Health

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Environment: Pacific politician calls out Australia’s climate duplicity

Published by Anonymous (not verified) on Sun, 16/06/2024 - 4:58am in

The temperature is rising and the world is getting increasingly dangerous, even the rich bits. Former Tuvalu PM slams Australia’s climate policies. Rights of and around rivers. All of the last 12 months were the hottest on record The graph below shows the average global temperature increase above the pre-industrial level (1850-1900) for each month, Continue reading »

“Debilitating a Generation”: Expert Warns That Long COVID May Eventually Affect Most Americans

Published by Anonymous (not verified) on Fri, 14/06/2024 - 6:46am in

Tags 

Health

In a candid discussion with INET's Lynn Parramore, Dr. Phillip Alvelda highlights the imminent dangers of long COVID, criticizing governments and health agencies for ongoing preventable suffering and deaths. *This is Part 2 of a two-part interview.

Think you've grasped the full extent of COVID's ongoing impact? Think again. As Americans shrug off vaccines and forget indoor air quality, the virus stealthily continues its destructive path. This was pretty much inevitable without new guidance urging a change in strategy and nobody telling us the full truth.

The danger is clear and present: COVID isn't merely a respiratory illness; it's a multi-dimensional threat impacting brain function, attacking almost all of the body’s organs, producing elevated risks of all kinds, and weakening our ability to fight off other diseases. Reinfections are thought to produce cumulative risks, and Long COVID is on the rise. Unfortunately, Long COVID is now being considered a long-term chronic illness -- something many people will never fully recover from.

Dr. Phillip Alvelda, a former program manager in DARPA’s Biological Technologies Office that pioneered the synthetic biology industry and the development of mRNA vaccine technology, is the founder of Medio Labs, a COVID diagnostic testing company. He has stepped forward as a strong critic of government COVID management, accusing health agencies of inadequacy and even deception. Alvelda is pushing for accountability and immediate action to tackle Long COVID and fend off future pandemics with stronger public health strategies.

Contrary to public belief, he warns, COVID is not like the flu. New variants evolve much faster, making annual shots inadequate. He believes that if things continue as they are, with new COVID variants emerging and reinfections happening rapidly, the majority of Americans may eventually grapple with some form of Long COVID.

Let’s repeat that: At the current rate of infection, most Americans may get Long COVID.

In the following discussion with the Institute for New Economic Thinking, Alvelda discusses the wider social fallout from this ongoing health crisis, which could be avoided with the right mindset and action. He raises tough questions: Without robust surveillance and mitigation measures, how do we prevent future outbreaks from spiraling out of control? Is our pandemic readiness up to par for looming threats like bird flu? How do we cope with a population ravaged by the lasting impacts of Long COVID? The answers are a wake-up call.

Lynn Parramore: You've raised concerns about Long COVID rates surging under the radar. The National Academy's new 265-page report is eye-opening, listing up to 200 symptoms affecting nearly every organ, hurting your ability to work, lasting months to years. They say cases of Long COVID are rising in 2024. How is this impacting people’s lives?

Phillip Alveda: Some people can get Long COVID, and maybe it ages them a little bit, but it doesn't change them very much. But for others, their lives are devastated. The daughter of a friend was infected in 2020 and started having seizures. She had to drop out of school and couldn’t exercise. It took her four years to recover. She was just getting back to health, but a strenuous workout, a few late nights studying, and stress triggered more seizures and a setback.

A new report commissioned by the Social Security Administration in 2022 says that Long Covid is a chronic illness. People see gradual improvement in symptoms over time, but a plateau may occur 6-12 months post-infection, and only 22% fully recover within a year. Others remain stable or get worse.

LP: Those people may never get to their former health.

PA: That’s right.

LP: A recent JAMA study found that US adults with Long COVID are more prone to depression and anxiety – and they’re struggling to afford treatment. Given the virus's impact on the brain, I guess the link to mental health issues isn't surprising.

PA: There are all kinds of weird things going on that could be related to COVID’s cognitive effects. I’ll give you an example. We've noticed since the start of the pandemic that accidents are increasing. A report published by TRIP, a transportation research nonprofit, found that traffic fatalities in California increased by 22% from 2019 to 2022. They also found the likelihood of being killed in a traffic crash increased by 28% over that period. Other data, like studies from the National Highway Traffic Safety Administration, came to similar conclusions, reporting that traffic fatalities hit a 16-year high across the country in 2021. The TRIP report also looked at traffic fatalities on a national level and found that traffic fatalities increased by 19%.

LP: What role might COVID play?

PA: Research points to the various ways COVID attacks the brain. Some people who have been infected have suffered motor control damage, and that could be a factor in car crashes. News is beginning to emerge about other ways COVID impacts driving. For example, in Ireland, a driver's COVID-related brain fog was linked to a crash that killed an elderly couple.

