The European Migration Crisis and Implications for Healthcare Delivery

By Sarah Green, BA Medicine, Health, and Society & History, Expected 2020

In 2015, the term “refugee and migrant crisis” was coined to refer to the ever-increasing number of asylum seekers in Europe. The number of refugees immigrating to countries in the European Union (EU) from non-EU member states reached over two million in 2017. Geopolitical tension, violence, climate-change related natural disasters, economic inequality, and diminished freedom across Africa and the Middle East prompted this mass migration. With more immigrants comes increased pressure on EU member states to accommodate the influx of people. Nationalist leaders, who have gained footing across Europe since the start of the decade, have blocked proposed common migration policies for European countries. By analyzing healthcare policy in Europe through the lens of migration, it is easy to see where disparities exist.

According to many European laws, especially Article 12 of the International Covenant on Economic, Social, and Cultural Rights, all individuals in Europe have the right to healthcare, regardless of citizenry. However, immigrants often slip through the cracks, as many are unable to pay the fees for care beyond emergency treatment. A phenomenon called the “healthy migrant effect” (the perception that immigrants are strong and healthy) undercuts immigrants’ often traumatic journey, their pre-existing conditions, and potentially, the underfunded healthcare systems in their country of origin. Immigrants from non-EU member states might only be familiar with emergency care, as the country they left might not have had primary care institutions. Lengthy office visits and poor understandings of migrants’ experiences contribute to substantial barriers to care. A bad experience at a European health care center can even turn immigrants away from seeking healthcare at all in Europe. Furthermore, language barriers can lead to poor medication adherence and noncompliance with treatment. Mass immigration poses significant challenges to healthcare providers too— navigating different understandings of healthcare, unfamiliar disease profiles (many migrants come from countries in epidemiologic transition), and unfamiliar languages and cultures can contribute to frustration between doctors and patients, and ultimately, form barriers for immigrants to access routine health exams and treatment.

Of course, immigration is so nuanced and complex that a solution to provide equitable citizenry, and therefore healthcare, for all those in Europe will not appear overnight. However, training healthcare providers in cultural competency— how to work effectively with people across different cultures— is a starting point to ensure positive healthcare experiences for migrants that will not deter them from seeking routine care. A 2018 case study from South Africa indicated that emphasizing cultural competency in the medical curriculum with more community-based research and increased language instruction improved healthcare delivery for minority populations. These improvements are general enough to be applied more broadly. Investment in language instruction is also critical to European healthcare providers, not only to increase cultural competency, but also to increase the number of translators available and doctors who can speak multiple languages with emphasis on languages spoken outside the EU. Additionally, the establishment of community health centers focused on immigrants’ care could be beneficial to both healthcare providers and immigrants. 

In Europe, there exists a notion of a shared identity called the “European Idea,” [1] enforced by political unions such as the EU which sustain the concept of European-ness [2]. Although the European Idea emphasizes unity, independent European nations have their own notions of citizenry and nationhood. Most European countries today exercise an assimilationist model, where immigrants who pursue citizenship accept their new country’s culture as their own and automatically become just as much a citizen as anyone born in that country. However, this égalité is more of a starry-eyed ideal, because in the face of mass migration, institutions like healthcare are put under so much pressure that they cannot adapt to serve vulnerable immigrant populations, especially refugees, who, being excluded from the basic rights guaranteed to Europeans, find it difficult to assimilate into their new country’s culture. It is also important to note that between 2016 and 2017, although immigration of people from non-EU member states to EU member states was 2 million, the number of people granted EU citizenship decreased by 17 percent. In conjunction with a recent rise in European populist voices critical of the EU gaining political traction, migrants’ freedoms and rights are on the line. Only one month ago, Susanna Ceccardi, the far-right anti-immigrant mayor of Cascina, Italy, described immigrants as exploitative “invaders” at an event for her campaign to earn a seat in the EU Parliament. Ceccardi became a right-wing star in Italy, premising that immigrants take jobs from Italian youth, who are facing unemployment rates of 30%. Sentiments such as Ceccardi’s further ostracize immigrants from citizenry-based rights in Europe.

It is difficult to say what the future holds for immigrants in Europe. The anti-immigrant politicians gaining traction now might lose ground in coming years, but their increasing popularity could have serious implications for migration to EU member states. Pressing issues such as climate change will inevitably produce more refugees with each year as more frequent natural disasters destroy peoples’ homes and land. Countries like Denmark, with xenophobia so pervasive that it has been institutionalized, are already grappling with protests over immigration policy. What we do know, is that migration to Europe has no end in sight, and in order to ensure the healthcare needs of every European citizen and migrant are met, changes must be made to the current healthcare system.


[1] Thorneycroft, Peter. “The European Idea.” Foreign Affairs (pre-1986) 36.000003 (1958): 472. Web.

[2] Brubaker, Rogers. Citizenship and Nationhood in France and Germany. Cambridge, Mass: Harvard University Press, 1992. Print.

Climate Change is Taking a Toll on our Mental Health

By Corrine Liu, BA Medicine, Health, and Society & German, Expected 2019

We have 21 years to fix our problems. This is the terrifying message from the United Nations’ Intergovernmental Panel report on Climate Change released last September. It predicted that humans could witness a major environmental catastrophe as early as 2040. To visualize the gravity of this, think of the final panel of Hieronymus Bosch’s Garden of Earthly Delights: a “paradise that’s been degraded and destroyed,” with a world of worsening food shortages, wildfires, a mass die-off of coral reefs, and other cataclysmic conditions.

The prospect of a world afflicted by climate change elicits a sense of pervasive loss, devastation, and fear about catastrophes in a very near future. The Lancet Commission on Health and Climate Change concluded that climate change presents “the biggest global health threat of the 21st century.” This harsh reality may leave many of us rattled and hopeless. A recent study demonstrated that there are 467 different pathways by which human health, water, food, the economy, infrastructure, and security have already been impacted by climate hazards. For example, researchers in Central America found that extreme heat brought on by global warming is damaging outdoor workers’ kidneys.

Our environment and physical health should not be our only concern. According to a 2017 report co-authored by the American Psychological Association (APA), Climate for Health, and ecoAmerica, “climate change-induced disasters have a high potential for immediate and severe psychological trauma.” Climate change is putting pressure on our ecosystems and our infrastructure, but it’s also taking a toll on our mental health. The authors highlighted that among a sample of people living in areas affected by Hurricane Katrina in 2005, suicides and suicidal thoughts more than doubled, nearly 50% of the people developed a mood or anxiety disorder, and 1 in 6 people developed post-traumatic stress disorder. This data informs that the destruction and loss of home due to climate impacts may diminish the sense of belonging and solace that people derive from their connectedness to the land.

In areas where catastrophic natural events not only make lands uninhabitable but also destabilize society, people are forced to take shelter overseas. Since 2008, an average of 24 million people has been displaced by catastrophic weather disasters each year. As projections of climate changes, such as desert expansion and sea level rise, progress over time, 143 million people  from sub-Saharan Africa, South Asia, and Latin America could be displaced by 2050. Inevitably, they will need to cope with displacement-related stressors that influence mental health: social isolation resulting from the loss of social networks; unemployment due to a lack relevant work skills or to host-society restrictions on permission to work; poverty and a lack of access to basic resources; perceived discrimination; increased family violence; and difficulties navigating settings of resettlement. As climate change worsens storms and droughts, climate scientists and migration experts expect the number of globally displaced persons will rise. But so far there’s no international agreement on who should qualify as a climate refugee — much less a plan to manage the growing scope of predicament. For this reason, climate refugees also face stressors that include uncertainty regarding their legal status, the possibility of being deported to the country from which they fled, and for many, prolonged detention in asylum holding camps, while their asylum claims are adjudicated. The depletion of these refugees’ coping resources by continuously stressful environmental conditions leaves them more vulnerable to the traumatic effects of climate change.

Those who are lucky enough to have stayed out of the direct path of climate change may be exposed to “unrelenting day-by-day despair.” Amid abstract global temperature trends and unfathomable volumes of melted sea ice, the everyday intimacy of climate goes under-acknowledged. Psychologically, however, such interaction takes shape in “some of the most resounding chronic psychological consequences,” according to the APA report. “Gradual, long-term changes in climate can also surface a number of different emotions, including fear, anger, feelings of powerlessness, or exhaustion.” Over long periods of time, chronic stress has been shown to suppress the immune system, “leaving people more vulnerable to pathogens in the air and water,” the researchers wrote. In other words, mental health is intimately linked with physical health, and prolonged despair can lead to disease. Susan Clayton, a psychologist at the College of Wooster predicted, “as we have more natural disasters, one would expect to also have increases in [depression, anxiety, post-traumatic stress disorder, substance abuse, and domestic abuse].” As natural disasters become more commonplace, so will mental illness.

