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Saturday 8 December 2012

Julian Assange: the fugitive



Julian Assange has been holed up in the Ecuadorian embassy for six months. In a rare interview, we ask the WikiLeaks founder about reports of illness, paranoia – and if he'll ever come out
Julian Assange
Julian Assange: 'I suppose it’s quite nice that people are worried about me.’ Photograph: Gian Paul Lozza for the Guardian
The Ecuadorian embassy in Knightsbridge looks rather lavish from the street, but inside it's not much bigger than a family apartment. The armed police guard outside is reported to cost £12,000 a day, but I can see only three officers, all of whom look supremely bored. Christmas shoppers heading for Harrods next door bustle by, indifferent or oblivious to the fact that they pass within feet of one of the world's most famous fugitives.
It's almost six months since Julian Assange took refuge in the embassy, and a state of affairs that was at first sensational is slowly becoming surreal. Ecuador has granted its guest formal asylum, but the WikiLeaks founder can't get as far as Harrods, let alone to South America, because the moment he leaves the embassy, he will be arrested – even if he comes out in a diplomatic bag or handcuffed to the ambassador – and extradited toSweden to face allegations of rape and sexual assault. Assange says he'll happily go to Stockholm, providing the Swedish government guarantees he won't then be extradited on to the US, where he fears he will be tried for espionage. Stockholm says no guarantee can be given, because that decision would lie with the courts. And so the weeks have stretched into months, and may yet stretch on into years.
Making the whole arrangement even stranger are the elements of normality. A receptionist buzzes me in and checks my ID, and then a businesslike young woman, Assange's assistant, leads me through into a standard-issue meeting room, where a young man who has something to do with publicity at Assange's publishers is sitting in front of a laptop. There are pieces of camera equipment and a tripod; someone suggests coffee. It all looks and feels like an ordinary interview.
But when Assange appears, he seems more like an in-patient than an interviewee, his opening words slow and hesitant, the voice so cracked as to be barely audible. If you have ever visited someone convalescing after a breakdown, his demeanour would be instantly recognisable. Admirers cast him as the new Jason Bourne, but in these first few minutes I worry he may be heading more towards Miss Havisham.
Assange tells me he sees visitors most days, but I'm not sure how long it was since a stranger was here, so I ask if this feels uncomfortable. "No, I look forward to the company. And, in some cases, the adversary." His gaze flickers coolly. "We'll see which." He shrugs off recent press reports of a chronic lung infection, but says: "I suppose it's quite nice, though, actually, that people are worried about me." Former hostages often talk about what it meant to hear their name on the radio and know the outside world was still thinking of them. Have the reports of his health held something similar for him? "Absolutely. Though I felt that much more keenly when I was in prison."
Assange spent 10 days in jail in December 2010, before being bailed to the stately home of a supporter in Suffolk. There, he was free to come and go in daylight hours, yet he says he felt more in captivity then than he does now. "During the period of house arrest, I had an electronic manacle around my leg for 24 hours a day, and for someone who has tried to give others liberty all their adult life, that is absolutely intolerable. And I had to go to the police at a specific time every day – every day – Christmas Day, New Year's Day – for over 550 days in a row." His voice is warming now, barbed with indignation. "One minute late would mean being placed into prison immediately." Despite being even more confined here, he's now the author of his own confinement, so he feels freer?
"Precisely."
And now he is the author of a new book, Cypherpunks: Freedom And The Future Of TheInternet. Based on conversations and interviews with three other cypherpunks – internet activists fighting for online privacy – it warns that we are sleepwalking towards a "new transnational dystopia". Its tone is portentous – "The internet, our greatest tool of emancipation, has been transformed into the most dangerous facilitator of totalitarianism we have ever seen" – and its target audience anyone who has ever gone online or used a mobile phone.
"The last 10 years have seen a revolution in interception technology, where we have gone from tactical interception to strategic interception," he explains. "Tactical interception is the one that we are all familiar with, where particular individuals become of interest to the state or its friends: activists, drug dealers, and so on. Their phones are intercepted, their email communication is intercepted, their friends are intercepted, and so on. We've gone from that situation to strategic interception, where everything flowing out of or into a country – and for some countries domestically as well – is intercepted and stored permanently. Permanently. It's more efficient to take and store everything than it is to work out who you want to intercept."
The change is partly down to economies of scale: interception costs have been halving every two years, whereas the human population has been doubling only every 20. "So we've now reached this critical juncture where it is possible to intercept everyone – every SMS, every email, every mobile phone call – and store it and search it for a nominal fee by governmental standards. A kit produced in South Africa can store and index all telecommunications traffic in and out of a medium-sized nation for $10m a year." And the public has no idea, due largely to a powerful lobby dedicated to keeping it in the dark, and partly to the legal and technological complexity. So we spend our days actively assisting the state's theft of private information about us, by putting it all online.
"The penetration of the Stasi in East Germany is reported to be up to 10% of the population – one in 10 at some stage acted as informers – but the penetration of Facebook in countries like Iceland is 88%, and those people are informing much more frequently and in much more detail than they ever were in the Stasi. And they're not even getting paid to do it! They're doing it because they feel they'll be excluded from social opportunities otherwise. So we're now in this unique position where we have all the ingredients for a turnkey totalitarian state."
