By Sohail Inayatullah and Ivana Milojević
Metafuture.org, 2022
The End of the Cow And Other Emerging Issues explores five disruptions that have the potential to dramatically impact wellbeing, food systems, climate change, gender equity, the family, and how we learn. It consists of six chapters:
By Ivana Milojević
First published 11 May 2020, Journal of Futures Studies.
“The challenge of the COVID-19 pandemic is that …[a]t times such as these, our stress levels become higher and our difficult emotions seem to surface more readily. This not only leads to more conflicts, it leads to more unresolved conflicts.”[i]
“As a rise in family violence due to the coronavirus crisis is set to strain an already critically overstretched social support system, some abusers are reportedly using COVID-19 as a psychological weapon.”[ii]
“We could be facing multiple famines of biblical proportions within a short few months … the world is not only facing “a global health pandemic but also a global humanitarian catastrophe.”[iii]
“Covid-19 has brought wealthy nations to their knees. What will happen when the virus breaks out in a war zone?[iv] … the impact [may]be unpredictable and potentially catastrophic.[v]
“As the coronavirus sweeps the world, it hits the poor much harder than the better off. One consequence will be social unrest, even revolutions.”[vi]
“Covid-19 is fuelling conflict: New ways will be needed to make peace.”[vii]
The headlines above suggest the critical importance of enhancing our conflict resolution capacities. As COVID-19 races around the world, we can anticipate further increases in conflicts. Indeed, psychologists and humanitarian organizations (such as WHO, the Red Cross, Beyond Blue) have already posted some helpful guidelines as to how to defuse intra- and inter-personal conflicts. Developing mental resilience along these recommendations is critical because it is our response to the pandemic rather than the virus itself that will cause conflicts. And while, at this stage, we cannot fully control the virus’s spread and its impact on the economy, there are still actions we can do to minimize conflict. Even in situations of protracted social conflict, the outbreak is opening up a variety of ‘new and unexpected scenarios’, making a whole range of strategies, impossible before the pandemic, possible today (Garrigues, 2020).
Exploring our options for the futures of conflict is linked to how and why conflicts arise in the first place. However, the causes and mechanisms of conflict differ. There are several specific areas over which conflicts tend to arise. They include: information, resources, relationships, structures, and values. Furthermore, there is intrapersonal/inner conflict. Negative economic, social, and health impacts of the 2020 pandemic are already expected to be huge.[viii][ix] Fuelling existing and emerging conflicts will only make matters worse. Epidemics and pandemics have historically been known to change the course of history. At times, the change was positive, for example: improvement in hygiene practices, redistribution of wealth, improved individual and social relationships in the aftermath, and even “the end of chattel slavery” (Snowden, 2020) in some parts of the world. How damaged, or, alternatively, how well we come out of this one, will depend on many factors, including how we negotiate numerous conflicts ahead. Smart and workable strategies to minimise, manage and even transform the conflict for the better, will significantly influence our future lives and worlds.
INFORMATION
To start with, conflicts often arise in relation to insufficient information. Addressing conflicts about information is one of the easiest ways to prevent and ease the conflict. Policy makers and government agencies, reputable media, ethical individuals, organisations, and various experts all have a role to play in providing timely, accurate, and transparent information. This should help with finding the right balance between underestimating (‘I/we will certainly not get it’) and overestimating (‘we are all doomed’) the threat from the virus. Gathering facts and clarifying confusion makes a significant contribution to the easing of rising tensions – tensions that commonly bring fear, superstition, magical thinking, and conspiracy ideation into the open. This is always important, but it is especially critical nowadays (i.e. with the prevalence of ‘false/fake news’ and the ‘doubling-down’ of ideological positions), to rely on scientific, evidence-based and reputable sources of information. Governments, social media, and all of us can make a positive contribution in that regard. It can also be helpful to have a guiding metaphor or tagline to enable a focused strategy. For example, a helpful saying to address conflict related to insufficient or false information could be: ‘Accurate information, timely shared’ or ‘Information Hygiene’.
Brian Mcgowan, Unsplash
RESOURCES
Another common source of conflict is the scarcity of resources. We have seen ‘the battle over respirators’ increasingly becoming a source of international conflicts, corruption, and weakening previously friendly ties between nations (e.g. the US versus Germany or France and Germany versus Italy). At the community level, the police needed to intervene when ‘battles over toilet paper rolls’ in supermarkets manifested in physical violence.
Three key developments work in relation to conflicts over scarce resources. First, conflict decreases when the need for the resources dissipates, or individuals anticipate that there is no restriction, i.e. there are positive expectations of the future. This will likely happen if the need for respirators and other necessities – either due to virus containment or prevention/the invention of a cure or even fair rationing – diminishes. The race to find a workable vaccine and/or cure is already occurring and should be further encouraged and enabled. Fair rationing is currently ad-hoc, dependent on the goodwill of businesses and sporadic government measures. These measures should be made systemic, ongoing, and predictable. Uncertainty feeds into the existing and creates new conflicts. As much as possible, uncertainty should be reduced.
Another common strategy is to provide more of the resources that are currently scarce. In the context of the Covid-19 pandemic that means producing more respirators and other necessities (i.e. products needed for hygiene and protection such as disinfectants, masks, and so on). As is already happening in some places (i.e. distillers producing hand sanitizers or clothing factories producing face masks) this means reevaluating current production priorities and/or repurposing existing production capacities. Local/national/global bodies coordinating such efforts could become invaluable.
The third strategy focuses on the fair sharing and allocation of resources. We usually deal with the lack of resources better than we do with uncertainty or (real or perceived) injustice in how resources are distributed. Clear and fair rules based on community needs and legal and ethical frameworks would go a long way in making this type of conflict dissipate. These rules and strategies should focus on people’s needs rather than wants; i.e. sharing what is needed, as opposed to free-market principles that enable panic buying.
A helpful guiding metaphor or saying for addressing conflicts related to the scarcity of resources could be: ‘There is enough for all – solidarity’ or ‘equitable/fair sharing’.
Mick Haupt, Unsplash
RELATIONSHIPS
Yet another common source of conflict is over relationships. We are already witnessing considerable damage done to interpersonal relationships because of people’s tendency to overreact and/or become more selfish when fear and panic strike. Also dangerous is the ‘blame game’ – accusations as to who has or may contract the virus from whom, who is (ir)responsible and who is excessively cautious/‘over the top’, who has done something similarly irresponsible in the past, and so on. These tensions will introduce some destructive elements to the existing differences between people and communities which would otherwise not cause many problems. Alternatively, if problems do arise due to these differences, they would (in calmer times) find relatively easy solutions. So what we all need to watch for is the possibility of the breakdown of personal relationships, and do our best to avoid stereotyping and scapegoating – both are very common practices amongst humans, especially during times of stress. The best antidote here is to not ‘other’ individuals and communities, but to turn our thinking around – from judgment and exclusionary/excessive self-focus to a compassionate view and concern for others. That is, other people can be seen as very similar to me/us, with the same fears, concerns and needs. This mental practice helps avoid ‘the worse of humanity’ which often manifests during times of conflict.
A helpful guiding metaphor for addressing conflicts related to relationships could be: ‘Everyone is me’ or ‘We are all in this together’.
Filip Filkovic-philatz, Unsplash
STRUCTURE
Conflicts about structure are related to access to power or resources, as well as to different amounts of respect and decision-making authority that are given to groups and individuals (Kraybill, 2001). We have created a very unequal world, where structural injustices determine that the well-being and even lives of certain groups of people are endangered. During crisis situations, the system ensures that those ‘on the top’ have higher chances of survival and a higher quality of life. Those at ‘the bottom’ face the opposite. For example, all over the world, the system of patriarchy ensures that women and children in situations of domestic violence will suffer violent conflict and abuse even more during the Covid-19 pandemic. Indeed, reports about the increased rate of domestic violence during lockdowns and other restrictive measures are multiplying (e.g. OHCHR, Graham-Harrison et al. 2020, Murray & Young, 2020, Kelly, 2020). As economically difficult and stressful situations are known to increase this type of violence, systemic countermeasures are absolutely necessary. Other protective measures are also needed for millions of people who are currently losing their jobs and incomes, those already unemployed and homeless, refugees and low-income foreign workers. Structural measures are needed to address the possibility of being evicted, deported or not being able to afford the basics – for this reason welfare payments, universal basic income or aid need to be enhanced. If these measures are not put in place, we could expect a rise in violent conflict, criminality and the number of preventable deaths. Ideally, the Covid-19 pandemic can provide an opportunity to address the world’s unequal systems and structures and create more equitable and fair societies. It is also an opportunity to provide much-needed support to the struggling health sector and health workers. In place of the ‘survival of the fittest’ and ‘dog eats dog’ the guiding metaphor could be ‘global fairness’, ‘equitable societies – better for all’ or ‘flattening the inequity curve’.
Rusty Gouveia, Pixabay
VALUES
Conflicts over relationships and structure can be difficult to resolve due to our common insular and myopic views based on short-term thinking. Even harder is resolving conflicts involving values. For example, the rush to create a workable vaccine may be motivated by values which focus on profit or national interest (such as the US president’s offer to purchase exclusive access to coronavirus vaccine being developed by a German company) versus those that focus on altruism and the long-term greater good. Yet another value position is based on certain religious beliefs (‘God decides what happens’) versus values based on rational/secular beliefs (‘Humans are in charge’). Values and beliefs are commonly formed based on certain previous life experiences or ideological and faith positions. We can expect a shift in personal values (i.e. ‘It is important to shake peoples’ hands when we first meet them’ towards ‘social-distancing’) based on new experiences, whereas others might solidify even further (i.e. various faith positions). For example, the anti-vaxxer position is unlikely to shift, even if a reliable vaccine becomes available and the illness caused by the coronavirus (SARS-CoV-2) becomes more visible in their community. Discourses about ‘Big Pharma’, ‘natural’ immunity and the ‘benefits’ of the virus eliminating the old or sick members of the community will most likely continue acting as a cognitive ‘shield’ that prevents personal values and beliefs from being undermined by external reality. The best strategy so far invented here is to allocate a separate sphere of influence for each set of values – rational/secular/evidence-based/scientific to the realm of the state and government and policy-making vis-à-vis religious beliefs to the realm of the spiritual and psychological. Moreover, there will be an ongoing discussion in relation to privacy issues and individual freedom vis-à-vis public safety. Individualistic and liberal communities and societies will struggle more with the coming restrictions than collectivist and rules-based authoritarian societies. The helpful guiding metaphor will thus depend on the context: i.e. ‘In Government/Our Leaders (or Scientists and Health Workers) We Trust’ or ‘Community Mobilizes’.
Jordan Hopkins, Unsplash
INTRAPERSONAL
Certainly, the inner, intrapersonal conflict will also skyrocket. ‘Should I exercise in a closed area?’, ‘Should I go visit such and such?’, ‘Should I travel to XYZ?’, ‘How much food should I stock up on?’, ‘Do I have enough toilet paper?’, ‘How long will this last?’, ‘How will I make ends meet?, ‘Is XYZ financial decision smart or stupid?’, ‘What will happen to the others if I get sick’, ‘How will I cope if I get ill?’, etc. The main conflict will be between our ‘rational’ self and our ‘fearful/panicky’ one, as well as between our ‘inner extrovert’ and ‘inner introvert’. The best strategy so far invented in this regard is to practice ‘watching one’s own thoughts’ (i.e. mindfulness, cognitive behavioral therapy, critical thinking) and to attempt to distance ourselves a bit from them. Once we gain that small distance, we can then try to investigate what each sub-personality has to offer. Perhaps some sort of balance between rationality and fear should inform our actions? For example, we can take some precautions such as washing our hands and channel our fearful self (subpersonality) into vigilance over that specific set of actions related to personal hygiene. Another specific set of actions we can take based on our fearful self is to be vigilant about sources of information and double-check whether they are coming from reputable sources – information hygiene. On the other hand, our rational self (sub-personality) can assist us in preventing overreactions and making rash decisions based on emotions. Striking a balance between the two will, once again, go a long way in addressing our inner conflicts. Thus, one may choose to see themselves as assets rather than imaging these selves as opposing sides in a battlefield.
Another common inner conflict is between ‘control’ and ‘letting go’. Once again, balancing insights from these different types of mental processes is critical. The key is to direct time and energy towards things we can control, such as how to qualitatively organize one’s time during self-isolation or which recommendations to follow and to let go of things we cannot, such as other people’s behavior or other external factors.
Indeed, refocusing our attention is critical to minimizing personal anxiety and interpersonal conflict. So instead of overly focusing on ‘I do not want to die,’ ‘I do not want [somebody close to me]to die’, or ‘I will not be able to cope if I [or somebody close to me]get sick’ (thoughts possibly at the back of most people’s minds), the focus could be on ‘How can I help?’, ‘What is and is not in my sphere of influence?’, ‘How can I best ‘let go’ of things I cannot control?’, or ‘What is the wisest way for me to contribute?’. Psychologists commonly recommend strengthening self-care in times of crisis. This includes both behavioral (i.e. sufficient sleep, good food, some safe exercise, relaxation, etc.) and psychological responses (i.e. being aware of one’s own thinking and behavior and adjusting these patterns if needed). Spiritual and religious practices have been shown to be beneficial in crises as well (i.e. ‘Let go and let God’), providing they do not cause the erroneous application of ‘faith-based solutions’ in the material world, where fact-based solutions are necessary. The best way forward is: 1. Choosing the thoughts and actions that minimize the possibility of violence arising now and in the future, and 2. Using existing conflicts to create something new, a better future.
The guiding metaphors could be: ‘The Kindness (to oneself and others) Pandemic’ or ‘Self-Others care’.
Andre Ouellet, Unsplash
EMERGENCE: CREATING INNER AND OUTER BALANCE
Finally, conflict theorists also commonly mention that every conflict can become a golden opportunity to create something new. For example, perhaps we could use this time to pause and reevaluate some personal values and practices (i.e. from ‘big life questions’ such as: ‘how should I live my life knowing that I can die unexpectedly and suddenly’, to smaller questions such as: ‘how should I organize my daily activities during this forced pause’, or, ‘how could I best be of service to others’)?
We can also inquire into solutions that are needed to improve existing social structures, systems and institutions. Perhaps the coronavirus and other environmental changes could help us rethink the human-nature relationship so that this relationship is also improved? Indeed, there is an opportunity to generate a strong global response to the climate crisis, and out of the “ashes of the corona crisis [create]something new” (Watts, 2020). Or, given the difficulties nations and states face to solve global problems, perhaps we could investigate what type of global and, alternatively, communal/regional/local institutions we should create or enhance?
