When you were born, your name, Xenia, appealed to me greatly because its etymology comes from the Greek word xenos, meaning ‘stranger’ or ‘foreigner’ and translates as ‘kindness to strangers’. The appeal of this name came in part from my belief that the best way to see your country, your society, is to see it through the eyes of an outsider, a refugee. Try mentally to travel to a faraway place, if not necessarily in order to move your world – though how splendid that would be! – but to see it clearly for what it is. Doing so will grant you the opportunity to retain your freedom. And to remain a free spirit as you grow up and make your way in this world, it is essential that you cultivate a rare but crucial freedom: the liberty that comes from knowing how the economy works and from the capacity to answer the trillion-dollar question: ‘Who does what to whom around your neck of the woods and further afield?’

[T]he long rise of capitalism, from 1500 right into the Industrial Revolution, caused dramatic social dislocation everywhere it went. The enclosure movement in Europe, the Indigenous genocides, the Atlantic slave trade, the spread of European colonisation, the Indian famines; all of this took a measurable toll on human welfare around the world. The scars remain starkly visible in the public health record. For the vast majority of the history of capitalism, [economic] growth didn’t deliver welfare improvements in the lives of ordinary people; in fact, it did exactly the opposite. Remember, capitalist expansion relied on the creation of artificial scarcity. Capitalists enclosed the commons – lands, forests, pastures and other resources that people depended on for survival [creating the land market] – and ripped up subsistence economies in order to push [dispossessed] people into the labour market [to fill “dark, Satanic mills” (William Blake, 1804)]. The threat of hunger was used as a weapon to enforce competitive productivity [as well as vagrancy laws to fill brutal workhouses]. Artificial scarcity quite often caused the livelihoods and welfare of ordinary people to collapse even as GDP grew.

It wasn’t until nearly 400 years later that life expectancies in Britain finally began to rise […]. It happened slightly later in the rest of Europe, while in the colonised world longevity didn’t begin to improve until the early 1900s [from decolonization, as the colonizers’ competition led to world wars]. So if growth itself does not have an automatic relationship with life expectancy and human welfare, what could possibly explain this trend?

Historians today point out that it began with a startlingly simple intervention […]: [public] sanitation. In the middle of the 1800s, public health researchers had discovered that health outcomes could be improved by introducing simple sanitation measures, such as separating sewage from drinking water. All it required was a bit of public plumbing. But public plumbing requires public works, and public money. You have to appropriate private land for things like public water pumps and public baths. And you have to be able to dig on private property in order to connect tenements and factories to the system. This is where the problems began. For decades, progress towards the goal of public sanitation was opposed, not enabled, by the capitalist class. Libertarian-minded landowners refused to allow officials to use their property, and refused to pay the taxes required to get it done.

The resistance of these elites was broken only once commoners won the right to vote and workers organised into unions. Over the following decades these movements, which in Britain began with the Chartists and the Municipal Socialists, leveraged the state to intervene against the capitalist class. They fought for a new vision: that cities should be managed for the good of everyone, not just for the few. These movements delivered not only public sanitation systems but also, in the years that followed, public healthcare, vaccination coverage, public education, public housing, better wages and safer working conditions. According to research by the historian Simon Szreter, access to these public goods – which were, in a way, a new kind of commons – had a significant positive impact on human health, and spurred soaring life expectancy through the twentieth century. [Source: Less is More: How Degrowth Will Save the World]

When I give food to the poor, they call me a saint.
When I ask why they are poor, they call me a communist.

-Dom Hélder Câmara

Money now began to pour in. Whereas his neighbourhood patients came to him only in their extremity, pleading their poverty, his new patients expected to be billed handsomely for the most trivial services. […]

Success was welcome but sometimes, as he sat in his newly furnished office, he looked at his hands and thought: what has changed? They were the same hands. Had they some new magic today that they lacked yesterday? He knew the answer: yesterday they had treated the poor, today they treated the rich.

[…] He found himself now a prisoner in a rigid system, with its "scratch-my-back-and-I'll-scratch-yours" outlook, and its rake-off for the general practitioners who sent him their patients. The specialist was expected to charge all that the traffic would bear, and the "gravy" would pass down the line, with the patient "taxed" to keep the system going.

Money was the beginning and end. He took as much as he could, and returned to his first patients in the slums to find his lost sense of peace, the tarnished ideals of the doctor serving the sick and the poor. […]

He had spent most of his life becoming a surgeon; as a surgeon he could heal the human body, not the whole damn stupid mess called society. "We, as physicians," he continued, "can do but little to change the external environmental forces which predispose to infection and re-infection. Poverty, poor food, unsanitary surroundings, contact with infectious foci, overwork and mental strain are beyond our control. Essential and radical adjustments of these are problems for the economists and sociologists." […]

He declared in all his writings that it was necessary to abandon the idea that T.B. [tuberculosis] was merely a disease of the lungs. It was in reality a disease of the body. The bacillus's attack on the lungs was the end product of the environment's attack on the whole organism. "Any scheme to cure this disease," he often said, "which does not consider man as a whole, as the resultant of environmental strain and stress, is bound to fail." […]

The province with the lowest standard of living had the highest T.B. rate. And throughout the country, in the city slums and bankrupt farm hinterlands, there were many thousands of people slowly succumbing before the disease without even knowing they had it.

Why? The question made him uneasy even as he continued to expound his theory of early lung compression. His search for the answers led him to another disease that was engulfing the world - a disease more deadly than tubercle bacillus and swifter than medieval cholera.

Like any other serious medical practitioner he had always known that T.B. fed on poverty. But now poverty, for some reason, seemed to be spreading everywhere, spewing forth ten new cases of T.B. infection for every single case he and other doctors cured. Now when he asked himself why, the answer beckoned him along many strange, new and disturbing paths. […]

While presidents and ministers talked of "prosperity around the corner," unemployment, bankruptcy and fear gripped every continent. Dislocation and collapse stretched from Spain, where Primo de Rivera ruled through military dictatorship; to Germany, where a strange creature and a strange movement, Hitler and National Socialism, had seized power; to China, where Chiang Kai-shek was busily reducing the population by massacres of opposition elements; to Japan, where a militarist clique dreamed of ruling all Asia.

To Bethune it began to appear as if some mass mania had laid hold of the world. Night seemed to be day and day never seemed to come. "Pull in your belts," cabinet spokesmen of ample girth advised, and stopped counting when the number of unemployed around the globe hit 40,000,000. It was a simple matter of overproduction, they said, but everywhere the people had nothing.

In the world at large he noted a disturbing contradiction. Millions were without clothes, and the United States ploughed under its own cotton fields. Tens of millions were hungry, but Canada burned its wheat. On street corners men begged a nickel for a cup of coffee, but Brazil dumped its coffee into the ocean. In Montreal's working-class districts the children were bowlegged with rickets, but oranges from the South were destroyed by the carload. [This capitalist contradiction/irrationality of destroying "overproduction" for the sake of profit while the masses are in poverty is famously illustrated in The Grapes of Wrath] And from the head of the Canadian Medical Association came a warning that disaster lay ahead for the profession and the people of Canada unless emergency measures were taken to provide medical services for the majority of citizens who couldn't afford to pay, and for the doctors who couldn't afford to treat their patients without payment.