model of care and medical education is the idea of prevention and public health. In the United States, clinical medicine and public health are very different disciplines, and there are only a few medical schools that I'm aware of that are trying to bring those two together. In Cuba, it's seamless, it's one and the same; you can't be a doctor without understanding epidemiology and population-based health, or without really understanding and promoting the basic ideas of preventative health.

It sounds like the Cuban system focuses on preventing problems from arising, as much as possible, and the American system focuses on fixing problems after they happen.

Correct. I think that's a pretty good summary. And I think that some of that's out of necessity; I mean, Cuba has very few resources compared with the U.S., and they have decided to put a lot of their resources toward preventative health so that they don't have the exorbitant costs that go with trying to treat things they can't afford to treat at a complicated stage.

That brings up the doctors' response to disasters. I know that Cuban doctors have been very much in the news because of the response of Cuba to the recent earthquake in Haiti. From what I'm reading, it seems that Cuban doctors are extremely well-versed and capable in dealing with disaster medicine. Is that true and is that an emphasis?

Yes, it certainly is true. Disaster medicine is taken very seriously in Cuba; and the Henry Reeve Brigade, which has been around for many years, is a group of first responders from Cuba that have responded to many high-profile disasters. With many of these disasters, especially in Haiti, they [the Brigade] were able to hook up with a large group of Cuban doctors that were already on the ground and who had been working within the public health care infrastructure that already existed. They were thus able to hit the ground running; there wasn't a lot of start-up time, and they already knew the community and knew what was really needed most. They were able to triage well, right off the bat.

It seems that Cuban doctors are able to do a lot with a little. How much do they rely on expensive tests and equipment compared to doctors in the United States?

Very little. I can tell the story from the perspective of a medical student since that's who I have the most contact with at ELAM and in the Cuban medical education system. Students are very regularly asked to make a differential diagnosis based largely on history and physical. They do a much longer and more thorough history and physical than they would do here in the United States, and they are able to make a diagnosis and do testing just to confirm their diagnosis. So they would use radiological or blood testing just to confirm their diagnosis.

When students round with attending physicians in Cuba, they'll be asked to present patients of theirs, and to describe their history and physical work-up – what they did – and then will be asked how they arrived at their diagnoses, as well as the tests they ran to confirm the diagnosis. Then the professors will often ask students, “Now what would you do if you were in a rural village in West Africa? How would you then treat your patients? How would you diagnose them and confirm the diagnosis?” So they're constantly being asked to think about how to best use the resources available to them in Cuba, and then to take it a step further and think, “Now how would you do that if you were in a really remote place?” That's really useful for students who are planning to go back to such places. It's also useful for U.S. students who are planning to come back here and practice in underserved areas, because many of their patients won't have insurance, and won't have ways to pay for diagnostic testing – and they may have to take that into consideration. Others will want to do international work where that may be a consideration.

That leads me to ELAM and its outreach to other countries. How is ELAM funded, since the school is free?

It's a decision that was made by the Cuban government to put resources into this program. Like all things in Cuba, it's funded by the government. Therefore, it's funded in part by the Cuban people. The Cuban people are really proud of this program. They're excited about it and feel that it's the right thing to do.

So the Cubans take pride in exporting this knowledge to the rest of the world?

Yes, that's a nice way to put it.

As far as the outreach to the U.S. students, you mentioned that it was free – I like that price! What are the requirements for U.S. students who want to go? Let's say that someone from an underserved or disadvantaged community in the United States was interested in being a doctor, or someone reached out to them and told them that there was this option; what would be the requirements and what would they have to do to qualify?

The prerequisites are that you have to have at least one year of college-level biology, chemistry, organic chemistry, and physics, which is the basic requirement for medical school here. Many students at ELAM have done an undergraduate degree; it's not a requirement, but you do have to have at least one year of those basic science courses. You have to be under 30 years old. That's a requirement that the Cuban government has, which I think is aimed at trying to get people who will have the longest possible impact in their career.

