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A National Health Service? The Migrant Levy – and Why Citizens Should Care

Should foreigners pay to use the NHS? At first glance, it’s not so unreasonable. After all, as Health Secretary Jeremy Hunt points out, it’s a National Health Service. And as the Department of Health’s consultation paper, released today, asks: why should “temporary” migrants receive “free” treatment, unless it’s a public health issue or an emergency? After all, tourists’  hospital visits  are already chargeable: this – the argument goes — is simply an extension of already-existing policy, designed to protect the NHS.
Bullshit.
The Department of Health’s consultation document, for all its delicate wording, is a toxic combination of two of this Government’s favourite pastimes: migrant bashing and privatisation. The former is convenient cover for the latter, especially when whipped into a frenzy by tabloid columnists.   The language of nationalism tells citizens they shouldn’t care about this, but that’s a dangerous slight of hand.
First, the evidence: or rather, the lack of it.  The Consultancy Paper claims “we know [health tourism] is a significant problem”.  Jeremy Hunt has argued health tourism – costs the NHS £200m a year, though he hasn’t offered any evidence explaining this figure and as George Eaton points out in the New Statesman, the cost could well be as low as £12m, or 0.01% of the NHS’annual budget.  Compared to the £50bnthat the NHS owes for Private Finance Initiatives (for infrastructure that cost just £11bn to build), the financial rationale for this “coordinated crackdown” seems pretty thin.  Especially when you also consider the £16.3bn (net) the OECD estimates that migrants contribute to the UK economy annually (that’s 1% of GDP).  Given the paper admits there’s a need for an audit to first understand the scale of health tourism on page 5, and no costing of the administration that would be required to process such a scheme, it’s hard not to escape the conclusion that this is a case of policy before (or regardless) of evidence.
But of course this isn’t primarily financial: it’s political.  It’s appealing to Britain’s rising tide of anti-migrant popular righteousness in the hope they won’t notice how privatisation is writ large across this Consultation document. 
The most significant proposal is that all those migrants who do not have Indefinite Leave to Remain in the UK – something you can normally only apply for after five years – should be asked to pay an annual Migrant Health Levy to access non-emergency treatment, of no less than £200 (‘an appropriate charge might be higher than this’).  Students, foreign spouses, skilled workers (including those nurses and doctors staffing your local NHS hospital): all charged more, even after several years in the UK.  It’s  also increasingly difficult to qualify to qualify for settlement in the UK, (even assuming you’re able to enter in the first place).   The Paper estimates that the average annual cost of providing healthcare to someone aged 15-44 (like most migrants) is £700.  Yet someone who meets the current minimum salary requirements for a worker’s visa — £20 300 – will already pay over £3500 in tax and National Insurance contributions in their first year of work. Is asking them to pay twice ‘Ensuring Fairness?’
There is a danger in following the taxation = entitlement link too far, for in discriminating on the basis of wealth, the very reasoning behind a national health system – equality of citizenship – is eroded. Of course, that’s unlikely to bother Hunt and co. too much. There’s a barely disguised assumption that any immigrant worth their salt wouldn’t deign to use the NHS anyway, but ‘may  want their healthcare needs to be met by private healthcare’.  When the rich opt out of citizenship, none of us gain – apart from the Health Industry. Let’s not forget BUPA made $604m in profit last year.
The Paper starts off with heady promises that the migrant levy will not see anyone refused ‘timely treatment necessary to prevent risks to their life or permanent health’.  Yet if you read on, ‘we want to consider further the possibility of charging for emergency treatment’, because it seems, some people ‘expect to pay’. Where this leaves those who can ill-afford to, and who wait till the last moment to seek care (risking poorer outcomes), is an awkward problem – as the document at least has the grace to admit.  Buried in the details are other outrages: the suggestion that pre-existing pregnancies should not be covered by any levy charged, for example.  So women married to British citizens and who come to the UK to give birth to British citizens may well be expected to pay out-of-pocket for the privilege (given that health insurers tend not to be keen on pre-existing pregnancy either).
Charging migrants turns GPs in unwilling border police, in pursuit of political objectives that only make sense if they’re framed by the wider privatisation project, and the nationalism that distracts from its hard logic. Yet in the end, after all the outrage at East Europeans’ arrival, their rights to use the NHS won’t change. We are European citizens, and we benefit from freedom of movement and access to their healthcare too:  not least from Poland’s dentists.
Part of the reason why I’m so angry is that since March I’ve been living in the US. Now, I’ve seen what privatised healthcare looks like first-hand, and it’s not pretty. Expensive insurance policies that still demand extra payments for such fripperies as appointments or prescriptions; over-medicalised middle classes; some of the worst health outcomes in the developed world, for twice the money. But plenty of competition, plenty of choice, plenty of glossy brochures.  If you can pay.
The NHS is one of the greatest accomplishments of the twentieth century.  Along with those other audacious achievements of that post-War government – national insurance; free education at all levels; child benefit – the NHS is evidence that, sometimes, governments can govern for the people. This narrow-minded petty nationalism is no fit legacy for the ideals that drove those reforms forward.  Time and time again the Consultation paper calls the NHS one of the ‘most generous’ health systems in the world.  We should be proud of that, not contemptuous. Yet it’s hard to escape the conclusion that we are witnessing the slow dismantling of the NHS. 
Jeremy Hunt claims that he’s just protecting our national health service. But while it may be only the foreign mothers of unborn British citizens, the high-skilled migrant tech workers (upon whose shoulders rest chances of British economic recovery), and the overseas students whose inflated fees keep British universities solvent who are billed this time, it’s another low blow undermining the principle of universal health care.  And it’s hard not to fear that pretty soon, there won’t be much of a health service left for anybody.
Anti-migration populism does not (whatever David Goodhart and others might claim) protect “our” poor.  It’s a smokescreen for policies that intend the very opposite: in this case, profits and private medicine.  It doesn’t have to be like this. The consultation is open until 5pm on 28 August 2013: please, read the paper, and make your voice heard.

