Category Archives: Sociology

In the words of Wikipedia: Sociology is the study of social behaviour or society, including its origins, development, organization, networks, and institutions. In the context of this blog, it usually relates to the sociology of health.

How do you make a grown man cry?

Answer: Give him £20.

You look baffled — like you missed the punchline to a joke. There was no joke and you didn’t miss anything. Although I have a perniciously dark sense of humour, this is not an example of it.

Outside a supermarket, in South London, there was a man begging. I had a £5 note amongst a couple of twenties and I fished it out and gave it to him. He looked grateful for this small windfall and tucked it away in one of the many folds in his layers of clothes.

COVID-19 has pushed people out of their jobs and out of their homes. The lockdown has reduced pedestrian traffic on the streets, closed public toilets, and made life even harder for the homeless than it was before.

He and I did not catch up on the state of business, but I imagine there were not many people giving him £5 notes. By the time I’d finished my shopping, he had already bundled his belongings together and headed off — I surmised, for food — and in his place was a new face.

I saw the new guy and my immediate thought was, “Yeah, Nah”. I did what anyone would do in these circumstances. I ignored him. I made no eye contact. I pretended I had not heard his polite request for help, and I headed down the street.

Before you judge me, let me remind you, I had already given away my £5 note and all I had left were the twenties. There were also other prospective givers, who felt no compulsion. If they weren’t giving, maybe they knew something about him that I didn’t — some mark or taint that made him less deserving of charity. I felt OK about the decision. Thomas Aquinas wrote, “because there are many in necessity, and they cannot all be helped from the same source, it is left to the initiative of individuals to make provision from their own wealth, for the assistance of those who are in need.” And I had already done my provisioning for the day.

Two hundred meters down the road, I thought to myself, “you arsehole”. And I walked back. I retrieved a £20 note from my wallet and I folded it so it could be passed to him more discreetly. As I got closer I was struck by how lifeless he looked. Huddled, still, and head bowed. He was not looking about anymore. He was not begging. He was spent.

I put my hand out with the money and he reached for it mechanically. Head up to say, thank you. Looked at his hand. Looked again. Started to say, thank you, and burst into tears. There is something profoundly wrong with a grown man being that grateful for £20 — a breach of protocol — so I joined him.

Covid Economics

“Governments will not be able to minimise both deaths from coronavirus disease 2019 (COVID-19) and the economic impact of viral spread.” [Anderson et al.]

A soup kitchen during the Great Depression. Apparently it was only men who were hungry

It is easy to see that the economies of the world are being affected by the COVID-19 pandemic. Share-markets have tumbled. Airlines are flying empty. Except for bizarre panic buying of toilet paper, malls and shops are more deserted. And if you have an employer with a large cash reserve and a bit of heart, you will be OK. There are many companies, however, that are at the margins and they are already failing because of the impact of COVID-19. Households are hunkering down: not spending, not going out.

These are the consequences of containment.

Now think about the daily wagers and piece workers, the sex workers, couriers, garbage pickers, rickshaw drivers and maids. Who will pay their bills, put food on their tables and ensure the same for their children?

Workplaces are instituting attendance rules based on health guidelines. Fevers, coughs, headaches and myalgia? Stay home! Recently been with someone who tested positive. Stay home! Etcetera.  That’s fine for me. I will apply for sick leave. In all countries, but disproportionately in Low- and Middle-Income Countries, large numbers of people in the workforce are in the informal sector. They are vulnerable. Even in the formal sector, many workers have no financial protection.

Think again about the daily wagers and piece workers, the sex workers and couriers. Their capacity to pay the bills and keep food on the table is proportional to their capacity to keep working. No matter what.

Death is not everything.

The obligation of countries who have committed to sustainable development goals is to “leave no one behind”. Governments should implement their public health measures to limit the effects of the COVID-19 pandemic, but the poor should not have to carry an unfair burden.

A street sweeper in Mokhali

The “underserved” are “undeserved”

I hate the phrase, “the underserved”. I would love to remove it from the lexicon of public health. But it appears to be here to stay, particularly in North America where there is even a journal devoted to them.

A girl with kwashiorkor during the Nigerian-Biafran War (Public Domain; Wikipedia).

On a number of occasions in public lectures I have played with the phrase using a comparison of the “undeserved” and the “underserved”. It usually takes listeners a few minutes to work out that I am not repeating myself over and over again. And if you thought I had typed the same thing twice, look again. “underserved”≠”undeserved”.

My spell-checker knows the difference. It tells me that “underserved” is a spelling error and I almost certainly mean “undeserved”, and herein lies the problem. It is not simply that these two words look and sound similar, it is that there is an unpleasant semantic connection between them. It seems to depend where you lie on the political spectrum which term you use to refer to the same group of people.

On the left, the powerless and the left-behind, those with poor access to services and care would be characterised as the underserved. On the right of politics (or a nationalist left where refugees and migrants are vilified) anyone in need, the powerless and the left-behind, those with poor access to services and care are more typically characterised as the undeserved. The same people, the same need, and the same suffering, but a more or less generous view of our social obligations.


To share power, someone has to give up power

Over the past few years I have been peripherally involved in various discussions with male colleagues about gender equity. The conversations have had a predictable ebb and flow.

Women’s empowerment. It’s great in theory, but who wants to give up power? Not these men. [source: reddit;]

The consensus, at least among my colleagues, is that gender equity is a good idea. In the abstract, we fully endorse it. The practice is another matter. It is not that we don’t want to share power. We’re enlightened! We know there is a problem, but can it be someone else’s power that is shared?

The reasoning goes something like this. I should not have to share power. I’m talented, I got here on merit, and I deserve everything I achieved. It is an absolute social good when I have power. For me to give up power would not be good, because I wield it benignly and actively promote gender equity. It would be great if another man gave up power because that would support gender equity.

At a fundamental level, power is a zero-sum-game. There are only so many seats around the high tables of power, and if someone gets a seat at the table, someone loses a seat. Sure, we can squeeze an extra seat in here or there — but there are limits. If someone sits on a panel, someone else cannot sit on the panel. If 50% of the world’s population suddenly achieved fair access to power, power that had been largely controlled by the other 50%, competition would increase sharply.

In 2017, the World Health Organization Director-General Tedros Adhanom Ghebreyesus, tried to fudge the arithmetic [it has since changed]. He appointed a substantial number of women to senior positions in WHO. He did this by increasing the pool of senior positions, and he appointed women to the new positions. Unfortunately, many of the new positions were without substantive portfolios, and without real power. In effect he dragged some extra stools to the table. Chairs for men. Stools for newly appointed women.

The strategy had all the right visuals without the structural capacity to support gender equity; i.e., the fair distribution of power.

Gender equity is a good idea. It will be achieved through structural changes that share power and resources, not through appeals to people’s better nature nor through empty gestures. The test of whether one person’s power has increased is whether another person’s power has been diminished.