Solidarity and Global Health 2009-12-07

From straightjacket

• Solidarity and Global Health - workspace

Contents 1 Abstract 1.1 Final 1.2 Edit 4 (Andrew) 1.3 Edit 3 (Kelly) 1.4 Edit 2 (Azad) 1.5 Edit 1 (Nanky) 1.6 V1 (Azad 2010.3.27) 2 Core Themes 3 References 3.1 Azad 3.2 Kelly 3.3 Andrew

Abstract

Final

Global health initiatives are often founded on notions of helping, aid and charity. While often arising from a noble sentiment, the limitations of this paradigm have become increasingly apparent. Rather than bringing about increased equity, particularly in the distribution of power, the asymmetric relationships implied by the “helping paradigm” often insidiously exacerbate the very inequalities the work was intended to reduce. This realization has led to an array of alternative frameworks for global health research and practice, such as participatory action and community-based research. These alternative paradigms attempt to address power differentials between stakeholders and emphasize the collaborative processes by which problems are framed and interventions selected. To build on these concepts and to further address the consequences of charity-based paradigms, we propose an alternative framework that is grounded in solidarity. Solidarity, a powerful idea that originates in social movement theory, can help us relate to the individuals and communities we work with. Using examples, we review the history of the concept of solidarity and its implications for the health of marginalized populations. Being in solidarity implies participating within communities in a manner that promotes the cultivation of a web of creative and balanced relationships. Such an approach often does not focus primarily on specific solutions to problems, but instead seeks to fortify communities' own powers to heal, grow, and resist the adverse effects of sociopolitical and economic forces on their health and well-being.

Edit 4 (Andrew)

Global health initiatives are often founded on a notion of charity. While often arising from a noble sentiment, the limitations of this paradigm have become increasingly apparent. Rather than bringing about increased equity, particularly in the distribution of power, the asymmetric relationships implied by the “helping paradigm” often exacerbate the problems the initiative was intended to address. This realization has led to an array of alternative frameworks for global health research and practice, such as participatory action research and community-based research. These paradigms attempt to address power differentials between stakeholders and emphasize collaborative processes. To build on these concepts and to further address the consequences of a charity-based paradigm, we propose an alternative framework that is grounded in solidarity. Solidarity, a powerful idea that originates in social movement theory, can help us relate to individuals and communities in a manner that aligns our objectives with theirs. Using examples, we review the history of the concept of solidarity and its implications for the health of marginalized populations. A "solidarity lens" is proposed to clarify motivations and understand power relationships while working within a community for social change. Being in solidarity implies participating within communities in a manner that promotes the cultivation of a web of creative and balanced relationships. Such an approach often does not focus primarily on specific solutions to problems, but instead seeks to fortify communities' own powers to heal, grow, and resist the adverse effects of sociopolitical and economic forces on their health and well-being.

Edit 3 (Kelly)

Global health initiatives are often founded on notions of helping, aid and charity. Despite arising from a noble sentiment, the limitations of this paradigm have become increasingly apparent. Instead of bringing about an increase in equity and an equitable distribution of power, the asymmetric relationships and locus of control implied by the “helping paradigm” often insidiously exacerbate the very inequalities the work was intended to reduce. This realization has led to an array of alternative frameworks for global health research and practice, such as participatory action, community-based research and evaluations. These alternative paradigms attempt to address power differentials between stakeholders and emphasize collaborative processes by which problems are framed and interventions selected. To build on these concepts and to further combat the consequences of charity-based paradigms, we propose an alternative framework that is grounded in solidarity. Solidarity, a powerful idea that originates in social movement theory, can help us achieve a more equitable mode of relating to the individuals and populations we work with. Using an array of examples, we review the history and various uses of the concept of solidarity and its applications in and implications for the health of marginalized populations. Solidarity can be used as a lens to clarify our motivations and understand power relationships while working within a community for social change. Being in solidarity implies participating within communities in a way that promotes the cultivation of a web of creative and balanced relationships. Such an approach often does not focus primarily on explicit solutions to individual problems, but instead seeks to fortify communities' own powers to heal, grow, and resist the adverse effects of sociopolitical and economic forces on their health and wellbeing.

