Communities of Healing Hands - The Hesperian Example

In my last post, Making The World Sick, One Country At A Time, I stated some key facts to illustrate how the American health care system prevents ordinary citizens from achieving economic resilience and self-sufficiency by bleeding them dry. I also said that I don't really expect the U.S. Federal government to enact any serious health care reform of the kind that would lighten the financial burden on the backs of ordinary users of American health care. I then stated my opinion that over the next several years, American health care will probably come to resemble the care provided in many Third World countries. (By the way, there are signs that this is happening now.)

My post then explored the sort of care that is now provided in the Third World, as well as explaining the philosophy behind much of that care as embodied in the 1978 Alma Ata Declaration of the World Health Organization. I cited the concept of Primary Health Care (PHC) embodied in that Declaration, as “...essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford...”

I then described how rich First World entities such as the World Bank and International Monetary Fund have worked to weaken Primary Health Care in the developing world, how they have forced the governments of Third World countries to dismantle their government-provided social services, and how they have worked instead to force an American-style privatized system of health insurance coverage on the poor citizens of the developing world. This failure to achieve a universal good for the world's people has occurred because the attempt to achieve this good relied on national governments that were beholden to selfish, rich corporations and other holders of concentrated wealth.

Yet there are good examples of individuals and volunteer organizations banding together to create social safety nets, including basic affordable health care, in the Third World and in the poorer parts of the First World. These groups are often quite innovative, due to the limits on the resources at their disposal, and the work they do is worthy of high praise. In his paper, “The Life and Death of Primary Health Care,” David Werner makes mention of the good work of non-government, community-based health programs and the groups that administer them.

One such group deserves particular mention. The Hesperian Foundation (http://www.hesperian.org/), based in Berkeley, California, is a non-profit publisher of books and newsletters for community-based health care, as stated in the “About Us” section of their website. Their published information is developed in collaboration with formally-trained doctors, citizens of poor communities in the developing world, and untrained or informally trained health care workers in these communities. Their literature is very simply written and is designed for people without any formal medical training, and it not only covers the treatment of disease, but also covers the underlying social factors in building healthy communities. Their most well-known book is Where There Is No Doctor, a book that has almost become the Bible of primary health care in the developing world. Hesperian has also joined forces with the worldwide People's Health Movement to promote health for all and the widespread implementation of Primary Health Care as defined in the Alma Ata Declaration.

I recently had a chance to conduct an e-mail “interview” of the Hesperian staff, which I have included as part of this present post. My questions are written in bold type, and their answers to each question are shown immediately below that question. I would like to especially thank Hesperian staffer Ingrid Hawkinson for taking the time to reply to my e-mail inquiries and to collect all the answers to my questions. The approach set forth by the Hesperian Foundation could prove to be a vital part of the response by ordinary Americans to our present health care crisis.

In reading the “Our Philosophy” section of your website, it seems that you have incorporated all of the principles of the 1978 Alma Ata declaration of the World Health Organization. That declaration defined health as “...a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity...” and stated that health is a fundamental human right. It also went on to address the underlying societal factors that influence the health of a nation. Are you familiar with the Alma Ata Declaration, and was it an influence on your philosophy?

Yes, we are definitely familiar with the Alma Ata Declaration – we have spent the past 30 years building on the successful model of Where There Is No Doctor to create other resources that also help people discover not only the ways they can have equal access to health care, but to do so in a sustainable way that examines the social, economic, and political issues that not only block access, but make our communities unhealthy. In line with the Alma Ata Declaration, our mission is to achieve the right to health for all people.

If ordinary people put their heads together to examine their health problems, come up with solutions, and organize, so many issues will be addressed including the power balance, the state of the environment, our sense of wellbeing. . . The concept of “health” and the reasons behind poor health are woven into the fabric of our existence.

Your programs match the definition of “Primary Health Care” as stated in the Alma Ata Declaration. After that Declaration was issued, many rich First World nations protested that implementing this Primary Health Care would be too “expensive.” Yet you seem to be able to provide what rich First World governments could not. How do you do it?

What we do is very simple. We supply information that people can use in formats they can understand and easily share. Our books are developed collaboratively to ensure they make sense to the end user. Once this information is in people’s hands, they come up with solutions that work for them. So if, for instance, our readers don’t have money, our books help them figure out how to take care of their health using the resources available to them under the circumstances, and to prevent health problems before they become serious and costly.

One barrier to affordable health care is that there’s so much mysticism surrounding what doctors do. Yet the methods doctors use to diagnose and treat the most common and basic health problems are simple. In addition, the vast majority of medical information is available but not accessible. Typically, it is in dry, expensive textbooks full of elaborately constructed sentences; jargon confusing even to those studying medicine; and illustrations that depict illness rather than communicate ways for the viewer to visualize a concept or technique that will lead to its cure.

Another barrier is that many rich, first-world countries are run by governments supported by industries with a lot of money, such as the healthcare industry. And of course, if people could spend much less money on health care, they would. It’s not in the interests of governments to champion alternatives to the industries that supply their funding. Their argument -- that providing a single-payer program would be too expensive -- strikes those who are suffering right where it hurts: in their pocketbooks. The argument is illogical, yet it’s still somewhat effective because it weakens those who have the most potential to make change.

