The evidence from all OECD countries shows that the private sector is far more bureaucratic and much less efficient than the public sector when it comes to providing health care.
Ten Health Care Myths
Gentlemen from Hooker - and many other places - are quite literally pouring these and many other poisons into your coffee and your kids' juice. They just do it in a more indirect, anonymous, and apparently socially acceptable way.
150 Years of Dirty Water
A coal miner who took part in the wave of strikes which shook the
former Soviet Union summed up the problems facing his local strike
committee as follows: "`We have to answer two simple questions:
`How are we going to live?' and `What do we do now?'"
Those are questions we all have to answer. We live in a world in crisis. Governments, corporations, and institutions assure us they have everything under control, and that better times are just around the corner, but all around us we see poverty, violence, injustice, environmental disasters, and wars.
For more than a decade, they have imposed a new-right agenda on our societies, telling us we have no choice but to adapt to a `new world order' based on `free markets' and privatization. Instead of experiencing the promised benefits, however, most of us find ourselves worse off, economically, socially, and spiritually.
Most of us are not living the lives we would choose to live, but the existing order insists there are no alternatives to itself, and most of us are sufficiently convinced or pre-occupied or discouraged to keep society from coming unglued. Many, many people wish there were alternatives, or think there ought to be, but are resigned to the conclusion that it is utopian to entertain any hopes for real change. The `system' is too big, too powerful, and we are too weak and too few in numbers.
`What do we do now?' `How do we live?' All too often, we mind our own problems and don't think about the rest.
Yet despite the pervasive feeling that `nothing can be done', people do join together to act in common when they feel threatened or wronged, or when they have a goal in sight which they desire passionately enough. Sometimes they organize quietly and gradually. At other times a mass movement explodes into being, seemingly out of nothing, despite the risks and the odds.
This Annual is dedicated to the idea that change is both necessary and possible. Its main intent is practical: to provide information about groups across Canada who are working at society's grassroots to create positive solutions to social, environmental, economic, and international problems.
We hope that by providing this information we will be making it easier for those already active to find out about and contact each other and to do their work more effectively and co-operatively. We hope that those individuals who are thinking about or looking for ways to become active will be able to use the information to find like-minded people to work with.
We hope, too, that this book will help to get out the message that there are viable alternatives to destructive and exploitative institutions and structures, and that there are people organizing to build those alternatives.
It is also a goal of this Annual to stimulate thinking about how we can work more effectively together toward our mutual goals, and how we can reach out to broaden our movements. If we can learn to do this well enough, we have the potential to create a much more powerful social movement, not only national but international in its scope, one that goes beyond single-issue organizing to work toward an integrated vision of a more just and caring world.
This does not necessarily mean that individual groups should be dissolving themselves into a large movement. But often the best thing we can do to help ourselves is to help someone else. By offering and extending solidarity to others, we establish bonds between us that give us strength too. Feelings and actions of solidarity can be a fruitful source of understanding, trust, and power, and that power is something that we too can draw on too.
Empowerment is a critical dimension of the process of change. We are seeking the power to create alternatives, and simultaneously we are seeking to dissolve the power structures that prevent us from doing so. We hope that this Annual will help to empower those working to create the alternatives.
Introduction to Arts, Media, Culture
The established wisdom has it that the media are neutral purveyors
of news and entertainment, while the arts are about individual creativity
and cultural values untainted by the vulgar concerns of politics
However, the experience of those outside the cultural mainstream is rather different. There, it becomes apparent that the arts and the media do reflect the biases and distortions of the wider society.
Working class people, women, people of colour, Native people, lesbians and gays, find that their lives and experiences are distorted or ignored, their voices too frequently unheard. Artists with an alternative vision have great difficulty penetrating the deadening homogeneity of the commercial arts marketplace. Those critical of the status quo have little access to the mass media. In every sphere -- television, film, radio, the record industry, publishing -- a few giants in the media and the cultural `industries' are almost totally dominant. The saying ``freedom of the press belongs to those who own one'' reflects the reality well, and not only where newspapers are concerned.
The situation might be compared to a huge sports stadium. Everybody is free to have their say -- so the dominant ideology claims -- but the established system owns and controls the loudspeakers, the video screens, the action on the field, the rules of the game, and the stadium itself, while we, the people in the stands, have only our unamplified voices with which to make ourselves heard. Not exactly a ``level playing field''.
And then, what happens if we decide that we don't want the game at all, let alone the existing rules? What do we do if we decide that we don't want to sit in a stadium, subjected to loudspeakers, watching someone else's game?
What if we want to transform the stadium into a park and talk to each other and play our own games instead of watching?
The groups in the Arts/Media/Culture chapter of the Connexions Annual are responding to such questions.
Some of them are challenging the cultural and media establishments to make them become more representative and more honest. Others are fighting for Canadian cultural survival in the face of market pressures and government legislation that threaten Canadian magazines, the CBC, and other cultural industries.
Many others have taken the route of creating their own alternatives. Here you will find alternative radio stations, magazines, theatre groups, book publishers, filmmakers and distributors giving voice to points of view that challenge the dominant culture. There are groups devoted to creating space for women, blacks, Native peoples and others who have little access to the mainstream. Groups are making use of the arts to stimulate people's imaginations so they can see the world in a new way and explore ways of changing it. New forms and new approaches to art are being developed and experimented with. Groups of artists are using the arts to create new bridges of trust between themselves and the communities where they live, and in so doing are helping to create alternatives that give voice to the experiences of ordinary working people.