Damage from COVID could be affecting people who are flying our planes, too. We’ve had pilots that had to quit because they couldn't control the airplanes anymore. We know that medical events among U.S. military pilots were shown to have risen over 1,700% from 2019 to 2022, which the Pentagon attributes to the virus.

LP: I suspect that most of the time, people don’t realize that COVID or Long COVID is an underlying factor in things like accidents or just feeling more tired or foggy or generally unwell than usual.

PA: Correct. The surges in these incidents are exactly correlated with each wave of the pandemic -- and I want to highlight here that they are correlated strongly with the COVID surges, and most explicitly NOT correlated with vaccine distributions. We know people are generally sicker today than before the pandemic. There are more people unable to work, there’s more absenteeism, etc. All of this has gone up overall, and it’s key to point out that we’re not just talking about older people. The people who are proportionately most affected right now are the caregivers of school-aged children.

LP: How do vaccines safeguard us from both the short-term and long-term effects of COVID?

PA: The latest boosters/vaccines do offer SOME protection from catching the disease. And while it varies somewhat from variant to variant, that starts at about 60%, peaking 2 weeks after inoculation and lasts for about 4 months, and then after that declines at about 4% decrease in effectiveness per month thereafter.

What they do very well is prevent bad outcomes in the acute phase of infection, when one is most likely — though not certain — to have symptoms.

What they do poorly is prevent bad outcomes in the post-acute phase whether one has had symptoms or not. Recent studies have shown that the very latest booster/vaccine only offers a 20% - 25% reduction in the likelihood of Long COVID. And if you’re not current on your boosters, you have essentially no additional protection from Long COVID. It’s this last bit of information that public health agencies are failing to openly and clearly disclose, and most governments continue to pretend otherwise, having yet to take meaningful action to stem a growing post-COVID pandemic of disability.

LP: You've criticized the track record of the CDC and the WHO – particularly their stubborn denial that COVID is airborne.

PA: They knew the dangers of airborne transmission but refused to admit it for too long. They were warned repeatedly by scientists who studied aerosols. They instituted protections for themselves and for their kids against airborne transmission, but they didn’t tell the rest of us to do that. They didn't feel like it would be advantageous, to be honest.

LP: You've also criticized the Biden administration for glossing over the ongoing situation during his presidency. Why the reluctance to offer clearer guidance and warnings?

PA: It’s interesting, I take part in a Global Biosecurity Working Group that played a big role in defining the nine-point plan to address the pandemic that Biden used to get elected. But the minute he was elected, he put a hedge fund guy, Jeff Zients, in charge of the pandemic response. Zients decided the best way forward was to convince people that the pandemic wasn't happening.

We’ve seen a very troubling memo sent in February 2022 by leaders of Impact Research, one of the top political strategy and polling consultancies for President Joe Biden, on how Democrats should position themselves on COVID. Impact recommended that they should declare it over, claim victory, and keep quiet about ongoing threats and mitigation efforts. You can read the memo on the US House of Representatives web server and see how the report suggests it'd be politically more expedient to convince people the pandemic is not happening than it is to actually address it. And that’s just what the Biden administration has done. They haven’t been following science. They followed the political advice.

The Biden administration discarded almost all aspects of the nine-point plan that could have halted the pandemic, saved lives -- and by the way, done better for the economy than their exclusive reliance on vaccines. They used the CDC, the WHO, and the HHS [Department of Health and Human Services] to amplify the message that the vaccine is all you need and you don't need to worry about anything else.

LP: How would you grade Biden on how he’s handled the pandemic?

PA: I’d give him an F. In some ways, he fails worse than Trump because more people have actually died from COVID on his watch than on Trump’s, though blame has to be shared with Republican governors and legislators who picked ideological fights opposing things like responsible masking, testing, vaccination, and ventilation improvements for partisan reasons. Biden’s administration has continued to promote the false idea that the vaccine is all that is needed, perpetuating the notion that the pandemic is over and you don’t need to do anything about it. Biden stopped the funding for surveillance and he stopped the funding for renewing vaccine advancement research. Trump allowed 400,000 people to die unnecessarily. The Biden administration policies have allowed more than 800,000 to 900,000 and counting.

I would further note that all the while, the White House has maintained the very strictest abatements to protect people who live and work there from the virus: In order to enter the White House, they have to have had no symptoms for 14 days, the latest booster vaccinations up-to-date, and a negative rapid test. They have nine or better fresh air exchanges per hour and all filters are upgraded to MERV 13. They have also installed 220 nanometer Germicidal UV lamps. After a positive test, you have to have a PCR Test negative to return to work. The White House admitted quietly on CSPAN that the protections were still in place in July of 2023 when an Israeli delegation was not admitted after testing positive for COVID, after claiming with much fanfare the prior April that the pandemic was over and that it was safe to return to work.

LP: All those precautions are certainly not happening at the workplaces of the vast majority of Americans and in our schools.

PA: No.

LP: So what would Trump's grade have been?