You have evolved a community-based, non-governmental approach to providing health and basic human services. Yet I am sure that you have interacted with governments in the nations where you work. Have you been able to collaborate easily with them? Are there any cases in which the relationship was strained or in which you faced opposition?

We are based in Berkeley, California, and we don’t provide health and human services – we produce materials to allow ordinary citizens to improve their health and organize for justice. We have an open copyright policy that encourages people to translate and adapt our books to suit their communities. Those who do adapt our materials negotiate with their own governments. We don’t normally work directly with other governments, though many large governmental health agencies use and distribute our materials.

Over the last two decades, the World Bank and International Monetary Fund have pushed many governments in the developing world to dismantle their social safety nets, including free health care. Have you ever encountered opposition or hindrances from the World Bank and IMF, or from First World governments, or from for-profit providers of Western medicine?

No, not that I know of.

What are some of your opinions about the present health-care reform debate in the United States?

Health care needs reforming, and as currently outlined in H.R. 676, with a single-payer system in which the government is the only health provider. In the United States, we could eliminate co-pays, deductibles, and employer contributions. At the same time, additional taxes would be added to individuals and employers (see the Healthcare-NOW website for a clear explanation of how H.R. 676 funding would work).

It is quite possible that the present recession will deepen, especially in the United States, while medical costs continue to escalate, and that there will be a sharp rise in the number of Americans without access to a doctor. If that happened, could individuals and communities in the U.S. implement the programs and approaches that the Hesperian Foundation has developed for the world's poorer countries? What would be the potential barriers and sources of opposition to such an approach?

Yes, absolutely, people in the United States could implement the approaches in our books, and some do already (people living on reservations, nurses, midwives, employees and volunteers at free clinics, travelers and sailors, professors of public health and environmental studies, ministers. . .). The only barrier is lack of knowledge and an unwillingness to change.

Is there anything you'd like to mention that I haven't covered?

• Most of our books are available for free download. We encourage you to print and share them.

• If anyone is willing to help us spread the word and spread health by posting a review, talking about our books on the radio, reviewing them in a magazine or newsletter, or by any other means, please contact Ingrid@hesperian.org.

• All profits from the sales of our books go towards printing, updating, revising, and creating more books, and also to our Gratis book program and Translations fund, both of which get health information into the hands of people around the world who might not otherwise have access to it.

• Give someone a present that really matters – send a gift of health to a poor community on behalf of a friend or loved one.

• We are currently working on a New Where There Is No Doctor for the 21^st Century, a new edition of HIV, Health and your Community, a Spanish translation of A Community Guide to Environmental Health, a Community Action for Women’s Health and Empowerment, and A Worker’s Guide to Health and Safety.

Making The World Sick, One Country At A Time

(Warning: this is a long post.)

The predicament that marks the probable end of our industrialized society has two stages. The stage most easily visualized by many of the first thinkers on this subject has its roots in the Limits To Growth scenarios first analyzed by the Club of Rome. Its most popularized images look like scenes from a dystopian science-fiction movie starring Charleton Heston or Will Smith or Mel Gibson or Harrison Ford – famine and the failure of technology; poisoned landscapes and cities with zombies running in the streets; “World of Warcraft” meets “Survivor” – in short, a “hard crash.”

However, there is a prior stage to the effects of resource scarcity: economic upheaval and contraction. The images that fit this are found in Dorothea Lange Depression-era photography; scenes from John Steinbeck's Grapes of Wrath; the Dust Bowl; tent cities; people losing jobs as the economy contracts; people being priced out of oil-based “necessities” as prices continues to increase; and people being thrown out of their homes, having their things repossessed and living under bridges due to “lack of sufficient funds.”

The second stage may be coming shortly, but the first stage is where we are now. The response to the onset of this first stage on the part of leaders in government and commerce by and large is as follows (there are, of course, exceptions): 1. A refusal to rearrange the social/political/economic systems under their control to make them more resilient in the face of the disruptions of Stage Two; and 2. A manic attempt to sustain their existing systems, which are unsustainable, and for which the writing is already on the wall. The leaders in government and commerce are now diverting all available public resources to this attempt to sustain the unsustainable.

Preparing for industrial and economic collapse in all its stages is therefore up to individual citizens. The captains of finance, economics and government will not institute the necessary changes, because such changes would reduce their power, prestige and access to wealth. This is why it's up to citizens. Yet the very nature and policies of the existing systems and their masters actively hinder the efforts of ordinary people to become resilient in the face of collapse. This hindrance comes either through government policies and laws that make resilience difficult, or through economic arrangements that bleed ordinary people dry so that they have no resources left for building resilience.

Such is the case with health care in the United States, that act of formerly selfless service embodied by the family doctors of decades ago and television doctors such as Dr Kildare, Ben Casey and Marcus Welby. This “service” has metastasized into a money-sucking “industry” so expensive that whereas the normal delivery of a live baby cost less than $100 in 1950, it now costs anywhere from $6000 to over $12000 today. According to one source, American national health spending is expected to reach $2.5 trillion in 2009, accounting for 17.6 percent of gross domestic product (GDP). Health expenditures are expected to increase at a rate of 6.2 percent per year from now to the year 2018, which is faster than even the most optimistic estimates of growth in GDP for this period. Part of the expense of American health care is due to exploding administrative costs. But there are other contributors, such as costs for prescription drugs that are rising at over twice the rate of inflation, cost increases for medical equipment and consumables, and inflation in employer-sponsored health insurance premiums which have risen at four times the rate of inflation during the past decade.