Introduction to Community, Urban, Housing
We humans have lived, worked, and played in community groupings
since the beginnings of our history. Our communities have been crucial
to us not only for our physical survival, but also as the source
and ground of our social life and our values. Our sense of belonging
to a community, of community as a bond between us, has held us together
and enabled us to live and act in common. The health of community
networks and community-feeling are vital indicators of social health.
Today, communities everywhere are in crisis. Industrial societies have proven themselves to be remarkably efficient destroyers of traditional communities, without, however, being able to offer viable alternatives to replace them. The automobile especially has led to the shattering of human-scale, face-to-face communities. Where people once lived within walking distance of their workplaces, their churches, and the local markets, they now tend to be dispersed and anonymous. `Home entertainment systems' -- television, radios, stereos, etc. -- have further contributed to atomization and the erosion of community networks and collective traditions, as have countless other patterns of modern life.
The erosion of community has also eroded much of the basis for potential movements of opposition and change. Successful movements for change require that people know and trust each other, through working together, living in the same neighbourhood, or through voluntary association. Without the existence of natural communities, this becomes much more difficult. Indeed, those in positions of power have often consciously pursued a strategy of encouraging divisions along the lines of race, gender, language, ethnicity, and religion, precisely in order to prevent people from coming together in unions or in community groups to challenge their dominance.
It is no surprise, then, that we are seeing everywhere the signs of a social breakdown which can be linked to the breakdown of community and shared values. The dominant value system can increasingly be reduced to the idea that the only thing that matters is to get as much for yourself as possible. The real estate speculators and the street criminals both live by this motto, and both contribute their share to making cities less liveable. Governments at all levels make planning and transportation decisions which only worsen the problems.
In the face of all this, people are attempting to organize resistance and to work for alternatives.
One key issue bringing people together is concern for the environment: the air we breathe, the water we drink, the noise and the toxic wastes in our neighbourhoods. Another crucial issue is housing. All across Canada the number of homeless or inadequately housed people has been increasing. Unemployment, skyrocketing prices, a failure to build affordable housing, and government policies of `de-institutionalizing' those in need of care, like psychiatric patients, by dumping them on the streets, are all contributing to the crisis. Community based organizations know that the disappearance of secure and affordable housing is a major contributor not only to homelessness, but to many of the other social problems with which they are trying to deal.
One response has been to initiate non-profit housing projects and to urge governments to do the same. Increasingly, co-operatives and community and church groups, rather than private developers or governments, have taken on the task of building low-income housing, albeit with much slimmer resources.
Some groups have also raised the vital, but explosive, issues of land ownership and control. They argue that land and housing should not be commodities bought and sold to enrich a few. They have proposed heavy taxes on speculators, and they maintain that land use should be guided by planning based on human needs and respect for the environment, not simply determined by whether someone can make a profit.
Groups across the country are working on these issues. Most are locally oriented, and some are also seeking ways of joining with others to increase their impact and potential.
Introduction to Development, International
In recent years, we have become increasingly aware that there
is only one earth. For better or worse, we share this planet with
other people, and with all other living species. If the rainforests
disappear, the greenhouse effect will have devastating effects on
us all. If other countries are in crisis, if they are ravaged by
economic catastrophes, repression, or civil war, their refugees
will appear on our doorsteps. If they douse the food they export
to us with dangerous chemicals, we and they will both develop the
Yet there are enormous pressures dividing us and pitting us against each other -- nation against nation, ethnic group against ethnic group, religion against religion.
The international nature of the world's economy, dominated as it is by multinational corporations, is itself an enormous source of division and conflict. The system sets up intense competition to attract economic activity, leading to pressure to keep unions out and wages low, slash taxes and social programmes, ignore environmental dangers. Local economies are warped to meet the demands of production for the international market.
Our hope of turning this around is to join together across international borders and other dividing lines to work together and support each other in evolving non-exploitative forms of sustainable development.
We in the `developed' world have a special responsibility to stand by the Third World, which, already desperately poor, is being plunged into further misery and environmental devastation by massive debt payments to first world banks and by irrational economic policies dictated by the International Monetary Fund, the multinational corporations, and the local elites they enrich.
We owe the peoples of the Third World a debt of solidarity, but beyond that we must realize that the issues of world peace and the global environment which concern us here in the West cannot be solved unless the issues of poverty, women's liberation, land reform, and sustainable economic development are dealt with in the Third World.
Many of the groups in this section are concerned with promoting alternative forms of sustainable development -- development as distinct from growth. Such approaches tend to the small-scale and the local, and are concerned with getting resources to those who need them most and will put them to the best use. Perhaps most importantly, such initiatives necessarily require empowering local people and communities (and especially the women who are often the key to rural economies), helping them to plan and implement projects which meet their needs and which they can control. It is a fundamental fact that a development project will only work if local people feel that it is theirs.
Other groups concentrate on education, a key component in development, and equally important in our own country to create support for appropriate forms of development.
Yet other organizations are concerned with issues in particular countries or regions, such as South Africa, Chile, or the Middle East.
All of them grow out of the belief that the principle of `Thinking Globally, Acting Locally' can and must also be extended to acting locally on behalf of and in solidarity with those in other parts of this globe.
Introduction to Economy, Poverty, Work
North American Native peoples were astonished by the strange ideas
of the newly arrived Europeans. One of the strangest of these was
the idea that land -- the Earth itself -- could be owned, bought,
and sold. To the aboriginal people, who saw themselves, the Earth,
and the things living on it, as part of a natural harmony, the thought
of buying and selling land was incomprehensible, absurd.