We are already seeing efforts to coordinate global health efforts, even transform existing economic and social structures as well as the worldview behind them. For example, a joint statement of the G20 leaders framed the Covid-19 pandemic as a ‘powerful reminder of our inter-connectedness and vulnerabilities’ (G20, 2020). Because ‘the virus respects no borders’ they committed to ‘presenting a united front against this common threat’ (ibid.). Their call for action should be replicated as a springboard for a host of other problems – from climate change to global inequality – conflicts around Covid-19 thus truly becoming an opportunity to create something substantially better for the future. In their words, what is needed is ‘a transparent, robust, coordinated, large-scale and science-based global response in the spirit of solidarity’ (ibid.). Beyond dealing with this pandemic, there is much work left to be done. In addition to addressing pandemics, a global campaign for ‘a new just world economic system, where all nations work for the benefit of the other in a win-win fashion’ is also needed – ‘we need to change our outlook, or we [humans]will perish’ (Askary, 2020). Indeed, countless individuals and organizations have already been working on workable solutions towards such a transition for decades.
And yet, we do live in an imbalanced nation-based geopolitical system. We are in the middle of numerous conflicts, inner and outer. Some entrenched values and worldviews are behind structures and systems that reward inequity and injustice. Alternatives are all around us, though they remain marginalized. Balancing acts are never easy. Yet, depending on how skilled we are or become in the process of minimizing versus enhancing thoughts and behavior that give rise to conflict, we can influence the development of more or less peaceful futures. Indeed, with each and every action we take these days, we already do so. Hope remains that we can all use this illness as a way to make ourselves, others, and the planet healthier. The new guiding metaphor could be: ‘A different, better world and the best possible selves are possible’.
| Source and Type of Conflict: | Makes it worse | Makes it better |
| Information | Inability to discriminate between false and real information | Relying on scientific, evidence-based and reputable sources of information |
| Resources | Uncertainty and unfairness of allocation | Clear and fair rules based on community needs |
| Relationships |
Blaming, scapegoating, stereotyping | Compassion and concern towards others |
| Structure | Measures that help the more powerful | Measures that help the most vulnerable |
| Values | Insularity, rigidity | Dialogue, openness |
| Intrapersonal | Focusing on thoughts and actions that enhance fear, create controlling behavior and lead to being overwhelmed | Awareness, self-other care, balancing sub-personalities, gratitude, surrender to what’s outside of one’s control |
| Source and Type of Conflict: | Detrimental guiding metaphor | Helpful guiding metaphor |
| Information | I see, I share | Accurate information, timely shared; Information hygiene |
| Resources | Me/We first; First come, first served | There is (will be) enough for all; Solidarity and fairness |
| Relationships | ‘They’ are causing the pandemic | We are all in this together |
| Structure | Survival of the fittest | Flattening the inequity curve |
| Values | Natural immunity; We/humans are powerless | In government/our leaders/scientists/ health workers we trust; Community mobilizes |
| Intrapersonal | The sky is falling | Kindness pandemic |
Table by: Ivana Milojević, Metafuture, www.metafuture.org
About the Author
Dr. Ivana Milojević is a researcher, writer and educator with a trans-disciplinary professional background in sociology, education, gender, peace and futures studies and Director of Metafuture. She has held professorships at several universities and is currently focused on conducting research, delivering speeches and facilitating workshops for governmental and academic institutions, international associations, and non-governmental organizations. Dr. Milojević can be contacted at ivana@metafuture.org
The author would like to thank Charmaine Sevil for her creativity on the images in this article. Charmaine Sevil is a futures designer and her website is www.sevilco.com.au
References:
[i] https://www.relationshipswa.org.au/news-events/current-news-and-events/2020/april/how-to-manage-relationship-tensions-during-covid-1
[ii] https://www.abc.net.au/news/2020-03-29/coronavirus-family-violence-surge-in-victoria/12098546
[iii] https://news.un.org/en/story/2020/04/1062272
[iv] https://www.lowyinstitute.org/the-interpreter/coronavirus-conflict-zones-fight-has-hardly-begun
[v] https://devpolicy.org/peace-and-the-pandemic-the-impact-of-covid-19-on-conflict-in-asia-20200414/
[vi] https://www.bloomberg.com/opinion/articles/2020-04-11/coronavirus-this-pandemic-will-lead-to-social-revolutions
[vii] https://www.straitstimes.com/opinion/covid-19-is-fuelling-conflict-new-ways-will-be-needed-to-make-peace
[viii] https://www.foreignaffairs.com/articles/2020-03-19/real-pandemic-danger-social-collapse
[ix] https://www.ncbi.nlm.nih.gov/pubmed/17167882; https://www.europarl.europa.eu/RegData/etudes/BRIE/2020/646195/EPRS_BRI(2020)646195_EN.pdf
By Sohail Inayatullah
January 06, 2012
While there is a great deal of bad, indeed, horrendous, news in the world - global warming, terrorism, the global financial crisis, water shortages, worsening inequity – there are also signs of positive change.
GENOMICS
First, in genomics, the revolution of tailoring health advice has begun. Among other websites, www.23andme.com provides detailed personal genetic information to consumers. It provides, “the latest research on how your genes may affect risk for common diseases and conditions such as heart attack, arthritis and cancers.” Once your genome is analyzed, you will also be able to “see your personal history through a new lens with detailed information about your ancient ancestors and comparisons to global populations today.” This development in genomics is good news in that more
information about your personal health future is available. Of course, these are just probabilities and should be used wisely, helping each person make better health choices today. Avoiding creating selffulfilling prophecies of potential future illnesses would be a priority in teaching individuals to understand their genome map. Bringing wisdom to more information is crucial especially given forecasts that within 10 years every baby will be given a complete genome map at birth.
MEDITATION
Second, there is positive news in meditation research. Study after study confirms that meditation is not only of individual benefit but as national health expenditures keep on increasing (because of increased demand from an aging population) along with exercise, lowfat vegetarian food and a close community, meditation as part of a national health strategy can reduce public health costs. For example, we know that studies show that regular meditators exhibit: 87% less heart disease, 55.4% less tumors, 50.2% less hospitalization, 30.6% less mental disorders and 30.4% less infectious diseases (Matthew Bambling, Mind, Body and Heart, Psychotherapy in Australia, February 2006, 5259). There are even reports on the benefits of meditation for military care providers, not a sector known for spiritual development. Meditation even changes the nature of the brain. Researchers at Harvard, Yale and MIT have found that brain scans reveal that experienced meditators boasted increased thickness in parts of the brain that dealt with attention and processing sensory input. The structure of the adult brain can thus change, suggests the research. Indeed, research as well suggests that through meditation we can train ourselves to be more compassionate toward others. It appears that cultivating compassion and kindness through meditation affects brain regions that can make a person more empathetic to other peoples’ mental states, say researchers at the University of Wisconsin in Madison.
While we have had anecdotal evidence of the importance of meditation, developments in MRI scanning have taken the research to new levels providing us with visual and repeatable (scientific) evidence.
SPIRITUALITY
Third, we are witnessing a rise in the significance of spirituality as a worldview and as a practice. Spirituality is defined broadly as a practice that brings inner peace and love for self and the transcendent as well as being inclusive of others, that is, it does not claim to be exclusive or in a hierarchy of who is above and who is below. In their book, The Cultural Creatives, Paul Ray and Sherry Anderson go so far as to say that up to 25% of those in OECD nations now subscribe to a new worldview with spirituality as a central feature. Overtime this worldview will likely have increasingly tangible impacts on economic, transport and governance systems.
In their book, A Spiritual Audit of Corporate America, Ian Mitroff and Elizabeth Denton found “spirituality as one of the most important determinants of performance.” Of the 200 companies surveyed, sixty percent believed that spirituality was a benefit provided no particular view of religion was pushed. Georgeanne Lamont’s research in the UK at ‘soulfriendly’ companies including Happy Computers, Bayer UK, Natwest, Microsoft UK, Scott Bader, Peach Personnel found lower than average absenteeism, sickness and staff turnover which saved the businesses money. In one example, Broadway Tyres introduced spiritual practices and absenteeism dropped from twentyfive/thirty percent to two percent.
And: research shows a positive correlation between spiritual organisations and the bottom line organisations that can inspire employees to a ‘higher cause’ tend to have enhanced performance because of the increased motivation and commitment this tends to generate.
HEALTHY AND GREEN CITIES
Fourth, we are seeing that while many problems are too big for national governments, local governance is thriving. Many cities are taking the future to heart. In Australia for example, Future 2030 city projects are slowly becoming part of the norm (Brisbane, the Gold Coast, Sunshine Coast, Logan City, for example). Cities are broadening democracy to include visioning. Citizens are asked about their desired image of their city – transport, skyline, design, and community – and are working with political leaders and professional staff to create their desired futures. This leads not only to cities changing in directions citizens authentically prefer, but it enhances the capacity of citizens to make a difference. Democracy becomes not only strengthened but the longterm becomes part of decision making – a type of anticipatory democracy is being created. Those politicians who prefer to keep power to themselves and not engage in the visioning tend to be booted out, suggests some research (Steve Gould, Creating Alternative Community Futures. MA thesis, University of the Sunshine Coast, 2009).
And what type of futures do citizens prefer? They tend to want more green (gardens on rooftops, for example), far less cars (more public transport), technology embedded in their day to day lives a seamless integration of nature, the built environment and high technologies – and far more community spaces. They want to work from home, and many imagine new community centres where people of different professions can work individually but also share costs (and avoid loneliness). Imagine the savings in transport costs as well as greenhouse gas emissions. And time! Instead of expensive new infrastructure, creating flexible homeworkcommunitytime options could save billions, not to mention no longer being stuck in traffic jams.
On a practical level, solid social science research demonstrates that cities can develop policies that enhance public health. For example in Australia, the Rockhampton 10,000 steps program has attempted to enhance the physical activity of citizens. Given the volumes of epidemiological evidence that show that regular physical activity promotes and improves health in endless ways, active health is a great best buy.
But it is not just physical health that planners are beginning to consider but psychological health. Research shows that green spaces in a city have a pronounced affect on the emotional health of residents, and the higher the biodiversity of green spaces, the more benefits. Thus, keeping green spaces helps in promoting physical and mental health. Enhancing green spaces can also reduce drought as there is considerable evidence that the suburban/strip mall model of development blocks billions of gallons of rainwater from seeping through the soil to replenish ground water (Tom Doggett, “Suburban Sprawl Blocks Water, Worsens U.S. Drought,” Aug 28, 2002, www.reuters.com).
As part of this rethinking of the city, planners are starting to see transport alternatives as being linked to community health. For example, we now know that air pollution is linked to heart disease, that is, clogged roads lead to clogged arteries (the amount of time spent in traffic increases the risk of heart disease. And if they do not design for health, most likely citizens who have been hospitalized will litigate against city officials for not designing cities for wellbeing.
NEW MEASUREMENTS
Fifth, nations, cities, corporations and nongovernmental organizations are creating new ways of measuring their success. While earlier indicators of progress were all about the dollar, now triple bottom line measurements have taken off, and will continue to do so in the future. Instead of only measuring the single bottom line of profit, impacts on nature (sustainability) and on society (social inclusion) are becoming increasingly important, even in this financial crisis. One Australia city has even followed the example of Bhutan and developed a National Happiness index.
This enlargement of what counts as the bottom line is occurring because more and more evidence points to the fact that the economy rests on society which rests on nature. All three have to do well for us to survive and thrive, to move toward individual and collective happiness. Focus on one works in the short run but in the long run having a dynamic balance works best. Even the President of the European Commission, Manuel Barroso, has argued that it is time to go beyond GDP, as this traditional indicator only measures market activity, and not wellbeing. Says, Barroso, writing about GDP, “We cannot face the challenges of the future with the tools of the past.” Confirming this new approach, HansGert Pöttering, the President of the European Parliament writes that: “wellbeing is not just growth; it is also health, environment, spirit and culture.” There are now even calls for spirituality to become the fourth bottom line.
PEER-TO-PEER AND SOCIAL NETWORKING
Sixth, while there are many benefits of the Information and Communication Technologies revolution, one of the key positive outcomes is the development of peer-to-peer power. Traditional hierarchical relations – top down models of relating to each other – are being challenged. And while it is far too early to say the dominator model of social relations will disappear in this generation, slowly over time there are indications that there will be far more balance in emerging futures. Hierarchy will become only one of the ways we engage with each other; the role of partnerships (through cooperatives) will continue to increase as new social technologies via the web make that possible. For example, already wikipedia has challenged traditional modes of knowledge authority. Websites such as kiva.org allow – though at a small level – direct person to person lending. This could have dramatic impacts on the big banks over time. Social peertopeer networking also reduces the ability of authoritarian states to use information communication technologies for surveillance benefits. Power moves from rigid hierarchies to far more fluid and socially inventive networks.
With more information available exponentially, the challenge will be to use information about our genome, our inner lives, and our localities in ways that empower and create harmony. New technologies such as the bodybugg and overtime health and ecobots will help a great deal as they will give us immediate, interactive and tailored information on the futures we wish for (as does the newly invented smart toilet with its likely web links to http://asnu.com.au/viagra-online/ health providers. Health and ecobots will be able to help us decide which products to buy (do they fit into my value structure, are they triple or quadruple bottom line), how much and how long to exercise and through social networking, enlist communities of support to help achieve desired futures.
HAPPINESS IS VIRAL
Seventh, finally, all the good news is infectious. Harvard social scientist Nicholas Christakis and his politicalscience colleague James Fowler at the University of California at San Diego argue “that emotions can pass among a network of people up to three degrees of separation away, so your joy may be [partly] determined by how cheerful your friends’ friends are, even if some of the people in this chain are total strangers to you. This means that health and happiness is not just created by individual behavior but by how they feed into the larger social network (Alice Park, “The Happiness Effect,” Time, Dec. 11, 2008). Happiness can be seen as viral; what the Indian mystic P.R. Sarkar has called the Microvita Effect.
All this does not mean we should dismiss attempts to transform social injustice but we need to appreciate how far we have come and focus on ways to improve material, intellectual and spiritual reality.
Positive steps forward can create more positive futures, for individuals and for societies.
Professor Sohail Inayatullah is a political scientist/futurist at the Graduate Institute of Futures Studies, Tamkang University, Taiwan; and the Centre of Policing, Intelligence and Counter Terrorism, Macquarie University, Sydney. He also an associate with Mt Eliza Executive Education, Melbourne Business School, where he co-teaches a bi-annual course titled, “Futures thinking and strategy development.”
