In the past few days, since the UK population became abruptly aware of the horrendous conditions facing people on the borders of Europe, political friends and foes have stressed distinctions between migrants and refugees. I have found the focus on and articulation of this distinction divisive and counterproductive, and hope to express why.
The distinction that has been shared about on social media goes something like this:
Migrant: Someone who would like to move somewhere else to improve their quality of life.
Refugee: Someone who has been forced to move somewhere else, e.g. to escape war, persecution, or natural disaster.
Let me say first that I understand that the term ‘refugee’ has a particular and distinct meaning in international law, and in particular in the Geneva Convention on Refugees. I don’t contend that there is no value in having these two terms, or that there are not substantial differences in motivations for movement between nations, but I am concerned about the context, timing and emphasis of the distinction, and of the consequences.
Refugees are people who migrate because their quality of life is so bad, to the point where it could result in the loss of life, that the desire to improve that quality is steeped in desperation and necessity. But it is a quality of life issue, and so the distinction between ‘migrant’ and ‘refugee’ rests on the nature and evaluation, to use the language of the UK government, of the ‘push-factor’.
In some cases, we may find it easy to distinguish between a refugee and a migrant by a cursory glance at the factors contributing to their desire to move, and in others we may not find that distinction so easy to make. The distinction is not an absolute one, there is blurring, there is grey, there will be differing interpretations and perspectives, not least between those already living in relatively safe countries and those trying to reach them. It concerns me that by emphasising distinctions between migrants and refugees as if these were absolutely separate categories, a stark binary arises that leads to us to treat all people who would want to enter the UK as one of either: ‘The Deserving Refugee’, recipient of pity and charity, or ‘The Undeserving Immigrant’, recipient of distrust and scorn.
The Undeserving Immigrant is a well-developed character in the column inches of the British Press and in the rhetoric of mainstream high-profile politicians. They are selfish, out for what you have, and not unlikely to hate you and pose a significant risk to your wellbeing. I worry that well-intentioned people are inadvertently buying into, or at least perpetuating, a belief in and hostile attitudes toward ‘The Undeserving Immigrant’, by pitching them against the ‘Deserving Refugee’.
I can see the rationale:
- There are millions of people in dire need of immediate assistance, but years of conditioning that have left a large proportion of the population instinctively hostile and suspicious of people arriving in the UK from overseas.
- That widespread hostility and suspicion risk delaying and blocking the assistance to refugees that is needed.
- By attempting to decouple the Deserving Refugee from the fabled Undeserving Immigrant, maybe we can circumvent the well-developed prejudices that are a barrier to us extending solidarity to those who most need it right now.
I think that’s the logic. But we need to proceed with extreme caution.
By sacrificing ‘migrants’ for the benefit of refugees, we risk making the problem worse. Firstly, who gets to decide who is a migrant and who is a refugee? Predominantly it will be a right-wing political establishment and bureaucrats following racist immigration policies, with undue influence from a reliably hostile and reactionary British Press. How should we expect these groups to utilise absolute distinctions between migrants and refugees? Which side of the line are they most likely to put people? How many desperate people will be implicitly defined as Undeserving Immigrants because politicians, state agencies and the press declare them to not meet their imposed criteria for bona fide refugee status?
These are not abstract questions, they can be answered with reference to the past and present – for example, by reminding ourselves that despite a high profile campaign to save him, Glasgow student Majid Ali was deported to Pakistan two months ago and to the best of my knowledge has not been heard of since. And by reminding ourselves that Aylan Kurdi, the three year-old boy photographed dead on Turkish a beach earlier this week, who died along with his five year-old brother and mother, was recently denied refugee status by the Canadian government. National governments controlled by a capitalist class will always tend to narrowly categorise people by their value to that class. Humane decision making will seldom follow; relegations to the status of Undeserving Migrant will.
By accepting a binary of the Deserving Refugee and the Undeserving Immigrant, we risk, no, we ensure, that some refugees will be declared undeserving and treated with the contempt and inhumanity that we have come to see as normal. Some of them will end up dead on beaches; more will end up dead or otherwise suffering beyond the scope of photographers’ lenses, and the fleeting concerns of populations in the West.
But the way we approach the refugee vs. migrant distinction is problematic on a more fundamental level. Even putting reactionary, nationalistic, capitalist authorities aside, how could we possibly expect people who have only ever known relative safety and comfort in the UK to make informed, balanced, fair assessments of the needs and motivations of people whose shoes they have never occupied? More explicitly, what on earth gives wealthy white Europeans the moral right to make judgements about where others can and cannot live? Intelligent civilised Westerners making clear and informed decisions on behalf of the barbarians at the gate? Oh dear.
We rightly condemn right-wing rhetoric that seeks to distinguish between the deserving and undeserving poor, but appear to be playing into an amplified version of that same binary, and accepting it so long as the people are arriving from overseas. It is surely not your or my call to make, whether someone feels safe in their country of origin, or whether they should live there. Why would it be? If that isn’t a brazen theft of agency, I don’t know what is. Is it so radical to suggest that as a general rule if someone wants to move from one part of the earth to another, for whatever reason, for they themselves will understand and own that reason better than anyone else, then they should be able to?