    On Outsourcing

    The idea that Britain is “overcrowded” is an oft-repeated mantra for those who want to see massive reductions in the numbers of immigrants arriving in the UK.  Now, Julian Brazier – the MP for my home town, Canterbury — has offered the latest thinking on how to rid our “Overcrowded Land” of unwanted immigrants, including outsourcing asylum.
    Certainly, some facts are true.  In the first decade of the 21st century, the UK population grew by 7%.  Between 1991 and 2010, half of the UK population’s increase could be directly attributed to the effects of migration, an extra 2.4 million people.
    Yet while growth undoubtedly demands better governance – more investment in infrastructure, better public transport, the building of new houses – it is laughable to suggest that land is a “zero-sum game” or that overcrowding is an absolute truth.  We aren’t the Malthusian peasants of the 14thcentury: as others have pointed out civil engineering, public health and modern architecture are powerful tools for development.  Nor do we actually live in the concrete jungle of our imaginations: in fact, only 10% of England is currently urban (and 80% of those urban areas aren’t built on).  Brazier’s polemic twists half-facts with unfounded assertion to arrive at a dystopian vision that ignores the economic realities of how much the UK needs immigration. The demographics can’t be ignored. Unless we all start having many more expensive (in both environmental and economic terms) children, that positive net migration figure is what will prop up your pension and pay for your state-subsidised care in old age (never mind staff the care home).[1]
    Brazier’s claims are spurious and ill founded. Yet what has made me most angry in reading this particular “Conservative Way Forward” are his conclusions. In particular, the assertion that:
    This measure is necessary, apparently, because new plans to prevent people being able to appeal immigration decisions until after they’ve been deported are going to lead to ‘all detected illegal immigrants pos[ing] as asylum seekers’.
    For now, I’ll leave aside the baffling leaps of logic required to arrive at this claim. I want to focus instead on the suggestion that we can – and should – ship our Somali asylum seekers to Kenya. Such a move ignores the fact that the vast majority of Somalis in the UK are not illegal immigrants or even asylum seekers (only 663 Somali asylum claims were submitted in the UK in 2012), but instead are legal residents and even British citizens. However it also displays a real lack of understanding about either Kenyan politics or the current sufferings of Somali refugees in Kenya.
    Although Britons may believe that we host a disproportionate number of refugees and asylum-seekers, they’re wrong. 80% of refugees are hosted by developing world states. Kenya alone currently hosts close to a million refugees, asylum seekers, stateless persons and internally displaced people (a reminder that Kenya’s democratic peace is a fragile one). That’s around 2.35% of the total Kenyan population. It hosts 568,000 registered Somali refugees.  Dadaab – the world’s largest refugee camp – is also the third-largest city in Kenya. Refugees and asylum seekers comprise just 0.33% of the UK’s population.
    The market evangelists may argue that this proposal wouldn’t add to Kenya’s refugee “burden” (although Dadaab actually contributes $14m into the regional economy each year), because in Brazier’s terms, it’s a mutually beneficial economic transaction, with UK development cash flowing in alongside UK asylum-seekers.  Yet the objections are obvious. Turning refugees into commodities stretches the moral capacity of market-based solutions beyond what is reasonable. And while neither the proposals nor the objections are new – Australia’s Malaysia deal, struck down by its High Court on human rights grounds, would have operated on pretty similar principles – the choice of Kenya, whether framed as ‘dumping ground’ or ‘migration management partnership’ suggests an extraordinary level of ignorance on Brazier’s part.
    For Kenya is a country where anti-migrant – and especially anti-Somali – sentiment is virulent. I first learned of Brazier’s plans when a friend sent me a link to an East African news site.  Many of the comments below the line would make Britain’s far-right proud.    It seems like Kenya is already “full” too.
    Refugees and migrants – particularly Somali refugees – have for over 20 years been a convenient scapegoat for Kenya’s ills.  This is in part a reflection of Kenya’s own national history and lingering suspicion about the allegiances of its own Somali minority.  Somalis are subject to suspicion, discrimination and exploitation, particularly at the hands of corrupt Kenyan police. In December, the Kenyan government announced that all urban refugees would be required to leave the city and live in (severely overcrowded) camps.  Though this decision has not been enforced, several thousand Somalis have fled Kenya in fear of forced relocation and possible returns to a still insecure Somalia. Given the disruption to the billion-dollar Somali economy centred in Nariobi, it appears to be another case of migration politics trumping global economics.  I suspect Brazier knows very little of this.
    And while Kenyans may agree with Brazier about the malevolence of asylum-seekers in general, they are opposed to his plan in particular. Britain doesn’t want them: we don’t want them either.  The sun set on Empire fifty years ago.  To suggest that Kenya should take those we do not want – even for a price – is unavoidably tainted by the wrongs of the colonial past.
    The easy response, of course, is that “it will never happen”. Brazier is a backbench MP: his comments aren’t intended to lead to actual policy, only to pull the current UK debate on immigration still further to the right and persuade UKIP voters to back the Conservatives. Yet Brazier’s comments will fuel already toxic fires, both at home and abroad. For they confirm the idea that asylum seekers are the “scum of the earth”: people to be detained, contained, deported, whose value can be calculated – like some form of human toxic waste – in their safe removal and storage. And in having an impact in Kenya, they also underline how the poisonous potency of “overcrowding” myths – peddled here by petty nationalists for Daily Mail readers — actually form part of a global anti-migration narrative that should shame us all.


    [1] This is not to suggest that migration can cure the social system – for that, we’d need one million migrants a year.  But it does suggest that cutting the working-age population isn’t exactly rational policy…

      Natural Humanitarians?