Professor Sohail Inayatullah
October 2006
The SEQ 2026 plan intends to: “protect biodiversity, contain urban development, build and maintain community identity, make travel more efficient, and support a prosperous economy. At the same time, the Regional Plan proposes that communities be built and managed using the most up-to-date and effective measures to conserve water and energy and for the design and siting of buildings to take advantage of the subtropical climate.”[1]
This is certainly a step in the right direction. SEQ provides a vision, direction so as to deal with expected demographic change and the resultant problems and opportunities.
Reflecting on lost opportunties, John Minnery writes that in 1944,” planners proposed a one mile wide ‘green belt’ of rural land encircling Brisbane’s developed suburbs, together with future satellite towns linked by road. Supporters argued that cities were spreading ‘like spilled treacle, engulfing everything in its path’. Such treacle cities city covered good agricultural land. They led to the overloading of water and sewerage mains and to insurmountable traffic problems.”[2]
However, this proposal was not implemented.
Asks Minnery:
“But just think how different South East Queensland would look today of the idea had been implemented. Clear breaks in the continuous suburban landscape now stretching from Noosa to the Tweed and beyond Ipswich. Public effort put into towns beyond the green belt with a better distribution of jobs and the infrastructure to serve them. And no public concern about the looming sprawling ‘200 kilometre city’.”
SEQ 2026 has learned from this lesson in setting out a vision and new directions for the future.
But what might 2026 actually look like? While we cannot know the future, we can reduce uncertainty; we gain a better sense of the possibilities through scenarios.[3]
I offer four futures for the SEQ region.
SEQ STILL LIVABLE
SEQ 2026 goals achieved. It is 2026 and there is plenty of opportunity in SE Queensland. The population has dramatically increased but through good governance, community consultation and foresight, negative possibilities (crime, congestion, pollution) have been mitigated and positive possibilities (job growth, green belt protection, water and energy management, travel choices) enhanced. People still want to move to SEQ even with higher housing prices. A two class society has not resulted as government has intervened to deal with inequity. Green spaces are plenty and urban design is far more sensitive to local conditions.
A fair, green and healthy go is still possible. Queenslanders still look to government to solve their problems but they are less dependent on the State. They are also more globalized, looking to live, work, travel, learn from, import and export to the broader world. Using dramatic new technologies, Queenslanders are planning for 2046.
SEQ HOT AND PAVED
SEQ 2026 goals failed as growth was too dramatic. Looking back, the plan needed far more teeth. While it was an admirable effort to take power away from local shires and put the region first, that is not how things turned out. Market pressures kept housing prices going up (demand from other parts of Australia and overseas) continued. Developers gave lip service to green and social concerns. A two class society has started to emerge. Traffic problems did not decrease, rather, every effort to widen highways, in a matter of years, led to more congestion. The vicious cycle continued. SEQ is a long highway between Coolangatta and Noosa. Global warming has only made life worse – temperature continues to rise, water shortages increase. SEQ is full of hot cities – paved cities with higher than normal temperatures. Many have made money but the quality has life for others have gone down. Health indicators continue to worsen – citizens look to local government to solve problems. Local government looks to State government which looks to the Federal. The Federal seeks to stay in power. Capacity continues to shrink.
SEQ WIRED AND MISERABLE
The last twenty years have been a series of confrontations between local authorities and regional government; between developers and environmentalists; between individual freedom and security; between councilors and state governments; between young and old; between rural areas and the beach; and between new migrants (many environmental refugees) and old migrants. Endless sprawl, congested highways, gang warfare have made SEQ a miserable place to live in. There are many gated communities – high gate, big dog – that give some peace to the elderly. But outside these communities social tensions fester. Peace is also kept via surveillance – live Google – and tough regulation. Air has been digitalized and citizens are monitored in every possible way. Discipline is the buzz word – SEQ returns to the political climate of the 1980s. The attempts to plan for the future, while admirable, were met with resistance at every level. Local concerns took precedence over regional – and it is all a mess now. Technology and power is used to keep collective peace.
SEQ TRANSFORMED
The concern for the long term future was ignored by some but became the passion for many. The SEQ vision enhanced the capacity of shires all over Queensland to develop their own visions (Logan 2026, Gold Coast 2046, Maroochy 2020, Brisbane 2026, for example). Community capacity to innovate resulted. The cultural creatives – less than 20% of the population in the early 2000’s – has grown dramatically in the last twenty years. The values of sustainability, spirituality, innovation, global governance have become the official values. These values have been reinforced through systemic (legislation, city design, tax regimes) changes.
Instead of suburbs, work-home-community electronically linked hubs have grown. Working in these hubs has led to dramatic jumps in productivity (less time lost on the road, more control of one’s work life). Travel choices – walking, bikeways, car, and light rain – have increased. Organic gardens have sprouted everywhere. Smart green technologies exist all over Queensland. Indeed, not only has this transformed Queensland, but exports of these technologies are slowly but surely changing Asian cities. SEQ is known has not just the smart centre for Australia but also the shanti centre. Yoga, for example, a three billion dollar business in the USA 20 years ago, has now become a trillion dollar business and SEQ has done well from it. Healthy eating and living were once a dream but the obesity crisis of the first ten years of this century led to a dramatic turn around. Systems became smarter and individuals took personal responsibility for their health. The invention of the personal carbon credit system[4] also led to reconfiguration of energy use. SEQ is a world leader. There are still conflicts but neighborhood mediation centres (not to mention peer mediation in schools) are used to resolve many of them. While population has increased, energy consumption has maintained steady. Innovation continues to breed technological and social innovation. While there are many global changes, SEQ can meet them as citizens do not see themselves at the mercy of large institutions, their capacity to influence their lives continues to increase.
WHICH FUTURE?
Which of these futures is the plausible one? It is certainly too soon to tell. But decisive factors will be (1) A shared vision of the desired future. (2) Good governance through enhanced community consultation and anticipatory democracy. (3) Use of smart, social and sustainable technologies to solve problems and enhance community capacity). (4) Moving away from quick fixes to the deeper issues (for example, not just expanding highways but increasing travel choices; not just speeding up all processes but exploring the slow city; not just training more doctors but changing the hierarchical structure of modern medicine). (5) Ensuring performance indicators are linked to the direction SEQ seeks to move toward and (6) Creating transitional strategies and cultures to move from the industrial era to the digital/sustainable era.
Which future do you want for SEQ 2026?
[1] http://www.oum.qld.gov.au/?id=468
[2] Full article available from John Minnery j.minnery@uq.edu.au, University of Queensland.
[3] For additional scenarios, see the work of Phillip Daffara at www.futuresense.org.au. Also see Steve Gould – <steve.gould@optusnet.com.au> who focuses on: divided seq; developmentalist seq; outlier seq and green villages seq.
[4] First thought of by social planner and Brisbane resident Jennifer Bartlett in 2004.
Sohail Inayatullah
Professor, Graduate Institute of Futures Studies, Tamkang University; University of the Sunshine Coast and Transcend Peace University. www.metafuture.org. s.inayatullah@qut.edu.au. [1]
FUTURE AS SITE OF CHANGE
Why explore visions of disability when the problems of today are so pressing? First, the present is often politicized. It feels unchangeable. Attitudes and structures, paradigms and policies, prevent us from changing today.[2]
Does this mean then that the future is more open, a table rasa, on which we can write freely? Unfortunately, our futures are often colonized – they are filled with the thoughts of others, the dogmas of history.
They are colonized by others’ who have thought through the type of world they want, often through the use of instrumental rationality – reason for personal gain.
But the problem is not just out there. The future is colonized as well by our own internal images – these are often unconscious – ensuring that the futures we create are not ours.
FUTURE AS GOAL
As well, when we focus on the futures we want, we use the intent of only our intellect. Thus, the minute we decide we want a particular future – a mission, a goal, or an objective, strangely enough “the universe” conspires to create resistance, or so it seems. This may be so that we become spiritually stronger. Or it may be that our future creating process is fragmented. We create it through a particular self, and we disown, we distance our other selves.[3] These disowned selves, or futures, then bite back. These are our fears, our cynicisms, but as well our hopes and cravings.
An integrated vision, or indeed as the Minister suggests, our visions, must include these disowned aspects. What parts of your life have you disowned to get where you are today? By owning these, our futures have a greater chance of success. They have the as Wayne Dyer writes, the power of intent with surrender.[4] And as P.R. Sarkar has argued, they are in the Rasa, or the flow.[5]
To get here, we thus have to own or disowned selves. This means using multiple ways of knowing the world – head, heart, spirit, action.
STEPS IN CREATING PREFERRED FUTURES
Other steps are also necessary.
1. The systems we live in also influence the future. It is not a static world or even just a dynamic world but a complex adaptive world, meaning, as we change, as we set goals, the world out there also changes – it adapts with us, changes with us. Forecasts and goals are often not realized because the planning environment is assumed to be stable, fixed, oblivious to our selves. But we are part of this system, as we change, so does the system.
Thus along with having visions is the need for adaptability, the capacity to change.
2. As just mentioned, we need to own our collective selves and disowned selves.
What aspects of disability at the collective level, in qld, have been disowned, positive and negative. Eg, Brisbane as it became international disowned its historical self, in positive form, its little country town self, and in negative form, its deep north image, as the site of brutal racism towards all those who did not fit conventional definitions of citizenship.
To own and disown is necessary, but another step is necessary.
3. This is decolonizing the future. Challenging the current trajectory, unless that is our preferred.
This is not an easy task. Doing so requires some steps.
We have trained facilitators who will aid in this task. I do not see this as a light task, it will be fraught with problems – anger at the historical system, frustration with the current system, and bleakness about the future.
It is crucial that all this must be named.
However, once named, if we want a different future, certain steps are required. Merely to go back in the past and historical wrongs, will ultimately not help us create desired futures. Where do we want to go?
To move to the future, some conceptual history is required.
CONCEPTUAL HISTORY
The first approach (and the dominant) to understand disability futures is:
1. Karma plus Spencer plus Darwin – ksd – kiss of death[6]
But it is not others per se but the deeper system and of course the worldview – the myth of survival of the fittest.
Professor Chris Newell describes it as disability apartheid:[7]
“For those of us who are wheelchair users just hailing a taxi from the street is an unrealised dream. Accessible taxis need to be ordered well in advance- and so often we wait, sometimes for more than an hour, for the special taxi which does not come, as many other regular taxis pass by.
Airline travel reinforces narrow norms and is a fresh opportunity for stigma as we have to be specially boarded first, and taken off last. In my case I need a medical certificate to say I am allowed to fly.
If I ever start to believe I might be “Dr Newell the valued frequent flyer” I quickly learn in travelling that I am “The Wheelchair in 3C” and the dangerous security risk with an oxygen cylinder.
One factor is certainly cost –this is a real tension and will most likely become more so in the future.
But perhaps deeper than cost it is this way because disabilities are the disowned self of Darwinian man – disability means vulnerability – the other tribe and the post-eden nasty world, where life is brutish and short.
Can we recover this disowned self and rethink evolution – ultimately this must the purpose of any meeting on the future. To heal the traumas of not just this life but our millions of years of evolution, and make the transition to a wise, reflective, integrative planetary species.
And did Darwin really say all this?
Writes David Loye of the Darwin Project.[8]
Of the so-called Darwinian idea that the primary drivers for our species are selfishness and the evolutionary dictate of “survival of the fittest” — which for more than a century has been used to legitimize the most predatory and globally devastating policies and actions for regressive individuals, governments, and corporations — he writes:
“But the more important elements for us are love, and the distinct emotion of sympathy.”
Darwin wrote only twice of “survival of the fittest,” but 95 times of love.
Of selfishness — which he called “a base principle” accounting for “the low morality of savages” —he wrote only 12 times, but 92 times of moral sensitivity.
Of competition he wrote 9 times, but of cooperation — which in his time they called mutuality and mutual aid —24 times.
2. Bacon, Descartes and science-military-industrial complex[9]
Science has been reductionist, giving humanity great gains. However, it is focused on the problems of the dominant and the powerful. Indeed without intervention of the Gates Foundation, third world diseases would get little funding (malaria, river blindness). We need to remember that by some estimates 50-95% of all scientists are employed in the military or with military associated projects. Focused on martial heroism, science has disowned its concern and care for the most vulnerable.
Is there a Kiss of life? Perhaps
3. Judeo-Christian
3a. Marxist-Islamic
4. Foucault and social constructivism[10]
5. Sarkar, the Dalai Lama and the perennial wisdom
For Sarkar[11], humanity is a caravan, we need movement, progress toward a goal, but all must be on board. Ultimately we are not physical or mental selves but spiritual selves – beyond all gender, race – spiritual humanism is our shining light, our dharma.
6. Capra, Swimme and Ravetz[12]
The New science – what has emerged from Foucault, Sarkar and others is a new post-normal science, which while remaining tied to the empirical brings in culture, paradigm, and asks questions from the views of the other (feminist science, vedic/tantric science) – it uses tradition, not ridicules, it asks different questions, searches for new areas (not genetics but bio-mimicry) – it is the new integrative science, uniting knowledge.
7. Venter, Drexler and Kurzweil – the three wise men from Silicone land[13]
Anything is technologically possible. We can manipulate our gene structures to eliminate that which causes pain. Disability, as conventionally defined, but also death or at least death before 120. Nano-machines will help us walk. Stem cells will help us see.
Our abilities will be amplified.
The real world will increasingly be virtual – our brains will be alight with experience. History is the problem, this is the great transition.
In the meantime, mobile phones, smart buildings, all will make life easier for persons with visual disability.
IMAGES PULLING AS FORWARD
What then are the futures of disability in qld? You are the experts but let me do my best here.
First, what are the main images pulling us forward.
These are:
1. Techno-utopianism – the problem of disability has a technological solution – enhanced application of science and technology are called for – ending disability
2. Caring Society – disability remains a problem but moral authority leads to the disability having an improved quality of life – better people are called for – ending disability discrimination
3. System Change – disability has defined remains located in the person, instead of the broader field or system that constructs who, how, and the where of the disabled. – a new society is called for – a society that enables potentials
4. Governmentalism – disability is like any other problem that faces government. They need to solve it now – more fair and efficient application of governance is called for – institutionalizing disability
5. Disability as the other – social apartheid – hidden throughout society.
EMERGING ISSUES
What are some emerging issues in the next 5-15 years that may change the map of disability. Emerging issues analysis patterns issues along an s-curve, searching for high impact low probability issues. Some emerging issues develop into trends (that have quantitative data) and some trends eventually become full blown problems.[14]
Many of these changes are technological.