In this dystopian future, Assange sees only one way to protect ourselves: cryptography. Just as handwashing was once a novelty that became part of everyday life, and crucial to protecting our health, so, too, will we have to get used to encrypting our online activity. "A well-defined mathematical algorithm can encrypt something quickly, but to decrypt it would take billions of years – or trillions of dollars' worth of electricity to drive the computer. So cryptography is the essential building block of independence for organisations on the internet, just like armies are the essential building blocks of states, because otherwise one state just takes over another. There is no other way for our intellectual life to gain proper independence from the security guards of the world, the people who control physical reality."
Assange talks in the manner of a man who has worked out that the Earth is round, while everyone else is lumbering on under the impression that it is flat. It makes you sit up and listen, but raises two doubts about how to judge his thesis. There's no debate that Assange knows more about the subject than almost anyone alive, and the case he makes is both compelling and scary. But there's a question mark over his own credentials as a crusader against abuses of power, and another over his frame of mind. After all the dramas of the last two and a half years, it's hard to read his book without wondering, is Assange a hypocrite – and is he a reliable witness?
Julian Assange Assange in the Ecuadorian embassy: ‘It would be nice to go for a walk in the woods.’ Photograph: Gian Paul Lozza for the Guardian
Prodigiously gifted, he is often described as a genius, but he has the autodidact's tendency to come across as simultaneously credulous and a bit slapdash. He can leap from one country to another when characterising surveillance practices, as if all nations were analogous, and refers to the communications data bill currently before the UK parliament in such alarmist terms that I didn't even recognise the legislation and thought he must be talking about a bill I'd never heard of. "A bill promulgated by the Queen, no less!" he emphasises, as if the government could propose any other variety, before implying that it will give the state the right to read every email and listen in on every mobile phone call, which is simply not the case. It's the age-old dilemma: are we being warned by a uniquely clear-sighted Cassandra, or by a paranoid conspiracy theorist whose current circumstances only confirm all his suspicions of sinister secret state forces at work?
But first, the hypocrisy question. I say many readers will wonder why, if it's so outrageous for the state to read our emails, it is OK for WikiLeaks to publish confidential state correspondence.
"It's all about power," he replies. "And accountability. The greater the power, the more need there is for transparency, because if the power is abused, the result can be so enormous. On the other hand, those people who do not have power, we mustn't reduce their power even more by making them yet more transparent."
Many people would say Assange himself is immensely powerful, and should be held to a higher standard of accountability and transparency. "I think that is correct," he agrees. So was WikiLeaks' decision to publish Afghan informers' names unredacted an abuse of power? Assange draws himself up and lets rip. "This is absurd propaganda. Basic kindergarten rhetoric. There has been no official accusation that any of our publications over a six-year period have resulted in the deaths of a single person – a single person – and this shows you the incredible political power of the Pentagon, that it is able to attempt to reframe the debate in that way."
Others have wondered how he could make a chatshow for a state-owned Moscow TV station. "I've never worked for a Russian state-owned television channel. That's just ridiculous – the usual propaganda rubbish." He spells it out slowly and deliberately. "I have a TV production company, wholly owned by me. We work in partnership with Dartmouth Films, a London production company, to produce a 12-part TV series about activists and thinkers from around the world. Russia Today was one of more than 20 different media organisations that purchased a licence. That is all." There is no one to whom he wouldn't sell a licence? "Absolutely not. In order to go to the hospital, we must put Shell in our car. In order to make the maximum possible impact for our sources, we have to deal with organisations like the New York Times and the Guardian." He pauses. "It doesn't mean we approve of these organisations."
I try twice to ask how a campaigner for free speech can condone Ecuador's record on press controls, but I'm not sure he hears, because he is off into a coldly furious tirade against the Guardian. The details of the dispute are of doubtful interest to a wider audience, but in brief: WikiLeaks worked closely with both the Guardian and the New York Times in 2010 to publish huge caches of confidential documents, before falling out very badly with both. He maintains that the Guardian broke its word and behaved disgracefully, but he seems to have a habit of falling out with erstwhile allies. Leaving aside the two women in Sweden who were once his admirers and now allege rape and sexual assault, things also ended badly with Canongate, a small publisher that paid a large advance for his ghosted autobiography, only to have Assange pull out of the project after reading the first draft. It went ahead and published anyway, but lost an awful lot of money. Several staff walked out of WikiLeaks in 2010, including a close colleague, Daniel Domscheit-Berg, who complained that Assange was behaving "like some kind of emperor or slave trader".
It clearly isn't news to Assange that even some of his supporters despair of an impossible personality, and blame his problems on hubris, but he isn't having any of it. I ask how he explains why so many relationships have soured. "They haven't." OK, let's go through them one by one. The relationship with Canongate…