Absurd though it was, it was no joke, as the Indians of the Americas, and the blacks of Africa, were soon to find out. The whites not only bought and sold land, they also bought and sold human beings to work on the land they appropriated.
The ideas that seemed so strange to the Native peoples still underpin our economic system. Unlike `primitive' people, who engaged in economic activity in order to satisfy their collective needs, we have made the buying, selling and individual ownership of things the basis of our economy.
One of the `things' that we still buy and sell is human labour. In a few countries, incredibly, slavery and serfdom still exist. In the rest of the world, more civilized, most of us are divided between two main groups: the vast majority of us, who for most of our lives sell ourselves to employers by the hour or the week in order to live, and the minority whose wealth enables them to hire, and profit from, the labour of others.
Economic decisions -- what is to be produced, where, by whom, and under what conditions, are made by those with economic power -- predominantly corporate executives and government officials. The rest of us have little or no say.
The nature of the system ensures that the basis of economic decisions will be `the bottom line'. Enterprises that are profitable (usually ones that create `growth') become bigger and stronger; the others are squeezed out. Whether the actual product or activity is rational or irrational, beneficial or useless, environmentally benign or destructive, whether the product is food or weapons, doesn't enter into the equation unless it affects ``the bottom line''.
Of course, this isn't the way it is supposed to work. The market is supposed to make sure everything turns out for the best. The market, so the theory goes, responds to demand, which reflects the needs of all of us as consumers, making it the most efficient way of allocating resources to where they are needed.
In practice, it doesn't quite work that way. If people in Africa are hungry because they have no money to buy food, they don't create a ``demand'' in the world market for food, and the market doesn't produce or allocate food for them. According to market theory, they have no need for food. For the same reason, the market continues to produce Mercedes and condos for the rich rather than housing for the homeless: the market allocates resources to where the greatest profits are to be made, not to where the need is greatest.
Nor is the market well suited to meeting needs that can't be produced as commodities. The market doesn't offer you the opportunity to buy streets which are safe to walk on, or water which is clean enough to drink and swim in, or a community in which those too young or too old to drive can get around easily.
The results are obvious everywhere: extremes of wealth and poverty, environmentally disastrous resource extraction and farming practices, planned product obsolescence, urban designs that force dependence on the automobile and destroy communities, working people forced to work for subsistence wages under unsafe working conditions, lack of affordable housing, deteriorating towns and cities, extremes of overwork and unemployment.
These things have not happened without opposition. Labour unions have long brought working people together to assert their interests against those of the owners, and they continue to play a leading role in fighting for better wages, pensions, working conditions, health protection, and social legislation. Anti-poverty and unemployment rights groups seek to improve the lot of the poor, whose ranks are filled disproportionately with women, children, the aged, and racial minorities. Housing co-ops and tenants' groups are responses to the pressures of the housing market. Worker co-ops and community economic development projects cultivate enterprises which try to combine socially useful production with concern for workers' needs and working conditions.
Many of these responses raise fundamental questions about what -- and who -- our economy is for, and about how we make economic decisions. Why shouldn't economic activities have to justify themselves on grounds of social usefulness if they are to consume our resources? Why does the taxation system place most of the burden on the middle classes and the poor, rather than on the corporations and the wealthy? Why should anyone be allowed to `own' the natural resources that are found in, or grow on, the earth? Why shouldn't all enterprises have to clean up after themselves, so that they have no negative impact on the environment? Why shouldn't we require them to safeguard the health of their workers and of the communities in which they are situated? Why can't we insist that they make economic sense, rather than simply make someone a profit? Why should there be a class of owners entitled to make decisions which profoundly affect thousands of people and entire communities, while those whose livelihoods and futures are at stake have no say? Why, indeed, shouldn't economic decisions be made democratically, by those who actually do the work and need the goods and services?
If these questions suggest the need for fundamental change, they also raise a further question: How is such change to come about?
Some groups listed here are focusing their energies on building alternatives to the present system: sharing, barter networks, co-operatives, non-profit community-controlled or worker-controlled enterprises, land trusts, credit unions, `ethical' and alternative investment funds.
Others concentrate on at least ameliorating the worst effects of the present economy as it affects the unemployed, injured workers, and the poor, or on winning a better deal within the system for women or minorities.
Important as these initiatives are, their potential is inevitably limited by the fact that the economic system as it stands has a virtual monopoly on society's resources, including capital, machinery, land, natural resources, and human energy.
The issue becomes one of power. To effect desired change, it is necessary to have the power to set a different agenda, and therefore to challenge the current concentration of economic and political power.
In Canada, the question has been posed more sharply by the (so-called) Free Trade Agreement with the United States, implemented even though a majority of Canadians voted against it, and by NAFTA, negotiated behind closed doors and passed into law with total contempt for even nominal democratic principles.
Free trade, which in fact has little to do with trade and much to do with re-shaping institutions to meet the demands of multi-national corporations, is part of a broader corporate agenda aimed at establishing an `unfettered capitalism' and at eliminating or crippling anything that stands in the way. Social, environmental, and cultural programs are being attacked in the name of reducing government spending and staying competitive, and working people's wages, working conditions, and unions are being hit through `privatization', plant closures, demands for concessions, and other pressures.
