Monday, July 24, 2017

Free-market cholera

In the first episode of the final season of the immensely popular Game of Thrones, the Hound has a few things to say about how men die. Some, he states matter-of-factly, "shit themselves to death." That is exactly how a person who is infected with cholera dies -- they shit themselves to death. A person who has "cholera-like symptoms" is, in effect, shitting himself to death and, barring the intervention of medical personnel, is likely to shit himself to death. When two Cabinet Secretaries of the Government of Kenya were admitted in hospital "suffering from cholera-like symptoms", they were shitting themselves, and would have shit themselves to death if it hadn't been for the intervention of doctors, nurses and pharmacists.

Cholera is not an "infection of the poor"; cholera is an indictment of a water and sanitation system that does not provide sufficient quantities of potable water to a population while failing to effectively evacuate and treat waste effluent, especially sewerage. Since a wedding in the upper-class Karen area in May, cholera has seemed to deliberately avoid poor people -- doctors at a high-end hotel got their chance to put their medical expertise into practice in June and failed miserably to either detect the cholera symptoms among their colleagues to manage the aftermath of the outbreak. Especially at the hotel, scapegoats were quickly found for the outbreak. Rest assured, the rich hotel was not to blame but the poor Kenyans living in "informal settlements" who shit in the various Nairobi "rivers" whose waters seep into underground aquifers, are extracted through boreholes and end up being used in places like the high-end hotel, putting hotel guests at risk.

The market logic of reforming and liberalising water services in Kenya was unimpeachable. Government had failed to properly manage water services. Millions who lived in urban areas did not have access to adequate potable water and millions more did not have access to sewerage services of any kind. Water "reforms" led to the creation of water services authorities, water services boards, and water and sanitation companies. Water "reforms" were supposed to lead to better and better water and sanitation services. The water "reforms", like it or not dear private-enterprise-capitalist zealot, failed. Its failure is writ large in the violently loosened anal sphincters of your foremost free-market proseltysers, the aforementioned Cabinet Secretaries. 

Because of the water "reforms", the City of Nairobi witnessed an incredible thing: in a period when water was being rationed, and only the well-heeled could afford private supplies (from god knows where), the most pampered class go hit by the shits that mostly arrives because of contaminated water supplies. If the water "reforms" hadn't been screwed up the way they were, fewer and fewer urban dwellers would have had to shit in water bodies, thereby contaminating water sources, suffering a period of drought-induced rationing, that led to reliance on "alternative" water supplies that happened to be contaminated because of the shitting in water bodies. Our casually cruel treatment of the poor and marginalised in our urban areas led to two Cabinet Secretaries, a whole bunch of doctors and foreign guests at a wedding, to be struck down by acute diarrhoea.

Free-market zealots, many of whom champion liberalisation and "deregulation" of market, lower taxes, smaller government and "personal responsibility", almost always forget that "market logic" and "the invisible hand" are not absolute truths, not when they apply to human beings in all their emotional volatility and complexity. Humans are not programmable computers or computer systems and will never, ever react predictably to all circumstances. The water reforms agenda was sound when looked at from the pure logic of free markets, deregulation and capitalism. If only the logic had been pure you wouldn't have Kenyans at risk of shitting themselves to death.

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