health


Historian Laurent Dubois … “Anyone who lives in a democratic society in which race doesn’t equal a denial of rights has some debt to the Haitian revolution,” he reflected in an interview. “The very notion of democracy that we consider commonsense emerged because of that revolution. If that’s something we cherish then we owe that to Haiti, which has suffered more for its victory rather than been rewarded for it.” 
from the Boston Globe in 2004

People gather outside a damaged MSF office in Port-au-Prince to receive help after a 7-magnitude earthquake hit the capital city on January 12.

It would be nice to give something back to Haiti, especially when help is so urgently needed.  A friend in the medical profession sent me this appeal. I made a contribution and I recommend the opportunity to your attention. As my friend said:  This is a great organization, please consider it if you are planning to donate to help.   

Haiti: MSF Teams Set up Clinics to Treat Injured After Facilities Are Damaged

Donate here to support MSF’s work in Haiti.

The first reports are now emerging from Doctors Without Borders/Médecins Sans Frontières (MSF) teams who were already working on medical projects Haiti. They are treating hundreds of people injured in the quake and have been setting up clinics in tents to replace their own damaged medical facilities.

The Martissant health center in a poor area of Port-au-Prince had to be evacuated after the earthquake because it was damaged and unstable. The patients are now in tents in the grounds and the medical staff have been dealing with a flow of casualties from the town. They have already treated between 300 and 350 people, mainly for trauma injuries and fractures. Among them are 50 people suffering from burns—some of them severe—many of them caused by domestic gas containers exploding in collapsing buidings. At the Pacot rehabilitation center another 300 to 400 people have been treated. In one of MSF’s adminstrative offices in Petionville, another part of Port-au-Prince, a tent clinic there has seen at least 200 injured people. More are getting assistance at what was the Solidarite maternity hospital, which was seriously damaged.

One of MSF’s senior staff, Stefano Zannini, was out for most of the night, trying to assess the needs in the city and looking at the state of the medical facilities. “The situation is chaotic,” he said. “I visited five medical centers, including a major hospital, and most of them were not functioning. Many are damaged and I saw a distressing number of dead bodies. Some parts of the city are without electricity and people have gathered outside, lighting fires in the street and trying to help and comfort each other. When they saw that I was from MSF they were asking for help, particularly to treat their wounded. There was strong solidarity among people in the streets.”

Another MSF coordinator there, Hans van Dillen, confirmed that Port-au-Prince was quite unable to cope with the scale of the disaster. “There are hunderds of thousands of people who are sleeping in the streets because they are homeless,” said van Dillen. “We see open fractures, head injuries. The problem is that we can not forward people to proper surgery at this stage.”

So many of the city’s medical facilities have been damaged, healthcare is severely disrupted at precisely the moment when medical needs are high.

MSF is also working to get more staff into the country. Around 70 more staff are expected to arrive in the coming days. MSF is sending out a 100-bed hospital with an inflatable surgical unit, consisting of two operating theaters and seven hospitalization tents. Nephrologists will be sent as part of the team in order to deal with the affects of crush injuries. However, transport links are difficult and it is not yet clear whether supplies and medical staff will have to go in through neighboring Dominican Republic.

MSF is also concerned about the safety of some of its own staff. There are 800 of them and not all have yet been accounted for because of the poor communications and general disruption.

Donate here to support MSF’s work in Haiti.

____________________

Added January 14

Oxfam International has an ongoing presence in Haiti, and are working with the critical issues of water and shelter.

Donate here to support Oxfam

Our immediate priorities will be providing safe water and shelter material for the people who have lost their homes.”
Cedric Perus
Oxfam’s humanitarian coordinator in Port au Prince
January 14, 2010

A six-strong team of Oxfam emergency specialists has been dispatched to Haiti from the UK today to bolster the charity’s response to the devastation wrought by the earthquake that struck the country on Tuesday.

Cedric Perus, Oxfam’s humanitarian coordinator in Port au Prince said:

“I have seen wounded people flooding into the hospitals and buildings of several stories high that are now totally flat. Several thousands have probably died in the quake, but it will it will take time to get a full picture. Bodies may stay under the rubble for a long time because it is difficult to access some sites and heavy lifting equipment is in limited supply.

