HealthPunk Vol 2: Easier to Imagine

Easier to Imagine

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He says there aren’t any easy answers. I say he’s not looking hard enough!  -Bart Simpson

The moving stories collected in healthpunk provide a wealth of ideas for imagining and realizing healthier futures in the face of looming global crises. As a researcher and educator in public health I immediately thought of challenges to this task posed by Western biomedical professions and the ways of knowing they have generated. In this commentary I explore what I see as the most important such obstacle: capitalism.

It is easier to imagine the end of the world than the end of capitalism. This quote, usually attributed to Fredric Jameson, captures how concern over climate change and other looming disasters often jumps to post-apocalyptic visions of civilization crumbling, rather than imagining changes to the capitalist power structures that got us here. Slavoj Žižek describes apocalyptic films where our subconscious desire to escape those capitalist structures finds misplaced expression in disasters that just blow the whole thing up, but where market structures are magically resilient “as if, even after a global cataclysm, capitalism will somehow continue” (Žižek, 2011, p. 334). ‘The Anthropocene’ as a concept conveys a related lack of understanding of the actual nature and history of capitalism. It holds that our current era began sometime in the late 19^th century despite apocalyptic and much earlier impacts of capitalism’s globally imperialist spread, such as the massive environmental change and human devastation that accompanied European colonization of the Americas (Davis and Todd, 2017). In public health, fields such as planetary health channel Anthropocene worries into new academic empires and interventions that envision the continuation or even intensification of capitalism. The dominant Rockefeller Foundation version of planetary health, for example, looks at the disastrous consequences of industrial development and proposes…more capitalism, in the form of financialized investment vehicles and (patentable) technological innovations (David et al., 2021). Planetary health may thus represent yet another “colonial proposal for preserving the capitalist order in the face of the perceived need to avoid environmental deterioration and its impacts on human health” (Baquero et al., 2021, p. 4). 

With even complexity-informed fields in public health appearing to take capitalism’s continuation as a given (and therefore helping to ensure that it is), can health speculative fiction writers do otherwise? Healthpunk authors weren’t specifically asked to, but promising ideas nevertheless emerged. ‘Time’ evokes time’s role in capitalist accumulation, such as factory owners lengthening the working day to extract more value from the bodies of workers (cf. Marx, 1992). After the story’s abolition of measured time, “Work now means completing things that fulfill us but contribute towards maintaining shared assets such as food sources, power sources, life, health, education.” The commodification of land in capitalism is also challenged in ‘Cantadoras de historias,’ in which the lands of the Tabajara and Potiguara peoples in what is today known as Brazil have become demarcated in the healthier future they envision. This rematriation of land underscores the fact that Indigenous control over their own territories has been systematically and disastrously eroded for over five centuries in the Americas by the rapacious spread of Eurocentric capitalism, at the same time as that spread was creating the climate crisis (Moore, 2017; Rivera Cusicanqui, 2012). ‘A note to future bodyworkers’ portrays white privilege as an actual source of embodied illness, “potentially caused by the fact that the patients, or their ancestral roots, are on the side of causing the climate crisis, and the enormous sense of guilt, whether conscious or unconscious, coming from it.” This condition evokes Martinican psychiatrist Frantz Fanon’s observations on the psychological distress experienced by agents of French colonial violence in Algeria, and calls to mind the inextricably white supremacist nature of actually-existing capitalism (Fanon, 2004; cf. Pulido, 2017). These examples thus show that healthpunk’s authors are not limiting themselves to the status quo futures that public health finds easier to imagine. 

Given how economic growth is fueled (literally), a related challenge involves energy and the ways in which it is obtained. Electricity rationing and energy-producing mood bracelets in ‘If we could turn our emotions into light’ and the photosynthetic post-humans of ‘Homo sapien’ show healthpunk authors wrestling with such difficult questions, which go well beyond fossil fuel combustion and its inequitably-distributed climate impacts. The hugely unfair environmental and social justice implications of renewable energy include land grabbing for biofuels and solar and wind farms, and ‘extractivist’ development models based on large-scale mining of the components of renewables. That the costs and benefits from such economic activities flow along centuries-old racialized, gendered and ecocidal channels dug by Euro-American imperialism demonstrates the importance of confronting ‘CO2lonialism’ and the futility of trying to do so using markets and assumptions of endlessly growing economies and energy demands (Dunlap, 2018; Hazlewood, 2012). 