The way a person would apply is by going through another organization based here in the United States, which has been involved since the very beginning of the ELAM project in terms of the U.S. students. That organization is IFCO – Pastors for Peace. They would go to their [IFCO's] website which is www.ifconews.org, and they could download applications there and get in touch with IFCO personnel to answer any questions and start the interview process.

MEDICC, the organization I work for, is also very much involved, but we're involved on the other end in terms of trying to make sure students have all the resources they need to re-enter the U.S. medical system after they graduate successfully. So we work with students as soon as they get to ELAM to connect them to mentor physicians in the U.S. We have a fellowship program that helps to defray the costs of their board exams, which are a requirement if you want to do a residency in the United States. For this, they need to pass a series of three exams, two of which cost about $750.00. The third costs nearly $1300.00. That can be a real barrier to students who are coming to medical school in Cuba largely because they can't afford the application process or tuition for medical schools in the United States. We have a set of programs to help make sure these students are getting the right support and resources they need in order to be competitive candidates for residency programs and get into the communities they want to work in and really start practicing.

As far as student satisfaction with the program, are U.S. students generally highly satisfied, moderately satisfied, really gung-ho? What's their reaction once they get through it?

I think the students are very excited about their education, and feel that they've gotten an excellent medical education. There is an attrition rate similar to that of U.S. medical schools; there are some students that get there and find that it's not quite for them, and that tends to be in the first one or two years. By the time they're into their more clinical years, which are years three through six, they're really excited, and they've settled in and they feel that it's an excellent opportunity and they have received an excellent education. And like you said, the price is right!

Oh yes, if I was under thirty, I'd be signing up right now! As far as student experiences after graduation, I know that ELAM really prefers that students from disadvantaged communities make a commitment to return to those communities after graduation. What is the general experience of a graduate after returning to the United States?

The first cohort of U.S. students graduated in 2007, and all residency programs are three years long. So we haven't actually seen graduates finish residency and enter practice. The lag is too long, so far. So it's going to take a little while to get enough numbers built up to see how effective this is in terms of being a model and pipeline for disadvantaged and under-represented students to go to medical school for free, as well as whether or not the alleviation of that debt burden [from attending U.S. medical schools] and the elimination of those financial and cultural barriers really are effective in leading toward a high rate of service in underserved communities. I think it will be successful, largely because these students have self-selected to participate in a program that is very geared toward the idea of committing to social service, an ideal that is reinforced throughout their education. The debt burden is really a motivator. People say that family medicine isn't a viable career path because you only make $150,000 a year. But to these students, that is a huge amount of money, and it would be a very comfortable life to live in their communities and do the work they want to do, and have the kind of impact they're looking for.

It seems that if a disadvantaged community in the United States were motivated and aware and doing research on options for taking care of themselves in a time of economic contraction and difficulty, such as this time, what they would be looking at in terms of providing primary health care would involve a long-term commitment...

Right. If they wanted to send one or two of their best and brightest to Cuba, they would be looking at a return ten years down the line. Those students would go through a six year program, then they would need to return to the United States and do a three year residency, and then be able to come back and really practice in their community. But it is an investment that has the potential to pay off in a very deep and sustainable way.

Have communities contacted you in the United States and said, “We want to put some of our students through this program?”

They haven't contacted MEDICC, because, like I said, we're not really involved in the recruitment and application process. They may have done that with IFCO. And I know that many students are supported by their churches – you know, you do need a little bit of money to pay for the plane travel back and forth if you want to come home for the summer, and like I said, there are the exam costs. So there are some incidental expenses that come up. I know that many students are supported by their community-based organizations or religious organizations. So I think there are people making that kind of commitment and investment.

Are there tutoring programs to help U.S. students to get the requisite first-year chemistry and physics requirements down?

You know, I don't know that there is a pipeline program just to get students ready to go to ELAM in particular. There are many pipeline programs to encourage under-represented minority students and students from low-income communities to get into the health profession. MEDICC is beginning to work with these programs and to explore ways that those programs and ELAM can be mutually beneficial and can learn from each other. So I think that's a great idea; I don't know that it's being done yet.

My last question is this: are there any passport or visa or legal issues that students need to know about before they get involved in a program like this?