1. Robot guide dogs in shopping centres for persons with sensor disability.[15]
2. Robot arms – 50,000 $usa per arm [16]
3. Smart toilet and other smart diagnostic devices – immediate relay of health information to health provider.
4. Ultimately, this is about the health-avatar – always on, always sending information on relevant data.
5. Smart house – one step further then the avatar. The entire house is embedded with technology, indeed, technology can not even be seen.
6. Stem cell research – reversing all sorts of sensory, physical and even neurological disabilities.
7. Stem cell research, fixing what has gone genetically astray – replacing organs and tissues, even reversing parts of aging.
8. Robots as carers
Pushing the technological dimension further, James Dator writes:[17]
What is considered a desirable ability is in part environmentally and largely culturally defined. Many of the physical and mental characteristics of the past that made people “disabled” in a hunting and gathering or agricultural–or even an industrial society (the celebrated “able- bodied laborer”)–don’t matter much any more, and will mean less and less in the future, not only for the technological reasons you mention (we can develop technologies that will enable the blind to “see” and the halt to “walk”), but mainly because people may not need to “see” in certain environments and certainly will not need to walk–indeed, having legs is a handicap in weightless environments.
I write this midway to Vancouver where the International Space University is having its annual summer session this year, and even the most “able bodied” earthling is helpless in the gravity-free vacuum of space, and functional in the lesser gravities and atmospheres of the Moon and Mars only with bulky prosthetic assistance.
But if space examples are exotic and irrelevant, then think of the fact that women ([constructed as] the “weaker sex” in a society that requires a lot of hard physical labor) are quite competitive, and perhaps advantaged in a sedentary information society and even more so in the coming dream society.
Beyond that, I use discussions of “disabilities” to problematize the entire notion of “normal” and “abnormal”, which is just a different focus on the point above, plus the fact that cultures of robots, cyborgs and Genetically modified humans suggests that entirely new notions of “normality” and “disability” are emerging, and should be encouraged to emerge now.
Thus, from technological change we get social and definitional change as well. We create technology which redefines us.
Some emerging issues are social
1. Change in transport and community making patterns. Not just designing quicker and better highways, but redesigning cities for communities. Going far beyond equal access to creating the sustainable and fair city. Green belts, real travel choices. Based on current research on correlation between city design and obesity.[18]
2. Government that takes seriously the social challenges – breakdown of family, future under-population – and funds carers, pre-school, kindergarden. This goes beyond “have three kids, two for the family and one for the State” by actually creating a society that supports the family, and thus the community.
3. Foresight in government – a state that is smart and long term oriented, not always focused on surviving current problems. Run by professional not by the pathology of a immediacy based media and a fearful politician.
4. No funding for disability as the enormous problems created by system breakdown (global warming, aging, lack of infrastructure, pollution, violence, depression) overwhelm.
5. Failed cities – Globalization without social justice leads to OECD following the route of Asian cities – a permanent underclass, fortress within and without: we all give up.
Some are spiritual
1. A new emerging image of what it means to be human – [19]
2. Meditation and IQ – enhancing IQ, productivity, learning[20]
3. The Triple and quadruple bottom line really applied to all organizations.[21]
4. Transpersonal medicine – healing at a distance, and certainly healing through touch, music leading to integrative medicine – inner and outer dimensions.
SCENARIOS
What are some of the scenarios – I will use the simple structure of Business as Usual; Worst Case, Outlier and Best Case.
Business as usual – This is the governmentalised plus institutionalized-caring society …disabled are cared for because that is what government is supposed to do. Caring but that is part of religious history. Funding remains marginal, social changes are all fought for. As well, as societal problems increase – global warming, aging, terrorism, depression – the disabled become less crucial for the agenda. Once voice among many vying for governmental attention.
Worst Case – Surveillance society. Advances in technology coupled with continued rise of the religious right with neo-liberal economic rationalism lead to a society where whatever that does not fit is: 1. Fixed. 2. Is watched, monitored. This starts out benign but eventually as in totalitarian nations everywhere, the spirit dies as no innovation is possible and deep dependency results. It is not Big Brother, but the Nanny State.
Outlier – Technology enabled augmentation of mind and body. A disabled person holds the 100 meter record and traditional definition abled and disabled Olympics disappear. Dramatic success in reversing numerous genetic based diseases through stem cell and nano-medicine. Far less concern to social reasons for disadvantage, and far less concern on intellectual impairment. Perhaps the Jetsons but without the chirpy-ness.
Best Case – I would prefer a society guided by deep sustainability – focused on not just solving problems but understanding that all problems have systemic reasons for them, and underneath they have a worldview context and a deep myth or stories that gives it foundational legitimacy.
I see this scenario as having four levels – each level is crucial, most of us live at level 1 and 2 –the problem at the systemic, but I see four levels to reality – the visible, the systemic, the worldview and the myth – all are real, and the best policymaking touches all four levels. Only staying at one level leads to failure, for example, in Queensland to blame Dr. Patel, instead of the system, or search out systemic inefficiencies instead of seeing that the problem is rooted in our modern medical system, or do all three but forget out the myth of the heroic doctor, or scientist, or the myth of immortality – the fear of death.
1. Solutions emerge a the level of the person. Inner change, finding one’s power, searching for assistance, partnership with others – essentially self-discovery.
2. Solutions emerge as systems are changed – technology, building design, city design, transportation systems are designed for community making and efficiency. They are tailored for persons and the communities they exist in. Technology is seen implicated in worldview and not neutral. Technology is used to help but is not seen as the holy grail … it can help communicate, not heal the soul.
3. Deeper change is Worldview shift– moving from industrialism to spiritual sustainability (but leaving out the population discourse that there are too many people – is not people but our footprints that need to be reduced). It is certainly not darwinian; the evolutionary challenge is one of cooperation within the self and within the social systems. It is not so much karma focused by dharma focused – our collective purpose.
4. Deepest is telling the new story – Myth – the story of the caravan, of the extended family. This is a different story than that of triage or survival of the fittest. Evolution was random; human dignity can make it purposeful.
Deep sustainability also requires the critical edge of transformation. Not everything needs to be sustained. Much needs to be transformed.
THE PROCESS
As you go through the next two days, start to think about what is your preferred image of the future; what are the weights holding you back from creating this future; who are your allies in creating this future?
What emerging issue might disturb your map of the future?
And what are the scenarios you see ahead.
Finally, what are your visions and vision ideas that you believe can transform the past, present and future.
[1] I would like to thank David Turnbull for extensive comments on earlier drafts of this presentation and Christopher Newell for his futures work in the field (See Gerard Goggin and Christopher Newell,”When Tomorrow Finally Comes: Imagining Disability” Australian Journal of Communication. Also see their new book, Disability in Australia: Exposing a Social Apartheid. Sydney, UNSW Press, 2004.
[2] For more on this, see Sohail Inayatullah, Questioning the Future. Tamsui, Tamkang University Press, 2005.
[3] See the brilliant work of Hal and Sidra Stone. http://www.delos-inc.com/
[4] http://www.drwaynedyer.com/home/index.cfm
[5] See Sohail Inayatullah, Understanding Sarkar. Leiden, Brill, 2002.
[6] For more on this, see Johan Galtung and Sohail Inayatullah, Macrohistory and Macrohistorians. Westport, Praeger, 1997. See, in particular, chapters on Spengler.
[7] http://www.abc.net.au/rn/talks/perspective/stories/s550758.htm. Accessed July 19, 2005.
[8] http://www.thedarwinproject.com/
[9] See the works of Zia Sardar for a critique of science.
[10] See Michel Foucault, The Order of Things: An Archaeology of the Human Sciences, New York, Vintage Books, 1973; Also see: Michael Shapiro, Reading the Postmodern Polity: Political Theory as Textual Practice, Minneapolis, MN, University of Minnesota Press, 1992
[11] See Sohail Inayatullah and Jennifer Fitzgerald, eds, Transcending Boundaries, Maleny, QLD, Gurukula, 1999.
[12] http://www.context.org/ICLIB/IC12/Swimme.htm, www.fritjofcapra.net and www.metafuture.org/bio.htm for more on postnormal science. Also, see Sohail Inayatullah, ed., The CLA Reader. Tamsui, Tamkang University Press, 2004.
[13] www.kurzweilai.net. www.venterinstitute.org.www.foresight.org
[14] Graham Molitor, The Power to Change the World: The Art of Forecasting. Potomac, MD, Public Policy Forecasting, 2003.
[15] http://robots.net/article/1407.html
[16] sg.news.yahoo.com/050705/1/3tayk.html
[17] Personal email, July 21, 2005
[18] http://www.texastransit.org/archives/000614.html. Reid Ewing et al, “Relationship between urban sprawl and physical activity, obesity and morbidity,” The Science of Health Promotion (September/October, Vol 18, No. 1), 2003.
[19] See, for example, www.ru.org. See work by P.R. Sarkar, Duane Elgin, Riane Eisler. The classic remains: O.W. Markley and Willis Harman, eds, The Changing Images of Man. Elmsford, NY: Pergamon Press, 1982.
[20] See www.tm.org
[21] Sohail Inayatullah, “Spirituality and the future bottom line?,” Futures (Vol. 27, 2005), 573-579.
Sohail Inayatullah, Professor, Tamkang University, Sunshine Coast University, Queensland University of Technology – www.metafuture.org
Invariably, at the end of a lecture on paradigm change, new visions or community capacity, there is always some one in the audience who asks: but what is the bottom line? This is especially so at technical universities and business organizations.
The “bottom line” question asserts that argument, visions and language display are all interesting but ultimately unimportant. What is important is what can be counted, that which leads to economic wealth: measurability and profit. Related is the challenge to the capacity to transform, that is the world is considered a tough place and only ego-maximizing real politics (money and territory) is possible – everything else is illusion.
For any speaker focused on gender, community, health, cultural or spiritual issues suddenly there is very little to say, since, well, it is not about the bottom line but everything else. The audience walks away save for a few who are thrilled and desire to save the world, either through community building, learning meditation, or recycling bottles.
Times have changed
In Australia, Westpac Bank recently issued an expanded approach to traditional accountability standards. They now measure their progress through three criteria: prosperity, social justice and environment. Their recent corporate report (www.westpac.com.au) includes claims of ethical business, transparency, human rights, environmental concerns, caring for employees, and more. Suddenly the bottom line is not so simple – it has become the triple bottom line. Organizations have their own interests – profit, survival – but as well they live in a local and global community, and are increasingly being forced to become accountable to them. These demands by shareholder groups and social movements have led to the need for social justice and social measures. And organizations and communities live with and in a natural world, and believe that they have a responsibility toward planetary sustainability – environment is no longer something out there for others to solve, an economic externality, rather, it has become defining for the success of an organization.
The triple bottom line movement has taken off. Indeed, 45% of the world’s top companies publish triple bottom line reports.[i] This change has not come about because of the graciousness of organizations but because of a variety of other reasons. First, changing values among stakeholders (and, indeed, the notion that multiple stakeholders define the organization, not just stockholders, but employees, managers, the larger community, and the environment itself!). Employees desire an organization that they can be proud of. Along with profit, organizations are expected to consider human rights, evaluate their impact on the environment, and on future generations. Jennifer Johnston of Bristol-Myers Squibb writes: “Work is such a large part of life that employees increasingly want to work for organizations which reflect their values, and for us, it’s also an issue of attracting and retaining talent.”[ii]
Second, CEOs are part of this value shift. This has partly come about because of internal contradictions – heart attacks, cancer and other lifestyle diseases – and because of looking outside their windows and seeing angry protestors, often their children. It has also come out because of external contradictions, stock prices falling because of investor campaigns. As well, ethical investments instruments, as with Calvert, championed by alternative economist, Hazel Henderson, have done well. Moreover, as John Renesch argues, leaders and organizations themselves are becoming more conscious – self-aware and reflective (www.renesch.com). We are moving from the command-control ego-driven organization to the learning organization to a learning and healing organization. Each step involves seeing the organization less in mechanical terms and more in gaian living terms. The key organizational asset becomes its human assets, its collective memory and its shared vision.
Even nations are following suite. Bhutan has developed a gross happiness index. While OECD nations have not gone this far, the UK is taking happiness seriously. “In the UK, the Cabinet Office has held a string of seminars on life satisfaction … [publishing] a paper recommending policies that might increase the nation’s happiness (wwww.number-10.gov.uk/su/ls/paper.pdf). These include quality of life indicators when making decisions about health and education, and finding an alternative to gross domestic product as a measure of how well the country is doing – one that reflects happiness as well as welfare, education and human rights.”[iii] There are even journals (www.kluweronline.com/issn/1389-4978) and professors of happiness.
Happiness thus becomes an inner measure of quality of life, moving away from the quantity of things. As nations move to postmodern economies, other issues are becoming more important, among them is the spiritual. It is ceasing to be associated with mediums or with feudal religions, but about life meaning, and about ananda, or the bliss beyond pleasure and pain.
But where there may be a subtle shift toward the spiritual, can it become the 4th bottom line? We certainly don’t see stakeholders holding long meditations outside of corporate offices and government buildings? And writes Johnston, “Corporations are already challenged trying to incorporate social indicators.”[iv] Certainly, more measurement burdens should not be the purpose of a fourth bottom line. It must be deeper than that.
By spiritual we mean four interrelated factors.1. A relationship with the transcendent, generally seen as both immanent and transcendental. This relationship is focused on trust, surrender and for Sufis, submission. 2. A practice, either regular meditation or some type of prayer (but not prayer where the goal is to ask for particular products or for the train to come quicker). 3. A physical practice to transform or harmonize the body – yoga, tai chi, chi kung, and other similar practices. 4. Social – a relationship with the community, global, or local, a caring for others.[v] This differs from a debate on whose God, or who is true and who is false, to an epistemology of depth and shallow with openness and inclusion toward others.
Thus, there are two apparently external factors – the transcendental and the social (but of course, the transcendent and social are both within) and two internal factors – mind and body (of course, external as well and interdependent).