PA: D at best. He screwed up on the distribution and he politicized the whole thing so that now half the country doesn't think the pandemic is real, and too many are disregarding precautions and opposing public health efforts. Trump really started the destruction of public health in the United States.

LP: How can we push for more effective COVID action from the government? Where to start?

PA: I think the number one thing is holding the people accountable who gave the bad advice that led to so many deaths, and removing them from positions of influence. It boggles my mind that in the UK, the proponents of the Great Barrington Declaration, which advocated for a herd immunity approach, continue to advise the government. That's still the policy in the UK, and it's still the policy here. We're still acting like Long COVID doesn't exist despite the growing mountain of evidence to the contrary.

LP: For those who may not recall, the Great Barrington Declaration was a controversial proposal sponsored by a libertarian think tank in 2020, which got people thinking that a sort of global chickenpox party would be a good idea for COVID -- that it would help us achieve herd immunity. The herd immunity approach to COVID is now widely regarded as impractical and unethical.

PA: Correct. And we now have irrefutable evidence that each additional infection a person gets does mounting cumulative damage to the immune system.

LP: If you had to sum up your greatest concern right now, what would it be?

PA: That we're slowly debilitating a generation by refusing to take obvious precautions.

LP: The parallels between the COVID situation and the Spanish flu are striking. The data from that pandemic tells a story of a generation dealing with all kinds of incapacitation, with many facing lasting post-infection health issues like respiratory troubles, neurological issues, and psychiatric disorders.

PA: Oh, for sure. People really want to forget what happened.

LP: Today, you see folks getting sick in all sorts of ways – dizziness, vision problems, more colds than usual, etc. -- and yet don’t imagine it could be COVID-related. There's this disconnect happening.

PA: Yes. You hear people saying they have another flu and they've had a cough for two weeks. But there's no flu in circulation -- and few flu infections last for two weeks. People don’t have a clear understanding of how you can still contract the virus. In their defense, no one has told them plainly that just walking into a room where someone with COVID was 40 minutes ago could get you infected.

LP: And as you've noted, a key issue is that people often don't realize they've been infected or reinfected. How accurate are the over-the-counter tests at this point?

PA: Not very accurate at all because they haven't been updated. They haven’t been updated because the government stopped sponsoring the creation of those tests. The volume of testing has dropped so low, it's just not profitable for companies to develop new ones anymore.

LP: If you're sick, how do you find out if it’s COVID or COVID-related?

PA: This is one of the problems with Long COVID. Many insurance companies are not even recognizing that Long COVID exists. Those that do require that you have a confirmatory PCR test. But many people have had COVID and didn't get the PCR test. The good news is that now there's a nucleocapsid test. This test can show you that you have had COVID, even if you don't have an active infection now. So that is something.

But it's a battle. My friend's child is covered by Kaiser and they are completely incapable and unwilling to do anything to help her because she's got a myriad of symptoms and doesn’t fit into their neat stovepipes of medical disciplines. Her brain was attacked by the virus and her autonomic nervous system doesn't work properly. She's got heart rate control issues, severe anemia, and sugar metabolism problems that are akin to diabetes, but it’s not quite diabetes. She's got seizures, muscle tremors, cognitive issues, and vision problems. All these things come and go depending on how her body is stressed. No one in Kaiser is steeped in Long COVID or the fact that all these symptoms come from the original source of a viral infection, just like HIV.

Some places offer help. There is a local Long COVID care clinic at UC San Francisco and another one at Stanford. But if you can't get a referral to those people, you're screwed. And by the way, these places are overwhelmed. They're not taking a lot of new patients.

LP: Can you say more about what’s at stake if we continue this way, with the low vaccination rates and abandonment of abatement measures?

PA: What does this look like if we continue on the way we are doing right now? What is the worst-case scenario? Well, I think there are two important eventualities. So we're what, four years in? Most people have had COVID three and a half times on average already. After another four years of the same pattern, if we don’t change course, most people in the U.S. will have some flavor of Long COVID of one sort or another.

LP: That’s a really alarming possibility -- that most Americans could potentially have Long COVID in as little as four years?

PA: That’s what I’m saying. And we know that somewhere between five and eight percent of those people will be so debilitated that they will no longer be able to work.

LP: What would be at the top of your list to move us in a better direction right now?

PA: I would put in place indoor air quality standards with teeth, standards that have tough compliance penalties, and requirements that every tested location be measured and certified regularly. And that should start with the schools. Then I would go to superspreader venues: arenas and churches, restaurants, bars, and gyms, especially the businesses that are densely populated, like meatpacking and assembly lines and things like that.

LP: Say you’ve taken your individual precautions – you’re getting your vaccine shot every six months, you mask in crowded places. What if your boss says, "I'm not shelling out fifty bucks for a CO2 device to test the air quality"? What can we do?