Let’s be absolutely clear: the inhabitants of the UK have done precisely diddle to ‘deserve’ to live here. The concept of ‘deserving’ to live somewhere is absurd. You and I do live here, we’re extraordinarily fortunate to do so, and ‘deserving’ just doesn’t come into it. I’d like to remain here for the foreseeable future, but there is no justifiable reason why you or I should have a veto on someone else doing the same. If someone genuinely believes that the arrival of another person to the UK will leave us hopelessly over-crowded and under-resourced, I would politely invite them to resolve the situation by leaving. Yes, yes, we’ve paid our taxes, and maybe you or, even more tenuously, your family members, fought in a war or something, but that doesn’t give us the right to control the lives of other people who mean us no harm. I imagine that if tomorrow a disastrous event were to render the British Isles an uninhabitable wasteland, then those who previously enjoyed luxury on the back of reinforced arbitrary borders would come to realise just how arbitrary they are.
While I think I understand the tactic of drawing distinctions between migrants and refugees at this moment in time, we ought really to be speaking and acting on principle, not least because of the unintended consequences that will otherwise follow. That principle? That people should be treated with dignity and respect, and that this should include respecting their freedom to live on whichever part of the planet they wish. Yes, we want the UK government to allow more refugees into the UK, but surely the call should be an inclusive and not a divisive one. Surely it should be a demand that empowers people, not that empowers reactionary forces to make judgements on the basis of racist policies and that seek to control people for the interests of profit. Surely the demands should be principled, clear, universalist and uncompromising:
End migrant detention
Open the borders.
Something exciting happened at the annual NUS National Conference in Liverpool earlier this year. The second day of the conference began with a debate on amendment “215c – Free education“. The text of the amendment can be found below. In summary, it resolved that the NUS should campaign for free, publicly funded education, without individual students having to pay via tuition fees, a graduate tax or any other mechanism. That might not sound too contentious, but NUS Conference had not actually supported free education in the UK for over a decade (the leadership have favoured a graduate tax model).
As expected, the amendment was strongly opposed by the NUS leadership, with NEC members and even the President taking to the podium to speak against it. However, after a lengthy debate, the vote was taken and the amendment passed, to a standing ovation in the hall. NUS Conference 2014 had voted in support of, and to campaign for, free education!
Fast forward to the end of May and the University and College Union (UCU), which represent academic staff in higher and further education, held its annual Congress in Manchester. Towards the end of the first full day, the Higher Education Sector Conference held a debate and vote on motion HE38, submitted by the Open University branch. The motion highlighted the severe harm that changes to HE funding over the last decade have caused, warned of the imminent threats posed by further planned privatisation, reaffirmed the Union’s position that the sector should be financed by a progressive corporation tax and resolved that the Union would actively campaign with student and other trade unions to bring about a return to public finance of HE.
The University of Bath UCU branch had submitted an amendment to the motion, so that it would explicitly call for an “abolition of student tuition fees”. I had the pleasure of speaking for the amendment and just about managed to get through the following in the 2 minutes allotted time:
“Conference, tuition fees are harmful to students, to staff and to the higher education sector as a whole.
They are part of a funding model that is expensive to maintain which represents poor value for money for the public, they are a barrier to entry into HE, they are a source of stress and anxiety for graduates and for current and prospective students, who are burdened with ever increasing levels of personal debt and, conference, they are at the forefront of the privatisation and marketisation of HE.
Tuition fees encourage universities to behave like corporations, VCs to act like CEOs and students to see themselves not as participant in the academy, nor recipients of a public good, but as consumers. In so doing, tuition fees drive a wedge between students and those of us who teach and support them. They undermine solidarity and unity in our common struggles just when we need it most.
This year Germany will abolish tuition fees, joining the other EU nations who never saw fit to adopt them in the first place. And this year, for the first time in a decade, NUS Conference has declared that tuition fees must be abolished and that HE must be free for all.
The time has come to end the failed tuition fee experiment, I move amendment 1 to motion HE38.”
The amendment and substantive motion were both carried with enormous majorities (in fact, I’m not sure that anyone voted against either). As a result, for the first time in over a decade, the NUS and UCU, the largest union of students in the country and of post-secondary educators in the world respectively, are united in their support for a return to free, publicly funded higher education.
So what now? Disappointingly, the NUS National Executive Committee appear to be dragging their feet. At a meeting in May they rejected a motion recognising what appears to be the clear will of the Union membership as decided at Conference. Undeterred, the National Campaign Against Fees and Cuts (NCAFC) are pushing forward, starting with a national meeting on Free Education to be held tomorrow (Sunday 15th June 2014) at the University of Arts Students’ Union in Holborn, London.
After the successes at NUS and UCU Conferences, it is vital that supporters of free education keep the momentum going. These were significant steps, but as the NCAFC have said:
“The campaign for free education is not won at NUS conference. It has to be fought for on the streets, in our classrooms and student unions. It won’t be won easily, and it is done in the face of much repression and difficulty. June 15th is the start of that, and we wish to work alongside all those who believe in free education.”
If you can make it to the conference tomorrow, please do, and take friends and colleagues with you. If you can’t get there, email the NCAFC to express your support and to see what you can do to help move the campaign forward.
After years of fees and cuts, and as we approach what is likely to be a close-run general election, there is an opportunity for us to reverse some of the most harmful policies enacted by recent governments. But that will not happen by accident or without organised effort – it requires that we all do our bit to fight for change. That fight starts now (or, more specifically, at 10:30 on Sunday morning in Holborn).
Update (2014-07-05): Following the national meeting on free education in June, a coalition of students and activists have declared their support for a national demonstration for free education on the 19th November. Add the date to your diaries and get involved – for Free Education: No fees. No cuts. No debt.
