DÍA MUNDIAL DE LOS DERECHOS DEL CONSUMIDOR

JUSTICIA, SALUD Y DESARROLLO (J,S & D - Bolivia)

Movimiento por la Salud de los Pueblos (PHM Bolivia)

Comité de Defensa de los Derechos del Consumidor (CODEDCO Bolivia)

Llamado Global de Acción Contra la Pobreza (GCAP Bolivia)

Red de Docencia, investigación y Extensión América Latina 

 (RED IDESAL).

La Paz (Bolivia), 13 de Marzo, 2015

Por:  Oscar Lanza V. (MD,MSc, MPH)

Publicado en: nuevatribuna.es 12 de Marzo de 2015  (Madrid – España)

                                                                                             

DÍA MUNDIAL DE LOS DERECHOS DEL CONSUMIDOR

Dietas Saludables: La captura corporativa

                                                                                                                     

INTRODUCCION

La selección de nuestra diaria comida, el hecho y modo de alimentarse son la expresión de los valores, la cultura, las relaciones sociales y la autodeterminación de las personas. El acto de alimentarse debería encarnar por tanto la soberanía de decisión de los consumidores y usuarios, pero la imposición de estilos de vida, la continua inestabilidad en los precios de  los alimentos, entre otros factores conducen a una mayor inseguridad alimentaria mundial, que afectan con mayor dureza a aquellas personas con menores ingresos.

Según expertos, se entiende por alimentación saludable aquella que permite alcanzar y mantener un funcionamiento óptimo del organismo, conservar o restablecer la salud, disminuir el riesgo de padecer enfermedades, asegurar la reproducción, la gestación y la lactancia, y que promueve un crecimiento y desarrollo óptimos. Una alimentación saludable debe ser satisfactoria, suficiente, completa, equilibrada, armónica, segura, adaptada, sostenible y asequible (1).

Una dieta saludable ayuda a proteger no solo la desnutrición y/o malnutrición, sino también contra las denominadas enfermedades no transmisibles (ENT), como ser la obesidad, diabetes, enfermedades del cardíacas, cerebrales, cáncer y otras (2). En la sociedad actual, asistimos a una proliferación de dietas poco saludables, que sumada a la reducción de la actividad física, contribuyen al incremento de los riesgos globales para la salud.

Las prácticas alimentarias saludables deberían empezar  a temprana edad con la lactancia materna, cuyos beneficios contribuyen no solo al bienestar del recién nacido, sino a lo largo de la vida, evitando variadas patologías como enfermedades infecciosas, el sobre peso, enfermedades crónicas,  la  obesidad,  etc.

A diez años del lanzamiento de la Estrategia Global sobre Dieta, Actividad Física y Salud propuesta por al Organización Mundial de la Salud (OMS),  hasta ahora, ningún país ha tenido éxito en revertir de manera importante el aumento de problemas tales como la enfermedades cardiovasculares, cáncer, obesidad, diabetes y otras, que los países de ingresos bajos y medios, resultan responsables de cerca del 75% de muertes, afectando a 28 millones de personas (8).

EL DERECHO AL ALIMENTO Y A UNA DIETA SALUDABLE

Es inaceptable que en un mundo de abundancia más de 800 millones de personas cada día se acuesten con hambre cada noche, mientras la obesidad en todo el mundo se ha duplicado desde 1980. En el año 2014, se estimó que más de 1,9 billones de adultos, mayores de 18 años, tenían sobrepeso (5). De ellos más de 600 millones eran obesos. En el 2013 se consideraba que.42 millones de niños menores de 5 años, tenían sobrepeso o eran obesos. En contraste, cerca de 150 millones de niños sufren de retraso en el crecimiento debido a la carencia de nutrientes y aproximadamente 800.000 bebés mueren cada año por no ser amamantados adecuadamente La injusticia en cuanto al acceso a información y orientación  en salud independiente es más que evidente y en los medios de comunicación este tema no se aborda suficientemente.

Muchos países de bajos y medianos ingresos enfrentan hoy en día una "doble carga de  enfermedad”, pues los Países en Vía de Desarrollo (PVD) deben enfrentar problemas derivados de la pobreza como ser enfermedades infecciosas, tuberculosis, desnutrición, etc y al mismo tiempo afrontar un rápido aumento de factores de riesgo generados por hábitos de consumo y estilos de vida, importados e impuestos desde occidente como “moda y que provocan inusitada carga de ENT (enfermedades no transmisibles), como obesidad y sobrepeso.

Por otra parte los niños en los Países en Vías de Desarrollo (PVD) ingresos son más vulnerables debido a la inadecuada asistencia prenatal, la precaria orientación en cuanto a nutrición del lactante y del niño pequeño, están más expuestos y son víctimas de  la voracidad comercial y publicitaria casi ilimitada, resultado de legislaciones débiles o incumplidas que toleran el consumo de productos cuestionados, como ser con alto contenido de grasas, alta cantidad de azúcares, alto contenido de sal, pobres en micronutrientes, de alta densidad energética, que tienden a ser de bajo costo, pero de baja calidad en cuanto a nutrientes, mientras sus autoridades de salud los toleran, resultando los consumidores los afectados por falta de protección efectiva del estado, generando un preocupante aumento de obesidad infantil y problemas de desnutrición y malnutrición (5).

ALGUNOS DATOS UTILES

La ingesta de energía (calorías) debe equilibrar el gasto de energía. La evidencia indica que la grasa total no debe superar el 30% de la ingesta total de energía para evitar el aumento de peso. El consumo de grasas debería estar alejado de las grasas saturadas, reemplazándolas por grasas insaturadas (3), y por la eliminación de grasas trans en la industria (4). Hay que limitar la ingesta de azúcares libres a menos del 10% de la energía total (2, 5).Se sugiere una reducción adicional a menos del 5% de la energía total (6) para beneficios de salud adicionales.

Mantener la ingesta de sal a menos de 5 g por día ayuda a prevenir la hipertensión y reduce el riesgo de enfermedad cardíaca y accidentes cerebrovasculares en la población adulta (7).

La OMS (Organización Mundial de la Salud)  junto a los Estados miembros, han acordado promover la reducción de la ingesta de la población mundial de la sal, en un 30% y así detener el aumento de la diabetes y la obesidad para el 2025.