“There are bodies all over the city. People have nowhere to put them so they wrap them in sheets and cardboards in the hope that the authorities will pick them. People have also piled bodies in front of the city’s main hospitals.

“Oxfam’s teams have now started to assess the scale of the disaster across the different parts of Port au Prince as some have been more severely affected than others. The epicenter was near the slum of Carrefour, where people were living in flimsy shacks. There are reports that over 90% of its buildings are in ruins.

Our immediate priorities will be providing safe water and shelter material for the people who have lost their homes. Many people have lost their homes and were sleeping out in the open last night. There has been no rain yet, but there was rain earlier in the week and if it comes again it will make the situation much worse for all those made homeless by this quake. It is dangerous at night. Lootings were widespread and some markets were ransacked.”

Oxfam is preparing to send stocks from its Bicester Warehouse in Oxfordshire, UK. Materials that will be sent include plastic sheeting and equipment for water distribution, purification and storage.

Communication has been difficult since the 7.0 on the Richter scale quake struck 10 miles southwest of Haiti’s capital, Port-au-Prince, but the situation is undoubtedly grave. Homes, office buildings, roads, schools, hospitals and hotels have collapsed. Millions of people are affected and the aid agencies need millions of dollars to get aid to all the people that need it.

Donate to the Haiti Earthquake Response Fund

Please consider helping fund our Haiti Earthquake Response Fund. These Oxfam affiliates are running direct appeals:

Up to 13 million barrels of oil have spilled in the Niger Delta ecosystem over the past 50 years, representing about 50 times the estimated volume spilled in the Exxon Valdez disaster in Alaska in 1989. Niger Delta Natural Resource Damage Assessment and Restoration Project, PDF.

Oil spill in the village of Ikarama, Bayelsa State, Nigeria, 7 February 2008  © Kadir van Lohuizen/NOOR

Oil spill in the village of Ikarama, Bayelsa State, Nigeria, 7 February 2008 © Kadir van Lohuizen/NOOR

These spills equal the amount of 1 Exxon Valdez sized oil spill per year. And this is taking place in one of the most sensitive wetlands of our planet, part of the lungs of the planet. The spills pollute the land, pollute the water, clog the creeks, and gas flaring pollutes the air and the rainwater, bringing down toxic acid rain on land and water and all that live there.

As one Niger Delta fisherman stated:

If you want to go fishing, you have to paddle for about four hours through several rivers before you can get to where you can catch fish and the spill is lesser … some of the fishes we catch, when you open the stomach, it smells of crude oil.

The Niger Delta is one of the 10 most important wetland and coastal marine ecosystems in the world and is home to some 31 million people. The Niger Delta is also the location of massive oil deposits.

Under Nigerian law, local communities have no legal rights to oil and gas reserves in their territory.

This report focuses on one dimension of the crisis: the impact of pollution and environmental damage caused by the oil industry on the human rights of the people living in the oil producing areas of Niger Delta.

This report is a report from Amnesty International Nigeria: Petroleum, Pollution and Poverty in the Niger Delta – Report PDF. The report was released June 30, 2009.

The main human rights issues raised in this report are:

  • Violations of the right to an adequate standard of living, including the right to food – as a consequence of the impact of oil-related pollution and environmental damage on agriculture and fisheries, which are the main sources of food for many people in the Niger Delta.
  • Violations of the right to gain a living through work – also as a consequence of widespread damage to agriculture and fisheries, because these are also the main sources of livelihood for many people in the Niger Delta.
  • Violations of the right to water – which occur when oil spills and waste materials pollute water used for drinking and other domestic purposes.
  • Violations of the right to health – which arise from failure to secure the underlying determinants of health, including a healthy environment, and failure to enforce laws to protect the environment and prevent pollution.
  • The absence of any adequate monitoring of the human impacts of oil-related pollution – despite the fact that the oil industry in the Niger Delta is operating in a relatively densely populated area characterized by high levels of poverty and vulnerability.
  • Failure to provide affected communities with adequate information or ensure consultation on the impacts of oil operations on their human rights.
  • Failure to ensure access to effective remedy for people whose human rights have been violated.