      Today is International Women’s Day: the day after tomorrow, Mother’s Day (in the UK). A juxtaposition I find unsettling.  Not because mothers don’t deserve flowers or breakfast in bed – or recognition for all the work they do in bringing us up to be sentient human beings – but because too often, it’s still wife and mother that are viewed as the only socially valid identities. In a world in which an estimated 150 million girls are victims ofsexual violence every year, in which women are still denied access to basic political, civil and human rights, the label ‘wife and mother’ can be a sentence as well as a celebration.
      Step forward International Women’s Day – which began, let’s not forget, as International Working Women’s Day.  Except it is sometimes still implied that the jobs we should wish to do are the ones that suit us because we’re women.  Even by those who should know better – like Valerie Amos, who declared this week in Stylist magazine that ‘women are natural humanitarians’.
      Humanitarian work undoubtedly attracts many empowered, articulate women. And I’ve writtenbefore about the obvious and overwhelming gender bias in the humanitarian classroom – 75% of my students are women.  In the NGO workshops and research conferences I attend, it’s not unusual for female participants to outnumber the men.  This engagement of women in humanitarian issues should be recognised and celebrated, not least because it provides a powerful impetus for change to crack that glass ceiling which mean Amos’ rise to the top of the humanitarian pyramid is still so unusual.
      Yet so many things are wrong with Amos’ statement that it is hard to know where to begin.  But let’s start with the idea that it’s women who are “natural” humanitarians.  Is the implication that men aren’t? Surely humanitarianism speaks, if nothing else, to the idea of a common humanity.  So either the claim’s redundant – because all humans are humanitarians – or it places the weight of alleviating human suffering in conflict, crisis and disaster upon women, exculpating – and excluding – men.
      But “women nurture, women care” I hear the Daily Mail cry. And isn’t that what humantiarians do? Feed the starving babies of Africa? Humanitarians, after all don’t do politics – they do assistance, they do ‘nurture and support‘. So it’s a very suitable job for a woman. This is the double danger in Amos’ words. 
      First, the implication is that, even in venturing outside the home, women should remain in the soft caring professions – and outside the hard political sphere.  Because this, after all, is what women do best. And it’s precisely this sort of framing that diminishes many women’s ambitions: the idea that somehow, we’re hard-wired to care, not to think.
      But second, Amos implicitly selling humanitarianism – and the women who work as humanitarians — short too.  Humanitarianism isn’t nurture, or charity: not when it’s done well.  It’s an exhausting, demanding, exhilarating job that often pulls you far away from relationships and family life. It demands confrontation both with impossible moral dilemmas and hard bureaucratic realities.  It’s not “natural” sentiment; it’s professional skill.
      Humanitarianism should not be reduced to the “natural” outcome of a “natural” emotional empathy that is apparently shared by only half the world’s population.  That’s not something to be celebrated. That humanitarianism isn’t ‘unstoppable’: it won’t get us anywhere.  It echoes the old ideas that women are best placed outside politics. It reduces humanitarian action to charity and emotional empathy.  Worst of all, in playing to the idea that gender roles and talents are hard-wired, it undercuts the notion of common humanresponsibility as the bedrock of humanitarian action and its capacity to effect change.
      The powerful are responsible for the wars and atrocities and terrible death tolls that cling to modern history.  And most of the powerful are not, have not, been women. So yes, our interests lie in challenging the structures of inequity and injustice and in reaching through politics.  But we have to recognise this in order to understand how our interests align with the disempowered, with changing and not just joining power.   That’s why – on International Women’s Day — we should reject the idea women are “natural” humanitarians, and instead laud the women – no nurture, no nature about it – who have made humanitarianism a conscious, political, choice.

        A tale of two Eastleighs…

        The people of Eastleigh go to the polls today, to cast their verdict on coalition government and disgraced politicians. Watching with the rest of the political chorus, it looks like an ill-tempered campaign to fit with the bitter grey February skies: rows over education, Europe and an ‘infestation’ of immigrants.  Only UKIP can apparently save us from moral catastrophe: this despite the fact that the 2011 census shows that Eastleigh is 91.8% White British, and that the greatest area of population growth in the past decade has been among the over-65s.  92.6% of Eastleigh’s residents were born in the UK: 3% in Europe.
        Many would argue that the result is moot: that it gossip for the Westminster village, yes, but – whether the victor is yellow or blue –  the result will change nothing. Yet in reading about the daily manufactured dramas of the by-election campaign, my thoughts keep turning to another Eastleigh.  In this Eastleigh, there’s another tale of migration and electoral politics unfolding. And here the election result may matter hugely, and the politics around migration foretell a serious humanitarian crisis.
        Welcome to Eastleigh, Nairobi.  This Eastleigh is roughly same size as the one in Hampshire (population 2011: 125,200). Yet, unlike its UK namesake, here the migration is very real.  This Eastleigh is home to tens of thousands of Somali refugees (as well as some Ethiopians and Rwandas): objects of police exploitation and public suspicion.  Are Somalis terrorists? A fifth-column inside Kenya? Or just extraordinarily effective businessmen and traders?
        Eastleigh is certainly sometimes a place of crime, chaos and poverty: but studies would suggest that economic livelihoods for the majority of the population here are far less fragile than in many other Kenyan neighbourhoods.  For the real story here is one of extraordinary economic dynamism. For ‘Little Mogadishu’ is the centre of global trade network and has seen investment of at least $1.5 billion annually, the commercial realisation of transnational commerce fuelled by remittances.  The twenty-first century’s future lies here, not in the greying Eastleigh of Southern England.
        But on 18 December 2012, Kenya ordered all refugees to leave the city.  Somalis were told to return to Dadaab: the overcrowded refugee camp, beloved of TV news reports, which already holds 500,000 Somali refugees. Although the Kenyan High Court has since issued a temporary staying order upon plans for forced evictions from Nairobi, fear is rife that this is the first step in a plan to push Somalis from Kenya altogether.  Many Somalis – up to 20,000 – have already left, many gathering the financial capital to move to other more tranquil settings in the region, particularly Kampala.  Rents have dropped in Eastleigh as Somalis relocate and the economy is dismantled.
        Why dismantle this business hub? Electoral politics are certainly part of the answer here too. On Monday, Eastleigh Nairobi – like the rest of Kenya– will also go to the polls.  Immigrants – especially the sort that undercut Kikuyu businessmen. and may include a terrorist or two in their numbers – are easy prey for politicians concerned with short-term race for nationals votes.  The result – if the Kenyan government forces through its plans in the run up or the aftermath of the election – is a potential humanitarian crisis and an economic disaster. As Refugees International’s report on the consequences of this uncertainty notes, the only undoubted beneficiaries are the Nairobi police, whose own Eastleigh economy – extracting bribes from the Somalis without strict legal right to be there – has just received an enormous boost.  Which informal economy would you prefer?
        It is clear – it has been for many years – that corralling refugees in camps is not an answer except in the language of short-term politics.  It ignores the fact of integration, the virtues of self-reliance and practises the expensive economics of dependency.  The fact of migration cannot be undone: national security will not be served by creating an underground population forced to live beneath the state or face potential encampment and an early return to Somalia.  This is not just a humanitarian crisis though: it makes no sense in the language of economics to hollow out Eastleigh and its transnational commerce.
        But is there anything that connects the Eastleigh of Middle England to the Eastleigh of Middle Kenya’s imagination beyond a shared name? At surface level, no. The Somali refugee crisis in all its multiple dramatic acts unfold far away from Hampshire.  We do not encamp Romanians, however much we may resent them.  Yet look more closely, and you begin to see how the narrow parochial interests that paint migration as a bogeyman translate from one Eastleigh to another: a shared language of suspicion that points the finger at foreigners and that ignores the economic contributions made by real migrants – not those we imagine.
        We need to see these linguistic connections: global hostility reinforces itself, legitimises actions that are contrary to law or common sense.  We know Dadaab isoverstretched, under-resourced, insecure. The UK should be condemning Kenya’s assault on asylum: but it’s hard to do that when you’re running on a similar ticket yourself. Better to send aid to a refugee camp.  But in the long run, it is the voters of both Eastleighs who will be the losers: for if you focus on migration, make that the policy problem, poor governance can go unnoticed, declines in service provision unchecked. Keeping out or kicking out the migrants may win votes: but oh, what small-minded, anxious votes, and at what cost.

