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Into the Streets

The New Physician October 2000
First came the ‘Battle of Seattle.’ Then, large-scale protests erupted in cities nationwide over economic globalization and corporate greed. Think it has nothing to do with you? Think again.

In Washington, D.C., in a drizzling, spring rain, they walk to the beat of metallic and plastic-sounding drums, chanting “This is what democracy looks like! Off the sidewalks, into the streets!” Thousands move across the puddly asphalt, many waving “Spank the Bank” banners, dressed in costumes and carrying gigantic puppets in the forms of pigs, turtles, skulls and humans. At times, they stop, lock arms and form a human chain, blocking traffic, until they are torn away by men in uniform. At other moments, they’re dancing in the park underneath the cherry blossoms, dragging dumpsters into the streets, listening to speakers on the Mall and undergoing protest training in churches and warehouses. And then there are the hours of standoff with police and the arrests. Some protesters get beaten and tear-gassed. Still, many remain safe in their numbers, their solidarity providing them protection to continue their civil disobedience.

Their cause? If you ask any of the individuals on the streets why they’re staging protests—and “staging” is the correct term, for these movements are highly organized and orchestrated events—their underlying answer will be this: They want to make a change, and it’s not a simple one. They crave a grand transformation involving three powerful giants—the International Monetary Fund (IMF), World Bank and World Trade Organization (WTO)—and the values protesters say these institutions represent, namely corporate greed. Protesters claim this greed has infected the democratic workings of the United States and threatens populations around the world through economic globalization. Activists’ demands vary from reforming to abolishing these organizations.

Mainstream media’s cursory glance at the December 1999 Seattle, April 2000 Washington, D.C., and July and August 2000 Philadelphia and Los Angeles protests hasn’t elicited much information. So far, the protesters have been accused of being just a bunch of kids with too much time on their hands—snotty suburban kids at that. They’ve been labeled anarchists with a mission to cause chaos. And they’ve been criticized for being too diverse—their movement lacking in cohesion. But this can’t be the entire or true story. In fact, the only way to know who these protesters are and what they’re angry about is to start talking to them—after all, many are your classmates and colleagues (See “Diary of a Student–Activist,” p. 13). Many are health-care professionals and students who feel bound by a sense of duty to participate in this growing movement against globalization.


“The greatest threat to our world is our mindless acceptance of corporate values. And the holy trinity of the IMF, World Bank [and] WTO are the most prominent vehicles for this corporate colonization of the world,” says Rian Podein, a third-year Temple University medical student who participated in the Washington, D.C., and Philadelphia protests. His language is common among many protesters, full of imagery and passion but lacking in detail that would help outsiders understand what he’s really talking about.

The IMF, World Bank and WTO are commonly referred to in activists’ camps as being members of the “holy trinity.” They earn this lofty status with the power they wield around the world, protesters say. Many in the United States have heard about the WTO, but the World Bank and the IMF are somewhat murkier institutions to the general American public.

The IMF and World Bank were created in 1946 at the Bretton Woods conference in New Hampshire. Twenty-nine countries signed on to the agreement, initiating the World Bank (then called the International Bank for Reconstruction and Development) as a financial agency to help rebuild war-torn Europe and aid impoverished countries’ development. The IMF’s assignment was to regulate an international monetary system and facilitate global trade. The WTO’s history begins here as well, with the General Agreement on Tariffs and Trade, after an effort to establish an international trade organization failed. The WTO was established in 1995.

Now known primarily as a multilateral lending agency, the IMF has 182 member countries, with the United States owning almost 20 percent of the organization’s voting power. For every dollar a country contributes to the lending pot, it gets a vote. The wealthier the nation, the more it contributes. But the member countries don’t really vote. Instead, decisions are made in conferences behind closed doors.

That’s part of the problem, says Robert Naiman, senior policy analyst at the Center for Economic and Policy Research (CEPR) and co-author of A Survey of the Impacts of IMF Structural Adjustment in Africa: Growth, Social Spending and Debt Relief. “It’s difficult for anyone outside of the process to know what’s going on,” he says.