The psychological effects of climate change are affecting even the youngest, most vulnerable members of society: our children. A study conducted by the Department of Psychology at Oregon State University found an association between experiencing a natural disaster and developing anxiety, depression, and increased aggression in children as young as two to nine years old. Don Arnold, a pediatric emergency medicine doctor at Vanderbilt Children’s Hospital, likened climate change to one of this generation’s versions of the threat of nuclear war during the Cuban Missile Crisis, “Thermonuclear war was an anxiety for kids in my generation and I think climate change, along with gun violence and […] social media is probably causing anxiety in kids today.”

We’re living through an unprecedented peak in devastating natural disasters, and with the trend we’re following, things will only getting worse. A recent article in Nature warns that unless we “aggressively” reduce our emission of greenhouse gases, by 2100 some areas of the world will be simultaneously exposed to up to six severe natural disasters simultaneously. On a more positive note, research has found that people with strong social connections and networks during, and in the wake, of a natural disaster tend to have lower rates of psychological distress and a higher capacity to withstand traumatic experiences. Restoring economic and housing resources to populations affected by a natural disaster would significantly reduce the mental health burden in populations, particularly those with resource loss, after a disaster.

Actions to mitigate climate change not only offer a wealth of immediate benefits like clean air and food security but also strengthen our mental wellbeing. Public transportation, for example, helps nearby households reduce 39 to 50 percent of their energy use, promotes cognitive functions, and augments community mental health by creating opportunities and networks to increase community cohesion. These mental health concerns must inform policymaking and a system-wide societal shift in how climate change is thought about and what the potential long-term impacts might be. Consequently, we should look beyond the mental health concerns to address the core causes of our changing climate and build social, economic, and environmental resiliency.

Why China’s Environmental Policies Are Inadequate for Improving the Nation’s Health

By Corrine Liu, BA Medicine, Health, and Society & German, Expected 2019

Nearly three years ago, Chai Jing, the former CCTV (China’s state television) investigative reporter, made her last public appearance in her documentary, Under the Dome. In the film, she demonstrates the severity of China’s air pollution issues, shows how they have formed, and assigns blame to state-owned petrochemical enterprises as well as openly criticizes the Ministry of Environmental Protection for failing to act against big polluters.

Unprecedented in its scope and range, the film caused an uproar on the Chinese internet; it was soon withdrawn from China’s mainstream websites by the government, with Chai blacklisted from TV work. Nevertheless, her efforts to inform millions of people as to the extent of the country’s environmental crisis have paid off. By revealing her experience of having her unborn daughter operated on to remove a tumor, which possibly resulted from the toxic dust that she inhaled, Chai shed light on pollution’s severe implications on health (Ren et al., 2011). Corroborating studies have shown that exposure to outdoor pollution is carcinogenic to humans and that levels of particulate matter (PM) in outdoor air are associated with lung cancer mortality (Hamra et al., 2014). Among children, long-term exposure to air pollution may increase arterial blood pressure (BP), although breastfeeding may reduce the negative impact of air pollution on BP (Dong et al., 2014). Compared to normal-weight children, overweight and obese children are more susceptible to the inflammatory effects of ambient air pollutant, leading to a higher prevalence of respiratory symptoms and asthma (Dong et al., 2013). In light of Chai’s heartrending story, there is evidence suggesting an association between ambient air pollution and adverse pregnancy outcomes. In particular, exposure to pollutants during vulnerable pregnancy periods is linked to preterm birth, low birth weight, and intrauterine growth retardation. Preterm births and low birth weight remain the most important predictors of neonatal mortality (death in the first 28 days) and infant mortality (death in the first year) in both developed and developing countries, illustrating the disconcerting fact that the effects of the pollution trickle through two generations (Behrman and Butler 2007; Blencowe et al. 2012; Institute of Medicine 2009; National Institutes of Health 2013; World Health Organization 2004).

The film came out not long after the country first started measuring nationwide levels of PM 2.5, which is a particulate air pollutant that becomes a concern for people’s health when levels are elevated, and instigated draconian anti-pollution policies demanded by the infuriated public (Cui, 2016). Collectively called the Air Pollution Prevention and Control Action Plan, the policies state that their “ultimate goal is to achieve environmental, economic and social benefits,” by enacting a strictly monitored, top-down implementation model, placing outright bans on polluting activities and disciplining local governmental officials for subpar emission management. Specifically, if targets of urban PM concentration – a 10% decrease compared with 2012 – would have been met in 2017, the Action Plan was expected to prevent 89,000 premature deaths, 120,000 hospital admissions, and 9.41 million hospital outpatients and emergency room visits. The total health benefit would be approximately 86.7 billion RMB per year (Lei et al., 2015).

Yet the command-and-control measures have failed to address Chai’s, as well as most Chinese’s, concern about the pollution’s actual health impact (Huang, 2018). Despite promising health benefits and encouraging public oversight on air quality control, official reports claiming victory on the all-out war on smog show little regard for the policy’s actual impact on health. A second look at the policies easily reveals why: health benefits are translated into monetary terms that are used to complement the overall economic goals. Environmental policies are guided by the National Development and Reform Commission – China’s economic planning body. As the country’s newly awakened environmental awareness jostles with its traditional energy sectors, political force is used to maintain the dichotomy between development and environment. The goals that are set accordingly are simply inadequate to meet public health demand: Beijing authorities pride themselves on bringing the city’s PM2.5 level below 60 micrograms per cubic meter, yet the World Health Organization recommends a maximum annual mean of 10 micrograms per cubic meter.

With a health-concerned, rather than a health-centered environmental model, many aspects of the environment-health interaction are not addressed due to the haste to fulfill and even overshoot the campaign’s targets. In an effort to avoid being named and shamed by their inspecting superiors, paying fines, or losing their jobs, overzealous local officials made sure to see a reduction in PM 2.5 in major economic zones – namely, Beijing-Tianjin-Hebei, the region surrounding the country’s capital. Yet the government’s pursuit of both clean sky and wealth has shifted the pollution elsewhere. National levels of PM 2.5 were only 4.5% lower in 2017 than in 2016 compared to the reported 54% reduction in Beijing, which implies that pollution rose in southern China.

By giving instructions to stay indoors and wear N95 respirator masks during heavy-smog days, the policies shift the burden of maintaining one’s health from local government to individuals. Additionally, staying in concrete apartment buildings, as most people do to steer clear of bad air, is also associated with risks of respiratory health hazards (Dong et al., 2013). As the country undergoes rapid urbanization and enjoys an improved living standard, an increase in construction work, housing renovation, and intensive usage of various new home decorating materials poses new health threats; associations between indoor pollution and asthma are especially notable among children (Dong et al., 2013). While public interest argument for improving indoor air has been gathering strength, the relationship between household factors and health is often overlooked when regulatory policies are devised (Roxburgh, 2013).

It is not hard to imagine why China, as one of the fastest-growing countries in the world, bases its environmental policies on economic realities. When it comes to sustainability, however, a health-centered approach is needed to fundamentally change the way China interacts with the environment, because ensuring the health of millions of individuals today will pay economic dividends long into the future (International Monetary Fund, 2004).


Behrman RE, Butler AS, eds. 2007. Preterm Birth: Causes, Consequences, and Prevention.
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Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R, et al. 2012. National,
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Dong, G.H., Qian, Z.M., Fu, Q., Wang, J., Trevathan, E., Ma, W.J., Liu, M.M., Wang, D., Ren,
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Umama Salamas: A case for including traditional healers in modern health systems

By Sarah Heerboth, VUSM Class of 2019 (expected)

Mama Irene confidently stepped in to coach a struggling primigravida, and Mama Regina expertly anticipated the clinician’s needs—these women were more than just the cleaning ladies. With growing suspicion, I approached them during a quiet moment to inquire about their pasts. The women, beaming with pride, stood to answer me, explaining that they had all once been traditional birth attendants (TBAs). They finished each other’s sentences as they spoke, excited to share their knowledge with someone who had independently recognized their expertise. Soon after this interaction, they draped a rubber apron over my head as if it were a championship medal, giving me their official blessing to assist in their domain.