          Stuck on repeat: Cameron on immigration

           If you repeat something often enough, people start to believe it’s true.  Just so with David Cameron’s latest comments yesterday that  ‘this open and welcoming economy’ must cut legal aid and other benefits for foreign nationals to avoid being seen as a ‘soft touch’. To prevent abuse of services, those who ‘haven’t contributed their taxes… should pay when they use the NHS’.  Cue applause and hysteria from Tory MPs, the Daily Mail, Migration Watch etc., and howls of outrage from UKIP, rushing to outflank the Conservatives on the right and campaigning to ‘stop open-door immigration’. The “debate” on migration shifts further right: the doublespeak turns half-facts into accepted truths.
          I hesitated before starting to write this blog: after all, I’ve written this blog before. So too have others. We get stuck on repeat. But the words need to be scrutinised: the claims called into question. An ‘open and welcoming economy’? Revealing perhaps to use the word ‘economy’ and not ‘society’: when hostility towards immigration is commonplace expression, amplified by tabloid journalism, we’re not an open and welcoming society. But our economy open?  That ignores the cries of software firms that they can’t find the skilled staff they need, the protests from universities about ever-more stringent visa regimes leading engineers and economists to look elsewhere for education.  As for open-door migration… even if we accept that EU freedom of movement (a reciprocal policy that opens the door to British emigration and a thousand Spanish fish-and-chip shops, let’s remember) is migration, there are still provisions in EU law to ensure that EU migrants cannot become “scroungers”: they must have sufficient resources and sickness insurance.
          Easy to pull apart the rhetoric.  But there’s something more at stake than migration. A week ago Nando Sigona wrote about how the turning of migrants into bogeymen is now affecting citizens: falling in love and building a family with a non-EU foreigner an income-dependent privilege. He’s right. However, I also think we can see in the language used to berate migrants’ abuses of public services (that they are very often paying for)  a darker story still, one that affects not just the private lives of citizens but the public content of citizenship itself.
          Read Cameron’s words again: those who ‘haven’t contributed their taxes… should pay when they use the NHS’.  But most migrants pay taxes: many British citizens don’t.  Income-dependent access to “public” services: who does that exclude? Not migrants per se: the poor.  And while the welfare state’s foundations lie in the fictions of equal citizenship binding rich and poor compatriots together, and Cameron needs British voters to believe he’s on their flag-waving side, the austerity decade is already rewriting our social contract in a manner that suggests migrants are not the only group seen as undeserving poor.  These are the foundations for a wider attack on the social rights of citizenship. And – with the threats Cameron’s recent speech makes to legal aid – the foundations of the British state in the rule of law. What have we become if we are a community in which a stranger is no longer entitled to a fair trial?
          The irony is that the hollowing out of citizenship is taking place at the same time as the citizen’s privileges are being shouted about at higher volume and more frantically than for many decades.  But that’s the beauty of doublethink.  And that’s why we need to keep dissecting the rhetoric, pointing out its inconsistencies and it’s dangerous implications. Because you never know – if you repeat the meticulously researched evidence about the impacts of migration often enough, some people might just begin to believe that’s true instead.

            On Citizenship

            What is citizenship for? That’s a question I’ve been asking for the last few years in an academicsetting: but it seemed more relevant than ever this week as I listened to commentators debate the logic of the Government’s new Citizenship Test: Too much history? The wrong sort of history? More on this in a moment. But it seems to me that before we can answer this question about what sort of qualifications are needed for citizenship, we need to think a little more about what citizenship itself is supposed to mean.

            According to the UKBA, one of the two benefits of citizenship is that you can vote in national elections. Except, of course, if you’re a Commonwealth citizen – Not just ‘White Dominion’ Australian or Canadian, but Ghanaian, Jamaican, Indian or even Pakistani – you can vote already. Very occasionally, the vestiges of Empire work both ways. That just leaves the British passport. Which is really as much about being able to leave as it is about being able to stay. Of course it’s more than that too – an emblem of belonging, a document that will save you bureaucratic form-filling and money as you no longer have to apply – again – for continued leave to remain. But the point is that citizenship should be seen not so much a pot of gold at the end of a rainbow, but a confirmation of community ties.
            But where’s the “British Community”? If the Citizenship Test is taken as indicative, it would appear to lie in the past, the memories of dead Englishmen and comedy groups that – however brilliant – disbanded thirty years ago. The truth – as Christian Joppke’s book Citizenship and Immigration underlines– is that the the story of national citizenships can only be told in the past tense, because the values that supposedly bind us together – tolerance, respect, democracy – are exactly the same as the values that Americans or Germans or South Africans would also claim bind their citizens together. Britain is the elite’s attempts to build a composite of national and regional identities: depending on whether you believe the publicity or the practice, its most powerful quality is either its ability to evolve and incorporate new, diverse belongings or its ability to continue to sustain rule by an Etonian English Establishment. My point is that Britain has always been an imagined community existing more in the minds of civil servants than in the culture of cities or country villages.
            So if citizenship is supposed to be a confirmation of community ties, why focus on reinforcing the creation myths of an ultimately hollow “Britain”? Why not on the citizenship of everyday life – paying taxes, your children attending school, queueing in the Post Office. Yes, this requires a working knowledge of English (or Welsh), and understanding of the broad contours of how to interact in modern British society – but given our draconian visa regimes, this is mostly taken care of before you even step foot in Britain, and in the rare cases when it is not, the answer is not a test but tuition. We should, though, be careful not to set the bar too high. As I sit typing this in London, I do not know my neighbours. I cannot make a nice cuppa tea (I hate the stuff). Just as expecting our new Citizens to master a pub quiz in Imperial history ignores the fact that only around one-third of sixteen-year olds sitting GCSEs even take History, and one-third of them don’t get more than a ‘D’ grade,an Arcadian vision of village fetes and street parties and cricket teas is not only fantasy, it’s many other (British) people’s hell.
            A common language; a smattering of cultural connections; the reasonable expectation of a livelihood. The desire to become a citizen. Surely that should be enough? After all, citizenship is the most arbitrarily distributed of goods (perhaps even more than wealth). Having the option to choose a different community seems a basic means of redressing the injustices resulting from birthplace or parentage. And what does citizenship mean anyway, when the state is shrinking and social rights being retracted? Moral panic about impending Bulgarian and Romanian floods may distract the masses, but British citizenship means less today not because of migrants, but because the entitlements of Empire are in the past, and the future laid out is one of private goods not public rights.
            ‘Citizenship’, wrote T.H. Marshall ‘has become… the architect of legitimate social inequality’. My favourite line on citizenship: one that reminds us that citizenship is ultimately a form of co-option, a social safety valve. Citizens are all equal, so the theory goes: so what does it matter whether I am rich and you are poor? It matters a great deal, of course, and the debate surrounding the citizenship test underlines the extent to which citizenship and its social rights are being eroded by a political project that sees power as ‘the privilege of a limited economic class’. Marshall, a great historian, knew well that History is written by the powerful: but also that progress lay in the inclusion of the powerless, the choices we made about what citizenship meant. And that’s why this new citizenship test is dangerous: it spins a British fairytale none of us should believe, just as the Bulgarians and Romanians are being spun a patronising horror story (for the edification of the British media). When in truth, we citizens should be less anxious about protecting our precarious privileges and more concerned about regaining, from our own government, our so easily-lost social rights.

