img_7441

Literature and Mental Health

I’ve always worked here and there: Saturday pharmacy assistant, casual hours waitressing and six months with a Debenhams concession in the back end of nowhere during my gap year. But not a ‘proper’ job, you know, one that alerts Student Finance England that you now need to pay back a hefty wedge of your monthly earnings that are deposited directly into your bank account, post-tax, pre-tips.

So, on top of a fractured clavicle and trying to finish my Masters dissertation writing up the research I carried out in Bangladesh earlier this year, starting work hasn’t been entirely straightforward. Aside from scrambling for press skills in a new context and familiarising myself with the positioning of the organisation I work for, the loss of a daily reading list (be that for a degree course or a personal long-list) has been quite a shock.

Of course, work hasn’t forbidden personal reading, but seems instead to have subsumed all energy and appetite for it. Slowly, I’ve been easing myself back in with some favourite fiction pieces, but it still feels a bit too soon to get my teeth back into the global health journals and the progressive currency of development-focused material that used to shape the thinking behind this blog.

Looking sideways has also helped. A friend who generously reads these pages recommended The University of Warwick’s ‘Literature and Mental Health’ e-learning programme which started earlier this week. I’ve signed up to virtual courses before, but never fully committed, instead cherry-picking choice reads and passively spying on user forums (not sure how this reflects on me, if at all!). This time, I’m going to do it properly. Engage with the material in its diversity and without a motive to ‘get’ anything from it, other than just to start enjoying hearing the voices of people working and writing in this area again.

I’m going to devote the next few posts to how I’ve found the course: looking at content that has appealed or warrants sharing with a wider audience, and to field your views also. If you want to get involved, sign-up to the free course here. I’d love to hear how you find it.

14191525_10154470927629730_1133711698_o

Travel Photographer of the Year

I’ve been twice before. Once to stand on the line representing the Prime Meridian for a school trip with the Brownie group (all the fun), and again last year to see a late night show at the Royal Maritime Museum. To the Royal Borough of Greenwich, that is. This long Bank Holiday weekend seemed the perfect chance to pose as tourists, sleeping in a local AirBnB spot, vintage shopping in the twilight market and heading to the University which is playing host to the Travel Photographer of the Year exhibition (TPOTY).

14137692_10154470928559730_71048357_n

14138388_10154470928199730_162571644_n

It’s the first year that I’ve made it to the show, and it didn’t disappoint with prize titles for both young and adult entries, amateurs and semi-professionals with submissions under portfolio categories titles including: ‘Faces, People, Encounters’; ‘Nature & Environment’; and ‘Monochromal’. TPOTY describes itself as a competition run by photographers, for photographers, with submissions from every continent (over 114 countries are represented), often seeking to highlight points and peoples under cultural or environmental threat.

Upon entry, there is a map that invites visitors to pin where they’d most like to visit in the world, whetting the appetite for an artistic gallop from tanneries in the suburbs of Dhaka to flyover rainbows in Tokyo:

14159868_10154470927289730_2046964138_n The Young Travel Photographer of the Year was the entrant who the judges felt submitted the best entry on the theme ‘Travels Through my lens’. 18-year old Chas Guttman from the USA claimed this title, already a two-time winner of this category, minor Instagram celebrity and recognised travel photographer. His series of images are taken in the frost-laden foothills of the remote nation of Lesotho, where the Basotho people wear traditional tribal blankets for village ceremonies and familial milestones, where shepherds converge on the jagged basalt cliffs of Maletsunyane Falls as the sun begins to rise, and where Basuto ponies are  pictured as crucial to the survival of local Sotho tribes. 14159684_10154470926979730_1689795357_n

14139063_10154470926794730_652693803_o

Meanwhile, Marsel van Oosten won the overall title for best submissions across the three portfolio categories. Van Oosten is a professional nature photographer from the Netherlands. His images are best known for his graphic approach to composition, the direct result of his previous career as an art director in advertising. In his work he tries to simplify, to get rid of the extraneous. For him, simplicity is the ultimate sophistication.

His images are featured in galleries and museums, and he is a regular contributor for National Geographic Magazine and together with his wife Danielle he runs Squiver, a company that organizes specialized wildlife and landscape photography tours and workshops for small groups of all experience levels to spectacular locations worldwide. His winning series features Danielle canoeing through the eerie cypress swamps of the Atchafalaya Basin on a trip they took through North America, with a self-referential quality often featuring her with poised camera.