QUIEN CONTROLA LO QUE COMEMOS? - FACTORES QUE PROMUEVEN UNA DIETA NO SALUDABLE

Ciertamente que la avidez por mayores ganancias resulta uno de los factores  determinantes para la expansión de dietas no saludables. Esther Vivas en su libro ”el negocio de la comida: ¿Quién controla nuestra alimentación?” (9) estima que en los 100 últimos años ha desaparecido el 75% de la diversidad agrícola, señala que una serie de empresas clave a nivel internacional controlan y dominan el mercado de la agricultura y la alimentación. Es bien conocido que Monsanto, Cargill, Nestlé, Mars Incorporated, Mondelez International Inc.,, Associated British Foods plc,Coca Cola, PepsiCo Inc., Danone, Carrefour, General Mills Inc., Auchan, Unilever,Kellogg's Company,  Mercadona se encuentran entre las principales(10). Desde las semillas, esencia de la vida y la agricultura, hasta la venta y consumo individual, cada uno de los tramos de la cadena agroalimentaria está monopolizado y controlado por unas pocas multinacionales, que deciden, con su poderosa influencia en los mercados, qué comemos, cómo lo comemos, qué precio pagamos por ello. Así, lo que comemos tiene muy poco de alimento y mucho de producto alimentario (9).

La voracidad comercial, la publicidad, la moda, el aumento de la producción de alimentos procesados, la rápida urbanización, la prisa, presionan hacia un consumismo irracional poco  ético, que conduce a cambios de estilos de vida y patrones de alimentación, factores que entre otros inducen a la preferencia por dietas no saludables. La gente asi, está consumiendo más alimentos ricos en energía, grasas saturadas, grasas trans, azúcares libres o sal / sodio, y consumen menos frutas, verduras y fibra dietética y granos enteros.

CUIDANDO POR UNA DIETA SANA Y EQUILIBRADA

La composición exacta de una dieta sana y equilibrada varia en función de las necesidades individuales (por ejemplo, edad, sexo, estilo de vida, el grado de actividad física) etc.

Para los adultos, se indica que una dieta saludable debe contener: Frutas, verduras, legumbres (como lentejas, frijoles), nueces y granos enteros (por ejemplo, sin procesar maíz, mijo, avena, trigo, arroz integral). Al menos 400 g (5 porciones) de frutas y verduras al día (2). Las papas, yuca y otras raíces amiláceas no se clasifican como frutas o verduras. Menos del 10% de la energía total de azúcares libres (2, 5), equivalente a 50 g (o alrededor de 12 cucharaditas rasas), pero posiblemente menos del 5% de la energía total de los beneficios de salud adicionales (6). La mayoría de los azúcares libres se añaden a los alimentos por el fabricante, cocinero o consumidor, y también se pueden encontrar en azúcares presentes de forma natural en la miel, jarabes, zumos de frutas y zumos de frutas concentrados. Menos de 30% de la energía total de la grasa (1, 2, 3). Las grasas no saturadas (por ejemplo, se encuentran en los aceites de pescado, aguacate o paltas , nueces, girasol, canola y oliva) son preferibles a las grasas saturadas (por ejemplo, se encuentran en las carnes grasas, mantequilla, palma y aceite de coco, crema, queso, manteca y manteca de cerdo) (3).

Las grasas trans industriales (que se encuentran en los alimentos procesados, comida rápida, bocadillos, comida frita, pizza congelada, pasteles, galletas, margarinas y pastas para untar) no son parte de una dieta saludable. Menos de 5 g de sal (equivalente a aproximadamente una cucharadita) por día (7) y el uso de la sal yodada.

Para los bebés y niños pequeños: en los primeros 2 años de vida de un niño, la nutrición adecuada reduce el riesgo de muerte y de las ENT en desarrollo. También fomenta un mejor desarrollo y crecimiento saludable y el desarrollo en general.

Los recién nacidos, infantes y niños pequeños deben recibir Lactancia Materna en forma exclusiva durante los primeros 6 meses de vida y luego prolongarla hasta los 2 años o más, junto a alimentos complementarios. La sal y azúcares no deben añadirse a los alimentos complementarios.

SISTEMA ALIMENTARIO HEGEMONICO Y EL MODELO  DE PRODUCCION AGRO INDUSTRIAL SESGADO

La Segunda Conferencia Internacional sobre Nutrición (ICN2) se celebró entre 19 la 21 Noviembre, 214, en la Sede de la FAO en Roma,( Italia) abordando el análisis de todas las formas de malnutrición. Más de 2.200 participantes representando a gobiernos, organismos de sociedad civil y el sector privado estuvieron presentes. Al final de tal conferencia, muchos expresaron que si bien fue un paso positivo, al abordar la malnutrición ampliamente, el evento, sin embargo, no estuvo libre de decepciones, ya que no se tuvo en cuenta las causas fundamentales de la malnutrición como ser que el actual sistema alimentario internacional es hegemónico y esta guiado por un modelo de producción agroindustrial  sesgado e incapaz de responder a las necesidades de salud y  a los urgentes problemas de desnutrición y/o malnutrición actuales.

La primacía de los acuerdos de comercio propuestos por la OMC (Organización Mundial de Comercio), el dominio de las industrias sobre el Codex Alimentarius, afectan, entre otros, el pleno ejercicio del Derecho a la Salud y el Derecho al Alimento, así como el apoyo a modelos actuales de agroalimentación, la promoción de los monocultivos, junto a la permisibilidad de las autoridades internacionales y nacionales para la expansión de organismos genéticamente modificados (OMGs), la tolerancia al acaparamiento corporativo de la tierra, los océanos, lagos, ríos y recursos acuáticos la falta de inversión en la producción de alimentos a pequeña escala, han provocado, entre otros, el desplazamiento y empobrecimiento creciente de los pequeños productores en todo el mundo y en especial en el sur. La falta de respeto a la movilidad de muchos productores, su sedentarización forzada, la falta de respeto a la tenencia comunal de sus recursos naturales, la privatización, el desmantelamiento de estructuras de gobierno y de la capacidad de interpelación de organizaciones de la sociedad civil y del movimiento Consumidores han causado la situación actual de malnutrición, desnutrición y  daño ambiental, con consecuencias irreversibles en los sistemas productivos. Muchos gobiernos parecen hoy más interesados en la “salud de su economía” que en la salud de sus pueblos. Se requiere, por tanto mayor gobernanza y participación democrática en los  temas relacionados a alimentos y nutrición, así como un marco regulatorio global más transparente.