              An M.Sc. in Markets

               I’ll get to the humanitarianism and migration later this week, I promise.  But tonight, a post on my other favourite mobility: social mobility. And Oxbridge. And the British Higher Education system.   A combination guaranteed to make blood boil and liberals rant.
              In the past week, Damien Shannon has confirmed he is suing St. Hugh’s College Oxford for ‘selecting by wealth’.  The Observer today announces ‘1000 postgraduates a year ‘too poor’ to take up Oxford place’.  It’s this second headline that leaves me a little uneasy. For Shannon’s point is a much narrower one, and I think it’s at risk of being used to push a wider agenda that actually obscures the real malaise eating away British Higher Education.
              There’s undoubted merit in Shannon’s claim that – given he could pay the fees – there’s little justice in University paternalism refusing him a place on the grounds they should judge what constitute an acceptable budget. Full information regarding likely expense: sure. A warning that unforeseen economic crisis will not lead to special academic treatment: absolutely.  Even make self-funding students sigh a disclaimer that they can have no expectation of emergency support.  But post-graduate students are independent adults. If they make the grade and can pay the fees, they should have right of entry.
              On to the Observer’s claim – those 1000 students. The piece that follows conflates the question of asking for liquid guarantees to cover projected living costs – indefensible – and the inability to pay fees.*  I have every sympathy with students who can’t afford to pay the sums demanded to study beyond undergraduate level.  But it seems to me that by blaming Oxford, we avoid confronting the wider fact that in our market-based semi-privatised higher-education system, you buy a service.  If you can’t pay, you aren’t let in.  This is not news: it’s a nasty reality.
              For this market absolutely selects by wealth – and will continue to do so even if Oxford no longer demands to see proof you can pay your rent check.  My own M.Sc. cohort (Cambridge) and the ones I’ve taught (Oxford and LSE) have been mostly North-American and European — and above all, wealthy. Scholarships are rare gold dust.
              At one level, then, it seems obvious and right to call for more funding for postgraduates.  Yet I worry that in two ways, this campaign doesn’t catch what’s wrong in our Universities.  First, proposals for a few dozen means-tested scholarships are a sop rather than a solution. They confirm the idea that there’s a market in Higher Education, albeit one that should allow a few subsidised entry.   But if post-graduate education is now necessary – the claim which is frequently made in the face of rising graduate numbers, and rising graduate unemployment – then shouldn’t it be a public good?
              I’d argue it’s a variation this second question we should be focusing on:  what’s post-graduate education for?  When is it necessary? The danger in focusing the debate on the right to an M.Sc. or an M.A is that it suggests that battles over access to undergraduate education have already been fought, and also ignores the fact that much of the rush into post-graduate qualifications isn’t driven by love of learning, but by the failures at undergraduate level where expansion and marketization since the 1990s have not delivered. We should be fighting not for a few means-tested scholarships for M.Sc. students, but a fundamental recognition of University education as a public good – which might involve trading the language of expansion for one in which smaller numbers can access meaningful funding and high-quality courses.
              Yet that is a conversation neither Government (nor Opposition) nor Universities wish to have.  Market ideals permeate political strategies around higher education. And when it comes to M.Sc.’s, universities certainly know what they’re good for.  Money.  The M.Sc. is the University cash cow. It is – very often – a poor-quality, high-volume product.  I know students from my own M.Phil still bitter nearly a decade later about a reality, which didn’t live up to its promises.  Keeping post-graduate education largely private (excluding the research-training streams) avoids some rather awkward conversations about value for money.  Caveat Emptor.
              So, yes, be angry about Oxford’s rules – and fret about the lack of state-funded M.As.  But the fact students are ‘too poor’ for postgraduate studies should demand a much more direct confrontation with the reality of how market logic has permeated higher education.  Means-testing scholarships circumvent  the wider structural inequalities for a few: they will not offer a solution for the many.
              *It also fails to mention that the overseas students whom we occasionally grant a visa to come here (55% of all students on a full-time taught M.Sc.) already have to meet stringent income requirements, an undoubted discrimination by wealth.
              But that’s another post…

                A Tale of Three Cities (or an Academic’s wanderings)