It will take a strong and determined grassroots movement to prevail against this. A crucial role in such a movement will have to be played by the unions, who have the numbers, the organization, and the tradition of militancy to fight back successfully, but if there is to be hope of success, the movement must also include farmers, environmentalists, women's groups, Native people, immigrants and minorities, and many others. One of the keys to building such a movement is mutual acts of solidarity, inspired by the principle that `an injury to one is an injury to all'. Developing such solidarity is a challenge that we must meet if our individual groups are to transform themselves into a wider movement.
Introduction to Education, Children
Although we like to think of ourselves as a society
that cares deeply for children and protects them from harm, children
are by no means immune to society's problems. Sometimes, in fact,
they face problems that are worse than those faced by most adults.
In Canada, children make up the largest group of poor people. More than one million children -- about one in six -- are growing up in poverty. In the poorest countries, they die in shocking numbers from malnutrition and disease. Children suffer from family breakdown and family violence; some are victims of sexual abuse. Certain environmental hazards, such as lead pollution, are especially harmful to children. Good day care for the children of working parents is in critically short supply.
Native children, especially, have often been treated appallingly: removed from their communities, separated from their families, forbidden to speak their own language. While the worst of these abuses have now ended, the effects will be felt for many years.
The school system often fails children. Children from working class and non-white backgrounds are disproportionately streamed into dead-end courses, and are much less likely to make it into university. (As governments cut university funding and tuition fees rise, this problem will worsen.) Many students leave school -- even as high school graduates -- unable, or barely able, to read. Few are really challenged by their schools, few receive encouragement for, or training in, thinking and reading critically.
Yet work is being done to improve the situation of children. There are groups pressing for more and better day care, organizations protecting the interests of children in the justice system, alternative schools trying to improve on the education system's offerings. One positive trend has been the development of school textbooks which avoid the old stereotypes of race and sex, to provide students with a more authentic picture of Canadian society.
Education is by no means confined to the school system, nor to children and youth. Indeed, adult education is one of the `growth industries' of our time (and one that is far more environmentally benign than many other `growth industries').
Especially vital are the literacy and English As A Second Language movements. They are tackling crucial problems which are responsible for keeping many Canadians, especially immigrants and the poor, out of the social mainstream. They have been leaders, too, in developing reading materials that actually deal with the lives an problems of the learners, and in involving the learners themselves in helping to create those materials. As a result, such programs have become catalysts for awakening a wider social awareness among people often not reached by other institutions and organizations.
Indeed, education is being seen as an essential element of grassroots development both in Canada and abroad. The guiding idea is that education is not merely concerned with imparting knowledge, but with helping people develop the skills and the confidence to analyse and solve problems and thus to act, both individually and collectively.
Because education is about how people see and respond to the world, education has also been identified as a priority by a wide range of organizations concerned with many different issues. Many groups concerned with peace, anti-racism, the workplace, or gender equality see education as a key to moving forward.
Introduction to Environment, Land Use, Rural
As we witness an apparently unending succession of
environmental hazards and catastrophes, awareness is spreading that
we are in the midst of a profound ecological crisis.
The dimensions of that crisis are frightening. Global warming -- the greenhouse effect -- threatens massive disturbances to climate, vegetation, sea levels, water supplies, and agriculture. Airborne pollutants, including acid rain, are causing the death of lakes and forests, and are a major cause of cancers and respiratory illnesses in humans.
Water pollution, including toxic wastes, raw sewage, oil spills, and garbage dumped at sea, is befouling shorelines and making water unfit to drink or to swim in. Fish and marine mammals suffer from these hazards, and from overfishing and huge deadly driftnets. The earth's protective ozone layer is thinning dangerously, with potentially devastating effects on the marine food chain and on humans who venture into the sunlight.
Rain forests are being destroyed at a catastrophic rate, with inevitable consequences for climate worldwide. We are in the midst of a massive wave of species extinctions, and countless other species of animals and plants are nearing the edge. Stresses on wildlife and habitat range from outright destruction to overhunting to the proliferation of all-terrain vehicles.
Unsustainable farming practices are degrading the soil, depleting water reservoirs that took centuries to build up, polluting lakes, rivers and groundwater with chemicals, inadvertently encouraging the biological selection of pesticide-resistant insect pests, and dangerously narrowing the genetic diversity of cultivated plant species.
If there is any hope, it is that people worldwide are resisting the urge to simply despair, and are instead seeking to do whatever they can to reverse the trend.
Many people are trying to change their own lifestyles by avoiding products and practices which are harmful to the environment, by reusing and re-cycling, by composting, by reducing the use of private automobiles. They are also pressuring governments and industries to change and supporting environmental organizations.
In Canada, environmental and conservationist groups have sprung up around a wide variety of concerns. Some concentrate on local issues, such as the clean-up of a river, or the dumping of raw untreated sewage into the ocean. Others deal with broader problems, such as acid rain, the preservation of wetlands and natural and wilderness areas, the pollution of the oceans and the Great Lakes, energy conservation, nuclear power, excess packaging, the forest industry, or urban planning and land use.
Farming and rural life are one area of particular concern. Canadian farmers (and the rural communities which depend on them) are caught up in the pressures of a market economy that squeezes small farmers while encouraging environmentally damaging farming practices. Farming ranks with mining, fishing, and construction work in its risk of physical injury or death, and in addition farmers are exposed to a range of hazardous pesticides. Farmers who want to get off the treadmill are often trapped by huge debts. In response, organizations working for the survival of family farming and rural communities have sprung up, as has a movement to return to more `organic' farming techniques. Happily, a market for `organic' products is rapidly developing.
