Injustice at Columbia: Power and public health

Not any more

Not any more

Update: There are now several petitions you can sign to support Hopper and Vance. If you have an academic affiliation, go here – there are petitions on behalf of both scholars. If you are an activist or advocate, you can sign a petition for Vance here

Columbia University is rich. This was brought home to me many years ago, the first time that — a kid from the countryside — I visited Rockefeller Center. As I walked through the marmoreal plazas of that temple of capitalism, someone, I forget who, pointed out that the Rockefellers didn’t actually own the land the skyscrapers were built on. Columbia University did, and rented it to Nelson, David, et.al. This astonished me. I thought of universities as assemblies of disinterested, impecunious intellectuals; it was like hearing that Keats personally built the British Museum, or that Van Gogh paid for his life of luxury by hiring out the Louvre. In fact, Columbia, a canny cross between Scrooge and Thomas Sutpen, has made a fortune by speculating in land. It moved its quarters uptown in 1896, building a formidable campus at what was then virtually the northern edge of settlement; its colonial relations with impoverished neighbors, a sorry record of exploitation and expropriation, led its own students to riot in 1968. But it clung to its midtown holdings, raked in the rent, and finally sold them to Rockefeller Center in 1985 for a tidy $400 million. It’s still growing like a sci-fi movie fungus, planning a whole vast new campus on 17 acres that used to be part of Harlem. Among US universities, its endowment of $8.1 billion puts it behind only Harvard, Yale, Princeton, Stanford and (get this) Texas A&M and the University of Texas; but that’s greater than the GDPs of, among others, the Bahamas, Haiti, Malawi, Moldova, Montenegro, and Tajikistan. American universities are unprecedented entities in the world: huge concentrations of power and money, economies in themselves, ostensibly devoted to free thought but despotically run as any petrostate, and virtually immune to protest since the scruffy ’68 generation moved on to practice corporate law.

Someday, son, all this will be yours, plus most of the surrounding neighborhoods: Aerial view of Columbia's main campus

Someday, son, all this will be yours, plus most of the surrounding neighborhoods: Aerial view of Columbia’s main campus

It’s worth remembering this while reflecting on the fact that Columbia just fired two of the most important public intellectuals working in the fields of health and human rights. Carole Vance and Kim Hopper had been professors at the Mailman School of Public Health for decades — 27 and 26 years, respectively. Vance, The Nation rightly says, has done “pioneering work on the intersection of gender, health and human rights”; Hopper “is both an advocate for the homeless and one of the nation’s foremost scholars on homelessness.” They were fired not because of any shortcomings in their research or teaching, but because they hadn’t raised enough money.

In an excellent article, The Nation expands on the Darwinian economics behind this move, and I can’t do better than quote them:

Like many schools of public health, Mailman operates on a “soft money” model, which means that professors are expected to fund much of their salaries through grants. (Many professors there, including Vance and Hopper, work without tenure.) Recently, the amount expected has increased—from somewhere between 40 and 70 percent of their salaries to as much as 80 percent …. Meanwhile, the [US government's] National Institutes of Health, the primary source of grant money, has seen its budget slashed. These days, only 17 percent of grant applications are successful—a record low.

Vance told the Columbia Spectator that “requiring faculty members to fund 80% of their salaries through external grants is unbelievable at an educational institution.” As The Nation points out, “Legally, professors who are 80 percent grant-supported have to spend 80 percent of their total workweek on grant-related research.” This means, says Vance, “that only 20% of faculty time is available for teaching, mentoring, and advising.” It’s even worse, in fact; you have to deduct the time spent hustling to corral the funds, because those grants don’t raise themselves.

Students of the Mailman School at a meeting to protest the firings: Ayelet Pearl, Senior Staff Photographer, Columbia Spectator

Students of the Mailman School at a meeting to protest the firings: Photo by Ayelet Pearl for Columbia Spectator

Students at the School of Public Health have protested vigorously; they donned T-shirts reading “Un-Occupy Mailman,” because funders have taken over the school’s priorities. A representative of the Dean responded in bureaucratese: “Public health depends on soliciting feedback from all stakeholders.” (References to multiple “stakeholders” always mean: You to whom I am speaking will get screwed.) “That is why Dean Fried invited doctoral students to share their concerns — concerns we all have — about the importance of maintaining the high quality of a Mailman education in the face of reduced federal support.” And further blather.

Carole Vance is a friend of mine. I’m well aware that when bad things happen to people, their friends often respond with public praise that is entirely merited but doesn’t really change things. The victims may end up with the sense that they are reading their own obituaries in advance, which may be pleasing but is hardly encouraging. There is nothing retrospective about Carole, and I will try to avoid this note of plangency.

51SE6423GcL._SL500_AA300_Still, you can’t fail to note that Vance has been a major force in US and international feminism at least since the 1980s, when she co-organized the famous 1982 Barnard Conference on Sexuality, and compiled many of the resultant papers into the landmark anthology Pleasure and Danger: Exploring Female Sexuality. These days, when people talk about the Sex Wars they may think either of Uganda or of something to do with Sandra Fluke; then, though, it meant an impassioned contest over how feminism would cope with the unregulatable reality of multifarious sexual desires. Carole’s groundbreaking work for thirty years has carried forward the message that both feminism and human rights practice have to integrate sexuality as a central human concern.

I first got to know Carole about fifteen years ago, when, with a grant from the Rockefeller Foundation, she organized a program to bring both activists and academics working on sexuality and rights to Columbia as fellows. The goal was to give activists space to reflect on the theoretical implications of their work, and theorists a chance to consider practical effects. I was never a fellow in the program, but I went to many of its workshops and meetings, so I can say with perfect objectivity that it not only brought together uniquely gifted groups of people, but gave a great many of them a second lease on their thinking and working lives. The Nation quotes Rebecca Jordan-Young, a professor of women’s studies at Barnard and a onetime student of Vance’s: “Truly there is nobody else that mentors with the intensity that Carole does … She’s being actively punished for being an extraordinary mentor—that’s the direction the corporate university is moving in.” Very true, but one thing the article doesn’t capture is how Vance’s extraordinary mentorship reaches beyond the borders of both the US and academia. She has fostered the dangerous mating of theory and practice among campaigners in places like India and Turkey, where she co-developed and co-directs an annual workshop for sexual rights activists from around the world.  Like the best of teachers, she makes spaces where people realize things for themselves. “Dr. Vance is remarkable,” an Indian activist commented in an e-mail I saw this week. “She has changed the way we think.”

carole-beck_blog

Vance (L) and Rebecca Jordan-Young

It’s here that Columbia’s decision is particularly menacing. Internationally, two groups in particular have benefited from Vance’s powerful thinking and teaching: LGBT activists, through her work on sexuality, and — through her cliché-breaking work on trafficking — activists defending sex workers’ rights. Anybody who’s even dabbled in these fields knows that LGBT rights remain underresourced, and sex work issues — unless you want to eradicate it, of course — face a pathetic dearth of funding.

Columbia has a pretty panoply of anti-discrimination policies that claim to protect LGBT people (sex workers, as always, are left unprotected); but its decision here, along with the implications of its funding policies, constitutes active discrimination. Research aimed at amplifying rights protections for these two groups is not, under current conditions, going to be a magnet for funds. (As Columbia well knows, the US government, the public health school’s major funder, has spent years trying to shut down or censor research and advocacy on sex workers’ rights.) The Mailman School’s policies, and the precedent it’s set, mean nobody specializing in that work is likely to be on staff in the foreseeable future. That’s discrimination. It’s also a disgrace to an institution of alleged learning. The university is abdicating its duty to be an impartial arbiter of knowledge and surrendering it to funders, who get to dictate its research directions and thus their conclusions — and who are in no sense impartial. That $8 billion endowment is useless unless it exists to prevent this.

When research in these areas is so underfunded, a policy like Columbia’s also forces scholars into a competition for scarce resources with the very communities they’re trying to serve. This is especially immoral. Traditionally, universities saw a duty to the broader world: to use their resources in disseminating knowledge where it is most needed. Columbia has abdicated that too. Instead, the university sits preening like a Roman emperor in the Coliseum, watching its own professors forced to battle it out with a few barbarian activists for the scraps they need to live.  Unlike the Roman gladiatorial combats, there aren’t even any spectators – the fights aren’t exciting enough to draw in the distraction-hungry masses. The only people entertained are the university administrators, who must have a sick and solitary sense of fun.

Ave Caesar Morituri te Salutant, by Jean-Léon Gérôme(1859)

Dean of a public health school, upper right, conducting routine classroom observation

Public health is and has always been an ambivalent profession. On the one hand there are the ethical and genuinely selfless practitioners who care about the public and the sundered individuals who make it up: their mythic stories fill a film like Steven Soderbergh’s Contagion, where the heroes fight disease with everything they’ve got and get carried out in body bags. On the other hand, the field has a long history of loving power, and serving the ambitions of those who have it. Surveillance, contact tracing, quarantines, sterilization, the fantasies of eugenics, the hygienic justifications for police control: all these are also part of its past, and sometimes of its present. Governmentality, in the Foucauldian sense, has been well served by public health, indeed was bound up with it from the outset.

Knights in white satin: How public health sees itself

Knights in white satin: How public health sees itself

Nietzsche wrote: “The ‘freedom’ that the state bestows on certain men for the sake of philosophy is, properly speaking, no freedom at all, but an office that maintains its holder.” Education is not offered by office-holders but by thinkers. The Mailman School’s funding policies cater to the worst in public health, and bring back the most disreputable impulses in its history. They force professors to kowtow to power: either government power or the power of capital. They imperil the ethical advances that have tried to reshape the field. They silence critical questions. They discourage conversations about rights. They ignore students while misusing the money they’ve paid for their educations. They ensure that unpopular and marginal groups will go unrepresented in the work of the institution. They discredit a distinguished — and wealthy — university.

Petitions to support Vance and Hopper can be found here. Please sign. There’s a Tumblr (this is 2014: there’s always a Tumblr) set up by students to fight the firings: it’s here. It includes various letters of protest, which you may take as models should you want to write the Dean directly (lpfried@columbia.edu). The critical thinking you save may ultimately become your own.

I'm sorry, it protects who?

I’m sorry, it protects who?

Uganda, the World Bank, and LGBT rights: Winners and losers

Participants in a march demanding health-care funding to fight maternal mortality, Kampala, Uganda, May 22, 2012

Participants in a march demanding health-care funding to fight maternal mortality, Kampala, Uganda, May 22, 2012

Victory! .. isn’t it? On February 27, the World Bank announced it was “indefinitely” delaying a scheduled $90 million loan to Uganda to improve health care, in response to the passing of the comprehensively repressive “Anti-Homosexuality Bill.” “We have postponed the project for further review to ensure that the development objectives would not be adversely affected by the enactment of this new law,” a Bank spokesman said.

In the circles where I move  – international (that is, North-based) activists working on LGBT rights — rejoicing burgeoned: finally the big funders are getting serious about queer people’s oppression! Politicians joined in. Nancy Pelosi, ex-speaker of the US House, tweeted joyfully:

pelosi wb copy

Jim Yong Kim, President Obama’s appointee to the lead the World Bank (an organization Washington still disproportionately funds and dominates) brought home the message with an op-ed the next day:

Institutionalized discrimination is bad for people and for societies. Widespread discrimination is also bad for economies … Legislation restricting sexual rights, for instance, can hurt a country’s competitiveness by discouraging multinational companies from investing or locating their activities in those nations.

Let’s pause to bask in the exhilarating effect of having a powerful institution intervene for LGBT people, with a leader in global development saying the “s” word — sex, as in “sexual rights.” Yes: it feels good.