No. Students who are enrolled in ELAM are able to travel legally and to be in Cuba legally – both from the U.S. and from the Cuban perspective. They get visas to study in Cuba, and they are able to travel freely and legally.

I've been talking with Rachel True of the Medical Education Cooperation with Cuba organization, which partners with the Latin American School of Medicine, known as ELAM. Thank you.

[Note: in the immediate aftermath of Hurricane Katrina, Cuba offered to send over 1500 doctors to New Orleans, along with badly-needed medical supplies. The United States Government under President George W. Bush refused the offer, along with an initial refusal of an offer of aid from France. Instead, the residents of New Orleans were treated to a round of infectious diseases. As President Bush said, “Heckuva job, Brownie!”]

The Dark Persons of America

Dark matter: that matter in the universe that is not directly observable. Dark internet: that portion of the Internet that can no longer be accessed through conventional means. Dark people: those individuals who have fallen out of society’s view, who have disappeared from society’s radar. (Most of them are poor.)

My follow-up post containing the rest of the brownfields interview will be posted this weekend. But for this present post, I want to discuss something different.

Bernard Hill is a name that is probably familiar to most people who remember the Lord of the Rings movies. He played Theoden, the King of Rohan. That role was the first role I saw him play, because I don’t go to movies much and I don’t have a TV. But because I was intrigued by the Lord of the Rings movies, I did a bit of research on the principal characters, and discovered a surprising amount of information on their previous acting roles. It turns out that an early breakout role for Bernard Hill was in a British TV miniseries titled, The Boys From The Blackstuff.

Hill played the character of Yosser Hughes, one of five unemployed asphalt (tarmac for you British) layers in the 1980’s. The series chronicled the lives of this loose gang of five men as they struggled to maintain their dignity and provide for themselves and their families amidst mounting national unemployment and the indignities of being “on the dole.” It was a struggle that each man eventually lost. The most harrowing portrayal of that loss was shown in Yosser Hughes, who lost his wife, his children, his home, and lastly, his sanity, while constantly asking – sometimes demanding, sometimes pleading – “Gizza job!”

The Boys From The Blackstuff was an eye-opener for many of the British, who had previously been trained by their culture and their own mass media to think of the poor and unemployed as mere scroungers. In fact, the series was widely seen as a dramatic denunciation of capitalist, free-market Thatcherism. Most of all, the series put a human face on the poor.

Such a series would probably not have been made or broadcast in the United States at any time during the Television age. (It is doubtful that such a series could be made anymore in Britain.)

Our nation has been trained to ignore the poor. This training has been accomplished through a steady diet of distraction and aspirational propaganda that claims that “anyone can be rich, and by Gum, everyone should want to be!” So we allow ourselves to be hypnotized by game shows, upscale living and “home improvement” shows, sports, the promise of the Lottery, and the advertising that goes with it all. When we go to the store, the magazines next to the checkout counter are full of flashy covers full of beefcakes and vixens and stories about the lives of these “stars.”

When events force the poor onto the American national consciousness, the response frequently consists of anger and hatred on the part of the rich and the “aspirational.” The poor are blamed for being poor. This, of course, gets the rich off the hook for any sort of duty or obligation of charity toward the poor. Thus the mainstream media (which is owned by the rich) denounces any suggestion that government social spending should be increased (though they are curiously silent when the Government bails out the institutions of the rich). They denounce any suggestion that the rich should be taxed more heavily than they are (and they are not taxed heavily right now). This is why the mainstream media in Oregon (such as that “progressive” newspaper, the Oregonian) have come out so vehemently against Measures 66 and 67. Measure 66 would add an increase of a (very) few percentage points to the tax rate of singles making over $125,000 a year or couples filing jointly making over $250,000 a year. How many people do you know that make over $125,000 a year?