The report also examines who is responsible for this situation in a context where multinational oil companies have been operating for decades. It highlights how companies can take advantage of the weak regulatory systems that characterize many poor countries, which frequently results in the poorest people being the most vulnerable to exploitation by corporate actors. The people of the Niger Delta have seen their human rights undermined by oil companies that their government cannot or will not hold to account. They have been systematically denied access to information about how oil exploration and production will affect them, and are repeatedly denied access to justice. The Niger Delta provides a stark case study of the lack of accountability of a government to its people, and of multinational companies’ almost total lack of accountability when it comes to the impact of their operations on human rights.

More oil is being prospected and discovered throughout Africa. Rather than an outdated holdover from an ugly past, Shell’s pollution of the Niger Delta is probably the model for oil exploitation across the African continent. Only if African countries stand up for themselves and their people, can the devastating effects be mitigated. Far too many governments in Africa are not accountable, or only barely accountable to their people. And even where there is a will, the outside powers and donor countries will not make it easy. Look at what is happening in Somalia, another potential source of oil. The international donor countries are keeping it destabilized in the name of fighting “terrorism”. When Somalia did develop its own government in 2006, it was rapidly crushed by the US using Ethiopia as a proxy. This is what is known as stability operations.

In response to a question, I was talking to someone in the neighborhood where I work about pollution and oil exploitation in the Niger Delta. He was not really interested and brushed it off, saying, “we have to get our oil from somewhere.” This is someone with whom I’ve had a number of friendly conversations, and generally think of as a nice guy. I think his response typifies the attitude of people in the US, and in the developed and rapidly developing world.

Just as the European colonial powers spoke of bringing Africa the 3 Cs, Christianity, Civilization and Commerce, the US, and the US Africa Command speak with straight faces of bringing Africa the 3 Ds, Defense, Diplomacy, and Development. It was a mirage the first time, and this is pretty much the same thing, minus Christianity. It is not done to benefit the people of Africa but to fool them. It is like the distraction of a magician, so you don’t see how he does the trick.

As Dr. Wafula Okumu testified:

To paraphrase Kenyatta’s allegory, “when the Whiteman came to Africa, he was holding a Bible in one hand and asked us to close our eyes and pray. When we opened our eyes after the prayer, his other hand was holding a gun and all our land was gone!” Africa’s colonial history was characterised by military occupations, exploitation of its natural resources and suppression of its people. After testing decades of independence, these countries are now jealously guarding their sovereignty and are highly suspicious of foreigners, even those with good intentions.

There are many professed good intentions, and very few genuine good intentions among the powers gathering around for this latest scramble for Africa, particularly in the search for oil. It behooves Africans to be very wary indeed.

Hero Rat sniffing a landmine

Hero Rat sniffing a landmine

From Afrigadget comes the story of:

“Scratch and sniff” Africas HeroRATS

I heard about this extraordinary use of rats years ago and am hoping that sharing it today will bring a smile to many faces. Although Mozambique’s civil war ended nearly two decades ago, unexploded ordinance continues to be a major cause of injury and death. But now they have a solution. Rats! Local giant rats are being trained and employed to assist in mine detection.

Rats have the amazing record of being able to detect mines 95% of the time. If only all our politicians would work this hard and for a banana….. I keep hoping against hope…

For more scientific information, read this article in the Journal of Mine Action

HeroRat videos on YouTube:

APOPO (5:55)
(links corrected 3/22)

You can adopt a rat at the HeroRat.org website for 5€ per month.

Adopt a HeroRAT

HeroRats not only detect landmines, they also detect tuberculosis in sputum samples. When demining:

A trained HeroRAT can clear 100 m2 in 30 minutes, equivalent to two days work for a manual deminer.

In detecting tuberculosis:

… in 7 minutes one rat can evaluate 40 samples which is the equivalent of 2 days of microscopy work for a lab technician.

Plus, the rats are too light to explode landmines, they don’t mind repetitive tasks, and because, although they are large rats, they are small animals, they are easy to house and move around, and inexpensive to feed. The program provides work for farmers and restores land for farming.

I think supporting this program is an excellent idea for anyone. It is also nice because it is something that can be shared with children. But it would be even better to see some government security dollars spent on an inexpensive program that actually makes people a lot more secure.