Still, this is Africa. And this is the World Bank. For international activists to laud its actions so unreservedly involves a wretched show of amnesia.

We think that debt has to be seen from the standpoint of its origins. Debt’s origins come from colonialism’s origins. Those who lend us money are those who had colonized us before … Debt is a cleverly managed re-conquest of Africa, aiming at subjugating its growth and development through foreign rules. Thus, each one of us becomes the financial slave, which is to say a true slave.

Probably few of my international colleagues will recognize those words– another leftist rant, right? But many Africans know them. It’s Thomas Sankara, then president of Burkina Faso, speaking to the African Union in 1987. Sankara had rejected the mandates of the World Bank and the International Monetary Fund and launched on a development path that promoted economic equality, gender justice, education, and health care as basic rights. Three months after saying that, he was dead: murdered in a coup. France and other creditor nations tacitly endorsed his killing. He’s remembered and mourned across Africa today. His successor brought the country back under World Bank and IMF tutelage; as a result, as a South African analyst remarks, “Today Burkina Faso remains one of the least developed countries in the world.”

 

For twenty-five years, the World Bank has pushed essentially unvarying policies across the developing world: privatization, cutting the public sector, fostering an export-based economy (so that poor countries become suppliers of raw materials to the industrial North, and don’t grow their own industries and markets). It imposed these restrictions as conditions for loans; that debt, in addition to crippling Southern economies, then became a weapon to enforce more conditions. Poverty spread, not development. The Bank has been friendlier to civil society than its IMF sibling; but their ideologies and impacts have been the same. Praising a World Bank intervention for LGBT rights in Africa while forgetting this history is like praising Putin’s tender concern for Crimean Russians, while forgetting the Ukrainians next door.

You can use the power of international lenders for certain instrumental ends. That doesn’t mean you have to love them. We shouldn’t just hail what they do, we should scrutinize it. And please. You cannot condemn (as indeed you should) the neocolonialism of foreign evangelists exporting homophobia to Africa, and ignore the neocolonialism of foreign financial institutions that enforce neoliberal economics on an abject continent. Why is it wrong to import one devastating ideology, and OK to import another? Sorry. You need to be consistent.

So in the spirit of scrutiny, some questions arise about what the World Bank did.

First of all: why postpone this loan? Mainly, the $90 million was earmarked to combat maternal mortality: aimed at “maternal health, newborn care and family … through improving human resources for health, physical health infrastructure, and management, leadership and accountability for health service delivery.” It entailed funding to expand and train medical staff, to “professionalize and strengthen” management, for obstetric equipment and medicines including contraceptives, and for renovating hospitals. These goals are unlikely to be “adversely affected” by the Anti-Homosexuality Bill. The real reason for the selection is that this loan was up for board approval on February 28. The Bank seized on the first loan that came along to postpone. It was a matter of convenience, not strategic targeting.

Progress, but not enough: Uganda maternal mortality rate, 1990-2013

Uganda maternal mortality rate, 1990-2013 (from http://www.countdown2015mnch.org/reports-and-articles/2013-report)

Second point: Maternal mortality is serious in Uganda — and a political issue.

The country’s rate of maternal mortality is extremely high. In the Millenium Development Goals — endorsed by nations at a UN summit back in 2000 — countries committed to reduce the level of maternal mortality by 75% by 2015. For Uganda, this would mean cutting a rate that hovered appallingly around 600 per 100,000 live births in the 1990s, to 150. A 2013 report found the rate had fallen to 310 per 100,000 live births — around a 3.2% reduction every year, the UN said, but still well above the goal. Fewer than half of mothers had adequate antenatal care, and only a third had sufficient postnatal care. Less than 60% had a skilled attendant at delivery. Despite the government’s loud promise of a National Minimum Health Care Package (UNMHCP) for all Ugandans, health services still fail to reach many poor and rural women.

Statistics on maternal health care in Uganda (from http://www.countdown2015mnch.org/reports-and-articles/2013-report)

Statistics on maternal health care in Uganda (from http://www.countdown2015mnch.org/reports-and-articles/2013-report)

By some estimates, between 6,500 and 13,500 women and girls in Uganda die each year due to “pregnancy-related complications.” That means at least sixteen women die every day.

In 2011, a coalition of NGOs petitioned Uganda’s courts to intervene. They argued 

that by not providing essential health services and commodities for pregnant women and their new-borns, Government was violating fundamental human rights guaranteed in the Constitution, including the right to health, the right to life, and the rights of women.

The case has stayed stalled in the legal system. At a September 2013 hearing, the government simply failed to show up, forcing an indefinite postponement. In May 2012, an emotional procession of women and health-care providers marched through Kampala’s streets to support the lawsuit. They got an apology from the judiciary for delays — too few judges, too little time — but the delays continued. They also met with Finance Ministry officials to demand increases in the health sector budget; those didn’t happen. Leonard Okello of the International HIV/AIDS Alliance Uganda told the press, “Dying mothers are not a priority in Uganda.”

Marchers in Kampala, May 22, 2012

Marchers in Kampala, May 22, 2012

Corruption and cronyism are undoubtedly at issue (top government officials waste a small fortune traveling for health care abroad), but the basic question is budgeting. Museveni has successfully battled back the political pressure to reorder his priorities. In 2001, African Union countries signed the Abuja Declaration, committing them to raise health spending to at least 15% of budget. (The development field seems particularly prone to these lofty professions of faith, which multiply like theological credos in the early Church.) Despite all its challenges, including one of the world’s best-known AIDS crises, Uganda has rarely made it much more than halfway to this target. The figures for recent years show a large decrease in the health sector’s budget share — from just over 10% in 2010 to under 8%:

On the right: health care as a percent of overall budget (from "Citizen’s Budget: The Civl Society Alternative Budget Proposals FY 2013/14 - 2017/18), at http://www.csbag.org/docs/Citizens_Budget_FY2013_14.pdf

On the right: health care as a percent of overall budget (from “Citizen’s Budget: The Civil Society Alternative Budget Proposals FY 2013/14 – 2017/18″, at http://www.csbag.org/docs/Citizens_Budget_FY2013_14.pdf)

Who gets the money instead?

Interesting question. Here are the allocations by sector from Uganda’s budgets for the last two fiscal years.

Uganda budget by sector, FY 2013/14 (from "National Budget Framework Paper," Ministry of Finance, at http://www.psfuganda.org/new/images/downloads/Trade/budget%20%20framework%20paper%202013-14.pdf)

Uganda budget by sector (from “The Background to the Budget, Fiscal Year 2013/14,” Ministry of Finance, p. 104, at http://www.budget.go.ug/budget/content/background-budget)

(Note the percentage figures on the right, and ignore the numbers in shillings, which are made irrelevant by inflation.) Health’s share goes down again, to less than half the Abuja Declaration goal. Other losers are education, agriculture, water and the environment. Huge shares of the budget are taken up by “Energy and Mineral Development” and “Works and Transport.” These partly reflect the growing exploitation of Uganda’s oil reserves. They also reflect the priorities neoliberal lenders like the World Bank have always urged on developing countries: go produce raw materials for export to the industrialized North! and go build the infrastructure to get them there! One commentator says the country is “focusing on physical capital at the expense of human capital.” That’s an understatement.

But the other big factor is the security sector.

Security doesn’t look so massive: only 8.2% of the latest budget. That’s only the tip of the AK-47, though. Many defense expenditures remain hidden. Uganda’s Independent newspaper noted that the “the budget for Defence in the BFP [Budget Framework Paper] has always been smaller” than the reality:

[I]n real terms that figure excludes monies accrued to Defence from external sources. The figure also does not include classified expenditure that is usually Defence’s biggest component. Because of national security, the army does not reveal certain expenditures.

The 2013/14 budget featured “about ten new taxes… introduced partly to finance the Ministry of Defence.” These included a value-added tax (VAT) on water and on wheat and flour, regressive imposts designed to squeeze money from the poor. Security is Museveni’s “topmost priority,” the Independent says, and it’s the great enemy of health. In 2012, rebel parliamentarians proposed cutting the military’s largesse by 15 billion shillings (about US$6 million) and boosting health spending by 39 billion (US$15.5 million). Museveni quashed the move in fury. He snarled that he “couldn’t sacrifice the defense budget for anything.”

The President prizes his troops: “a large military war-chest increases Museveni’s regional and international leverage, and helps cow opposition to him at home.” But the US loves the Ugandan military as well. America wants to see plenty of money spent on it.

David Hogg, Commander of US Army Africa, inspects Ugandan troops in April 2011. Photo: U.S. Army. .

David Hogg, Commander of US Army Africa, inspects Ugandan troops in April 2011. Photo: U.S. Army. .

I wrote two years ago about the US’s aims for strategic hegemony in Africa, driven by the promise of buried resources and the threat of China. Uganda, as ally and partner, is key to this design. Obama actually sent US troops to Uganda in 2011, to join its army in chasing the warlord Joseph Kony, loathed by well-meaning white people everywhere. This was a small reward for Museveni’s larger services in bringing a desolate stability to Somalia. In 2012, the Pentagon “poured more than $82 million into counterterrorism assistance for six African countries, with more than half of that going to Uganda.” Money and equipment keep flowing to Museveni’s forces. Obama showers Uganda with “lethal military assistance,” writes the pundit Andrew Mwenda, because “America’s geostrategic interests in our region, and Museveni’s pivotal role in them, demand that the American president pampers his Ugandan counterpart.” 

And here is where we can start to understand some ambiguities in the World Bank’s actions.

The $90 million loan for “Uganda Health Systems Strengthening” that the Bank was on the verge of giving drew on two earlier Bank analyses of Uganda’s health crises. There’s a 2009 paper, Uganda: A Public Expenditure Review 2008, With a Focus on Affordability of Pay Reform and Health Sector. A longer 2010 working paper, Fiscal Space for Health in Uganda, elaborated on this. (Peter Okwero, task team leader for the loan, helped compose both.) They’re fascinating documents that reveal much about Uganda and much more about the Bank. It’s an honest institution in many ways, frank with figures and often good at diagnosing what’s wrong. But its prescriptions seem to come from a different place from its diagnoses — one permeated with politics and ideology. Its medicines rarely match the disease.

The findings are unsurprising. Aside from considerable waste (caused by theft of drugs but also poor procurement and storage practices) the main problems in health care stem from lack of funds. Capital spending in hospitals has shrunk; many hospitals are old and decaying. Medical costs are rising: “Growing resistance to the existing treatment for malaria (and more recently for TB), is forcing Uganda to adopt more expensive treatments.” Meanwhile, “Uganda faces a serious shortage of health personnel in the workforce,” with only 8 doctors per 100,000 population. Staff are underpaid (even drug stealing, a major component of waste, is surely related to salaries, though the reports don’t draw the connection). And many sick people need resources just to use the system: 

65 percent of women reported lack of money to pay for treatment as a constraint to seeking treatment. Other problems included travel distance (55 percent), the necessity of taking public transportation (49 percent), concern over unavailability of medications (46 percent) …

“Preliminary health sector modeling work carried out under this study suggests that Uganda clearly needs to increase public health spending for non-salary cost at clinics and hospitals.”

Student nurses in the caesarean section ward of Rukungiri hospital, 2007: ©  Patricia Hopkins, ABC news (Australia)

Student nurses in the caesarean section ward of Rukungiri
hospital, 2007: © Patricia Hopkins, ABC news (Australia)

Except the conclusion is, weirdly, Uganda can’t. Here’s where the medicine stops fitting the diagnosis. “[Only] limited opportunities for additional public funding seem to exist,” the 2009 report says. The reports adduce this from looking at the national budget, and finding there’s just no flexibility there.