Edit 2 (Azad)

Global health initiatives are often founded on notions of helping, aid and charity. Despite arising from a noble sentiment, the limitations of this paradigm have become increasingly apparent. This realization has led to the development of an array of alternative frameworks for global health research and practice, such as participatory community-based research and evaluations. These alternative paradigms focus on power differences between different stakeholders and the collaborative process by which problems are framed and interventions selected. Instead of bringing about an increase in equity and an equitable distribution of power, the asymmetric relationships and locus of control implied by the “helping paradigm” often insidiously exacerbate the very inequalities the work was intended to reduce. In order to combat the consequences of such charity-based paradigms, we propose an alternative framework that is grounded in solidarity. Solidarity, a powerful idea that originates in social movement theory, can help us achieve a more equitable mode of relating to the individuals and populations we work with. Using an array of examples, we review the history and various uses of the concept of solidarity and its applications in and implications for the health of marginalized populations. Solidarity can be used as a lens to clarify our motivations and understand power relationships while working within a community for social change. Being in solidarity implies participating in communities in a way that promotes the cultivation of a web of creative and balanced relationships. Such an approach often does not focus primarily on explicit solutions to individual problems, but instead seeks to fortify communities' own powers to heal, grow, and resist the adverse effects of sociopolitical and economic forces on their health and wellbeing.

Edit 1 (Nanky)

Global health initiatives are often founded on notions of helping, aid and charity. Despite arising from a noble sentiment, the limitations of this paradigm have become increasingly apparent. This realization has led to the development of an array of alternative frameworks for global health research and practice, such as participatory community-based research and evaluations. These alternative paradigms focus on power differences between different stakeholders and the collaborative process by which problems are framed and interventions selected. Instead of bringing about an increase in equity and an equitable distribution of power, the asymmetric relationships and locus of control implied by the “helping paradigm” often insidiously exacerbate the very inequalities the work was intended to reduce. In order to combat the consequences of such charity-based paradigms, we propose an alternative framework that is grounded in solidarity. Solidarity, a powerful idea that originates in social movement theory, can help us achieve a more equitable mode of relating to the individuals and populations we work with. Using an array of examples, we review the history and various uses of the concept of solidarity and its applications in and implications for the health of marginalized populations. Solidarity can be used as a lens to clarify our motivations and understand power relationships while working within a community for social change. Working in solidarity implies participating in communities in a way that promotes the cultivation of a web of creative and balanced relationships. Such an approach often does not focus primarily on explicit solutions to individual problems, but instead seeks to fortify communities' own powers to heal, grow, and resist the adverse effects of sociopolitical and economic forces on their health and wellbeing.

V1 (Azad 2010.3.27)

http://csih.org/en/index.asp

Global health initiatives are often founded on notions of helping, aid and charity. Despite arising from a noble sentiment the limitations of this paradigm have become increasingly apparent. This realization has led to the development of an array of alternative frameworks for global health research and practice, such as participatory action research and ..[better examples]. Central to many of these alternative paradigms is a focus on relationships between stake holders [alternative phrasing please] and the collaborative process by which problems are framed and interventions selected. Instead of bringing about increasing equity and an even distribution of power, the asymmetric relationships and locus of control implied by the “helping paradigm” often insidiously exacerbate the very inequalities the work was intended to reduce. As an alternative we propose solidarity: a powerful idea originating in social movement theory which can help us achieve a more equitable mode of relating to the individuals and populations we work with. Using an array of examples, we review the history and various uses of the concept of solidarity and its applications in and implications for the health of marginalized populations. Solidarity can be used as a lens to clarify our motivations and understand power relationships when working in community for social change. Being in solidarity implies participation in communities in a way that promotes the cultivation of a web of creative and balanced relationships. Such an approach often does not focus primarily on explicit solutions to individual problems, but seeks instead to fortify the community's own powers to heal, grow, and resist the assault of external powers on its health and wellbeing.