14137756_10154470925989730_89943857_n

The exhibition leads you around the continents, guided by sign-posts that also detail distances to key landmarks around the globe. 14191300_10154470927009730_2097421218_o

14139252_10154470921394730_762069430_o

The monochromal portfolio category was my personal favourite, with the winning submission from Xia Xuejun beautifully rising to the challenge of creating good composition through light, tone, and shadow without the natural impact of colour. 14138386_10154470926474730_719941436_n

14123445_10154470926124730_1774418240_o

Running until 4 September, this is just one more reason to make a trip down to Greenwich, covering inspiring ground that might just prompt enough to submit for this year’s TPOTY competition. Who knows where it might take you.14138450_10154470927784730_2076612661_n

14159738_10154470928329730_814706357_n

 

Image Credit (all): A.Bow-Bertrand

Kala-Azar-081916-News[1]

Kala Azar: The Overlooked Killer

The title of this article was awarded an Honourable Mention via Global Health NOW’s ‘Untold Stories in Global Health’ competition. It is also available on their blog, here.

It is unsurprising that neglected tropical diseases get the fewest column inches and remain unknown to vast swathes of the general population. But if you were asked what the largest parasitic killer was, after malaria, would you correctly answer Kala-Azar?

Also going by the names of Leishmaniasis and black fever, this isn’t a disease of the European or Northern Hemisphere masses, despite long causing significant fatality figures and appearing on many NGOs agendas—including Médecins Sans Frontières (MSF), which reports treating more than 100,000 people with the disease since 1988.

Endemic in almost 50 countries and with an estimated 200 million at risk, there are an estimated 201,500 – 378,500 cases a year, according to Lepra (an active NGO working in this field). The unseen Leishmania parasite is transmitted by the bite of the equally insidious yet unprepossessing female phlebotomine sandflies. Tropical areas, especially during the autumn harvesting season, prove particularly hospitable to this vector.

Kala-Azar progresses from skin ulcers at the site of infection to the more aggressive form of visceral Leishmaniasis, effectively destroying the immune system. Left untreated, it almost always causes death through complications of any combination of anaemia, weight loss and vital organ failure, notably swelling of the liver and spleen.

It is also associated with poverty: Lepra identifies it as “the poor man’s disease.” For example, sandflies frequently occupy cracks of houses made from mud commonly inhabited by the poor. The disabling aspect of the disease prevents sufferers from being economically self-sufficient while the burden of treatment costs can push their families further towards extreme poverty.

Unfortunately, being identified with and treated for Kala-Azar is fraught with its own dangers. The most effective diagnostic tools are invasive, requiring extraction of either bone marrow or splenic aspirate to visualize amastigotes (an intracellular form without visible external cilia or flagella typifying the leishmanial stage). Invariably, this diagnostic gold standard is unavailable in endemic areas, but serological testing is a common and generally reliable alternative, according to the WHO.

What is life actually like for someone with Kala-Azar? Lepra’s work in Bihar, India offers a telling insight. Consider 8-year old Ruby Kamari, who was originally misdiagnosed with malaria. Only after a series of referrals and 2 rounds of treatment—which proved financially devastating for her family—is she able to eat a little more than half a chapati (flatbread) a day, sleep in more regular cycles and see the melon-sized ballooning of her abdomen lessen.

Another case echoes this debilitating lack of knowledge across the general population: Devi, the father of a 7-year old son who is 2 months into treatment for Kala-Azar remarked, “We thought it was just a simple fever. We live in a hut, we don’t have the knowledge. If a mobile testing facility and treatment facility came to us, it would make life easier.”

Speaking at the London-based Medsin (UCL) conference in 2015, MSF clinician Ana Garcia Mingo shared her experiences working within conflict areas to curb the spread of Kala Azar. She underscored that after any crisis, preventative care is the first thing that stops, but this is also a truism of this disease across the regions it targets.

While there are no prophylactic drugs nor vaccine for the disease, preventative recommendations as per other insect-borne diseases extend to limiting time spent outdoors, particularly from dusk until dawn when sandflies are most active, and application of insect repellent. Indoors, at-risk populations are advised to apply pyrethroid-containing insecticide to furnishings and to make use of bednets.

Although entirely treatable, inexpensive yet effective chemotherapy is lacking in many endemic areas, not least Sudan, according to a 2008 study published in Transactions of the Royal Society of Tropical Medicine & Hygiene. Although the overwhelming portion of those who receive treatment reportedly recover and are highly unlikely to contract the disease again, access to treatment and both donor and health system awareness of the disease is varied but still, devastatingly, the disease occupies a discourse of the ‘neglected.’