What gets decided at these meetings is important, activists say, for of the three institutions, many argue that the IMF wields the most power. “But they all have very long tentacles,” says Robert Weissman of the Washington, D.C.-based activist group Essential Action. It helped organize the protests against the IMF and World Bank in the nation’s capital and is connected with Green Party presidential candidate Ralph Nader.

Public enemy No. 1 for many activists is the IMF’s and World Bank’s (the two are interconnected) structural adjustment policies. Practically unheard of in the United States, these programs have impacted countries across the globe for decades. Countries take special low-interest loans from the IMF, and as a condition of the loans and some World Bank programs, they must restructure their government spending. IMF senior press officer Kathleen White says these “corrective measures” are geared to stabilizing a country’s economy and encouraging development.

Many of the requirements include making cuts in areas the IMF deems “unproductive”; frequently these involve a government’s public health and education spending—although the institution says it encourages spending in these areas. The IMF is also accused of encouraging countries to privatize their industries, eliminate government subsidies for food and other popular items, reduce trade barriers and invite foreign investors. This ideology, Naiman says, is an “aggressively free-market one [with] absolutely no role for government.”

And as a result of the restructuring, critics say, these programs have crippled many already suffering nations around the world, especially in sub-Saharan Africa, and introduced profit-hungry managed-care organizations (MCOs) into Latin America.

For example, they point to such countries as Zimbabwe and Mozambique. According to the CEPR report, in the early 1990s, Zimbabwe entered into a reform program in order to obtain a $484 million IMF loan. Among the loan requirements, the country had to lower the minimum wage and eliminate certain guarantees of employment security. As a result of these changes, public health sector employees’ income dropped dramatically, causing many physicians to move to private businesses. For Zimbabwe’s poor, this meant a decrease in quality of and access to health care, Naiman says. Similar problems resulted in Mozambique when it began to modify its government spending as part of the IMF’s Heavily Indebted Poor Countries program. “People were better off when they had universal services,” Naiman says.

The same is true in terms of health care in Latin America, according to Dr. Howard Waitzkin, a practicing physician and director of community medicine at the University of New Mexico (UNM). He calls globalization “the No. 1 policy issue facing us today, [and it’s] generally quite deleterious.” In 1999, he co-authored a study about the exportation of MCOs to Latin America, which was published in the New England Journal of Medicine. Waitzkin says his research shows that MCOs have led to an increase in barriers to health care for many Latin Americans who can’t afford the system’s user fees.

The IMF contends it doesn’t impose reforms on a member country. It says member countries come to them and seek advice on sensitive issues. “This is a cooperative institution,” White says. But many outsiders, especially these activists, don’t believe it.

“That’s basically a lie,” Naiman says. In IMF’s private meetings, he says, “some animals are more equal than others.” But he concedes that “the [IMF’s power] varies from case to case and country to country. Bigger economies have better leverage.… If Mozambique told the IMF to get lost, it’d likely be cut off by many bilateral aids.” He explains that many countries and institutions, including the World Bank, require the IMF’s seal of approval before lending assistance. So if Mozambique were to default on their IMF loan, he says, it would be closing the door to future help.

The crux of the issue for many protesters is this inequality between smaller and larger countries, corporations and communities, and, in general, institutions and individuals. They complain that the imbalance of power results in steep injustices and abuse, which leads to monetary and control gains for those who already wield more power.

“Democratically elected governments are [made] impotent,” says Simon Ahtaridis, a third-year Temple University medical student who participated in the IMF/World Bank and Philadelphia protests. He accuses the two institutions and the WTO of not being held accountable for their programs and for not instituting safeguards protecting communities from the jaws of corporate interests. Ahtaridis points to the cases involving totalitarian or corrupt governments. These leaders aren’t too interested in doing what’s best for their people. And this becomes dangerous, he says, when that government negotiates with the IMF, World Bank or WTO on policies that could affect everything from what crops farmers should plant to how much help families can get in sending their children to school. “That undermines communities,” he says.