I went on to spend much of my free time folding gauze and hanging laundry with these Umama Salamasso that I could learn about their experiences. Leah, a Community Health Worker (CHW), told me about a particular delivery that still haunts her: she knew long before the baby was born that it had died. Her bare fingers macerated the fetus during her exams, but she couldn’t tell the mother or express her sorrow—she was fearful the patient would be too distraught to continue. She explained how helpless she once felt in the face of maternal and child mortality. What she loved most about being a TBA was not delivering babies, but rather meeting new women, earning their trust, and helping them in whatever way possible. When Lwala was founded and began offering antenatal services, Leah was not at all sorry to see her former profession go. She expressed gratitude to the organization for welcoming her into a formal health system. Now, she says, she has the tools she needs to truly make a difference in her community.

Mama Elizabeth wrote for me some of her former practices that she now regrets

In low resource settings, the inclusion of lay health workers is crucial to the success of the health system. Infectious disease and childbirth are still major sources of mortality, so education and prevention are of the utmost importance. But with only a handful of clinical officers and nurses working at each health facility, it is also essential to ensure that they are spending their time working at the top of their capabilities. With some training, community members can easily fill gaps in health education and prevention initiatives, often doing so in ways even better than their formally trained counterparts. In fact, significant reductions in childhood morbidity and mortality are achieved when lay health workers are deployed as a foundational component of health care systems. They’ve also been shown to increase breastfeeding, childhood immunizations, and tuberculosis treatment completion.[i]It is not a far leap to say that lay health workers have the power to help many of the Sustainable Development Goals become reality.

Debate remains, however, on the inclusion of traditional birth attendants in the lay health worker framework. Within their communities, TBAs are respected sources of health information and possess experiential knowledge of health problems. But many TBAs are illiterate, making training and data collection more difficult, and there is fear they may be overconfident in their abilities or reluctant to abandon traditional medicine. One study examined whether outcomes improved if TBAs were given a basic training in modern practices. While the results were somewhat promising, statistically significant impacts on mortality were not achieved.[ii]Conflict and distrust between TBAs and health care professionals have been cited as reasons why other similar efforts have been unsuccessful.[iii]

When TBAs are integrated into a larger healthcare system, however, significant increases in skilled antenatal care and birth attendance are seen.[iv],[v]Mama Elizabeth, who was a TBA for 20 years before joining Lwala, told me that women still show up at her door pregnant and bleeding or in labor. She herself had brought some of those mothers into the world, but “Lady’s Delivery Home of Uriri Village”is no longer open for business. Now, when she receives these unexpected visitors, she immediately accompanies them to the health facility, leaving their side only after they have been admitted. In my literature searches, a dichotomy emerged between studies showing success and failure of TBA engagement, perhaps accentuated by the success I have witnessed at Lwala. When TBAs are ostracized or seen as a lesser member of the healthcare team, challenges outweigh results. But when efforts are made to respect, include, and learn from TBAs, maternal and child health outcomes improve.3

Elizabeth writes what she now tells women who visit her

It is my firm belief that Lwala has its TBAs to thank for much of the success they have seen in maternal and child health. This success has been impressive: 97% of women deliver in the health facility, compared to a county average of only 53%; they’ve seen a 64% reduction in childhood deaths and a 73% reduction in neonatal mortality.[vi]  By earning the trust of the TBAs and treating them with the respect that they deserve, the organization itself earned the trust and respect of the community at large. They gained an army of strong, intelligent, and dedicated women in the fight against maternal and child mortality. Other organizations would do well to follow Lwala’s lead, finding new roles for traditional healers in modern health systems.

 Flora estimates that she conducted over 2,000 deliveries before joining Lwala as a CHW. She is unable to write her name, but has a wealth of experiential knowledge and is a treasured member of both the health facility and the local community.


For more information about Lwala Community Alliance, visit:

[i]Lewin, Simon, et al. “Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases.” The Cochrane Library(2010).

[ii]Sibley, Lynn M., Theresa Ann Sipe, and Danika Barry. “Traditional birth attendant training for improving health behaviours and pregnancy outcomes.” The Cochrane Library(2012).

[iii]Glenton, Claire, et al. “Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health: qualitative evidence synthesis.” Cochrane Database Syst Rev 10.10 (2013).

[iv]Byrne, Abbey, and Alison Morgan. “How the integration of traditional birth attendants with formal health systems can increase skilled birth attendance.” International Journal of Gynecology & Obstetrics 115.2 (2011): 127-134.

[v]Hamela, Gloria, et al. “Evaluating the benefits of incorporating traditional birth attendants in HIV Prevention of Mother to Child Transmission service delivery in Lilongwe, Malawi.” African journal of reproductive health 18.1 (2014): 27-34.

[vi]“2017 Annual Report” Lwala Community Alliance. 2018

The Quiet Communism of Modern Italy

Sarah Taylor, Staff Writer

 Though commonly considered to be a thoroughly Western and modernized country, a look into Italian politics sheds light on the deeply rooted cracks in the system created by underlying communist ideals. Smaller cities in Italy experience lower living conditions and struggle to develop sustainable local economies, leading to commonplace power outages, high unemployment, and low salaries. The unemployment rate in Italy is around 11%,[1] with the average salary less than 1400 euros per month.[2] For contrast, the United States’ unemployment rate as of October 2017 is 4.1%[3] with an average salary of around $3400 per month.[4] In the case of Italy, these conditions are representative of a more deeply rooted and intricately difficult political history. Many of the central regions in Italy have maintained close ties to the communist ideology that was once reflected in the local power of the Partito Communista Italiano (PCI). The depressed living conditions of many historic cities and towns stems from a history of political complexity, spurred by the everlasting search for power of the Italian communists.

Many elements of the particular brand of communism predominant in Italy differ from the traditional Stalinist origins of the ideology. Compared to the Bolshevik-driven birth of communism in the Soviet Union, Italian communism and the PCI specifically were not revolutionary in origin, and operated within a capitalist regime, adapting to the system in place.[5] Italian communism encouraged political pluralism, and worked to actively attract new members to the party by acquiescing to the extant ideology of the Italian people. A country steeped in Catholicism, the Church posed a potential, and sometimes real, threat to the legitimacy and operations of the PCI. After World War II, Communists and Catholics alike participated in the Resistenza (Resistance) against Fascism, working to topple Benito Mussolini’s dictatorship. Italians who felt allegiance to both Catholicism and Communism formed the Party of Communist Catholics.[6] As the Christian Democrat party started to take shape, however, the possibility of cooperation between Catholics and Communists dissipated. The tensions between the Catholic church and the Communist faction in Italy reached their height in 1947, leading up to the 1948 election. In May of 1947, Alcide de Gasperi, the leader of the Christian Democrats, drove the Communist party representation out of government.[7] The election of 1948 pitted devoted Catholics against staunch Communists. The victory of the Christian Democrats was seen as a victory of the Church over the USSR. Relations between Catholics and Communists began to improve after the 1948 election, however. Pope John XXIII (1958-1963) brought in a new era of political freedom within the Church, encouraging Italian Catholics to make their own political choices, and supported cooperation between the Socialist and Communist parties.[8] The elections of 1948 in Italy brought great concern to the United States and Great Britain, who feared that the feverish communism would spread from the USSR and Eastern Bloc into Italy. In order to prevent a full transition into a communist Italy, the CIA allegedly worked to sway the elections against communism, supporting a rising Christian Democrats party that would continue to rule in Italy until 1992.

One of the major points that makes Italian communism unique in the international community is its survival after the fall of the Soviet Union. The PCI developed a unique brand of Communism from Soviet Communism, maintaining a much larger degree of internal differentiation in terms of structure, ideology, and behavior.[9] The elites and the mass population were brought together under the common ideals of Communism, and the existence of a party that encouraged this pluralism the way the PCI did enhanced the general stability of the Italian political system as a whole, thereby legitimizing the spread of Italian Communism. While the ideology of different communities and different people varied greatly, leading to conflict between regions and individuals, the PCI kept radical leftism in check and pushed for more left-leaning policy under the Christian Democrat rule.[10] Achille Occhetto, a prominent Italian Communist politician, was responsible for the major reforms that aimed to place a larger emphasis on individual liberties, environmental protection, and women’s rights. These changes led to the official dissolution of the PCI in 1991, permanently transforming Europe’s largest communist party (second only to the Soviet Union).[11] The party was officially renamed to the Partito Democratico della Sinistra (Democratic Party of the Left, or PDS), though this rebranding was merely that: a curtain over the still-existing communist ideology of the party in the face of the fall of the Eastern Bloc. Interestingly, many of the similar elements of Communism in Italy are seen in the conservative parties farther right. The prevalence of Communism enabled the Italian people to think of politics in terms of anti-institutional and anti-establishment sentiments. The rising populist party, Lega Nord (Northern League), draws on these same sentiments translated into conservatism and federalism.