[I guess we are talking about a kind of holistic global health, focusing on fortifying the community's own immune system and hemostatic mechanisms as opposed to addressing individuals pathogens]

Core Themes

[Andrew]

1. Health is political. Those engaged in GH must grapple with this reality and understand their role in shaping politics.
2. Politics is about power and resistance to power. GH should play a role in supporting resistance to power.
3. Solidarity is about relationships in the context of power and resistance. It is a powerful idea that originates from social movement theory, and can help GH practitioners/students/researchers shift their focus from the individual to the collective.

[Kelly]

1. Solidarity is a principle that must underlie our interactions with others as social changemakers, in order or our work to be transformative. (as opposed to current principles, like "helping")
2. We can use solidarity as a lens to clarify our motivations and understand power relationships when working in community for social change (via examples)
3. The global health movement can be molded by our individual and collective decisions to think and act using a relational lens,
   • (shifting our focus from the individual to relationships within communities). (... "as solidarity in resistance to all forces that adversely influence health of communities & ecosystems")

[Azad]

1. Charity vs. solidarity as conceptual frameworks for relationships and partnerships
   • The limits of help/charity - examples
2. A community & relation-based view of global health work: giving primary importance to the relational outcomes
   • What it looks like: examples
   • How we bring it to our own work: analysis of examples & extraction of principles
   • what "sustainability," "resilience," & "resistance" in the face of contrary power look like from this "relational lense"
   • Relational vs. material wealth & poverty - "the happy poor"; "[living on $1/day... these people were not poor, they were living on the land not on dollars. When their land was taken away and they had $3/day in wages to live on, then they became poor]"
3. healing as solidarity in resistance to all forces that adversely influence health of communities & ecosystems

References

Azad

Altruism / Help

1. Daniel Goleman , “Why aren’t we all Good Samaritans? ” (Monterey, California , March 2007), http://www.ted.com/index.php/talks/daniel_goleman_on_compassion.html.
   • In regards to being too busy to help, often when I think about N. American global health programs, part of the reason they often come across as runaway train projects with no critical reflection is that the administrators and MDs within these programs DO NOT HAVE THE TIME to be reflective. They are doing and not thinking. They can't take on new projects. They are filled up to the brim with tasks. In regards to the diffusion of responsibility concept brought up at the end of this talk, I think it's similar with large GH programs - no one can stop to think because everyone is running at an unbelievable pace and really unable to look around within the context of their work. They are all missing the slumped over guy - who in my mind represents that we are often missing the whole point of GH within our huge programs (ie actually making health better globally!) [ka]
2. Other sources I have summarized in http://www.straightjacketstudio.com/node/17 , including Walden. The "moral neuropolitics" stuff I was talking about is mentioned in there. If you are interested in the topic there are two good article by Gary Olson at http://www.zcommunications.org/znet/ViewArticle/16246 and http://www.zmag.org/znet/viewArticle/15381