La actual situación y la tendencia alimentaria ha dado lugar a impactos ambientales profundamente negativos como ser la erosión del suelo y la contaminación, acidificación de los océanos, la pérdida de la fertilidad, reducción de la biodiversidad y el cambio climático.

La elaboración de cualquier plan de políticas, programas y medidas sobre alimentación y nutrición debe ser la comprensión inequívoca y el respeto a los derechos de los consumidores a una alimentación adecuada a la salud, a una  nutrición apropiada, el acceso a agua segura y potable, como derechos humanos fundamentales. Las personas somos titulares de derechos y los estados son titulares de deberes con la obligación de respetar, proteger y cumplir estos.

LA CAPTURA CORPORATIVA DEL ESPACIO POLITICO

Los Gobiernos debilitados, son presas más fáciles para la “captura corporativa del espacio político”. Se observa con alarma la disminución continua de la gobernanza, desmantelando paulatinamente muchos de los avances para la protección efectiva de los Consumidores, como en el caso de Bolivia, mientras se registra un aumento significativo en las asociaciones público-privadas y el progreso de las iniciativas  “filántropo-capitalistas” que con frecuencia dan lugar a grupos de presión empresariales fortalecidas al ganar influencia.  Esto conlleva a la reducción del espacio  para una la rendición de cuentas de los gobiernos no solo en relación con los alimentos, la nutrición, si no en cuanto a otras obligaciones de Derechos Humanos. La política pública debe estar  dirigida a cuidar el interés público y es fundamental para ello, abordar plenamente el tema de conflicto de intereses. La creciente criminalización de los movimientos sociales con respecto a la protección de Derechos Humanos, Derechos de los Consumidores, protección de la alimentación y la defensa de la nutrición, resulta  totalmente inaceptable.

LA INFORMACION, LA COMUNICACION

Es necesario aplicar regulaciones más estrictas que prohíban la comercialización de productos no saludables, ultra-procesados con alto contenido de azúcar, grasa y / o saladas, incluidas la leche de fórmula y lactantes y alimentos para niños pequeños promovidos a los padres, los niños y jóvenes. Los derechos de los consumidores incluyen el acceso a información independiente, imparcial, adecuada, equilibrada, basada en evidencia y la educación del consumidor resulta fundamental, para evitar la influencias nocivas en el tema de alimentación y nutrición alertando a las personas sobre potenciales los riesgos.

PROPUESTAS PARA LA ACCION

·         Brindar apoyo pleno a la propuesta Convención Global para la Promoción  y Protección de Dietas Saludables, formulada por el Movimiento Mundial de consumidores.

·         El Comité de Seguridad Alimentaria Mundial (CFS)  de FAO debe reafirmar su rol para ser un espacio crítico donde la coherencia de políticas sobre seguridad alimentaria y la nutrición tengan un fuerte enfoque de Derechos Humanos.

·         Los Estados miembros de NN.UU. deben garantizar que en la agenda de desarrollo post 2015 (ODS) se reafirme el Derecho a la Salud y el Derecho a la Alimentación y que sus indicadores resulten coherentes con los imperativos de seguridad alimentaria y nutricional.

·         Los Estados miembros de la OMS deben presentar informes periódicos a la Asamblea Mundial de la Salud (AMS) sobre el grado de cumplimiento de los compromisos asumidos en cuanto a políticas de salud y nutrición cuidando la primacía de dietas saludables, ante los saludables negocios.

·         El Consejo de Derechos Humanos debe efectuar un estrecho seguimiento a las políticas de salud, alimentación y nutrición de los estados, cuidando  por el pleno ejercicio de los derechos de los consumidores.

·         Hay millones de ciudadanos hambrientos y desnutridos, sin ingresos suficientes para comprar suficientes alimentos nutritivos para ellos y sus familias. La solución no es proporcionarles suplementos alimenticios. La nutrición debe estar enraizada en los sistemas alimentarios locales basados en la soberanía alimentaria.

·         Los consumidores tienen derecho a conocer, en términos fáciles de entender, el contenido nutricional de los alimentos y bebidas a ellos ofertadas, así como una información completa e independiente sobre su origen, composición, la presencia de sustancias potencialmente nocivas, así como ingredientes de cultivos de OGM en cualquier nivel de la cadena de producción.

·         La nutrición no se puede separarse de los alimentos. La separación artificial de la nutrición de los sistemas alimentarios (incluidos los sistemas alimentarios tradicionales), la salud, el medio ambiente y la agricultura es alentada por el actual modelo económico de libre mercado, que plantea soluciones técnicas y basadas en productos y que ignoran el aspecto económico, ambiental, social, sanitario y cultural como  determinantes.

·         Una Nutrición adecuada requiere promover dietas saludables, bajo un régimen ecológico y socialmente justo de alimentos que no promueva la privatización, y ponga las necesidades de los productores de alimentos a pequeña escala en el centro de soluciones.  Esto incluye la necesidad de un mayor apoyo de las comunidades .Todas las personas tienen derecho a una alimentación sana, segura y libre de químicos.

·         El concepto de "responsabilidad social corporativa" está siendo manipulado  como instrumento para proteger a corporaciones de su verdadera responsabilidad con la complicidad de algunos estados miembros. Los consumidores deben ejercer mayor control social sobre este instrumento.

·         Los ciudadanos consumidores debemos mostrar mayor  preocupación social por la toma de control corporativo de los sistemas alimentarios, que han logrado hacer que la nutrición se haya convertido en una industria en sí misma, generando enormes beneficios, no a través de la provisión de alimentos nutritivos naturales, sino debido a la sustitución por costosos suplementos y alimentos excesivamente procesados que no responden a las verdaderas necesidades nutricionales de las comunidades.