In terms of the WTO, protesters charge the organization with bowing to corporate influences. Probably some of the sharpest criticism lately of WTO trade laws involves the international AIDS crisis.

Activists around the world, including members of the World Health Organization, charge that the WTO “Agreement on Trade-Related Aspects of Intellectual Property Rights” (which refers to patents, copyrights and trademarks) allows pharmaceutical companies to price their drugs higher and out of the range of HIV-infected individuals in impoverished nations.

So where do the Philadelphia and Los Angeles protests fit in? Activists say they were taking advantage of the media attention surrounding the two political party conventions to bring about some sort of national debate on their specific causes and the larger issue of corporate influences on the U.S. political system. Whether or not this worked (few mainstream news media outlets paid attention to the protesters, except to show some arrests), activists say the convention protests proved to be powerful unifying events for themselves, regardless of their varying agendas.

Ahtaridis describes the Philadelphia protests, known to activists as R2K, like this: “One person’s cause was everyone’s cause. Every cause moved our society in a more just, democratic and sustainable direction. So, whether it was universal health care, protecting rain forests, freeing Mumia [Abu-Jamal], campaign finance reform or ending human rights abuses, everyone was there for the same reason—to make the world a better place.”


“Why protest? Sometimes bad ideas get stuck in society, becoming so politically correct you can’t question them. Slavery, apartheid, denying women the vote—all of these appalling practices were politically correct years ago,” says Dr. Rick Stahlhut, who attended the Washington, D.C., and Philadelphia protests. “None of these situations changed merely because people voted for the right party, or because experts had calm discussions. They changed because brave, ordinary people took to the streets and made injustices obvious. Protests woke up the public and encouraged reformers inside the system to act.”

Not every activist on the street understands the specific workings of the institutions they’re protesting, but all talk about the movement’s basic principle: taking power out of the hands of corporations (which many activists refer to as having “superhuman rights”) and giving it back to the people.

“We’re trying to alleviate the damage that can occur just by capitalistic forces,” says Rael Cahn, a second-year University of California, San Diego, medical student. Cahn was one of thousands protesting on the West Coast in Seattle and Los Angeles. “It’s inevitable that globalization will occur, but it’s just a question [of] what will happen,” he says. “The people in these groups aren’t evil, really, in their hearts; they’re just not thinking about what they can do.” So, in march the activists.

Dr. Kirk Murphy, a practicing psychiatrist and assistant clinical professor at the University of California, Los Angeles, describes the protests as “the immune system of the body politic” battling what he calls “a cancer.” Murphy participated in the Seattle, Washington, D.C., and Los Angeles protests as a medic, healing lacerations, broken bones and the effects of the police’s chemical weapons. However, these ills are much easier to cure than the problems protesters complain about. They say a long road awaits them.

In order to succeed at their mission, they say there needs to be massive awakening, within the United States and countries worldwide. Protests against the IMF, World Bank and WTO have been occurring in other nations, long before the “Battle of Seattle.” And, there have been several attempts within Congress to cut U.S. funding of the IMF. But a problem remains.

“People are just looking out for themselves,” says ex-Navy medic Thomas Lash, who participated in the Los Angeles protests. “They’re afraid to rock the boat.” Activists say it’s going to take a lot of effort to change what Podein referred to earlier as the “mindless acceptance of corporate values.” And protesters fear that Americans don’t feel the need to get involved in this movement—especially if they aren’t impacted in their daily lives by the policies of the IMF, World Bank and WTO.

They see glimmers of hope, though. “I think that people are very sympathetic [to our cause],” Essential Action’s Weissman says. And, they say these protests are a beginning. Already, many point to successes, starting with the WTO demonstrations. Activists say that for many reasons, they won that battle.

