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Dying For Growth (Shoepf)
-Neo-classical economists, sometimes dubbed the “Washington Consensus”, attribute the
region’s decline primarily to internal factors, such as misguided policies,
mismanagement, and corruption of African gov’ts. Under the sway of it in early 1980s the
int’l financial situations (IFIs) began to impose a series of structural adjustment programs
(SAPs) which they claimed would restore health to stagnant African countries.
-The movement of soldiers and migrant labourer over large land areas led to the spread
of STDs, which lowered fertility. While earlier Western writers depicted Africa as rife w/
disease from time immemorial, in fact the unhealthiest period in all African history was
undoubtedly between 1890 and 1930,” the era of colonialists’ primary capital
-Africa gained independence in the 1960s. 2 closely related sets of problems shaped
Africa’s future: political and economic.
-Whether African gov’ts chose statism and nationalization of foreign firms or “liberalism”
and “Africanization” of management, independence failed to alter European economic
-Widening disparities in wealth and failure to meet popular expectations for a better life
brought political dissent and popular rebellions.
-The results of SAP implementation in the 1980s bore little resemblance to the predictions
initially offered IFI experts. Poor countries’ economies stagnated while their debt burdens
continued to increase. By the end, debt levels were so high that gov’ts of most non-oil
producing countries used 30-70% of export revenues for debt service.
-The IFIs proposed to trade “short term pain for long term gain”. This failed to
acknowledge that for already vulnerable populations short-term pain could mean
devastating long-term helath consequences affecting future generations, and that those
least responsible for the crisis would be it’s primary victims.
-SAPs impact on the health of the poor: 1) rising social and political violence with the
1994 genocide in Rwanda 2) spread of HIV/AIDS 3) poor people’s reduced access to
biomedical health care 4) deteriorating quality of health care available to the poor and
middle classes and 5) consequences of SAPs’ effects on food production and nutrition.
•State tyranny, civil conflict roots in the legacy of European colonialism, in the
structural violence of poverty and in the competition among privileged groups.
•Struggles for control of the state as a site of enrichment have led to “implosion” o
states in civil wars. Brought millions of civilian deaths, rapes and population
•State and ethnic violence come to be known as “structural violence”
•Rwanda avoided urban bias. The Bank ignored violations of human, economic,
•Rwanda avoided the urban bas by hampering urban growth. By mid-1980s 1
million landless and near-landless people were held “down on the farm” by pass
•Systematic discrimination against Tutsi was instituted in 1973. They were barred
from the army and limited in their access to gov’t posts.
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