·         La caracterización de "emergencias" nutricionales en situaciones de crisis y o en circunstancias de crisis prolongadas, promueven y refuerzan los programas de “ayuda” y las "soluciones" que tienden a ser llevadas a cabo sin consultar a las comunidades locales, y no satisfacen las necesidades nutricionales reales de las comunidades afectadas, creando una preocupante dependencia.

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Referencias y Bibliografía:

1.- GREP-AEDN, grupo de expertos en nutrición - Asociación Española de Dietistas-Nutricionistas España – 2005

2.-OMS – Dieta Saludable  Nota descriptiva N ° 394 , Actualizada enero 2015 http://www.who.int/mediacentre/factsheets/fs394/en/

3.-Las grasas y los ácidos grasos en la nutrición humana: informe consulta de expertos. Roma: Organización para la Alimentación y Agricultura de Naciones Unidas; 2010 (FAO: Alimentación y Nutrición 91). http://www.who.int/mediacentre/factsheets/fs394/en/

4..- Nishida C, Uauy R, editores. OMS actualización científica sobre los ácidos grasos trans (AGT).European Journal of Clinical Nutrition, 2009, 63 Suppl 2: S1-S75.

5.- WHO - Obesity and overweight - Fact sheet N°311 - Updated January 2015 http://www.who.int/mediacentre/factsheets/fs311/en/

6.- Moynihan PJ, Kelly SA. Efecto sobre la caries de la restricción de la ingesta de azúcares: revisión sistemática para informar a las directrices de la OMS. J Dent Res, 2014 93: 8-18.

7.- Guía: El consumo de sodio para adultos y niños. Ginebra, Organización Mundial de la Salud, 2012.

8.- OMS Enfermedades no transmisibles Nota descriptiva - Enero de 2015 - http://www.who.int/mediacentre/factsheets/fs355/es/

9.- Esther Vivas,”el negocio de la comida. ¿Quién controla nuestra alimentación?”- Icaria editorial,  España, 2014 - http://arainfo.org/2014/12/esther-vivas-lo-que-comemos-tiene-muy-poco-de-alimento-y-mucho-de-producto-alimentario/

10.- Las 10 corporaciones que dominan el mercado alimenticio mundial Publicado: 24 ago 2014 - http://actualidad.rt.com/economia/view/138126-companias-dominio-mercado-alimenticio-mundial  

PARA MAYOR INFORMACION:

JUSTICIA, SALUD & DESARROLLO (Bolivia)

Llamado Global de Acción Contra la Pobreza (GCAP Bolivia)

Movimiento por la Salud de los Pueblos (PHM Bolivia)

Comité de Defesa de los Derechos del Consumidor (CODEDCO Bolivia)

Red IDESAL (Bolivia)

Telefax: (591 2) 2228596 – 725 15932
E-mail: Idesa.Bolivia@gmail.com,oscarlvd@gmail.com

La Paz – Bolivia

Empowerment, Citizenship, Participation

Empowerment through local citizenship

Catherine Dom (Mokoro) on behalf of Irish Aid.

Poor people live their daily lives at the local level where they engage with the state, public

services, markets and the political system. Their empowerment requires participation and

accountability in local governance and decision making through effective and inclusive local

citizenship. Supporting inclusion requires an understanding of existing power relationships and

the practical obstacles to participation faced by poor people. Public sector decentralisation

is an important opportunity for empowerment through increased accountability for public

expenditure allocations and local delivery of pro-poor policies. Capacity development, for both

communities and citizens, must promote leadership and facilitation, communication, advocacy

and political skills. Widely available, transparent and substantive information is a critical but

easily achievable first step in capacity development. All development aidmodalities can support

local empowerment and donors should co-ordinate to identify and maximise opportunities for

empowerment at the local level.

Effective and inclusive citizenship

A citizen is someone with rights, aspirations and responsibilities in relation to other social

and economic actors and to the state. Empowerment through local citizenship of people in

poverty is about changing who has decision-making power and who has a voice at the local level.

Effective and inclusive local citizenship means that all people can participate in local decision

making processes and hold others to account. In ideal situations, individual citizens should

be able to participate. Experience shows that marginalised people gain much from organising

themselves into groups in order to use their collective bargaining power to greater effect.

Ingredients

Participation

For pro-poor growth policies to emerge, poor people need to be informed and

empowered to participate in a policy-making process that is accountable to them. They

need to have the tools and opportunities to participate in, and influence, the decisions that

are made at local level, and which impact on their daily lives. Promoting the participation

of marginalised groups involves changing existing power relations, both the visible and the

invisible ones. Participating in local government budget discussions is not enough if the

existing powers are drafting the budget proposals and setting the agenda for the debate.

Accountability

Participation is only effective when the institutions of the state respond. Consultation

without due recognition of power and politics will lead to voice without influence. The

critical challenge is for citizens, particularly the excluded and marginalised, to be able

to influence policies and institutions, and for these in turn to become more accountable

to them, and act in their best interest. It is not only government institutions that need to

be accountable to the poor. Local politics also involves a multiplicity of local entities

(e.g. rural producers’ organisations, market stall owners, wholesale buyers and sellers,

semi-state enterprises) operating at the interface between state, market and society in an

environment characterised by blurred boundaries between the sectors and unclear lines of

responsibility.

Inclusiveness

Effective participation and accountability mechanisms require the direct involvement of

poor and marginalised people. Many factors drive poverty and exclusion. Gender inequality,

religion, membership of social or ethnic groups, regions in which they live as well as their

material wellbeing all affect people’s access, status and influence in local politics. Facing

exclusion and discrimination, people living in poverty may be too alienated or oppressed to

seize new opportunities to act. Women (or men) may not be willing to participate, or work

alongside the opposite sex. Designing in inclusiveness in empowerment strategies is crucial

and may require different interventions to accommodate all marginalised groups.

Challenges

The local level is sometimes seen as a level at which voice/participation and

accountability are easier to “get right”. Yet there are complex challenges to effective and

inclusive local citizenship that donors need to be aware of. For donors, an analysis of the

Poverty Reduction and Pro-Poor Growth: The Role of Empowerment – © OECD 2012

Fluid boundaries and informal mechanisms

The boundaries between state, society and market are particularly fluid at the local

level. For example, in an Ethiopian sub-district 10% of the population sit on the elected

local council making it perhaps more a community organisation than government. On the

other hand the sub-district leader is elected by the community but is directly accountable

to the district administrator. In this case it is difficult to say where the boundary between

community and local government lies. Providing support to an entity that appears

community-based but is in fact government-controlled, can further entrench patterns of

informal relationships and loyalties that may be keeping poor people in poverty.