Can Uganda increase the share of its Government budget devoted to health? Reprioritizing health spending at the expense of other sectors seems unlikely. It is not clear which other sector budgets can feasibly be cut in order to increase allocations to health. Government policy has emphasized fiscal consolidation, whilst agriculture, energy, roads and USE [universal secondary education] are each identified as priorities in the coming years. … The best option for generating more health outputs in Uganda would seem to be through improved efficiency of Government spending rather than increasing Government spending. [Emphasis added]

So much for those lawsuits based on human rights! Instead … blah, blah. “Uganda’s health policymakers must identify a combination of efficiency savings and re-prioritization to sustain progress towards health targets … Efficiency gains will be needed and can be found …  The most pressing priority is to utilize the existing funding for health more efficiently.” (Italics added.) The reports show that Uganda needs increased health spending. But they end with “Recommendations to reduce the growing pressure to increase health spending.” They remind you mothers are dying, and then offer Museveni advice: how to tell those irritating women who march about dying mothers to get lost.

And it’s very interesting what budget sectors the World Bank looked at. They examine “agriculture, energy, roads” and education and find there’s nothing there to give to health care (even though Uganda’s most recent budgets managed to cut the first and last items). What the Bank doesn’t mention — not once – are defense and security, the military and police. Shifting money out of those sectors isn’t even under consideration. For the Bank, Museveni’s guns are sacrosanct. It’s the butter that needs trimming.

It’s tempting to say the Bank is showing a delicate sensitivity to Museveni’s feelings here. Why antagonize the old dictator by menacing his pet Praetorians?  But the World Bank has never hesitated to tell governments to cut their favorite projects. Instead, we need to recall the Bank’s political situation. The US is its largest shareholder; the American President appoints its head; the Yankee-led Bank put the Washington in the Washington Consensus, balancing off the European-dominated IMF. The Bank’s approach to Ugandan budgeting reflects the US’s priorities. The US gives its share of support to health care in Uganda, through PEPFAR and other programs; but its main interest is Museveni’s military, and it has no desire to see money for soldiers shifted to obstetricians. The Bank, likewise, is not going to threaten the defense sector. If that’s the choice — and they don’t even dare to suggest it — health care has to fend for itself.

The Washington Consensus: Street art from Argentina

The Washington Consensus: Street art from Argentina

The $90 million loan was meant as a way out of this dilemma, giving the Ugandan health system a bit more breathing room. It’s interesting, then, how the Bank moved so quickly to suspend it. According to BuzzFeed, the Democratic leader of the House herself called the Bank:

“Yesterday, Leader Pelosi [a curiously North Korean locution] spoke with President Kim to express the concerns of Members of Congress about the legislation enacted in Uganda,” Pelosi’s spokesman, Drew Hammill, told BuzzFeed in an email. “While we appreciate the difficult decisions President Kim has to make and their impact on the lives of many in the developing world, many Members believe that such a blatant act of discrimination should not go unnoticed.”

How odd that Pelosi phoned the Bank about its aid package before dialing her own government’s agencies. Yet it makes a certain sense; for Obama was under pressure to do something about Uganda, and some were pointing to that sacred military aid as a tempting target. Just one day earlier, Stars and Stripes — the US Army’s own newspaper – suggested as much.

[D]owngrading cooperation with Uganda’s military would be a way to send a signal to the leadership in the country, said J. Peter Pham, director of the Atlantic Council’s Africa Center. … 

“Military assistance is the one area where the U.S. has options,” Pham said. “[T]he Ugandan People’s Defence Force remains one of the few bastions of professionalism in the country, and its leadership is about the only check on Museveni and his ambitions to impose his son as a successor; hence, a shot across the UPDF’s bow might get some attention from those best positioned to get the president’s attention.”

The paper quickly backtracked: “Some experts, however, say that military ties are unlikely to be cut. Given the role the Ugandan military plays in promoting regional stability, dramatic cuts in aid should be avoided.” Lovely stability! You can see how the World Bank’s loan postponement was a happy distraction. It ended any pressure on the US government to trim its military commitments to Kampala. Uganda was already suffering, and Obama no longer needed to pile on. Pelosi’s call served its purpose.

This is stability: Ugandan soldier in Mogadishu, 2007

This is stability: Ugandan soldier in Mogadishu, 2007

The gesture is more a symbolic than a real one. The World Bank is unlikely actually to cut the loan, with four years of planning behind it. Sheila Gashishiri, the Bank’s spokesperson in Kampala, told the AP on February 28 that “the project run by Uganda’s Health Ministry will continue despite the postponement.” That probably means the funds will come through after a suitable interval.

In fact, Museveni’s regime will benefit. The whole brouhaha gives him wonderful room for rhetorical posturing. “The West can keep their ‘aid’ to Uganda over homos,” the ruling party’s press man Ofwono Opondo said, adding both that “Africa must stand up to Western domination” and that “Western ‘aid’ to Africa is lucrative and profitable trade they cannot cut off completely.” The politicos can have their cake of indignation — and ultimately eat their cake of $90 million credits too. Their rage, their language, pits LGBT people against pregnant women — a terrible side-effect of the Bank’s action. Surely that can only help brutal violence against the former spread.

Moreover, even a brief interruption in the health care loan gives Museveni ammunition. He can stand up to NGOs, Parliament, and even the courts if they demand more funding for the health sector to fight maternal mortality. “What money? The World Bank money? Where is it? There is no cash.” Those marching women can just go away. His security budget is even safer now from niggling jealousies.

And yet all this aid-cutting and health-care gutting is, we’re told, a blow for equality, against discrimination. We talk so much about “equality,” in the Western LGBT movement! The word is our fetish; we raise up those rosy equal signs as if they were the Black Madonna of Częstochowa.  But maybe we need to think more deeply about equality’s meaning.

Here is the logo for the State Department’s Global Equality Fund, which supports LGBT organizing around the world.

GlobalEqualityFund_blog

You have to love that rainbow circle: it’s seductive as the One Ring. So, too, is the call for dialogue. But what if that sphere dialogued with this one – a chart of global inequality, prepared by no less impeccable a capitalist center than a famous Swiss bank:

oct18_global_wealth

It’s a bit more … detailed. As are these circles:

Top: Wealth shares by country, 2000 (from Wikipedia; data from  http://www.wider.unu.edu/research/2006-2007/2006-2007-1/wider-wdhw-launch-5-12-2006/wider-wdhw-press-release-5-12-2006.pdf; Bottom: Wealth shares by region, 2010

Top: Wealth shares by country, 2000 (from Wikipedia; data from http://www.wider.unu.edu/research/2006-2007/2006-2007-1/wider-wdhw-launch-5-12-2006/wider-wdhw-press-release-5-12-2006.pdf; Bottom: Wealth shares by region, 2010

You’ll notice that Africa, with one-sixth of the world’s population, has one percent of its wealth. Uganda is a tiny, tiny sliver within that. I want the rainbow ring, but there’s something missing. How do these visions of equality connect?

The US-based Human Rights Campaign, which gave those iconic equality symbols to the world, also weighed in on the World Bank’s statement, inveighing at recalcitrant countries that

you will pay a high price for discriminatory practices. Whether viewed through a moral or economic lense [sic], discrimination does not pay. … HRC applauds Secretary Kerry and World Bank President Kim for taking a stand on LGBT equality. But the work is far from done.

HRC’s international work, of course, is mainly supported by the profits of vulture funds, exploiters who traffic in Third World debt and immiseration. Equality can mean so many things.

VULTURE 9So who won, and who lost? The World Bank won. They’ve sent the US a message that they are pliable to its political requirements. They’ve sent Uganda a message that there will be Consequences, but the Consequences won’t affect the programs Museveni most loves — the ones with guns. Then, messages mailed, the World Bank can finally produce the loan, which will take it off the hook (except to collect the interest). Uganda’s government is also a winner. They get to stand up theatrically to the blackmail of perversion; in the end, they probably get the cash. They also get an excellent argument against shifting money from the security establishment, or ending the deaths of pregnant women.

To these you can add the US government, which can rest confident that its military aid to Museveni has again evaded question. And you can add Western gay movements — especially those in the United States, allied not-quite-knowingly but easily with the administration’s interests. They’ve flexed their macho muscles and proven that they have some power, power to make the poor pay for what other people have done. I mean, it’s true that LGBT communities in Uganda are still laboring under oppression, and we haven’t done so much about that; but at least we get to oppress someone too. Isn’t that a consolation?

The losers are all in Uganda. They’re folks whose voices, though sometimes ventriloquized, are too faint or peripheral to be heard: mothers, children, LGBT people. Here’s to the victors! Great job.

mother-support

From Uganda: Guidelines for action against the Anti-Homosexuality Bill

 Miriam Makeba, A luta Continua

When Uganda’s “Anti-Homosexuality Bill” first appeared in Parliament in late 2009, human rights groups, women’s movements, LGBT organizations, HIV/AIDS NGOs, and other forces in the country formed a Civil Society Coalition on Human Rights and Constitutional Law (CSCHRCL) to fight it. With help and support from partners across Africa and the world, they kept the bill at bay for over four years.

Now, at last, the bill has passed and Museveni has signed it into law. The Coalition has sent out helpful guidelines, mainly meant for the international community, on how to offer needed, continuing assistance in the fight for LGBTI people’s human rights in Uganda.  With their permission, I’m posting the guidelines here. I’ve added a few links that may help explain some issues — the links are my own, and don’t have the Coalition’s endorsement. Same with the illustrations.

Solidarity to our comrades in Uganda! Viva the Coalition Viva — as they say in South Africa.

cschrcl copyGUIDELINES TO NATIONAL, REGIONAL, AND INTERNATIONAL PARTNERS ON HOW TO OFFER SUPPORT NOW THAT THE ANTI-HOMOSEXUALITY LAW HAS BEEN ASSENTED TO

Introduction

Dear Partners, Friends and Colleagues,

We thank you for all the support you have accorded the Civil Society Coalition on Human Rights and Constitutional Law (CSCHRCL) in its fight against the Anti-Homosexuality Bill (the Bill) over the years. We specifically thank you for the support since the Parliament of Uganda passed the Bill on 20th December 2013.

Unfortunately, despite the intensive work that has been done since 2009 to stop the passage of this draconian bill into law, President Yoweri Museveni Kaguta of the Republic of Uganda on Monday February 2014 signed the Bill into Law. We now have to work with the reality of the Anti- Homosexuality Act (2014).

These guidelines are intended to all our partners on how to support the CSCHRCL in this new context:

1. Speaking out: It is very critical that we continue to speak out against the law and its implications in terms of security of the LGBTI community, their allies, and the general implications of the Act on the work around public health and human rights in general.

Important to Note: In all communication about the impact of the law, please refer to the shrinking and deteriorating policy space that civil society is experiencing; not only about this human rights issue, but about “mainstream” human rights as well: Uganda’s track record is bad, and is getting worse, and these issues are related. In this regard please also be aware of the Anti-Pornography Act and the Public Order Management Act when discussing the situation of civil society activists in Uganda.

Women in Kampala protest against dress code and anti-pornography legislation, February 26: AFP

Women in Kampala protest against dress code and anti-pornography legislation, February 26: AFP

2. World Wide demonstrations. We call upon all partners, friends and allies to organize demonstrations in different cities around the world now as this Act is set to have detrimental effects for all of us. We all MUST continue to speak out. These could include demonstrations at the Ugandan embassy in our country, or asking your place of worship to organize a vigil.

3. Call on Multinational companies that have businesses in Uganda to go public about their concerns on the Act and their future economic engagements in Uganda. For example Heineiken, KLM, British Airways, Turkish Airlines, Barclays Bank, and other companies with important interests in Uganda and that already respect and value LGBT rights in their own internal policies, should note the risk that these laws pose for the safety of their own employees, as well as the impact on their brand image of continuing to do business in Uganda.