There's been much controversy this year over the possibility of Federally mandated health care reform. I really don't expect the Democratic or Republican Parties at any level of government to craft genuine reform of the sort that would lighten the economic burden for the recipients of that care. Some of our expectations regarding American “health care” may also be unrealistic, including the expectation that the Government can afford to pick up the tab for health care as it is currently practiced in the U.S. for all residents of the U.S. My suspicion is based not only on the unjustifiable rate of rise in American health care costs, but also on the fact that most of the wealth we could have devoted to equitable Government-backed health care and other safety nets has been squandered on covering the monetary losses of the rich. Our remaining tax revenues will largely be dedicated to servicing our large public debt, and the ability of our government at all levels to borrow additional money will shortly be severely curtailed.

I think it is also unrealistic for the masters of the health care “industry” - the doctors, hospitals, HMO's, insurance providers, drug companies and providers of medical technology – to expect that the system they have created can survive unbroken and unchallenged once almost no one but the rich can afford to use it. Already that system has priced 86.7 million Americans out of health care from 2007 to 2008. In 2008, at least 46.3 million Americans were without health insurance for a full year, according to the U.S. Census Bureau. In 2009 these numbers will only increase, due to the explosion of job losses, exhaustion of workers' unemployment benefits and continued escalation of insurance costs.

In short, I expect the nature and experience of health care to change drastically in the United States over the next several years. Increasingly, it will resemble the care provided in many Third World countries. Hopefully we will witness the adoption of some of the more beneficial and fair systems now operating in the Third World. Yet before we all rush to the countries of the developing world for inspiration and guidance, we need to see how the architects of the present American system of health care have attempted over the years to wreck viable, low-cost Third World alternatives. These attempts at wreckage were intended to protect and increase the revenue streams from the world's poorest people to the First World providers of expensive medical intervention and treatment.

The History of Western Medicine in the Third World

In his paper, “The Life And Death Of Primary Health Care,” David Werner writes that from colonial times until recent decades, the providing of Western medical service to the Third World was not equitable. The most expensive services were directed to the privileged, whereas health services directed at the “natives” were few, and were designed mainly to keep them healthy enough to work for the rich. But in the post-World War II era, there was a dawning awareness of health and health care as fundamental human rights. This led to efforts by rich countries to make Western medical practice more widely available in Third World countries.

However, this approach to expanded health care proved to be unsustainable, since Western medicine was too expensive even then for most Third World governments to widely support, or for indigenous peoples to use. This was partly due to the influence of budding multinational pharmaceutical corporations whose advertising induced a dependence on expensive treatments while eroding traditional forms of self-care. By the late 1970's it was widely recognized that the standard Western model of health care was failing in the developing world. This realization led to an international health care conference hosted by the World Health Organization in Almaty (formerly Alma-Ata) in the former Soviet Union in 1978.

Alma-Ata And Its Aftermath

The Alma-Ata Declaration of 1978 defined health as “a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity...” This declaration set forth this health as a primary goal to which governments should strive, and deemed existing health inequalities to be unacceptable. In order to achieve the goal of universal health, the declaration proposed a “Primary Health Care” which was defined as “...essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford ...”

The implementation of this Primary Health Care was to involve all major elements of community life, such as sanitation, the provision of safe and healthy food, access to clean drinking water, housing and other basic needs. Very importantly, this implementation was to be community-based, “...requiring and promoting maximum community and individual self-reliance and participation in the planning, organization, operation and control of primary health care, making fullest use of local, national and other available resources; and...developing through appropriate education the ability of communities to participate ...”

The Alma Ata Declaration was revolutionary its emphasis on addressing the root factors of health and giving ordinary people more control over their health and lives. It proved to be too revolutionary for the heads of the governments of the First World, who systematically transformed Primary Health Care into merely another program for extending conventional Western, top-down health services into the Third World. This was accomplished by the promotion of “selective” Primary Health Care by donor countries; by the increased shifting of costs of Western medicine onto end users (ordinary poor people) via “Cost Recovery”; and the takeover of health and social policies of Third World governments by the World Bank and the International Monetary Fund (IMF), which enticed many countries into taking loans with ruinous repayment terms, then forced those debtor countries to dismantle their social safety nets as part of their repayment.

One word on “selective” Primary Health Care: one of its initiatives was the so-called “Child Survival Revolution” that focused on growth monitoring, oral rehydration therapy (ORT) (for diarrhea), breast-feeding and immunization. The approaches implemented in this “Revolution” favored expensive treatments sold by pharmaceutical corporations – especially the pre-mixed ORT packets that were pushed instead of homemade foods and liquids.

The gutting of Primary Health Care as a viable option, combined with the World Bank's forcing debtor countries to dismantle government-sponsored social safety nets, led to a deterioration of health in the developing world. In addition, the World Bank has insisted on privatization of services formerly provided by governments, and has been an active agent in expanding the role of private health insurance in Third World health care.