PA: It’s an important question. OSHA [the Occupational Safety and Health Administration] has been largely sidelined. Their decision not to emphasize the airborne transmission message stemmed from their acknowledgment that if they did, it would shift liability from individuals avoiding droplet transmission to institutions responsible for maintaining air quality. And they did not want the institutions to have that liability. Now, without question, the CDC and the WHO have finally acknowledged that they've been aware all along of its airborne nature. Donald Trump admitted as president he knew it was airborne in February of 2020.

We’ve been advising them since that time that it was airborne. In May 2020 [atmospheric chemist] Kim Prather did the actual physical experiment that demonstrated unequivocally that it was airborne and briefed [Anthony] Fauci and [Deborah] Birx in the White House. They have known for a long time that it's airborne and they have resisted. And OSHA has been effectively powerless.

But I think the key is now that everyone's admitted that the virus is airborne, there needs to be new indoor air quality standards. The healthcare industry has to require that healthcare workers are given proper respirators, N95 or better respirators, and not surgical masks.

I'm encouraged by a recent Colorado ruling where a surviving spouse got a judgment for her husband who was a healthcare worker. The courts said that the illness he died from was due to COVID contracted on the job and the employer, a nursing home, is responsible. That happened for the first time a few weeks ago.

LP: That’s a bit of encouraging news. Which nations, by the way, are doing a better job than the US and the UK? Who can we learn from?

PA: Those that did the best job are the ones that were run by women, notably, New Zealand, Taiwan, Norway, and Finland. It's also the ones that are run by scientists and engineers: Singapore, Taiwan, Japan, Korea, Germany. The ones run by right-wing demagogues have done the worst.

LP: How can advances in surveillance and tracking technology help us as we go forward?

PA: Well, they're almost immaterial because the government has shut down all the subsidies for them. The CMS [Centers for Medicare & Medicaid Services] system still wants to charge so much for testing that it's not monetarily feasible to do it on a national scale. And the government just turned off the requirement that the hospitals report their occupancy anymore. We’re turning off all the surveillance systems to try and get people to forget the fact that it's still ongoing. Each new variant, really it's just a coin toss on how lethal it is.

Now we also have to be concerned about the bird flu and the responses and mitigation efforts associated with that. Bird flu appears to have a very high death rate from infection, as high as 58%.

LP: The situation with bird flu is certainly getting more concerning with the CDC confirming that a third person in the U.S. has tested positive after being exposed to infected cows.

PA: Unfortunately, we’re repeating many of the same mistakes because we now know that the bird flu has made the jump to several species. The most important one now, of course, is the dairy cows. The dairy farmers have been refusing to let the government come in and inspect and test the cows. A team from Ohio State tested milk from a supermarket and found that 50% of the milk they tested was positive for bird flu viral particles.

LP: The FDA says that the milk is safe due to pasteurization, but they’re telling some states to curb the sale of raw milk and to test cows. What are you most concerned about?

PA: There’s a serious risk now in allowing the virus to freely evolve within the cow population. Each cow acts as a breeding ground for countless genetic mutations, potentially leading to strains capable of jumping to other species. If any of those countless genetic experiments within each cow prove successful in developing a strain transmissible to humans, we could face another pandemic – only this one could have a 58% death rate. Did you see the movie “Contagion?” It was remarkably accurate in its apocalyptic nature. And that virus only had a 20% death rate. If the bird flu makes the jump to human-to-human transition with even half of its current lethality, that would be disastrous.

LP: Does the mishandling of COVID render the population more vulnerable to other pandemics?

PA: Yes, it does. We're facing a population with weakened immune systems that resist adhering to pandemic controls. That’s not a good foundation for dealing with bird flu and other potential pandemics.

LP: Thank you, Phillip. I hope we’ll be talking to you again as the bird flu situation progresses.

The Doulas Who Help Navigate Gender Exploration

Published by Anonymous (not verified) on Thu, 13/06/2024 - 6:00pm in

This article originally appeared in Yes! Magazine.

Before Ash Woods got gender-affirming top surgery last January, they stapled together a zine-like booklet filled with all sorts of delicious smoothie recipes. On the front cover, Woods drew a T-Rex in a self-effacing nod to how the surgery was going to render their arms virtually useless for at least one week after they received a more masculine-looking chest. Before their surgery, they set the booklet down next to the blender in their kitchen so it was ready to go when they got home from the hospital.

Woods, who is trans and nonbinary, works as a birth doula in the Seattle area. As part of their job, Woods extensively plans for a client’s post-labor recovery, and they wanted a similar level of care after their surgery. Top surgery was going to be vulnerable and challenging, Woods knew, and rather than rely solely on a partner or friends, they decided to hire an expert: a gender doula.

Similar to birth doulas, gender doulas are non-clinical companions who provide advocacy, knowledge, and support. These days, you can count on two hands the number of people who have assumed the formal title of “gender doula,” but they have existed over the decades in other forms as “transgender transition coaches” or more informal word-of-mouth mentors. With exploration of gender-nonconforming identities becoming more common and gender-affirming surgeries on the rise, people are turning to gender doulas to navigate an often unwelcoming environment.