 

Image Credit: Ruby and her family look out from beneath their bednet. Peter Canton via Lepra.

IMG_7195

Year in Review

MattersduMonde has been around for a whole year! With at least one post per week, it’s been an adventure into my own global health reading, writing and the wider blogosphere. Although the blog was originally motivated by a solipsistic need to textually spell out, and consider the aspects of global health that I find most troubling or intriguing, over the past year MdM has gathered a loyal but modest following that extends beyond my own project. Nothing is more self-affirming than finding others who also want to engage with the people, places and conditions that comprise ‘global health’. As well as introducing regular roll-over features, namely ‘Photographer’ and ‘Book of the Month’, some of the personal highlights on the blog this year have been contributions to the ‘Writing Health‘ section, which also became the subject of my TEDx talk. So it seemed as good a time as any to dig through the archives and revisit the top five most popular pieces on the blog since it started, as marked by you – in your numbers and words.

  1. ‘Pakistan behind the headlines’

This piece was a variation on the monthly photography feature, and was particularly popular in that the photojournalist in focus, Sa’adia Khan, was running an exhibition of material commissioned by MSF at Asia House in London at the time of publication. In the blog, as in person, Khan talks through a narrative of this commission, which becomes about much more than getting the perfect shot, and touches upon the struggles to fairly expose the unwritten, hidden and untold lives and experiences of the most oppressed persons around the globe.

2. Writing the Self: Creating Health

To omit this feature from a line-up of highlights from the past year would be falsely self-deprecating. It details how the ‘Writing Health’ section of this blog piqued the interest of TEDxUCL organisers who were seeking speakers on the theme of ‘Growth’, including personal growth. The first tentative proposal meeting found me discussing personal experiences I though had been more than fully explored and discussed in other guises and spaces, perhaps as a direct consequence of a blogging process that found me revisiting health experiences close to home. The premise of TED talks is that speakers have ‘ideas worth sharing’. Perhaps, if there is anything that this process highlighted, it is that unexpected opportunities often call on you to move and speak in ways you never knew needed, or warranted, expression.

3. Dear Mr Cameron

This was the first in a series of commissioned features for the ‘Writing Health’ section in which the intuitive and brilliant Charlotte Chorley uses spoken word to consider the black hole and contradictions of existent policy around and relays received experience of female genital mutilation across the UK. With her own interests including health, development and policy, Chorley’s creative writing is worth exploring. Clichéd, perhaps, but she is one to watch – and it looks like you all agree.

4. Character is what you are in the dark

I developed MdM during my lunch breaks of a summer internship with Roll Back Malaria at the World Health Organization headquarters in Geneva. At the time, I’d recently graduated from Cambridge, had no job definitively lined after the internship which found me communicating around Neglected Tropical Diseases (NTD), a long-held area of interest. I’d also been Press Officer for Polygeia, a student-run global health policy think-tank, so when, mid-way through my internship I decided to start writing about developmental topics of interest, and with no finite plans, I looked into a friend’s recommendation that I pursue a Masters in Global Health and Development. I’m fortunate that I was able to apply and consider my place, starting at UCL the same week I flew back from Switzerland. The finite deciding factor in continuing in education at the time was the prospect of conducting primary data collection for my Masters dissertation. Unsurprisingly, perhaps, this found me researching leprosy, and the mental health of persons with this NTD alongside Lepra, an organisation with whom I had previously volunteered on a policy commission. This blog offers a snapshot of my first days in Bangladesh, where I spent a month collecting data earlier this year.

5. MdM Talks: Daniel Flecknoe on Darfur

For someone who has always experienced an unhealthy level of imposter syndrome, it is surprising that curating a blog has positioned me to narrate the stories of others. Conferences and press events have become a rich source of connections and potential interviewees, with the blog network lively in it’s own right, evidenced in invitations to guest blog for Global Health NOW  (article available here) and to speak at the November conference of Medicine Unboxed. In this interview, Dan shares his own experiences of making connections across languages, and marrying seeming impasses in the conflict zone of Darfur. His professional capacity as a lecturer in public health lends a fascinating research steer to his reflections.

Want more of the same? Areas you would like covered? People interviewed? With feedback here’s hoping the next year on MdM doesn’t just become a personal indulgence and can contribute to the wider global health conversation.

 

Image Credit: A. Bow-Bertrand

Portrait of young boy from village of Dardiste.