The involvement of local administrations in licensing and regulating agricultural

markets (e.g. nominating designated commodity buyers) and the influence of public

expenditure programmes (e.g. purchases of school furniture or the supply or sale of

agricultural inputs and products) blur the distinction between state and market and can give

rise to diverse and contradictory interests and influences.

Power within the community

The power relationships at play in communities are rarely beneficial to people in

poverty. Changing the status quo requires finding ways of avoiding various forms of local

elite capture. In many rural contexts, community participation translates in reality into

participation of older, land-owning and better-off men; and traditional dispute resolution

mechanisms favour men over women and older people over younger. Local patterns of

power that may keep people in poverty are particularly difficult to challenge as many are

deeply embedded in the local history and norms – thus strongly internalised and almost

invisible. It takes great sensitivity to tackle these traditional hierarchies in a way that

becomes acceptable to all members of a community.

Nevertheless, when an acceptable solution is negotiated, it can have a long-lasting

positive effect. Support from customary elites may be crucial in legitimising local propoor

mobilisation processes, and their support makes the new status quo sustainable

(e.g. the Ngorongoro pastoralist land movement was strongly backed by customary mutual

restocking committees).

Even in a very small community “the poor” are not a homogeneous group. They confront

multiple and varied drivers and manifestations of deprivation and exclusion. There is a need

to recognise the diversity of their concerns and interests and of their highly individualised

strategies of alliance and resistance. This, in turn, requires striking a balance, at times

promoting approaches in which different groups of people in poverty develop alliances to act

collectively in larger numbers; at other times highlighting the necessity of different actions

for different groups.

The representation of marginalised groups at local level

How poor people are represented within the community, at the local government

level and at higher levels is critical to the extent that they can actively participate in local

decision-making processes. Special measures such as quotas on local elected bodies or in

community groups can lead to greater representation of marginalised groups. Before such

a measure is suggested, issues of correct targeting and the acceptability of the person(s) for

whom a quota is created need to be considered. The reservation of seats for Dalits in India

(in effect for decades) or the many cases of quotas for political representation of women

in local political bodies are examples of successful targeting. Better developed and more

inclusive political parties, denser civil society, higher literacy and education levels, reforms

of the electoral system, and support to broad-based cross-party caucuses have all been

proven to have a positive effect on a quota system for the representation of the marginalised

(UNIFEM , 2008).

Targeted approaches, focusing organisation and mobilisation efforts on groups that

have a shared profile and strong common interests, can be very effective and may be

necessary to foster empowerment of certain vulnerable groups. The Self-Employed Women

Association (SEWA ) in India managed to obtain far-reaching empowering policy changes

by targeting the poor women working in the informal sector and helping them to form their

own organisations (Box 3.3).

Decentralisation doesn’t always increase accountability

In decentralised countries, the nature of the relationship between central and local

authorities is critical. Successful decentralisation requires a strong but enabling centre,

genuinely committed to devolving both decision making powers and commensurate

resources. Donors can contribute by supporting the institution of a clear decentralisation

framework, which grants sufficient autonomy to local authorities; provides resources that

match their mandates; instils effective upward and downward accountability, as well as

ensuring technical support from central and regional government levels.

The political nature of the link between the central government and local government

also matters enormously. Where local and national elites collude, decentralisation is unlikely

to be pro-poor and empowering. Donors can play a role in supporting the empowerment

of poor citizens to fight nepotism, and to claim their right to participate in decentralised

local decision making. Under the right circumstances, for example where electoral reform

and democratisation is making progress, a situation can be created in which more political

capital is to be gained from acting to the benefit of poor people than from colluding or

embezzling – a positive politicisation of poverty reduction.

Bridging the gap: citizenship, participation and accountability.

Andrea Cornwall and John Gaventa

Andrea Cornwall, Fellow, Institute of Development Studies (IDS), University of Sussex, Brighton BN1

9RE, UK. E-mail: a.cornwall@ids.ac.uk

John Gaventa, Fellow, Institute of Development Studies (IDS), University of Sussex, Brighton BN1

9RE, UK. E-mail: j.p.gaventa@ids.ac.uk

Introduction

Around the world, a growing crisis of legitimacy characterises the relationship between citizens and the

institutions that affect their lives. In both North and South, citizens speak of mounting disillusionment with

government, based on concerns about corruption, lack of responsiveness to the needs of the poor and the absence of a sense of connection with elected representatives and bureaucrats (Commonwealth Foundation 1999).

As traditional forms of political representation are being re-examined, direct democratic mechanisms are

increasingly being drawn upon to enable citizens to play a more active part in decisions which affect their lives. In this context, the questions of how citizens – especially the poor – express voice and how institutional responsiveness and accountability can be ensured have become paramount. 

In this article, we explore some of these challenges. Repositioning participation to embrace concerns with

inclusive citizenship and rights, we examine a range of contemporary participatory mechanisms and strategies

that seek to bridge the gap between citizens and the state.

New contexts, new challenges

In many countries, measures to bring government ‘closer to the people’ through decentralisation and devolution have prompted shifts in approaches to service delivery that have widened spaces for citizen involvement. At the same time, the increasing marketisation of service delivery in many countries has introduced new roles for those who were formerly the ‘beneficiaries’ of government services.

Users have come to be seen as ‘consumers’ or ‘clients’ and civil society organisations have become significant coproducers of what in the past were largely state functions. To some, these new roles are seen as welcome forms of partnership between the state, the market and civil society, while to others they suggest the danger that the state is off-loading its larger social responsibilities to private or non-governmental actors (Cornwall and Gaventa, 2000).

Bridging the gap

In the past, there has been a tendency to respond to the gap that exists between citizens and state institutions in one of two ways. On the one hand, attention has been made to strengthening the processes of participation – that is the ways in which poor people exercise voice through new forms of inclusion, consultation and/or

mobilisation designed to inform and to influence larger institutions and policies. On the other hand, growing

attention has been paid to how to strengthen the accountability and responsiveness of these institutions and

policies through changes in institutional design and a focus on the enabling structures for good governance.