A movement for change is gathering steam, and is chalking up local successes as well as having a broader social impact.
Those active in environmental issues are also wrestling with how best to organize. Some groups see their role as lobbying and pressuring governments or businesses on a particular well-defined issue. Other groups are strictly local, using tactics that range from education and petitioning to civil disobedience.
Still other organizations have developed broader strategic visions. Some see themselves as primarily ecological (e.g. ``deep ecology'') while others incorporate an economic and social vision as well (e.g. ``social ecology'', ``bioregionalism'' or the Green movements). Some stress the development of alternative models of sustainable economic activity based on decentralist and `human scale' approaches.
Also receiving recognition is the fact that environmental issues are closely linked to third world development issues, and to questions of peace and urban planning. The increasing awareness of the global nature of environmental problems has made it apparent there is no hope of solving them unless the problems of poor countries generally are addressed. For example, most third world countries have no sewage treatment facilities, no controls on industrial pollution, and no means of dealing with hazardous wastes except by dumping them in the sea. Rain forests will continue to be cleared unless local people see viable economic alternatives for themselves.
There is still hope for reversing the trend toward environmental collapse, but only if we are able to work together worldwide to achieve profound changes. Our many local initiatives are steps toward achieving that, but many more steps are needed before we become a movement capable of bringing about those changes.
Introduction to Health
In the twentieth century we in the industrial nations witnessed
a marked improvement in many of the indicators of human health.
Infant mortality has been greatly reduced, life expectancy has increased
significantly, many illnesses and injuries which were formerly fatal
or incapacitating are now treatable. We tend to live longer, and
This progress is largely due to advances such as public sanitation and sewage treatment, drinking water that is free of disease-causing bacteria, better nutrition, improved standards for handling food, and large-scale vaccination. Advances in medicine and pharmacology have contributed, though their contribution relative to public health measures is frequently over-stated.
These benefits have not been shared equally. In the third world, lack of food and clean drinking water kills millions. In Canada, Native peoples and the poor have worse health, less medical care, and lower life expectancies.
In the population at large, health issues continue to be a major focus of concern. Smoking -- including second-hand smoke -- and inappropriate diet are massive, preventable causes of ill health which reflect not only individual choices but also the effects of advertising, social pressures, and institutional policies.
Workplace health issues are among the most serious and widespread of all health problems. Canadian workers and farmers are killed or injured at work in appalling numbers. Often they are exposed to noise, dust, radiation, and dangerous chemicals, at levels far above those considered `acceptable' for the population at large. Frequently they are deliberately lied to or kept in ignorance about the hazards which they face at work. (Asbestos companies, for example, knew for decades that asbestos was lethally dangerous before they admitted to their workers that the substance was in any way hazardous.) Workplace health issues are becoming a major battleground as workers fight for the right to earn a living without sacrificing their health.
Such issues frequently become struggles for power, specifically the right of workers to full knowledge of the substances they are working with, the right to have a significant say in managing work to minimize health risks, and the right to refuse unsafe work without being penalized. The emergence of such issues presents a significant opportunity for alliances to be made between unions, environmental groups, and health organizations.
Environmental health issues have similarly become the subject of widespread concern as risks become known or suspected. Air and water pollution are linked to cancer and respiratory disease. Highly toxic chemicals lace our water supplies and the fish we eat. The thinning of the ozone layer makes us more vulnerable to the carcinogenic rays of the sun. Modern farming practices leave pesticide residues in our fruit and vegetables and anti-biotics and growth hormones in our meat. Rising levels of noise cause increased stress for many.
Pharmaceuticals are another issue of concern. One problem is the widespread over-prescribing or mis-prescribing of drugs, especially to the elderly, women, and psychiatric patients. Doctors are often lamentably ill-informed about the drugs they prescribe, with most of their information about particular drugs coming from the companies that sell them. The giant multi-national drug companies aggressively pursue their market share, all too frequently by producing drugs of little value, or their own brand-name versions of another company's already existing product.
In the third world, drug company marketing strategies have resulted in a tragic misallocation of scarce resources, and the companies continue to resist fiercely any efforts to adopt the `rational prescribing' policies advocated by the World Health Organization. In Canada, the drug multi-nationals, backed by the U.S. government, were successful in pressuring the government to pass legislation drastically restricting the right of independent pharmaceutical firms to produce cheaper generic equivalents of their expensive products.
Financial issues generally are contentious in the health care system. Government spending going to health care has been increasing rapidly in many parts of Canada, yet sectors of the health care system are suffering from underfunding. One important debate revolves around how much money should be going to `high-tech', hospital-oriented, doctor-driven approaches, and how much to education, prevention, home care, and other health care providers such as midwives, nurse-practitioners, and alternative healers.
Some are also looking for ways to reduce doctors' disproportionately high share of income and power. Nurses especially have been putting their concerns forward with increasing militancy. The Patients' Rights Association has been pressing for patients to have increased say in their own care.
With governments pursuing an agenda of budget cutbacks, it seems certain that financial pressures will increase. One way in which governments have shed expenses has been through `deinstitutionalization'. In theory, this means moving people from large institutions to community-based care. In practice, it has more often tended to mean dumping psychiatric patients and the disabled onto the streets with little or no support, follow-up, or care. Parents nearing retirement age find themselves forced to single-handedly shoulder the burden of caring for children with severe disabilities; children, epecially daughters and daughters-in-law, find themselves responsbile for caring for aging parents.