NUS and UCU Conference Motions
Motion passed by NUS conference 2014 (215c – Free education)
1. There is an alternative paying for university through tuition fees or a graduate tax – public investment for free education.
2. The proposal to replace tuition fees with a ‘graduate tax’ is simply replacing one form of student debt with another. Under both systems the experience for the overwhelming majority of students would be the same: to pay tens of thousands of pounds for a university degree over the course of a number of decades after graduation, taking the form of automatic deductions from graduates’ wages every month.
3. Higher education is a public good and should be free for everyone to access.
4. Free education would pay for itself. The government’s own figures show that for every £1 invested in higher education the economy expands by £2.60.
5. Investing in free education would not only offer opportunities for young people but would play a central role in reviving the economy now and in promoting longer-term prosperity and growth for the future.
6. There is an austerity agenda that refuses to fund education properly, which produces a false choice between underfunded, fee-laden, debt-ridden education for the many or free, elite education for the privileged few.
7. This is no choice at all.
8. NUS believes in democracy – but political democracy is incomplete when the distribution of wealth is violently unequal and undemocratic.
9. Vast wealth lies in the coffers of a handful of rich, powerful people and their private businesses, instead of being invested in socially useful purposes such as education.
10. In 2008, the UK government spent £850 billion to bail out banks, but these banks have continued to operate much as before, instead of being required to spend that public money on the public good.
11. If this wealth was instead under democratic control, our society could use it to build a comprehensive accessible free education system for all and pay every education worker decently, and still have plenty left over for free, world-class healthcare, good social housing, and decent public services and benefits for all.
12. NUS should reaffirm the idea that education is a right not a privilege
1. To reject the absurd idea that our society lacks the resources to provide decently for its citizens, and make campaigning for the democratisation of our society’s wealth a priority running through NUS’s work.
2. To make the case for free education and demand that free, accessible, quality education, and decent wages, public services and benefits, are funded by:
a. Ending tax evasion and avoidance and cracking down on tax havens b. Imposing serious taxes on the incomes, inheritance and capital gains of the rich
c. Taking the banks, and their wealth, under democratic control
3. To raise these demands in particular when putting forward positions on fees and education funding, and when organising protest actions.
4. To oppose and campaign against all methods of charging students for education – including tuition fees and a ‘graduate tax’ which is nothing more than a euphemism for ‘student debt’.
5. Foundation courses should be free of fees for all students, regardless of age or nationality, with full access to a grant.
Motion passed by UCU Conference 2014 (HE38 – Sale of the student loan book -Substantive Motion including Amendment HE38A.1)
HE sector conference notes:
- the 40% fall in part time HE students since the introduction of higher fees and the current student loans system
- that the proposals in the Rothschild report and sale of the student loan book will open the door to lobbying from private companies for higher interest rates on student loans
- vulnerable sections of the population who are debt averse will be even less likely to enter HE
- that enrolments of adult part-time students in HE may fall further, exacerbating the damage already caused by ELQ cuts and fee increases.
Conference re-affirms that higher education should be financed by progressive corporation tax, and resolves:
- to make this a politically sensitive issue, and campaign with student unions and other trade unions for the abolition of student tuition fees and for a fundamental reversal of the policy changes of the last decade, and return to public finance of higher education.
So Boris Johnson has sort of agreed to maybe stand in front of a water cannon, and now he is the story. This is precisely what makes him, Nigel Farage and other buffoonish entertaining right-wingers so dangerous. They manage to smuggle in pernicious positions and policies by putting on a blokey-bloke and/or slapstick performance. The problems with water cannons have been detailed elsewhere, here I just want to comment on the manner in which some noxious political positions and decisions get smuggled through to become acceptable, or even policy.
What should be widespread condemnation and outrage that the Mayor of London has purchased three water cannons to be used against civilians has quickly descended into a bit of a laugh about how funny old Boris has agreed to do a silly thing. The press are complicit, safe in the knowledge that they’ll sell more copy/get more hits with a “Boris agrees to get soaked” story than a “Your right to protest is looking increasingly like a piss-take”.
Personality has once again dominated over principle, and as a result the story risks becoming shallow, with little to no emphasis on the context – austerity, the curtailment of human rights and civil liberties, obscene social inequality, corruption, institutional discrimination and a prevalence of toxic narratives that scapegoat those without privilege while absolving those who abuse theirs. When a story about an issue is stripped of its context we are left with little more than gossip column tittle-tattle, easily replaced in tomorrow’s papers with more personality-driven noise. No joining of the dots, no critical analysis, just entertaining noise to tickle, satiate and distract.
Now, if we were talking about rounding up the coalition cabinet, kettling them for half a day in freezing temperatures without food, water or access to toilets, then beating them and pushing them to the ground for no justifiable reason, and THEN repeatedly firing them into concrete with water cannons until even ATOS declared them unfit for work…well, then I might be a bit more interested. But having a well briefed policeman squirt some water at half the normal pressure in the direction of Boris Johnson so that he can hold a photo shoot to further his political aspirations? No thanks.