American-Style Health Insurance – Coming To A Country Near You

Private health insurance is a very fast-growing worldwide market. The insurance “industry” is especially interested in the developing world, where it grew more than twice as fast as in the First World from 1994 to 2004. The promotion of private health insurance is especially attractive to the Organisation for Economic Co-Operation and Development (OECD), an association of thirty nations, most of whom are the richest in the world, and whose member countries are home to the largest multinational insurance and investment firms. One OECD study notes the extensive penetration of private health insurance in Latin America, while discussing strategies such as subsidized coverage in order to boost penetration in East Asia. However, even the authors of that study admit that the introduction of private health insurance “...might also lead to cost escalation, a deterioration of public services, a reduction of the provision of preventive health care and a widening of the rich-poor divide in a country's medical system.”

Private health insurance is threatening to displace other options, partly through advertising that seeks to induce dissatisfaction with public health care, and partly through the promotion by the World Bank of so-called “free market” policies and privatization of social services in Third World countries. In fact, since 1993 the World Bank has pushed a view of Third World health care as simply a means of enhancing worker productivity for economic growth – a view that is very similar to the colonial view of the purpose of medicine in the Third World: to keep the natives healthy so they can work for the rich.

Conclusion

Because of the power held by the medical and insurance industries in the United States, I expect that the present attempts by our leaders to “reform” our health care system will turn out as badly as the attempt by the WHO to implement the Alma Ata Declaration. As that declaration was thwarted by the rich, I expect that our health care “reform” will also wind up as simply another means of moving money from the pockets of poor people into the coffers of the rich. Ah, but that's what our health care system is already...

Sources:

• “Health Insurance Costs,” National Coalition on Health Care, http://www.nchc.org/facts/cost.shtml

• “Paying The Price: The High Cost of Prescription Drugs For Uninsured Americans,” Maryland Public Interest Research Group, http://www.marylandpirg.org/home/reports/report-archives/health-care/health-care/paying-the-price-the-high-cost-of-prescription-drugs-for-uninsured-americans

• “Employer-Sponsored Health Insurance Erosion Continues, Will Likely Accelerate Through 2009,” Elise Gould, Economic Policy Institute, September 2009, http://www.epi.org/publications/entry/jobspicture_20090306/

• “The Life And Death Of Primary Health Care,” David Werner, International People's Health Council Global Summit, 1995, www.healthwrights.org/.../Life_and_Death_of_PHC-Global_Summit_Sweden.pdf

• “Health for All Beyond 2000: The Demise of the Alma-Ata Declaration And Primary Health Care in Developing Countries,” John Hall and Richard Taylor, The Medical Journal of Australia, 7 November 2002, http://www.mja.com.au/public/issues/178_01_060103/hal10723_fm.html

• “Declaration of Alma-Ata,” International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September 1978, World Health Organization, www.who.int/hpr/NPH/docs/declaration_almaata.pdf

• “Rich Countries and World Bank Must Stop Pushing Privatized Health In Poor Countries,” OXFAM International, 12 February 2009, http://www.oxfam.org/en/pressroom/pressrelease/2009-02-12/rich-countries-world-bank-must-stop-pushing-privatized-health-to-poor

• “The IMF And The No User Fees Policy In Health,” Sandra Graham, Jamaica Observer, 15 August 2009, http://www.jamaicaobserver.com/columns/html/20090814T200000-0500_157495_OBS_THE_IMF_AND_THE_NO_USER_FEES_POLICY_IN_HEALTH_.asp

• “Private Health Insurance for the Poor in Developing Countries?”, Denis Drechsler and Johannes Jütting, OECD, August 2005

• “Is there a role for private health insurance in developing countries?”, Denis Drechsler and Johannes Jütting, German Institute for Economic Research, October 2005

Intermission - September 2009

I will not be posting anything heavy this week. Instead, I'm taking a bit of a break. However, I hope to have another post for you all next weekend, followed by another short break. Thanks for all your readership and comments so far.

In the meantime, some of you may want to check out Trimet Confidential (http://danbusdriverman.blogspot.com) to get a taste of public transit through the eyes of a bus driver. Trimet Confidential is written by Dan, who is a follower of my blog, The Well Run Dry. (Fortunately, my transit trips usually aren't nearly as exciting as some of his stories.) One day, I hope to run into Dan the Bus Driver Man. I'll get on his bus, show him my transit pass and say to him, "Are you Dan? I am TH in SoC..."

The Secret Lives Of Wage Slaves

There's a Russian church near my house, to which I have paid occasional visits over the last year or so. On one of my visits, a recently married young man volunteered to translate for me. (A good thing, since my Russian is rather horrible – almost nonexistent, in fact.) After the service, we got to talking and he found out that I play guitar. So he asked me if I could teach him. I told him that I'd be glad to teach him – for free. Thus he has been coming to my house once a week for the last several weeks to learn.

I'm a big fan of learning the fundamentals of music, including learning to read notes in standard notation. This is something that many guitar instruction books and teachers gloss over, preferring instead to teach a few chords and the tabs (tablature) to a few American pop hits. On the other hand, what I have been doing with my student is to teach how to read notes on the musical staff and how to play them in first position. Later, we will hopefully move on to more fun stuff.

My student does not mind my approach, and in fact he seems eager to learn. But last week, I have to admit that he sounded like he hadn't been practicing as much as he should. We have covered all six strings in first position, yet when he was playing the short version of “Spanish Study” in Frederick Noad's black Solo Guitar Playing book, he was missing some of the notes on the lower three strings.