Sometimes that anger and hatred takes even more grotesque forms. Pat Robertson, the outspoken founder of the Christian Broadcasting Network, recently denounced the country of Haiti, saying that the earthquake that struck that country several days ago is God’s judgment on its people for “making a deal with the devil” two centuries ago in order to get free from their French (white) colonial masters. If the earthquake is “God’s judgment,” that excuses rich Americans from having to help Haiti, doesn’t it? By the way, Mr. Robertson has a net worth of between $200 million and $1 billion, according to Wikipedia.

(Pat Robertson claims to be a Christian and a minister of the Gospel. But I am a Christian, and I’ve read the Bible, and I think Mr. Robertson might have to prepare for an unpleasant surprise on the Day of Judgment – see Matthew 6:24; Matthew 25:31-46; Luke 16:19-31; 1 Timothy 6:9-10 and James 5:1-6. I shall have more to say about him on my other blog. Has he ever heard of a place called Gehenna?)

Usually, though, the eyes of American society are directed away from the poor. There’s a store I regularly visit that carries Newsweek Magazine next to its checkout counter. Last week, Newsweek’s front cover was dedicated to picturing the “new face of Al-Qaeda” – the supposed black Nigerian threat. This week’s cover featured the growing American conservative acceptance of gay marriage. To the best of my knowledge, Haiti did not even make the front cover of Newsweek. (In fact, I’ll bet that in two weeks, Haiti will be forgotten – just like New Orleans was after Katrina.)

But we don’t have to go as far as Haiti to see how hard our leaders are working to keep our eyes off the poor. There are the “official” Government unemployment figures that are regularly cooked to a reality-obscuring flavor. I am truly thankful for those analysts who are able to sniff out the truth, people who publish websites like Shadowstats and The Automatic Earth. Basically, what they reveal is that in order to keep the “official” unemployment rate from going much above ten percent, the Government is ignoring huge and growing sectors of the unemployed population. Would you like to meet a “dark person”? You may not have far to look.

Meanwhile, if you want a peek at the lives of these dark people, feel free to rent or buy The Boys From The Blackstuff. You won't find another such portrayal in our mainstream media. It’s a good preparation for the time when you yourself will have to shout out the American version of the plea, “Gizza job!”

An Adaptor's Reading List

Over the last year I've picked up enough reading material to choke a horse. I guess my New Year's resolution will be to schedule enough time to read it all. Most of it serves the very useful purpose of equipping readers to adapt to the present and ongoing collapse of the Western industrial economy. (However, none of it is about how to reload your own ammo, where to find the best site for a bunker, buying gold, or the best brand of baked beans to stockpile in a mountain hideaway.) Some of it is in hard copy and some of it I downloaded for free from the Web. Here's a short list of some titles that stick out immediately:

The Humanure Handbook, Joseph Jenkins, Jenkins Publishing, 2005. This is a good book for learning why our present industrial Western system of human waste management is unsustainable, how this system is contributing to impending worldwide shortages of fresh water, and what individuals can do about it. I got a paperback copy for myself and I am about halfway through it. I also downloaded a free PDF copy from Joseph Jenkins' website.

Decentralised Composting for Cities of Low- and Middle-Income Countries: A Users' Manual, Eawag/Sandec and Waste Concern, 2006. This publication is available as a free PDF download from the Eawag webpage “Department Water and Sanitation in Developing Countries,” along with a number of other publications. I just started this one. (I'm up to page ten.) While I like Joseph Jenkins' approach to humanure composting, I am always impressed with the potential of ordinary humans to foul something up. The problem is not in Jenkins' method, but in the incompetence of some people I know (who might also say the same thing about me ;) ).The Eawag/Sandec publication seems to be a good way to insure that the composting process is put into trained and competent hands, even at the neighborhood level.

Where There Is No Doctor, David Werner, Hesperian Foundation, 1992. I downloaded this one for free from the Hesperian website as well as picking up a used paperback copy from a bookstore. We've been going through Chapter 11 of this book at work, during my “Neighborhood Resilience Brown Bag Lunches.” My paperback copy has a slightly musty smell, as if it spent a lot of time in someone's backpack in the tropics. Nothing like having something well broken in by the time you get to use it! I also downloaded a PDF chapter out of Where There Is No Dentist.