4. Issue statements condemning the passage of the Bill into Law. We need the Government to know that they shall not get away with their actions. These statements should reflect the other human rights violations in the country, not just about LGBTI rights. Please always alert us to any such statements, whichever language they are written in, such that we may either post them on our website (ugandans4rights.org) or a link to your website.

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Ugandan policeman beats a journalist, Kampala, May 28, 2013

5. The question of cutting Donor AID has arisen. Our position on this is very clear. We do not support General Aid Cuts to Uganda. We do not want the people of Uganda to suffer because of the unfortunate Political choices of our government. However, we support Strategic Aid Cuts to specific sectors, such as the Dutch Government’s decision to withdraw funding from the Justice Sector. We encourage urgent review of Aid to organizations and government institutions that have failed to demonstrate respect for Human Rights and those that have been actively supporting this bill. We DO NOT support cuts in support to NGO’s and other civil society institutions that offer life saving health services or other important social services to the People of Uganda.

6. Partners should expand investment in funding for service delivery and advocacy in defiance of the law, targeting LGBT populations, to attempt to mitigate the harmful impact this law will have on access to services, and on human rights.

SMUG banner at the World Social Forum, Nairobi, Kenya, 2007

SMUG banner at the World Social Forum, Nairobi, Kenya, 2007

7. We encourage you to lobby your Government’s Immigration Services to adjust their asylum policy with regard to LGBTI persons from Uganda, Nigeria, Russia, Cameroun and other countries in which levels of state-sponsored homophobia are rapidly rising.

8. We further request that you send us information on which organizations can be helpful in assisting the individuals who are at risk if the situation gets worse and they have to get out of the country and seek asylum or relocation elsewhere.

9. We request you to prepare for Urgent Actions given that LGBTI people or people doing work around LGBTI rights are increasingly liable to being arrested. Urgent actions could include sending messages to the Uganda Government to protest such arrests, use of social media such as Twitter, Facebook, WhatsApp, to raise awareness that arrests have happened, contacting your own embassies in Uganda to voice your concerns.

10. Call for your governments to issue travel advisories on Uganda, and remind them that they have a duty to protect and therefore should take responsibility for alerting their own LGBTI citizens to the risks of traveling to Uganda.

11. Contact travel companies to urge them to also routinely issue such travel advisories to their customers (on the same principle that tobacco products must have a health warning visibly displayed, so flights and package holidays should have warnings of the risks of traveling to Uganda!)

12. Get more foreign leaders in foreign governments to say something about the Act as they have not come out strongly as it was expected.

13. Get celebrities to say something against the Act. We need more voices that Ugandans recognize and revere socially to speak out against this Law.

14. Get more international Aid groups especially those responding to HIV/AIDS work to say something for example: USAID, Pepfar, CDC, Global Fund and others.

15. Use your influence and work or networks to encourage and Pressure more African leaders to speak out against the rising levels of homophobia through state sanctioned Anti Gay laws.

Joaquim Chissano, former president of Mozambique, who urged African leaders to end discrimination based on sexual orientation and gender identity in a 2014 open letter: http://www.theafricareport.com/Soapbox/an-open-letter-to-africas-leaders-joaquim-chissano-former-president-of-mozambique.html

Joaquim Chissano, former president of Mozambique, who urged African leaders to end discrimination based on sexual orientation and gender identity in a 2014 open letter: http://www.theafricareport.com/Soapbox/an-open-letter-to-africas-leaders-joaquim-chissano-former-president-of-mozambique.html

16. Engage with any non-LGBTI partner organizations in Uganda that you may collaborate with or whom you fund to issue statements condemning the passage of the AHB and its implications to the work of Non Governmental Organizations (NGOs). Remind them that this Bill is going to further shrink NGO spaces and is bound to affect the work they are doing.

17. Draw international public attention to issues such as corruption, human trafficking, nodding disease in northern Uganda, land-grabbing, as well as the suppression of media freedom and civil society space, the Public Order Management Act so that attention shifts to where it properly belongs; in the best interests of the country’s population as a whole. We need to step up public criticism to other negative trends in Uganda and remind the world that this Act is being used as a tool to divert attention from other pertinent issues that Ugandans are facing.

18. Get religious leaders of all faiths (Catholic, Anglican, Muslim, Protestant, Seventh Day Adventists, Quakers, etc.) to issue statements encouraging tolerance and respect for human rights for all Ugandans and Africans.

19. Call for your governments to ‘recall’ ambassadors back to their respective Capitals for at least one week for strategic consultations on how to move forward when dealing with Uganda and Nigeria in regards to the two draconian laws. This will give the Ugandan government food for thought.

20. Contribute physical, financial, or technical support to the Coalition and the LGBTI community as well as the exposed Human Rights Defenders working on LGBTI rights who are likely to begin to be arrested and charged or otherwise persecuted. Financial and technical support for challenging the Act in the Constitutional Court and the East African Court of Justice.

For More information Contact:
Jeffrey Ogwaro : jogwaro@gmail.com /ahbcoalition.coordinator@gmail.com Tel: 256 782176069
Clare Byarugaba: clarebyaru@gmail.com /ahbcoalition.coordinator@gmail.com Tel: 256 774068663
Kasha Jacqueline: jnkasha@gmail.com Tel: 256 772463161
Frank Mugisha : frankmugisha@gmail.com Tel: 256 772616062
Pepe Julian Onziema: onziema@gmail.com Te: 25 772370674

Ugandan billboard against corruption

Ugandan billboard against corruption

On not being well

Michael Ancher, "The Sick Girl," 1882

Michael Ancher, “The Sick Girl,” 1882

My mother died when she was 51 and I was 17. Here is how it happened. She had gone to Ohio — we lived in Virginia — to see her own mother, a solitary and sometimes bitter woman; an argument had broken out; my mother was struck by chest pains, and an ambulance took her to the hospital with angina. She’d never had heart problems before. That was on the Fourth of July, 1980. The next day, my father and I drove the hundreds of miles across monotonous mountains to her. Prone in the metal bed, she was pale and distracted. She asked me to rub her back. As I did so a small volcanic spike erupted on the monitor behind her, connected to her chest by wires. We left her, seeming a bit better we imagined, and my father and I went to a Howard Johnson’s somewhere nearby to eat silently. When we returned, the outer hall of the intensive care ward looked strange, congealed, like light glancing off obsidian. Nurses were gathered, and my mother’s beloved aunt was there. A band of bright fluorescent light showed under the door to my mother’s room, and I started toward it, and someone stopped me and told me rapidly what had happened. A massive heart attack, nothing anyone could do …. My great aunt held me. After a while they asked me if I wanted to see her, and I said no. I couldn’t have stood it. Many of these memories are blurred now — I don’t recall exactly who stopped me, or who told me. I remember those jagged peaks on the monitor, and I remember the color of that band of light as clearly as if it were shining in the next room now. It was only some years later, in graduate school, when I read The Duchess of Malfithat I found words to match in some degree what I must have felt. Cover her face; mine eyes dazzle; she died young. 

The ensuing years involved the usual inept evasions of guilt and sorrow. An event like that, especially when you are 17, does not enforce lessons, even if it should. Now I am 50. Ten days ago, I woke up in Cairo with a straining pain in my left leg: the kind of pain that suggests a bad soprano trapped inside there, trying to sing something from ToscaI knew what it was, but for 24 hours I persisted in hoping I had simply pulled a muscle. The next day I took a taxi downtown, and discovered I couldn’t walk at all. A familiar cafe near Bab el-Luk had just opened after Friday prayers, and the waiter propped me there and I started calling friends for help. The pain now indicated that the soprano and the orchestra were working from different scores in different keys. After a while my friends Tarek and Fady arrived with a car, and took me to a hospital in Giza. My leg had swollen to the size of one of those limbs of cattle that hang in butcher’s shops here, and was as red, but with a necrotic blue noli me tangere tinge of rot. As I lay in the emergency room, a doctor told me I had a “massive” deep vein thrombosisWhy massive? Why do they always call them massive? I asked myself. The caterwauling in my leg and in my head had reached a point where the orchestra was trying its hand at a Mahler symphony while the soprano, drunk and flu-ridden, was howling out Pierrot Lunaire.

What it felt like, generally: Caricature of Gustav Mahler conducting, 1900

What it felt like: Caricature of Gustav Mahler conducting, 1900

I spent five days in the hospital, laid flat and depressively eating flavorless soups, while the musicians gradually sobered up and wound down. I am home now, but the clot is still there, diminished but undefeated. I can’t walk much: even staggering to the corner pharmacy to pick up medicines makes the leg swell up again. I inject myself with something in the stomach daily, intrigued by how this doesn’t hurt. Kind friends are staying with me, to cook and run errands and clean. There’s no travel, no boarding an airplane till this is over, and I’m not sure when it will be over.

This isn’t the first time for me. Modernity has done wonders, for those of us in rich countries, to expand the life-span; specimens of homo sapiens in the European Middle Ages were lucky to grasp the goalpost of 35. But the payback is the onslaught of technologically demanding ills that start in the forties, as a reminder that what lies ahead of you is a stretch of undeserved and unnatural existence endowed by civilization’s artifices, that you owe this borrowed time to the bank.

Warfarin way back when

Warfarin way back when

My mother was diagnosed with high blood pressure in her forties. Almost four years ago, I had my first thrombosis. That one started in my leg too, but showed no traces there; it climbed — they’re natural mountaineers — unnoticed to my chest and nested there as if in a Himalayan cave, and I still felt nothing till one night, running to catch a bus on a New York street, things went white and I collapsed. There were massive blood clots (there you go again) in both lungsMy heart almost failed.

After that came two years of staying on blood thinners. The most popular one, Warfarin, was invented by the Wisconsin Agricultural Research Foundation (WARF) decades ago, in search of a humane way to kill rats by bleeding them to death internally. I went to sleek offices to have blood drawn all the time — little pipettes and big bleeping machines became my neighbors, like the vampires civilisés of True Blood – to test my “international normalized ratios,” (INRs) which determine the “extrinsic pathway of coagulation.” You get used to the jargon. Then 18 months ago my doctors took me off the drugs experimentally, since I seemed to be doing reasonably well. Bad call. 

Warfarin now

Warfarin now

In a condition like my current one, you lie in bed all day and think. The first fact about not being well — it should be obvious, but isn’t to the young and healthy — is how boring it is. The second, related, is that your horizon shrinks: all reality concentrates in the point or body part where you hurt or fear, and neither action nor emotion can happen without reference to the fundamental given of what’s wrong with you. How’s my clot today? That question obliterates the sunrise and the revolving world.  Auden wrote a poem about the sick:

They are and suffer; that is all they do:
A bandage hides the place where each is living,
His knowledge of the world restricted to
The treatment metal instruments are giving.

They lie apart like epochs from each other
(Truth in their sense is how much they can bear;
It is not talk like ours but groans they smother),
From us remote as plants: we stand elsewhere.

This is why visiting the hospital-bound or the very old is so horribly dull for everybody else, to be avoided like (literally) the plague, or turned into a quick drop-off of chocolates or floral arrangements, surgical as a Special Forces raid. What have they got to talk about? Their skin is the absolute limit of their interests. I don’t know how my friends, who have been generous with their time, can stand it.

Brooklyn Navy Yard hospital ward, ca. 1900

Brooklyn Navy Yard hospital ward, ca. 1900

At the same time, in high Western modernity, we’re obsessed with disease. With the idea of disease. This is understandable, since we are, as I say, living on borrowed time. Stolen, really: every year we eke out beyond our fourth decade is not just the gift of our technological civilization, but a robbery from other people whom we deny the diet, the drugs, the requisite machines.