So why wasn't he practicing as he should? Was it because he was losing interest? Was it because I was a boring teacher? Or was it because of his job, which involves on-site customer service for office equipment, and which had forced him to be on the road from 7 in the morning to 7 at night on the day he came to my house? And is it reasonable to suppose that his job regularly requires such long hours?

Why work so hard, one may ask. That's a very good question. Maybe it has to do with the fact that our cost of living is so elevated, even now. My friend is a renter. Rent for a one bedroom apartment in our town runs over $1,100 a month according to this source: Portland, Sweet Sixteen? For Singles. Rental homes cost around $1200 a month on average, although some smaller homes can be had for around $900. My friend rents a house, but I haven't asked him how much he pays each month.

(I have another neighbor, with a wife and young son, who lives very near me in Portland, yet works in Salem. He's on the road before the sun rises, and when he comes home on weekdays, he has time only to eat and get ready for bed. He's hemmed in by his circumstances, with a lack of other jobs of his type to which he could easily transfer. He's been trying to sell his house so he can move closer to where he works, but selling is next to impossible in these times.)

My guitar-learning friend also needs medical insurance, I am sure. This is especially true because of his wife, who will one day have a baby, I suppose. I've heard that having babies can be quite expensive ($6,000 to $8,000 for a normal delivery and $10,000 to $14,000 for a caesarian section if you're not insured, according to this source: http://pregnancy.thefuntimesguide.com/2009/01/cost_to_have_a_baby.php). Even those with insurance must pay over a thousand dollars for a delivery. By the way, in 1950, the cost for a normal delivery was eighty-six dollars and thirty-three cents. (Source: The Cost of Having a Baby... in 1950) The American infant mortality rate was lower in 1950 as well.

My friend drives a relatively new car. It's not an extravagant car by any means, yet it is the sort that a man would buy if he was starting a family. I know that such cars are not cheap. If a man wanted to buy a “family-mobile” like a 2009 Honda CR-V, for instance, he'd have to pay around $22,000 for a base model. With a 48 month loan and interest rate of 8.25 percent, monthly payments would run around $540 a month. And that doesn't count insurance, or the spike in operating expenses that will come once oil resumes its rise in price. (This is one reason why a car-dependent society is such a bad idea.)

Housing, health and transportation costs are just three examples of how people like my acquaintances are being squeezed by a predatory economic system whose masters seek to make all necessities as expensive as possible in order to maintain their profit margins. But that system has nibbled away at the working class in other ways, namely, in the stagnation or actual decline in worker wages even as worker productivity rose in the period from the 1970's until now. (Sources: http://monthlyreview.org/0607wkt.htm; http://washingtonpolicywatch.org/2009/03/12/looking-past-the-banking-crisis-stagnating-real-wages-part-1-of-3/ and http://www.dailykos.com/story/2009/5/21/733001/-No-Sustained-Economic-Growth-without-Real-Wage-Growth, to name just a few.)

The average salary for white collar workers in the U.S. in 2005 was $39,629 according to the Bureau of Labor Statistics. However, many people with technical degrees earned significantly more than this. (Of course, many of their jobs are now vanishing.) If we assume that my friend has a bachelors degree from an accredited university, he can expect to earn a million dollars more over his lifetime than someone with only a high-school degree – at least, that's what most advocates of higher education say. But what with the inflation of tuition costs over the years, at least one source (http://www.aei.org/outlook/100034) claims that this million-dollar figure should really be whittled down to around $120,000. Of course, all depends on what subject your degree is in. If my friend took out student loans to finance his tuition, he's probably still in the hole today. (See also Wikipedia, http://en.wikipedia.org/wiki/College_tuition#Hyperinflation_of_college_costs.) For what it's worth, I don't think my friend has had much post-secondary education.

As the prices of key necessities continue to be artificially inflated while the real earning power of working-class people continues to decline, those ordinary people who continue to rely on the system of the “official” economy begin to resemble children clinging for dear life to a merry-go-round that's spinning faster and faster out of control. Those who fall off or let go are dashed cruelly to the ground, yet to keep hanging on requires all one's time and strength. The merry-go-round is on the verge of breaking, yet those who are still hanging on have no energy left for learning to adapt to life without the merry-go-round. There's very little strength or time left for learning skills like gardening, or for beginning the steps of adaptation to economic collapse. In fact, there's not even time to learn to play the guitar.

Citizen Media - The Stories We Must Tell

We come on the ship they call the Mayflower,

we come on the ship that sailed the moon;

We come in the age's most uncertain hours

and sing an American tune...

– Paul Simon, American Tune

As I have said in previous posts, corporate media is a tool of the present masters (owners of the major pieces) of our economic and political systems, and is used by these masters to enforce the present status quo. This is done by telling the story of the rich as if it was the only legitimate story, by marginalizing the stories of the poor, and by suppressing any dissent to the present system. Thus corporate media is unwilling to accurately depict the failings of and threats to the prevailing system, or to state the need for alternatives that threaten the power of the masters of this system.

So we hear of green shoots instead of plain evidence of continued economic collapse; Peak Oil is never discussed; major newspapers write editorials against genuine health care reform; and the threat of man-made climate change is not publicized. When alternatives to the present system are discussed, their discussion in corporate media is frequently in disparaging tones (as when describing those “frugal doomer/survivalist loonies riding bicycles and raising chickens!!!”). When the rich prosper (as in stock prices rising due to corporations cutting costs and returning dividends), this is held up as a sign that the economy is recovering – even though hundreds of thousands of ordinary people are still being thrown out of work each month.