Oil spill fouls the water supply

Oil spill fouls the water supply

defenders of human rights

defenders of human rights

Violence has been an instrument of governance in the Niger Delta as a constant companion to the oil business. Sokari Ekine has written a moving and well documented account of “how women have spearheaded the defence of local livelihoods through organised protests which cut across regional ethnic divisions” in Women’s responses to state violence in the Niger Delta, Violence as an instrument of governance.

The Niger Delta is a region of Nigeria that has been subjected to excessive militarisation for the past 13 years, where violence is used as an instrument of governance to force the people into total submission (Okonta and Douglas, 2001; Na’Allah, 1998). It is where, by far, the majority of the people live in abject poverty and where women are the poorest of the poor (Human Rights Watch, 2002; 2004; 2007). This region has little or no development, no electricity, no water, no communications, no health facilities, little and poor education. In contrast, the region generated an estimated over US$30 billion in oil revenues over a 38-year period in the form of rents for the government and profit for the multinational oil companies

Now, in order to keep this population poor, without water, without communications, or health facilities, or education, or jobs, in order to keep oil and money coming out of the Delta, going to the politicians and the oil companies, according to Nigeria’s Next, The Mercenaries Take Over.
(h/t Foreign Policy Exchange)

The Niger Delta is crawling with British and American private paramilitary companies providing security services for clients in the oil and gas industry, in clear violation of Nigerian law

There are at least 10 mercenary companies operating in the Delta, including Triple Canopy, Control Risk, Erinys International, ArmorGroup, Aegis Defence System, and Northbridge Service Group, the successor company to the now defunct Executive Outcomes … “the notorious South African paramilitary force known for its role in helping the Angolan government during the war with the rebel UNITA forces of Jonas Savimbi,and for fighting directly in the Sierra Leonean civil war.

Our laws forbid foreigners from operating armed security companies or paramilitary organisations of any kind and, strictly speaking, these hired guns are forbidden from freelancing here. But almost all of them have sought to get around the law by forming vague partnerships with local companies and by claiming to provide mainly advisory services, which contradict their stated objectives and services on their parent websites and their known activities in other countries.

Government denial

Astonishingly, our military and security services also claim to know nothing of their presence.

“I am not aware,” said the spokesman for Defence Headquarters in Abuja, Col. Christopher Jemitola. “If there is any evidence, including photographs, bring them up and we will address the issue.”

Some of the security companies also claim not to bear any arms in the Delta, a chaotic frontier where foreigners are routinely kidnaped and gunfights are a fact of daily life in cities such as Port Harcourt and in the creeks of the mangrove swamp.

This denial beggars belief, said Ishola Williams, a former commandant of the Nigerian Army Training and Doctrine Command.“They must be magicians,” said the retired general. “Are they going to fight the militants with karate or judo? We have to be very realistic, because if someone gives you a contract to provide protection for oil workers in the Niger Delta, what would you do– you would go there with your bare arms?”

Apart from the Biafran war of 1967-70, paramilitary groups are relatively new to Nigeria. But the protracted and deteriorating insurgency in the Niger Delta has made them increasingly sought after. One of the security companies that claims local partnership in Nigeria is Erinys International, a British company with experience of guarding oil installations in Iraq.

In the wild frontier of the internet, private military companies are rife and active, peddling their services to prospective patrons. Many of them have announced that they are now operationally domiciled in Nigeria’s Niger Delta, and some claim they work in partnership with the military Joint Task Force, the Nigeria defence forces known by its acronym JTF and which has primary responsibility for security in the area.

A JTF spokesman, Musa Sagir, denied knowledge of the existence of the foreigners nor any collaboration with them. We don’t have any connection with any foreign military contractor,” Col. Sagir said, adding that “With my inside knowledge and experience in the Niger Delta, in particular River State, I don’t have formal or informal knowledge of the existence of foreign military contractors.”

What was more, he added, somewhat indignantly, “we are trained for the job and we know what to do at the right time.”

Willaims, the retired general and now head of the local Transparency International office in Nigeria, was buying none of that. “Remember that these are government officials. If they say they know them, you as the press will go and blow it up that foreign military companies have taken over the job of security in this country and what are they doing? The House of Representatives will take it up and want to investigate, and it shows the weaknesses of all the armed forces and all the security agencies in Nigeria.”