Water cannons are effective at one thing – suppressing dissent. The police must not be able to use dangerous and potentially lethal weapons like these against civilians. Yet the Mayor of London, Boris Johnson, has written to the Home Secretary asking her to licence water cannons for use of the UK mainland for the first time. So…
1) Read this list of 10 reasons why water cannons are a disastrous idea:
2) Write to your MP (https://www.writetothem.com/) to let them know:
I am writing to you as a concerned constituent. The Mayor of London, Boris Johnson, has written to the Home Secretary asking her to licence water cannon for use of the UK mainland for the first time. These weapons are completely ineffective for reducing crime but are extremely dangerous and a useful tool for suppressing legitimate protest. The government often talks about British values. Those values surely include tolerance and freedom of expression, assembly and protest. The introduction of water cannons to the UK mainland would contradict these and further increase division and distrust between the police and the public they are supposed to protect, not attack.
I am therefore asking that you publicly declare your opposition to the use of water cannons on civilians and that you make representations to the Home Secretary expressing the same sentiment.
Update 2: Please also sign this petition to the Home Secretary.
Following a proposal by members of the British Medical Association (BMA) to introduce GP appointment fees, colleagues and I wrote an open letter to doctors at our local GP surgery. The letter was the subject of an article in the local paper, and is reproduced below.
Department of Pharmacy and Pharmacology
University of Bath
Tuesday, 13 May 2014
University Medical Centre
Dear Drs McMaster, Lloyd and Bligh,
We are writing to you as patients and as students and academics in medicine-related fields to express our concern over recent proposals by members of the BMA to charge a fee for GP appointments. The proposals to be voted on at the local medical committee conference later this month would fundamentally violate two of the three core founding principles of the NHS – that it be free at the point of delivery and that it be based on clinical need, not ability to pay. We strongly urge you to publicly oppose any introduction of fees for access to NHS services and would appreciate your reassurance that you will do what you can to convince your colleagues to do the same.
Mr Christopher Roche, Post-graduate
Dr Christopher Bailey, Senior Lecturer
Dr Jenny Scott, Senior Lecturer
Ms Kim Luetchford, Post-graduate
Ms Nour Alhusein, Post-graduate
Prof Roland Jones, Professor of Neuropharmacology
Ms Amy Stallard, Administrator
Dr Michael Beeton, Technician
Mrs Lidia Alhalaseh, Post-graduate
Mrs Penelope Lye, Teaching Fellow
Mr Stephen Phillips, Technician
Mr Greg Hopkins, Technician
Mr Alistair Taverner, Research Assistant
Mr Kevin Smith, Team Leader (Research)
Prof Mike Threadgill, Professor
Mr Chris Coy, Technician
Dr Joanna Swarbrick, Research Associate
Dr Peter Massey, Research Officer
Dr Olivier Reelfs, Research Officer
Dr Hannah Family, Lecturer
Dr Andrew Riley, Research Fellow
Ms Patricia Higgins, Laboratory Assistant
Mr Donald Perry, Technician
Mr Cormac Sammon, Research Associate
Mr Matt Udakis, Post-graduate
Update (2014-07-14): Apologies for the delayed update. The partners of the University Medical Centre replied at the end of May to confirm that they agreed “that access to a GP within primary care should continue to be based on the core principles on which [the NHS] was founded: to meet the needs of everyone, be free at the point of delivery and remain based on clinical need and not the ability to pay”. They also informed us that they had contacted the Chief Executive of Wessex Local Medical Committee, who informed them that he intended to speak against the proposal to introduce fees for GP appointments, but that the vote was held before he had an opportunity to speak. In any case, I was relieved to hear that the proposal was rejected by the majority of Conference delegates.
A copy of the reply can be found below:
Workers at the Ritzy cinema in Brixton have mounted a strong campaign to get a living wage from their employer. The owner of the cinema, Picturehouse, owns a chain of others around the country, including the Little Theatre in Bath. The director Ken Loach has expressed his support for the workers at the Ritzy, and as a result Picturehouse have refused to host his latest film at Bath’s Little Theatre. I have already sent a short email to the Little Theatre expressing disappointment at this behaviour and would encourage you to do the same if you have a spare minute.
I’ve lived in Bath for around ten years and have always been a regular at the Little. This story (http://www.bathchronicle.co.uk/Ken-Loach-s-sadness-Bath-s-Little-Theatre-owners/story-21115486-detail/story.html) saddened me greatly and it is with a heavy heart that I must pledge to not step foot in the cinema again until the Picturehouse staff at the Ritzy are paid a living wage as they reasonably demand. Should your own staff start a campaign to also earn a living wage I will of course come to stand in solidarity with them as will many of my colleagues.
You can also…
- Write on Picturehouse’s Facebook page here:https://www.facebook.com/picturehouses?fref=ts
- Email their HQ here: firstname.lastname@example.org
- Phone them here: 020 7734 4342
More info about the campaign at the Ritzy here: https://www.facebook.com/RitzyLivingWage and here: http://www.standard.co.uk/business/business-news/striking-ritzy-workers-warn-picturehouse-boycott-could-go-national-9417854.html
News recently broke that the Stop the War Coalition (StWC) invited Mother Superior Agnès Mariam de la Croix to speak at its November 30 International Anti-War Conference. Fellow guests included MPs Diane Abbott and Jeremy Corbyn and journalists Owen Jones and Jeremy Scahill.
Responding to a firestorm of protest, Jones and Scahill vowed to boycott the event if the Syrian-based nun spoke alongside them. Eventually she decided to “withdraw” from the conference and StWC issued a statement without explanation. Nor did it divulge why anyone would object to a Syrian cleric’s participation in an ostensibly pro-peace event.