The Barefoot Architect, Johan van Lengen, Shelter Publications, 2008. I ordered a paperback copy of this book from Hesperian. I was surprised by how thick it is. So far I've barely had time to scratch the surface of the book. But to get some idea of how useful it actually is, I brought it in to work recently and gave it to an architect friend of mine to check out. (I also wrote my name all over it, just to make sure I get it back ;) )He and his colleagues seemed quite impressed. Looks like it's a keeper.

Setting Up Community Health Programmes, Ted Lankester, Hesperian Foundation, 2009. I ordered a paperback copy. This one was also surprisingly thick. I've only had time to lightly peruse it. I saw one rather unnerving section on setting up private health insurance plans in developing countries. I didn't have time to really dig in and see what Mr. Lankester was advocating, so I am holding off judgment on that section for now.

All of these books present simple, low-cost solutions and methods for individuals and communities to meet basic needs for sanitation, shelter and health. These books definitely strive to avoid high-cost, technologically complex, energy-intensive methodologies. They are suitable for poorer people in the Third World. And I suspect that as the glamor and notional wealth evaporates from the societies of the First World, we will see how applicable these resources are to us as well. Already I believe there are municipalities in the U.S. which can no longer afford complex wastewater treatment, or which are facing rate increases due to privatization of wastewater treatment. (See America's clean water systems and “State's wastewater treatment facilities have problems on tap due to declining revenue” for instance.) As I read these books and resources, I may dedicate a post to a more detailed review of each publication.

If anyone has other books or resources they'd like to recommend (or further comments on the books I have listed), feel free to send me a comment. Next week, I hope to have a useful and interesting interview for you all. I also have a new series of articles in the works. Thanks for reading and have a good week!

Christmas 2009 - Notes From The Road

I just got back from visiting family in So. Cal. The trip was an interesting experience, but then again, it always is. It's amazing what a guy notices when he moves away from a place and only returns for occasional visits. This time, I dropped by a former neighbor who lives in a house almost directly across the street from where I used to live. We got to talking about people we both knew, while a couple of his grandchildren showed me their new puppies and their Christmas presents.

He told me about another neighbor who sold his house a few months ago, for a bit over $250K. The man was forced to sell his house because of the lifestyle he had lived during the good years of the Southern California real estate boom. He had added a couple of rooms on to what was originally a Korean War vintage, two bed, one bath house in a working-class neighborhood, and had decked out the interior with genuine tile floors, granite countertops and the works. He had also bought an RV, two all-terrain tricycles, an SUV, and a boat in addition to his work truck. He paid for it all by refinancing his home loan with an adjustable-rate mortgage. He ended up owing a few hundred thousand more than he paid for the house when he bought it. When the mortgage reset, he could no longer afford the monthly payment. Even though he was able to sell his house and relocate, he is still massively in debt.

Of course, I had known that our present economic collapse would be hard on many Americans who had made foolish choices because they were seduced by wanting to live rich. But my friend began to tell me about his own situation, a situation of unavoidable hardship caused by economic contraction. My friend is originally from Mexico, and does not have a college education. He does, however, have a great deal of common sense, and he has chosen to live within his means. He too has a two-bed, one-bath Korean War vintage house, and he is paying only the original mortgage he received when he first bought his house. But his employer is slowing down and may close the place where he works. If that happens, he too will be forced to move.

This was sad news to hear. But it did provoke a discussion of true wisdom in these times, and the art of living happily without a lot of money. It also showed how sharp my neighbor is. As I said, he is originally from Mexico, and did not go to college. His English is not that good. (My Spanish is much worse, believe me!) Yet when, over two years ago, I put my house up for sale, I remember him coming by and asking why I was moving, and I explained to him all that I was then finding out about Peak Oil and the fragile state of the American economy. He got it. Every word. This is much better than I can say of many college-educated Americans I have talked with over the last two years, men and women who refuse to examine the back story behind the illusion of wealth in which we all have lived for the last few decades, and who refuse to believe that it's all about to end. My friend, on the other hand, is a clear-eyed realist. He still gets it.