Life expectancy in the rich US is 78.62 years these days. (Almost thirty years to go, Scott –voice shrinking to a whisper — insh’allah.)  That’s lower than Monaco, which has hit an amazing 89.63 (insert joke about a good gamble, please) but well above Egypt, where I am now. A cheap, efficient medical system, the legacy of Arab socialism, can’t overcome radical poverty to raise the allotted time above 73.19. In Sudan, just south, the expectancy falls to 63 years; from there on, as you follow the paths of slave caravans and colonial explorers across the continent, it keeps plummeting, to 54 years in Uganda, 53.86 in Zimbabwe, 52.78 in Malawi. Finally, in South Africa, it reaches 49.48 years, one of the worst in the world (in 2013 only Chad was lower), the aftereffect of forty years of apartheid and twenty more of equality deferred. Democracy does not heal; it does not cure history. These figures don’t just map out disease or poverty. They are a geography of power, because who has power has life. (It’s no coincidence that I’m getting the numbers from the CIA.) As a bedridden American in Cairo, on the broad Northern shelf of Africa, I’m sitting atop an inverted pyramid of injustice.

Life expectancy by country plotted against average annual income, 2010: From www.gapminder.org

Do click on this chart. Life expectancy by country plotted against average annual income, 2010: From http://www.gapminder.org

There’s always some symbolic sickness in the West, a disease representing how we think about these powers and inequities: a condition that stands in for what we know about our place in the world, or what we’d rather forget. Cancer used to be the great symbol. Its origins were obligingly inexact; either there were Enemies Within (anonymous little Communists in the liver or the lungs) or Enemies Without, chemical or biological opponents like Third-World dictators making the whole known environment unstable. (Todd Haynes’ Safeabout a woman rendered sick by almost everything in the plastic life around her, is still one of the scariest American films.) Thirty years ago, HIV/AIDS displaced cancer as an imaginative malady. We figured out what caused it fast enough — that retrovirus — but it was easily attributable less to a microscopic invader than to lifesize Others whom we disliked. There were a lot of them. Haitians, homosexuals, and heroin users for US paranoiacs were quickly joined by fearsome cousins around the world: Bulgarian nurses, Zimbabwean migrants, sex workers, black men on the down low, black women who slept with them, Africans in general, foreign tourists, foreign truck drivers, that ethnic minority who stink, the whole sick crew. It’s a truism that HIV prevalence provides a chart of inequality. But HIV mythology provides something almost as valuable: a chart of hate. The political power and the ideological convenience of HIV have always lain in its double gesture: simultaneously exposing injustice, and giving hate a justification.

I’ve watched relatives die of cancer, and friends live and die with HIV/AIDS. The kind of thing I’ve got is different: not worse, certainly, just different. There’s a reason heart disease and its associated syndromes have never become such symbols, such subjects of imaginings. They’re just there. Their ultimate cause is generally in the genes or in some combination of accidents; that multiplication of factors doesn’t lend itself to mythology. In my case, the blood just clots the wrong way, much like my mother’s did. I will have to take modified rat poison for the rest of my life to thin it. This is not intolerable. (The rats are happy.) The problem is, of course, that as a condition it’s controllable but not excisable; it doesn’t go away, and there is always that low basso ostinato uncertainty about whether or when you’ll wake up with a strange pain in the leg that gets more insistent, or keel over in the street. It’s impossible to interpret something like that in any meaningful or order-instilling way. It’s an existential insecurity insusceptible to the consolations of metaphor. It teaches nothing except that the body is frail, unreliable. In no sense can that be made reassuring, not in the way that it’s always comforting to identify some chemicals to eschew, some culprits to loathe, some immigrants to expel.

Jean Bourdichon, The Four Conditions of Society : Poverty, ca. 1500

Jean Bourdichon, “The Four Conditions of Society: Poverty,” ca. 1500

Nobody likes these uncertainties, from which there’s nothing to be gained or learned. Nobody likes knowing the body is weak and prone to betrayal.  All that money, all our accumulations of political power, all those drugs we hoard behind patent laws, all the debt we extract from others to fund our happiness, all the food we store up while others starve, all our drones and armies and the authority our societies claim, can’t contend against our physical random flaws, doesn’t alter the aleatic vulnerability of the individual body. It’s an old cliché:

Gold cannot buy you health;
Physic himself must fade. …
Brightness falls from the air;
Queens have died young and fair.

But do we ever hate hearing that.

The rich die well, but they still die: Paul Delaroche, Cardinal Mazarin's Last Sickness, 1830

The rich die well, but they still die: Paul Delaroche, “Cardinal Mazarin’s Last Sickness,” 1830

You would think that Western gays, after years of confronting HIV, would have come to terms with the body’s unreliability. But no. In fact gays particularly hate the idea. Maybe it’s because their identities are so tied to a set of physical acts that to admit bodily weakness would undermine their selfhood in a particularly drastic way. Maybe it’s because one common reaction to AIDS has been an extreme compulsion to look and act healthy. Back when I came out, in the 80s, you were required to be buff and butch and the picture of wellness (odd that the Marlboro Man, a pitchman for killer cigarettes, served as icon of this vital manhood). The slightest sag into infirmity or unaccountable cough, and no one would touch you for fear of infection. We queers measure triumph or disaster by our bodies. We can’t afford to let them be mistrusted.

I learned this in a curious way, the last time I got seriously sick; I learned it from a bunch of people who don’t like me. When I resigned from Human Rights Watch, I discussed the blood clots in my lungs that triggered my departure, in a letter that made its way around the Internet. What struck me about the many responses was that people who disliked me for political reasons felt compelled to turn that into medical mistrust; they simply didn’t believe I could get sick. This took nasty forms. The ever-love-filled and litigious Peter Tatchell repeatedly circulated e-mails to thousands, saying that “Scott Long left Human Rights Watch. He claims it was because of ill-health. Others suspect he was sacked.” Peter’s friend Michael Petrelis, the crank-slash-stalker in San Francisco, developed this theme, blogging that “Long developed a severe case of a Soviet-style case of the flu … His official explanation for moving on would have delighted the editors of Pravda in Brezhnev’s day, it was so full of obfuscation and self-pity.” Melanie Nathan, a peculiar West Coast blogger, just three months ago sent me an series of messages saying — among many other things — that “We all know that your ‘embolism’ was a convenient excuse” (not clear for what). She also called me a “vile bucket of anal slime,” which I think is a quote from some website. There were more. I would have to be superhuman not to be angry at these creeps; I felt like sending them my medical charts as proof, or maybe my medical bills. Some of these folks were crazy, some permanently enraged, and some simply hadn’t a clue what they were saying. But — trying to stand back slightly — I hear in all this vituperation a very human fear. Your foes are always supposed to be there, even more so than your friends; they’re an identity and linchpin, a pole against which you define yourself. They’re spectres and ideas, not frail and physical people. God forbid they should have bodies; God forbid their bodies should do them wrong. I’m sorry I got sick, and I’m sorry that unsettled Tatchell and Petrelis so much. Perhaps I can understand, though, why the news of somebody else’s sickness roused them to so much anger. “Rage against the dying of the light” translates quickly into a rage against those who remind us of the dying.

So here I sit in Cairo, thinking about my body.

Edvard Munch, "The Sick Child," 1885-86

Edvard Munch, “The Sick Child,” 1885-86

My mother died when she was a year older than I am now: much too young. I can’t remember her without seeing, almost like a light beneath her skin, the banked fires of things undone. The memories don’t grow easier. I cannot read Paul Celan‘s poems about his lost mother without breaking into uncontrollable tears:

Rain cloud, above the well do you hover?
My quiet mother weeps for everyone.

Oaken door, who lifted you off your hinges?
My gentle mother cannot return.

Celan’s mother died in the Holocaust, in Transnistria. It’s presumptuous to compare personal loss to historical catastrophe. But loss is what it is, always different in its circumstances and in other ways always the same. My mother died because her body failed her. It was part of a world in which she’d suffered, and also where she had a relative degree of safety: a world where she had tried to compensate for both by a constant, wearing labor of compassion. It didn’t matter. My mother died because her body was part of the world, and the world is perishing.

It’s strange that I’ve spent so much of the years since then working on things like “sexual rights” and “bodily autonomy.” Bodily autonomy is a beautiful ideal. Like so much in human rights, it gestures toward a vision of a perfect cosmos, lit by Platonic concepts that burn in the corridors like inexhaustible candles. Yet our bodies are not autonomous. Our bodies are part of the world. They are subject to its vicissitudes, implicated in its weakness, its injustices, its power, its deaths. They live with the world’s joys and fail with its wrongs. This is a fact, not a lesson. It can be said; it can’t be learned. I will only learn it by dying.

Jeddah Prison, Cell 18: Entrapped in Saudi Arabia

Baiman Prison, Jeddah, Saudi Arabia: from a video leaked to international media in 2012 to expose overcrowding (see http://observers.france24.com/content/20120201-leaked-images-overcrowding-saudi-arabian-prisons-mobile-phone-video-jail-jeddah-khoudar-hygiene-crowded-health)

Braiman Prison, Jeddah, Saudi Arabia: from a video leaked to international media in 2012 to expose overcrowding (see http://observers.france24.com/content/20120201-leaked-images-overcrowding-saudi-arabian-prisons-mobile-phone-video-jail-jeddah-khoudar-hygiene-crowded-health)

“Ahmed” is not his real name, and I’m afraid it’s not a very inventive substitute. As we sat trying to brainstorm a proper pseudonym for him, he told me he’s always wanted to be called “Ginger.” But he doesn’t look like a Ginger: he’s a dark and slightly stolid-looking figure in his 30s, conveying a composed center of gravity that probably stood him in good stead through everything he had to endure.

I talked to him the day after he’d been forcibly deported back to his native Egypt from Saudi Arabia.  He spent more than two years imprisoned in Jeddah, for visiting a gay chatroom.

Here is his story.

I was working as a pharmacist in Saudi, in Jeddah.  I worked in one hospital for four years, but then I transferred to another hospital because of a disagreement about the salary. When I changed to the second hospital there was a problem about the accommodation. In my first hospital I was living alone, I had my freedom. When I was transferred to the second hospital I was living with two other foreign guys who were straight, and they knew I was gay. They refused to have a gay with them, they forced me to leave the apartment. I handed in my resignation, came back to Egypt, stayed maybe three months, found a new contract for another hospital in Jeddah. I returned, and I enjoyed working in the third hospital.

In that place I think they realized that I was a gay, but they accepted me because I was doing my work, I wasn’t doing anything bad.  There was another guy at the hospital, a doctor from East Asia, and everyone knew that he was a gay—he’d flirt very openly with guys he liked, saying “We can hang out together if you can teach me Arabic.”

There’s a lot of life, everything is available in Saudi. For gays there are parties. Makeup, men in dresses… everything you can imagine or you cannot imagine. But for sure it’s hidden. There were foreigners in the scene, but it was mostly Saudis. So many Saudis like gays. If they know that you are gay, they will like you. Not everyone is hating! Some of them are enjoying having sex!

So one night in 2011 – I was working night duty – I finished and came home to my flat. I had something to drink – I knew some guys who could get it for me. Then I got onto a public chatroom, and I started to search for people. A guy said, Can I know you? How old are you, how do you look?

I told him my A/S/L [age, sex, location] and my e-mail. I offered to show myself on the cam. At that time, I was wearing my hair up, wearing some lingerie and my makeup and stuff like that.  I was looking cute.