Here are some reasons why we consider Mother Agnès-Mariam’s inclusion in an anti-war event to be a “red line” for opponents of conflict. Despite contrary claims, she is a partisan to—rather than a neutral observer of—the war in Syria.
Mother Agnès claimed that the Syrian opposition faked films of Bashar al-Assad’s 21 August 2013 sarin-gas attack on Ghouta in the suburbs of Damascus. In her 50-page dossier on the horrible events of that fateful morning, she wrote that the dead, gassed children documented in those videos “seem mostly sleeping” and “under anaesthesia.”
According to Father Paolo Dall’Oglio, a Jesuit priest exiled by the Assad regime for speaking out against its suppression of peaceful protests and currently a prisoner of al-Qa’ida’s Syrian affiliate, ISIS, Mother Agnes “has been consistent in assuming and spreading the lies of the regime, and promoting it through the power of her religious persona. She knows how to cover up the brutality of the regime”.
Moreover, Syrian Christians for Peace have denounced Mother Agnès for claiming there had never been a single peaceful demonstration in Syria. The also accused her of failing to disburse any of the money she raised in the name of their beleaguered community. They have asked “that she be excommunicated and prevented from speaking in the name of the Order of Carmelites.”
Having a massacre denier and apologist for war criminals like Mother Agnès speak alongside respected journalists such as Jeremy Scahill and Owen Jones is not only an insult to them and their principles. It is also, more insidiously, a means of exploiting their credibility and moral authority to bolster hers, both of which are non-existent. No journalist should be sharing a platform with Agnès when she stands accused of being complicit in the death of French journalist Gilles Jacquier by his widow and a colleague who accompanied him into Homs during the trip arranged by Mother Agnès in January 2012.
Given that her UK speaking tour is still scheduled to last from the 21st to 30th November we, the undersigned, feel compelled to express our profound and principled objections to those who give a platform to a woman condemned by Syrian pro-peace Christians for greasing the skids of the regime’s war machine.
- Prof. Gilbert Achcar, SOAS
- Assaad al-Achi, Local Coordination Committees in Syria
- Rime Allaf, Syrian writer
- Omar al-Assil, Syrian Non-Violence Movement
- Hussam Ayloush, Chairman, Syrian American Council
- Noor Barotchi, Bradford Syria Solidarity
- Mark Boothroyd, International Socialist Network
- Kat Burdon-Manley, International Socialist Network
- Clara Connolly, Human Rights lawyer
- Paul Conroy, photojournalist
- Donnacha DeLong, National Union of Journalists
- Hannah Elsisi, Egyptian Revolutionary Socialist
- Raed Fares, Head of Kafranabel Media Centre
- Naomi Foyle, writer and co-ordinator of British Writers in Support of Palestine
- Razan Ghazzawi, Syrian blogger and activist
- Christine Gilmore, Leeds Friends of Syria
- Golan Haji, poet and translator
- Marcus Halaby, staff writer, Workers Power
- Sam Charles Hamad, activist
- Nebal Istanbouly, Office Manager of the National Coalition for Syrian Revolutionary and Opposition Forces (SOC) in the UK
- Tehmina Kazi, human rights activist
- Ghalia Kabbani, Syrian journalist and writer
- Khaled Khalifa, Syrian writer
- Malik Little, blogger
- Amer Scott Masri, Scotland4Syria
- Margaret McAdam, Unite Casa Branch NW567 (pc)
- Yassir Munif, sociologist and activist
- Tom Mycock, Unite shop steward (pc)
- Maryam Namazie, Spokesperson, Council of Ex-Muslims of Britain and Fitnah – Movement for Women’s Liberation
- Tim Nelson, Unison Shop Steward (pc)
- Louis Proyect, Counterpunch contributor
- Martin Ralph, VP Liverpool TUC (pc)
- Ruth Riegler, co-founder of Radio Free Syria, Syrian International Media Alliance
- Mary Rizzo, activist, translator and blogger
- Christopher Roche and Dima Albadra, Bath Solidarity
- Walid Saffour, Representative of the National Coalition for Syrian Revolutionary and Opposition Forces (SOC) in the UK
- Gita Sahgal, Centre for Secular Space
- David St Vincent, contributing writer and editor, National Geographic Books
- Reem Salahi, civil rights lawyer
- Salim Salamah, Palestinian blogger
- Yassin al-Haj Saleh, Syrian writer
- Richard Seymour, author
- Bina Shah, author and contributor to the International New York Times
- Leila Shrooms, founding member of Tahrir-ICN
- Luke Staunton, International Socialist Network
- KD Tait, National Secretary, Workers Power
- Peter Tatchell, human rights campaigner
- Paris Thompson, International Socialist Network
- Hassan Walid, Anas el-Khani and Abdulwahab Sayyed Omar, British Solidarity for Syria
- Robin Yassin-Kassab, author and co-editor of Critical Muslim
- Qusai Zakariya, activist from Moadamiyeh, Syria
- Nisreen al-Zaraee and Wisam al-Hamoui. Freedom Days
- Tasneem al-Zeer, activist
- Razan Zeitouneh, human rights lawyer
- Ziauddin Sardar, writer, journalist and editor of the Critical Muslim
Originally published on: http://pulsemedia.org/2013/11/20/open-letter-to-the-stop-the-war-coalition/
In the midst of thesis writing, as my mind yearns for sources of distraction and topics of procrastination, I’m coming up with lots of things that I really ought to do. Now in reality, many of these things aren’t important, they’re just things I’d rather be doing than data analysis. But some of them are important, they’re just not as urgent as this thesis submission. So, this post is going to be the receptacle for these important, but not urgent, things: things I’d like to do, love to do, need to do, want to do, should do…but just not right now. Three to start:
1) Learn about climate change, human impact upon it and what can be done.