Another strategy has been privatization: in essence, shifting the responsibility for care of the elderly and others from publicly accountable institutions staffed by unionized workers to privately owned companies using workers paid little more than the minimum wage.
Financial considerations also directly affect the users of health care. While the existence of medicare gives Canadians a much more egalitarian health care system than Americans, financial deterrents to access exist in the form of user fees in some provinces.
AIDS in particular is raising significant ethical, economic, and political issues which relate to both health care and human rights. AIDS activists are highly critical of how the health care system has responded to the pandemic so far, and are concentrating their efforts simultaneously on political pressure, education and self-help.
A woman's right to choose whether or not to have an abortion is still under serious attack, presenting a major challenge for pro-choice groups which advocate that women have access to safe legal abortion and reliable contraceptive information.
Many of the groups in this chapter deal with a particular pressing health issue. Others, such as those advocating a `healthy city' strategy, are trying to develop a comprehensive approach to changing public policy in the many sectors which affect our health. When health is seen in its wider context, it is apparent that many of the issues identified elsewhere in this Annual are also health issues, suggesting that there are many fruitful ways in which health groups and other groups can work together.
Introduction to Human Rights & Civil Liberties
Western society is strongly coloured by the idea that there are
rights which belong to all human beings ``by right'', rights which
no authority is entitled to deny or to take away.
At the same time, however, we also know that whatever rights one thinks there ought to be, or whatever rights people are said to have, the rights that people actually have exist only because they fought for them and achieved them. Rights are won.
And rights can be lost. They can be lost if those who are concerned with defending them are isolated, weak, not organized enough, or not vigilant enough.
There is no universal agreement on the definition of human rights. On the contrary, competing definitions -- and more precisely attempts to legislate and implement particular rights -- give rise to some of the sharpest conflicts of our time. This is because in many instances, the assertion or expansion of a particular human right brings it into conflict with what some other groups see as their rights, or has costs associated with it which others are reluctant to pay.
In our day we can see this as a wide range of groups attempt to assert their rights, including many rights that have a strong social or economic component. Thus the French-speaking majority in Quebec trying to assert its right to a francophone Quebec comes into conflict with the English-speaking minority seeking to preserve its linguistic rights. Tenant groups who see housing as a human right, and workers wanting the right to change unsafe workplaces both conflict with those defending the rights of property. Those advocating affirmative action clash with those who believe that the principle of hiring strictly on merit is being attacked.
In question too is how real `paper' rights are in the absense of the conditions needed to exercise those rights. How real is our right to free speech when a few conglomerates control nearly all the mass media? Are a forestry giant and a citizens' group really equal before the law when the company is able to bankrupt the tiny challenger simply by dragging them into court and letting legal fees mount?
And what about more radical extensions of our rights? If we have the right to democracy, can't one argue that this should also include the right to democratic control over the corporations which now control most of our economy?
Perhaps the single most crucial question facing any group concerned with extending or defending human rights is that of its attitude to the state. While people and organizations concerned with human rights know that it is vital to win support and allies in the wider society, they also know that the most powerful potential sponsor of all may well be the state itself -- the government, the courts, the police.
Therein lies a fundamental dilemma. The state is a dominant force in society whose help often seems essential if a particular right or policy is to be achieved effectively.
Indeed, we are often told that in order secure our rights, it is necessary to extend the powers of the state. In order to have the right to be safe from crime and terrorism, we are expected to give more power to the police and the state security agencies. So that we may have the right to enjoy essential services, the government has to have the right to ban strikes. To be protected from hate literature, we have to yield to the police and the courts the right to decide what we are allowed to publish or read. In other words, to gain certain rights, we have to give up other rights, especially our civil liberties, our right to be free of state interference.
As a result, we have witnessed a steady erosion of our liberties. We are subjected to restrictions and forms of surveillance that would have been unthinkable in the past. If one trend is clearly visible in virtually every society, it is toward greater centralization, bureaucracy, and social control, and a corresponding curtailment of individual freedoms.
This is a tremendously dangerous trend, especially for those who are hoping to bring about social change, because those working for change frequently attract the hostility of the powers that be. The more we acknowledge that the state has the right to grant or deny us our liberties, the more it is likely to use it in ways we will regret.
For example, the more it is considered permissible to curtail freedom of speech, the more groups working for change become vulnerable to having their freedom of speech curtailed. This has been demonstrated regularly even in Canada, where laws originally targeted at Nazi hate literature have been used against groups protesting American domination of Canada, and where anti-pornography laws have been used against gay liberation publications, feminist videos, and sex education materials.
Consequently, a strong case can be made that a serious strategy for promoting right and liberties should challenge the right of the state to grant or withhold our rights and freedoms. Those who seek a freer or more just society are in danger of subverting their own goals if they expect the government or the courts to achieve them on their behalf.
There are times when using them is unavoidable, but there is always a cost: a hidden but real shift of power away from us to the government and the courts. In the long run, our goal should be to create a society that is less, not more, state-dominated.
To do that, we need to look to each other for help. We can better secure our own rights and freedoms if we support the rights and freedoms of others. Groups working to win or defend one set of rights greatly increase their chances if they form alliances with other groups, especially if such alliances are not merely expedient, but rooted in an understanding of how different causes are contributing parts of a larger struggle for justice and freedom. We should try to be guided by the idea that "if one of us is not free, then none of us is free''.