"Oh my God!" he interrupts angrily, raising his voice. "These people, we told them not to do that. They were wrong to do it, to violate the author's copyright like that." Did he ever consider giving his advance back? "Canongate owes me money. I have not seen a single cent from this book. Canongate owes me hundreds of thousands of pounds." But if he hasn't seen any money, it's because the advance was deposited in Assange's lawyers' bank account, to go towards paying their fees. Then the lawyers complained that the advance didn't cover the fees, and Assange fell out with them, too.
"I was in a position last year where everybody thought they could have a free kick. They thought that because I was involved in an enormous conflict with the United Statesgovernment. The law firm was another. But those days are gone."
What about the fracture with close colleagues at WikiLeaks? "No!" he practically shouts. But Domscheit-Berg got so fed up with Assange that he quit, didn't he? "No, no, no, no, no. Domscheit-Berg had a minor role within WikiLeaks, and he was suspended by me on 25 August 2010. Suspended." Well, that's my point – here was somebody else with whom Assange fell out. "Be serious here! Seriously – my God. What we are talking about here in our work is the deaths of hundreds of thousands of people – hundreds of thousands – that we have exposed and documented. And your question is about, did we suspend someone back in 2010?" My point was that there is a theme of his relationships turning sour. "There is not!" he shouts.
I don't blame Assange for getting angry. As he sees it, he's working tirelessly to expose state secrecy and save us all from tyranny. He has paid for it with his freedom, and fears for his life. Isn't it obvious that shadowy security forces are trying to make him look either mad or bad, to discredit WikiLeaks? If that's true, then his flaws are either fabricated, or neither here nor there. But the messianic grandiosity of his self-justification is a little disconcerting.
I ask if he has considered the possibility that he might live in this embassy for the rest of his life. "I've considered the possibility. But it sure beats supermax [maximum security prison]." Does he worry about his mental health? "Only that it is nice to go for a walk in the woods, and it's important – because I have to look after so many people – that I am close to the peak of my performance at all times, because we are involved in an adversarial conflict and any misjudgment will be seized upon." Does he ever try to work out whether he is being paranoid? "Yes. I have a lot of experience. I mean, I have 22 years of experience." He'd rather not say to whom he turns for emotional support, "because we are in an adversarial conflict", but he misses his family the most. His voice slows and drops again.
"The situation is, er, the communication situation is difficult. Some of them have had to change their names, move location. Because they have suffered death threats, trying to get at me. There have been explicit proposals through US rightwing groups to target my son, for example, to get at me. The rest of the family, having seen that, has taken precautions in response." But it has all been worth it, he says, because of what he's achieved.
"Changes in electoral outcomes, contributions to revolutions in the Middle East, and the knowledge that we have contributed towards the Iraqi people and the Afghan people. And also the end of the Iraq war, which we had an important contribution towards. You can look that up. It's to do with the circumstances under which immunity was refused to US troops at the end of 2011. The documents we'd published directly were cited by Iraqis as a reason for discontinuing the immunity. And the US said it would refuse to stay without continued immunity."
Assange says he can't say anything about the allegations of rape and sexual assault for legal reasons, but he predicts that the extradition will be dropped. The grounds for his confidence are not clear, because in the next breath he adds: "Sweden refuses to behave like a reasonable state. It refuses to give a guarantee that I won't be extradited to the US." But Sweden says the decision lies with the courts, not the government. "That is not true," he snaps. "It is absolutely false. The government has the final say." If he's right, and it really is as unequivocal as that, why all the legal confusion? "Because there are enormous powers at play," he says, heavy with exasperation. "Controversy is a result of people trying to shift political opinion one way or another."
And so his surreal fugitive existence continues, imprisoned in a tiny piece of Ecuador in Knightsbridge. He has a special ultraviolet lamp to compensate for the lack of sunlight, but uses it "with great trepidation", having burned himself the first time he tried it. His assistant, who may or may not be his girlfriend – she has been reported as such, but denies it when I check – is a constant presence, and by his account WikiLeaks continues to thrive. Reports that it has basically imploded, undone by the dramas and rows surrounding its editor-in-chief, are dismissed as yet more smears. The organisation will have published more than a million leaks this year, he says, and will publish "considerably more" in 2013. I'm pretty sure he has found a way to get rid of his electronic tag, because when I ask, he stares with a faint gnomic smile. "Umm… I'd prefer not to comment."
Assange has been called a lot of things – a terrorist, a visionary, a rapist, a freedom warrior. At moments he reminds me of a charismatic cult leader but, given his current predicament, it's hardly surprising if loyalty counts more than critical distance in his world. The only thing I could say with confidence is that he is a control freak. The persona he most frequently ascribes to himself is "gentleman", a curiously courtly term for a cypher–punk to choose, so I ask him to explain.
"What is a gentleman? I suppose it's, you know, a nice section of Australian culture that perhaps wouldn't be recognised in thieving metropolises like London. The importance of being honourable, and keeping your word, and acting like a gentleman. It's someone who has the courage of their convictions, who doesn't bow to pressure, who doesn't exploit people who are weaker than they are. Who acts in an honourable way."
Does that describe him? "No, but it describes an ideal I believe men should strive for."