Though the Christian Democrat party was the majority party for half a century, the PCI and communist ideology had a lasting impact on the social structure and functioning of Italy. The communist following in Italy developed a cultural dictatorship to compensate for their political losses, a facet of Italian culture that has remained heavily ingrained in present-day culture. PCI brought high culture, literacy, personal dignity and an enhanced sense of self to many Italians.[12] Tensions within and between the political parties that dominate Italian politics have created an uncertainty among the Italian people over whose cultural program to follow. For a country with an already deep divide between the regions, these competing ideologies and cultural elements have only strengthened the regionalism of the country. Different regions represent different political ideologies that produce rivalries between regions and disunity over the entire country, such as the rising populism of the Lega Nord in the northern regions and prevalent communism in the central and southern regions. With these tensions drawing most of the focus of the competing parties, little attention is paid to the real underlying problems that have been caused by the political infighting and erroneous wealth distribution. The regions of Tuscany, Emilia-Romagna, and Umbria in particular still show strong allegiance to the communist ideology, as the PCI had a stronghold in local and municipal government administration in these regions, establishing a “red belt” through the country.[13] The cities remain the same aesthetically as they did in the thirteenth and fourteenth centuries as a testament not only to the importance of beauty and history in Italian culture, but also to the stagnant growth and reluctance to spend money on public works. The cost of living is high while the salaries are low, and the youth unemployment rate of over 35%[14] is forcing most people under the age of thirty to move back in with their parents. When the PCI was dissolved, the provincial and local governments that had relied on Communist leadership in these key regions were left with gaps in their administration. The resulting political instability left the regions stuck in a 1980s time-loop, unable to resolve the poor living conditions and properly allocate resources. Communism in Italy underlies many of the problems with polarization and conflict at the government and regional levels, as well as the slow economic growth of the country as a whole. Interregional tensions and a Western aversion to Communism make it unlikely that the problems caused by this political instability will be resolved with definitive, comprehensive policy.


[1] “Italy Unemployment Rate 1983-2017.” Trading Economics. Accessed November 10, 2017.

[2] 2

[3]“Bureau of Labor Statistics Data.” U.S. Bureau of Labor Statistics. Accessed November 10, 2017.

[4] Doyle, Alison. “How Much Is the Average Salary for US Workers?” The Balance. October 24, 2017. Accessed November 10, 2017.

[5] Bosquet, Michel. “Aspects of Italian Communism.” The Socialist Register. 1964. 83.

[6] Carrillo, Elisa. “The Italian Catholic Church and Communism, 1943-1963”. The Catholic Historical Review, 77 (4), 644-657. 1991. 644.

[7] Carrillo, “The Italian Catholic Church and Communism, 1943-1963”, 650.

[8] Carrillo, “The Italian Catholic Church and Communism, 1943-1963”, 654.


[9] Tarrow, Sidney. “Political Dualism and Italian Communism”. The American Political Science Review, 61 (1), 39-53. 1967. 42.

[10] Tarrow, Sidney. “Political Dualism and Italian Communism”. The American Political Science Review, 61 (1), 39-53. 1967. 40 – 41.

[11] Eubank, William Lee, Gangopadahay, Arun, Weinberg, Leonard. “Italian Communism in Crisis”. Party Politics, 2 (1), 55-75. 1996. 55.

[12] Baranski, Zygmunt G. The Cambridge Companion to Modern Italian Culture. Cambridge: Cambridge University Press, 2001.

[13] Breschi, Danilo. “From Politics to Lifestyle and/or Anti-Politics: Political Culture and the Sense for the State in Post-Communist Italy.” Telos, 2013. 113 – 114.


The Flight of the Rohingya

Emma Donahue, Staff Writer

Behind the Name

The term “Rohingya” refers to a religious ethnic group which practices a form of Sunni Islam who have historically inhabited the Burmese (or Myanmar) state of Rakhine. Their name is controversial because it derives from “Rohang,” their word for “Arakan,” the former name for the Rakhine State, the region of Myanmar which holds the majority of its Muslim population. Since this title is essentially a claim to a portion of Myanmar’s land, the government and majority Buddhist population are extremely wary of its usage by a Muslim group who are not officially recognized as citizens.[1] Despite having their own language and cultural practices, these technicalities and years of conflict with their Buddhist neighbors have left the Rohingya as one of the largest stateless groups in the world.[2]

Tensions flared in 1982 when the Burmese government identified 135 ethnic groups who were entitled to citizenship, yet the Rohingya were not included on this list, despite having been granted equal rights as citizens in the country’s independence from Britain in 1948.[3] Following the implementation of this legislation, the Rohingya were almost immediately stripped of their previous rights. Persecution ensued over the next several decades, including the enforcement of a two-child law, the banning of interfaith marriage, and a lack of access to government-funded education and healthcare.[4] Violence emerged in 2012 after Muslim men allegedly raped and murdered a Buddhist woman, and over 100,000 Rohingya were displaced as a result of the assault. In response to the crisis, the Myanmar government offered to grant the group a reduced level of citizenship if they would register as Bengali rather than Rohingya, an offer not taken well by a group so connected to their identity and the suffering faced because of it.[5]


Continuing Violence

            In October of 2013, a group of Buddhist men carried out a series of attacks on Muslim villages throughout Rakhine. Three years later, an insurgent group formed within the state of Rakhine known as the Arakan Rohingya Salvation Army (ARSA). ARSA attacked a number of Myanmar’s security outposts as a response to the recent violence towards the Rohingya and the fallout from these offensives caused the military crackdown that has displaced hundreds of thousands of Muslims in the past few years.[6] Over the next four months, Myanmar’s army, known as the Tatmadaw, (which is unaffiliated with the civic government) was responsible for the alleged killing and gang rapes of countless Rohingya, who were forced from their homes with a scorched earth policy.[7] On August 25, 2017, ARSA attacked several police posts and an army base, spurring the most current influx of refugees into Bangladesh in light of the vicious counter attacks against the civilian population: rape, killing, brutal beatings, and more burning of villages.

According to Tom Malinowski, U.S. diplomat and former Assistant Secretary of Democracy, Human Rights, and Labor, the Burmese military made the mistake of responding to extremist group ARSA with force towards innocent civilian populations, thereby using a religious conflict between the majority and minority populations to preserve their political authority over the Myanmar Buddhists.[8]


Myanmar’s Response

            Historically, the Burmese have been wary of the Rohingya claim to an autonomous area of land, which would be taken out of Rakhine territory near the Bangladesh border. The military believes this desire for sovereignty would create a breeding ground for ARSA-like militant groups.[9] While the Rakhines are also an ethnic minority in Myanmar, they are a predominantly Buddhist people, placing them on the same side as staunch Buddhist nationalists who do not want their country overtaken by Muslims (despite the fact that the overall Muslim population is 4%).[10]

Some responses to these issues have included the proposition of joint military action between Bangladesh and Tatmadaw against ARSA, as well as Myanmar’s UN commision under former Secretary-General Kofi Annan to review the 1982 citizenship law and issue recommendations.[11] While Myanmar’s civic government leader, Aung San Suu Kyi, embraced these recommendations, ARSA unleashed further attacks following the release of the government report which caused another military crackdown and further revenge violence towards the Rohingya.