Avoiding the trap of such easy answers in imagining healthier futures will likely be complicated by the biomedical ways of knowing in which many of us are schooled. Medicine’s historical co-evolution with capitalism saw it adopt a focus on individual behavioural and technical factors that would not ruffle feathers by challenging societal power structures (Turshen, 1977). Medicine simultaneously evolved the ‘subject positions’ which biomedical professionals can inhabit in society –  as when privileged individuals enter health professions and related academic careers through competitive processes, making investments in capitalism’s continuation inherent to life as a healthcare professional (Foucault, 1973). The fact that healthpunk’s stories often come from students who are not necessarily committed to such careers may be a helpfully disruptive source of resistance to such investments in the capitalist status quo, whether emotional, intellectual, professional or financial. 

Such resistance would also need to transcend other ‘easier to imagine’ tendencies, such as biomedicine’s focus on discrete, commodifiable medical interventions and technologies that can be deemed evidence-based (and high impact-factor publications about them). This focus enables careers as successful health professionals and ‘academic capitalists,’ but misses opportunities for societal changes that would vastly improve health. For example, holistic understandings of social and ecological determinants of health such as those long held by Indigenous peoples around the world were casualties of biomedicine’s reductionist co-dependency with capitalism (Redvers et al., 2020). Health in ‘Cantadoras de historias,’ in contrast, is comprised of reciprocal and caring relationships among plants, animals, winds and ancestors, paralleling Indigenous models of health and land relations in places far from northeastern Brazil (cf. Richmond, 2015). Following this example could lead us to imagine futures in which broad attention to fairness and reciprocity among communities (both human and non-human) hugely reduces the overall burden of disease needing existing or imagined healthcare interventions. Such a future would require profoundly rethinking both the structures of capitalism driving social and environmental injustice and – by extension – the nature of lives in the health professions and disciplines. 

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References

Baquero, O. S., Benavidez Fernández, M. N., & Acero Aguilar, M. (2021). From Modern Planetary Health to Decolonial Promotion of One Health of Peripheries. Frontiers in Public Health, 9, 637897. https://doi.org/10.3389/fpubh.2021.637897 

David, P.-M., Le Dévédec, N., & Alary, A. (2021). Pandemics in the age of the Anthropocene: Is ‘planetary health’ the answer? Global Public Health, 16(8–9), 1141–1154. https://doi.org/10.1080/17441692.2021.1893372

Davis, H., & Todd, Z. (2017). On the Importance of a Date, or, Decolonizing the Anthropocene. ACME: An International Journal for Critical Geographies, 16(4), 761–780.

Dunlap, A. (2018, May 10). End the “Green” Delusions: Industrial-scale Renewable Energy is Fossil Fuel+. Verso Books Blog. https://www.versobooks.com/blogs/3797-end-the-green-delusions-industrial-scale-renewable-energy-is-fossil-fuel 

Fanon, F. (2004). The wretched of the earth. Grove Press.

Foucault, M. (1973). The birth of the clinic: An archaeology of medical perception. Pantheon Books.

Hazlewood, J. A. (2012). CO2lonialism and the “Unintended Consequences” of Commoditizing Climate Change: Geographies of Hope Amid a Sea of Oil Palms in the Northwest Ecuadorian Pacific Region. Journal of Sustainable Forestry, 31(1–2), 120–153. https://doi.org/10.1080/10549811.2011.566539 

Marx, K. (1992). Capital, volume 1: A critique of political economy. Penguin Classics.

Moore, J. W. (2017). The Capitalocene, Part I: On the nature and origins of our ecological crisis. The Journal of Peasant Studies, 44(3), 594–630. https://doi.org/10.1080/03066150.2016.1235036 

Pulido, L. (2017). Geographies of race and ethnicity II: Environmental racism, racial capitalism and state-sanctioned violence. Progress in Human Geography, 41(4), 524–533. https://doi.org/10.1177/0309132516646495 

Redvers, N., Poelina, A., Schultz, C., Kobei, D. M., Githaiga, C., Perdrisat, M., Prince, D., & Blondin, B. (2020). Indigenous Natural and First Law in Planetary Health. Challenges, 11(2), 29. https://doi.org/10.3390/challe11020029 

Richmond, C. (2015). The Relatedness of People, Land, and Health. In M. Greenwood, S. de Leeuw, N. M. Lindsay, & C. Reading (Eds.), Determinants of Indigenous Peoples’ Health (pp. 47–63). Canadian Scholars’ Press.

Rivera Cusicanqui, S. (2012). Ch’ixinakax utxiwa: A Reflection on the Practices and Discourses of Decolonization. South Atlantic Quarterly, 111(1), 95–109. https://doi.org/10.1215/00382876-1472612 

Turshen, M. (1977). The political ecology of disease. Review of Radical Political Economics, 9(1), 45–60.

Žižek, S. (2011). Living in the end times. Verso.