Are there any indicators that spirituality can become a bottom line? There are two immediate issues. First, can the immeasurable be measured? I remember well the words of spiritual master, P.R. Sarkar on the nature of the transcendent – it cannot be expressed in language[vi] – that is, it cannot be measured. There are thus some clear risks here. By measuring we enter tricky ground. We know all attempts to place the transcendent in history have led to disasters, every collectivity that desires empire evokes God, claiming that “He” has bestowed “His” grace on them. Languaging the Transcendent more often than not leads to genderizing, and thus immediately disenfranchises half the world’s population. Along with the problem of patriarchy, comes the problem of caste/class, elite groups claiming they can best interpret the transcendental. The transcendent becomes a weapon, linguistic, political, economic; it becomes a source of power and territory, to control.
And yet, this is the nature of our world. All concepts can be utilized as such, especially, profound ones. The key, as Ashis Nandy[vii] points out, is that there be escape ways from our visions – that contradictions are built into all of our measures and that we need competing views of the spiritual, lest it become official.
Taking a layered view might thus be the most appropriate way to consider measuring the immeasurable. Using the metaphor of the iceberg of spirituality, the tip of the iceberg of could be measurable, as that is the most visible. A bit deeper are the social dimensions of the spiritual – community caring, even group meditations, shared experiences. – the system of spirituality. This too can be evidenced. Deeper is the worldview of spirituality – ethics, ecology, devotion, multiple paths, transcendence – and deepest is the mythic level, the mystical alchemy of the self. As we go deeper, measurement becomes more problematic, and the deepest is of course impossible to measure.
Is there any evidence that spirituality as an issue is gaining in interest? There appears to be. As anecdotal personal experience, workshop after workshop (in Croatia, Pakistan, Malaysia, Australia, Thailand, Germany, Taiwan, New Zealand, Hawaii, for example) the spiritual future comes out as desirable.[viii] It is generally constructed as having the following characteristics. 1. Individual spirituality. 2. Gender partnership or cooperation. 3. Strong ecological communities. 4. Technology embedded in society but not as the driver. 5. Economic alternatives to capitalism. 6. Global governance.
Of course, other futures also emerge, particularly that of societal collapse and that of “global tech” – a digitalized, geneticized, abundant and globally governed world.
Interestingly, the spiritual (gaian) vision of the future confirms the qualitative and quantitative research work of Paul Ray and Sherry Anderson. They document a new phenomena, the rise of the cultural creatives. This new group of people challenge the modernist interpretation of the world (nation-state centric, technology and progress will solve the day, environment is important but security more so) and the traditional view of the world (strong patriarchy, strong religion, and strong culture, agriculture based and derived). Ray and Anderson go so far as to say that up to 25% of those in OECD nations now subscribe to the spiritual/eco/gender partnership/global governance/alternative to capitalism position (www.culturalcreatives.org). However, they clearly state that cultural creatives do not associate themselves a a political or social movement. Indeed, they represent a paradigm change, a change in values.
It is this change in values that Oliver Markley, Willis Harmon and Duane Elgin and others have been spearheading (www.owmarkley.org). They have argued that we are in between images. The traditional image of “man” as economic worker (the modernist image) has reached a point of fatigue, materialism is being questioned. Internal contradictions (breakdown of family, life style diseases) and external contradictions (biodiversity loss, global warming) and systemic contradictions (global poverty) lead to the conclusion that the system cannot maintain its legitimacy. The problem, especially for the rich nations, has become a hunger for meaning and a desire for the experience of bliss.
There is data that confirms that materialism does not lead to happiness. “One study, by Tim Kasser of Knox College in Galesburg, Illinois, found that young adults who focus on money, image and fame tend to be more depressed, have less enthusiasm for life and suffer more physical symptoms such as headaches and sore throats than others (The High Price of Materialism, MIT Press, 2002).”[ix] Indeed, Kasser believes that advertising, central to the desire machine, should be considered a form of pollution, and be taxed or advertisers should be forced to include warning messages that materialism can damage one’s health.
Spirituality, while enhancing, economic productivity, social connectivity, inner and outer health, should not be confused with economic materialism or indeed any type of materialism (even the spiritual variety, that is, collecting gurus, mantras, or using the spiritual to accumulate ego).
Spirituality and educational-life transformation
However, the emerging image of cultural creatives may not have enough staying power as it is largely associated with the baby boomer generation.[x] While the spiritual is linked to health, it is yet to be linked to economic prosperity/justice and social inclusion. Spiritual practices often lead to an escape from the material world. Moreover, the languaging of the spiritual remains nationalistic or groupist, and not neo-humanistic (ie outside of the dogma of class, varna, nation and gender)
But as Sarkar has argued, a new theory of economy would make the spiritual central (www.anandamarga.org). This is partly evidenced by reports from the TM organization (www.tm.org), which documents hundreds of scientific studies claiming increased IQ, productivity and even increased community peace. But for Sarkar, spiritual practices lead to clarity. It is this clarity, argues Ivana Milojevic,[xi] which can enhance productivity. Most of our time is spent uncertain of our mission, uncertain as to how to do what we need to do. Spiritual practices allow clarity of intent (and a slowing of time) thus enhancing productivity. Sarkar’s model of political-economy, PROUT, is based on this – increasingly using intellectual and spiritual resources for the good of all. Of course, along with the progressive use of resources is a clear ceiling and floor of wealth – a progressively linked top and bottom.
However, educator Marcus Bussey (www.metafuture.org) argues that the pedagogy of meditation must be stage-like. Schools clearly should not push spirituality for productivity purposes. Primary, is the creation of a more balanced, integrated and holistic individual and community. Children have dreamlike phases in their development and these should be supported, not quickly framed in bottom-line language. Of course, as they move to adulthood, then work practices and outcomes should benefit from regular spiritual practices and approaches. One measure or approach cannot be the same for all.
Part of the challenge in the future is to transform our template of our life itself. Currently it is: birth, student, work, retirement and death. In the Indian system, it is student, householder, service to society and then monk. In a spiritual model, spirituality would travel through all these stages. As well, “studenthood” would never terminate but rather continue one’s entire life – true life long learning. In addition, the worker phase would be forever, transformed to mission, doing what is most important, and into life long earning. Service to society as well would be daily, finding some way, every day, to contribute to others. Thus, seeing spirituality as the fourth bottom line means transforming the foundational template we have of our lifecycle. This is especially crucial as the aging of society changes our historically stable age pyramid.
Health changes
The rise of the spiritual paradigm comes as well from the health field. This is partly as the contradictions of modern man are in the health area – civilizational diseases are rampant, and not just from lifestyle but from structure. A recent study reports that city design as in suburbanization is directly related to obesity, and thus cancer/heart disease rates.[xii] Thus the paradigm of modernity – the big city outlook, faster – becomes the site of weakness, and transformation.
As a sign of public acceptance, the August 4, 2003 issue of Time Magazine is titled “The Science of Meditation.” “Meditation is being recommended by more and more physicians as a way to prevent, slow or at least control the pain of chronic diseases”[xiii]
An article in the Medical Journal of Australia finds that over 80% of general practitioners in Victoria have referred patients to alternative therapies, 34% are trained in meditation, 23% acupuncture and 20% herbal medicine. Of particular interest is that nearly all GPs agreed that the federal government should fund/subsidize acupuncture, 91% believe hypnosis should be, and 77% believe meditation should be government funded, and 93% believe that meditation should be part of the undergraduate core medical curriculum[xiv] Doctors, of course, only accept practices of which there is an evidence-base. And meditation continues to build an impressive evidence base. A recent study, reports Time magazine, shows that “women who meditate and use guided imagery have higher levels of the immune cells known to combat tumors in the breast”[xv] Even near American president, Al Gore meditates. So, does the evidence stick at the “bottom” of society, with meditation leading to decreased recidivism among prisoners
Grand Patterns
For those who study macrohistory, the grand patterns of change, this is not surprising. Modernity has brought the nation-state, stunning technology, material progress but the pendulum has shifted so far toward sensate civilization that it would be surprising if the spiritual as a foundational civilizational perspective did not return. In this sense, spirituality as fourth bottom line should not be seen as selling to global corporatopia but in fact ensuring that the pendulum does not take us back to medieval times but spirals forward. This means keeping the scientific, inclusionary, mystical parts of spirituality but not acceding to the dogmatic, the sexist, the feudal dimensions. That is, all traditions grow up in certain historical conditions, once history changes, there is no need to keep the trappings, the message remains important but there is no need to retreat to a cave.
It is also not surprising that it is gender that defines cultural creatives. Modernity has been defined by male values as were earlier eras, there is likely gender dialectic at work. Patriarchy has reached its limits. It is often those outside the current system who are the torch bearers for the new image of the future. In this case, gender is crucial. Of course, the system remains patriarchy laden. Individuals may change but the system, for example, city design, remains faulty.
However, the triple bottom line, and spirituality as the fourth, may be a way to start to change the system so that it is spiritual-friendly, instead of ridiculing and marginalizing it. This could be the very simple use of Feng Shui to a rethinking of shopping to suburban planning. And, individuals want this change. Philip Daffara in his research on the future of the Sunshine Coast reports that over 30% desire a Gaian coast – a living coast where technology and spirit are embedded in the design and policies of the area. Others preferred the triple bottom line sustainability model and the linked villages model. Only a few percent still desire business as usual.[xvi]
The evidence does point to a desire for a spiritual future, throughout the world. Indeed, sociologist Riaz Hussain writes that this complicated matters for Al-Quaeda. They become even more radicalized as the Islamic world is in the process of a religious revival.[xvii] However, religiousity is not necessarily spirituality. They overlap. But one is exclusive, text-based only and generally closed to other systems and worldviews. The spiritual is not linked to race or nation. However, it is certainly the deeper part of every religion.
For spirituality to become part of the global solution it will have to become transmodern, moving through modernity, not rejecting the science and technology revolution and the Enlightenment, nor acceding to postmodernity (where all values and perspectives are relativised) or the premodern (where feudal relations are supreme).
Measures
But for spirituality to become associated with the quadruple bottom line, the bottom line will be finding measures. Measuring the immeasurable will not be an easy task.
We need to ensure that measures match the four dimensions – transcendental, mind practice, body practice, and relationship, the neo-humanistic dimension of inclusion, an expanded sense of identity.
Measurements as well would need to be layered, touching on the easiest and obvious – the ice berg metaphor – physical practices (% in a locale engaged in regular meditation or disciplined prayer) to systemic measurements (city design) to worldview ones (neo-humanism as demonstrated in educational textbooks). Of course, this is for spirituality generally, for organizations, we would need measures that showed the movement from the command-control model to the learning organization model, to a vision of a living, learning and healing, conscious organization.
What are some potential indicators (explored further by Marcus Bussey in this issue). There are positive indicators such as well-being, happiness (qualitative measures) and negative ones (far easier to collect). Death by lifestyle diseases to measure worldview and system contradictions. Suicide indicators to measure societal failure. Hate crime indicators and bullying in schools and organizations that help us understand levels of inclusion. Cooperative growth, looking at economic partnership, at new models of economy. Cigarette consumption. Treatment of animals (wider ethics).These are just a few. This is not an easy process at any level. For example, some believe that enhanced spirituality in itself can lead to reduction in automobile fatalities ( http://www.tm.org/charts/chart_48.html) However, I would argue that it is not driver education per se but changing the nature of transportation. However, I am sure those making the meditation = decrease in car accidents would argue that there is less road rage, more clarity, less drunken driving.
One way to move toward indicators is to ask foundational questions of society or organization. These would include: 1. is the organization/society neo-humanistic (that is, expanding identities beyond nation-state, race, religion and even humanism)? 2. Is there a link between the highest and lowest income, that is, are they progressively related, as the top goes up, does the bottom go up as well. 3. Is the prosperity ratio rational, especially in terms of purchasing capacity for the bottom? 4. Does gender, social and environmental inclusion go beyond representation (number of women or minorities on a leadership board) to include ways of knowing (construction time, significance, learning, for example)? 5. does the leadership of the organization demonstrate through example the spiritual principle (and the other three bottom lines)?
Finally, there is an additional challenge. In spiritual life there can be dark nights of the soul, where one wrestles with one’s own contradictions – it is this that cannot be measured, nor can the experience of Ananda. However, after the experience of bliss, there is the issue of translating, of creating a better world.
Even with a world engulfed by weapons sales, by killing, even in a world of rampant materialism, of feeling less, of unhappiness, even in communities beset by trauma, what is clear is that the spiritual is becoming part of a new world paradigm of what is real, what is important. What is needed is a debate on indicators that can evaluate this new paradigm in process.
[i] Lachlan Colquhoun, “Corporate Social Responsibility,” Silverkris, August 2003, 57.
[ii] Ibid, 57.
[iii] Michael Bond, “The pursuit of happiness,” New Scientist (4 october 2003), 40.
[iv] Email, October 3, 2003.
[v] Riane Eisler argues in The Power of Partnership that this caring for others is central to creating a partnership spirituality – with nature, society, family, and self. “Partnership spirituality is both transcendent and immanent. It informs our day-to-day lives with caring and empathy. It provides ethical and moral standards for partnership relations as alternatives to both lack of ethical standards and the misuse of “morality” to justify oppression and violence.” Eisler, The Power of Partnership, Novato, New World Library, 2003, 185.
[vi] Sohail Inayatullah, Situating Sarkar. Maleny, Gurukul, 1999 and Understanding Sarkar. Leiden, Brill, 2002.
[vii] Ashis Nandy, Traditions, Tyranny and Utopias. Delhi, Oxford University Press, 1987.
[viii] For more on this, see reports and articles at www.metafuture.org and www.ru.org
[ix] Michael Bond, “The pursuit of happiness,” 43.
[x] And the research is far from established!
[xi] Personal Comments, August 2003
[xii] Reid Ewing et al, “Relationship between Urban Sprawl and Physical Activity, Obesity and Morbidity,” The Science of Health Promotion, Vol, 18, No. 1, 2003.
[xiii] Joel Stein, “Just say Om, Time, 4 August 2003, 51.
[xiv] Marie V. Pirotta, March M Cohen, Vicki Kotsirilos and Stephen J Farish, Complementary therapies: have they become accepted in general practice? MJA 2000; 172: 105-109.
[xv] Op cit, Time, 55.
[xvi] Sohail Inayatullah, Scanning for City Futures. Brisbane, Brisbane City Council, 2002.
[xvii] See Hasan’s Faithlines: Muslim Conceptions of Islam and Society. Oxford University Press – forthcoming.
Sohail Inayatullah[1]
“Cities to play a major role in global governance, in a reformed United Nations”
“Digitalization, aging, globalization, global warming, new viruses, as well as expanded expectations, all point to dramatic changes in the nature of Mayoral Responsibilities”
“Nothing will change in my role as Mayor in twenty years – just more of the same.”