Metaphors, the "Development" model,

1. Wolfgang Sachs, The Development Dictionary: A Guide to Knowledge as Power (Zed Books Ltd, 1992). Organized as a dictionary with articles on specific buzz words. The chapters listed below are the most relevant. It traces the history of each term as it entered the development discourse, how the meanings shifted over time etc. It was a real eye opener for me. It views the terms as part of a discourse and hence a mental structure. It's the books explicit goal to dismantle that structure. I haven't read the whole book yet. I have an extra copy. "The authors of this book deal neither with development as technical performance nor with development as class conflict, but with development as a particular cast of mind. For development is much more than just a socio-economic endeavour; it is a perception which models reality, a myth which comforts societies, and a fantasy which unleashes passions. Perceptions, myths and fantasies however, rise and fall independent of empirical results and rational conclusions; they appear and vanish, not because they are proven right or wrong, but rather because they are pregnant with promise or become irrelevant." and "On the one hand, we hope to disable the development professional by tearing apart the conceptual foundations of his routine; on the other hand, we would like to challenge those involved in grassroots initiatives to clarify their perspectives by discarding the crippling development talk towards which they are not leaning."
   • Marianne Gronemeyer, “Helping,” in W. Sachs (Ed.) The Development Dictionary: A Guide to Knowledge as Power (Zed Books Ltd, 1992), 53-69.
   • Wolfgang Sachs, “Introduction,” in W. Sachs (Ed.) The Development Dictionary: A Guide to Knowledge as Power (Zed Books Ltd, 1992), 1-5.
   • Gustavo Esteva, “Development,” in W. Sachs (Ed.) The Development Dictionary: A Guide to Knowledge as Power (Zed Books Ltd, 1992), 6-25.
   • C. Douglas Lummis, “Equality,” in W. Sachs (Ed.) The Development Dictionary: A Guide to Knowledge as Power (Zed Books Ltd, 1992), 38-52.
   • Wolfgang Sachs, “One World,” in W. Sachs (Ed.) The Development Dictionary: A Guide to Knowledge as Power (Zed Books Ltd, 1992), 102-115.
   • Majid Rahnema, “Poverty,” in W. Sachs (Ed.) The Development Dictionary: A Guide to Knowledge as Power (Zed Books Ltd, 1992), 158-176.

Loss of cultures and ethnocide

1. Wade Davis, “Cultures at the far edge of the world” (presented at the TED Conference, Monterey, California , February 2003), http://www.ted.com/index.php/talks/wade_davis_on_endangered_cultures.html.
2. Wade Davis, “The worldwide web of belief and ritual” (presented at the TED Conference, Monterey, California , February 2008), http://www.ted.com/index.php/talks/wade_davis_on_the_worldwide_web_of_belief_and_ritual.html.

Relating to the other

1. Meas Nee, Towards Restoring Life in Cambodian Villages (Phnom Penh: JSRC, 1999). (I have this, you likely wont find it anywhere)
2. Voluntourism (CBC) 2009-02-01

Other potential references

1. James A. Trostle, Epidemiology and Culture, 1st ed. (Cambridge University Press, 2005).
2. Duncan Pedersen, “At the crossroads between global health and local cultures: a critical perspective,” in Lolas F., Martin D.K., Quezada A. (Eds.) Prioridades en Salud y Salud Intercultural, 1 (Santiago de Chile: CIEB and Universidad de Chile, 2007), 141-162.

These two looked interesting but I have not seen the actual books yet. Are either of you familiar with her work?

1. Vandana Shiva, Earth Democracy: Justice, Sustainability, and Peace (South End Press, 2005).
2. Vandana Shiva, Staying Alive: Women, Ecology and Development (Zed Books, 1989).

Kelly

New Articles:

