Friday, October 9, 2009

Privatization of the state

Alex de Waal has just finished up his five-part critical review of Jean-Francois Bayart's The State in Africa. (For those without the time or inclination to read the full five-part series, I'll serve up the punchline here: despite critiquing the lines of analysis Bayart does and does not pursue, de Waal concludes by giving the book the highest praise an academic work can hope for – that it's “useful.”) Part Two looks at the idea of extraversion, which I discussed in a previous post. De Waal uses the Sudan/Chad/CAR context to illustrate his critique of extraversion, and in so doing he lays out the broader context of the raiding dynamics I'm studying ethnographically in CAR.

In another of Bayart's books, The Criminalization of the State in Africa, the author argues that the state in Africa has become privatized. The public/private distinctions associated with the Habermasian democratic ideal are inoperative and political institutions represent means of private enrichment. The political position is coterminous with its holder, rather than existing as a set of theoretical ideals of service apart from the “kota zo” (big person) inhabiting it.

I have mentioned in earlier posts how the French leased pretty much the entirety of CAR's territory to concessionary companies. Any administration was a by-product of the quest for private profit. That kind of privatized state is pretty straightforward to imagine. It is similar to contemporary enclaves like mining operations. But what does it really mean to talk of the privatization of the whole state today? I heard a story yesterday that provides an excellent illustration, if also a tragic one.

Armed men, believed to be members of the Lord's Resistance Army, attacked a truck carrying humanitarian and development supplies for an NGO working in the southeastern part of the country. Two of the people in the truck were killed, and one was gravely injured. The injured man suffered a bullet in his spine, leaving him paralyzed from the waist down, and he was airlifted to the hospital in Bangui. There, his condition worsened and his body wasted as the doctors waited, apparently unsure whether they had the expertise to treat him. Finally, two weeks after his arrival in the capital, the doctors issued their verdict: he should been flown to Cameroon and operated upon immediately.

The NGO employees launched into making this happen. Foreigners here generally have health insurance and so can be evacuated with relatively little red tape, but CAR nationals do not, and airlifting them requires a signature from the minister of health. Following many frantic phone calls and intervention by the UN humanitarian chief and various other high-placed people, the minister of health signed the paperwork at 11am on Tuesday. The once-weekly plane would depart just three hours later. One of the NGO employees called the doctor needed to accompany the injured man. For various reasons, only this one doctor could accompany the patient – it is a state hospital, and the patient was his responsibility.

The doctor was at home when he received the call. Perhaps he expected that it would take longer to obtain the minister's signature than it did. But he flat-out refused to get on the plane. He said he didn't want to. It didn't suit his schedule. He didn't elaborate and didn't seem at all ashamed that he was so flagrantly neglecting the responsibilities of his post. Obstinate, the doctor continued stalling. Soon the plane would depart, and he wouldn't have to leave for another week, if at all.

In the end, the NGO employees prevailed, and the wounded, quite possibly dying man made it on the plane to Cameroon at the last possible minute.

In this situation, the doctor's position in the civil service position represented little more than a bundle of his individual interests. It could almost seem like to the doctor, the patient was somehow less than human – otherwise, how to explain the lack of empathy for the dying man under his care?

This question reminds me of Peter Singer's recent book, The Life You Can Save: Acting Now to End Poverty. In it, Singer argues against valuing the lives of those proximate to us over the lives of those far away. Thousands of people die of water-borne illness and worms and other scourges, and all of these would be easily treatable if only the world's wealthy people would open their pocketbooks. Moreover, our dollars go further in poor countries than they do in rich ones. Singer asks readers to picture a starving person, or a worm-ridden person, standing in front of them: shouldn't you give a few bucks to save that person's life? It shouldn't matter that in reality the person lives thousands of miles away. Singer, in other words, argues that we all face the doctor's choice on a daily basis, and most of us respond as the doctor did.

I don't think the situations are as analogous as I imagine Singer might, but they do raise the issue of the relationship between responsibility and proximity when it comes to helping those in need. Still, I find the privatization of the state especially troubling because it means that the structures intended to ensure some kind of generalized responsibility for fellow humans are just a front for personally-determined interests. It is such an insidious problem it's difficult to know how it will ever change.

But then, perhaps from the perspective of people like the doctor, there isn't really a problem. Perhaps from his perspective, responsibility does not lie with him, but rather with the NGOs that have stepped in to fill the need created in the wake of the neglect of people like him and the officials who preceded him. If so, the doctor and Singer would be making strangely similar arguments, both placing private charity above public responsibility.

Either that or private charity has become the new public responsibility. But in that case what's the value of the vestigial state structures?

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