When left to itself, corporate media ignores the stories of the exploitation of the poor by the rich. When the poor rise up against such exploitation, their action is either not covered at all, or is too frequently called “agitation,” “terrorism,” “militancy,” or some other derogatory term. Corporate media portrays certain segments of humanity unsympathetically in order to legitimize the robbing, exploitation and general mistreatment of these segments by the rich masters of First World society.

Citizen media is a countermeasure to all of this, a weapon by which the poor and powerless can defend themselves. Citizen media is the means by which we can tell our story when no one else will. Here are some stories we should be telling:

• The general stories of our communities and of the people in them. This is especially important for poor people and minority neighborhoods. When mainstream America sees that we are just as human as the subjects favored by the media, they can't easily oppress us in good conscience. They can't so easily write our neighborhoods off as merely another “high-crime” area or “blight district.” Create a biographical sketch of the people of your place, of their hopes and fears and struggles and humanity.

• The things we are doing to make our communities a better place. This includes not just general betterment, but also steps to make our places resilient in the face of economic collapse and resource constraints. Show the world your care for your place by showing the investment of time and effort that you are putting into your community.

• The actions taken by some of our economic and political masters to break our neighborhoods, destroy our resiliency and exploit us. By publicizing these stories, we make it harder for the big people to get away with what they are doing. Talk especially about the things being done by the big guys (both corporate and governmental) to thwart the things ordinary people are doing to make their communities better and more resilient.

These stories must be told in a format that is of high quality, regularly updated and readily accessible. This will mean hard work for would-be citizen journalists if they want to turn out a quality product. (I can testify that trying to write a quality blog is hard work! It takes a serious investment of time.) But those who rise to such a calling will find that it's quite rewarding. A case in point is the example of Ralph Kennedy and those with him who founded the Fullerton Observer, a local independent paper based in Fullerton, California. The Observer is available both in hard copy and on the Web as a free download. I recently asked Ralph's daughter Sharon Kennedy for some background information on the Observer as well as thoughts on running a community newspaper. Here is her response:

“The Observer was started on a shoe-string by a group of friends after the OC Register bought up the local hometown paper (and 31 others) and turned it into an advertising rag. The friends each had their interest in a certain part of the town such as city hall, police relations, homeless issues, affordable housing, transportation and bike trails, education, keeping some open space, etc. or accomplished other tasks such as pasting up (before computers), driving to the printer, picking up the papers and distributing them.

“Each reported on meetings and happenings around town on their issue and each contributed money to the paper for years before it became self-sustainable. Over the years the paper has had an influence on numerous issues and has made the town of Fullerton, one of the better towns in OC. It also created a sense of community by offering citizens a place to sound out and find others with the same concerns. And since it is read by Fullerton officials, these concerns reached city hall in a different way and built support or opposition which improved our town in one way or another. The paper helps keep officials and institutions accountable to the people of the town.

“The paper also served local entertainment by letting people know what was offered right here in town and local businesses by providing inexpensive ad space so they could offer their services and products. It is a very rewarding all-volunteer community written paper which makes it unique. All towns used to have a hometown newspaper. Another effect of the paper has been to make the OC Register have to create a more adequate version of the Fullerton paper they bought. My father, the founding and longtime editor Ralph Kennedy felt independent newspapers are necessary for a healthy democracy.”

One final note is in order. Citizen media now relies heavily on Web-based tools such as blogs. But we must also begin to look beyond the Web to other means of cheaply and easily broadcasting our stories. This is especially true now that the freedom of the Web in America is coming under increased scrutiny from the United States government (as in the proposed Cybersecurity Act of 2009). Of course, the governments of several other nations, including China and Iran, are already trying to restrict the freedom of Internet communication for their citizens. Therefore we must not put all of our citizen media eggs in one Web basket.

Citizen journalists may therefore need to rely more exclusively on “old-fashioned” means of distribution such as hard-copy community newspapers. But there are other means of sharing electronic media beside the Web – especially with the availability of cheap memory sticks, CD burners, and such. We may see the revival of the “sneakernet,” as described in the following link: http://www.lowtechmagazine.com/2009/02/sneakernet-beats-internet.html.

Citizen Media In Action - A Few Examples

Here are some links to citizen media in action – namely, citizen video being used to publicize important issues and to defend groups of poor and marginalized people now threatened by our official economy.

• “Minnesota Homeless Denounce Health Care Cuts...on YouTube!”, Allvoices, http://www.allvoices.com/contributed-news/3924443-minnesota-homeless-denounce-health-care-cutson-youtube. Evidently, activists with cameras are teaming up with homeless people in the Twin Cities area to raise the issue of lack of medical care for the poor. This is a fitting antidote to the spectacle of shouting right-wing shills at “town-hall meetings” now being shown by the mainstream media. There is a link at the bottom of the article that allows people to see all the YouTube videos produced by the homeless advocacy group.

• “Homeless fight back with high tech,” St. Petersburg Times, 2 February 2007, http://www.sptimes.com/2007/02/02/Southpinellas/Homeless_fight_back_w.shtml. This story is a bit old, yet it shows how homeless people were able to fight the breakup of their encampment by shooting video of police actions using cheap, disposable, 2007-vintage digital cameras.