2) Help out a particular friend, who’s under a lot of pressure with family commitments, by giving them a break from their duties once per month.
3) Write that article I’ve been meaning to on why Humanists should adopt drug policy and harm reduction as issues as core to their movement and campaigns as right-to-die and reproductive rights are now.
This article was originally published by YouthRise.
In April 2013, the Independent Drugs Commission for Brighton and Hove published a report that attracted much attention from the national press. Among the recommendations was a call for the local council affiliated public health and order agencies to consider the inclusion of drug consumption rooms (DCRs)a in the city’s harm reduction strategy. Whilst this was not the first report to make similar recommendations nationally, support from local politicians and officials has generated confidence that Brighton and Hove, home to around two thousand problem users of heroin and cocaine, will soon host the first DCR in the UK. This essay is an attempt to briefly outline and place into context the current situation, summarise the arguments and evidence for and against DCRs and discuss the way forward.
Drug Consumption Rooms: Concept and Context
DCRs are officially sanctioned healthcare facilities, where people can use pre-obtained drugs under the supervision of trained staff, in a hygienic, safe and non-judgemental environment. They are operated primarily for people with a history of problem drug use, dependency and addiction.[b] Most DCRs are physically integrated with other services for people who use drugs (PWUDs), typically providing needle and syringe exchange, drug treatment, advice on safer drug use, general healthcare, counselling and social support.[c] While traditionally most DCRs have focussed on people who inject drugs (PWIDs), an increasing number supervise drug inhalation as well.
The first officially approved DCR opened in Berne, Switzerland, in 1986. There are now over ninety in Europe (in Switzerland, the Netherlands, Germany, Spain, Norway, Luxemburg and, most recently, Denmark), with a single facility in Sydney, Australia, and another in Vancouver, Canada. These sites have been established for a range of stated reasons, with differing rationales reflecting local and national drug-related concerns and priorities. The most commonly cited problems are high rates of fatal drug overdose, prevalence of blood borne viruses (HIV, Hepatitis B (HBV) and C (HCV)) and public harms, such as discarded injecting equipment and anti-social behaviour, including public drug use. How do these issues correlate with the situation in the UK, and what evidence is there that DCRs are able to address them?
Preventing Fatal Drug Overdoses in the UK
In the UK, around 380,000 people are engaged in problem drug use and the number of drug-related deaths, around two thousand per year, is consistently among the highest in the European Union. Approximately eight hundred of the fatalities involve heroin or morphine; the majority as a result of overdose. Non-fatal overdoses, which are more common, can cause hypoxia-induced brain damage and a host of other injuries.
The doctors, nurses and other trained staff at DCRs are able to respond rapidly to suspected overdoses, for example by the provision of oxygen and/or the opioid antagonist naloxone. The evidence from existing DCRs is unambiguous: they prevent deaths from drug overdose, and have the potential to significantly reduce the harm caused by non-fatal episodes. This is most succinctly demonstrated by the fact that after millions of consumption episodes in DCRs around the world, over almost three decades, not a single overdose death has been recorded.
Introduction of the large DCR in Vancouver has been associated with a 35% reduction in the rate of fatal drug overdose, with a similar decrease in deaths in the subgroup where cocaine use was deemed contributory. This latter result, along with the observation that approximately one third of facility visitations were for injection of cocaine, is potentially significant given the absence of interventions demonstrated to reduce the risk of fatal stimulant overdose.
Tackling Unhygienic and Public Use
Consumption of drugs with shared and reused equipment, often in unhygienic settings, is associated with substantial risks to health, including the transmission of blood borne viruses (BBVs) and contraction of other infections. In the UK, the majority of drug injections are made with used (but not necessarily shared) needles and 17% of PWIDs report to have shared needles or syringes in the past month. The prevalence of HIV among PWIDs in the UK, approximately 1.1%, is relatively low compared to other countries with less successfully deployed harm reduction strategies. However, there remains significant regional variation (prevalence in London is almost four times the national average) and other blood borne viral infections are more common and have increased over the past decade. Almost half of PWIDs now have HCV.
DCRs can reduce the prevalence of BBVs and other harms associated with sharing and reuse by providing sterile equipment to facility users, preventing sharing on-site, operating BBV testing and vaccination programmes and offering education and advice on safer drug use practices and sexual health. Bacterial and fungal infections, damage to veins and other health problems can be further reduced as drug use is relocated from public spaces and other unhygienic settings to clean, well lit environments, free of the pressure to rush injections.6 The results are impressive: a 70% reduction in equipment sharing among frequent DCR users, reduced injection-related injuries and non-viral infections and widely reported improvements in injection hygiene.
The reduction in public drug use brought about by DCRs has been repeatedly demonstrated and is important not only in reducing the private harms mentioned above, including overdose deaths, but also in addressing public harms. These are discussed further below.
A Unique Interface
The primary target population for DCRs are those at greatest risk of fatal overdose, BBVs, poor general health, homelessness and marginalisation. These same people are the most difficult for health and social services to engage with. In this regard, DCRs offer a unique interface through which a traditionally difficult to reach group can access drug treatment, counselling, accommodation, education, health and other social services. 15-50% of DCR users have never been in drug treatment before and many others are out of contact with treatment services. Uptake of provisions, on-site or by referral, is generally high and there is some evidence that DCRs may bring about an increase in participation with drug treatment programs.