Photojournalist of the month: Tomislav Georgiev

Currently based in Skopje, Georgiev is a photographer who covers the least popular – and populist – subjects and contexts. It is perhaps for this reason that he is so little-known having ducked beneath even the radar of increasingly celebrated photojournalists and war correspondents. He is, however, a member of the Balkan Photographers Collective and numbers commissions from UNICEF MK, the branch based in Macedonia, as well as nationals including Le Monde and The Sunday Times. 

His most powerful work focuses on Kosovo A Power Station, a lignite power station with five units at Obilić. It is the second largest power station in Kosovo and is described as the worst single-point source of pollution in Europe and it is expected to be closed by 2017. Indeed, the A block alone emits around 2.5 tonnes of dust per hour, which exceeds EU regulation standards by some 74 times. The following are drawn from Georgiev’s series called Toxic Legacy and with their associated captions, expose a terrible insight into the lives of the people living within its shadow.

Approximately 5,000 people die each year from cancer in Kosovo. The proportion of those from family units in the Obilić area is far higher than elsewhere and surpasses worst expectations for an otherwise non-urban area. The following billboard is from the local Pristina hospital reading ‘For Good Health’:

Screen Shot 2016-08-06 at 10.17.14

The power plant behind a man with his cow in the village of Dardishte. The local terrain is heavily polluted making vegetable production and grazing low yield and problematic.

Screen Shot 2016-08-06 at 10.18.28

Children play near the power plant:

Screen Shot 2016-08-06 at 10.17.01

Following the closure of Cesmin Lug camp near the Trepca mine in North Mitrovica, Kosovo. The camp was built close to the Trepca lead mine and smelting works. The factory was closed by order of UN administration in 2000 but the slag heaps were never cleared. As a result, the residual lead blackens the teeth of local children, affects their memory and leads to stunted growth. Their activity patterns jump from bursts of nervous hyperactivity to comatose states. Doris Nitzan of WHO said, at the time, “This is the worst ever lead poisoning that we know of in Europe”. The inhabitants from Cesmin Lug moved to the Osterode camp.

Screen Shot 2016-08-06 at 10.18.14

The home of Rodna Zifkovksa with her grandchildren in Osterode camp in North Mitrovica. To limit risk of poisoning, the existent topsoil was replaced with concrete, which was later classified by WHO as “safer” than before. 600 people now live here.

Screen Shot 2016-08-06 at 10.17.50

Hyra Shanini’s house is only 50 metres from the 40 year old power plant. Her only son, Kahmiron, died in December 2010 when he was thirteen years old following  brain tumour, considered directly related to environmental factors. He was initially operated on in Tirina, but Shanini was not able to afford his second operation. Here she is holding her late son’s shoes.

Screen Shot 2016-08-06 at 10.17.59

While Georgiev continues to quietly document the lives of his fellow nationals, awareness of the lasting health impacts and consequences of living within the shadow of polluting giants must be raised and addressed, for the safeguarding of future generations in Kosovo.

Image credits (all): T. Georgiev.

IMG_8729

Book of the Month: Self Portraits

Lauded by Susan Sontag as ‘a valiant writers whose work honors literature’, Frederic Tuten is a recently revisited favourite of mine in the form of his ‘Self-Portraits: Fictions’, which was given to me earlier this month. He is best known for ‘Tintin in the New World’ which is characteristic of an oeuvre studded with Borgesian, Conradian and Proustian influences and edged with mystical realism. Published in 2010, ‘Self-Portraits’ brings these same influences together in a series of interrelated stories that offer as much enjoyment as narratorial ingenuity. Cross references and allusions are frequent but lightly spun across trajectories that wind out of control and back again.

Not dissimilar to the premise of this website’s ‘Writing Health‘ section, Tuten’s self-portraits contour lives and experiences through words in an attempt to hold them up to a readerly, or spectator’s gaze. Although not directly claiming to pertain to health, global citizens and readers will relish the thread through tales in which  a young boy barters with pirates for his grandmother’s soul; Death appears as a genial waiter in a bar across from the Metropolitan museum; a lonely man lectures circus bears on the history of art; miniature glaciers tumble from a refrigerator in an East Village apartment, heralding a voyage to Antarctica on a frozen schooner anchored in Tompkins Square Park with two lovers reappearing time and again in new guises, through new voices and in new places.

Reading as escapism is true of all of Tuten, but especially of this work. Writing at the close of the Prologue, he muses ‘Stories. Like air, like food, like hope. I read them, I told them, and later, I wrote them, stories about men and women seeking the faraway in revolutions, in art, and in the dreamy search for love’. I can offer no better invitation into another world.