Friday 7 December 2012

What good luck to miss out on a £64m lottery win

 

The national lottery symbol
'If I fantasise about winning the lottery, it doesn’t take long before all sorts of worrisome potential consequences occur to me.' Photograph: Danny Lawson/PA
 
What would you do if you discovered that you were the owner of the lottery ticket that won £64m, but you didn't claim it in time?

It would be nice to think you were big enough simply to be pleased that you had become the country's biggest philanthropist of the year by mistake, since at 11pm on Wednesday night, the unclaimed prize was handed over to charity. But I think most of us would be haunted by thoughts of what might have been for the rest of our lives.

Perhaps, but you don't need to have just missed out on a fortune to have dreams of "maybe … ". Life is full of what-ifs, many of which could easily have been realities, had just a few things been different.

Bitter regret is the consequence of being more confident than we should be about where those alternative paths would have led us. The truth is that we will never know. What looks like good fortune can easily turn out to be an incredible stroke of bad luck and vice versa. Albert Camus got in a car going back to Paris instead of getting the train, only to be killed in a fatal road crash. Then there are the passengers who were running late the day of the London bombings of July 2005 and missed the tube or train journey that would have killed them.

If we find it hard to believe that winning millions might not be so lucky after all, we just don't have a good enough imagination. If I fantasise about winning the lottery, it doesn't take long before all sorts of worrisome potential consequences occur to me. I think about how I might spread the love, and worry that it would take away the incentive for someone to work at what might really give them satisfaction; or that they might spend the cash on things like cosmetic surgery or drugs that are no good for them in the long run. Meanwhile, of course, I trust myself to spend wisely, unaware of all the ways in which I too might screw up my life by making bad choices.

The point is not to convince ourselves that wealth brings misery, which is just an idea the rest of us cling on to make ourselves feel better. It's simply that we don't know what would happen in any given case, and so we should not mourn for an alternative future (or past), the outcome of which is mysterious.

If we really do want to turn our near-miss into a positive, then we should take it as a lesson about how fickle fate is. We often don't notice how many of the things that have gone right for us depended on chance events that could have been otherwise. If I think about my choice of university and subject, or meeting my business and life partners, things that set the course of my life, it is frightening how easily none of them could have happened at all.

My greatest consolation would come from an article I researched several years ago, in which I chased up seven members of two rock bands that had very nearly, but not quite, made the big time. For one, it probably came down to no more than a technical hiccup, meaning Simon Bates never played their single on the then biggest radio show in the country. All accepted that it would have been great to have broken through, although one was convinced it would have killed him, so seduced was he by the rock'n'roll life. But all had made their peace with their near misses and could see now that what really mattered was continuing to do what they loved. I thought I had written a great piece, but it never got used. Another "nearly" moment.

We can't control whether we are rewarded for our endeavours, with cash or recognition. It is not up to us how much cash or time we get on Earth, but it is down to us how we spend it.

Sex tips for writers

 

stiletto boot and mouse
‘Bad sex' writing is funny because the anatomical vocabulary of conventional sex writing is hackneyed, impossible to visualise, stale, and given to bragging.
 
I started ruminating about sex writing while thinking about the annual Bad Sex awards – won this year by the novelist Nancy Huston for Infrared. Most sex writing is either soft-focus romance, (like those fuzzy movies you can rent in hotel rooms), utterly elided ("they read no more that night ... ") or hardcore one-handed reading, designed more as a substitute for sex than a realistic description of sex, which is usually comic, following Henri Bergson's definition of comedy as something that occurs when the body fails the spirit. Of course "bad sex" writing is funny because the anatomical vocabulary of conventional sex writing is hackneyed, impossible to visualise because full of ludicrously mixed metaphors, stale, and given to bragging.

Years ago Renaud Camus wrote a book called Tricks, which astonished everyone because he was determined to record his fiascos as often as his triumphs. (Today some people don't even know what the word "tricks" means).

Everyone seems agreed that writing about sex is perilous, partly because it threatens to swamp highly individualised characters in a generic, featureless activity (much like coffee-cup dialogue, during which everyone sounds the same), and partly because it feels ... tacky. Even careful writers begin to sound like porn soundtracks when they turn to sex writing.