1. Sarah B MacFarlane; Marian Jacobs; Ephata E Kaaya. In the Name of Global Health: Trends in Academic Institutions. Journal of Public Health Policy; 2008; 29, 4; Research Library, pg. 383.
   • this article argues for "a new generation of truly global leaders working on a shared agenda on equal footing."
2. Solomon R. Benatar, Abdallah S. Daar, Peter A. Singer. Global Health Ethics: The Rationale for Mutual Caring. International Affairs (Royal Institute of International Affairs 1944-), Vol. 79, No. 1 (Jan., 2003), pp. 107-138 Published by: Blackwell Publishing on behalf of the Royal Institute of International Affairs. Stable URL: http://www.jstor.org/stable/3095544
3. Lynda Tyer-Viola, Patrice K. Nicholas, Inge B. Corless, Donna M. Barry, Pamela Hoyt, Joyce J. Fitzpatrick and Sheila M. Davis. Social Responsibility of Nursing: A Global Perspective. POLICY POLIT NURS PRACT 2009; 10; 110 originally published online Aug 20, 2009.
   • this article addresses in part social justice vs. social responsibility vs. solidarity?
4. The Ethical Implications of the Social Determinants of Health: A Global Renaissance for Bioethics. Bioethics. Volume 23 Number 2 2009 pp ii–v
5. Wade Davis. The Wayfinders. Massey Lecture, November 2009. http://www.cbc.ca/ideas/massey.html
   • most notably the last chapter describing how Inuit communities are openly facing and adapting to the challenges of climate change, when it has been the global south that remains environmentally at fault. This is a strong showing of community and global solidarity. http://www.cbc.ca/ideas/massey.html (note, I misplaced this book and my notes inside so can't add more details right now, Feb 2010)
6. John Ralston Saul. A Fair Country: Telling Truths About Canada. 2008. (and summary from a multiculturalism lecture at UBC which I will have to find the exact referencing details of...) http://www.cbc.ca/canada/story/2008/10/29/f-vp-handler.html
   • John Kelly, Grand Chief, in the 1970, "As the years go by, the circle of the Ojibwe gets bigger and bigger, Canadians of all colours and religions are entering that circle, you might feel you have roots somewhere else, but in reality, you are right here with us."
   • Mohawk definition of Sovereignty (and related to solidarity?) harmony achieved through balanced relationships.
   • Principles coming from aboriginal philosophy, creating the heart of Canada and Canadians: 1. we worship complexity, we and place fit together, we are non-monolithic. 2. interculturalism. 3. we adore negotiation, 4. We balance the absolute protection for individual rights with absolute protection for group rights, and then we just sort it out. 5. We are based on the idea of the great circle; we work in adoption, not assimilation. "we all eat from the great bowl, community not charity". 6. We are an oral/aural civilization.
   • From Northrop Frye, The Great Code (New York: Harcourt, Brace, Jovanovich, 1982), 43, "Symmetry in a narrative always means that historical context is being subordinated to mythical demands of design and form".... or, "If the story is reassuring and smooth and agreeable it is probably a lie" JRS. "This is disturbing to what we hear everyday, disturbing to what we learn in schools, disturbing to our standard version of ourselves.... I am applying paint remover to peel away the false and smooth myths of the 19th century.... and the reaction is, these arguments release us from our emotional prison of false memory".
7. Christina Balwin. Storycatcher: Making Sense of Our Lives through the Power and Practice of Story. New World Library, 2005.
   • "words are how we think, narrative is how we link." (pg 10),
   • "the stakes are high. If people truly discover each other, we will make a million circles and sit down and laugh and cry at our commonalities... we will not so unconsciously exploit other people's lives in order to make our own lives more comfortable." (pg 33)
   • "people began to see themselves within a broader context because they could read about the world beyond their personal experience." (pg 39)