                This is a New Year’s tale – suitably introspective, ending with a resolution and the beginning of a journey. Next post, back to the political.  But – despite the fact this one’s personal — it seems appropriate to include here, because in a sense it’s my own riff on the questions I’ve asked an awful lot of other people over the past six years: not just where’s home, but what’s home?
                I’ve built a career around extolling the virtues of free movement. We are all post-nationals now!  Home is people, not places! Refugees and would-be migrants can build lives that cross borders, connect towns and cities, build new ideas of homes between spaces… while for a global cosmopolitan elite, mobility is the new normal. Somali businessmen commute between Nairobi and London; Indian software engineers who hop between Bangalore and Palo Alto.   Mobility will set you free.
                I’d still defend that cry.  But I’d add some caveats.  In the past two years, personal experience has given me reason to if not question, at least revise my professional judgement. I’ve come to recognise that while living between places and trying to craft out multiple homes may be a necessary part of finding freedom, and that mobility may be part of the “new normal” for high-flying professionals, it’s no new ideal.
                Why the change in tone? Well, like many academics, I’ve ended up with a house in one town (Oxford) and a job, friends and weekday flat-share in another (London).   Living the mobility dream. When strangers ask where I live, the answer is convoluted, a contorted explanation that perhaps amounts to “I don’t really know”.  The UK, sure:  but beyond that?
                It’s just sixty miles. A distance that pales into insignificance when compared to those crossed by the twenty-first century’s Somali nomads or West African wanderers, especially those without the privileges of legal visa stamps and air crossings.  And I make the journey in two hours, at least once a week.  Yet it’s enough: too much. It’s tiring. It’s lonely.  You cannot be in two places at once.   Perhaps it’s turning thirty, leaving the wanderings of my twenties behind. But practising mobility, it turns out, isn’t all I cracked it up to be.
                Is home a people, a city, a house? I’ve come to realise that my house is my home, but it’s empty half the time; that London (multilingual, multicultural, busy, disruptive) is my cultural home, my community of friends… but I can’t afford to live in it without forfeiting the space and the green in Oxford.   Spare me no pity: I’m hardly a forced migrant.  I’m lucky to have the choice to live in two places at once, to stitch together a vegetable garden with Ethiopian restaurants into my own version of “home”. And in fact, innumerable Saturday evenings have been spent working out that this is the best compromise, that – given our lives – this is the closest we can come right now to that mythical, elusive, enveloping “home” and still pursue our ambitions and aspirations.
                There is, however a serious point to this: be careful what you wish for.  Mobility – the possibility of living between places, not anchored to a single “home” – can and has allowed many to pursue opportunities that would otherwise be lost, especially women whose careers might otherwise be relegated.  But increasingly I’ve come to feel it’s a double-edged sword.  For it’s also creating a world in which the expectation of mobility creates its own pressure.  Nowhere is this more evident than in the number of young academics “Living Apart Together”. My husband’s given up asking my academic colleagues where they live: inevitably, if they’re under 35 (and quite possibly if they’re over 35 too), it will be somewhere other than the University they’re working at.   Mobile – or rootless?  And if this becomes what’s expected to succeed, is it much of a choice any more?
                So Christmas was spent (in part) confronting my own mobility-induced stress. And in fact, this has already had at least two positive outcomes, one professional and one personal.  The first is a resolution to bring these insights into my own work – and while I’ll remain sceptical about the idea of “natural” homelands, I already have much more sympathy with those I’ve spoken to about the longing for a home, a house – and the cost of a mobile (let alone a transnational) life.
                But while I’ve come to recognise mobility is an imperfect choice, it’s also an imperfect world. For many, it remains the best possible option on the table, especially when constrained by poverty or conflict in a country of origin just beginning to emerge from War.  The real political fight remains to open up these possibilities to the poor, to push against borders, barriers and visas.  Migration can still be the best possible solution: even if alongside it you long for home.
                And in the end, it’s sometimes migration that can help build a home.  As it has for us.  For this is a tale of three cities:  London, Oxford – and Palo Alto.  The second personal gain might be counter intuitive, but in fact, it turns out the way for us to beat the mobility trap and have just one home (at least for a while) is to both move 5000 miles to the West.  Free to move, not forced to move: a fitting mantra for 2013?

                  Bureaucratic borders and inequality: reflections from a paperwork day

                  Sometimes – unlikely as it may seem – real life and my research collide. Take me to an immigration checkpoint, ask me for my passport and I’ll immediately become a cross between an investigative journalist and a philosopher, trying to work out who’s paying – and who’s profiting.

                  But if the question ‘what are borders for?’ is a source of endless fascination to me, the question ‘what are visas for’ tends to be a source of endless frustration instead. And this week, I embarked upon the Indian Visa Application Process. It was a day which ended up revealing a lot about the papers that regulate our rights to travel and ensure that it’s only the rich who have the right to move.
                  Indian bureaucracy is in a special category of its own when it comes to forms-filled-in-triplicate, so I was reasonably well-prepared for the questions about my mother’s, father’s and spouse’s birthplaces. But India has now managed to hold onto the colonial controls of the Raj’s paperwork and combine them with that 21st century bureaucrat’s dream, outsourcing. Pay an extra £7.00 so VFS Global can process the forms by taking them to the High Commission for you.  In fact, apply for any visa and it’s increasingly likely VFS Global will be the ones handling the paperwork
                  Visas make money; they are also a paper statement of the state’s power to exclude (at least in legal terms). But – when everyone is forced to apply – there’s nothing effective about any security screening. Two days after I handed over the forms, my 50mm*50mm photos (eight pound coins slotted into the ageing photo booth for two photos), and perhaps most importantly of all my credit card, I now have a visa. The information I entered into the painful online system will sit on file: almost certainly unread, unchecked and unnecessary.
                  This started me thinking: maybe every cosseted Western tourist, grown spoilt on Schengen areas and ESTA visa waivers, should be made to apply for an Indian visa. After all, the minor inconvenience is at least a pale comparison of the hoops we make other foreign nationals jump through to come here, only with added humiliation, disruption and cost. The irritation I felt was partly because I’m unused to anyone presuming even for a moment that I don’t have the right to travel to their country. A bureaucratic, inefficient charade it may be. But it at least made me pause to remember my Guatemalan Spanish teacher’s humiliation at being turned down by the US Embassy for a travel visa when she wanted to visit her ageing mother (being cared for by her US-resident sister), colleagues who have fought for years to cut their way out of paper prisons so husbands and fathers have leave to remain in the UK.
                  On my way home from the Visa Application Centre, I read about Teresa May’s plans to interview100,000 students coming to the UK. Another hoop. Additional cost. A logic that just collecting information allows better decision-making – even if the information threatens to overwhelm an already over-burdened student visa system. So you spend more money to check public money isn’t being wasted: and then you put up the visa fees to cover the cost of administration. The result? Travel (let alone studying abroad) is yet more the preserve of the wealthy. And the people you want to keep out – the pseudo-students? Quite a few will find another way in, negotiating their way through the shadow migration economies. While quite a few genuine students – fee-paying, economic contributors – will go elsewhere.
                  Of course bureaucratic borders have many functions. They make profits for those selling the passes: they are a visible sign of state power. But they offer little real “protection” from the types of “abuse” that is supposed to haunt our nightmares. Because organised crime has money. And most importantly of all, paperwork and visa costs reinforce economic inequalities. The rich can travel. The poor cannot.
                  This is dangerous. Because even as the link between migration opportunities and inequality is increasingly clearsee this Milanovic paper for their take on it – it’s being made increasingly difficult for the poor to migrate legally. May may be prepared to simplify the Chinese visa, but then that’s economic prophecy too. And visas and paper borders don’t just reinforce these economic inequalities – they reinforce them – by making it impossible for the poor to move in search of legitimate opportunity.
                  At home: an envelope in the post box. My Canadian passport had arrived. And if ever a sign of how arbitrary the right to travel has become, how our entitlements to passports bear little resemblance to need or national belonging, here it is. A stark reminder that many people have sold their souls in search of one of these Western passports. Many people have died. And here I have not one, but two. It’s manifestly arbitrary and unfair, but the gap between citizenship rights and freedom of movement isn’t about national identity: it’s about rich and poor.
                  So in the end, a paperwork day turned out to be the research question I want to focus on in 2013 confronted as a personal dilemma. For shouldn’t we stop worrying about the people who can move, and focus instead on those who – trapped by economic segregation – can’t go anywhere, even if they want to?