A person with a clipboard supportively puts a hand on another person's arm.A gender doula might offer guidance about how a patient can communicate with their doctor, though they will not offer medical advice. Credit: Media_Photos / Shutterstock

The gender doula could remind Woods to take their medication, supervise them on a walk in case they started feeling dizzy, or record how much fluid was draining into their post-surgical plastic bulbs to ensure they weren’t at risk of infection. The doula could also act as an advocate at doctors’ appointments and ensure Woods’ correct pronouns were being used, given that they are often misgendered at the hospitals where their clients are giving birth, though “they/them” pronouns are clearly written on their badge.

“When you’ve fought for so long, and have been silenced or not seen, and are finally stepping into your body, and then someone doesn’t see or acknowledge it … it’s just a dismissal of your existence,” Woods says. “And it’s crushing.”

According to a 2020 Center for American Progress survey, nearly half of the 1,500 transgender adults surveyed reported experiencing mistreatment or discrimination with a health provider. This includes misgendering, care refusal, and verbal or physical abuse. The rates are higher for transgender respondents of color, with 68 percent reporting a negative interaction. This in turn leads to health avoidance and delay, which can further exacerbate chronic health problems.

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stef shuster, author of the 2021 book Trans Medicine: The Emergence and Practice of Treating Genders, says medical providers are often not trained as experts in gender, which means they bring in a lot of assumptions — sometimes bias — into their work about what they think a trans person should look or sound like.

“Anyone who doesn’t fit that mold, providers get really concerned about opening up access to care,” shuster says. “The structure of this system is flawed because it amplifies medical authority and minimizes trans people’s autonomy.”

Gender doulas help maintain autonomy, and sometimes, that looks like educating medical providers. Luigi Continenza, a gender doula in Tacoma, Washington, coaches health care providers to be trans-competent — like using the word “chest tissue” rather than “breast tissue,” or not asking patients about their top surgery scars when they’re seeking care for their ankle.

Ken McGee.Ken McGee. Credit: Danielle Barnum

Woods wanted a gender doula who could navigate the system, so they chose Ken McGee, a fellow birth doula who’d recently transitioned. He was also a physical therapist for a decade who’d seen how isolating gender-affirming surgeries can be and didn’t want people going through the process alone. McGee began pursuing gender doula work during the pandemic. He’s especially excited about educating clients and planning for rehabilitation post-surgery. “How are you going to be set up for sleeping? How do you think you’re going to wipe your bum? What’s showering going to be like?” he says. “I’ve never seen a surgeon’s office have a handout that covers all of that.”

For those who decide to medically transition — not a requirement for a transgender identity — a gender doula might offer guidance about how a patient can communicate with their doctor. But they won’t dish out medical advice. Gender exploration can be delicate, and many doulas are there to listen and help people process, though it’s important to note they are not trained therapists.

Eli Lawliet, one of the first and only full-time gender doulas, says people often seek him out when they’re exploring their gender and feeling scared or confused. Like McGee, he started during the pandemic and much of his practice is online. He hosts virtual workshops such as “Love Your Trans Self” and monthly breath work circles, but a bulk of his work is one-on-one consultations.

Eli Lawliet. Eli Lawliet. Credit: Abby Mahler

Lawliet holds a PhD on the history of transgender medicine — one of his clients dubbed him the “trans librarian” — but he also has lived experience. “It took me a long time to realize that actually, I’m a gay man,” he says. “If I had had somebody just talk it through with me, I feel like I could have saved eight years of consternation, you know?”

Lawliet says listening to Erica Livingston, a birth doula with Birdsong Brooklyn, on the Tarot for the Wild Soul podcast inspired him to pursue his current path. “She said this line: ‘We need a doula for every threshold.’ Of course, the threshold I was working with was transition,” Lawliet says. “I had a huge, thunderous, lightning moment.” Eventually, Livingston and her partner, Laura Interlandi, became his mentors, teaching him the skills to guide people through their most vulnerable and tender moments.

From his apartment in Los Angeles, surrounded by Dolly Parton art and tarot decks, Lawliet meets his clients over Zoom, which allows him to see people anywhere in the country — more than 115 of them so far with a growing waitlist. On a given day, it’s not uncommon for Lawliet to discuss everything from the spiritual aspects of transitioning and not feeling trans enough to the current political climate. Then there’s the logistics — insurance, clothing, name change — all the complex, moving parts of being trans, he says.

There’s currently no certification process. (Birth doulas have a certification process, though it isn’t a legal requirement.) However, Lawliet is continually receiving requests for mentorship, so he is planning to offer a structured mentorship program in the future. For now, he has only taken on one mentee, who is Filipinx and Yaqui, which gives clients of color an option for someone with more shared experience.