Clearly, the positive effects of DCRs are not limited to safer practices within the facility. Their utility in engaging difficult to reach PWUDs with a wide range of services and, uniquely, providing tailored education and advice on safer drug use extends their benefits far beyond the site walls. With patient consent, consumption rooms can also facilitate collection of data on drug use patterns and the efficacy of harm reduction strategies, including of DCRs themselves, to inform an evidence-based drug policy.
Fears of Increased Drug Use & High Risk Behaviour
Despite the substantial and growing body of evidence showing DCRs to be effective in the reduction of drug-related harm, they remain controversial compared to more established harm reduction approaches. In addition to the reactionary responses given to many pragmatic, evidence-based harm reduction strategies, there are some commonly raised specific concerns and objections to DCRs. These are addressed below.
Critics have argued that DCRs may encourage initiation and continuation of injected drug use. To mitigate risk of the former, facilities generally exclude people who would be injecting for the first-time, as well as under-18 year olds. Drug distribution and sharing is prohibited within the facilities and patients and staff are not allowed to directly assist novice users (or indeed anyone else) with injections.
Evidence from existing facilities suggests that the fears of an initiating effect are unfounded. Only 0.5-4.5% of DCR users report first injecting in a facility and it is not known what proportion of this group would have begun injecting in the absence of DCR provision. A typical DCR user is over thirty years of age, has used heroin and/or cocaine for at least ten years and is likely to have a history of public injecting. The European Monitoring Centre for Drugs and Drug Addiction has concluded that “[t]here is no evidence that naive users are initiated into injecting as a result of the presence of consumption rooms.”
The evidence also contradicts fears that DCRs could delay entry into treatment and promote continued and high risk use. A study monitoring the impact of the DCR in Vancouver, echoing the results from other sites, found: “no substantial differences in rates of relapse…or stopping injected drug use”. This study also saw no increase in binge use or decrease in methadone use, though encouragingly a small decrease in the rate of relapse to binge use was observed.
In summary, studies from Europe, Canada and Australia have shown no evidence to suggest that DCRs cause increased drug use, nor initiation, relapse, delay to treatment or high risk consumption behaviour. There is however some evidence that DCRs may be associated with a reduction in binge drug use and, as mentioned previously, that they may bring about an increase in use of drug treatment services.
Why do ‘They’ Deserve it? Resources, Cost and Public Harm
Other raised objections relate to the impact of DCRs on society, both in terms of resource diversion and the potential public harms resulting from DCR establishment. The former can manifest as moral disapproval: why do ‘they’ deserve these facilities? With a considered analysis of outcomes, this type of objection is easily addressed.
DCRs not only reduce harm to PWUDs but also to society as a whole. Public using is in itself an anti-social behaviour, and so too is the resultant discarding of used drug administration equipment (including needles and syringes) in parks, public toilets, car parks and residential areas. These are both harms about which the public often express particularly strong feelings, and are both reduced substantially by DCRs. It should also be noted that the costs involved in operating a DCR are off-set by reduced demand for other services, including ambulance call-outs and hospitalisations due to drug overdose, BBVs and other symptoms of poor health. Costs can be further reduced by integrating DCRs within existing facilities, such as needle and syringe exchange programs, rather than operating stand-alone units.
In any case, the question “why do ‘they’ deserve these facilities?” can also be answered with a simple moral retort. The principle users of DCRs are among the most socio-economically deprived people in society, with low levels of general health (physical and psychological) and a high likelihood of traumatic life experiences and homelessness. Even ignoring the benefits to public health and order, a strong moral case can be made that would-be DCR users are among the most deserving recipients of social support.
Despite fears to the contrary, there is no evidence that DCRs will lead to an increase in net or local crime. In fact, with increased interaction between people with problem drug use and treatment and social services, it may be that DCRs will indirectly cause crime rates to fall. Related anxieties about a ‘honey pot effect’ are again largely unfounded. Several studies have shown that DCR users are generally unwilling to travel any significant distance from a drug market to consume drugs. In existing facilities between 63% and 93% of patients are local. It is precisely for this reason that for DCRs to achieve their harm reduction aims, they must be located close to existing drug markets. Surveys of community attitudes have shown that establishment of DCRs can be associated with a decrease in anti-social behaviour and nuisance to local residents.
Legal & Political Obstacles
The international legal environment has been discussed elsewhere. In summary, the UN drug conventions emphasise the requirement for “treatment, education…and social integration” of PWUDs as well as control of drugs. It has been interpreted that harm reduction measures, such as DCRs, may be compliant with the conventions. Indeed the UN’s own legal experts agree.[d] It would seem that there is sufficient scope for interpretation of international laws to proceed with the introduction of DCRs. Countries who have already done so, all of whom are signatories to at least two of the three UN drug conventions, have conducted analyses of the international legal position and found that DCRs do not represent an infringement. Where necessary, national and/or local laws have been amended to protect service users, staff and others from arrest and prosecution. It is likely that, in the UK, the Misuse of Drugs Act 1971, among others, may have to undergo such an amendment process. With political will, this is not a barrier to progress.