 

Image Credit: Tournesols, A. Bow-Bertrand

IMG_2306

Relief/Development: bridging the divide

When one reads a news article titled ‘policy change crucial for international development’ or ‘governments must get behind the relief effort in XYZ nation, in XYZ context’, one rarely pauses to consider the link, interchangeability or otherwise of ‘relief’ and ‘development’ as terms and actualities. Perhaps it is the history as an English Literature student, but ingrained in me is the habit of dissecting every term to the sum of its parts and to consider how it interacts variously given its context, narratorial voice, intended audience and so on. But this scrutiny over terminology is necessary from any critical reader, particularly one concerned with global health, and the international agenda for it determines accountability, motivation and outcome.

So, what’s in a name? The two definitions most readily associated with ‘relief’ include a feeling or encouragement of emotions of reassurance following periods of anxiety or high stress as well as financial or practically oriented assistance given to those parties or persons in critical need or difficulty. Meanwhile, ‘development’ is most generally associated with a specifiable state of growth, optimistically linked with progress or change through space, time and people. The crossovers between the two are apparent and, indeed, rather than considering each term and concept in silo, it is best to see them as a continuum. In temporal terms, relief humanitarian assistance usually segues into development, but this chronology is not always linear with the two happening in tandem in many circumstances of humanitarian crisis,  fragile states and insecure environments.

But this broad brush approach to theory does not always trickle down into good practice, which returns us to the reason behind discussing these terms and states in the first place. Humanitarian, relief and international development organisations usually pitch themselves as just that – umbrella groups that want to address the acute and the chronic like the most forward-thinking, prophylactic minded doctor. However, the two states have diverse objectives and priorities as usually a different government department is involved in allocating relief aid funding to that involved with international development. This is evidenced in the United Kingdom’s Department for International Development (DFID) which regularly has to clarify the position of it’s central funding mechanism, UKAid Direct, which awards grants to small and medium sized UK and International Civil Society Organisations to reduce poverty overseas.  It was formerly known as the Global Poverty Action Fund (GPAF) but this titular revision also likely has something to do with managing interpretation and associated expectations.

The divide is also widened in related funded  gaps frequently carved through donor motivations and constraints that are, at times, sadly at cross purposes to those in most need. The group of diseases that fall under ‘Neglected Tropical Diseases‘, such as Kala Azar and leprosy are, in part, so categorised because they are less de mode, or emotive than some of the often great, white man killers such as AIDs which dominated funding and coverage in the late twentieth-century across the United States. So too, the missions around ‘relief’ and ‘development’ demand and employ different skills with income generation a priority of current development such as the food security approach. Furthermore, different priority is given to sustainability. Vaccination programmes, a cornerstone of many development initiatives, are frequently hard to implement in anything but a scatterfire manner in acute crisis zones such as mutating refugee camps through which peoples often pass unidentified.

To bridge these gaps, it seems that best practice is to both speak about and act on development in relief and relief in development. There is a clear opportunity here for researchers and workers in disaster preparedness (i.e. the measures taken to prepare for and reduce the effects of disasters) to increasingly bring these two closer together, so that when relief is needed, it is readily available and part of a comprehensive, on-going development effort.

 

Image Credit: Jonction, Geneva. A.Bow-Bertrand

Screen Shot 2016-06-22 at 14.25.35

Photojournalist of the month: Jiro Ose

Hailing from Osaka, Japan, Jiro Ose has worked as a freelance photojournalist since 2005, and has covered the historical election in Congo, the Sudanese refugee crisis and the departure of deposed president Jean-Bertrand Aristide in Haiti amongst other events and states. His coverage of the Democratic Republic of Congo election won him the Award of Excellence in the Magazine General News Story category of the Pictures of the Year International competition . The selection below are drawn from Ose’s ‘SOS from Iraq’ which he describes as follows:

I was sent to cover the 2003 Invasion of Iraq by Newsday, one of New York’s dailies. I entered Northern Iraq (Kurdistan) through Iran, like many other journalists who were rushed in to cover the war. When the City of Kirkuk fell, I entered with Kurdish Peshmaga fighters and thousands thronged the streets and greeted us as though we were liberators of the city. Saddam was finally gone. The air was filled with euphoria. People danced and chanted on the street. A bronze statue of Saddam was brought down and beaten with their sandals.

I hardly saw any fighting except American bombers dropping bombs on Kirkuk in the distance. Infamous Republican Guards peeled off their uniforms and melted into the population. It was dangerous, still. It was still a war. I walked the field where another journalist was killed by stepping on a landmine. I drove past the intersection where, only half an hour later, another journalist was killed when a suicide bomber drove through in a car laden with explosives. What was to come there after is beyond comparison: the total collapse of Iraqi society, fighting between religious and ethnic lines. Yet, the only time I saw the dark sign of what was to come was the second night in Kirkuk.

