Slums

Connection with Health

Slums may be the most important single measure of the health of the world’s economic practices. If a significant portion of human beings are living in filth, disease, and squaller, then the economy of the world is not in a state of health regardless of anything that GNPs or economic growth figures might show. Measured by this yard stick, the neo-liberal policies that the “Washington Consensus” has forced on the world are not simply a failure. They are an unmitigated disaster. A health disaster.

When a physician assesses the health of an individual, he or she does not say, “never mind about the brain cancer; the heart and lungs are healthy.” Slums are the visible cancerous tissues in a world that may be terminally ill. It matters little that there are more countries now where people can drink coffee at Starbucks or grill stakes in their walled off enclaves. A world divided into slums and gated communities is not a world in a state of health.

Issues

The moral interpretation of slums

In a variety of ways – some subtle and some not so subtle – the existence of slums is presented as a function of the moral inferiority of its inhabitants. The inhabitants live in slums because they are violent, irresponsible, lazy, and/or addicted to drugs. No doubt one finds lazy and irresponsible people in slums just as one finds them in the upper echelons of society. But the core issue with regard to slums is that the inhabitants cannot find jobs that provide a living wage. Most of them would be overjoyed at the prospect of jobs that enabled them to provide a descent life to themselves and their children. Many of them work very hard at low paying and unrewarding jobs that simply do not provide them a way out of the economic trap they are in.

The brutality of removing the safety net

When people are forced into homelessness and poverty by economic and natural forces beyond their control the humane and decent thing for a society to do is to provide them a safety net – a system of services that will provide them with at least the minimum that is needed for health and survival. One of the more brutal agendas of the Washington Consensus has been the prevention of adequate safety nets in Third World countries and even in the United States. This hostility toward safety nets is based on two concerns: 1. That wealthy individuals and corporations might be taxed to provide for the safety net. 2. That the existence of a safety net would mean that the multi-nationals and other businesses would have to provide a living wage and tolerable work conditions in order to motivate rational people to do their work. In the meantime, the absence of a safety net has been the cause of untold disease and suffering of people of all ages throughout the world.

The central importance of clean water and disposal of wastes

The lion’s share of health changes in slums and in the Third World in general are not going to be the outcome of the application of sophisticated medical procedures or subtle technologies of any kind. Above all else three things are needed. The first is clean water. The second in an adequate system of garbage disposal. The third is an adequate sewage disposal system that allows people to urinate and defecate with dignity and without polluting their environment. These are the factors that produced the biggest reduction of disease and biggest increase in life expectancy in developed nations. They are the same factors that will accomplish these ends in the Third World.

Governments have the responsibility to provide access to clean water, sewage disposal and garbage disposal for all their citizens. To force the privatization of these services in the slums of the world is criminal. Whatever the motive, such policies serve as a form of genocide against the poor.

Infectious diseases remain the overwhelming health problem in Third World slums. Clean water and sanitation are the first lines of defense against such diseases. This defense must be provided as a right to all citizens even if it means implementing a progressive tax structure to implement it.

The slum as an exploitable resource

For multinationals slums are not only not a problem; they are an asset. Slum dwellers who are in desperate circumstances are willing to work for next to nothing, with no questions asked about medical insurance, benefits or an adequate wage. Sweat shops thrive in slums where businesses can get labor intensive tasks done for next to nothing, making inexpensive products and huge profits for business possible.

The illusion that self-help will solve the problem

One of the popular fictions of the neo-liberal position is that the dynamics of the free market will by themselves solve the economic problem in the slums as entrepreneurs rise from poor classes to create the wealth needed to lift the slum residents out of poverty. Governments need not regulate businesses nor even provide for the development of an infrastructure of roads or services. They need not provide for affordable housing. They need not provide universal health care. Indeed, governments need not even provide for clean water or adequate sewage disposal. The unfettered market, like the invisible hand of God, will do all this. Such has not turned out to be the case.

The illusion that "charity" is the answer

Charity serves a number of functions in economies based on neo-liberal policies. It defuses the energies that the poor might direct into demanding the needed changes in the system that would make self respect and a fair chance in life a right. It perpetrates the illusion that a cruel and ruthless system based on unrestrained greed is really a compassionate system. The wealthy want to enjoy their plunder with a clean conscience. Charity also ensures that their is minimum participation of the poor in the distribution of goods and services and little chance that the status quo will be changed. The Pentagon does not depend on bake sales or the largesee of a few wealth individuals to underpin its budget. Neither can access to essential health, educational and social services be reliably provided for in this manner.