He said, Can I come to you? You have a place. So he came to my home. He sat around with me, talking and joking.  But we didn’t do anything. He said, We can meet again this evening. I have my own flat, and I don’t feel comfortable here. I knew some guys didn’t feel right in a stranger’s place, and I respected that.

The evening came, around 7 PM or so – I still remember it vividly. He called and told me, I gave you my word, and I’m not lying, I’m coming to you. He said, I have a gift for you.

Then he told me also to bring my things, lingerie and makeup and stuff like that. I trusted him.

I went down to the front of the building to meet him. Just after I got in his car, maybe after a few minutes, I found the government, the guys in the religious police [Gama’t al-Amr be al-Ma’arouf], opening the door of the car, putting the cuffs on me. Of course he knew my home, so they came back there and took everything, the lingerie, condoms, my laptop, which contains porno movies and some pictures of myself

Then I found myself in the police station.

Preventing vice, encouraging virtue: Saudi religious police

Preventing vice, encouraging virtue: Saudi religious police

I was in a horrible state, crying — I think I had a nervous breakdown. They accused me of being a shazz jenseyyan [sexual pervert]. Everything they asked, I told them yes. Was I taking a contraceptive pill for females [for hormones]? Yes. The lingerie is for you? Yes. You’re a shazz, you’re getting fucked, you feel deeply inside yourself that you are a girl. Yes. But I said, Even if I do feel something like that, it’s not hurting anyone.

I knew the law, because it’s a religious country — not just religious but it’s a country where you must be straight. I know what happened before in Egypt [the Cairo 52 case and the subsequent crackdown] and that was in Egypt – what about a country like Saudi Arabia? Each time I went out on a date, I had a fear that I would be arrested. I expected it. But I did not expect that I would stay in prison so long.

The police didn’t use any violence against me. It’s not a matter of violence, it’s a matter of the whole process being unfair. I wish they had treated me with violence, instead of leaving me in jail for two years.

The manager in the hospital visited me in the jail. He told me that because I’d confessed, I would be deported.  To me this was something good: at least I would be free.

Instead, after a week, they summoned me from jail to the court. The judge was an awful judge, the worst. He told me, You are a sexual pervert.  I didn’t know how to answer. I answered I have dressed and made myself up like that but I’m not having sex — I’m just showing off. He did not tell me or ask me anything after that.

That day, I was handcuffed to another guy from the same cell. He was also in a gay case, but his hearing was before another judge, so we were led together to my judge, then together to his judge. His judge was reading the case file, asking him about the details, what happened, what they were saying – telling him, If you want I will call the witnesses, but if they say it’s all true, the sentence will be double. If you want to confess now, I can help you. I was astonished. Why was no one investigating my case that way? Why didn’t I even have the right to make a defense?

Two or three weeks later, they told me the judge wanted to transfer my case to the higher court [al-Mahkama al-A’ama] and he was asking that court to give me the death sentence.

The higher court, which can impose the death sentence, only can do that in cases where two people are arrested together and they each say, yes, he did that with me. Or if you have previous convictions. Or if you are married – it’s much worse to be accused of homosexual acts if you are married. None of that was true of me.

I waited in jail for four months or five months, and nothing happened. After that I was summoned to interrogation again.

The person who questioned me is called an interrogator (al-mohaqqek), but he’s the same rank as a wakil niyaba (deputy prosecutor) here in Egypt. The question he asked over and over was whether I was married, or had ever been married. Finally he wrote on a paper that I had not, and I put my fingerprint, and he said, Your case belongs in the jurisdiction of the lower court.

I was so happy that day.

But I waited for another four months. My birthday passed. Another summons came from that interrogator again. I had a lawyer by now. (It had been really hard to find one; nobody my friends approached in Saudi would take the case, because it was so dirty. Finally I asked my father in Egypt to look for a lawyer there who could pull strings with Saudi colleagues to get them to represent me.) I got in touch with my lawyer and told him my case was back with the lower court.

But in two weeks he called me to say, no, it was still in the hands of the higher court. Then he told me that instead it had been referred back to the interrogator. And the interrogator summoned me again, and he went over every point in the case. The new point that they asked me about – it was only the second time it had come up —was about the pictures on the laptop. There was a photo of two guys having intercourse, but the photo was only of their bodies, no faces. One of them was actually me; but there was no way of proving that. In the police station they’d asked me about it, and I’d claimed it was photoshopped or something, that it wasn’t me.  Now the interrogator asked about it again and I told him I had no idea who the men were — but he said, You already confessed to the police that it is you. I protested, I never said that! Where is my confession? But on that basis he transferred the case to the higher court again.

After maybe six weeks, they summoned me to the higher court. The lawyer was with me now, and the judge was very correct, asking me lots of questions.  The only point I admitted was that I had some feminine clothes and I like sometimes to look like a girl, but only inside my home. But they kept insisting that I had sex.  The only proof of this was that I had condoms. I admitted that I owned the condoms, and when I did that, they convicted me, saying it proved I was having sex in Saudi Arabia.

If you buy now, comes with a free three-year prison sentence: Vintage Orientalist condom packet from the US

If you buy now, comes with a free three-year prison sentence: Vintage Orientalist condom packet from the US

At least the request for the death penalty was refused. They sentenced me to three years and 300 lashes, to be delivered over six sessions, 50 lashes each.

In the end I spent two years in Braiman Prison in Jeddah, and I only went through three sessions of the lashes, 50 lashes each time. Finally I was released by a pardon of the king, a general amnesty.  The homosexuality cases are included under these and the amnesties happen regularly, so that most people convicted in a homosexuality case don’t spend too long in the jail. There was a guy with us whose sentence was seven years and he got out after one year. I was unusual, I stayed more than two years.  And after I was released, they deported me.

In prison, I understood that the purpose of the judge in the lower court, when he sent the case to the higher court, was just to keep me in jail for a long time waiting for the court decision, since I couldn’t be amnestied till I was convicted. He just wanted to prolong my jail time.

I spent those two years in Cell 18 in Braiman Prison. It is the special cell for people convicted for homosexual acts. There are a lot of men there. The day I arrived, there were maybe 50, 55, or 58 in the cell. But when I left there were 75.  Most of them feel like girls – we call each other by feminine names. We were sleeping on mattresses on the floor.

A lot of them had been arrested on the Internet, I can’t count now how many. The chief of the cell was arrested over the Internet, through chat on Palringo.  Some had been arrested on Hornet, someone on U4Bear, some on WhosHere — the religious police know all the apps and chatrooms. Some of them had got a phone call asking to meet, from someone they’d talked to before on WhatsApp, and that guy turned out to be police.

That handsome, bearded man wants YOU to prevent some vice and encourage some virtue

That handsome, bearded man wants YOU to prevent some vice and encourage some virtue

I actually enjoyed getting to know these guys in the prison. Some were Saudis but most were from [a nearby country].  From there they go to Saudi legally, some for regular work, some for prostitution. And those are making so much money. Maybe for fucking just one time they can rake in 300-500 Saudi riyals [$75-125 US].  The religious police were more concerned with targeting foreigners than Saudis. The foreigners don’t have complete rights in Saudi. It’s a kind of racism.

No one knew of anyone who had been executed [for homosexual conduct]. People would talk about one case that had happened a long time ago. One guy, an Egyptian in our cell, gave me some details; but I don’t know if he was telling the truth. He said these guys were arrested at a party. They stayed in in jail for maybe two or three years without even getting a sentence, and they could tell they would stay more and more. That guy told me that they were having sex in front of everybody in the cell, prisoners and officers, and they were even singing at the time of prayer. [The authorities] told them it’s not right to do that, you have to stop. And you are in jail, so there must be some kind of repentance.

They refused to stop. So their case was transferred to the higher court. And the guy heard they were executed. This, he said, was maybe two decades ago. He told me he had been arrested once in Saudi maybe ten years back, and heard about this from other prisoners as something that had happened five or ten years before that.  But I don’t believe everything he said.

Since then, though, because executions were getting bad publicity in the media, they stopped the death penalty for most cases of homosexuality – only for rape of a child, a boy, a man, something like that. In cases like mine, they just hold the sentence over you as a threat, to scare you; but it’s not actually going to happen.

But it’s not easy to look at a paper in jail and read that the judge is demanding that you be put to death.  It’s difficult. It scares you. It still scares me.

Still from leaked footage: A cell in Braiman Prison, Jeddah, 2012

Still from leaked footage: A cell in Braiman Prison, Jeddah, 2012

ProstitutionSpeak, ideology, and death

"Moral Reform Directory" of 1839: This town is a horrible sump of abominable corruption, and here are the addresses

The God’s honest truth is, I get so depressed when I think about sex work.   Nothing ever changes. Or — well, let me correct that a little. Sex workers change.  The conditions of sex work change. The demographics of who goes into sex work change. The clients of sex workers change according to time, place, the economy, and other factors. The collective consciousness of sex workers changes. Even the laws around sex work change. But two things never change: The way the media reports on sex work, and the way Nicholas Kristof goes out in the wild to save some sex workers whenever there’s a full moon.   And the immobile persistence of these overwhelming facts cancels out all the other changes: the same way the occasional wobble in the earth’s axis, though it might produce an Ice Age or a mass extinction on the local scale, doesn’t alter the drone of the planet’s endless billions of rotations around the sun. The sun is a fixed fact; Nick Kristof is a fixed fact; and phrases like “Street Prostitution Keeps Its Wily Hold” are fixed facts that will last till every newspaper and every computer chip are shreds of superheated carbon inside a red dwarf. And so it goes.

“Street Prostitution Keeps Its Wily Hold” was in the headline of a New York Times article this month.

Two men dressed as women strutted in and out of the shadows cast by the moon, past the locked doors of residences, just off one of Brooklyn’s nondescript commercial strips.

One wore knee-high boots and jeans with flowery designs. He had the straightened hair, exaggerated lashes and thick lipstick of a drag queen. The other was a rocker type, the bright red tresses of his wig bouncing giddily off his leather jacket whenever he peered over his shoulder into the headlights of an oncoming car.

Eight months ago, it was not uncommon to see as many as 20 scantily dressed women shimmying along the side streets near this one-block stretch of Madison Street between Broadway and Bushwick Avenue, selling sex for cash or other gifts, like drugs or alcohol. But a recent police crackdown and an influx of transvestite prostitutes have sent most of the women elsewhere — at least for now.

Who writes this stuff for the Times?  (Answer: Al Baker and Tim Stelloh.)  Who edits it? On what other subject would the Newspaper of Record slip into such purple prose, as if it were donning its own flowery off-the-rack fuck-me hooker outfits? What does it mean to have “the straightened hair, exaggerated lashes and thick lipstick of a drag queen”? Does that mean she is a drag queen?  Or did he just mug a drag queen and steal his facial features?  Why isn’t the Gay and Lesbian Alliance against Defamation nailing the Times to the wall for this, instead of standing up for Ellen, who can probably stand up for herself?  Oh, I forgot: “transvestite” prostitutes aren’t respectable, unlike camera-coddled or drug-addled celebrities, and even Neil Patrick Harris could probably get away with calling them “drag queens” or, as GLAAD puts it, “tr*nnies.”