As Susan Sontag once observed, pornography is practical. It was designed as a marital aid, and its vocabulary should follow natural biological rhythms and stick with hot-button words in order to produce a predictable climax. It is not about sex but is sex. Whereas the great sex writers (Harold Brodkey, DH Lawrence, Robert Gluck, David Plante, the Australian Frank Moorhouse) have a quirky, phenomenological, realistic approach to sex. They are doing what the Russian formalists said was the secret of all good fiction – making the familiar strange, writing from the Martian's point of view.

I've written some of the strangest pages anyone's typed out about sex. In my first novel, Forgetting Elena, an amnesiac man is drawn into sex by the Elena of the title. Only he doesn't remember of course what sex is, and he veers from thinking it's a coded form of communication to imagining it's a way of inflicting pain mixed with pleasure on oneself and on one's partner. I suppose I was basing it on my own first experiences of sex as a sub-teen. In another obscure novel, Caracole, I have lots of heterosexual sex, which is written from the point of view of a virginal teenage boy.

To be sure, most of my sex writing has involved two teen males or two (or more) adult men. I always bear in mind Harold Brodkey's remark to me that if you write "she went down on him", it is a "lie", because no one can summarise an intense, prolonged and inevitably unrepeatable and original sex act with a snappy five-word formula like that. He felt that every sex act had to be entirely rethought and reimagined from the beginning to the end. Which of course made his sex writing very, very long.

I've always thought that the main problem with gay erotica is what I call "the cock-and-balls" problem. It seems to me that gay sex writing is a major test for the typical reader, who is a middle-aged woman. Isn't it terribly alienating to have to read about those rigid shafts and hairy bums?
I guess straight men would hate such lurid passages just as much if they read fiction. But older women, at least, often like sex to be linked to sentiment and never to be purely anatomical. I imagine that's why so few gay novels have "broken through" to the general public; all their sexual hydraulics must seem either bleak or seedy. Or "boring", as middle-class people say when they're shocked.

Morphine: The cheap, effective pain-relief drug denied to millions

 


A terminally ill hospice resident with her music therapist in Lakewood, Colorado in the US In the UK and US, patients who need morphine get it - it's a different story elsewhere


It's cheap, effective and easy to administer - so why are millions of people around the world dying in pain, without access to morphine?

In an open ward at Mulago Hospital in Uganda's capital city, Kampala, an elderly woman named Joyce lies in the fifth bed on the left.

She has twisted the sheets around herself, her face contorted by pain. Joyce's husband, thin and birdlike, hovers over her.

Joyce has cancer - it has spread throughout her body - and until a few days ago, she was on morphine. Then it ran out.

"She's consistently had pain," says a nurse. "And she describes the pain to be deep - kind of into her bones."

The Ugandan government makes and distributes its own morphine for use in hospitals, but poor management means the supply is erratic.

"We're in a very difficult situation," says Lesley Henson, a British pain specialist on duty at Mulago Hospital. They have patients whose pain has been kept under control with morphine - but they are running out it.

A patient in Uganda being administered morphine

In many ways, morphine is an excellent drug for use in developing countries. It is cheap, effective, and simple and easy to administer by mouth.

Yet according to the World Health Organization, every year more than five million people with cancer die in pain, without access to morphine.

"The fact that what stands between them and the relief of that pain is a drug that costs $2 [£1.25] a week, I think is just really unconscionable," says Meg O'Brien, head of The Global Access to Pain Relief Initiative, a non-profit organisation that advocates for greater access to morphine.

O'Brien says in well-off countries, like the UK and United States, there is enough morphine to treat 100% of people in pain - but in low-income countries, it's just 8%.

In many low- and middle-income countries - 150, by some counts - morphine is all but impossible to get. Some governments don't provide it, or strictly limit it, because of concerns that it will be diverted to produce heroin.

And many doctors are reluctant to prescribe morphine, fearing their patients will become addicted.

In India, whether you can get morphine depends largely on where you are treated.


Tata Memorial Hospital, a modern and well-equipped medical centre in Mumbai, has no problem getting morphine for patients.

"We have all the medicines necessary," says Dr Mary Ann Muckaden, head of pain relief at the hospital. "We never run out."

But in other parts of the country, it's a different story. Muckaden estimates only 1% to 2% of Indians with cancer pain get morphine.

Dinesh Kumar Yadav, 28, has come to Tata Memorial - a 30-hour bus ride from his home - to get morphine for his wife.

He tells me she is bedridden with pain but can't get morphine in the north Indian state where they live.

Dr Muckaden says part of the problem is a stifling bureaucracy.

"Many physicians in the north, they don't want to go through the rigorous licensing to store morphine," she explains.

A morphine-use map of the world

A map showing access to pain relief in different parts of the world. Country size is adjusted to reflect opioid medication use per death from cancer or HIV/Aids
  • $2 (£1.25) - cost per week per patient
  • 100% - percentage of people in UK and US who have access to morphine, if they need it
  • 8% - percentage in the developing world who get morphine when required
  • 20% of the world's painful deaths are in sub-Saharan Africa, but only 1% of morphine use
Source: GAPRI

There is a place in India where there are no barriers to morphine. But even at the CIPLA Palliative Care Centre in the city of Pune, in Maharashtra state, there are still challenges.