                    Feet of clay: Aung San Suu Kyi, UNHCR and the Rohingya refugees

                    Idolatry is a dangerous habit. As a starry-eyed liberal teenager, I knew the names I was supposed to venerate. Aung San Suu Kyi was on the list, sandwiched somewhere between Martin Luther King Jr and Nelson Mandela on the roll-call of twentieth-century saints. But idols, of course, usually turn out to have feet of clay. Suu Kyi’s nasty little secret? Turns out she’s a nationalist too, reluctant to comment upon the political exclusionof the Rohingya from Burmese citizenship, or condemn the latest round of violent physical discrimination.

                    The Rohingya have only recently been discovered by the writers of World News. But they are a horribly familiar tragic figure to anyone who’s spent some time working on refugee issues. Since 1978, hundreds of thousands of Rohingya have been repeatedly trapped between the persecutions of the Myanmar state and its army, and what passes for sanctuary in Bangladesh: an impoverished, reluctant and occasionally violent host. If we’re voting on who deserves that most contested of titles , ‘the most persecuted minority on earth’, these Rohingya refugees, halfway to stateless, are guaranteed at least an honourable mention.
                    Aung San Suu Kyi’s refusal to condemn the persecution of the Rohingya or to acknowledge that this is not mere sectarian violence but systematic violation of a minority’s human rights is as disappointing as her suggestion that all parties should respect “the rule of law”. As others have pointed out, what can that mean when, as in the case of the Rohingya, it’s the rule of law which is perpetuating the injustice? But we’re wrong if we’re surprised to find her silent, a missing moral compass. In fact, Suu Kyi has never shown much interest in the minority question. They aren’t her people: not part of her imagined Burmese nation.
                    I remember talking to a contact at UNHCR several years ago, long before her release from house arrest. He shook his head at the suggestion that the Rohingya would be trapped in limbo until regime change within Burma: ‘You know, in her view, the Rohingya are not her problem’. Principles are a valuable currency for a political prisoner: but Suu Kyi was always a Burmese politician too, trapped in the same national logic, fighting for the same, enfranchised voters.
                    However, perhaps its convenient to have a figurehead, complete with feet of clay, ready to burn over a sudden loss of moral direction. For there’s another story too, one arguably far less palatable to Western audiences and Western power-brokers, and certainly far less visible in the mainstream media. And that’s a story about the international community’s treatment of the Rohingya over the last thirty-five years, and repeated attempts to force their return “home”.
                    In 1978, 200,000 Rohingya wereeffectively starved into returning from Bangladesh to Myanmar. Food rations were withdrawn: 10,000 refugees died. UNHCR sanctioned the repatriation. Fourteen years later – by which time 270,000 refugees had once more sought sanctuary in Bangladesh’s refugee camps – history was repeated. A “voluntary” repatriation in which Rohingya were beaten by Bangladeshi camp commandants, and not informed of their rights under international law to refuse to return to the Myanmar state, was supported by UNHCR. UNHCR staff admit privately – though they’re more reticent in public – that this was a disastrous repatriation, driven by personal and institutional ambition rather than an interest in refugee protection.
                    Today, there are once again 250,000 Rohingya refugees in Bangladesh. And although there’s been a noticeable (and encouraging) silence in recent weeks, this time last year senior UNHCR officials were waxing lyrical about Burma’s “newdawn” and repatriation was inching back on the agenda. Ironically, it may be Aung San Suu Kyi’s very public failings on the Rohingya issue that actually help to secure continued asylum space by making an imminent repatriation far more difficult for UNHCR to sanction.
                    So what lessons can we learn from this miserable tale? That politicians – even those who are victims of injustice themselves – are no heroes. But, perhaps more importantly, that the Rohingya crisis is not new. And while the military junta’s stranglehold on Myanmar during this protracted displacement explains in part the intractable nature of the crisis, the international community looks pretty guilty too. For the past twenty years, we’ve been fixated on “solving” refugee crises by returning them “home”.* The Rohingyan repatriations may rank among the worst, but they’re by no means the only that have taken place in dubious, violent and coerced circumstances (see Tanzania 1997: and again today, when history would appear to be repeating itself in Mtabila camp).
                    “Solving” our refugee problems too often turns the refugees themselves into collateral damage. And the logic underpinning this drive to repatriate is the same as that fuelling Suu Kyi’s equivocations. Ultimately, nation-states are for citizens: by definition they exclude perople even as they include others. So until we can start to untie the toxic knots of nationalism that too often strangle citizenship, the Rohingya are very likely to remain the “scum of the earth”. For that, Aung San Suu Kyi should be ashamed. But then, we should be be too.
                    *and for the last five I’ve been tracing this history – The Point of No Return (OUP) will be out in 2013.

                      If Men Make War, Do Women Study Peace?

                       There are so many women’, a colleague whispered at last year’s induction.  It must be noted that this particular colleague had just arrived from Sandhurst, where there are rather a lot of men. But he’s right.  Development Studies is awash with female students. Why?  And – if there really is something significant driving this gender bias at M.Sc. level – what implications does this have for the wider politics of development?
                      This is a conversation I’ve now had many times. The anecdotal evidence is clear. At LSE, I have ten academic advisees.  This year, they’re all women. Last year, nine of them were. It’s not that unusual to teach a seminar where a lone male (depending on temperament, either terrified or elated) sits surrounded by fourteen female students.  On the M.Sc. course I taught in Oxford, two or three years previously there had been only three male students had passed into legend. This fact had passed into legend, so that the current slightly less-skewed gender ratio was presented as almost balanced.
                      Official statistics back up personal observation. At LSE between 2009 and 2012, 72% of Development Studies and 78% of Development Management students were female. The department’s new degree, International Development and Humanitarian Emergencies, had 62% female students in its first year (2011).  This year it’s 72%. (Most of these statistics are here – though you’ll need an LSE log-in).
                      In other words, it’s disproportionately women who are studying development. But why? It’s pure speculation, but I’m going to hazard a guess that it might reflect a very different interest in understanding conflict and power. While this is clearly a crude distinction, Conflict and Security studies often dissect war in technical and political terms from above. And traditionally, the battlefield is a very gendered space indeed. In contract, Development considers the human cost of poverty and crisis from below.  When I’m in the mood to provoke, I’ve been known to suggest that International Relations is for those people who want to understand and share power:  International Development appeals to people who want to change the way power is distributed. Could experiences of gender play into these choices?
                      This is not to suggest that there’s something innate about women in Development studies. Oh no. Leave your “nurturing” and “caring” adjectives to one side.  The women I teach and work alongside are bright, articulate, determined.  Often radical.  And I feel incredibly lucky to work in a professional field where strong women are the norm not the exception. I’d have no problem naming half-a-dozen female mentors with remarkable careers who have not played by the patriarchy’s rules. It’s that, I think, which means the number of women choosing Development Studiesis remarkable. And I’d argue it deserves recognition beyond shared anecdotes over lunch, or occasional worries about the “gender gap” or the “missing men”.
                      Why?  Because the men aren’t missing, even if the male students are off studying war and inter-state relations. I’ve been called an “honorary middle-aged male” on at least one previous occasion because I’m not listening to the lectures: I’m giving them. Structures of power, social expectations and the facts of biology combine to mean that far fewer than should of these bright women are likely to climb the career ladder to the top in Development. A waste of talent? Yes. But more than that.  If I’m right, and the number of women choosing to study development reflects at some level a more fundamental interest in prioritizing problems differently, in placing people rather than institutions at the centre of our gaze, what’s being lost is a much wider chance to rethink social and political order.
                      So the end of men (in Development) and the rise of women? Not quite yet (and nor should the second be premised on the first). But I do think it’s time to more openly acknowledge the gender dynamics of Development Studies, and to see this in positive terms.  This could start a discussion which goes beyond superficial labels that just reinforce gendered stereotypes, and instead considers how the supporting number of women choosing to work in this field could help to shape human development for the better.