Official denials and a seeming lack of awareness of the activities of these companies also demonstrate the enfeebled state of the Nigerian state, said Kayode Soremekun, a professor of international relations at the University of Lagos.

My own problem here is that the ministry of internal affairs and ministry of defence are not aware of their existence,” Soremekun said. “It is either one or two things: the ministry of defence is genuinely ignorant of this particular development, or it is pretending. Either way it does not bode well for the Nigerian state. And it simply shows what a lot of people had thought all along, that those who really control the Nigerian state, those who really determine what happens in the Nigerian state, cannot even be located in this country. You can locate them offshore.”

Since our laws do not allow for foreign owned security company to operate locally, most of these private security contractors have resorted to calling themselves “risk management consultants” rather than hired guns.

This way, they are able to provide a cocktail of services and products that are not different from what regular private military companies provide– or what the same companies do elsewhere in countries like Sierra Leone

Most of the companies are not forthcoming about their activities, for example:

At Control Risk, yet another of these security companies active in the Niger Delta, company spokesman, Edward Murray, told Next on Sunday to “go to hell” when asked to help define the scope of their Nigerian operations.

The company states that it is in Nigeria to protect British oil workers and names “a large oil producer” as a client. However, its mission includes, according to its official web site, “the provision of technical security services (onshore and offshore) and sophisticated management of security strategy in places where security is linked to broader issues of social performance.” In plain English, the company guards oil company interests against restive locals.

The mercenary companies are there to protect the “rights” of the oil companies to kill and oppress the people of the Niger Delta, pollute their land and water, and steal the resources from under their feet.

The people who are suffering most are the women. They are also organizing and fighting back. So women and children will remain major targets of violent military governance.

Meredeth Turshen wrote in 2004:

Specific effects of oil development on women’s health seem not to have been investigated. Although I found an article on the effects of exposure of crocodiles to sub-lethal concentrations of petroleum waste drilling fluid in the Niger Delta basin, I could find nothing on the health of women who live near oil wells and oil production stations, and nothing on reproductive outcomes in areas adjacent to petrochemical plants. Yet it is known that cadmium, chromium, mercury, and lead are contained in the refinery effluents that are constantly discharged into nearby bodies of water. At high concentrations these metals cause metabolic malfunctions in human beings. They enter the food chain through the drinking water and the local fish that people consume. Fish store mercury without metabolizing it, and people who eat mercury-contaminated fish can contract Minamata disease.

The health of the people and of future generations is not even important enough to study. The people polluting the environment don’t want the effects known. Until there is a serious effort to create a political solution to the problems of the Niger Delta, the people will continue to suffer, and the health and lives of the entire population are in danger. The proliferation of armed mercenaries will only escalate and prolong the problem.

(h/t sdnnigeria’s photostream)

Using PDAs for public health in Zambia

Using PDAs for public health in Zambia

The African Loft has an intriguing article about using open source software on PDAs to collect health data and monitor community health. Titled How PDAs are Saving Lives in Africa, Dr. Joel Selanikio writes:

… through a year-old pilot program, Zambia is replacing paper-based health surveys with those used on PDAs (personal digital assistants). This means no data entry, no cumbersome clipboards, and most importantly no waiting weeks or months for data entry clerks to enter stacks of paper into a computer for analysis.

Zambia today is helping to lead a public health revolution that has the potential to improve the lives of millions of people in the developing world. By switching from paper-based to mobile-enabled digital health systems, Zambian health workers are empowered with new ‘eyes and ears’ in the field-devices that increase the speed and accuracy with which vital health information can be collected and recorded. These PDAs, sometimes more powerful than laptops of the recent past, quickly are becoming a vital public health management tool.

EpiSurveyor operates using a Java-based engine and a Windows-based Designer application that allows fast and easy creation of forms and data systems. It allows anyone with average computer skills–the ability to use a word processor or email, for example–to create and share mobile data collection systems in minutes, and without the need for consultant programmers.

In keeping with its mission to break down the barriers that block access to health data in developing countries, EpiSurveyor is free–anyone with internet access can download the program. EpiSurveyor is also open source, enabling those with higher-level programming skills to manipulate the program to respond to health needs as they arise. Finally, EpiSurveyor is built to run on mobile devices, providing maximum mobility and ease-of-use for health workers who spend most of their time in the field. Pilot project training is conducted using the Palm Zire.

