Tuesday 25 August 2009

Wealth, Virtue and American Mythology

In the late 80s/early 90s, I put some frequent flyer miles on the old broomstick and spent a great deal of time in the US. Not the real US – a cultural anomaly they call New York City. But I travelled a great deal and experienced other parts too. On a person by person basis, I’d say that the US has as friendly a citizenry as you could hope for anywhere and yes, that goes for New Yorkers too (although they’d kill me for saying so!)

Of course I always made sure that I had health insurance. In the event that I broke my arm and leg, I wouldn’t have wanted the afflicted body parts to be confiscated in lieu of doctor’s fees. American health care was, and is, so notoriously expensive that it strikes fear into the wallet of any well-informed traveller. If your policy ran out while there (you could get them to run ninety days at a time then) we Nouveau-Yorkers had elaborate plans to get the quickest flight out while bent over clutching at the chest/stemming gouting blood spurts around a stab wound/dying of the plague inconspicuously in the back row of the aircraft (they allowed smoking there in those days). Just DON’T GO TO THE HOSPITAL WITHOUT MONEY.

The insurance was a good buy. It turns out that a kidney infection can turn you from a youthful, grinning impression of a spring lamb on pogo sticks to a groaning, human pretzel sweating like a homeopath at a chemistry exam … all in about twelve hours. I grabbed my insurance certificate and got wheeled off to the nearest emergency room.

I won’t make any cheap shots and, in any case, one hair-raising anecdote does not a statistical analysis make. I spent a week in hospital, I’m alive, let’s leave it at that. It was expensive, but who cares? I didn’t pay - Messers. Readem & Ouipe, insurance underwriters did. It did not affect my medical outcome that my room-mate was a lady with an explosive farting condition and a fractious family. Security guards are probably regularly called in to separate sparring partners in London hospital wards too.

So what, dear reader, did I learn? Apart from ‘take your own charcoal gas mask to hospital’.

Just get insurance. Treatment is expensive as hell and they tend to over-treat because they’re scared of litigation. Also, they don’t appear to have time targets for treatment in the emergency room – bring a tent and your own pain relief. That may have since changed or been an anomaly, but it’s most likely down to the fact that ERs are the only kind of free care provided by law in the US, so they have a larger and more clinically desperate clientele than we do here.

But insurance is a different matter for US residents. For one thing, it’s a lot more expensive, pro-rata, than the kind of extended vacation coverage that I had. While I don’t have the time in my tea break to cite multiple statistics on the subject, I think it’s fair to generalise on the following points as they’re relatively uncontroversial:

  • More is spent on health, on a per capita basis, in the US than in any other country in the world
  • Despite the massive cost, the average satisfaction level of US healthcare is below that of many other wealthy, industrialised nations
  • The USA is perhaps the only wealthy, industrialised nation that does not ensure that all its citizens have some kind of health provision; around fifteen percent of Americans have no coverage at all
  • Medical debt is the principal cause of personal bankruptcy in the US, and this includes not just the feckless, but people who eventually find their insurance doesn’t cover all their costs

The US is able to provide wonderful outcomes on such conditions as prostate cancer, suffered by rich old men. It’s less able to provide good outcomes on infant mortality, suffered by babies who haven’t earned much yet.

Oh, we could go on for hours … and it truly is a complicated subject with reasoned points on both sides. It involves issues of tax breaks, effects of government interference on free markets, medical research funding and so much more.

But my focus here is on the attitude of many Americans to the idea of universal healthcare provision. Watching FOX news and other broadcast reactions to the subject must have left the rest of the world wondering just what on earth had been suggested: that China should be allowed tweak international human rights law? That Iran should be given a warhead or two for Christmas? That a black man should be president? There was more hyperventilation than at a ‘Twilight’ screening at a girl’s school. It’s also noticeable that healthcare debates in the US don’t get far before somebody hurls the ‘s’ word (‘socialised’ or ‘socialist’) like a piece of verbal dog poo at the would-be reformers. These ‘ad. verbum’ moments precipitate the kind of national shudder normally experienced when Mount St Helen’s clears her throat.

But I’m not a healthcare expert - I’m an observer of how mythology inspires human behaviour. And I believe that a bit of American mythology is instrumental in the emotional engine of this reaction The American mythology in question is that wealth equals virtue. That Puritan streak still possesses so much of the American subconscious, despite the passage of time and the influence of subsequent cultures.

I believe it’s true, for most people in industrialised nations, that prosperity is roughly proportional to work (especially if you add tactics, such as the use of delayed gratification). Life isn’t completely random. But life experience surely also shows us that it is possible for some to thrive without work, and others to work without thriving. In US mythology though, the thought that somebody else – especially a lazy person – should profit from your labours is anathema. In a nation where wealth equals virtue, the poor are immoral.

As I said in the opening paragraph, I truly believe that Americans as individuals are a lovely bunch, not abnormally callous or brutal. But the simple equation of money and virtue means that at a societal level, the level where generalisations and outgroups appear, that those ‘without’ can be written off as undeserving, maybe even of life.

Tuesday 11 August 2009

Nigeria's Witch Children

Jack of Kent in his latest has brightened all our days invoking the Python – not the spirit of the Delphic Oracle - the merry band of satirists who gave us such classic songs, phrases and sketches as ‘Every Sperm is Sacred’, “He’s not the Messiah, he’s a very naughty boy” and the scene from ‘Monty Python & The Holy Grail’ in which a woman has been dressed as a caricatured witch to force a prosecution.