Suu Kyi has faced much criticism from the international community for her silence regarding the ongoing persecution and subsequent refugee crisis. At one point, the Myanmar government slowed humanitarian aid to Rakhine, leaving those remaining with scarce food and water.[12] This action was explained as being a necessary counter-insurgency precaution rather than a human rights crisis, and Suu Kyi has been avoiding public statements because her power hinges on not being overthrown by the military, which she has no governance over.[13] Her office leaked a phone call made early this September to the President of Turkey, during which she is recorded saying that misinformation about the crisis is being spread to promote the interests of terrorists in Rakhine. Soon afterwards, she cancelled her planned visit to the UN. Many have remarked on the fact that she is in a difficult situation politically, as the military is backed by the majority of the country, while others have called for the recall of her Nobel Peace Prize.[14]

Despite this, she recently made a statement calling for a relief plan for the Rohingya Muslims. She wishes to set up a civilian-led agency to give aid and resettle those displaced from their homes by the violence- a number now greater than 500,000, most of whom are currently residing in Bangladesh.[15] Some have arrived in recent days, which is inconsistent with the Tatmadaw claim that it halted actions against the Rohingya in early September. One of Suu Kyi’s advisor’s claimed that the leader is attempting to make her government more transparent to the international community by accepting foreign aid to help with the migrant crisis, and that her previous silence was due to her precarious situation with the military rather than a lack of acknowledgement.[16]


Refugee Situation

            Currently, about half of the refugee population is residing around the Bangladeshi city of Balukhali in tent cities, and the rate at which it has grown over the past several months has made this the quickest mass exodus since the Rwandan genocide in 1994.[17] They are living next to Kutupalong, another refugee camp home to the first wave of Rohingya who fled Rakhine in the 90s’. To say the Bangladesh government is overwhelmed would be an understatement; only a fifth of the newest arrivals have access to food rations (which consist of rice and biscuits), and aid agencies say water sources could run out in a few months. Furthermore, only 100,000 of about 288,000 children have access to any sort of education.

Both local and international organizations have been helping the government with humanitarian aid: the World Food Program and UN agencies set up relief centers in the camps, and local Bangladeshi groups have filled trucks with food and clothing and distributed the aid.[18] The government itself has set aside 2,000 acres in Balukhali for their military to set up a more organized camp, but construction has barely begun and it has been reported that the land is nearly uninhabitable. Refugees also need biometric forms of identification in order to receive aid distribution, and the process of creating these IDs could take up to half a year.

The level of poverty and disease within these camps are unthinkable. Besides the shortage of food and water, there is an absence of latrines or any form of sewage, so the ground is covered with waste and human feces. To prevent the spread of disease and further chaos, the government imposed travel restrictions on the Rohingya so that they are not permitted past a certain checkpoint; essentially, they are trapped in these camps and largely unable to return to Rakhine. Many claim to have seen landmines being installed along the border to prevent their return, and others are certain they would not be permitted re-entry as they are not identified as citizens.[19]


Possible Resolutions

            A local government aid coordinator for Bangladesh recently stated that the refugees only have a temporary home in their country, and that while they will feed and aid the refugees for as long as they can, it is not a permanent home.[20] Suu Kyi’s recent unveiling of her plan for the repatriation of the Rohingya refugees is a step in the right direction, assuming she can keep the military at bay and protect her own authority in the process. However, a long term, comprehensive strategy needs to be determined regarding Myanmar’s treatment of their Muslim population, along with more thorough investigations into the soldiers’ behavior towards civilians to prevent the same tragedies from repeating themselves in the future.



[1]  Megan Specia, “The Rohingya in Myanmar: How Years of Strife Grew Into a Crisis,” The New York Times,  September 13, 2017,

[2] Ibid.

[3]Krishnadev Calamur, “The Misunderstood Roots of Burma’s Rohingya Crisis,” The Atlantic, September 25, 2017,

[4]Megan Specia, “The Rohingya in Myanmar: How Years of Strife Grew Into a Crisis,” The New York Times,  September 13, 2017,

[5]Krishnadev Calamur, “The Misunderstood Roots of Burma’s Rohingya Crisis,” The Atlantic, September 25, 2017,

[6] Megan Specia, “The Rohingya in Myanmar: How Years of Strife Grew Into a Crisis,” The New York Times,  September 13, 2017,

[7] Ibid.

[8]Krishnadev Calamur, “The Misunderstood Roots of Burma’s Rohingya Crisis,” The Atlantic, September 25, 2017,

[9] Ibid.

[10] Ibid.

[11] Ibid.

[12]Megan Specia, “The Rohingya in Myanmar: How Years of Strife Grew Into a Crisis,” The New York Times,  September 13, 2017,

[13] Ibid.

[14] Ibid.

[15]Patrick Wintour, “Aung San Suu Kyi unveils relief plans for Rohingya Muslims,” The Guardian, October 13, 2017,

[16] Ibid.

[17]Max Bearak, “One month on, a bleak new reality emerges for 436,000 Rohingya refugees,” The Washington Post, September 25, 2017,

[18] Ibid.

[19] Bearak, The Washington Post

[20] Ibid.

“Cool Japan” and the Sources, Extent, and Implications of Japanese Soft Power in the United States

Thomas Bell, Staff Writer

From our Print Edition, 2017-2018

  Throughout most of history, international relations have been largely defined by hard power.  Hard power is an element of national strength, centered around the basic functions of the nation-state: military force and economic action.¹ This historical reality is logical, given the limitations on communication and transnational exposure for much of the pre-20th century world, with hard power oftentimes being the only way to interact between states.  In the diplomatic arena before instantaneous communication, it would be difficult to exert national will in any other way, with the target country often seemingly distant and mysterious. Contrarily, soft power  is a relatively modern phenomenon, especially since the end of the Second World War. It also centers around achieving national objectives, but is more concerned with using cultural and societal means to persuade other nations to share their goals.²  This requires a high level of interconnectedness between civilizations to allow for cultures and ideas to be traded and to have an effect. Such a high level of cultural exchange was impossible before the advent of modern technology and global connectedness.

  This is not to say that all countries have been able to maximize this new element of international relations.  The culture of Kyrgyzstan, for example, is relatively unknown in the United States. That country’s morals, goals, and societal structures are difficult to understand for most non-Kyrgyz, and thus, their soft power is largely nonexistent on an international scale.  One of the countries, however, that has best adapted to this new element of the global arena is Japan.

  The reasons for Japanese dominance of soft power are arguably not by choice.  The Japanese have been largely forced down this road, and the reasons why are best exemplified in the current Japanese constitution, adopted after World War II.  Article 9 of that document states that “the Japanese people forever renounce war as a sovereign right of the nation,” as well as “the threat or use of force.” It further decrees that “land, sea, and air forces, as well as other war potential, will never be maintained.”³ Though Japan maintains a “self-defense force,”⁴  its ability to project itself internationally is virtually nonexistent. This means that even economic hard power is curtailed, as the implicit threat of force is not present. As we have seen since 1945, it can be difficult for a nation to adequately wield hard power when its ability to use force is effectively eliminated.  

  Adapting to this new reality has been a tremendously successful endeavor for the Japanese.  Now unable to conquer nations with its once formidable military, it has had to rely on cultural domination.  The government has emphasized the idea of “Cool Japan,”⁵ in order to improve the economy and national image. Japanese society has seen itself stretch far beyond its borders, a remarkable development for a nation known for its historical isolation.  A new era of international affairs was born, and the Japanese soon found themselves exporting their culture at an absolutely unprecedented rate.

  In the United States, this has manifested itself in a number of important ways.  As an example, Japanese food has become immensely popular; or at the very least, Japanese-inspired food.  Ever since the California roll was invented in Los Angeles in the early 1970s,⁶ Americanized sushi has become a modern staple of the United States, spreading further to other countries.  Japanese food is available in most American supermarkets, and it is estimated that there are approximately 9,000 Japanese restaurants operating in the country today.⁷

  Japanese popular culture is also a critical player in the American psyche.  Media franchises such as Super Mario, Hello Kitty, Godzilla, and Final Fantasy sell a multitude of products in the United States, from video games and movies to lunchboxes and t-shirts.  Japanese manga and anime, though a relatively niche category, have become increasingly popular in the United States, with series such as Dragon Ball, Naruto, and Pokémon achieving high levels of success.  There is a level of acknowledgment of Japanese influence, and it has embedded itself in the fabric of modern American popular culture, especially among younger generations. It is the actualization of “Cool Japan.”⁸

  The impact of Japan transcends even obvious exemplars of culture, as a sampling of the largest Japanese corporations reveals dozens of household names⁹.  Americans drive cars made by Toyota, Honda, and Nissan, fixed with Bridgestone tires. They use Canon and Nikon cameras, and buy electronics from Panasonic, Toshiba, and Sharp.  Their pianos come from Yamaha, and their video games from Nintendo, Sony, and Sega. The products of Japanese corporations fill American households and workplaces, bringing a level of cultural intimacy that the soldiers on either side of the War in the Pacific could never have imagined in 1943. Ultimately, this is the point of soft power.  To imagine that a country like Japan could flip the script, from mortal enemy to supplier of cars and televisions, from militaristic empire to pop-culture hegemony, points to the influence and importance of Japanese soft power. In a 2015 Chicago Council Survey, 88% of Americans recognized that bilateral relations with Japan were either very important or somewhat important.¹⁰ As opposed to the sharp edge of military force or economic action, Japan has made its former enemy into its now-biggest supporter, while staying mostly constrained to the realm of non-forceful action.