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Given the lack of official training, Lawliet strongly believes a deep interrogation of self needs to happen before someone assumes the title of gender doula. He’s always thinking about the ethical considerations of the role—confidentiality for one, or not trying to force people to grow or heal in a way that he thinks they need. He also created an online community with other gender doulas, including McGee, Luigi Continenza, Bowie Winnike and Ro Rose, where they share resources, troubleshoot and refer clients to one another.

In the end, McGee worked with Woods for a month. He taught them the signs of abnormal swelling and of course, made smoothies. When Woods wanted to step out into the world, McGee was right there alongside them, reminding them to take pauses when they felt winded, filling in the awkward silences, and stopping when they wanted to admire the exuberant branches of their favorite monkey puzzle tree.

Eventually, Woods healed. The first time they slipped their favorite black hoodie over their head and looked in the mirror, they cried and thought: “That’s how it’s supposed to look.” Woods and McGee are still in touch, and every now and then will go for a walk, together.

Yes! Magazine is a nonprofit, independent media organization. Learn more at Yes! Magazine.

The post The Doulas Who Help Navigate Gender Exploration appeared first on Reasons to be Cheerful.

Witty and apposite

Published by Anonymous (not verified) on Thu, 13/06/2024 - 7:10am in

He might have added that he personally was never stupid enough to spend £4bn on unusable PPE or £27bn on test and trace. Now he couldn’t possibly be part of that government could he?... Read more

Deaths of infants and young children in Gaza. A fact-based estimate.

Published by Anonymous (not verified) on Thu, 13/06/2024 - 12:21am in

To the death toll of the violence in Gaza, around 15.000 additional deaths of infants and children between 1 and 5 have to be added. This is a rough and, in my opinion, a lower-bound estimate. However, the calculations are based on robust information, and sizeable additional mortality in infants and young children in Gaza […]

Q and A with Naila Kabeer on Renegotiating Patriarchy

Published by Anonymous (not verified) on Tue, 11/06/2024 - 8:47pm in

In this interview with Anna D’Alton (LSE Review of Books), Naila Kabeer discusses her new book, Renegotiating Patriarchy: Gender, Agency and the Bangladesh Paradoxforthcoming from LSE Press in September. The book examines positive social change in Bangladesh over the past 50 years, in particular the factors that enabled significant and rapid gains for women in areas like health, education and employment within a deeply patriarchal society.

LSE Festival Power and Politics 2024

Join Naila Kabeer, Monica Ali, Phillip Hensher and Sarah Worthington for an event, Power and Storytelling on Saturday 15 June as part of LSE Festival.

Renegotiating Patriarchy: Gender, Agency and the Bangladesh Paradox. Naila Kabeer. LSE Press. 2024.

Bangaldesh Paradox naila kabeer book coverWhat is the “Bangladesh paradox”?

Bangladesh has been described as a new nation but an ancient land. For much of its history, Bangladesh was colonised by foreign powers, first by Hindu and Buddhist rulers from other parts of India, then by the Moghuls, followed by the British. When the British left in 1947, what is now Bangladesh was incorporated into Pakistan but occupied the status of a quasi-colony. It fought a war of liberation before finally becoming independent in 1971.

The long history of colonial extraction meant that Bangladesh embarked on independence as one of the poorest countries in the world. It had extremely high fertility rates which made it one of the  most densely populated countries in the world. It had a largely illiterate population that eked out a living in subsistence agriculture. It also had a very patriarchal culture, one it shared with the northern plains of India, that gave rise to very strong son preference and a tradition of discrimination against daughters. The high fertility rates in the country were partly due to the pressure on women to have enough children to ensure a minimum number of sons, pressure which resulted in very high rates of maternal mortality. Bangladeshi women were described by a Population Crisis Committee report from the 1980s as “poor, powerless and pregnant”, with the lowest status among women from the 99 countries covered by the report.

Bangladesh was regarded by the donor community at the time [of independence in 1971] as an “international basket case”[] Yet by the 1980s, fertility rates began declining at a speed that set a record in demographic history.

Bangladesh was regarded by the donor community at the time as an “international basket case”, a country would need foreign aid into the foreseeable future if it was to survive, let alone thrive. Yet by the 1980s, fertility rates began declining at a speed that set a record in demographic history, there were striking improvements in health and nutrition and educational levels began to rise. What stood out about these changes is the disproportionate gains made by women and the resulting decline in gender inequality.  So the term “Bangladesh paradox” is used as shorthand to describe the remarkable progress that the country made in spite of high levels of poverty and poor levels of governance.

There is one other element to the paradox that is less widely remarked on that interests me. The improvements observed in gender equality came at a time when the country had begun experiencing a steady rise in a very orthodox version of Islam, one imported from the Middle East and antithetical to many of the gains women had made.

Q: What aspects of the Bangladesh paradox does your book, Renegotiating Patriarchy address?