I heard a lot of commotion outside the hotel. Parked in front was a taxi. On its bonnet lay a boy’s lifeless body. Half of his head was blown clean off. A group of men who had surrounded the taxi were shouting; these were Turkmen, one of the many minority groups in Iraq. They said they were under attack by Kurds, and that the boy was shot by a Kurdish sniper. They knew that a group of international journalists were staying at the hotel. The protest lasted about an hour and when the men left the lifeless body on the ground remained. Several hours later, someone could no longer tolerate its sight, so covered it with a flag of Turkmen.

Yet, I still did not really seen the real cost of the war, if you call it a war, until I visited Red Crescent Hospital in Amman, Jordan 5 years later.

Walking through the 2nd floor of Red Crescent hospital in Amman, Jordan, you bear witness to the devastation the war and ensuing violence have brought upon the civilian population on a daily basis in Iraq. Because of the curfew, lack of safety and medical supplies, hospitals inside Iraq cannot perform long and complicated surgery. They are the lucky ones (referring to a selected few who are brought to the hospital to the program by Medecins Sans Frontiers , MSF, France),” said Dr. Nasser, an Iraqi plastic surgeon who preferred that only his first name to be used. Because of the escalating violence, MSF France pulled their international staff from Iraq three years ago. Now they assist Iraqi hospitals across the border by providing drugs and medical supplies. They also set up a surgical program in cooperation with the Jordanian Red Crescent Hospital in Amman where they perform reconstructive surgery for patients who have been handicapped by injuries or incomplete procedures free of charge, including transportation from Iraq and back after the recovery. 

Screen Shot 2016-06-22 at 14.19.52

Screen Shot 2016-06-22 at 14.19.18

Screen Shot 2016-06-22 at 14.19.12

Screen Shot 2016-06-22 at 14.18.58

Screen Shot 2016-06-22 at 14.19.38

Screen Shot 2016-06-22 at 14.18.53

Screen Shot 2016-06-22 at 14.19.04

Screen Shot 2016-06-22 at 14.18.37

Screen Shot 2016-06-22 at 14.18.30

Screen Shot 2016-06-22 at 14.19.44

Screen Shot 2016-07-01 at 13.31.18

Brexit and Non-place

What’s the current situation?

It is a week since almost half (48% to 52%) of the United Kingdom (UK) reeled at the news that the majority had voted to leave the European Union (EU) – its constitution, ideals and politico-economic partnership. Since then the respective leave and remain campaigns have been posthumously dissected, their leaders and leadership questioned and the integrity and informedness of the voting public duly challenged.

As the title of this blog suggests, MattersduMonde is about matters that affect the world, often starting from the local, and health-based infrastructure with previous posts exploring the National Health Service and foreign aid programmes via the Department for International Development (DFID). However, if nothing else, these critical days since the largest suffrage determined political decision taken during my voting history, I have been struck by countrywide engagement with what it means to be the United Kingdom, more commonly – and loosely – used interchangeably with notions of ‘Britain’ and ‘British’.

Notwithstanding the disappointing level of abstaining voters particularly of the 18-24 age range, and the widely varying degrees of information or mis-information (given the complex, often contradictory and repeatedly deceitful policies of both campaigns) held by each voting citizen, every one of those 30 million plus voters has an opinion, before, during and most importantly following the outcome of last week’s referendum.

Bit of a mess?

Bit of a mess? Somerset House ‘Utopia’ exhibition, detailed below.

 

Where does this ‘leave’ us?

While there is real value in reading, sharing and re-writing the present experiences and reactions of the UK’s constituents, it is imperative to note that while a local issue for many, the implications of this vote have global consequences, from Donald Trump’s looming presence in Scotland last Friday morning and that state’s predicted distancing from the result, to Northern Ireland’s renewed clamour for independence. Fundamentally, the economic, social and literal health of the populace of the UK we are ever a part of is ironically dependent on the peoples and places beyond this island’s increasingly literal borders.

Many leave voters cast their weight behind a campaign that promised an impossible finite end to free movement to the UK associated with membership of the EU. Many of these same voters claim it is acceptable for immigration in the form of skilled workers – doctors, lawyers, pharmacists. All of which crystallises into a persistent and little explored anxiety that this referendum was seen less as a heterogeneous, multi-faceted decision of unity in all its forms, and more of a reverse process founded on the widely silent, but influential idea of what the UK or ‘Britain’ really is.