So far, year-old pilot projects in Zambia and Kenya are showing that data received from the field has streamlined the inoculation of children against measles, collected information on HIV, and has even helped to contain a polio outbreak.

This sounds like a powerful, cheap and practical way to manage a lot of public health information functions. It looks well worth further exploration. You can read the entire article here.

Map of Tullow’s recent oil discovery in Ghana
click on the map to see the larger view

The Guardian published an article this week about the oil discovery in Ghana, and potential effect on the Ghanaian economy. Ghana enters oil age with wary eye on neighbors.

.

. . as the euphoria dies down, people are debating whether oil is really the economic injection their country needs.
. . . “Nigeria has oil in abundance, yet the local people have nothing,” said George Moore, a 29-year-old restaurant worker in Axim, a fishing village near Cape Three Point. “Is that what is going to happen here?”
. . .

“Our country works, but the idea of us producing oil still scares me,” said Kofi Bentil, a business lecturer at Ashesi University in Accra. “It will totally change the structure of the economy. It could push us into overdrive, but it could also lead us to self-destruct.”

One advantage that Ghana has over its oil-producing neighbours, said Mr Bentil, is experience and political stability. While countries such as Nigeria were already swimming in oil money at independence, Ghana has had 50 years to build up institutions to manage its finances.

It is also one of the few countries in the region to hold free and fair elections with peaceful transitions of power.

Although corruption at state level remains significant, accountability has improved greatly in recent years, donor officials say.

Mats Karlsson, the World Bank country director for Ghana, said that even without oil, Ghana was on track to become a middle-income country by 2015, when it would start to wean itself off aid. Oil revenues could accelerate that process.

Or, oil revenues could reverse the process.

The US Africa Command could be a destabilizing influence in Ghana as well as other countries. The focus of Africom is oil. Cooperation with African military organizations is an attempt to manage this resource. And the more the interests of the military in a country are supported above the interests of other citizens, the more chance there is of creating and extending coups and military governments. Currently Nigeria, Equitorial Guinea, and other places, are experiencing this kind of US military support. In the words of Vijay Prashad:

Resource wars in the Congo (over diamonds and coltran) and in West Africa (over oil) have set the continent on fire. The U.S. has thus far engaged with these conflicts through Africa’s national armies, who have increasingly become the praetorian guards of large corporations. None of this can be justified directly as a protection of the extraction of resources, so it has increasingly been couched in the language of the war on terrorism. The Pan-Sahel Initiative (created in 2002) draws U.S. Special Operations Forces to Chad, Mali, Mauritania, and Niger. In 2004, the U.S. extended this to the major oil producing countries of Algeria, Nigeria, Senegal and Tunisia and renamed it the Trans-Saharan Counter-Terrorism Initiative. After 9/11, the U.S. moved a Special Operations Force into a former French Foreign Legion base, Camp Le Monier, in Djibouti. In July 2003, the U.S. earned the right to deploy P-3 Orion aerial surveillance aircraft in Tamanrasset, Algeria. Under the guise of the War on Terrorism, the U.S. government has moved forces into various parts of Africa, where they were able to train African armies and to intervene in the increasingly dangerous resource wars.

Ghana needs to diversify her economy, and protect and develop her agricultural sector, if the oil is to help rather than hurt. And Ghana needs to provide health care, and free universal public education. This is a public good, even necessity, and should not be an individual privilege. Ghana needs all its brain power active and healthy, not just the brain power of the rich. Rich brains are not always the best brains. Every cedi invested in education will be paid back many times over in business development and revenues.

As b real points out in a comment, the US Senate has a hearing today on the Africa Command, Exploring The U.S. Africa Command And A New Strategic Relationship With Africa. In his opening remarks there were a few words Senator Feingold said that offer a glimmer of optimism even though the goal is still to acquire African oil and resources. I have emphasized them below.

I am prepared to fully support a unified, interagency U.S. approach that creates a military command with the primary mission of supporting our policies towards Africa and ensuring continued diplomatic, development, humanitarian assistance, and regional initiatives led by the Department of State, USAID, and other key stakeholders – including national and international NGOs, other bilateral and multilateral development bodies, and of course, African political and military leaders.