   • "in terms of tending, language can lift us beyond the borders of our individual lives to imagine realities of other people, other times and places; to empathize with other beings; to extend our supposing far into the universe; to even imagine God." (pg 63)
   • " This resistance to diverse reality and all its inconsistencies is the prison of privilege" (pg 83)
   • from Soul of a Citizen by Paul Rogat Loeb, "the illusion of powerlessness can just as easily afflict the fortunate among us. I know many people who are confident and successful in their work and have loving personal relationships, yet can hardly conceive of trying to work towards a more humane society. Materially comfortable and professionally accomplished, they could make important social contributions. Instead they restrict their search for meaning and integrity to their personal lives. Their sense of shared fate extends only to their immediate family and friends. Despite their many advantages, they, too, have been taught an explanatory style that precludes their participation in public life, except to promote their narrow self interest'. (pg 83)
   • "And when we reveal details that we think are excruciatingly personal, we discover that the personal is universal" (pg 85)
   • "In the midst of overwhelming stimulation, when we turn off the technology, and turn to one another, story still has the potential to calm us, to call us back into ourselves, to remind us of the length and breadth of the journey from which we come... so we can find each other, awaken each other, welcome each other." (pg 93)
   • "When you sit in meditation, you sit for everybody." (pg 163)
   • "A good question releases a good story." (pg 180).
   • "we support conversations that are meaningful, generative, and deeply honouring of the wisdom each person carries into the room." (pg 187, speaking about the "From the Four Directions" international conversation intiated by Margaret Wheatley and co-founded with Christina's organization Peer Spirit (www.peerspirit.com).
   • from Toke Paludan Moller, "So I see the work is to keep looking for the right moment and to support that moment coming alive in every person, in every way I can. I am happy to dedicate the rest of my life to asking the questions that can crack the trance - 'hey everybody, the emperor has no clothes and he's not even an emperor, just another confused fellow, so let's see if we can imagine a new story, right here on the street corner, in the taxi, and meeting in our organizations" and then we will sit down and build a little fire, and heat some water for tea, and tell each other stories that change the world" (pg 198).
   • "They are not rescued from the trials of the world; they are offered community, communion, and the conversation so they know their experience is help within the larger story" about the Episcopal Church in the Potrero Hill section of San Fransisco, and co-pastors father Donald Schell and father Rick Fabian. (pg 203)
   • "The great stewpot of collective wisdom" (pg 223)
8. Thomas King. The Truth About Stories, A Native Narrative. CBC Massey Lectures. Anasi, 2003. http://www.cbc.ca/ideas/massey/massey2003.html
   • "Ah. You've heard this all before, haven't you. You may have already leaned over to a friend and whispered, Platitude. Platitude, platitude, platitude. Thomas King is the duck-billed platitude." (I like this! Let's avoid platitudes, too)
   • in regards to photographs that Curtis took of Indians, he writes, "I am grateful that we ahve his images at all, for the [people]who look at you from the depths of these photographs are not romantic illusions, they are real people". (pg 37)
   • "I know he's Indian, said my brother, and you know he's Indian, but how is anyone else going to be able to tell?" (pg 42)
   • "In the end, there is no reason for the Indian to be real. The Indian merely has to exist in our imaginations." (pg 54)
   • In regards to being asked "How will taking photographs of Native artists benefit native people?"... "It wasn't a question I would have ever asked...that contained the unexamined implication that the lives of Native people needed improvement" (pg 58)
   • .... I'm not quite finished this book yet, there may be other nuggets of wisdom.