  The extent of Japan’s soft power has even become so influential that it permeates the international community.  This was apparent in a brief video played during the closing ceremony of the 2016 Rio Games, touting the upcoming 2020 Summer Olympics in Tokyo.  Amidst a flurry of sporting events and scenic shots of Tokyo prefecture, cultural figures such as manga character Captain Tsubasa, a cheerleading Hello Kitty, and a racing Pac-Man featured prominently,¹¹ tying the most famous elements of Japan’s popular culture to the capital city itself.  Most telling, however, was a scene when the Japanese Prime Minister, Shinzō Abe, was digitally transformed into Mario, before emerging in Rio de Janeiro, red cap and all. This scene represented not only a metaphorical, but a physical connection between Japanese culture and the government. It best demonstrated the desire to use Japan’s wide portfolio of cultural assets, such as the internationally known Mario, for the benefit of the Japanese nation itself and its image.  The implicit message was that to love Japanese culture is to love Japan, as embodied by the Prime Minister.

  However, this message has not worked with everyone.  This is most true in Japan’s own neighborhood, where 67% of South Koreans believe that Japan’s influence is negative, and 74% of Chinese say the same.¹²  Though the easy answer is to say that the legacy of the Second World War is to blame, ultimately nations like the United States, United Kingdom, Australia, and Indonesia fought long wars against the Japanese, and suffered under them, only to now have a positive outlook on the country.  Could the greater extent of devastation in China and South Korea explain the reluctance to support Japan, or does soft power simply have its limits? It is likely that the real reasons lie in the pages of history, where centuries of rivalry and conflict have poisoned the status of East Asian relations.  It can thus be argued that soft power, though effective in improving bilateral relations, is perhaps incapable of reversing centuries of tension. Soft power works as a deterrent and a healer of international wounds, but cannot heal the deep gashes of history – at least, not without more time.

  Ultimately, Japan’s ability to project and improve its national image through its soft power has opened up an entirely new element of international affairs, and a different way of measuring the dominance of states.  Writer Douglas McGray, in a famous essay, described Japan’s ability to manipulate its soft power as its “gross national cool.”¹³ Though obviously not a quantifiable statistic like gross national product or the human development index, this new term represents a variation in what it means to be a great power in the post-World War II era.  For Japan, this has meant a rise in soft power and in its ability to shape its own national image and the international perception of that image. Americans born in the years since World War II have been raised in a society where it is common to travel to the store in a Japanese car, buy Japanese inspired food and a Japanese television set, and use that set to watch Japanese cartoons and movies.  The two cultures have grown increasingly interconnected, and this has proven to be beneficial for both countries – Japan in particular. A nation once looking to heal itself and redefine its national identity after the most devastating war in human history, it has proven capable of using its soft power to not only survive in the post-war community, but to thrive as one of the world’s true great powers.


1) Nye, Joseph S. “Propaganda Isn’t the Way: Soft Power.” Last modified             January 10, 2003.     power.

2) Nye, Joseph S. “Propaganda Isn’t the Way: Soft Power.” Last modified             January 10, 2003.     power.

3) The Constitution of Japan. Tokyo, Japan: Japanese Government, 1946.

4) Pike, John. “Japan – Introduction.” Global Security. Last modified February 27, 2016.

5) Iwabuchi, Koichi. “Pop-culture diplomacy in Japan: soft power, nation branding and the    question of ‘international cultural exchange’.” Taylor and Francis Online. Last modified June 23, 2015.

6) Renton, Alex. “How sushi ate the world.” The Guardian. Last modified February 26, 2006.

7) Lee, Jee Hye, Johye Hwang, and Azlin Mustapha. “Popular Ethnic Foods in the United States:     A Historical and Safety Perspective.” Wiley Online Library. Last modified December           17, 2013.

8) Iwabuchi, Koichi. “Pop-culture diplomacy in Japan: soft power, nation branding and the    question of ‘international cultural exchange’.” Taylor and Francis Online. Last modified June 23, 2015.

9) EW Content Team. “Forbes Global 2000: Japan’s Largest Companies.” Economy Watch. Last       modified July 3, 2013.

10) Friedhoff, Karl, and Dina Smeltz. “Strong Alliances, Divided Publics: Public Opinion in the    United States, Japan, South Korea, and China.” The Chicago Council on Global           Affairs. Last modified October 19, 2015.            opinion-united-states-japan-south-korea-and.

11) Easton, Yukari. “Tokyo 2020 and Japan’s Soft Power.” The Diplomat. Last modified August    31, 2016.

12) BBC World Service, ed. “Views of China and India Slide While UK’s Ratings Climb: Global     Poll.” BBC. Last modified May 22, 2013.


13) McGray, Douglas. “Japan’s Gross National Cool.” Foreign Policy. Last modified November          11, 2009.

Mexican Presidential Elections 2018

Thomas Bell, Staff Writer

In 1990, Peruvian writer and Nobel Prize winner Mario Vargas Llosa famously said that “México es una dictadura perfecta”, or “Mexico is a perfect dictatorship”.  The relevance of his statement is not immediately apparent.  The country, after all, has had elections since the implementation of the current Constitution in 1917.  However, those elections have not proven to be democratic.  In 1929 the Institutional Revolutionary Party, or PRI for the Spanish acronym, won the presidential elections as the Revolutionary National Party.  Their victory claimed over 93% of the vote.  Starting with another PRI win in 1934, there were federal elections to select the new President of the Republic every six years.  With regular elections and a constant flow of new presidents, as the incumbent could not (and still cannot) run for reelection, Mexico possessed the appearance of an efficient democracy.  But the political history of the country, leading up to the present day, reveals the characteristics of dictatorship and corruption that Mario Vargas Llosa referenced in 1990.

The success of the Institutional Revolutionary Party in 1929 would turn out to be long-lasting.  In every presidential election between 1929 and 1994, PRI won, and oftentimes in unanimous landslides.  Before 1988, all PRI candidates won with more than 70 percent of the vote.  This was because opposition forces did not have the same opportunities to participate, with PRI dominating the government, news infrastructure, and the economy.  In fact, former President Miguel de la Madrid said in 2009 that PRI lost the presidential election in 1988, and committed massive electoral fraud to fake the victory.  In 2000, though, hope finally seemed to be on the horizon.  The National Action Party, or PAN, won the presidential election, and there was tremendous optimism that the country would change.  But after twelve years, conditions in Mexico had not improved, and the current President, Enrique Peña Nieto, won as a PRI candidate in 2012.

After years of governmental corruption and vast instability, a new party of the left, Morena, has the chance to contend for the presidency.  The elections this year could fundamentally change the country, and Morena could be a powerful new force for the political history of the nation.  Morena is a new party, unlike its competition.  It was founded in 2012 by Andrés Manuel López Obrador, or AMLO as he is called.  AMLO is a popular politician in Mexico, and was the head of the Government of the Federal District (Mexico City) from 2000 to 2005.  In 2006 and 2012, AMLO was a candidate in the presidential elections with the Party of the Democratic Revolution (PRD), a leftist group.  But with Morena, AMLO is seeking to introduce a new movement to Mexican politics, separate from the old parties.  He is a populist, and his rhetoric is often anti-establishment.  Additionally, AMLO has voiced strong criticism of the American President, Donald Trump.  Enrique Peña Nieto has not had the same vigor in his opinions on Trump.  Ironically enough, the fiery rhetoric of the U.S. President can help AMLO, as many Mexicans experience a surge in nationalism against what they perceive as a threat to their society and culture.  Regardless of left vs. right wing, Morena offers a new approach to politics and governance.  With the legacy of corruption in PRI and PAN, a substantive change is necessary for the development of Mexican democracy.