These were some of the perspectives articulated by 96 Mayors from around the Asia-Pacific Region at the October 20-22 Asia-Pacific Cities Summit 2003. Held in Brisbane, Queensland, Mayors and civic leaders embarked on a foresight process to anticipate future problems, develop scenarios of the future city, and articulate a preferred vision of the “Future of the City”.
Along with plenary sessions with world renowned speakers such as green architect Ken Yeang, Time Magazine hero of the planet Vandana Shiva, “Alternative Nobel” Right Livelihood winner Johan Galtung, Feminist Futurist Ivana Milojevic, City Planner Steven Ames, Chairman of the Future 500 and former CEO of Mitsubishi Electric America Tachi Kiuchi, Mayors met in a series of sessions to chart out the direction of the future city. The sessions were facilitated by political scientist and professor of futures studies and social sciences, Sohail Inayatullah.
Familiar Ground
The first session was familiar ground for Mayors as they identified current issues (solving problems is why they were elected to their positions in the first place). Some of these issues included population drift (rural to city, small to large cities), traffic congestion, growth occurring faster than infrastructure development, lack of partnership between city and business, loss of cultural heritage, long term water supply, lack of skills of the workforce, lack of support of central government to local government and lack of employment opportunities. The main overall categories of current problems were: sustainability and the challenges of increased growth; infrastructure decline and affordability; governance, environmental protection and resource scarcity, and community capacity.
Mayors, of course, spoke from their personal experiences. Taipei Deputy Mayor Chin-Der Ou challenged Mayors to think not only of SARS but of future viruses. Mayors from Fijian cities (Gani from Nadi, Simmons from Labasa, Goundar from Lautoka) spoke of the challenges of a central government that was not sympathetic to local issues. Mayor Sirajuddin Haji Salleh of Ipoh commented that globalization – in the form of increased travel and heightened information – had raised the expectation of Ipoh citizens. They expected Ipoh to have the same levels of “development” (services, for example) as an American or European city, New York or London, for example.
From current issues, Mayors moved to identifying future problems. To do so, Mayors were asked to identify drivers that were pushing us into the future. The drivers selected included the usual suspects: Population growth, Economic and Cultural Globalization, and Environmental Changes.
Based on these drivers, Mayors then focused on emerging issues. The purpose of this was so that they could better anticipate the future and thus better meet the changing needs of citizens (and new stakeholders – global corporations, global non-governmental organizations, global institutions). These issues included what could go wrong but also opportunities for greater prosperity and democratization.
Along with the expected issue of the increased income gap between the haves and have nots being created by globalization, Mayors saw that the future would make their roles more complex. They would have to address issues such as the ethics associated with medical and technological advancements, e-governance, as well as the broader issue of the role of the civic leader in a digitalized e-city. And along with a squeeze from the Central Government – in terms of less funds but more responsibilities – Mayors would be caught in a squeeze from nature, with extensive competition for water and other natural resources. Aging as well would change the nature of the city, leading some cities to becoming increasingly dysfunctional and others far becoming retirement centers. Along with the demographic shift of aging, immigration, especially the new wave of global knowledge workers (and refugees), would change the face of the city.
But through all the changes, the Mayors were clear that their role would be to ensure that communities stayed connected. It was creating strong and healthy communities that was central, focusing on relationship building. This was a central point made by Caboolture, Mayor Joy Leishman. Without a leadership role – developing a vision of the future and creating structures and processes that could deliver that the future – cities would find themselves swamped by a rapidly transforming global, regional and local worlds.
Scenarios
From these issues, four scenarios emerged.
The first was a warning of what could go wrong if technocratism overwhelmed governance. This was High-Tech Anomie, with technologization leading not to greater community building but to further alienation. In this future, the internet would become a site of fragmentation and crime, drug shopping, for example. Improvements in genetics would only benefit the rich, creating cities divided by class.
The second was a future where Mayors were unable to meet the changing expectations of citizens. Democratization, globalization, a highly educated, technology savvy population demanding instant response from cities would lead to a condition of permanent crisis. Leadership would succumb to these pressures and citizens would resort to undemocratic expressions to get their needs met.
The third future was one where Mayors spent most of their time and resources on disaster management. Whether it was SARS (and future diseases from genetic errors) or HIV or the global water crisis, cities should expect a difficult and bleak future, where survival was of primary importance.
The fourth future was far more hopeful. Mayors argued that with a highly educated and informed populace, their jobs would become that of the facilitator. Their role would be focused on the capacity building of city employees and citizens. Creating learning organizations and communities would become the vehicle wherein citizens took far more responsibility for of the future of their city. Part of being a learning community was to embed in the city, processes of conflict resolution – mediation and arbitration – within their communities, so that the rights of individuals and groups and the pressure of social advancement could be negotiated.
The first three scenarios required leadership to ensure that the trends were managed or that they did not occur, while the last was focused on what could be done to anticipate and accommodate any future.
Fishbowl scenarios
The next session was a plenary fishbowl wherein these scenarios were tested.. Along with speakers Johan Galtung, Vandana Shiva, and Tachi Kiuchi, were Mayors Tim Quinn of Brisbane, Mayor Sirajuddin Haji Salleh of Ipoh, Mayor Ho Pin Teo of North West District of Singapore, and of Mayor Robert Bell of Gosford. In an interactive session, led by Inayatullah, these futures were refined.
Galtung evoked the rainforest to imagine the future of the city. As Ken Yeang had argued earlier, the built environment should be, and could be, integrated into the natural environment. Not only would cost savings results – energy bills, health costs, – but the beauty of the city would be restored.[2] Green could become gold. Vandana Shiva reminded participants that for cities to create the futures they wanted they had to challenge the strategies and tactics of large private corporations, particularly in the areas of water management.[3] Water, she asserted, must remain a public resource, and, as much as possible, cities needed to ensure that globalization did not erode democratic decision-making processes. Tachi Kiuchi, as well, focused on the Rainforest as the guiding image of the future. City design and planning had to be based on different principles – cooperative evolution between nature and city, technology and community, for example. Mayor Ho Pin Teo brought out practical examples of how Singapore was becoming more green and healthy while retaining its business focus
However, not all in the audience were impressed. The city as international and , prosperous, focused on economic development, attracting large projects (theme parks, for example) – , that this the Big International City outlook was brought up as a counter image – indeed, as the only realistic future. The Mayor of Cairns, Kevin Byrne, in particular, argued that the Rainforest as guiding metaphor for the city was inappropriate. Mayor Wang Hong Ju of Chongqing, as well, saw prosperity and internationalization as primary.
However, fish bowl participants saw that the Big City scenario only as only a continuation of the present. Current trends would lead to expected outcomes:.
1. A divided city, with a number of fault lines: between (A1) the winners and losers of globalization, (B) the young and old, (C) local residents and new migrants, and (D) the on-line and the off-line.
2. Urban sprawl would exacerbate loss of green areas, destroy livable communities by continuing the car-highway-oil paradigm of the future.
3. As well, in the current model, pollution and, traffic jams would just worsen, building more development would only lead to more buildings, and not only increased costs (The World Bank estimates that the cost to the world ofis $500[4] billion a year is lost on deaths and injuries plus congestion, sprawl, noise loss of forests and farms, and carbon emissions)[5] but cities would miss the financial, social and cultural benefits of creating green and healthy cities.
4. Furthermore, the current model would reduce democratization, reduce the capacity of local people to save community and public spaces and make decisions as to their own futures.
5. Finally the Big City model was being discarded by most Western cities, as they searched for new visions to lead them forward. Copying a used-future was unlikely to lead to prosperity, rather the same old mistakes would be committed again.[6]
The debate was not resolved, however, with some considering these costs as externalities, part of the price for progress.
What is clear that the future should not be seen in simplistic terms. Rather, creating a clean, healthy, urban village, public and community space focused city, where people (social, environmental, and cultural capital was foundational) were the true landmarks, and not the tallest buildings, would lead to increased prosperity for all. It was not the single bottom line of the developer or the radical green activist that was being called for but the triple bottom line of prosperity, social justice and environmentalism.
Not polluting – and ensuring that this did not happen via persuasion, fines and incentives – would enhance the desirability of the city. Traditional notions of desirability were about size, grandness – the modern city – however, new notions are focused on individual health, community capacity building, well being and quality of life. Case studies on the steps required to realize this future were presented by Prasit Pongbhaesat , the Deputy-Director General of Policy and Planning for Bangkok Metropolitan Administration (the healthy cities project) and by Deputy Mayor Chin-Der Oh of Taipei (the cities acclaimed recycling project)
VISION
The final session was focused on the preferred future. What type of city did Mayors desire? And how could cities work together to create a shared future? As expected there was not full agreement. Representatives were from a variety of cities, some with populations in the millions, others in the thousands, some the economic size of nations, others without a true middle class, however, general points were agreed upon.
1. The city needs to be clean and green.
2. The city must focus on creativity and innovation, instead of traditional models and knowledge structures. This was the best way to become prosperous.
3. The city must be an inclusive place of opportunity, offering equity of access to citizens.
4. The city must balance the immediacy of growth with protection of the environment, of people’s culture and traditions in the wake of globalisation.
5. The city of the future needs to be a city where opportunities are available to all its citizens, meaningful work, education, empowerment and self worth – that is survival, well-being, identity and freedom needs must be met.
6. Cities must remain people friendly – true communities – and ensure that their decisions today did not foreclose the options of future generations.
While there was general agreement, the debate between the large international city and the green clean and healthy image was not resolved.
However, clear steps were formulated so that cities could create their desired futures.
Vision 2020 / Summit City Commitments
A. Enhance city relationship
1. In the short term, foster information sharing between local governments through a range of expanded exchange programs.
2. In the medium term, strengthen the role and outcomes of Sister City relationships, to include technology, resource exchanges and capacity development.
3. In the long run, creating a global association of local governments, to move towards cities as central to Global Governance, making the first steps towards a House of Cities.
B. Enhance the green city
4. Focus on environmental education for young people, with a view to protecting the environment of the future.
5. Building consensus between all levels of government on key issues of environmental protection and the health of cities.
C. Enhance capacity
6. Actively engage young people in the Summit process, with delegates bringing one young person from their city to the next meeting, to ensure that their views are heard and acted upon, especially as their experiences are being formed by different drivers for change.
7. Enhance volunteer participation in community capacity building in cities, in particular through local government workforces.
8. Investigate new ways to use technology to encourage participation of all citizens in local government decision making. For example, chat rooms, SMS messaging on the future vision for cities, e-democracy and so on.
D. Ensure Future-Orientation
9. Evaluate these issues on an ongoing basis at future Ssummits, in particular the Summit of 2023, seeing visioning the future as an ongoing process.
10. Continue to measure the performance and outcomes of Asia Pacific Summits, to determine the most viable model for future city interactions.
Finally, a conclusion of the Summit was that a full record of the proceedings of the Summit and the outcomes agreed by Mayors should be placed in a time capsule, to be opened and presented to the Asia Pacific Summit of 2023, to determine progress on the Summit City Vision.
As a city planner of sorts, Lao-Tsu once said: “A journey of a thousand miles must begin with a single step”.
[1] Sohail Inayatullah, Professor, Tamkang University, Taiwan, Sunshine Coast University, Australia and visiting academic, Queensland University of Technology. www.metafuture.orgs.inayatullah@qut.edu.au
[2] Recent studies assert that urban sprawl is directly related to obesity. City design thus correlated with health indicators. Reid Ewing et al, “Relationship between urban sprawl and physical activity, obesity and morbidity,” The Science of Health Promotion (September/October, Vol 18, No. 1), 2003. Given the direct correlation between obesity and a variety of illnesses (heart disease, cancer, to begin with) city planners have a lot to answer for.
[3] Urban sprawl is also directly related to water issues. For example, we now know that suburban sprawl – strip malls, office buildings and other paved areas – have worsened the drought covering half the United States by blocking billions of gallons of rainwater from seeping through the soil to replenish ground water. Tom Dogget, “Suburban Sprawl Blocks Water, Worsens U.S. Drought,” Science – Reuters. 28/8/2003
[4] Choosing the Future of Transportation, Molly O’Meara Sheehan (Research Associate, Worldwatch Institute), The Futurist, 35:4, July-Aug 2001, 50-56.
[5] More than one million people a year are killed on the world’s roads, and ten times as many become disabled. By 2020, road traffic injuries will be the third largest cause of “disease” in the world, according to
a research team led by epidemiologist Ian Roberts of the London School of Hygiene and Tropical Medicine. http://www.cochrane.org/cochrane/revabstr/AB003734
[6] Exemplary is a recent issue of Newsweek (October-December 2003). Andres Duany, “The Best of the West,” 55, argues that “the urban landscape is changing fast. But if Asia doesn’t change course, its cities will be dark and dismal.” Instead of symbolic power – the largest city – it is quality of life that has become more important. While hard to measure, some questions are key. Writes Duany: “ Is the city a pleasant place to be? Is there free time, or is it consumed by commuting? Is the air clean? Do people have enough income to buy good housing or is it tied up in purchasing automobiles, which are necessary to get around?” Duany offers the following choices: Asian cities can be like “Dallas and Los Angeles: stuffed with high-rises and surrounded by jammed highways, shopping centers that sprawl across what was once countryside. Or they can be like Portland or Boston: cities of compact, mixed-use neighborhood with a variety of housing: pleasant, walkable streets lined with shops, and a well-run public transit system.” Of course, the key is not to purchase any used future, but to vision the preferred future within Asia’s own historical terms and alternative futures.
BEYOND ROADS, RATES, AND RUBBISH: THE ALTERNATIVE FUTURES OF THE CITY
Opening comments by Sohail Inayatullah
2003 Asia Pacific Cities Summit International Keynote Panel. 20 October 2003. Brisbane.
We are to explore the alternative futures of the city.]
These futures are based on the consequences of current trends as well as the anticipation of emerging issues that will likely alter the current trajectory of the city, in all its meanings.
The themes that were developed were based on an environmental scan of the futures of the city, a sorting out of hundreds of articles, books and speeches. They were not mean to reproduce current knowledge but to move toward emergent ideas.
What has resulted are five broad themes:
These are not your typical concerns, normally, city politics is mired deep in local politics, in issues of what is called here in Australia, roads, rates and rubbish.
However, cities were never, and especially now are not immune from the forces of globalization, digitalization, multiculturalism, global warming, and other factors that transform the nature of risk.