For example, most of us may hope never to be in prison, but as long as we tolerate prisons that cage human beings under conditions that would be illegal for animals in a zoo, we lend our acquiescence to the idea that it is permissible to treat human beings inhumanely. If we tolerate discrimination against women, or racial minorities, or the handicapped, we give our consent to injustice. If we accept that anyone may be denied their rights, their freedom, then we undermine our own rights and freedoms even as we undermine social solidarity.
Introduction to Lesbians, Gays, Bisexuals chapter
Sexuality is not something that our society handles
well. We produce and reproduce sexual images by the untold millions,
we talk about sex incessantly but as a society we are profoundly
uncomfortable with this primal force.
We have a long history of trying to repress or tame sexuality, of trying to keep it channelled, under control. Consequently, we also have a long history of punishing sexual `deviance' -- behaviour that differs from the prescribed norms -- although we have an equally long history of `deviating' anyway, and often of quietly tolerating officially forbidden behaviour as long as it wasn't `flaunted'.
Homosexuality was long felt to be particularly threatening by official society, meeting with reactions that were frequently hysterical, vicious, and violent. Homosexuality was simultaneously seen to be completely against human nature, and yet so attractive that a single `queer' teacher could corrupt a whole school. The very existence of homosexuals was seen as an affront, a threat.
For a long time, gay men and lesbian women felt compelled and were compelled to keep their orientation quiet, `in the closet', prisoners of economic and social pressure, repressive laws, and frequently personal agonies of doubt and guilt.
In the last two decades this has changed, as a powerful movement for lesbian and gay liberation emerged to assert that their sexual orientation was every bit as `normal' as heterosexuality.
Though much remains to be done, this movement has been a powerful force is changing society's attitudes and in sweeping away legal and other barriers denying equality to gays and lesbians.
Many of the groups in this chapter are focused on continuing the long struggle for lesbian and gay rights under the law, and within institutions like the churches. Others are concerned with providing support and services to gays and lesbians, or to particular groups within the community.
Beyond their particular emphasis, gay and lesbian organizations are also by their nature dealing with the issue of empowerment, giving an identity, strength, and a sense of collectivity to a section of society that was long oppressed and silent. For lesbians, this quest for identify and empowerment has often meant forming their own organizations after finding themselves limited in male-dominated gay organizations.
For lesbians, this process has also meant confronting their oppression as women, and claiming their place in the broader women's movement. For some, it has meant the development of a lesbian `separatist' identity. For others, who enjoy erotic literature or S&M, it has meant a further struggle to claim a space for themselves within the movement.
The movement has helped to test and extend our sexual limits. The space for diversity which it has created has also benefitted bisexuals, who now feel freer to pursue their orientation without guilt or censure.
Together with the women's movement, the lesbian and gay movement has helped to make the wider society understand that personal issues, sexual issues, are also political issues. Gays and lesbians have shown that while on one level -- rights, employment, etc. -- sexual orientation doesn't matter, on another level, sexual politics are profoundly important. They do matter, and no movement for change can ignore them.
Introduction to Native Peoples chapter
North American Native peoples are the victims of a
historical calamity that is difficult for non-Natives to comprehend.
In a relatively short period of time, a continent-wide web of self-sufficient
communities, in balance with nature, was invaded and destroyed by
an alien civilization. Most of their land was taken away, the animal
populations they had relied on were decimated, they themselves were
deliberately killed or ravaged by diseases to which they had no
resistance. The survivors were shoved onto reservations with few
means of livelihood, their economy, culture and traditions shattered.
Despite the catastrophe that befell them, the aboriginal peoples have shown a tenacious will to survive and prevail, and a great willingness to share their knowledge and spirit with non-Natives. The first whites to arrive could not have survived at all without the help given to them by the people they called Indians. Future generations owe more than they know to the accumulated knowledge of the original peoples. Today, the ecology movement is returning to the ideas of living in balance with nature which the Native people practised.
Across the country, Native people are organizing to deal with the critical and chronic problems that face them.
Land claims are far from being resolved. Multinational resource corporations and huge domestic entities like Quebec Hydro continue to explore and stake claims in the North, despite warnings of vast and irreparable ecological and social damage. The consequences of the institutional racism of Canadian society continue to damagingly affect Native people. This is reflected in rates of unemployment, number of suicides, incarceration and infant mortality rates that far exceed the national average, and substandard health care, education, and housing.
A principal concern of Native people across the country is to achieve viable forms of self-government and self-determination. Governments are being pressured to resolve land claims. Native communities are trying to develop models of self-sustaining economic activities that will give them greater control over their own economic future. Native centres are placing increased emphasis on preserving Native culture, heritage, and language through radio stations, videos, oral history projects, artisans networks and social activities.
Discriminatory legislation has been challenged in courts from the municipal, provincial and federal level to the United Nations. Native women successfully fought the section of the Indian Act which took away women's Native rights if they ``married out'' of their band.
However, the Indian Act remains a discriminatory piece of legislation, and little advance has been made in the fight to have Native peoples' rights recognized in Canada's constitution or in the Charter of Rights and Freedoms. Meanwhile, the federal government has been placing additional restrictions on funding for Native communities and Native education.
In the face of this, Natives have been intensifying their resistance, and more militant forms of protest are becoming increasingly common.
Canadians concerned with social justice can also be working in solidarity with the Native peoples in their struggle for justice. We can add our pressure to the demand for a quick and just resolution of land claims and for meaningful economic assistance to native communities. We can also join with them in promoting an approach to living on this continent that stresses self-reliance and ecological harmony.