• “Jailers Accused of Forcing Recorded Inmate Boxing Matches,” Inmatesworld, http://www.inmatesworld.com/news/weblog/1441.html. It appears that last year, jailers at the Grant County Detention Center in New Mexico forced inmates to engage in multiple boxing matches with each other (yet another evidence of the corrosive effect of our prison system on the prevailing American culture). The jailers were caught and indicted due in part to videos taken by a cell phone belonging to one of the jailers.

• “Citizen Videos Spread Online Showing BART Police Officer Shooting Unarmed Man To Death,” boingboing, 6 January 2009, http://boingboing.net/2009/01/06/citizen-videos-sprea.html. This was an horrific event; yet the good thing about the abundant citizen video is that the wicked man wearing a police uniform – the man who committed this murder – now has no cloak or excuse for his deed.

Lastly, allow me to introduce a term many readers may not have encountered before: “sousveillance,” which can be loosely translated as “watching from underneath.” Sousveillance is inverse surveillance in that, as surveillance is typically understood as the watching of ordinary citizens from above, that is, by people in positions of power, sousveillance is the watching of the holders of power by ordinary citizens. It is the act of keeping tabs on people in high places and their agents, by those who are underneath. Sousveillance is a form of self-defense for poor and working-class people.

Most of us can now engage in a bit of sousveillance, due to the availability of cheap yet capable digital cameras and cell phones with video capture capability, along with YouTube and blogs in which video can be embedded. And there are vendors selling digital cameras optimized for output to YouTube (see the Slippery Brick review of an entry-level camera: http://www.slipperybrick.com/2009/08/casio-ex-z33-digital-camera/). And for a more in-depth discussion of sousveillance, see these articles: http://wearcam.org/sousveillance.htm, http://www.nytimes.com/2006/12/10/magazine/10section3b.t-3.html and http://www.sousveillance.net/.

* * *

Some other items: I have taken a few more steps to reduce my dependence on the breaking systems of the official economy and its energy sources. This week I got LASIK surgery. So far, everything seems to have turned out fine, and hopefully I'll never need glasses or contacts again. I am also superinsulating my house. (Sooner or later I've got to finish building that chicken coop...) It's good to make oneself resilient and to prepare oneself for doing without, as I think most of us are going to have to do without shortly.

Our office had warned me that I might be laid off. That was over a month ago. Yet miraculously, work has continued to dribble in. I feel a bit like a man on death row who's been given an all-you-can-eat buffet ticket for his last meal, and who likes to chew a hundred times before swallowing each bite. Anyway, I still have a job...

Dave Cohen of the Association for the Study of Peak Oil (ASPO-USA) has written a really interesting article about the huge inequality in income between the richest 10 percent of Americans and the rest of us. It's titled, “The New Gilded Age,” and it can be found here: http://www.aspousa.org/index.php/2009/08/the-new-gilded-age/. It's a good read if you want to see yet another example of our thanatoeconomic system and how the fortunes of the rich rise whenever the livelihoods of the rest of us are taken away.

Telling Your Story As Self-Defense - Necessary Tools

I'd like to rejoin a theme I first took up in my post titled, “A Safety Net Of Alternative Systems - Citizen Media.” That post dealt with the fact that most major media outlets in the United States are owned by a mere handful of very rich corporations, who have a vested interest in presenting a view of life in this country that does not line up with reality. Rather, what they present is designed to maximize profits for advertisers and to support the policies of those who hold political power. Therefore they tell us that “most Americans don't support single-payer health care,” or that “the economy is turning a corner,” or “the signs show that the recession is ending,” or “green shoots of economic recovery are starting to sprout.”

Yet there is a much harsher, grimmer, contrary reality inhabited by a large and growing population of Americans. Millions of us are on the verge of experiencing this reality, or have already begun to experience it. Although the mainstream media occasionally covers some of its less controversial aspects, there are stories that are almost never probed by any mainstream news outlets. Many of these stories deal with the barriers created by governments and corporate masters to prevent ordinary people from becoming resilient in the face of economic collapse, and the ruin that comes to ordinary people as a result.

These stories must be told. Telling these stories – as loud as possible, to as many people as possible – is one of our best defenses against the system of predatory capitalism in which we live. The widespread telling of such stories makes it harder for the rich to get away with continuing to prey on the poor. In my earlier post on citizen media, I talked a bit about how ordinary people can tell their stories, as well as the digital tools they can use to get their stories out to the public. In today's post, I'll talk a bit more about tools for capturing the real stories we see happening all around us.

The importance of pictures

We've all heard the cliché, “A picture is worth a thousand words.” In reporting controversial or contested events, pictures serve as an important element of verifying the truth. For instance, the abuses of Iraqis by American soldiers at the Abu Ghraib prison in Iraq were documented in pictures taken by cell-phone cameras. (Source: http://www.textually.org/picturephoning/archives/cat_the_military_and_iraq_images_and_issues.htm)

If a still picture is “worth a thousand words,” videos are worth much more. Videos capture incidents as they are happening, and they can do so in such a way that there is no room for alibis for perpetrators of evil deeds. This is very important when the perpetrators of evil are agents of the government. Some good examples of video capture of government evil are the video of the Rodney King beating, the videos of the G20 protests (including the one which showed British police attacking Ian Tomlinson), and the videos of the recent Iranian protests. Of course, the most effective videos have reasonably high resolution and high quality. Shooting such videos requires suitable equipment.