Slumming: A resembles-a-drag-queen and her manner-of-a-pimp

The arbiters of what’s Fit To Print, I suspect, fall back on such adj.- and adv.-filled language because they still think sex work would be unprintable in bald noun-verb phrases. The reigning ideology is all about hiding the fact that something very simple is happening, the exchange of sex for money. Instead, sacred horror and legal revulsion must cast their nebula over the scene, made up of purple rain and red-tressed wig and elaborate lighting effects to allow fantasies of rot and exploitation full play. Nothing in ProstitutionSpeak (or Pr*st*t*t**nSpeak) simply is itself. Everything resembles something, everything is like something, as if the jism of metaphor spills over and obliterates the outlines of thought. It’s all swept up in the “vibrancy and persistence of the old-fashioned street hustle, which in the predawn darkness of Bedford-Stuyvesant on Thursday spilled forth in all its crafty, competitive mercantile ways”:

As the transvestites walked up and down Madison Street looking for clients, a man, who had adopted the dress and manner of a pimp, followed them, sometimes at a close distance. Their parade was interrupted by a Mercedes sedan that pulled up to a traffic light; a door opened and a prostitute bolted out. The Mercedes sped away.

Is this guy a pimp?  Or did he beat one up, like the drag queen, and make off with his dress and manner? How do you know that’s a prostitute? Maybe she just stole a prostitute’s profession. Jesus, it’s a dangerous neighborhood.

And now it’s even more dangerous. Why? Well, there’s the police. Wheeling their attention briefly from the omnipresent Muslim threat, the cops, over three days in January, “made 195 arrests and seized 55 vehicles in what police officials called Operation Losing Proposition.” (That’s almost as good as Infinite Justice.) It’s hard to tell how they even identify the sex workers underneath all the metaphors, but in their hard-boiled wisdom, they manage. Here’s my favorite sentence from the entire piece:

In a separate case underscoring the ubiquity of streetwalking, a 32-year-old Pennsylvania man was arrested on Feb. 6 after impersonating a police officer to extort sex from prostitutes, the police said.

Hilarious. But why does it show the “ubiquity of streetwalking”? Doesn’t it really underscore the ubiquity of … cops? Of real cops and fake cops alike, swarming everywhere, the greatest danger to prostitutes’ health and integrity? As Raymond Chandler wrote at the end of his greatest novel:

I never saw any of them again—except the cops. No way has yet been invented to say goodbye to them.

So true. But then if you’re a cop, you probably don’t even notice that no one can get rid of you, or that anyone is trying.

The general gist of the article is that while “other crimes recede” in greater New York, prostitution-related arrests stay steady. But this isn’t surprising.   Those arrests, a fertile field for extortion, have always provided supplemental income for the police; and since streetwalkers are exposed pretty much by definition, it’s easy to nab them — and their clients. As it happens, Governor Eliot Spitzer (before he was brought down by the scandal over his patronizing a DC sex work ring) signed a bill changing the laws on prostitution in the state of New York. Selling sex remained a Class B Misdemeanor ( worth three months in jail or a $500 fine); but patronizing a prostitute, the crime and associated hypocrisy soon to topple Spitzer, went up to Class A, carrying one year in jail or a $1,000 fine. For cops, the clients have always represented a readier source of bribes, since they have both more money to offer and more reputation to save. Now they also face more risk. So it’s not surprising that Police Commissioner Raymond Kelly’s chief target in Operation Losing Perspiration was the johns.

Protest against Raymond Kelly: We don't just spy on Muslims anymore

The article tries to put the best gloss on this by suggesting the notoriously un-cosmopolitan Commish was in fact mimicking the famous “Swedish model” — a Nordic effort to target “the point of demand” rather than the prostitute herself. For Head Cop Kelly, the guy who goes to Bed-Stuy looking for a blow job is now engaged in “human trafficking”: the slave trade in women, or in “drag queens” or “transvestites.” All this, the writers claim, “occurred after Mr. Kelly took part in a series of meetings, beginning last year, with advocates from Europe and others aiming ‘for a fairer approach to prostitution.’” But:

Some advocates for prostitutes noted that 10 prostitutes were included in the mid-January arrests, which sends a mixed message. Others, including one former call girl, said it was wrong to focus on johns because it could make those clients more nervous and less likely to share the kind of personal information prostitutes rely on to ensure their safety.

Stop that man! Marketing the Swedish model

Predictably, in letters to the Times’ editor, advocates of the Swedish model call it a “human-rights, women’s-rights-based approach.”  Is it — even in Sweden? There, one analyst reports that, since the system began in 1999,

Police harassment of prostitutes has increased – they can be forced to appear in court to provide testimony against the client (they can refuse to witness, but they are still summoned and sometimes escorted to courtrooms), and whenever they are caught with a client, their belongings are searched and they may be frisked. Anything that police think they can use as evidence against clients (such as condoms) are confiscated. In those cases where a man was caught with a condom on his penis in the back of his car, police have used that fact to argue that he was breaking the law. This practice clearly has consequences for condom use among sexworkers. It provides both them and their clients with strong incentives to avoid using them. The law has been a catastrophe for non-Swedish sexworkers – if the prostitute found with a client is not a citizen or legal resident of Sweden, she is immediately deported; in fact government prosecutors complain that in a number of cases they were unable to gain convictions against clients because the prostitutes they were found with had been deported before they could even give a statement. This fact affects the willingness of non-residents to report on violence.

But the model’s goal is not actually to defend the rights of sex workers — in or out of the trade. It’s to pursue a project both chimerical and, in its infatuation with the radical absolute, Stalinist: the eradication of sex work altogether.   We “must work to end it — in our lifetime and forever,” Nora Ramos, of the Coalition against Trafficking in Women (and “drag queens”? and “transvestites?”), instructs the Times. 

Prostitution won’t end. But the fantastic dream of its elimination will continue to inspire brutality in the inquisitional name of an erasing justice.  Since the crime leaves neither victims nor evidence behind, the quest to find and eradicate it breeds deep intrusions into personal and physical privacy, and torturous semantic reinterpretations of proof.  In Kathmandu, Nepal, in 2007, I listened to a police inspector try to justify the arrest and beating of several metis (a local Nepali term for effeminate men) the night before. The cops had inspected their penises by the light of mobile phones in search of numinous sex traces. That didn’t work– but “Of course they were engaged in immoral activity,” he shouted. “We found condoms on them!”

The same inquisitive spirit animates police from Bed-Stuy to Stockholm.  In a miraculously more sympathetic article this week, the Times writes:

When she worked the streets, Yvette Gonzales said, she frequently saw other prostitutes working without condoms. But they were not having unprotected sex at the request of their customers.

Often, Ms. Gonzales said, the police would confiscate condoms when making a prostitution arrest so they could be used as evidence. And as soon as the prostitutes were released from jail, she said, they would go right back to work without protection; or refrain from carrying condoms at all, for fear of being arrested. …

In a recent survey of 35 prostitutes conducted by the Sex Workers Project, 16 said they had not carried condoms at times because they were afraid it might lead to trouble with the police. Fifteen said their condoms had been destroyed or taken away by the police. Three of those 15 said they had engaged in sex afterwards without a condom.

Don't take the C train

For thirteen years, lawmakers have tried to push a bill through the New York legislature that would bar prosecutors from using possession of condoms as evidence of criminal conduct. For thirteen years, it’s died in committee. Now, it may have a chance of passage. The Times waffles characteristically on the rights and wrongs here: “Excluding certain types of evidence from criminal court is rare, but not unprecedented,” it intones. But that’s not the point: condoms aren’t evidence of criminal conduct. Even where prostitution is penalized, a woman, a man, a “drag queen” or a “transvestite” may have condoms in their pocket simply because they want to protect themselves, and be ready for opportunities. They should have them. As one judge in Manhattan Criminal Court said, “In the age of AIDS and H.I.V., if people are sexually active at a certain age and they are not walking around with condoms, they are fools.”

The New York Police Department did not respond to questions about the proposal, but prosecutors said they wanted the option of including condom evidence at trial.  “I oppose any law that would restrict our use of evidence,”  said Charles J. Hynes, the Brooklyn district attorney. “Prosecutors in my office assess evidence on a case-by-case basis, determining what is appropriate in each situation.”

It’s a wrenching misuse of language for the anti-trafficking crowd to claim that those officials are bent on a “human-rights, women’s-rights-based approach.”   Only the vagaries of ideology can allow such a distortion. The police and prosecutors are on the side of death.

P.S. Rick Santorum thinks sex is cheap

In a speech to a huge mob of pitchfork-wielding, witch-incinerating, rabid conservatives today, Rick Santorum opposed the whole idea of including contraceptives in insurance plans. Surprise!  His argument, though, wasn’t so much moral as economic:

[I]nterestingly enough, here is what they are forcing them to do—in an insurance policy, they are forcing them to pay for something that costs just a few dollars. Is that what insurance is for? The foundational idea that we have the government tells you that you have to pay for everything as a business. Things that are not really things you need insurance for, and still forcing on something that is not a critical economic need, when you have an economic distress, where you would need insurance. But forcing them even more to do it for minor expenses.

Of course, the kids you might have otherwise (or the abortions) aren’t exactly minor expenses, so this might turn out to be a bit of a false economy in the end.  Still, it reflects his sense that sex is not a “need,” or a drive, or even an impulse. It’s a cheap treat, like the mint a restaurant gives you at the end of a meal.

 

The war on contraception: Principles, compromises, and payment plans

In the nineteenth century, pr-st-t-t–n,  sometimes along with other illicit forms of s-x that couldn’t be named in print, was often referred to as “the Social Evil.”  As a way of describing our running obsession with the morality of human arousal, I much prefer this to the term “Culture Wars,” which imputes a degree of excitement to the endless sex conflict that, in its rhetorical monotony, it really doesn’t possess. Moreover, “Social Evil” is multivalent. It can mean the sex itself, or the way we think about it, or the way we try to suppress it, or the fact that we think about it at all.   I’m inclined to use it to signify the latter, but that’s neither here nor there. In any case, whenever I say “Social Evil,” think culture wars and all they contain, and let healthy images of Rick Santorum nude mud-wrestling Ellen Degeneres fill your mind.

And now that you’ve vomited: the Social Evil is back. This presidential season was all supposed to be about jobs, jobs, jobs, and suddenly it is all about sex, sex, sex. First there was the Planned Parenthood fracas.  You know about that: funding withdrawn from a major provider of mammograms because the right wing feared any medical services might somehow be infected by the proximity of abortions. Then there was furor when the Obama administration decided that employee health insurance plans offered by religious charities, hospitals, and universities had to cover contraception in the same way other employers’ would. In the middle of this, the Ninth Circuit in California dissed the opponents of same-sex marriage, holding there was no compelling reason for Proposition 8 to snatch away the right the State Supreme Court had granted. And Rick Santorum won three states on Tuesday.  The French Revolution is coming, he said, along with “the guillotine”: “if we do and follow the path of President Obama and his overt hostility to faith in America, then we are headed down that road.” Presumably the fat king and his jewel-encrusted wife will die, along with plenty of priests. (A warning to Newt Gingrich?)  The French, he went on, had a constitution that

was very similar to the American Constitution. But it was one difference. Their constitution was based on three principles. Liberty—good. Equality—good. And fraternity—brotherhood. Brother-hood. But not fatherhood.

A stiff dose of patriarchy keeps the Social Evil away.

Although pundits affect some surprise that this diversion from the Important Issue of the economy is taking place, in fact it’s not shocking at all. Culture is what Republicans talk about instead of talking about class. (They talk about race, too, but it requires more caution and so is less fun.) And culture means sex; the whole intellectual apparatus that the left-wing cultural elites try to foist on the uncorrupted masses, from nudie pictures to sweaty and shoulder-rubbing subway rides, is one giant excuse to stimulate the nether organs and jump-start nonprocreative copulation. In a year when inequality has become, against all conservative predictions, a central political issue, yelling about sex is not just a diversion for the right wing: it’s an attempt to translate an anger that most people are feeling, out of an incomprehensible language of economic justice into a vocabulary of resentment Republican leaders can understand.