But a simple argument against corruption will not be enough.  The party’s liberalism would represent a change from the policies of PRI and PAN.  PRI is a centrist party, but uses nationalism and a level of corruption to govern.  PAN is a conservative party, but they failed to change the basic structure of the country in their twelve years in power.  Morena’s platform offers a departure in ideology, which could prove popular.  For example, they want to improve access to basic public services.  Mexico’s healthcare system is universal, but the quality of care is well below that of the United States and Europe.  There are not many public hospitals, with the majority being reserved for people with private access.  In a country where there is a tremendous amount of poverty, it is necessary to improve access to medical care.  The party also wants free access to education and improved academic standards and quality.  Especially in southern Mexico, the education infrastructure is weak, with only about 45% of students completing high school.  Additionally, only 25% of students go on to complete their studies at a university.  With a sluggish national economy, the country needs more young people with an education to compete in the global economy.  Morena also wants access to the Internet for the entire population as a right of citizenship.  This would again be a sign of modernization and could contribute to Mexico’s economic competitiveness.

But none of these proposals matter if Morena cannot win.  This is the problem that other parties have had throughout Mexico’s long political history.  They could very well have the support of the people, but corruption could lead to electoral fraud.  During the era of PRI domination, the incumbent president selected the candidate of the party, leading to elections that were largely a formality.  This process was called “el dedazo”, which has no direct translation in English but essentially refers to the unilateral selection of the next leader by the incumbent.  With the current President being a member of PRI, there is a level of concern that history could repeat itself.

However, the polls suggest an opportunity for Morena and AMLO.    Enrique Peña Nieto is the most unpopular President in recent history, with an approval rate of 6%.  In an October survey by El Universal, a Mexican new agency, Morena had 24.0% support in the upcoming election.  This polled higher than PAN’s 14.3% and PRI’s 13.9%, the two parties that could realistically pose a threat to Morena.  The creation of alliances, though, can lead to different results, something which has been done a number of times in the past.  Therein lies the danger to Morena and AMLO.  Morena has at this point formed an alliance with the Labor Party (PT), a group that supports socialism and anti-imperialism.  But PT is not a very large party, with no members in the legislature or serving as governor of a state.  AMLO was the PRD’s candidate, but they have formed an alliance with PAN, a right-wing party, and the Citizen’s Movement (MC), a left-wing party.  This alliance is not politically consistent with two parties on the left and a large conservative party.  In what likely amounts to a simply vote-grabbing ploy, the substantially sized PAN and medium-sized PRD combined could defeat Morena and PT.  Besides these two, however, it is crucial to remember that PRI is the dominant party of government.  They will likely create an alliance with the medium-sized Green Ecologist Party of Mexico (PVEM), and two small groups in the New Alliance (PANAL) and Social Encounter Party (PES).  With a new standard-bearer in José Antonio Meade, PRI can be competitive in 2018.  It should be noted that PES is actively considering abandoning its alliance with PRI and joining with Morena, although this likely will not impact the polls in any substantial way.  El Financiero, a Mexican newspaper, published a survey of support for the alliances in November, and the results were closer than a grouping of the individual parties.  Morena-PT had 24% support, PRI-PVEM-PANAL-PES had 22%, and PAN-PRD-MC had 18%.  With 21% who said “none” and 15% who said “I don’t know”, any of the alliances could win in 2018.  But if Morena can detail the corruption and incompetence of PRI and PAN, especially relating to their time governing the country, they could earn the support of the Mexican people.

The political history of Mexico is a long saga of corruption and fraud.  When PAN won in 2000, undoing a decades-long regime, the change that many Mexicans expected did not take place.  Now, Morena and its leader have an opportunity to present a new legacy for Mexico.  With the nationalism and corruption of PRI and PAN, the country has not taken its place as a great power in the international community.  In a new regime, with more access to education, healthcare, and the Internet, Mexicans could develop the economy, the political system, and society that they have craved since 1929.  And, after nearly a century of waiting, the long-lasting “perfect dictatorship” could finally come to an end.

The Transition of Sri Lanka

 Leah Field, Staff Writer 

The South Asian island nation of Sri Lanka is currently in the midst of a difficult transition following the end of a decades-long civil war. The legacy of the Sri Lankan Civil War, which officially came to an end in May 2009, continues to cast a shadow on the country’s future. More than 100,000 civilians were killed over the course of twenty-five years in the violent conflict between the Sri Lankan government and minority Tamil militant groups. The outbreak of war was a culmination of longstanding ethnic tensions in the region. The majority of Sri Lankans, about seventy-five percent, are ethnically Sinhalese. However, Tamils make up a significant minority—between 10 and 15 percent of the population are Tamils. Sinhalese and Tamil Sri Lankans have their own cultures, languages, and traditions. The island is heavily segregated between the two groups, with the majority of Tamils living in areas in the north and east of the island. Religion is another key contention between the two groups, as Sinhalese Sri Lankans are Buddhist while Tamil Sri Lankans are predominantly Hindu. The Liberation Tigers of Tamil Eelam, colloquially known as the Tamil Tigers, emerged as the most prominent Tamil militant group in the country in the 1970s, and war officially broke out when clashes between the Tamil Tigers and government forces erupted in 1983.

What followed was a bloody and violent civil war with mass human rights violations committed by both sides. The Sri Lankan government regularly committed massacres of Tamil civilians—committing torture and causing disappearances of their enemies. Likewise, the Tamil Tigers tortured, used child soldiers, and committed massacres against Sinhalese civilians. The war came to an end with the adoption of a ceasefire in 2009, but the aftermath consists of heightened ethnic tensions, violence, and discrimination.

In October 2015, the U.N. Human Rights Council passed a resolution calling for the pursuit of truth, justice, and reconciliation in Sri Lanka. Yet, more than two years after the resolution’s passing, the government of Sri Lanka has taken no substantial action to remedy the nation’s ongoing crisis. On the contrary, many recent government policies have only exacerbated tensions and violence. Thousands of internally displaced Tamil Sri Lankans receive no aid from the government, which has instead implemented a policy of moving Sinhalese citizens into formerly Tamil areas. Tamil regions remain largely militarized, and any protests are met with quick and brutal repression by police. One of the government policies most strongly condemned by the international community and human rights groups is the oppressive Prevention of Terrorism Act. Passed in the 1970s to allow the government to indiscriminately detain and torture Tamil Tiger members or their suspected supporters, the Prevention of Terrorism Act is still in effect today. The act is used today to detain people without due process for years at a time, and under the act, torture and sexual abuse are rampant. Political opponents and peace activists are common targets of the PTA, which is disproportionately used against Tamils. These policies only scratch the surface of the continuous injustices in Sri Lanka.

In 2016, a Consultation Task Force was appointed by then prime minister Ranil Wickremasinghe with the purpose of making recommendations on how Sri Lanka should advance justice and reconciliation. In 2017, the CTF released a detailed report that extrapolated upon the policies recommended by the 2015 UN resolution. Like the resolution, the Sri Lankan government has refused to consider any of the CTF’s suggestions. However, in spite of the government’s obstinacy, the recommended mechanisms are crucial if Sri Lanka ever hopes to move past the violence and tension of its civil war.

One of the most important recommendations made by the CTF report is that of a truth commission. A truth commission, one that can formally hold perpetrators accountable and bring closure to mourning families, is an essential step towards justice and reconciliation in Sri Lanka. In recent decades, truth commissions have been used across the world as a method of moving past conflict and into the future. Most famously, the South African Truth and Reconciliation Commission implemented a combination of investigations, witness testimonies, and trials to cope with the country’s violent apartheid past. Truth commissions are certainly not perfect, and they cannot solve all of a country’s problems on their own. However, a truth commission is sorely needed in Sri Lanka as a first step in a transition toward democracy and peace.