                        Wot I did in my Summer holidays

                        I spent most of my Summer in Uganda, which explains the recent silence on this blog. I’ve been trying to understand how those on the margins of a developing society – especially refugees and migrants – negotiate their way through the maze of papers and identity documents you need to live a life beyond subsistence. The answers – black-market passports, fraudulent voting slips, local citizenship cards, even a stint in Baghdad as a security guard for allied forces – are fascinating stories of enterprise and strategy, startling in their diversity.The trouble is, trying to make draw this web of corruption and creativity into some semblance of a narrative, now I’m back in the UK and surrounded by the paperwork of university life, leaves my head spinning. Where do you start when you’re trying to work out the gulf between legal and legitimate behaviours? When does corruption offer people choices that would otherwise be denied – and when is it necessary to survive in an opaque paper-bound system?

                        So perhaps the obvious place to begin is with my own story. Here follows my own tale: which was if nothing else, an education in how well-meaning bureaucratic obstacles can effectively leave people with no choice but to enter the black market.

                        Maybe it was inevitable that, having spent two months negotiating round the edges of Kampala’s networks of document-brokers, I’d end up there myself. But it wasn’t my intention, and in fact, I only resorted to document-buying on my very last day in Uganda. I was travelling on to Ethiopia: and the international travel regulations say you have to have a valid YellowFever certificate to enter from another endemic Yellow Fever area. I’ve had the vaccine. But – 24hrs before I was supposed to travel – the actual certificate that I’d brought with me in July? Now lost.
                        I called the GP at home. Fairly clear the receptionist didn’t have a clue what a yellow fever certificate was, but after some persuasion that data protection wasn’t my main concern here (I wanted people to know I’d got the vaccine), they agreed to email a copy of my vaccination record. The result was a semi-official printout: probably enough to get you through a check, but not quickly, especially not if a cash-hungry official wanted to make trouble.
                        So off I went to a Kampala practice. Perhaps – with a fax from the GP in the UK – they’d be able to help? No. Not unless I was already on their system, because – the nurse said – of the high incidence of certificate fraud in Uganda. I could have the injection again: but the new certificate wouldn’t become valid until 10 days later, so wouldn’t solve the paperwork problem for a flight later that evening. And I didn’t need the vaccine: just the papers. Having rated my chances of passing through Bole Airport at 50-50, the nurse confirmed again there was no official solution.
                        But aha, she’d mentioned fraud. And by now I knew all about Kampala’s alternate document systems. Time to check it out? A google later – and it appeared that the place to get your fake yellow fever certificate was outside the (KCCA) City Council’s health centre, amere five minute boda ride away. Arriving at the gates, I waved my UK-printout and explained the need for a new certificate to match the batch number and date. And within five minutes, I had a pre-stamped official certificate, batch number already entered, handed to me by a man in the car park for what was undoubtedly a mzungu price of around $15. My vaccination proof was sorted – bought from a man selling them out the back of his van. Presented at the airport in Addis on request some six hours later, I was waved through in less than a minute.
                        So, what’s the moral of the story? Apart, of course, from the obvious one – don’t lose your yellow fever certificate in the first place. But it seemed to me – as I negotiated my way around the need to find a certificate and avoid a really bad start to my week’s holiday in Ethiopia – this was a short experience of the troubling economy that binds migrants, refugees and others living in the shadowlands to underpaid and corrupt officials. To avoid paying a bribe I could not control at one end of my journey, I negotiated my payment at the other end. I would have gladly paid more for a legitimate, official replacement certificate: but faced with a dysfunctional system that could not do that, you circumvent. It underlined the gap between legality and legitimacy which many urban migrants and refugees face: I obtained my certificate illegally, but I had a legitimate claim to get one somewhere: I’d had the injection. Not so unlike the migrant who’s built a business, a family, become part of the local community without legal papers. Are the ones they bought really illegitimate, or do they just represent a practical, reasonable (if illegal) shortcut formalising integration that’s already taken place?
                        And yet the experience was also very troubling. When everything has its price, value is distorted. And when we move away from abstract concepts like citizenship to the very real consequences of infectious disease, the real impact becomes clear. I’m no health expert, but there arevery clear reasons why – for personal as much as public health –everyone in Uganda shouldbe vaccinated against yellow fever. I’d had the vaccine. For me it was a one-off. I’m legit again: on my return to the UK, I got “real” replacement yellow fever certificate. But most people buying the papers haven’t and won’t have the vacine. So the ready availability of black-market certificates clearly helps to perpetuate a cultural reluctance to take the need for immunisation seriously. That is wrong.
                        But the existence of the market also reflects the problems inherent in relying on paperwork rather than persuading people. Given similar reports of fraud from Nigeria, I’d be interested to know whether WHO really believes that yellow fever certificates – so easily forged, a relic of the pre-computer age (my vaccination booklet also includes a page for smallpox) – really play a role in controlling yellow fever’s spread through international travel in parts of the world where borders are porous and – as so many of my interviewees told me – ‘money is everything’.
                        For if my summer taught me anything, it’s that sometimes it’s the paperwork itself that prevents legal behaviour and distorts legitimacy.  Papers are powerful, but they’re no panacea: and in cases like this, they may even be part of the problem.