Tools for video capture

What qualities should should a citizen journalist look for in a video camera? Such a camera should be rugged (or at least not fragile), unobtrusive, and easy to use without having to read a lot of books. It should provide clear images, moderate to good low-light capture, adequate optical zoom, and smooth video (in other words, not excessively jerky). And it should have a low price. Nowadays there are many video capture devices available, including cell phone (and iPhone) cameras with movie capability, “point and shoot” digital still cameras with video capability, and actual camcorders. How do these devices measure up?

I was thinking hard about this question around three or so weeks ago, when on a sunny Saturday afternoon, my own camera came to mind. It is a Sony Cybershot DSC-W70 with a 7.2 megapixel sensor, and I bought it in 2006 for under $200. I have been entirely satisfied with its still picture capabilities including low-light picture taking. But I had tried capturing video in low light shortly after I bought it, and noticed that it could only produce extremely grainy videos below a certain light level (not good if someone had to shoot an outdoor nighttime scene). I decided to see how it did in broad daylight.

On my front porch, I did a couple of panoramic sweeps, including one in which I captured one of my neighbors pulling out of his driveway and going down the street. Then I captured a kid on a skateboard passing by. The neighbor and the kid were at least thirty feet away from me at the point of closest approach. Then I uploaded the video to my computer.

As I watched the video, I noticed that most objects were broadly recognizable. I could read the license plate on my own vehicle in the driveway, which was about eight feet from me. However, I could not read the license plate number on my neighbor's car as he pulled away, nor could I recognize the face of the skateboarding kid, whose motion was rather jerky in the video. Also, though the camera allowed for changing zoom during still picture capture, the zoom was locked while recording video.

It seemed that my camera's limitations would prevent capturing video of the quality seen from citizen journalists who covered the G20 protests. Would such video require a camcorder? Or were the video capabilities of digital still cameras evolving to the point where they could compete with camcorders? I decided to visit a digital photography store to find out.

My Interview at Pro Photo Supply

Armed with questions about citizen media and digital video, I called on a few stores to arrange an interview. One store unfortunately only sold film cameras, and another store which is part of the Ritz Camera chain was unwilling to take time for an interview. Then I called on Pro Photo Supply, a locally owned, well-stocked digital photography store located in northwest Portland. (By locally owned, I mean that not only is the store in Portland, but so are the owners.) There I met with sales associate Judd Eustice, who was very helpful and knowledgeable.

We talked about modern camera trends, which are leading to the eventual creation of a one device that can do both still picture and video capture, and can do both well. At this time, there are camcorders that can provide single frames, as well as camcorders with a dedicated “still photo” button. Their still image quality is not yet at the level of some of the better point-and-shoot digital still cameras, but it is adequate for most work. As an example, Judd showed me a Canon consumer camcorder (I think it was the FS21) with flash memory that sells for around $450. This camcorder has the “still photo” button and a decent optical zoom. It is also relatively small, though it's too big to be “pocket sized.” And it has the ability to receive audio signals from external microphones.

We compared this to a Canon digital still camera with HD video capability, the SX-200IS. This camera has an optical zoom of up to 12X, and is advertised as being able to take HD quality videos. It sells for around $350. We checked out its long-distance zoom capabilities. Faces viewed from around 30 to 40 feet away were recognizable, but a bit blurry. (Also, another reviewer noted that the zoom is locked and can't be changed while shooting video.) As far as low-light capture, it has an ISO 1600 rating. It also seemed a bit more rugged (and far less obviously noticeable) than the Canon camcorder.

Canon is by no means the only manufacturer worth consideration. We also talked about Ricoh and Panasonic cameras. And Judd also showed me an example of video capture using an iPhone.

So is there a single, relatively inexpensive ($350 and under) digital device that can capture both still pictures and video, at decent distances and in most light conditions, and that can do these things adequately? Answering that question is partly a matter of individual judgment. If you're in the market for a new camera or camcorder, I'd suggest the following tips for checking out a camera or camcorder before leaving the store – try it out, ask if you can upload images to a store computer to see how they look, try going to the store at night and shooting a low-light scene, then make your decision.

And don't count the cell phone out as a video capture device; even though it has its limits, it can still be quite useful, as seen here: http://www.youtube.com/watch?v=id3C8GC78dA. (Although the resolution of distant objects is not very good in this video, it is still possible to identify the general features of the police who are abusing an emergency medical technician.) And don't count older digital cameras out, either. My Sony Cybershot camera's video and audio quality is at least as good as the Youtube video of the police assault which I just mentioned.

For more on capturing digital still pictures, there is an excellent essay titled, “Digital Cameras for Cyclists” by Carsten Hoefer at crazyguyonabike (http://www.crazyguyonabike.com/doc/?o=3Tzut&doc_id=5447&v=CQ). (By the way, bike tour journals are a form of citizen journalism. Camera needs for touring cyclists are likely to be the same as for other citizen journalists). And for emerging legal barriers to citizen video, check out these links: http://arstechnica.com/tech-policy/news/2009/01/congress-gets-bill-to-make-cell-phone-cameras-go-click.ars, http://carlosmiller.com/2009/01/28/the-war-on-cell-phone-cameras-begin/ and http://thephoenix.com/boston/News/56680-Echoes-of-Rodney-King/.