For this trip, I drove down and back, as usual. (I no longer entirely trust flying.) I noticed that a lot of rest stops in California are now closed. Also, there didn't seem to be as many Highway Patrol cars as usual. I am sure that this is due to California's budget “crisis.” But these things got me thinking on the return trip, as I was driving north past Bakersfield and before Sacramento. On that particular stretch, I was listening to a podcast I had downloaded of a presentation given by a man named James Howard Kunstler to the Commonwealth Club of California in March 2007. (For those who have heard that podcast, it's the one where at the end, Kunstler doesn't realize that he's still being recorded and he asks the chairman of the club, “Where's my mug?” Maybe they give commemorative mugs to their guest speakers.)

Mr. Kunstler had stated in his talk that social systems organized on a giant scale would get in trouble in an era of economic contraction. Those closed rest stops were just one sign of the trouble that California is in. But those closed rest stops made me ask what the citizens of California were actually getting in return for their tax dollars. For they had been asked to accept severe cutbacks in State government services in order to balance their budget, yet they were still required to pay taxes. I know that money is not going toward maintaining a safety net for Californians, because many of them have been trained to regard government safety nets as evil. And they surely are not building that high speed rail line that voters approved in 2008.

Anyway, it seems that we all, including those of us in government, will have to quickly learn the art of living happily without a lot of money. As the benefits provided by government at all levels continue to shrink, this will mean that we must do much more for ourselves.

Digital Fabbers, Resilient Communities and The Flow Of Stuff

Here's the next installment of my study of digital fabbers and their role in building communities that are resilient in the face of resource constraints and economic contraction. My interest in this subject is not merely academic. Rather, I am confronting this study as a man who realizes that the world has become a very messed-up place, and that the country I live in has become a particularly messed-up nation. I consider these issues in much the same way that a man's interest in aerodynamic principles might be sharpened by being in a seat on a turboprop flying through an ice storm.

When people are in trouble, it is only natural for their attention to be focused on evaluating potential solutions to their trouble. The world in general, and the United States in particular, face a number of very severe predicaments caused by the end of a cheap resource base for our industrial economy, the destruction of the environment due to that economy, and the resulting contraction and disintegration of that economy. Yet our leaders (and many of the common citizens) are proceeding cluelessly into the future, lost in wish-fulfillment fantasies. I see what's coming, and I want to make my passage through the coming trouble as easy as possible.

So I'm looking at John Robb's concept of “resilient communities” and the prominent role played by continually advancing technology (especially the digital fabber) in these communities, and I've been wondering, “can these concepts save me and my community from some serious trouble?”

In previous posts on this blog, we considered small, home-made digital fabbers (microprocessor-controlled automatic fabricators of machined parts) as a means of jump-starting small-scale manufacturing in the United States, a country which over the last several decades has outsourced the majority of its manufacturing to low-wage countries, and which is now heavily dependent on imports. The most laid-back promoters of digital fabbers point out their potential to empower local communities to make for themselves the goods on which they rely, without having to depend on regional or international trade networks. This is a benefit, as declining energy supplies and economic contraction will likely cripple large-scale or global trade networks.

The more enthusiastic promoters of digital fabbers tout them as a key step along the path to “superempowerment” of individuals and small groups. Digital fabbers enable small groups or individuals to make most or all of the things that are now provided by large corporations or governments. This democratization of manufacture is very similar to the democratization of the creation of artistic media (movies, songs, recordings, published writings) which occurred because of advances in microelectronics and digital communication.

According to some of the sources Robb quotes, the technologies with potential to drive the advance of resilient communities do not have fundamental constraints such as energy use that limit progress. This is because they achieve the expansion of their capabilities by miniaturizing functions, thus enabling more to be done in a smaller space with fewer resources. (Microelectronics are a prime example of this, with the size of discrete transistors, diodes, etc., shrinking all the time, so that the number of components that can fit on a chip increases exponentially as time passes – “Moore's Law” in action.)