Each perspective has often perceived the other as inadequate, with one warning that consultation without

attention to power and politics will lead to ‘voice without influence’ and the other arguing that reform of political institutions without attention to inclusion and consultation will only reinforce the status quo. Increasingly, however, we are beginning to see the importance of working on both sides of the equation. As

concerns about good governance and state responsiveness grow, questions about the capacity of

citizens to engage and make demands on the state come to the fore. 

In both South and North, there is growing consensus that the way forward is found in a focus on

both a more active and engaged civil society which can express demands of the citizenry and a more responsive and effective state which can secure the delivery of needed public services. At the heart of the new consensus of strong state and strong civil society are the need to develop both participatory democracy and responsive government as ‘mutually reinforcing and supportive’ (The Commonwealth Foundation, 1999:76, 82).

Re-positioning participation 

Both social participation and political participation have carried with them a distinctive set of methods or

approaches for strengthening or enhancing participation.Traditionally, in the field of political participation, such methods have included voter education, enhancing the awareness of rights and responsibilities of citizens, lobbying and advocacy, often aimed towards developing more informed citizenry who could hold elected representatives more accountable. 

In the social and community spheres, we have seen the development of a number of broader participatory methods for appraisal, planning, monitoring large institutions, training and awareness building. The emphasis here has been on the importance of participation not only to hold others accountable, but also as a self-development process, starting with the articulation of grassroots needs and priorities and moving towards the establishment of selfsustaining local organisations.

Engagement in social and community participation has inevitably brought citizens in closer contact with the

institutions and processes of governance. Conversely, leaders of projects, programmes and policy research

initiatives have increasingly sought the voices and versions of poor people themselves.

Where citizens have been able to take up and use the spaces that participatory processes can open up, they have been able to use their agency to demand accountability, transparency and responsiveness from government institutions. An informed, mobilised citizenry is clearly in a better position to do so effectively; the capacities built through popular education on rights and responsibilities also extend beyond taking a more active interest in the ballot box. 

Equally importantly, however, where government agencies have taken an active interest in seeking responsiveness and have not only listened to but acted on citizens’ concerns, otherwise adversarial and

distant relationships have been transformed. Clearly, this also holds the promise of electoral advantage. 

These moves offer new spaces in which the concept of participation can be expanded to one of ‘citizenship

participation’, linking participation in the political, community and social spheres (see Figure 1).

New thinking about participation as a right 

The concept of ‘citizenship’ has long been a disputed and value-laden one in democratic theory. New approaches to social citizenship seek to move beyond seeing the state as bestowing rights and demanding responsibilities of its subjects. In doing so, they aim to bridge the gap between citizen and the state by recasting citizenship as practised rather than as given. Placing an emphasis on inclusive participation as the very foundation of democratic practice, these approaches suggest a more active notion of citizenship. 

This recognises the agency of citizens as ‘makers and shapers’ rather than as ‘users and choosers’

of interventions or services designed by others (Cornwall and Gaventa 2000). As Lister suggests, ‘the right of participation in decision-making in social, economic, cultural and political life should be included in the nexus of basic human rights… Citizenship as participation can be seen as representing an expression of human agency in the political arena, broadly defined; citizenship as rights enables people to act as agents’ (Lister 1998), (1998:228).

Building on this new thinking about participation, inclusive citizenship, rights and responsibilities, DFID’s recent strategy paper Human Rights for Poor People offers important new directions for participation in development. 

Using the more insistent language of ‘obligation’ rather than the softer term ‘responsiveness’, it enjoins

governments to honour commitments to citizens. Casting participation as a human right in itself, it situates the right to participate as basic to the realisation of other human rights: ‘Participation in decision-making is central to enabling people to claim their rights. Effective participation requires that the voices and interests of the

poor are taken into account when decisions are made and that poor people are empowered to hold policy makers accountable’ (DFID 2000).

At the same time, there is a growing recognition that universal conceptions of citizenship rights, met through a

uniform set of social policies, fail to recognise diversity and difference and may in fact serve to strengthen the

exclusion of some while seeking inclusion of others (Ellison 1997). With this has come a renewed emphasis on inclusion and on issues of social justice. In all three spheres of political, social and community participation, greater emphasis is now being placed on the involvement of those with least power and voice, with particular attention being paid to measures to address entrenched gender bias.

New spaces and places for citizenship participation

Such new thinking about citizenship, participation and rights raises the question of how to create new

mechanisms, or spaces and places for citizen engagement. It also requires that greater attention is paid to the

interface between citizens and the state, to the intermediaries who play an increasing role in bridging the

gap and at processes that can enhance responsibility as well as responsiveness on all sides.

One area of innovation has been to extend the traditional places for citizen engagement from the episodic use of the ballot box. Conventional spaces such as public meetings and committees can be transformed when lent

new powers and responsibilities, as user groups and citizen councils become actively involved in deliberation.

Innovative processes taking place in public spaces where the majority of citizens spend their everyday lives involve  more than a self-selecting few, opening up spaces for broader engagement. The use of PRA for poverty or wellbeing assessments, for example, offers ways of taking the consultation process to citizens in their own spaces. 

Legislative theatre performances draw together policy makers, service commissioners, providers and managers with community members to engage with the lived realities of everyday life and explore solutions to real-life dilemmas.

Another emerging space for the exercise of citizenship has come with the opening up, and indeed the levering open through citizen action, of formerly closed-off decisionmaking processes. On the one hand, in a number of countries enabling national policy has created a new imperative to consult and involve. In Bolivia and Brazil, for example, participatory municipal planning and budgeting, respectively, have national or state backing. In the UK, central government support for public involvement has led  to a wave of innovation in consultation over a number of high-profile government schemes. 