You don't see the challenges when you walk through the cool courtyard gardens with fountains and manicured walkways, or in the beautiful whitewashed buildings with large airy wards, each named after a flower.

"This is heaven on earth," says Asha Dikshit, whose mother came here last year in the last stages of breast cancer.

"She was in agony. Her shoulder had dislocated. It could not be fixed back," says Dikshit. "She had pain in the back, and sometimes there were hallucinations."

But she says her mother died - peacefully - on morphine.

Making morphine

Opium poppies produced for morphine near ripeness in a field in Salisbury, England
  • Comes from the opium poppy
  • Discovered in 1804
  • First marketed for pain relief in 1817
  • Recommended by WHO for pain relief under certain conditions

Every patient here has cancer, and the care is free. The Indian generic drug manufacturer CIPLA supplies the morphine and pays all the other expenses.

But even with all the centre offers, the occupancy rate runs at only about 60%. One big reason, says director Priya Kulkarni, is a result of patients' own concerns about morphine. They often think morphine equals death, and they recoil when doctors suggest it.

Kulkarni says many local oncologists don't want to send patients here for that reason.

"They don't want to give up when it comes to giving them hope," she says. "And saying something like, 'I am going to refer you to a palliative specialist,' is indirectly saying 'There is nothing more I can do for you.'"

Despite all the obstacles to the use of morphine in the developing world, Kulkarni and others say things are starting to move in their direction.

In low-income countries, morphine consumption is up tenfold since 1995, according to the International Narcotics Control Board. And several countries where not many years ago there was no morphine - like Uganda - at least have some today, even if the supply is unreliable.

Back at the hospital in Kampala - where the pharmacy ran out of morphine and Joyce, the cancer patient, had to go without - palliative care specialist Leslie Henson finds a bit of luck. After leaving her patient, she steps into an office, glances at a bookshelf, and sees a forgotten bottle of morphine. It's enough to treat two or three people.

"Hopefully, we'll go take this to her and see what we can do," she says as she troops back to Joyce's room.

Soon, a doctor administers the morphine.

Joyce smiles. Her face untwists. And her husband looks ecstatic.

I ask Joyce if she's glad to get the morphine. Her husband answers. "Very much, indeed."

Other people in the hospital will remain in pain - there is not enough morphine to go around - but for the next few hours, at least, Joyce will be pain-free.

Wednesday 5 December 2012

Blacklisting is the scandal that now demands action

 

kenyon
'Workers across Britain have been systematically and illegally forced into unemployment by some of the country's biggest companies.' Illustration by Matt Kenyon
 
As in the phone-hacking scandal, the evidence of illegality, surveillance and conspiracy is incontrovertible. In both cases, the number of victims already runs into thousands. And household names are deeply tied up in both controversies – though as targets in one and perpetrators in the other.

But when it comes to the blacklisting scandal, the damage can't only be measured in distress and invasion of privacy. Its impact has already been felt in years of enforced joblessness, millions of pounds in lost income, family and psychological breakdown, emigration and suicides.
It's now clear that workers across Britain have been systematically and illegally forced into unemployment for trade union activity – often on publicly funded projects and in collusion with the police and security services – by some of the country's biggest companies, using secret lists drawn up by corporate spying agencies.

Liberty has equated blacklisting with phone hacking, insisting that the "consequences for our democracy are just as grave". Keith Ewing, professor of public law at King's College London, calls it the "worst human rights abuse in relation to workers" in Britain in half a century.

But whereas David Cameron ordered a public inquiry into hacking, he rejected any investigation of blacklisting out of hand. And while a mainly anti-union media has largely ignored the scandal, all the signs are that it's continuing right now, in flagship public projects such as the £15bn Crossrail network across the south-east.

Thanks to leaks, tribunals, evidence to MPs and an information commissioner's raid, we now know that one of those private espionage outfits, the Consulting Association, had 3,213 names on its blacklist before it was shut down in 2009. Most were construction workers, based at sites from Clwyd to Croydon, but they also included environmental activists.

For an annual subscription of £3,500, 44 construction and outsourcing giants such as Balfour Beatty, Carillion, Sir Robert McAlpine and Wimpey paid £2.20 a shot for "intelligence" on the 40,000 names a year they ran past the association's database.

For that they could have access to such gems as "keeps extremely interesting company", "union activity", "brought in H&S issues", "politically motivated", "troublemaker", "recently seen at a leftwing meeting" and "girlfriend … involved in several marriages of convenience". Mostly, workers were branded "involved in dispute" or "company given details and not employed".