Some Favourite other Resources:

1. Ivan Illich, “To Hell with Good Intentions” (presented at the Conference on InterAmerican Student Projects, Cuernavaca, Mexico, April 20, 1968), http://www.swaraj.org/illich_hell.htm.
2. Nikko Snyder, “The complexities of hope,” Ascent, 2007, http://www.ascentmagazine.com/articles.aspx?articleID=282&page=read&subpage=past&issueID=38.
3. John A. Crump and Jeremy Sugarman, “Ethical Considerations for Short-term Experiences by Trainees in Global Health,” JAMA 300, no. 12 (September 24, 2008): 1456-1458, doi:10.1001/jama.300.12.1456, http://jama.ama-assn.org.myaccess.library.utoronto.ca.
4. Dambisa Moyo. Dead Aid: Why Aid Is Not Working and How There Is a Better Way for Africa (Douglas & McIntyre, 2009). Interview: http://www.guardian.co.uk/society/2009/feb/19/dambisa-moyo-dead-aid-africa

Andrew

1. Pogge T. World poverty and human rights. Ethics and International Affairs 2005; 19 (1): 1-7.
   • Pogge is becoming well known for his 2003 book, of the same title. This issue of Ethics and Int Aff has this summary article plus several people critiquing and questioning his thesis: that the rich countries have violated a negative duty to not harm, hence owe the poor countries significant changed behavior, if not compensation.
   • "That world poverty is an ongoing harm we inflict seems completely incredible to most citizens of the affluent countries. We call it tragic that the most basic human rights of so many remain unfulfilled, and are willing to admit that we should do more to help. But it is unthinkable to us that we are actively responsible for this catastrophe"
     • [ka]I think this reflects back to us needing to change the way we live as individuals. Yes, we're willing to go on one-month jaunts to [insert name of African country] but are we willing to give up our cars, stop purchasing excessively, inform ourselves fully, quit working for 'bad' corporations, etc?
   • "Are there steps the affluent countries could take to reduce poverty abroad? It seems very likely that there are... the common assumption, however, is that reducing severe poverty abroad at the expense of our own affluence would be generous on our part, not something we owe, and that our failure to do this is thus at most a lack of generosity that does not make us morally responsible for the continued deprivation of the poor."
2. Aviles LA. Epidemiology as discourse. J Epidemiol Community Health 2001;55:164–171
   • Excellent look at how neo-colonialism enters GH research.
3. Smith, L.T. Decolonizing methodologies: research and indigenous peoples. Zed Books (1999).
   • This book is an amazing assessment of the role of research/academic studies in the maintenance of the oppression of indigenous people. It follows Said's Orientalism thesis.
4. Birn A-E. Health and human rights: historical perspectives and political challenges. Journal of Public Health Policy 2008; 29 (1): 32-41.
   • This paper does a good job of summarizing where health and HR is coming from, and its potential.
5. Wakefield SE. Reflective action in the academy: exploring praxis in Critical Geography using a “food movement” case study. Antipode 2007; 39 (2): 331-354.
   • This paper helps us understand the idea of praxis in the academy, with the local (Toronto) example of being involved in the food security movement.
6. Waitzkin H, Iriart C, Estrada A, Lamadrid S. Social medicine then and now: lessons from Latin America. American Journal of Public Health. 2001 Oct;91(10):1592-601.
   • Excellent review of the history of social medicine, drawing the connection between Virchow, to Allende to Navarro.
7. Bambra C, Fox D, Scott-Samuel A. Towards a politics of health. Health Promotion International 2005; 20 (2): 187-193.
   • Calls for a new understanding of the role of politics in health, particularly from HP lens.
8. Courtwright, A. JUSTICE, STIGMA, AND THE NEW EPIDEMIOLOGY OF HEALTH DISPARITIES. Bioethics 2009; 23 (2): pp 90–96
   • "Rawls argues that organizing a society in accordance with the other principles of justice creates the conditions necessary for self-respect. This occurs through two mutually supportive pathways. First, in a just society, the state fosters its citizens’ self-respect because the society’s institutions respect everyone equally. Rawls writes, ‘The basis for self-respect in a just society is . . . the publicly affirmed distribution of fundamental rights and liberties.' If the state were to treat some people as less equal in this regard, providing only limited rights, this would be potentially damaging to those individuals’ self-respect.For Rawls, the attitudes that public institutions express are essential for creating the conditions necessary for self-respect. There is, however, no guarantee that a state whose policies reflect respect for its citizens will be populated by individuals whose relationships with one another are conducive to developing self-respect. Rawls writes that, ‘Our self-respect normally depends upon the respect of others. Unless we feel that our endeavors are respected by them, it is difficult . . . to maintain the conviction that our ends are worth advancing.’When we become uncertain about our ability to accurately assess the value of our various traits, projects, and endeavors and are met only with the negative judgments of others, our self-respect may be in jeopardy.Therefore, the second way in which a society structured by the two principles of justice fosters self-respect is that, within this system, there are associations made up of individuals with similar projects and goals. Rawls writes,‘The internal life of these associations . . . provides a secure basis for the sense of worth of their members and reinforce the sense that who they are and what do is valuable. In other words, they represent groups of people whose attitudes help ground one another’s self-respect as a way of resisting stigmatization." ([ka] and I would add, builds a sense of solidarity with other associations and communities)
9. McIntosh. Unpacking the Invisible Backpack of White Privilege.
   • [ka] Many of the statements in her list were quite reversible, or I should say, applicable to any majority population despite geography. Many of these statements were untrue for me when I lived in Kigali, despite being white. Of course some statements hold true no matter the geography. I think her article, read in 2010, now refects much of the discussion we have in Canada around cultural safety. When we talk about solidarity there is certainly a thread of cultural safety that must be woven in, in terms of how solidarity is cultivated moment-to-moment in human interaction.