The adoption of participatory mechanisms for project and programme planning has extended beyond the bounds of discrete initiatives, in some contexts, to on-going processes of citizen involvement in monitoring and evaluation through initiatives, in some contexts, to on-going processes of citizen involvement in monitoring and evaluation through which citizens play a part not only in offering opinions but

also in holding agencies to account 

On the other hand, the increasing use of participatory and deliberative processes have contested and begun to reconfigure the boundaries between ‘expertise’ and ‘experience’ (Gaventa 1993). As citizens are increasingly considered to have opinions that matter and experience that counts, government agencies have involved them more in the kinds of decisions that were once presented as technical, rather than acknowledged as value-laden and political. Nowhere is this more the case than in the opening up of public expenditure budgeting to citizen engagement, as has been the case in several municipalities in Brazil. 

At the local level, a growing emphasis on the co-production and co-management of services has also served to create new spaces for citizen involvement, as the ‘owners’, and to some extent the ‘makers and shapers’, rather than simply ‘users and choosers’ of services.

In other contexts, pressure placed on governments by civil society organisations has forced open spaces through demands for responsiveness and accountability. Perhaps the most notable example of this is the work of MKSS in India, whose public hearings on recorded public expenditure have named and shamed officials and exposed graft to audiences of thousands of citizens

(Goetz 1999). 

Numerous other examples exist where NGOs have sought to intermediate between government

and citizens through the use of participatory mechanisms for enhanced service responsiveness and accountability; for example in the growing move for citizen involvement in local health service management.

In areas characterised by uncertainty, the use of mechanisms such as citizens’ juries offers an important

new dimension: moving beyond eliciting opinions from citizens towards a process in which views are aired and defended, in which contrasting knowledge and versions are weighed up and interrogated, before ‘judgements’ are sought. 

These processes offer a valuable corrective to the tendency found in some participatory processes of simply

gathering people’s views, rather than providing opportunities for exploration, analysis and debate.

At the same time, citizen involvement in processes where the emphasis has been on mutual learning and new

courses of action has helped mould new forms of consensus, bridging differences of interest and perspective

within communities as well as between community members and statutory or non-statutory agencies. This, in

turn, has helped create better mutual understanding and with it, the prospects for enhancing relationships that

were previously characterised by mistrust, suspicion and distance.

Making participation real

Forms of participation run across a spectrum, from tokenism and manipulation to devolved power and citizen

control. As the uses of invited participation to rubber stamp and provide legitimacy for preconceived

interventions grows, citizens are becoming increasingly sceptical. A recent report by the Commission on Poverty, Participation and Power in the UK for instance warns of ‘phoney’ participation, in which power relations do not shift, and in which rhetoric is not reflected in reality.

In this context, making participation real raises a set of complex challenges. A key challenge is building

confidence in the willingness of agencies to hear rather than simply to listen, nod and do what they were going to do in the first place. Where the use of participatory methods for consultation has often been most effective is where institutional willingness to respond is championed by high-level advocates within organisations. Where such ‘champions’ exist and where they can create sufficient momentum within organisations, the processes of invited participation that they help instigate can make a real difference.

New public management strategies emphasise incentives for change from within. One important incentive is to be ‘championed’ as a model for others to follow, as an example of good practice. Equally, recognising and rewarding changes in practice can have significant ripple effects. By creating spaces within bureaucracies in which responsiveness is valued, wider changes become possible.

Yet, as we suggest earlier, such changes are only one part of the story. The best-laid plans for public involvement can falter where citizens express disinterest and where cynical public officials simply go through the motions with no real commitment to change. Citizen monitoring and other forms of citizen action can help force some measure of accountability. To do so effectively, however, requires a level of organisation and persistence that is often beyond many communities who are involved in consultation exercises. Building the preconditions for voice and enabling citizens to actively take up and make use of available spaces for engagement calls for new combinations of older approaches to social, community and political participation.

It is in this that some of the most exciting challenges for a new generation of participatory processes reside: in ways of building more deliberation into consultative processes; in participatory rights assessments that enable people to recognise and articulate their rights; and in moves that turn the tables on processes to gather ‘voices’ to enable poor people to engage in analysing the policies and institutions that affect their lives, as a starting point for changes that will make a difference.

Citizenship and empowerment: a remedy for citizen participation in health reform

1. Joan Wharf Higgins

+ Author Affiliations

1. Joan Wharf Higgins is an Assistant Professor in the School of Physical Education at the University of Victoria in British Columbia Canada

1. Address for Correspondence: School of Physical Education, PO Box 3015, Victoria BC, Canada V8W 3PI.

Abstract

The article begins by identifying the shared features of participation, empowerment and citizenship by reviewing the literature and grounding the discussion in the case study in health reform in one region of British Columbia. The ethnographic case study followed four health planning groups' efforts to foster community participation in developing local community health plans over an 11 month period. Data were also collected through interviews with participants, and focus groups with non-participants. As the article chronicles, despite the best intentions of the health planning groups, their work more closely resembled a social planning orientation than a community development one. The findings suggest that the concepts of citizenship and empowerment are useful in explaining why some individuals engaged in the work of the health planning groups and others did not. The sense of full citizenship—enjoying the formal status and substantive effects of civil, political and social rights as an equal member of the community—distinguished participants from non-participants. The article concludes with a discussion of the findings from the case study in terms of informing the theory and practice of community development. 

The Psychology of Crowd Dynamics

The Psychology of Crowd Dynamics
Stephen Reicher
School of Psychology University of St. Andrews

Address for correspondence: Stephen Reicher, School of Psychology, University of St. Andrews, St. Andrews, Fife, Scotland. KY 16 9QS. Tel.: +44 (0) 1334 463057. Fax.: +44 (0) 1334 462072. E-mail: sdr@st-andrews.ac.uk

The challenge of crowd psychology

Crowds are the elephant man of the social sciences. They are viewed as something strange, something pathological, something monstrous. At the same time they are viewed with awe and with fascination. However, above all, they are considered to be something apart. We may choose to go and view them occasionally as a distraction from the business of everyday life, but they are separate from that business and tell us little or nothing about normal social and psychological realities . Such an attitude is reflected in the remarkable paucity of psychological research on crowd processes and the fact that it is all but ignored by the dominant paradigms in social psychology. The second edition of The Handbook of Social Cognition (Wyer & Srull, 1994) has no entry in the index under ‘crowd’. Indeed, within a discipline that often views literature from a previous decade as hopelessly outdated, the little reference that is made to such research still tends to focus on Gustave Le Bon’s work from a previous century (Le Bon, 1895). As we shall shortly see, it is most clearly reflected in the content of Le Bon’s research and that of his followers. It was Le Bon, in terms of his theories if not his practices, who divorced crowds from their social context. His theory assumed that crowd participaton extinguishes our normal psychological capacities and reveal a primal nature which is usually well hidden from view. It was he who, with typical Victorian gusto, consigned crowds to the realms of a social scientific theatre of curiosities (cf. Reicher, 1996a; Reicher & Potter, 1985).