How to Progress from Here
The arguments and evidence in support of DCRs are compelling. They provide a safer, more hygienic environment for use and have been shown to save and improve lives, by preventing fatalities from drug overdose, reducing infectious disease transmission and providing an interface through which hard-to-reach PWUDs can engage with medical and social support services. Via advice, education and provision of clean consumption equipment, their positive effects extend beyond use within the facilities. By reducing public use and discarding of needles and syringes, DCRs reduce public as well as private harms. Studies from multiple existing sites indicate that these benefits can be achieved without increases in drug use, high risk behaviour or crime.
Despite the case for DCRs appearing to be relatively clear cut among harm reduction advocates, they remain controversial. This is true not least among social conservatives, who are often instinctively averse to harm reduction programs, some preferring an ‘abstinence at all costs’ approach, often in the pursuit of a utopian drug-free society. Some of these critics have much less concern for the welfare of PWUDs than for reducing the visibility and proximity of anti-social behaviour to the rest of society (sometimes utilising a crude and puritanical cleanliness narrative, such that priority is given to the removal of the behaviour and those engaging in it from the public space, i.e. to getting it/them “off the streets”). Harm reduction advocates should acknowledge the political reality of this diversity in perspective and priority, and seek to achieve broad support for DCRs by emphasising the potential for reductions in public drug use, violence, low-level crime and discarded consumption equipment, as well as the array of benefits to public health.
The Independent Drugs Commission for Brighton and Hove’s report was discussed by the Safe in the City Partnership Board at the end of April, and an announcement on the proposal to include DCRs in the local harm reduction strategy will be made in 2014. Experience from existing sites has shown that success with consumption rooms is most pronounced when coupled with broad popular and political support. Armed with a wealth of literature, harm reduction advocates must now work to foster that support and bring the UK, in this regard at least, towards an evidence based drug policy.
[a] Drug consumption rooms are also known elsewhere as ‘safe(r) consumption sites’, ‘safe(r) injection facilities’, ‘supervised injection facilities’ (SIFs), ‘fixing rooms’ and ‘shooting galleries’. The term ‘drug consumption room’ is used in this article so as to include the growing number of facilities that allow the smoking and inhalation of drugs as well as injection, and to distinguish from unofficial, unsupervised, often unhygienic and high-risk venues for illegal drug use.
[b] Problem drug use is defined by the European Monitoring Centre for Drugs and Drug Addiction as “injecting drug use or long-duration or regular use of opioids, cocaine or amphetamines”.
[c] Service provisions vary between existing DCRs; whereas a few are stand-alone and routinely refer patients to other sites, some are comprehensive, with on-site services including subsidised catering, showering facilities, laundrettes and social spaces, in addition to the services listed above.
[d] Though the INCB, for whom the advice was prepared, take a contrary and characteristically conservative view.
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I saw a video today of a debate involving charismatic professional Muslim and sugar-coated Islamist, Hamza Tzortzis. In it, Mr Tzortzis kindly explains why and when it’s okay to have sex with nine year old girls. Apparently, it’s okay if she’s “physically fit”, “emotionally” and “mentally ready” and if it’s “socially acceptable”. (The horror starts at 1hr 58 mins.)
Incredibly, I think this would be less disgusting if he’d just said he thought it was sometimes okay to rape children, and left it at that. Somehow though, he’s taken just about the most vile and morally reprehensible statement, and made things even worse by trying to justify it. What on earth does “physically fit” mean? How does one decide how much damage they will do to a nine year old by raping them, before doing so? I can only assume “physically fit” means “they look ready”, which translates to “I want to fuck them”. It’s beyond disgusting.
My skin crawled as I heard the terms “mentally ready” and “emotionally ready”. Ready to be raped by a grown man? What child is “ready” for that? Presumably their readiness too is decided by a grown man, or perhaps a committee of grown men.
And then we have “socially acceptable”. It becomes okay to have sex with a child if it’s “socially acceptable”. Hamza has a problem with the apparently absurd “arbitrary” ages of consent found in “secular law”, but if sex with kids is “socially acceptable”, there’s no problem. As long as grown men are okay with it, that’s the main thing.
Even for Tzortzis, this brazen defence of the indefensible is incredible. Not that a nine year old can consent to sex anyway, but, where in his list of criteria is the little girl’s view on the matter? Pah, that’s irrelevant! Allah, and grown men, know best.
Just to seal the deal, Hamza informs us that not only was it socially acceptable for Mohammad to rape a child, but that “her father” and “tribe” were down with it too, so, I guess it would almost be unethical not to go ahead with it, right? This takes the objectification of young girls to an extreme I don’t think I’ve ever witnessed before.
At least, one might think, this vomit inducing display might cause a degree of cognitive dissonance too great to bare for the audience. Perhaps Hamza’s sugar-coating might taste sufficiently rancid to throw up some objections from his fans in the room. But, wait: where is the scathing condemnation, where is the stunned silence, the revulsion, the protests, the heckles, walk-outs and cries of “shame”? None. Nothing. Instead there are rapturous applause, whoops and takbirs.
What the heck kind of perfect society is this that Hamza and co. are trying to sell, and that vocal young Muslims in the audience seem to want to buy? A society where nine year old girls can be raped by old men, but can’t play with boys, ride a bike, listen to music, dance, or wear what they want?
Hamza Tzortzis is a popular Islamic apologist among young Muslims in the UK. His organisation specifically targets universities and student Islamic societies, and when he justifies old men having sex with nine year-olds, members of his audience clap, cheer and declare that god, and apparently Hamza, are the greatest. I despair.
(H/T The Rationaliser – https://twitter.com/TheRationaliser)