Through this covert power, building workers were driven on to the dole during a construction boom. Both Dave Smith, an engineer, and Steve Acheson, an electrician, were sacked from one major construction job after another after raising health and safety concerns (asbestos and lack of drying facilities) over a decade ago. They have never been able to work in the trade for more than a few weeks ever since.

Their cards had been marked by blacklisters. "Those people ruined my life," Acheson says. For some workers, they destroyed it. After hundreds involved in disputes on London's Jubilee line extension were blacklisted in 2000, at least two who were unable to find work committed suicide.

The Consulting Association, which used material the Information Commissioner's office said "could only be supplied by the police or security services", was fined £5,000 for breaching data protection law (paid by the Conservative donor Sir Robert McAlpine). Blacklisting was formally outlawed in 2010, but covert arrangements are by their nature difficult to expose.

Corporate managers who have been revealed to have been up to their necks in blacklisting are now running major publicly funded projects – including Crossrail and the Carillion-run PFI Great Western Hospital in Swindon – that are the focus of new blacklisting and bullying disputes.

Last week, Ian Kerr, the man who headed the Consulting Association, spoke in public for the first time, telling MPs there had been an "awful lot of discussion" between Crossrail contractors and his outfit, as well as those at the Olympic Park, Wembley stadium and other public construction projects. "Like it or not," he declared, blacklisting "will always be there".

Of course blacklisting isn't new. Throughout the cold war, the virulently rightwing Economic League ran a similar corporate espionage outfit, from where Kerr brought his database. And more recently civil servants, police and corporations have been shown to work hand in glove against climate change and other environmental activists.

Nor is blacklisting confined to construction, where unions still have real power. But in a deregulated economy – where union weakness has helped slash the share of wages in national income and an anti-union firm such as Starbucks can announce it's cutting staff benefits on the day it's in the public dock for tax dodging – this ugly corporate victimisation isn't just an outrage against civil liberties.

It's also a block on the revival of union organisation essential to turning the tide of inequality – and the defence of those paying the price of a failed economic model. Labour, which took 11 years to put its own ban on blacklisting into law out of deference to big business, now needs to commit to tougher rights at work. The scandal of corporate blacklisting doesn't just demand a public inquiry and compensation, but a real shift of direction on power in the workplace.

Monday 3 December 2012

Drugs are taken for pleasure – realise this and we can start to reduce harm

 

Clubbers hug
'The fact that there are so many users of illicit drugs means that the pleasures must often be seen to outweigh the pain, just as they do for alcohol and tobacco.' Photograph: Scott Houston/Sygma
 
The mainstream penalty-driven approach to drugs control is both morally and intellectually flawed. Morally, it ignores the use and, in some cases, promotion of drugs such as alcohol and tobacco that are much more harmful than most "illicit" drugs. Intellectually, it ignores the reasons people choose to take drugs, and why they value them. One of the most important motivations for taking drugs, which cannot easily be acknowledged by the authorities, is personal pleasure.

The UK government position seems predicated on the view that all drug users are addicts, enslaved to their drug of choice by virtue of a lack of moral fibre. In fact, we know that even for the most addictive drugs – heroin, crack cocaine and crystal methamphetamine – most users do not become addicted. And of course at the initiation of use people are not addicted, with almost everyone who tries out a drug doing so through personal choice rather than being made to by dealers; so there is clearly a lot of choice in the use of drugs.

There are several reasons for people choosing to try drugs. For "legal" drugs particularly alcohol and tobacco, that most people find unpleasant to start with, the choice to use is largely driven by fashion, manifesting through peer pressure. With alcohol, the drinks industry has marketed less aversive mixtures (alcopops) to help people overcome the taste of alcohol. It also engages in massive sexually orientated advertising to induce use, much of this illegally targeted at underage drinkers via social media sites.

In the UK last year half of all 15- to 16-year-olds were intoxicated on alcohol at least once a month, despite the drinking age being 18. This behaviour is de facto "illegal" though the government turns a blind eye, which means that many are addicted to alcohol before they are able to legally purchase it. For "illicit" drugs the choice to use is more complex, as the risk of being caught and getting a criminal record needs to be taken into consideration. Yet up to 50% of young people break the law to use these at some stage in their lives. To better deal with the consequences of this use – for example up to 5% of regular cannabis users may be dependent — we need better information about the reasons for use.

In some cases illicit drug-taking is about challenging authority, but in most cases it's about psychological exploration, often driven by positive comments and encouragement from friends. Then, once the hurdle of "breaking the law" has been overcome, the value of the drug in terms of personal pleasure and positive social engagement can be weighed against the risks of being caught. For a sizeable minority of users "illicit" drugs are taken to reduce pain and suffering (eg cannabis for multiple sclerosis, psilocybin for cluster headaches). Similarly, alcohol is often used to reduce anxiety and deaden sadness.