The much-cited statistics that show a demographic skewing of the older population across England, Northern Ireland, Scotland and Wales towards a leave vote and vice versa at the other end of the age scale should be increasingly seen not based on electoral or life experience, but in terms of how this shaped one’s understanding of what it is to be British. What is palpably clear as orchestrator of the leave campaign, Boris Johnson, has shown in his sudden shadowy disappearance from the now 5-way race Conservative leadership line-up, is that the people of Britain and their understandings of it are so wildly different, that to try and unify them for a future Britain that is based on modern change, innovation and progression, is an insurmountable ask.

Utopian vacancies at Somerset House exhibition, 2016.

Utopian vacancies at Somerset House exhibition, 2016.

Indeed, our respective understandings of Britain and our role as citizens of this nation are most formally pinned to the ‘Life in the UK’ citizenship test first introduced in 2013 under the imperative ‘prove your knowledge of English or citizenship and settling’. Such lexicon of proof and knowledge are constructs bandied about during this referendum as though quantifiable. But of course, it goes without saying that such a test is so anachronistic when so many current citizens would not pass. It is intellectually comic that one of the questions in the aforementioned test is as follows:

Screen Shot 2016-06-30 at 15.28.28

Reproduced from the condensed version of the YouGov citizenship test for the Independent.

Aside from ideological correctness of such answers, many of the other constituent questions are so divorced from educational-derived curricular knowledge as well as national identity that this test’s value – and marker for ‘Britishness’ – is undermined.

 

Where has this come from?

Rather than suggest what our future will look like, as I don’t think that there is a clear nor comprehensive vision, or reality, this discussion turns instead to look back through history and literature to the model of utopian thinking and impossible dreaming that has coloured and discoloured every sovereign state and every independence narrative. Utopian thinking, the American dream, scriptural, Edenic Paradise are all permutations of a similar model characteristic of humanity – the striving for something that is perfect in the eyes of the perceiver.

Of course, perception rarely correlates with feasibility which in turn causes the very personal and emotive fall-out experienced by so many of us in the UK and beyond this past week. Furthermore, ‘utopia’ is etymologically rich, deriving from Greek stems to form the hybrid of ‘non-place’. From Thomas More’s possibility dreams (Utopia 1516) to Francis Bacon’s political ideology (New Atlantis 1627) and Margaret Cavendish’s wonderland of the imagination, the seventeenth century reader and audience alike were accustomed to the idea of ‘a world elsewhere’. In itself an epoch of upheaval across currencies of religion, philosophy and politics, these learnings and writings are increasingly critical to the immediate now.

In addition to the main Somerset House exhibition and series of talks, there are collaborative pieces running in conjunction with the neighbouring Courtauld Institute and King's College London

In addition to the main Somerset House exhibition and series of talks, there are collaborative pieces running in conjunction with the neighbouring Courtauld Institute and King’s College London.

The debt Thomas More owes to humanism for the origins of Utopia is an area in which much debate has been devoted, in part due to the malleable connotations and contextual meaning of pigeonholed definitions. The Renaissance saw a resurrection of the classics and humanists heralded furthering the arts of reason and the dignity of man within the Christian doctrinal frameworks. Famously described as a ‘revival of good letters’, humanism was perhaps less ideological than often attested.

Whilst the humanist influences of Plato and Erasmus are powerfully vocal in Utopia, so too is a contradictory turn from them, most notably in discussions which theorise beyond the boundaries of Christian monogamy both on personal and national levels. The principal elements of utopian writing so understood, are a chance landing or shipwreck on the coast of what turns out to be an ideal commonwealth followed by a return to – specifically – Europe, and a commentary on what has been remarked.

 

What are the dangers of utopian thinking?

So too, as argued by Margaret Cavendish (1623-73) who engaged with and practised a form of experimental science through her literature, imaginative freedom is considered a prerequisite for intellectual maturity, social change and intellectual development. Indeed, commonly held truths (or unexamined perceptions or ‘proof’ of what Britain is) are utopian experiences that must be deconstructed for they are ultimately unavailable for representation and appropriation.

In Cavendish’s The Description of the New World, Called the Blazing-World (1666), Cavendish, herself the actual and literary figure of the ‘Duchess’ of Newcastle finds herself on a satirical trajectory as scribe to a beautiful maiden – the Empress – who writes her way into another world with different stars in the sky and creatures on its shorelines. When the Empress desires to share this found world, the guiding-force of the Duchess encourages her to construct her own, redirecting utopian expectation away from material production to shared creative activity.