The place of illegality in the "New World Order"

A great show is made of keeping illegal aliens out of the country, and of preventing children and other illegal workers in the slums from earning any money. Middle class workers may in fact resent illegal workers, and may patrol the boarders to try to keep them from crossing. But illegal labor – either in slums or crossing the boarders – is a boon to business. Illegal workers are absolutely powerless. They cannot collectively bargain for increased wages or benefits or complain at any outrageous actions that are taken against them by business. They are, from a business persons perspective, the perfect employees.

Connections to other topics

Access to resources

The primary hindrance to accessing services in rigidly capitalist countries is lack of money. A large proportion of the population simply can’t afford medical insurance. Certainly poor people cannot afford the costs associated with any major illness. That adequate medical services can be provided in an affordable way through a government program even in a very poor country has been well demonstrated by Cuba.

Often one is faced with choices between cost and quality when choosing how to provide services. This is not true with regard to health services. Universal health care made available by the state has been shown to be both cheaper and of higher quality than that provided by a privatized system – even for the wealthy.

Diseases

That diseases of all kinds flourish in the crowded and unsanitary conditions found in slums is abundantly documented by many sources. Here perhaps what should be most emphasized is the central importance of infections diseases. Most infections diseases are no longer life threatening to people who live in sanitary conditions with adequate access to medical services. These diseases are, however, still major killers in slums.

Ecology

Slums develop their own ecological patterns that are quite damaging to their residents in a variety of ways. In addition they have a large and negative impact on the larger environments around them.

Equity

The existence and increasing size of slums all over the world, in contrast to the wasteful consumption consumption that one finds in gated communities is perhaps the strongest statement one can find about the growing inequity in the world and its ugly consequences.

Global economics -- debt relief

The issue of debt has for a long time been the point of leverage that has allowed wealthy countries to dictate to the poorer countries policies that are clearly not in their interest. Given the long and brutal history of colonization, which the United States is attempting to continue in slightly altered forms in the Middle East and elsewhere, the real bottom line with regard to debt is clear: the former colonizers owe the previously colonized nations more that they will ever be able to re-pay. The complete cancellation of the debts of the poor countries would be a good beginning.

Water

The central importance of clean water to health has already been highlighted. The privatization of water is one of the most destructive polities of the IMF and the Washington Consensus.

What Can Be Done?

The problem of slums is huge and overwhelming. It is an understatement to say there there are no easy solutions. But perhaps something can be done even now at a time when the multinationals with their neo-liberal philosophy seem to be firmly in control of everything. There are a number of myths that serve to justify and perpetrate the slums. These myths need to be aggressively attacked wherever and whenever they are encountered – in conversation, in on-line discussions, in the local newspaper, or in journals.

The idea that slums owe their existence to the moral inferiority of their residents rather than to economic factors that are beyond any individual’s control is perhaps the most important of the myths that perpetrate the continuing failure of governments developing policies that might lead to real change.

The idea that hard working and creative entrepreneurs from the slums will somehow solve the problem through the magic of the free market is another myth that serves to justify inaction.

The idea that the charity of a few good-hearted rich people will suffice to correct the situation is a third pernicious myth that needs to be aggressively challenged.

Finally we have the “old rags to riches” myth that is so popular in the United States. Anyone who is willing to work hard, and truly wants to better him or her self, can. Not true. It is true that a limited number of slum dwellers do become small time entrepreneurs and succeed in “bettering themselves” economically. However they have generally done so at the expense of others in the slums. These entrepreneurial efforts in slums seldom if ever allow for the accumulation of sufficient capital to create slum based businesses that pay a living wage. What they do succeed in doing is the create further inequity in the slums and divide the community against itself so that it lacks the solidarity to pursue its real interests.

Dispensing with these myths will not, by itself, lead to the needed changes. But at least it will clear to ground for a consideration of those structural and economic policy changes that may actually make a difference.

Changes in the world must begin with changes in thinking. With regard to slums, the needed changes in our thinking must begin with an attack on those thoughts that serve to justify that which is in no way justifiable.