Introduction to Peace chapter
War, or the threat of war, is an ever-present reality
in our world but in the relative comfort of the West, we have the
luxury of shutting off the wars raging in other countries by changing
the channel on our TV sets.
Even here, however, we have had, for more than a generation, to live with the possibility that human society could be destroyed almost instantly in a global nuclear war. Frozen in the threatening postures of the Cold War, societies East and West warped their economies and their thinking in order to defend themselves against the threat from the other side. In order to guarantee `mutually assured destruction', resources were bled away from real human needs and poured into the military.
The Cold War has ended, but militarism, nationalism, imperialism, and the arms trade have not. The major industrial powers, with the United States leading the way, continue to depend on military production to power their economies. Arms remain the number one export of the United States (followed closely by the products of the U.S. entertainment industry), underlining the dictum that "war is the health of the state", even in `peace-time'.
In the Cold War era, the western peace movement sought to establish closer ties with independent peace groups in the Eastern bloc. They understood that more successful we are in using people-to-people contacts to create an international peace movement that is not tied to the policies of any particular government, the better our chances will be of taking control of our destinies away from the militarists who often loom so large in governmental decision-making.
This truth -- the importance of international links to oppose the rivalries and abues of nation-states -- remains vitally important in the chaotic `New World Order' which is emerging. Preparations for war -- and for military intervention against countires whose rulers `get out of line' -- continue even as the military searches for new enemies.
In Canada, the peace movement is pressing for an end to the testing over our territory of U.S. and NATO jet fighters, bombers and cruise missiles.
The Canadian peace movement is also demanding an end to the manufacture of arms for export, and an end to the export of uranium, which can be used for weapons even if it is ostensibly intended for nuclear power plants. By allowing such exports, Canada contributes to arms races between Third World nations, and to the potential development of nuclear weapons by such countries.
Vicious wars are being fought right now in several parts of the world, and many other countries have experienced the ravages of war since the end of World War II.
In the past decade alone, the wars in the former Yugoslavia, in Somalia, the U.S.-led war against Iraq, the Iran-Iraq war, the war in Afghanistan, the Sudanese and Ethiopian civil wars, the Indonesian invasion of East Timor, the wars in Nicaragua, El Salvador, Angola, and Mozambique, to name but a few, have taken and are taking enormous tolls of life.
There are many countries where ethnic or tribal minorities are engaged in an ongoing resistance against the central authority, or where governmental repression -- assisted by armaments purchased from the industrial nations -- is so severe as to amount to war against a particular group in society.
The build-up of the military at enormous cost in countries which cannot even afford to feed their own people is common. Consequently, working for peace and working for economic development are opposite sides of the same coin.
However, the enormous power of the military-industrial establishments, with a vested interest in continuing a vastly profitable international arms trade, makes the task of shifting resources from war to peaceful activities a truly enormous challenge, both here and in the Third World.
While the military of all countries has an insatiable hunger for new weapons of all kinds, these weapons are not necessarily used against foreign enemies.
In many countries, the military is used primarily to buttress dictatorial regimes against their own people. For this reason too, movements for justice must be striving to lessen the power of the military everywhere.
At the same time, it must be remembered that soldiers themselves are often recruited from the ranks of the poor and the jobless, and that a movement for peace and social justice should be attempting to reach them too with its message. A movement for peace must in the end also include the soldiers if it is to prevail.
Introduction toWomen chapter
The modern women's movement has had a profound and far-reaching
impact on almost all spheres of society. It has challenged and changed
the way women see themselves, their expectations, their treatment
in society. It has shaken and transformed relationships and the
family, the law, the educational system, the labour movement, and
Yet for all its success, the challenges that remain are enormous. Women with full-time jobs earn about 65% of what men make. Over 50% of one-parent families headed by women are poor, as against 9% of those headed by men. The pension system works against many women, especially those who have been homemakers or who have taken time off from jobs to raise children. 50% of elderly women live in poverty. Women are subjected to violence or harassment in the home, the workplace, and on the street. The number of women's shelters is nowhere near to meeting the need. Women's right to reproductive choice, to control over their own bodies, uncertain to begin with, is under attack.
Because women tend to be poorer and economically more vulnerable, they are also hit harder by many of the other problems that exist in Canadian society. Non-existent or inadequate child care services make it harder for women to earn a decent living. A lack of affordable housing hits single mothers and elderly women particularly hard. Native women, immigrant women, and women who belong to visible minorities are disadvantaged even within their own communities. Free trade is expected to be especially devastating to industries like textiles which have a high concentration of older female workers.
These problems continue because they are built into the structure of Canadian society, and also because there are still many forces which reinforce sexism in public and private life, and which socialize our children into that system.
The various elements of the women's movement have adopted a wide variety of strategies to challenge sexist structures and ideology. Some groups are working to fight discrimination in the workplace. Others are providing services to battered, disabled, or immigrant women, services designed to help them take control over their own lives. Many groups focus on education or self-help.
Whatever the particular focus, many women's groups are united by the idea that the women's movement needs to concern itself with the entire social system, and with the nature of human relationships within that social system. They believe that the liberation of women cannot be achieved unless the whole system of oppressive and unjust structures is confronted, and equally that those structures cannot be dismantled unless the oppression of women within them is forcefully challenged.
This perspective applies also to movements for social change, who have been and are being forced to confront their own sexism and their own oppression of the women within them, and in the process are themselves being transformed even as they work to transform society.