The contraception battle, though, is perhaps the most revealing as far as the attitudes of the right wing go.  For those interested in the question’s legal ramifications, you can turn to David Boies (attorney and gay-marriage maven), who together with Joan Walsh explains it as “an issue of labor law, and the government’s regulation of employers (relatively minimal, compared to other countries) on issues of health, safety and non-discrimination.” The Christian Science Church may believe that modern medicine is a submission to the sinful world of materiality, but that doesn’t mean the Christian Science Monitor can refuse to cover surgery in its employees’ insurance. To make contraception a part of (near) universal health care coverage, meanwhile, is to recognize the reality that women want to have sex more often than they want to have babies. This fact is bound up with their health and well-being, as well as their autonomy. By institutionalizing the requirement, Obama has not so much promoted “broad, societal liberalization” (as Dana Goldstein wrote in the Daily Beast last summer) as brought policy into line with what’s already taken place.

This case persuades plenty of Catholics, but not the hierarchy. Catholics for Choice offers up a useful graphic: 98% of sexually active Catholic women use contraception banned by the Church.  (I like the two stylized bishops to the right, representing the other 2%; at first I thought they were nuclear warheads.)  It may then seem self-defeating that, as the New York Times points out, the US Catholic hierarchy has spent seven months preparing for this fight. But:

The speed and passion behind the bishops’ response reflects their growing sense of siege, and their belief that the space the Catholic church once occupied in American society and the deference it was given are gradually being curtailed by an increasingly secular culture.

The conflict puts not just the White House, but also the bishops to the test. Will their flock follow their lead? And are they sufficiently powerful, now that they have joined forces with evangelicals and other religious conservatives, to outmuscle the women’s groups, public health advocates and liberal religious leaders who argue that the real issue is contraceptive coverage for all women, and that the Obama administration was right?

The desire of most women to control their own bodies (along with the desire of some priests to control the bodies of little boys) has caused a catastrophic collapse in the prestige and influence of the American Catholic Church.  Trying to move the conflict to the grounds of “religious liberty” is in fact a theatrical bid to regain that power, and the loyalties of individual believers. In the process, though, the church — and the evangelicals and Republican politicians who are supporting them — show that, fifty years after the Pill was introduced, they are still unreconciled to birth control as a woman’s freedom and decision. The Catholic bishops made this clear this week. Their head lawyer said:

“There has been a lot of talk in the last couple days about compromise, but it sounds to us like a way to turn down the heat, to placate people without doing anything in particular … We’re not going to do anything until this is fixed.” That means removing the provision from the health care law altogether, he said, not simply changing it for Catholic employers and their insurers. He cited the problem that would create for “good Catholic business people who can’t in good conscience cooperate with this.” “If I quit this job and opened a Taco Bell, I’d be covered by the mandate.”

No covered birth control for anybody! Fast-food cooks breeding compulsorily the way God wanted! Santorum, a Catholic and an exceptionally candid politician, repeats at every opportunity that while “many of the Christian faith have said, well that’s okay, I mean y’know, contraception is okay: It is not okay.” But even evangelicals, who lack the Papal devotion to the dignity of the unconjoined egg and sperm, regard contraception with horror: feminism and the sexual revolution, modernity’s whole Gomorrah-bound slouch, emerged in their view from birth control’s defanging of of a principal control on sex. The war on a small provision in health-insurance policy is a war on the social acceptability of contraception — and on its recognition as a right in law.

Santorum on how birth control is bad for women

It’s in this light that one should judge the “accomodation” Obama announced today.   It lets religious organizations refuse to include birth control coverage in their employee insurance plans. But in that case, the insurers themselves must offer contraception coverage to workers directly, and cover the cost themselves. Women won’t lose contraceptive care. It’s just that their employers won’t have to pay for it.

The new policy has already stimulated wonky debate. Catholics for Choice argues that “this compromise relies on insurance companies doing the right thing.” In fact, even before Obama’s announcement, Matthew Yglesias laid out why the insurance companies will do just that:

While birth control costs more than nothing, it costs less than an abortion and much less than having a baby. From a social point of view, unless we’re not going to subsidize consumption of health care services at all (which would be a really drastic change from the status quo) then it makes a ton of sense to heavily subsidize contraceptives. … [J]ust on the dollars and cents subsidizing birth control is a no-brainer. The unfortunate thing is that under the American setup the subsidies tend to be passed through the employer, which has set the stage for this controversy.

Obama, of course, just took the subsidy cost away from the (religious) employer and landed it on the insurer. But by Yglesias’s argument, the insurers should be happy about this; the contraception costs are less onerous than the alternatives.  They might even save money, and the premiums the employers pay for other things may go down. (Others are less sure. Sarah Kliff at the Washington Post contends that somebody’s premiums will have to go up. But, according to the Guttmacher Institute, it adds up to less than $22.00 per premium to put contraception in an insurance plan. Even if the costs for a small number of religious-institution employees get spread around among the much larger number of employees who work elsewhere, the increase would hardly be crippling.)

The more interesting thing is the way Obama is grasping the moral high ground. Jonathan Cohn notes that while the US Catholic bishops are likely to reject the “accomodation,” the Catholic Health Association immediately endorsed it. (The CHA similarly split with the men in dresses in supporting Obama’s health care reform bill.)

This difference of opinion is not surprising. As a veteran health care operative once pointed out to me, health care is a reality for the nuns who run the hospitals. For the bishops, it’s more of an abstraction. And so while the former think long and hard about how to improve access to care, for the sake of their institutions as well as their patients, the bishops tend to focus more on other imperatives, like the church’s declaration that contraception is a sin.

But the right wing continues to roar, and to make it clear they want everybody exempted from the mandate to provide contraception. Four conservatives, including a former Vatican Ambassador to the U.S., condemned the administration’s

insistence that religious employers, be they institutions or individuals, provide insurance that covered services they regard as gravely immoral and unjust.  Under the new rule, the government still coerces religious institutions and individuals to purchase insurance policies that include the very same services. [emphasis added]

A Nebraska Congressman vowed to defend not just the bishops, but Taco Bell to the death: “Congress should protect the religious liberty and conscience rights of every American who objects to being forced by the strongarm of government to pay for services to which she or he has deeply-held objections.” Of course, once you let employers opt out of any coverage to which they can muster a moral objection, you’ve pretty much ensured that thousands will discover their deep religious discomfort with the extra $22 on the premium. And you’ve turned health coverage into Swiss cheese. Different holes will riddle each job’s insurance plan. No worker will have a right to much of anything.

American women are unlikely to stand for the all-out war on birth control that the bishops and their allies have opened. And even people who dislike Obamacare, and have an workplace-based insurance plan that suits them well enough, won’t want their health care infinitely exposed to a hirer’s moral vagaries. As Amanda Morcotte at Slate interprets the administration’s strategy, Obama’s been

letting Republicans work themselves into a frenzy of anti-contraception rhetoric, all thinly disguised as concern for religious liberty, and then created a compromise that addressed their purported concerns but without actually reducing women’s access to contraception, which is what this has always been about. … With the fig leaf of religious liberty removed, Republicans are in a bad situation. They can either drop this and slink away knowing they’ve been punked, or they can double down. But in order to do so, they’ll have to be more blatantly anti-contraception, a politically toxic move in a country where 99% of women have used contraception.

Last summer, a spokesman for the bishops said:  “We consider [birth control] an elective drug … Married women can practice periodic abstinence. Other women can abstain altogether. Not having sex doesn’t make you sick.” That’s their vision for women’s health (and sanity). Obama is betting that most of a modern country will resoundingly reject it.   Let’s hope he’s right.

The state and your sex life, II

Government by speculum: Big Brother is examining you

Brazil has its first woman president, Dilma Rousseff, as you may be aware. Why, then, is a Brazilian feminist complaining that “The government wants to send Dilma into our bodies? I’m feeling stabbed anyway. And what is worse: in the back!”

Because Rousseff’s administration is cooperating with those black-and-blue forces, the Church and the Law, that want to find out exactly what is happening inside women’s organs. The day after Christmas, the President, along with the Ministry of Health, promulgated a new decree that creates –what should one call it?– a state-sponsored speculum, ready to inspect women’s reproductive systems willy-nilly.

Provisional Measure 557 (MP 557) creates a “National System of Registration, Tracking and Follow-up of Pregnant and Puerperal Women for the Prevention of Maternal Mortality.” It aims, so it says, “to ensure better access, coverage and quality of maternal health care, notably for pregnant women at risk.” And it mandates “universal registration of pregnant women and mothers, to enable identifying pregnant and postpartum women at risk, and assessment and monitoring of health care they received during prenatal care, childbirth and postpartum care.” Registered pregnant women will be eligible for up to R$50 (around $27 USD) in assistance. The measure states, in Article 19-J, that “public and private health services are required to ensure pregnant women and the unborn the right to safe and humane pre-natal care, delivery, birth, and postpartum care.”

Past and present Presidents: Two kids in every womb!

It is, as Brazil’s authorities surely know, hard to criticize measures couched in the admirable goal of preventing material mortality. But the scary thing for women about this huge new surveillance mechanism is that the decree explicitly elevates “the unborn” as rights-bearers to the same status as the mothers. Brazil, which many calculate is the largest Catholic nation in the world, bans abortion except in the case of rape, severe genetic abnormalities, or danger to the mother’s life. Women face prosecution and prison if they terminate a pregnancy. Yet a 2010 study showed that one in five Brazilian women has had an abortion, and the Health Ministry estimates that 200,000 are hospitalized each year as a result of unsafe, clandestine procedures.

As opposed to its neighbors, Uruguay (which is on the verge of decriminalizing abortion) and Argentina (which saw a first-ever parliamentary debate on the subject last year), Brazil seems determined to reinforce its draconian restrictions.   According to Maria José Rosado, of Catholics for Free Choice in Brazil, a member of Congress has previously proposed a similar pregnancy registry, “declaring his objective loud and clear: to fight abortion.” The Chamber of Deputies is now considering a bill  to pay a pregnant rape victim who does not have an abortion a minimum wage until the child reaches 18 — creating what activists call a “rape pension.”

Nicolae and new Romanian: More of these, or else

Brazilian feminists show little doubt that MP 557, which was launched without any consultation with women’s movements, can and will be used to control reproductive freedom.The clear parallel to the new database in the land of “order and progress” is the practice of Romania’s defunct Communist dictatorship. Nicolae Ceaușescu, obsessed with raising his country’s birth rate, banned both abortion and birth control. He required all women of childbearing age to undergo regular, six-month gynecological exams. Someone who proved pregnant at one examination had to come back in half a year with a child, a bigger fetus, or a good explanation. So unpopular was the regime of pro-natal surveillance that the abortion and contraception bans were the first measures scrapped by Romania’s post-revolutionary government in 1989.

What Ceaușescu did in the name of nationalism, Rousseff pursues as part of a prolonged political flirtation with Catholic and evangelical forces. Feminist activist Fátima Oliveira says:

Unfortunately … Dilma, who is our first female president, is throwing in the trash all the commitments made by Brazil in the arenas of the United Nations in the area of ​​women’s health. Together with Brazilian women’s struggle for full health care and sexual and reproductive rights, which began in the military dictatorship. A setback of 30 years, unprecedented. …

I have the moral authority to say what I say now, because at the time of the Constituent Assembly [the 1988 convention that wrote Brazil's democratic constitution], I have collected many signatures for freedom of religion in Brazil. I defend the right of everyone in authority to have the religion they want. Only that religion is a thing of personal intimacy, for domestic consumption. The religions of the rulers can not be the rule for  the exercise of public power. In public office, religious issues cannot be conducting public policy. …

It’s time to say to the government that our bodies belong to us and cannot be a bargaining chip with anyone.