Cities as well are becoming the site of social change – UN conferences are referred to by their respective city hosts, Rio 92, for example. Nation-states are hard to maneuver, like grand oil tankers, towns do not have the budget or populations to make a difference, but cities do, they become the nexus between globalization and localization, creating glo-calization. This means ensuring that local people are not lost in the drive for the movement of capital but ensuring that they benefit from internationalization.
City futures is essentially about city design, city policymaking and city planning. Why is this crucial. A recent study reports that that there is a direct relationship between city design, in this case suburbanization, and obesity. We know as well that there is a direct correlation between obesity and cancer and heart attack rates. Thus, what seem as isolated phenomena are in fact directly link. How we design cities in fact dramatically can alter the quality of life of its citizens. Destroy communities for the sake of modernity and what will result is increased crime, anomie, suicide an depression. Build endless suburbs and the benefits of tradition – walking, talking, connecting – will disappear. The healthy city is thus about design.
And it is about money. Have city policies that balk at green issues and the cost of business will go up far more than the cost of business of following green regulation. Urban and suburban sprawl, traffic jams, car and bus pollution should not be seen as externalities to be dealt with by individuals and the federal health system but rather they are intrinsic to the city. Water for example is seen as an externality but as water becomes a crucial issue research is showing that the drought is linked to urban planning patterns. For example, we now know that suburban sprawl – strip malls, office buildings and other paved areas – have worsened the drought covering half the United States by blocking billions of gallons of rainwater from seeping through the soil to replenish ground water.
Thus, Business costs go up, individuals and companies move to other cities, a vicious cycle starts, and soon, what is left is a highly populated, and poor city, caught in a cycle of corruption and waiting. At this stage, neither moral individual actions or inspired leadership is enough, since the structure has taken over.
But by looking at future problems, anticipating them before they become too big to solve, individuals and leaders can do a great deal.
Thus, issues of recycling, clean energy public buses, transparency, walking and bicycle lanes may seem unrelated but they are all directly related to creating a better city.
Digitalization is not separate from creating a better city, indeed, technology must be embedded into all our future themes – digitalization can create a seamless city, with information on tourist arrivals and departures all linked so that costs are held to a minimum. Technology can be used so that more is created with less, technology can help create a healthier city, mapping health providers, making it easier to have access, monitoring our habits via health-bots. Technology, however, is not the solution, we know we will have more of it. The key is its appropriate use, and more ever, it is in innovation in social and organizational know ware as well as in transforming the worldviews that govern how we create the future city that is far more important, and pivotal.
City design and policy planning can thus influence individual behaviors but more importantly is that it transforms systems. We know that better driver training is not the solution of traffic fatalities but rethinking the transportation system. Underneath this system is the worldview of the fast and big city. City design is also then searching for new paradigms and visions of the city. It is understanding the relationship between events, structures, paradigms and images.
I know that for many of you that word comes out at election time and then disappears when the endless politics of budgets takes over. Thus, it is a long term issue, and not meant to solve today’s issues but to ensure that 1. your visions and not colonized by others 2. your visions are the most effective and for the good of all.
It is these visions and alternative scenarios that we will focus on in the mayoral forums and the fish bowls. Research from the sunshine coast suggests that the view of the city as business as usual, while certainly raising housing prices and thus benefiting owners, is not the desired future by most, indeed, only 5% favored this. Most favored three other images. These were 1. electronically linked urban villages, that is, instead of big cities, many linked villages. 2. the triple bottom line sustainable city – prosperity, plus social justice plus environmental concerns. And 3 – the living gaian city, that is, the city that literally becomes alive become of digitalization and spiritualization.
What this means is that spiritual and ethical behaviour is not seen as divorced from local city politics. Normally we segment – and rightly so – the church and city hall (or the temple and city hall) but this emerging vision calls for the integration, reconciliation, of the two. Thus politics is not just seen as what happens at election time, and meditation is not just seen as a personal practice but a new integration of the personal and the political, creating a new imagination of the city.
Certainly we are unlikely to see this type of ethical evolution (here moving far away from Darwinian evolution) for 40-50 years, but in some form, I believe, it is likely to come.
The issue for you as leaders and policy makers is that 1. do you want to resist this image, 2 or create a new vision.
This meeting is your chance to do so, to explore the futures of the city. My hope is that by the end of our three days, we will be able to create not only new memes for the city future, but to say, that at Brisbane, many of the world’s cities charted out a new course for themselves, fundamentally changing city politics and economics.
By Sohail Inayatullah
Over 50 health care professionals met on April 17th at the Redcliffe Convention center to develop a shared vision of the future. The aim of this conference was underpinned by a need to create a single intent that ‘pulled’ multiple realities held by limited stakeholders into one vision that could:
1. Facilitate growth in community building.
2. Integrate and align effort towards a common purpose with a beginning towards an integrated planning approach.
3. Articulate an image of preferred Health Futures.
4. Create an opportunity to develop relationships and possible partnerships within a common cause.
The driving reason to conduct such a session was due to limited levels of integrated approaches to health planning by health professionals within the Redcliffe and Caboolture Regions but other regions throughout Australia. The intention was that this model of grassroots futures work could become portable, allowing real transformation in health delivery throughout the nation.
2. Conference Day
The conference day was divided into the following stages.
1. An opening presentation by Aboriginal Elder Peter Bird. Bird’s His main point was that to develop a shared vision of the future, we must acknowledge how settlement destroyed the health of aboriginal peoples. Creating a future must begin with redressing past grievances.
2. The first session focused on creating health pasts. The three main trends identified were: (1) less funds available and thus the move from abundance to tough choices; (2) the development of community health and (3) technological advances
3. A keynote address by Sohail Inayatullah. He made the following points. 1. Creating an integrated framework for health care is foundational necessity given the overwhelming changes to health. Whether it is genomics, cyberhealth, an aging population or the rise of complementary medicine, traditional delivery systems of health are being dramatically challenged. The economic reality of globalization – more porous nations, privatization – force agencies to do more with less. While daunting this is possible through integrative visions and strategies. Four solutions were provided: coordinate care; smart card; community care; and integrated system.
4. Sectorial presentations from Ralph Smallhorn (General Practice), John O’Brian (Queensland Health), Jeanette Evans (Blue Care); Darryl Baker (Redcliffe City Council) and, Chantal de Vere (Natural Healing). We briefly summarize their main points.
Ralph Smallhorn made the following points. 1. There are not enough gps (or nurses). 2. We will see an increased number of part time GPs. This is already evident in women GPs. 3. GPs should treat only what others groups cannot. 4. GPs must work with other groups as to create a multi-door integrated scenario of the future.
John O’Brian articulated Queensland Health’s vision for the future. This is:
Health is a lifetime investment, education as consciousness of health choices
both in terms of life style and smart consumer, and health as resource (a healthy population is cheaper to maintain). The main future issue is the transition from health for children to health for the aged.
Darryl Baker developed how the local council is working in the health area. His talk focused on community capacity building, as for example, the local library which has become a core areas of learning and community building.
Jeanette Evans saw health a pivotal investment to our future. While the demand for health for often insatiable and increased aging made health care delivery even more difficult, advances in technology (tele-health, for example) and the possibility of integration offered some hope for the future.
Chantel De Vere pointed out how complementary medicine was leading the way in many areas of health care, and, becoming increasingly respectable. The presented numerous case studies – for example, at Southern Cross University – to illustrate that the walls between traditional and complementary medicine were breaking.
Next were six break-out groups. They were charged with the task of developing a preferred vision. Points of agreement from the disparate groups where developed in a collective visioning session.
3. The Vision
VIRTUAL MULTIDOOR HEALTH/VIRTUAL MULTI PERSONAL LIFE HEALTH PLAN/HEALTH FOR LIFE
S Seamless Portals
M Multi-Tier
A Access
R Relations and Community Building
T Trust/Respect/Ethics
The following describes in more detail the vision:
· Virtual teams
· Person-based, holism
· Prevention, early intervention
· Unique ID number, card system, health points
· Co-ordinate life style interventions
· Community Care at the centre/core – person – trust
· Funding values shift towards wellness model
· Smart system – interactive – TV
· Seamless strategic alliances
· Volunteerism
· New measurements
· Smart astute use of current resources
· Shared doable vision
· Breaking down barriers
· Sustainablility
· Client focused
· Federal plus local
· All individuals accountable
· Multiple entry – suppliers
Some of the social factors necessary for this vision included.
· Ten year funding cycle
· From greedy society to community
· 30 hour working week – improved connectedness/health
New indicators were measure movement toward this vision, among them were: no homeless and a comfortable death.
An essential value behind this vision was: trust and respect.
To move toward this vision, it was agreed that a pilot project was necessary.
Further next steps included:
Community Information
· Involvement
· Focus groups
· funding
· local members, political buy-in
· Media involvement
These communities needed to be: Physical and Virtual
Potential users/suppliers needed to be assessed as well.
4. Small Groups
What follows are the reports from the small groups. They are the data, information and values from which the group prepared a consensus vision.
1. Red Group: Facilitator Philip Daffara. Vision 2101
Ensure a wholistic continuous lifetime care plan is co-created for each individual, encompassing Prevention, Empowerment and Sustainable well-being
To achieve this Vision we the Redcliffe-Caboolture-Bribie community intend to:
· Develop a web portal of all health service providers in the District to integrate the sequential delivery of individual (care plan) based services;
· Build community leadership and Ethics;
· Promote and provide incentives for the development and maintenance of care plans using credits for preventative actions;
· Promote and facilitate the switch of restructuring of Federal and State funding and reporting arrangements so that it moves with the Care Plan outcomes.
· Develop a system and Strategic Plan to measure the “Health” of the community, the effectiveness of Strategic alliances and collaborative partnerships to achieve the vision;
· Facilitate the planning of future health service needs with Local Governments (Redcliffe, Caboolture and Kilcoy Councils) so that social infrastructure is provided for new developments in accordance with the integrated Planning Act.
· Habitat needs to sustain community health.
· Empower Minority and Mainstream communities and provide physical and cultural space and freedom to allow them to improve their own health. Eg Indigenous, Youth, Gay)
· Promote Life Education at schools and for the disadvantaged to increase the awareness of the benefits if a lifetime Health Care Plan, responsibility for their choices and the benefits of a holistic view.
· Promote the Investigation of the triple bottom line benefits of introducing a Health Tax or excise on unhealthy products, to increase alternative sources of funds; and investigate the impact of having Private Insurance premium reductions if preventive actions are implemented in an individual’s care plan.
Shared values were:
Innovative, tolerant, sensitive, compassionate, fulfilling, proactive, flexible, Ethical, confidential, equitable, socially just, sustainable, viable, responsive, mentors, sharing, honest, openly communicative, building relationships.
2. Green Group. Facilitator. Eric Dommers. Vision for Redcliffe Caboolture health system in 2012.
Structural
1. There is alignment of all district service providers (health, education, housing, employment, council etc), and all operate on a 10 year funding cycle. This enables budgets to be designed with a view to reaping savings/investments from prevention initiatives. This has enabled local service providers to invest in both inter-organisational integration initiatives, as well as primary prevention initiatives.
2. Inter-organisational arrangements include Memoranda of Understanding linking various service providers for both ‘population groups’, and whole of population initiatives. All service providers are fully accredited and are also academic institutions conducting professional/vocational preparation and training courses. The focus of these courses is on training service providers to be multi-disciplinary. Health service providers have agreed on the use of best practice protocols and guidelines for various disease entities.
3. Primary care is still provided and co-ordinated by GPs. GP businesses are operated within a range of quasi-corporate structures. The local community still regards GPs as a first point of access, and no-one in need is denied access (ie. some bulk billing arrangements are still in place). GPs work with a range of other primary care providers such as “St. Blues” to co-ordinate the care of patients with complex needs.
4. Structural efficiencies and a concomitant need for flexibility have resulted in a wide range of strategic alliances and amalgamations among health service providers. The preventive arena has become a market, with payments available for locals who are in danger of falling through the gaps in the safety net. A wide range of service packages is available for at risk/marginalised individuals.
5. Service information is accessible through various home and community media, and a key social education tool is ‘service literacy’, and ‘health literacy’.
6. All salaried employees work a maximum 30 hour week. This enables people to have mote quality time with their families, and in supporting their local community. Volunteering is a strong community theme. The 30 hr working week has also increased the levels of employment, and improved local health, and social connectedness.
Scenario
Mrs. Jones wakes in the morning, and tunes into her health information channel. The monitor bids her good morning, bio-senses her health status, makes a health service appointment with a local GP, and advises her of the time of the appointment with the Mayne-Blue-QUT-Salvos Health Service and tune up centre.
Mrs. Jones’ estranged younger cousin Mary, is homeless, unemployed, and physically and emotionally depressed. She is identified as ‘at risk’ by the ‘Blue Salvos’ bounty group. Mary is offered a holistic and co-ordinated package of services including temporary shelter, a shower, aromatherapy, ‘quality listening’, a health check, and employment counselling. The package is paid for by the ‘Upstream Health Investment Fund’, which pays for the services from a ten year ‘prevention contributions levy’ contributed by relevant local service providers on the assumption that there will be a return on their investment through a reduction in Mary’s estimated future use of acute and emergency services. Mary’s QoL improves dramatically, and she is now working as a volunteer for the local council.
3. Blue Group Facilitator., Steve Gould
Stated Vision: ‘Relational Health’
To break down the barriers through community/service provision, education, and sharing by empowering that which leads to seamless care in sustainable health environments.
This vision was based upon descriptive statements of what measures could be observed by participants within their respective health care fields of work and is based upon preliminary descriptors of meaningful outcomes/visions previously mentioned.
Themes
No paper.
High levels of customer satisfaction (both internally and externally).
Acceptance of “stay ins” as a right of choice to remove oneself from the community.
Expedient access and processing of health clients through the medical system by multi team approaches.
Layered assessment of health clients to target interventions based upon primary vs acute care.
Empowered and informed communities to facilitate targeted interventions based upon primary vs acute care.
Provision of alternative options to ‘first choice’ medical interventions other than the GP as the first point of contact.
Removal of barriers to local GPs which prevent locals accessing their preferred GPs.
(This situation was due to long waiting lists.)
Increased access points to multiple health providers within the existing health system by community.
Increased usage of virtual technologies to alleviate demands on health system.
Functional integrated planning for local health community.
Developed partnerships and relationships within the local health community.
Sharing of health clients and information to facilitate expedient service to clients.
Partnered ‘funding generation’ activities.
Care providers as a vehicle of change via communication and braking down the barriers.
Increased opportunities to be involved in future visioning.
Shared values were:
· Direction or told what to do.