In the case of Sri Lanka, an effective truth commission is perhaps even more necessary because of the nature of the country’s past conflict and civil war. Unlike in other truth commissions, such as in the South African TRC, a Sri Lankan truth commission will have to investigate and hold accountable human rights abuses perpetrated by both opposing sides of the war. The sensitivity of this endeavor is enormous, and the concept makes Sri Lankans on both sides fearful and angry. However, the alternative to accepting the civil war’s reality is much grimmer. Already the Sri Lankan government has begun to rewrite history in their favor. The government’s official stance is the denial of any human rights abuses perpetrated by their forces during the war, and they additionally continue to ignore hundreds of forced disappearances that affect families to this day. Perhaps the most obvious subversion of history by the Sri Lankan government was in the form of the Lessons Learnt and Reconciliation Commission (LLRC) carried out by the government in 2010. Nominally, the LLRC was a truth commission intended to investigate and corroborate the human rights violations that took place during the civil war. In reality, the LLRC did no such thing. Both human rights groups and the international community have lambasted the LLRC as inaccurate, hopelessly biased, and destructive towards peace- a political tool used by the Sri Lankan government to exonerate themselves of all crimes while allowing them to claim that they pursued accountability.

False attempts to remedy the past such as the LLRC only inflame tensions in the country and emphasize the need for an accurate and sincere truth commission in Sri Lanka. While this goal is seemingly far away, it is still possible. This past fall, the Sri Lankan government caved to international pressure and established an Office of Missing Persons in order to investigate unresolved cases of forced disappearances. While many accuse this action of being merely another instance of “cosmetic maneuvering” for the sake of international actors, it nevertheless proves a point: with the combination of continued international pressure and the persistent internal outcry for justice, the implementation of a truth commission and other transitional justice mechanisms is possible in Sri Lanka. 

Controversial Australian Welfare Plan Sparks Criticism

Derek Brody, Staff Writer

  In an age of large welfare states and massive government entitlement programs, some countries are taking steps to increase accountability in the distribution of these benefits. Late last summer, the Australian government announced plans to randomly drug test welfare recipients in an effort to do just this, but this has been met with immediate pushback from those on the center-left who claim the program simply reinforces existing social and political power gaps. This has been a common proposal across the world from those who claim to have conservative political ideologies, supported by unfounded claims that these welfare recipients use their vouchers to purchase illicit substances. Minister for Social Services Christian Porter released a statement detailing the rationale behind the program, saying, “The aim of the policy is to help job seekers to receive the help they need to get on a path towards securing a job and building a better future for themselves and their families.”

The program, which took effect in January of this year, will begin by randomly selecting 5,000 people who receive welfare payments from the federal government. The government will perform urine, saliva, or hair tests on the randomly selected pool to search for traces of meth, ecstasy, heroin, or marijuana. If a recipient tests positive for one of the substances, the Australian government will convert 80% of their welfare payment to a “BasicsCard,” which is only eligible to be used for food, rent, or childcare. A second positive test will automatically trigger a medical visit and addiction counseling program for the recipient. If the recipient fails to engage in treatment at this point, their welfare payments could be stopped. This effort is being undertaken to reduce government social welfare spending, as well as a motivating factor to encourage low-income residents to re-enter the workforce.

  After a two-year trial period, the program will be reevaluated by the federal government for effectiveness and cost-efficiency. As a part of the pilot program agreement, the government will only implement this procedure in three locations: Canterbury-Bankstown, Logan, and Mandurah. These areas were selected based on their relatively high levels of unemployment and drug use. Approximately 12,000 residents of Canterbury-Bankstown are currently receiving welfare payments, and the new program plans to test about 1,750 of them by next February.

  Liberal Senator Eric Abetz utilized age-old rhetoric regarding welfare reform and fiscal responsibility in an attempt to promote the plan. Abetz touted the plan, saying, “I think most Australians are aware of some, not all, some welfare recipients that actually sadly use the welfare system as a hammock, as opposed to a safety net, and as a good, competent government looking after the welfare of those individuals as well as the taxpayers, it makes good sense that you look at policy options to encourage people into work, into self-reliance and relieve the burden on their fellow Australians.”

Randomly drug testing welfare recipients has not been widely adopted across the globe, but there are several examples of other governmental agencies carrying out similar programs. New Zealand implemented a similar program in 2015 with startling results. Armed with a $1 million budget, the country drug tested 8,000 welfare recipients. Only 22 tested positive, indicating the flawed logic behind the program itself. Likewise, the state of Florida also randomly drug tested their welfare recipients, and only 2.6 percent tested positive for any of the four substances. Recent estimates in the United States have found that about one in five welfare recipients had used illicit drugs in the past year, which makes drug use 50% more common in welfare households than the general population. The study went on to find, however, that less than 5% of welfare recipients met the diagnostic criteria for having a substance abuse problem, further providing evidence to refute many of the claims made by the Australian government.

  The Australian Green party, which holds 1 of the 150 seats in the House of Representatives and nine of the 76 seats in the Senate, came out in fierce opposition to the proposal. The Green Party is a left-leaning organization whose largest commitment is to environmental rights and protections. A release from the party stated, “the legislation completely ignores the advice and evidence from both medical professionals and social security experts. The Australian Greens are deeply concerned by the government’s repeated rejection of the expertise and evidence given by stakeholders in their continued pursuit of harsh cuts to income support.”

  The Green Party went on to criticize the cost of the program, pointing to several similar attempts in the United States. A program in four American states over an 18-month period tested over 200,000 individuals at a cost of over $1 million. These tests went on to disqualify 847 recipients, equaling a cost of over $1,100 per disqualified individual. At this cost per disqualification, it is clear that programs similar to this are a poor use of public funds.

  Likewise, the response by several Australian medical groups have clarified the negative consequences of this program. Australian Medical Association (AMA) President Michael Gannon released a statement voicing his displeasure, noting that, “The populist idea is that there are armies of drug-addled people bludging off the welfare system. But the reality is, we’re talking about some of the most vulnerable people in the community who need a hand up. These proposed measured will only serve to marginalize and stigmatize an already-impoverished group.” The negative response from medical professionals, policymakers, and private industry indicate the potentially negative ramifications of this program’s implementation.

  Human Services Minister Alan Tudge responded to the criticism of the program in early August, noting that, “This is a trial in every sense of the word, where we want to try something new, evaluate it, and if it works then we might roll it out further. If it does not work then we adjust. That is how you do a trial. By the way, all medical advances are done on this basis, of trial and error. And if it is good for health policy, why isn’t it good for social policy to do it this way?” Mr. Tudge’s analogy, however, fails on numerous accounts. Clinical trials in the health field are traditionally carried out systematically and with the consent of patients, while this trial period will occur with little input from the public. Likewise, medical clinical trials are subject to strict oversight from grant funding programs, while a similar system of responsibility has not been established in this program.

  The program has also received pushback from those in private industry, including a damning statement from Jobs Australia CEO David Thompson. In a statement from this August, Thompson noted that some may stop asking for welfare assistance altogether, “Simply because they feel that the whole process is really quite demeaning and humiliating.” He went on to state that many would turn to other measures to receive the financial backing they so desperately need. He noted that some may turn to charities for this assistance, while others may resort to crime or prostitution. Fiona McLeod, the president of the Law Council of Australia, reacted similarly to the news. She went on record saying, “What we don’t see here is evidence that this will be beneficial, and we don’t see a benefit that outweighs the imposition or the punitive effect on a certain group of people. It interferes with people’s liberty and it certainly interferes with our responsibility to protect those in our community who are not so well off.”

  The round of criticism led to a response from Liberal backbencher Ben Morton, who advocated for the passage of this program. “I can’t believe there are organizations that are closing their mind to something that could work,” Mr. Morton said. “I think some of the policy officers in some of these peak bodies need to stop focusing on ideology.”

  The program also includes a secondary provision, which introduces major changes to the compliance regime for welfare recipient jobseekers. By utilizing a demerit point-style system, the government claims it will save over $200 million. It also eliminates several pension payments programs, including those for individuals who are unable to lodge a full claim or those receiving bereavement allowance. This is done as a means of reducing government spending and cutting down on social welfare programs, a conservative ideological goal.

As the government readies itself to implement the program by the beginning of next year, it must continue to respond to the harsh criticism levied from all sides. Critics have raised several questions regarding the effectiveness, cost-efficiency, and morality of the program, and the Australian polity now has 24 months to answer those queries. Regardless, it will provide important and powerful context to worldwide drug policy in the future. After careful consideration of the responses of other policymakers and health experts, as well as the results of similar programs in the United States and New Zealand, it is increasingly clear that this program’s implementation is an assault on members of Australia’s lower class. Rather creating an honest system to increase accountability in the process of welfare distribution, Australia’s polity is instead attempting to widen the existing class divide and further punish those at the lowest rungs of its socio-economic ladder.