There have been many explanations of the Bangladesh paradox, but they tend to focus on the role of powerful actors such as the state, the donors and the non-governmental sector. They all have a part to play, but at the heart of the story I tell in this book is what I believe to be the main driving force behind the changes we associate with the paradox: the ideas, values and motivations of ordinary people. This hidden story of change takes as its starting point the evidence emerging in the literature that there had been a significant decline in son preference and a move towards more egalitarian preferences, with many parents satisfied with only having daughters. This was in sharp contrast to India where parents were seeking to reconcile their desire for fewer children with the practice of female-selective abortion to ensure that their children were only, or mainly sons.

At the heart of the story I tell in this book is what I believe to be the main driving force behind the changes we associate with the paradox: the ideas, values and motivations of ordinary people.

Clearly there had been some kind of shift in the structures of patriarchy in Bangladesh: girls were now more likely to survive the early years of life than boys (the norm in much of the world); they were more likely to be enrolled in primary and secondary school than boys and their labour force participation rates had been rising consistently, overtaking those of India and Pakistan.

My book sets out to find out what led ordinary people make the changes in their lives which coalesced into the Bangladesh paradox. And because there was evidence accumulating in various studies that women had played an important role in making these changes happen, I was particularly interested in this aspect of the story. Given Bangladesh’s patriarchal traditions, I wanted to know what motivated women to seek change and how they were able to bring it about when the changes they sought seemed to go against the grain of these traditions.

Q: What was your methodological approach and how did you arrive at it? 

The book is interdisciplinary in its approach and pluralist in its methodology. As I noted earlier, there have been many “big picture” stories about the Bangladesh paradox. What has been missing are the multitude of “small picture” stories from ordinary men and women. A great deal of the book is made up of these stories, gathered from my own research and from research that others have carried out. By examining the experiences and motivations related by different generations of women and men over successive periods of time, I was able to trace the unfolding of the Bangladesh paradox through the shifts in attitudes that they reported, the actions they took in response to survival imperatives and the changes in their aspirations as new possibilities came into view.

These narratives form the core of my analysis, but I draw on a range of other sources of information as well. I go back into the history of Bangladesh to understand the more tolerant version of Islam that had flourished in the country, an amalgam of the various religions that had co-existed in the region and that may have been a factor in allowing women to make the gains they did. I draw on secondary literature to understand the evolution of the country’s policy and legal architecture, piecing together the story of the economic changes that allowed the country to transcend its past poverty. These constitute the structural context within which individuals and groups were able to exercise certain forms of agency but not others, which allowed women to “renegotiate” the more oppressive aspects of patriarchy rather than to overthrow it.

Individuals and groups were able to exercise certain forms of agency but not others, which allowed women to ‘renegotiate’ the more oppressive aspects of patriarchy rather than to overthrow it.

In addition, woven into my account of the qualitative explanations that men and women gave for their behaviour are statistical findings that helped me to distinguish between the explanations that embodied the experiences of the few, perhaps those who were ahead of their time or lagging behind, and those of the many whose experiences were widespread enough to shape the larger statistical trends.

Q: A central research question in the book is around the decline for son preference among families and communities in Bangladesh. What were the reasons for son preference?  

Bangladesh is a part of a larger region that Deniz Kandiyoti refers to as “the belt of classic patriarchy” stretching from North Africa across the Middle east and the northern plains of the South Asian sub-continent, including Bangladesh. These countries may have very different histories, different religions, different economic trajectories, but they share certain features of their gender and kinship relations in common. They are characterised by patrilineal descent so that the family name and property pass through the male line. There are strict restrictions on women’s mobility outside the home so they are confined to reproductive and home-based activities, dependent on male breadwinners for most of their lives.  Daughters are married off early and leave the parental home to be absorbed into their husband’s lineage. Sons, on the other hand, carry on the family line, inherit its property, engage in productive work and look after their parents as they get older. Not surprisingly, these societies are characterised by a strong preference for sons, with lower levels of female education and labour force relative to male and, in contrast to the rest of the world, higher levels of female mortality, particularly in the younger age groups.

A woman in Bangladesh wearing an orange sari holds a tool and looks off camera with trees behind herA woman in Subarnachar, Noakhali, Bangladesh. Photo © Jannatul Mawa.

Q: In your research, you discovered that there was a decline in son preference in the past forty or fifty years. What were some of the reasons for that decline? 

My interest in son preference goes back to 1980 when I was doing my PhD at LSE and researching the reasons for high fertility in Bangladesh. I spent a year doing field work in a village in Bangladesh where it became clear to me that women had a particularly strong preference for sons over daughters, both to assure their status in their husband’s family and because sons represented security in old age. After my PhD, I joined the Institute of Development Studies, Sussex and continued to do research in South Asia. I was aware of the various studies from Bangladesh documenting, among other things, increasing gender equality in survival rates, health, nutrition and education. To find out why this was happening, I went back to the village in which I had conducted my PhD field work.