Jack points out that despite the medieval setting of the film (the grail mythology was a phenomenon of the twelfth/thirteenth centuries) witch prosecutions were not common and did not reach their zenith in England (and also Europe) ‘til much later – the sixteenth and seventeenth centuries.

It’s true. I think that for most people unfamiliar with the chronology, the natural assumption would be that witch hunts belong to eras with magical religious traditions, rigid social strata, simple technology, agrarian economies and pre-Renaissance thought patterns. It’s a jolt to find that the worst happened in the early modern era. In actual fact, large scale witch hunts in Europe were a phenomenon of the Reformation.

So far, so theoretically interesting … to a witchcraft nerd, at least. What does this have to do with the price of henbane.

On the 30th July, a child’s rights conference in Calabar, Nigeria on the subject of ‘Child Rights and Witchcraft’ was raided and temporarily halted by supporters of an evangelical church, ‘Liberty Foundation Gospel Ministries’. The church had gained international notoriety after its leader, Helen Ukpabio, was featured in a BAFTA and Amnesty award winning documentary ‘Saving Africa’s Witch Children’ which was broadcast in the UK in late 2008. Mrs. Ukpabio herself can be seen relating her views on the problem of witchcraft in contemporary Nigeria here.

The raid can be seen here. It was serious: the stage was occupied and one of the organisers, Leo Igwe, was physically attacked and had personal items stolen.

Liberty Foundation Gospel Ministries promotes belief in witchcraft, producing films such as ‘Rapture’ and ‘Hellfire’ in which execrable special and makeup effects depict the effects of demonic rampage. But while it’s easy for us to snort at a movie that looks like it was shot on an mobile phone after a particularly gruelling afternoon necking a litre of grain alcohol, it’s worth remembering that the subject matter is taken very seriously by its audience. And ‘Saving Africa’s Witch Children’ was a harrowing account of how belief in witches is real, large-scale and having deadly effects on many children in Nigeria today.

So is there anything that we can draw upon from our own ignominious past to help our understanding of what is happening?

I think the first thing is to remember that witch hunts are a distinct phenomenon from belief in sorcery, which seems to have been endemic in pre-industrial Europe and is probably present in large swathes of modern Africa. Belief in sorcery does not automatically bring large-scale witch hunts. Trying to persuade people that sorcery does not exist is, in the short term, unlikely to change their minds and certainly unlikely to reduce the paranoia and scapegoating that are the primary features of a witch hunt, things which come from the social and economic circumstances at large.

The second is the counter-intuitive issue that Jack mentioned and which I recounted above: witch hunts happen in times of social and economic dislocation, rather than among people who are simply socially or technologically ‘backward’, however you like to define such a problematic concept. The Reformation in Europe, fuelled by the invention of the press in 1440, signalled a (albeit slow) move towards democracy, individualism, an industrial economy and the (relatively speaking) meritocratic society which must accompany it. It took the monopoly on spiritual services from one immensely powerful and multi-tendrilled political entity, Vatican Inc., and replaced it with several ‘authorities’ who were free to squabble vigorously about doctrinal differences.

Any parallels?

Nigeria is one of the fastest growing economies in the world, but has only had ten years of democracy. Prior to that there were several shaky attempts interspersed with military coups, all after a dreadful civil war which had left over one million dead. It is a wealthy country, but that wealth is not well distributed nor yet gone to creating good infrastructure. Corruption is a massive problem. It is also easier to draw distinctions between groups of Nigerians than to note similarities: there are two major religions (Islam in the north and Christianity in the south) and three ethnic groups (the Hausa, the Yoruba and the Igbo). There is also ethnic violence, especially in the Niger Delta where there is a booming oil industry and money to be made.

Nigeria is a country going through every kind of transition you could imagine.

But why children?

Sorcery accusations in Europe were notable for involving very few children, but they did involve beggars and the chronically needy. The reduction of the power of the church sometimes meant that traditional means of welfare relief disappeared; a poverty stricken neighbour who came begging for food was no longer a pitiable fellow in Christ who could be directed to the local religious house, but a pest with whom you were obliged to share. Nigeria is undergoing explosive population growth and it may be difficult to take care of so many young, especially when life of all ages is so vulnerable to cholera, polio and malaria. The children cited in ‘Saving Africa’s Witch Children’ all seemed defenceless in some way, fatherless or totally parentless – essentially, a potential drain on the charity of the community they live in. (Of course Africa has another reason not to share our benign view of children and childhood: many nations have within living memory seen the phenomenon of forcibly recruited child soldiers.)

It is to be hoped that eventual stability, prosperity, distribution of wealth and enjoyment of social consensus will take care of the fear and scapegoating. However, Africa is not developing economically in the way Europe did and presently enjoys/suffers from the attentions of fully-formed power-structures in the form of foreign interests. It remains to be seen whether ethical progress (such as eradicating corruption) can be cultivated along with economic development.

In the short term I believe that the single most important intervention would be to aggressively target professional witch hunters. Witch hunts employ specialists who, for obvious reasons, ensure that the hunt is self-begetting. Inquisitors in Europe have their counterparts in modern Nigeria, pastors who specialise in finding witch children and performing rituals to denature them – for a price. Stopping witch hunters would not stop accusations of sorcery nor fix Nigeria’s social and economic problems, but it may confine the issue of sorcery back to local levels.