· Learning
· Sharing
· Relationships
· Purpose
· Results
· Influence
4. Facilitator: Ivana Milojević. Preferred Vision for the Future of Redcliffe-Caboolture Health.
Collaborative Care 2020
· Only two levels of government in Australia: e.g. national (federal) and regional
· Movement from the greedy society towards giving one. Cultural values are changed: promotion of ‘old-fashion’ values of caring, tolerance, compromise. Sense of community also back.
· Health system more integrated: ‘share-care’, collaborative approach, collaborative action research planning, teamwork – ‘mobile working teams’ (not necessarily in the same building). Mutual respect and recognition crucial (instead of saying nurses or doctors or allied health practitioners ‘are only good for …’). Everyone’s skills are respected and valued. Also important to accept the limitations of what service providers can offer.
· Collaboration between ‘mobile working teams’ through improved communication and connection. There is enhanced communication and referral linkages facilitated by unique ID number, client data record (similar to smart cart), owned by client.
· Client and community are put in the middle – services are planned around them and their needs.
· Responsibility goes back to people themselves who are in charge of their own health. People are more responsible and accountable for their health. Affordable and timely access to healthy lifestyle is improved. Focus on lifestyle change and promotion of wellness. Focus on education (of children, parents, health workers, community, society).
· There is an increased focus on prevention across community service providers. Resources are re-distributed – there is a balanced placement of funds on ‘prevention-early intervention-illness-palliative care’ continuum.
· There is life course approach to health – intervention at transitional milestones (e.g. birth, starting school, adolescence, etc.). Services working together around schools.
Recommendations
· More funding into community. Community based system.
· More aged care facility. More appropriate staff, nurses, allied health practitioners, teachers-educators.
· $ freed by money moving from (1) rearrangement in governance, (2) illness end – prevention saving money in the long term
· Land development taking into account broader set of issues – e.g. public spaces.
· Development of healthy food chain stores.
· High employment rate, reduced gap between rich and poor.
· Euthanasia debate over – replaced by palliative care [not generally agreed upon]
· Emergence of a ‘major computer virus’ – re-introduction of traditional games among children, as subjects at school, etc.
5. Faciltator. Marcus Bussey.
The vision had two dimensions – a wellness building and wellness hug.
The Wellness Building
This definition of wellness as an essential social capital builds a 4 tiered health system that is rooted in consciousness: education for Living. It progresses through a Community health network of positive relationships; moves to the physical centres of health and healing and has at its summit the Spiritual “I”, that acknowledges that the role of meditation and personal reflection is central to a well being.
This was represented as a pyramid.
The “Wellness Hub”
Represented as a wheel with relationship at the centre.
This idea places relationships at the centre of health, both personal and professional.
A sick person enters the health system through their own chosen modality. This trusted professional acts as a guide. She or he may or may not be a GP but they will be able to provide clear pathways through an integrated system that includes home care, library access, meals on wheels, mental health, specialist treatments, etc…
Values Shift
· Sickness to Health
· Specialist to Holistic
· Isolation to Integration
Key Ideas
· Needs Management for client based on personal relationship
· Relationships between client and workers
· Information Management Infrastructure (Computers)
· Clear Marketing of integrated services
· Opportunities for self referral
Outcomes
· Relationships leading to responsiveness to individual needs
· Wellness Vs Sickness resolved in favour of former
· Value structures for funding to change
· Information management – techno + humane
6. Facilitator: Patricia Kelly
Vision: Client Focused Future
Features
· One prime level of government
· Tiered roles addressed staff shortages as professionals are supervising and engaged in educating families.
· Community and residential services integrated including transport services – to support well aged
· A comfortable death -pain free, intervention if required, euthanasia not illegal
· Health maintenance and prevention of illness means that everyone experiences wellness in all aspects, physical, mental, spiritual, cultural.
· It is a concerned community, with everyone accountable and responsible
· No homeless, no pollution
· Nuclear and extended families
· Ethical decision making
· Consensus based on trust. Competition has gone with changed funding
· Competency testing for over 65s
· More accountable – accurate, informed choice
o May not get the choice you want eg if you are a smoker or a drinker you may not get access to heart transplant
· Better focussed
· Discourse – turn problems into challenges
· Funding – limited supply
· Yearning for quality of life
· Explosion of technology
· Expansion of knowledge
The Client focussed future was presented as a diagram with a virtual centre at the core.
Coming off this were these elements
1. client focussed – in all dimensions
2. trust
a. professional respect
b. re-evaluated roles – chosen core business, specialty areas
3. one bucket of money
a. shared accountability
b. local government to take responsibility for health services through negotiating and accountability
4. community services
a. minimal duplication
5. consumer choice
a. “health points” linked to…
b. smart card,
c. better marketed to population … linked to…
6. information integration and transfer
a. data bases all linked electronically so no need for reassessment, hard to lie to system
7. health maintenance and illness prevention
8. All These Changes Began With A Pilot Program In 2002/3with the suggestion this might be North Lakes.
Additional information
Trust. Service providers need to be non-territorial and recognise the professionalism of others. This requires trust that has to be built through discussion hence the pilot project. All agreed that competition for limited funds creates much of the current tension between groups.
Integration, Including transport services
An Alternative Scenario to the preferred vision was:
2012 Breakdown Scenario
· No integration
· Duplication of infrastructure leading to wastage and inefficiency
· Under-resourcing
· Low socio-economic groups leading to third-world conditions and disasters in multiple areas, including raised suicide rates.
· Unrepresentative demographics with majority aged
· Budget cuts leading to equity issues – not enough people to provide services leading to
· Burn-out
There was consensus that we are currently on this track
Facilitator Comments
1. Ivana Milojević
Comment
General agreement on the first part. ‘Other ideas’ show some contradictions with the general vision or haven’t been more thoroughly explored, or there was some disagreement among participants. E.g. there was a contradiction between ‘more aged care facility’ (promoted by palliative care nurse) and ‘no need for increased funding, instead, redistribution of resources’ as well as ‘more balanced placement of funds’ meaning more resources into prevention and less into ‘end-stage of illness’. Similarly, emergence of a ‘major computer virus’ inconsistent with the development of electronic ID card. Also, some ideas too broad, e.g. high employment rate or reduced gap between rich and poor.
2. Steve Gould
Reflections
Upon assessment of events from Wednesday 17th April 2002, the following questions remain unanswered:
· Q: How will GPs release themselves from traditions knowledge based hierarchies?
· Q: How will future policy making impact upon how decisions are made?
· Q: How will future funding be dispersed and under what criteria?
· Q: What are the implications for future technologies upon industries that are dependent upon existing health service provisions.
· Q: How will the shift towards self-diagnosing and self-dispensing technologies impact upon current service deliveries?
· Q: Who are the future stakeholders?
· Q: What is the future role of Government entities? Regulation or Socialistic Service provision?
· Q: Where is the ‘way forward’ manual?
Conflicts to the Vision
Possible barriers to ennobling the preferred Vision are:
· Loss of power bases.
· Hoarding of patient knowledge.
· Impotence of action.
· Translation into pragmatic languages.
· Adherence to existing health practices.
· Espoused rhetoric without behavioral transformation.
· Limited stakeholder ownership.
Future Implications
Possible implications are:
· Diffusion of traditional power bases, from GP to allied health practitioners.
· Equity and access to medical information.
· Development of ‘redundancy mentality’ within practitioners.
· De-mystifying the diagnostic processes through knowledge empowerment.
· Developing the evolution of alternative health intervention choices as acceptable and valid.
· Growth in litigation behaviours within the community.
Future Actions
To continue with the momentum generated on the vision workshop, it is crucial to follow up quickly with a series of activities to evolve the endorsement of the vision by all stakeholders. This can be achieved by:
1. Plan a series of workshops to develop ‘ownership’ of the vision. This can be achieved through stakeholder assessment workshops.
2. Develop a ‘Values Statement’ for the Region to dovetail into the Vision.
3. Explore preferred scenarios for the Region
4. Develop a Strategic and Operational plans to enable the ‘operationalisation’ of goals and strategies from the preferred vision.
5. Develop ‘meaningful measures’ that PULL the desired future and act as feedback loops into future reflection workshops.
3. Patricia Kelly
Comments:
. The preferred scenario depends on an assumed computer literacy, which seems unlikely for the majority of this ageing population.
. Any futures work with any of the groups or in the suggested pilot project would benefit from time to air and discuss concerns and current problems, possibly in separate groups and then coming together with a summary of issues.
. To do quality futures work the participants may need more work with Futures ideas and concepts.
By Sohail Inayatullah
Will health-bots monitor your caloric intake, warning you if you’ve eaten too much or not exercised enough?
Which medical model is likely to dominate – the democratic, the professional or the corporate? Can medicare continue or will globalization end Australia’s unique universal health care system?
How will the internet change how patients get information about their illnesses? Will doctors become knowledge navigators, helping patients decipher what is gold and what is crap? Will they be able to accommodate the dramatic rise in patients using alternative therapies such as chiropractic, acupuncture and meditation?
Will general practitioners even be needed as genomics and other dramatic technological advances repair defective genes? In twenty years, will general practitioners be seen as quaint practitioners of complementary medicine?
What will general practice look like in twenty years?
On February 11 and 12th, 2000 over 140 health professionals met for three days at the Brisbane Novotel to ponder these and other questions related to the health futures of Queensland and Australia. Professionals consisted of general practitioners and senior managers of the various health divisions in Queensland. Included also were directors of Queensland Department of Health, futurists, academics, pharmaceutical representatives and members of the community.
Participants were treated to a day and half of lectures on (1) systems approaches to international health, (2) impacts of the internet, the human genome project, ageing and complementary therapies on general practice (3) funding issues from the perspective of the Federal Government, (4) the role of state divisions in health care, (5) rural health care, and (6) perspectives from the hospitals.
The intent of these lectures, however, was not merely to provide the latest information but to help general practitioners and division chiefs develop a map of the future of the health care. To do this, along with plenary sessions there were eight small group sessions facilitators by futurists. In these groups the drivers of change were identified. From these drivers a systems map of how each subsection of the health system interacted with others (for example, how funding impacts who gets health care and through what delivery mechanism) was developed. This in turn was used to develop possible and probable scenarios. Once the alternatives were explored, participants articulated their preferred vision of the future. From this, a backast – a memory of the future – was developed so as to deduce which trends and events are likely to create the preferred future. The concluding session then asked participants to personally commit to action steps that reflected their preferred future. Considerations of the future were thus central to action steps today.
Drivers and Scenarios
As expected the drivers were: technology, funding issues and the costs of health care, globalisation, ageing of society, consumer demands, availability and distribution of resources, and expectations of the future.
Participants developed scenarios that can be divided into four distinct categories.
1. High-technology scenarios. They were called: digital doc, dr. robot, medi-net, IT and Star Trek. Of the five groups that reported this scenario, three considered these negative scenarios and two considered them positive. Features of this future included: 1. Germ line engineering (eliminating genetic defects for current and future generations), genomics (customized gene therapy), robodocs and smart cards and health-bots (interactive wearable computers that monitor one’s health). Generally, participants believed that the new technologies are likely to be patient-led. Doctors, while overwhelmed in this future, become far more holistic in their treatment, focusing on what technology does not give patients.
2. Corporatist scenarios. These were called: Big business ownership, corporatist, $ and corporate piracy. No group saw it as a preferred scenario although one or two individuals in various groups did find it preferable. Generally, loss of control was feared, and, even while there were some gains for consumers (lower cost and seamless service) gps believed that overall the quality of health delivery would decline in this future since cost considerations would become primary and managerialism would take over as the dominate organizational mode. However, one group did argue that instead of other corporations taking over gps, they foresaw a “future where gps develop a national corporation which has equity in, and market control over, services such as radiology, pharmaceuticals, nursing homes and private hospitals. Gps would then lead the money instead of follow the money as the do now”.
3. Worst case scenarios. These were largely around the axis of power. They were called: Drone, Mots (More of the Same), Big Brother and Capitation. In each case, doctors lost their autonomy and felt disempowered. For example, in the Big Brother scenario, “technological developments play into the hands of centralists by both increasing specialist monopolies and also eroding the meaningful relationships that are at the core of the GP Ethic”. Clinical governance creates a hegemonic culture wherein gps lose their maneuverability in creating the futures they desire.
4. Network/multi-door. This future consisted of a more diverse but strongly connected system. The titles given were: back to values, quality and network, multi-door, division cooperative, consumer ownership, GP ownership and medi-network. The central point in these networks/multiple doors was that doctors remained the gatekeepers with divisions or associations playing a systems coordinating role. For example, some of the roles the divisions played were: “advocacy with local services, research interpretation (separating the gold from the crap on the web), brokerage role through virtual amalgamations)” as well as a funding role. All these were considered positive. In this future, community members felt part of the system, indeed, this scenario was gp and community/patient-led.
5. Preferred Scenario
The preferred scenario had a range of titles. These included: multi-door (flexible, multiple integrated systems, doctors as gatekeepers and knowledge navigator), futuretopia (wisdom, consultation with the community, regional governing systems, empowerment of patients, focus on quality of life), Community Care (community instead of hospital focus, gp as gatekeeper, use of smart bots, practices staff and family friendly), Nimbin (partnership between gps and the community, reduced alienation, alternative and allied care, shared ownership and reduced isolation) and the Happy Health Centre (multi-door, part of lively gp network, and highly efficient).
In general, gps wanted new information and communication technologies to make the system more seamless (for administrative purposes) and so that they can have a higher degree of connection with other gps.
They desired the system to be far more community focused and power to be decentralized
What This Means
For Queensland health divisions, this is a clear mandate for them to take a more significant and decisive role in shaping the future of general practice. It also a clear indicator that doctors want a far more integrated and seamless system that is fundamentally based on the community health model – interactive horizontal relationship and not vertical integration is the desired vision of the future.
It also means that doctors, as long as they are the gatekeepers (deciding issues of quality, scientific evidence, etc), are open to alternative forms of health care, to alternative medicine.
Finally, for large pharmaceuticals this means that as they attempt to gain entry and leverage to local health divisions and gps, they must do so in the context of the community model, they must become a local community business, and not an external player.
For this Australian government, as globalization pressures the State to reduce universal care, they need to understand that doctors will resist this. Any changes in the health care system must begin with serious consultation with general practitioners, the divisions and community members. Vertical pressures from globalisation must as well live with the desire for localist community models of care, if they are to ensure that efficiency does not merely mean that the accountant instead the doctor runs the practice.