The aim of this chapter above all else is to free crowd psychology from being imprisoned at the margins and to restore it to its rightful place at the centre of social scientific enquiry and, more specifically, of social psychological thought. As I have previously argued (Reicher, 1982, 1987) one of the more remarkable features of traditional crowd psychology is that it has tended to constitute a theory without a referent. Rather than starting from a set of phenomena that are in need of explanation, a set of explanations were elaborated in order to underpin certain ideological presuppositions about the crowd - or at least the suppositions of gentleman observers who viewed the masses with alarm from the outside. To them, crowds seemed anonymous, their actions inherently destructive and random, their reasons unfathomable. However, these hostile and external observers never took care to investigate the patterns of crowd action and the conceptions of crowd members to see if their suppositions were warranted. If one did - and there is a growing literature by historians and social scientists that does (e.g. Feagin & Hahn, 1973; Krantz, 1988; Rude, 1964; Williams, 1986) - then two things would become immediately apparent. The first is that crowd action is patterned in such a way as to reflect existing cultures and societies. Perhaps the classic example of this remains E.P. Thompson’s study of eighteenth century food riots in England (Thompson, 1971; 1991).
Of all examples of crowd action, one might at first think of food riots as a domain in which social analysis has least to offer. Surely starving people are simply motivated by a biological need to eat, to grab - by force if necessary - whatever food is available, and to make off with it. And yet, as Thompson notes, people are often passive in the face of starvation and protests are comparatively rare. When they do occur, food riots are far from inchoate explosions. In an analysis of several hundred such riots in England around the turn of the 19th century, Thompson shows how riots had a characteristic pattern both in terms of how they started and how people behaved within them. Moreover, these patterns reflected collective belief systems. Thus the riots occurred in the context of a shift from feudal to market based economies. These were matched by different ‘moral economies’. For the one, produce was meant to be sold locally and, for the other, produce was legitimately sold where it fetched the highest price. Riots generally started when grain was being transported to a distant market and the populace attempted to enforce their moral economy against that of the merchants. Events then unfolded in a way that reflected localist beliefs: grain was sold at a popular price and the money - sometimes even the grain sacks - were handed back to the merchants. In short, and in complete contrast to prevalent visions of anarchy, the food riot demonstrates how crowd action is shaped by ideology and social structure.

The second obvious feature of crowd phenomena is that they are not only shaped by society but that they in turn bring about social change. Indeed the changes wrought by crowds exist at three levels. There is change in the ways that crowd members see themselves as social actors. Autobiographies and studies of activists (e.g. Biko, 1988; Burns, 1990; Cluster, 1979; Haley, 1980, Teske, 1997) repeatedly show that people do not enter collective movements with fully fledged movement ideologies but that they develop their understanding of society and who they are within it as a consequence of participation. Crowds and collective action also leads to changes in the collective ideologies themselves. Indeed, as Eyerman and Jamison (1991) argue, the actions of social movements “are bearers of new ideas, and have often been the sources of scientific theories and of whole scientific fields, as well as new political and social identities” (p. 3). To take but one example, the rise of environmental science, of ‘green’ sensibilities and ‘green’ identities cannot be understood outside the actions of anti-nuclear activists, roads protestors and other collective acts of opposition. Finally, crowd action can bring about the entire restructuring of society. Just over a decade ago, such a point may have required more justification when the role of the sans-culottes in the French revolution of 1789 (Rude, 1959) or of the July day crowds in the Bolshevik revolution of 1917 were only historical memories. However since the transformations in Eastern Europe - whether through the peaceful mass demonstrations of Czechoslovakia’s ‘velvet revolution’, the confrontational demonstrations in East Germany, or the violent clashes between Romanian crowds and state forces in Timisoara and elsewhere (cf. De Rudder, 1989/90; Garton Ash, 1990), the claim hardly needs to be laboured.

Putting the two features together, it should be clear that, in simultaneously encompassing social determination and social change, crowd action reflects what is possibly the central paradox of human action. Characteristically, even when this paradox constitutes the focus of enquiry, these twin facets of the human condition are studied in relation to different phenomena. However both come together in the crowd. It follows both that the crowd provides a privileged arena in which to study social (psychological) processes and also that any adequate explanation of the crowd must take us a long way towards understanding the general bases of human social behaviour.

As well as delineating the extent of the challenge, even such a brief account as that provided above suggests the nature of the tools which are necessary to meet it. Thompson’s analysis suggests that the impact of structural and ideological factors upon action is achieved through actors collective understanding of their position as social subjects. Conversely, the work on social change indicates that it is as social subjects that people act collectively in ways that bring about transformations - including in the way they understand their own position. In other words, the psychological processes which relate society to crowd action are those of identity. If we are to understand the nature of crowd action we therefore need a model of identity which explains both how society structures identity and how identity organises action. Failure to do the former will lead to a desocialised crowd psychology, while failure to do the latter will lead to an abstracted social theory. In either case, it will be impossible to complete the cycle of crowd dynamics whereby social factors affect identity which organises action which then reflects back upon society - and so on.

When one measures the actual performance of traditional crowd psychology against the size of this challenge the results are sorry indeed. The failure has not been to explain either social change or social determination at the expense of the other but to ignore - no, to deny - both. The theoretical underpinning of this denial, which has unfortunately been bequeathed to much of social psychology in general, is a theoretical model of the self which writes society out of the picture and which therefore cannot address how it either shapes or is shaped by actors and their actions. This neglect is hardly accidental. It reflects the concerns which led crowds to become a focus of explanation. In order to understand the deficits of classical crowd theory and how to transcend them it is necessary to start by considering the context in which crowd psychology was born.