Robb has speculated that this miniaturization might also be applicable to non-electronic systems – in particular, social systems organized on the community level might evolve to foster an exponential increase in wealth creation for the members of such communities. Such social system improvement would be enabled by, and dependent on, the continued availability of cheap, highly capable microelectronics and digital communication. (For instance, see “RESILIENT COMMUNITY: Fabrication Networks.”) These communities would be able to “enjoy the benefits of globalization without being vulnerable to its excesses.”

Can technology-driven “resilient communities” such as those envisioned by Robb deliver on such promises? I don't have a definitive answer. But I do have a few cautionary observations. First, I question the digital fabbers that would form the backbone of relocalized manufacture. We have already seen that they cannot yet make their own microelectronics. We have also seen that the making of silicon-based microelectronics is very energy intensive. Organic electronics don't require nearly as much energy to make, but they also don't perform nearly as well as silicon-based devices, and they require the use of exotic materials like nanotubes in order to boost their performance to levels approaching that of devices made of ultrapure silicon. The exotic additives to organic electronics also have high energy costs and require manufacturing facilities almost as elaborate as those used to make silicon devices. This means that even communities that had local small-scale fabricators would still depend on large-scale, centralized manufacturing facilities for some of the goods used by them.

But let's say that we were able to make digital fabbers that could make nearly anything, and could fit in the average suburban garage (right next to the washing machine and just behind that exercise machine you no longer use). We are immediately faced with a second question: where do we get the feedstocks used by the fabbers to make their goods? For instance, let's say I want to fabricate steel tubing for use in bicycle frames. I need a source of steel for the fabber to work on. Who will provide the steel? Or the plastic for fabbed plastic parts? Or the other feedstocks? What if some of these feedstocks require large amounts of concentrated energy for their production? If I want to make things out of aluminum castings, for instance, I must realize that producing raw aluminum as a feedstock requires large amounts of energy in mining bauxite ore, and in separating the aluminum in that ore from the other components. Then someone must deliver the finished aluminum to me. In a future of declining energy, how much raw material and what kinds of raw material will be available even for local manufacturers (let alone the big guys) to turn into finished products?

Next, how do local communities who possess their own means of production prevent the draining of wealth from themselves? It's fine to talk about relocalization as a means of keeping wealth within local communities. But we must realize that this is a reasonable goal only if the primary factor in the flow of wealth is the choice of the members of the community in spending that wealth. Now, however, we are seeing that the flow of wealth within communities and between communities and the larger world is no longer within the control of the members of those communities. Relocalization was a defensive response by communities to the sucking of wealth out of those communities by the super rich who were far removed from these communities. But the goals of relocalization have been overruled by the super-rich, who have enlisted the government as a tool to continue siphoning wealth from communities in order to concentrate that wealth within their own hands.

There are two obvious examples of this: the continued bailouts of the financial sector by the U.S. government, approved by politicians from both parties over the objections of their constituents; and the proposed “health care reform” legislation in Washington which would force all Americans to buy private health insurance. As the fortunes of the rich are threatened by the contraction of the global economy, they will increasingly use the government as a tool to extract wealth from the rest of us. This will mean the passage of laws designed to force ordinary members of ordinary communities to continue paying arbitrary “rents” of one form or another to the rich. As long as this happens, no community can achieve “resilience,” if resilience is defined by enjoyment and possession of material wealth in a technology-driven community.

I guess my main issue with John Robb's vision is that sooner or later, technology runs up against limits. Our limits are arriving fairly quickly. Soon we will not have access to large quantities of highly refined, specialized feedstocks for high-tech goods. A declining energy supply, combined with the exhaustion of available ores and other materials, will lead to scarcity of these things. I think that communities that are resilient (in the way I am now thinking of resilience) will be made of people who know how to reuse, how to hack things that already exist, and who are wise enough not to need or want shiny new stuff all the time. Such communities will be able to exist in the absence of globalism, which is a good thing, since I don't think anyone will be enjoying the benefits of globalism for much longer.

What might a different flavor of community resilience look like? In a future blog post, I might just give you a small picture of that. Meanwhile, though I don't think Mr. Robb even knows I exist, I hope he reads my little series of ruminations on his ideas. It would be interesting to hear his answers to some of my questions.