The fact that there are so many users of "illicit" drugs such as cannabis, MDMA and ketamine means that the pleasures must often be seen to outweigh the pain, just as they do for alcohol and tobacco. Until we properly understand the personal value of all drugs (including alcohol and tobacco), harm- and use-reduction policies are bound to fail.

In some countries even admitting that there might be a value in drug use is effectively barred from public discourse. In order to start an honest dialogue with people who use drugs we need to balance the focus on drugs-related harms by exploring pleasure, which is what motivates most people who use drugs, including alcohol.

The new web-based Net Pleasure Index, part of the 2013 Global Drug Survey is an attempt to gather this information for a wide range of drugs. It is aimed at the recreational rather than addicted user of alcohol and other drugs (tobacco users rarely admit to any pleasure, as they are mostly dependent).
Along with questions on drug policy and prescription drug use, the data it generates will help decision-making by government and individual users about the relative likelihood of new "legal highs" becoming a problem and help us better understand what motivates the use of different drugs. It will also guide advice on websites such as the Independent Scientific Committee on Drugs (ISCD) and aid harm-sation educational approaches such as the Global Drug Survey drugs meter.

If you are one the 90% of the UK population who use some sort of drug then please take the time to join the 13,000 people who have already taken part in this year's Global Drug Survey and give us your insights.

Borussia Dortmund boss attacks Premier League's oligarch owners

 

• Chief executive says English game is losing its soul
• Germany's cheap tickets and standing areas show the way
Dortmund supporter
Borussia Dortmund's chief executive, Hans-Joachim Watzke, says that links between fans and clubs in Germany are now stronger than they are in England. Photograph: Gary Calton for the Guardian
 
The chief executive of Borussia Dortmund, who play Manchester City in the Champions League on Tuesday, has launched a passionate defence of German football principles and attacked English clubs' ownership by rich men from overseas.

Hans-Joachim Watzke described German football as "romantic" for retaining its "50% plus one" rule, which requires Bundesliga clubs to be owned by their members. He questioned the ethos and sustainability of Premier League clubs' ownership, including City being owned and funded by Sheikh Mansour of Abu Dhabi.

Of City, a club he visited for last month's 1-1 draw in the first match between the two, Watzke said: "I am a little bit romantic, and that is not romantic. In England people seem not to be interested in this – at Liverpool they are fine for the club to belong to an American. But the German is romantic: when there is a club, he wants to have the feeling it is my club, not the club of Qatar or Abu Dhabi."

Watzke was a prominent supporter of the 50% plus one rule when it was challenged last year by Martin Kind, the president of Hannover. Dortmund are floated on the stock market, but the members elect the president and four members of the club's supervisory board – and also vote to decide major issues of club policy.

"I was the biggest opponent of changing the rule," Watzke said in an interview with the Guardian at Dortmund's Signal Iduna stadium in the build-up to the City match. "Germans want to have that sense of belonging. When you give [the supporters] the feeling that they are your customers, you have lost. In Germany, we want everybody to feel it is their club, and that is really important."

All 36 Bundesliga clubs are owned or controlled by their members, except the historic exceptions of Wolfsburg, owned by Volkswagen, Bayer Leverkeusen, owned by the pharmacy giant Bayer, and Hoffenheim, which is now funded by a single very wealthy entrepreneur, Dietmar Hopp.

Apart from those three and Kind's Hannover, the remaining 32 voted to keep the 50% plus one rule, which was introduced in 2001 when the Bundesliga clubs broke away to run the league competition independently from the German Football Association, the DFB.

"In former times in England I think the relationship between the club and supporters was very strong," Watzke argued. "Our people come to the stadium like they are going to their family. Here, the supporters say: it's ours, it's my club."

Watzke, himself a lifelong supporter of Dortmund, who drew 1-1 with runaway Bundesliga leaders Bayern Munich on Saturday, linked the system of member-ownership and control to the maintenance of affordable tickets and standing areas at top flight German football.

At Dortmund, the 25,000 fans who form the famous "Yellow Wall" standing area in the Signal Iduna stadium's south stand pay just €190 (£154) for a season ticket for the 17 home Bundesliga matches. Season tickets that also include entry to the first three Champions League group games cost slightly more at €220, working out at exactly €11 for each match.

"Here, it is our way to have cheap tickets, so young people can come," Watzke said. "We would make €5m more a season if we had seats, but there was no question to do it, because it is our culture. In England it is a lot more expensive. Football is more than a business."

Watzke argued that Dortmund, who top the group of City, Real Madrid and Ajax while the English champions cannot qualify for the knockout stages, have been able to compete with such clubs thanks to sensible management, coaching and player recruitment, despite not having the resources of a rich individual such as Sheikh Mansour backing the club.

"Everybody told me you cannot play in the Champions League against clubs like Manchester, they have more money. But we are trying to do it ourselves, in our way.

"There are a lot of ways to Rome," he said. "Chelsea have won the Champions League. But Chelsea's question is: what happens after [Roman] Abramovich?"