What is not being said?

What is not being said in the public and academic discourses about poverty and marginalization? What topics are not being discussed? What is intentionally or unintentionally being kept hidden? I ask these questions because they can point to truths that we try to avoid—truths that may be unpleasant but nevertheless productive of new ways of thinking about the issues and addressing their roots.

Systems are burning people out

I think one of the most serious silences relates to the gap between the rhetoric around social and health services and the realities that too many clients and patients face. I am referring specifically to the fact that too many health care practitioners do not seem to care about their patients. Or their mode of caring is constrained by the need to “maintain professional boundaries.” Similarly, too many social service professionals are oriented to serving the system they work in rather than its clients. You do not have to be poor and marginalized to have had the experience of feeling dehumanized by a health care practitioner or a civil servant.

My intention here is not to criticize individual professionals. I worked in the social service and health care systems for many years. Most of my colleagues were dedicated, hard-working, caring people. But the systems we worked within and the systems that educated us did not support our efforts to fulfill the generous motives that inspired us to enter a helping profession. Too many people in these professions are depressed, cynical, dissociated—in a word, burned-out. Too much skill, experience, and commitment is being wasted or lost entirely. And too many of the people who receive services or take part in social programs are burned by their experiences in these systems.

It is time to consider the question of whose interests are really being served by these institutions and how these systems can be re-oriented to align with their stated goals. Since universities and colleges educate the people who hold the most power in these institutions, since post-secondary institutions have a societal mandate to delve into critical policy questions, and since they have less to lose from posing this question, post-secondary institutions have a responsibility to play more of a leadership role in figuring out how to humanize large, complex bureaucracies.

Not everyone can be a success story

homelessReports on social programs and appeals for donations to non-profit organizations often tell touching stories of people who have overcome obstacles and gained (or re-gained) a place in society. Social programs typically articulate ambitious goals about people being freed from poverty or social isolation or whatever issue the program focuses on. With the success of the movement to close state-run institutions that housed the mentally ill and disabled, the social services field seems to have adopted the perspective that everyone can live in the community, everyone can lead a normal life, and everyone can aspire to the dominant culture’s image of success. What is required is just the design and delivery of the right combination of services in order to meet people’s needs, including the needs of “the underserved.”

There is no doubt that the de-institutionalization movement was justified. Sometimes, human rights were being violated and basic standards of care were not being met. But the reality is that some people cannot succeed in urban North America. There are people who are too sick, too disabled, too mentally ill, and/or too addicted to make it on their own. You see such people on the streets in the Downtown Eastside. In fact, the Downtown Eastside is an important message about this reality. We must be willing to listen to it.

No one wants to go back to the days of the madhouse or the poorhouse. But society needs to offer some place between the asylums of old and the streets of today for those whose needs cannot be met by the existing array of “community-based” services. Some such places exist. But not nearly enough.

It seems to have become politically incorrect to acknowledge that some people will not succeed according to society’s expectations. Meritorious efforts to end discrimination against people with disabilities or mental illnesses have, it seems, made it difficult to talk about how to care for people who have complex or severe needs. It is as if the pendulum has swung from the extreme of, “These people are lost causes,” to the opposite extreme: “Everyone can do anything.” But if we cannot talk about what formal and informal support people need or want, what such support might realistically achieve, and what it might cost, we end up with what we’ve got—a social service system that is fragmented, difficult to navigate, prone to letting people fall through the cracks, frustrating for both professionals and clients, and whose costs are impossible to quantify. How might we carry on a conversation about the circumstances of people with complex and difficult needs that allows for the possibility they will never be “normal?” How can the drive to embrace diversity in terms of people’s abilities include those whose limitations challenge our latest assumptions?

Limited resources are being allocated without enough consideration

Part of the problem is that it is very difficult to predict who might be able to overcome their difficulties and who might not. Working in the Downtown Eastside you hear about instances of seemingly miraculous transformations that no one predicted. How does anyone know what might be possible or impossible for a particular person? Who decides what the goal of giving support should be? And perhaps the most important question: Why are decisions about what support to give to whom made based on future potential or the presumed lack thereof? Why is the future the focus rather than the present?