The ‘Britain’ idealized in the subconscious of all voters is a utopia of sorts – not a venture until is examined in the open – but still an irreconcilable state. The other; the ‘European’ in this case, like the Orient and prolific discourses in the field of global health of the ‘west and the rest’ quickly become the subject of the languages of dream and Utopia, ‘the object of a powerful fantasy’ (Hall, 1992).

 Readers and citizens must surely be left wondering about the value of the ‘otherness’ of Utopia and its paradoxical comparability with sixteenth-century England. Unlike Plato’s Republic, Utopia is not a maquette for an ideal commonwealth; it seems more dramatically to be one of More’s theatrical metaphors ‘in which disparate and seemingly discontinuous aspects of […] existence come together, touch, and resonate’ (Greenblatt, p. 27).

Preach.

Preach.


And the possibilities of such dreaming?

The contradictory design and rhetorical paradoxes of these cited utopian writings are self-interrogative, challenging, and reflects the wealth and the weakness of words to influence worlds. The final line of More’s Utopia hovers in the subjunctive, so what happens next is for us to decide. Certainly, the utopia of one human may be the dystopia of another, so to the very last, the polemical nature of the literature and author remain. More specifically, when angling this pitch through a perspective of health and globality, the idea of a global society should not be construed as a utopian world free of conflict. Rather, as in most national societies, one would expect a global society to be characterised by ongoing political conflict and competing views. As Frenk (2010) notes, ‘what the notion of a global society does imply is that underpinning such conflicts would be a widely shared understanding of health interdependence and an acceptance of some responsibility for the health of others as members of the same society—in other words, a shared commitment to realisation of health as a human right based on a recognition of our common humanity’.

Is this pathetic fallacy? Dark and gloomy Somerset House quad the weekend post-Brexit vote

Is this pathetic fallacy? Dark and gloomy Somerset House quad the weekend post-Brexit vote. Might just be the monochrome filter.

It so happens that it is the 500th anniversary of More’s Utopia celebrated in a challenging and ever-relevant events programme at London’s Somerset House. Yet, as the programme preface articulates: the text and commemorative events are, once again, ‘not a blueprint for the future, instead he [More] places importance on the process of dreaming in the now. His work continues to inspire communities and provide a framework for true innovation in our time.’ In a world that has just witnessed the return of ESA astrologer Tim Peake from the International Space Station, surely the brand of extra-terrestrial exploration and utopian dreaming as read through Francis Goodwin’s The Man in the Moone (1638) indicates the worth in looking at the bigger picture and reassessing the simple but time-old answers we would give to an alien asking ‘what is Britain’?

With constant personal reflection translated into political representativeness, I think there might be hope for a Britain that is united in understanding the nation is ‘great’ for being in flux, flawed but imperatively free. A renewed brand of utopian ideology, distanced from it as a reality, will be instrumental in shaping this future.

As simple as an OS map.

‘Paths to Utopia’: as simple as an OS map…

 

Bibliography

Bruce, S. (ed.), (1999) Three Early Modern Utopias: Utopia, New Atlantis and the Isle of Pines (Oxford: Oxford University Press)

Comp, A. and F. K. Pizor (eds.) (1971), The Man in the Moone: An Anthology of Antique Science Fiction and Fantasy, (London: Sidgwick and Jackson)Frank E. and Fritzie P. Manuel (1979), Utopian Thought in the Western World (New York: Belknap Press).

Frenk, J. et al (2010), Global Health is Public Health in The Lancet. Vol. 375; pp. 535-6.

Greenblatt, S. (1980), Renaissance Self-Fashioning: From More to Shakespeare (London: The University of Chicago Press)

Hall, S. (1992), The West and the Rest: Discourse and Power. Available from: <https://analepsis.files.wordpress.com/2013/08/hall-west-the-rest.pdf&gt; [Accessed 28 June 2016]

Lilley, K. (ed.) (1994), The Blazing World and Other Writings, ed. Kate Lilley (Harmondsworth: Penguin)

Logan, G. M. (1983), The Meaning of More’s Utopia (New Jersey: Princeton University Press)

Nelson, E., Greek Nonsense in More’s Utopia. The Historical Journal, 44 (2001), pp. 889-917.

Skinner, Q. (2002), Visions of Politics. Volume III: Hobbes and Civil Science (Cambridge: Cambridge University Press)

Image Credits (all): A. Bow-Bertrand. The featured image reads ‘Utopia’ transliterated into Thomas More’s alphabet.