My interest in son preference goes back to 1980 when I was doing my PhD at LSE and researching the reasons for high fertility in Bangladesh.

What I found makes up the concluding sections of the book where I also touch on why a similar shift in son preference had not been happening in India. The full answer on the reasons for this shift, detailed in the book, are complicated and tangled up with the overall story of the Bangladesh paradox. The short answer revolves around changing intergenerational relationships and the belief on the part of parents that sons had become more focused on their own wives and children to the neglect of their parents, that daughters-in-law were not as subservient as they used to be and that daughters are now not only regarded as more loyal to their parents than sons. They are perceived as being more concerned about their welfare, but also, with the rise in their income-earning opportunities, in a better position to help them materially. It was mothers who were often at the forefront of this revaluation of daughters.

Q: You deal with the rise in women’s labour force participation in your book. What was its significance?  

It has been very significant. There is an interesting contrast here between Bangladesh and India. India has one of the highest per capita growth rates in the world but its female labour force participation has been declining steadily and is now among the lowest in South Asia. In fact, the jobless nature of India’s growth has seen high levels of unemployment among men as well. Although Bangladesh’s growth rates are also high, it remains far poorer than India.  However, it has had a more labour-intensive pattern of growth and generated opportunities that have benefited women as well as men. Its microfinance programmes have allowed women to take up income-generating activities that could be carried out within or near the home. Its export-oriented garment sector had a largely female labour force. Community-based services, including those provided by NGOs, hire large numbers of women. In Bangladesh, women’s ability to make a direct contribution to household income has been an important factor in enhancing their voice and agency within their households, has made daughters appear less of a burden to their families and has given women the motivation to resist the efforts of Islamist forces to curtail their opportunities.

Women’s ability to make a direct contribution to household income has been an important factor in enhancing their voice and agency within their households

Q: Do you think that the positive social changes, including the progress on gender equality that the paradox describes will be sustained in the future? 

It’s hard to say. I feel somewhat pessimistic but not just in relation to Bangladesh. The whole world seems to have become darker – it is more unequal, there are more wars, more natural disasters, more financial crises and, of course, accelerating climate change. And the same market fundamentalism that impededes our ability to put things to right in the rest of the world is also holding it up in Bangladesh.

We have seen inequality rising in Bangladesh over the last decades. Whereas in the early years after independence, it was possible to make important gains on the health front with low-cost vertical programmes, we now need broad-based health services so that everyone can be assured of decent care when they need it. Quantity in educational provision has been achieved at the expense of quality, and quality has been undermined by compromising on a secular curriculum in deference to Islamist forces. We have had multiparty democracy since 1990 and mainly civilian rule, but when the same party has been in power since 2009, we know it is not a very healthy democracy. Meanwhile, the rise of an intolerant Islamic orthodoxy has continued and may have been given fresh oxygen by what is happening to Palestinian people in Gaza today. I am not sure whether the pace of social progress we saw in the past will be sustained in the future. But who knows? Bangladesh has defied the odds before; it may do so again.

Note: This interview gives the views of the author, and not the position of the LSE Review of Books blog, nor of the London School of Economics and Political Science.

Main image credit: A woman in Subarnachar, Noakhali, Bangladesh. Photo © Jannatul Mawa.

 

Rebuilding the NDIS

Published by Anonymous (not verified) on Mon, 10/06/2024 - 4:58am in

660 000 Australians are participants in the National Disability Insurance Scheme, and 400 000 work in NDIS-related jobs. Our country needs the NDIS, but it’s expanded too quickly in recent years, as state-based services have withered on the vine. 11% of five- to seven-year-old Australian boys, and 5% of five- to seven-year-old girls, are now Continue reading »

Time to change the law

Published by Anonymous (not verified) on Mon, 10/06/2024 - 4:55am in

One of my closest friends was recently diagnosed with early stages of dementia. She is 80 years old and believed that the problems she experienced with her memory, were due to normal age-related forgetfulness. She has a science background, and after receiving her diagnosis she started to research the topic in great detail. She read Continue reading »

Environment: When will politicians take climate change seriously?

Published by Anonymous (not verified) on Sun, 09/06/2024 - 4:58am in

Tags 

climate, Health

Both the WHO and UN may be starting to take seriously the effects of climate change on health. A global plan to save 1,000 freshwater fish from extinction. Covid reverses life expectancy at birth. WHO resolution on climate change and health It’s difficult to know whether to celebrate (the achievement) or groan (about the delay) Continue reading »

The ‘unaffordable’ NHS…

Published by Anonymous (not verified) on Fri, 07/06/2024 - 7:11am in

This is from tax lawyer Dan Neidle: I’m not talking much about the general election tax debate. Because it’s irrelevant. The few £bn being discussed is dwarfed by the actual UK tax increases over the last few years, and the further tax increases we’ll almost certainly see in the future. Perhaps tax increases will be... Read more

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