First, they say, there is the spread of activism. “[Seattle] was a momentous occasion—a galvanizing event that spurred a lot of people into activism in their own communities,” Cahn says.

Second is the cessation of WTO talks. They ended sooner than planned, with some agenda items left untouched.

Third, they feel their protests bolstered some delegates’ objections to WTO practices. Weissman, who attended the Seattle events, says African, Caribbean and Latin American representatives stopped the WTO from holding private meetings that left them out of the negotiating table. The WTO had argued that the closed conferences would allow for speedier decisions, but the disregarded members didn’t buy the WTO’s rationale. “We know we will not get anywhere with this [negotiating] arrangement where things are hidden,” Nigerian negotiator Mustapha Bello told Essential Action’s Multinational Monitor.

And along with the Seattle “win,” activists say their marches and sit-ins have impacted the IMF, World Bank and WTO. Activists point to the defense tactics the institutions have had to take on issues like globalization. The three organizations’ Web sites now include their own arguments on the debate. “The institutions are clearly rattled,” Naiman says.


“There was a strong feeling of solidarity. If someone said they were cold, four people offered a coat. If someone needed food, it was offered. If someone was pepper-sprayed, another person would risk getting in the line of fire to get them out. I can’t say enough good things about the kindness and unity of the protesters. It was really remarkable,” Ahtaridis wrote in an e-mail to friends and colleagues after his involvement in the IMF/World Bank protests, so eager was he to share what he experienced on the streets of the nation’s capital.

What many activists say is so striking about this movement is the awakening it sparks among activists themselves, many of whom are so familiar with these issues they could argue them in their sleep. It’s as if the process of protesting is just as important to them as the message they want to spread. They say it’s a feeling of empowerment, but also a reminder of the realities they are up against.

“The upswelling of grass-roots democracy brings tears to my eyes,” says Dr. Michael Greger, a recent Tufts University medical school graduate who used his training to be a medic during the Philadelphia protests. He finds this work to be so fulfilling that he’d like to make a career out of activist medicine.

“Just walking around with a sign in my hand, I felt so great,” Lash says of his Los Angeles involvement.

Podein says he felt the same about Washington, D.C., and R2K, during which he was a medic, but there was also a sensation of something else—a revulsion. “As far as the protester community [goes], it was beautiful…but on the other hand, what people were up against was disgusting.”

Podein says he was shocked by the show of police force. “Ninety-nine percent of the [protesters] wanted the radical idea of a better world.” His baffled response to arrests and tear gas is common among protesters, especially those who are new to the activity.

Murphy, a more seasoned activist, says the show of police force he witnessed in Seattle and D.C. was “a stark reminder of the militarization [that’s in place] to serve the corporate interests, not the public interests.”

Over the past year, police from across the country arrested thousands of protesters, sometimes innocent bystanders and members of the press. Pepper spray, tear gas and batons were used to control the swarming activists, many of whom feel they had done nothing to provoke the attacks. The American Civil Liberties Union has filed several lawsuits against enforcement agencies, claiming the police overstepped their bounds.

But activists say it will take a lot more than arrests and tear gas to stop their movement. This is not a passing trend, they say. Protests will be staged around the world, held in conjunction with future IMF, World Bank and WTO meetings, as well as during the presidential debates. But protesting, many say, is not the final answer to achieving their goals.

Activists say the next step is to focus on education. Forums on globalization have been held at universities and in community centers across the nation, and activists say there will be more. Academics like Waitzkin are using their classrooms as means to spark discussion. The UNM professor introduces his research on the exportation of MCOs to his “Comparative International Health Policy” and “Latin American Social Medicine” courses. “Students usually respond favorably, after the initial shock,” he says.

Through demonstration, forums and classroom discussion, activists argue that their efforts are making a real difference. “We’re living in a watershed, historical time...,” Lash says. “I think we’re on the verge of creating a world that we all can be proud of.”
Rebecca Sernett is editor of The New Physician.