In so-called primitive societies, there were cultural norms and traditional practices that governed how the community responded to cases of extreme weakness or dependence. These practices were designed to make sure the community did not over-extend its resources or jeopardize its own survival. For example, babies born deformed or sickly were not cared for. Old or sick people who could not keep up with nomadic tribes on the move were left behind. The norms and practices were based on calculations that gave precedence to the welfare of the group. The rights of individuals were secondary or not even part of the cultural conversation.

In modern, civilized societies, the life of the individual is seen as paramount. Every baby should be saved. Every old person’s life should be sustained as long as possible using every means possible. To do otherwise is seen as barbaric. In countries like Canada, we think we no longer sacrifice individuals for the sake of the collective.

In fact, we apply values about the sanctity of life and the alleviation of suffering selectively without admitting it. Our communal resources are limited just as those of “primitive” societies are. Professionals in the health and social service sectors make decisions about people’s eligibility for support every day. The effects of these decisions are not as direct or immediate as some practices in primitive cultures. But some people do not get the support they believe they need; they feel they have been abandoned, condemned. Is there a way to open a dialogue about the ways we allocate limited societal resources without everyone automatically assuming ideological positions that allow no room for new ideas?

Class differences matter

graffiti and manYou cannot spend time in the Downtown Eastside without seeing class differences. But surprisingly little is said about class per se. The subject rarely came up among professionals I worked with. Low income people seem more willing to raise the issue. Calling professionals in the health and social service agencies “poverty pimps” is one way that Downtown Eastside residents call attention to the structure of the local social system. Another is saying that, “We don’t need people from outside coming down here and telling us how to live a better life.” I heard many people express this sentiment during the consultation that led to the creation of the Learning Exchange. One of the Learning Exchange patrons said something similar when he described the attitude of people outside the Downtown Eastside as being, “You are going to hell because we made it and you didn’t.” Another long-time patron used the language of class warfare when he said that he and I were “enemies” and that I was part of “a killing machine.”

As is usually the case, those who feel they are on the receiving end seem to be more sensitive to discrimination than those who intentionally or not are guilty of it. I was aware that class was an elephant in the room at the Learning Exchange. It did not take me long to realize that some of the patrons at the Learning Exchange storefront had a love-hate relationship with us. There were people who came to the storefront every day who were also vocal critics. I used to wonder why they spent so much time at the storefront if they found it so objectionable. But I did not connect their apparent ambivalence with the elephant. I now wonder whether these patrons felt that we were exploiting them so they might as well exploit us. This seems to be the opposite of gift-giving relationships. Instead of the flow of gifts and generosity keeping the community going, I wonder if this unusual community of mostly middle-class people from the university and mostly poor people from the Downtown Eastside was sustained partly by a circulation of presumed entitlements and subterranean emotions.

After I interviewed patrons for this website, I regretted that I had not had that kind of in-depth conversation in the early days of the evolution of the Learning Exchange. I realized that if I had taken more time to get to know patrons as people (which I was constantly exhorting students to do) I would have done things differently. When I asked myself why I did not have such conversations ten years earlier, I saw the elephant clearly for the first time. I was afraid of the unknown (people from a social class I was not comfortable with). I felt defensive about my position (I knew I had more power than local residents and did not know how to carry this power). I think I was afraid that if I connected to people as equals, I would not know how to perform my role.

When I finally did have these conversations I was no longer in my role. I had nothing to lose and nothing to defend. Fear was replaced by curiosity. My experience is instructive. I do not think much progress will be made in the effort to solve the problems of poverty and social marginalization unless the issue of class differences is addressed openly. I think we need to develop some new ways for professionals to interact with people who are poor and marginalized. But this will be extremely difficult to do. Poor people are angry. Middle class people feel guilty. Professionals fear they have a lot to lose. It will not be easy to get past long-standing stereotypes and emotions.

I know the question of how to openly talk about class needs to be raised. I am short on answers about how to engage in this dialogue skillfully. But I do believe that bringing university students into poor communities as volunteers is one place to start. Students have less to lose by engaging with the issues. They do not yet have careers or employers to defend. By virtue of being low status players in large bureaucratic institutions, they can relate to the experience of oppression. Maybe they can help us all unlearn the stereotypes and assumptions that underpin classism. Maybe they can help us find better ways to organize societies where categories of people are not dismissed as dispensable.

For more on these topics, see Being on the outside and the other articles in the Reflections section.

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