African leaders look a bit like an afterthought, but at least they are mentioned, unlike in the Bushco documents from the Heritage Foundation that lay out the Bush/Cheney vision of Africom.

I read an interview today with Mike Davis about his book, Planet of Slums. I have copied some key quotes from the article, though I recommend reading the whole article. It has implications for people on every continent. It has relevance to the US and US policies, most immediately in Iraq. It also has particular relevance to West Africa and citizens of the countries of the Gulf of Guinea. Here follow some passages from the interview:

Sadr City, at one point named Saddam City, the Eastern quadrant of Baghdad, has grown to grotesque proportions — two million poor people, mainly Shia. And it’s still growing, as are Sunni slums by the way, thanks now not to Saddam but to disastrous American policies toward agriculture into which the U.S. has put almost no reconstruction money. Vast farmlands have been turned back into desert, while everything focused, however unsuccessfully, on restoration of the oil industry. The crucial thing would have been to preserve some equilibrium between countryside and city, but American policies just accelerated the flight from the land.
. . .
In my book, I looked at the relationship between the pervasive global slum, everywhere associated with sanitation disasters, with classical conditions favoring the rapid movement of disease through human populations; and on the other side, I focused on how the transformation of livestock production was creating entirely new conditions for the emergence of diseases among animals and their transmission to humans.

We have the:

. . . urbanization of livestock . . . millions of chickens living in warehouses, in factory farms. Bird densities like this have never existed in nature and they probably favor, according to epidemiologists I’ve talked to, maximum virulence, the accelerated evolution of diseases.
. . .
At the same time, wetlands around the world have been degraded and water diverted.
. . .
This is a formula for biological disaster and avian flu is the second pandemic of globalization. It’s very clear now that HIV AIDS emerged at least partially through the bush-meat trade, as West Africans were forced to turn to bush meat because European factory ships were vacuuming up all the fish in the Gulf of Guinea, the major traditional source of protein in urban diets.
. . .
the future of guerrilla warfare, insurrection against the world system, has moved into the city. Nobody has realized this with as much clarity as the Pentagon, or more vigorously tried to grapple with its empirical consequences. Its strategists are way ahead of geopoliticians and traditional foreign-relations types in understanding the significance of a world of slums…
. . .
The question of the exchange of violence between the city of slums and the imperial city is linked to a deeper question — the question of agency. How will this very large minority of humanity that now lives in cities but is exiled from the formal world economy find its future? What is its capacity for historical agency?
. . .
Well, here you have an informal working class with no strategic place in production, in the economy, that has nonetheless discovered a new social power — the power to disrupt the city, to strike at the city, ranging from the creative nonviolence . . . to the now universal use of car bombs by nationalist and sectarian groups to strike at middle-class neighborhoods, financial districts, even green zones. I think there’s much global experimentation, trying to find out how to use the power of disruption.
. . . I’ll tell you what I suspect may be the greatest of disruptive powers — the power to disrupt global energy flows. Poor people with minimal technology are capable of doing that across the thousands of miles of unguardable pipeline on this planet.
. . .
The city is our ark in which we might survive the environmental turmoil of the next century. Genuinely urban cities are the most environmentally efficient form of existing with nature that we possess because they can substitute public luxury for private or household consumption. They can square the circle between environmental sustainability and a decent standard of living. I mean, however big your library is or vast your swimming pool, it’ll never be the same as the New York Public Library or a great public pool. No mansion, no San Simeon, will ever be the equivalent of Central Park or Broadway.

One of the major problems, however, is: We’re building cities without urban qualities. Poor cities, in particular, are consuming the natural areas and watersheds which are essential to their functioning as environmental systems, to their ecological sustainability, and they’re consuming them either because of destructive private speculation or simply because poverty pours over into every space. All around the world, the crucial watersheds and green spaces that cities need to function ecologically and be truly urban are being urbanized by poverty and by speculative private development. Poor cities, as a result, are becoming increasingly vulnerable to disaster, pandemic, and catastrophic resource shortages, particularly of water.

Conversely, the most important step toward coping with global environmental change is to reinvest — massively — in the social and physical infrastructures of our cities, and thereby reemploy tens of millions of poor youth.

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