Salud Promodores, Barefoot Doctors, Home Health Workers, and Iranian Health Houses Come Knocking

Healthcare Workers in Iran

New Orleans   In organizing the process of strengthening weak ties to build the strong welds of solidarity can be very personal, tediously time consuming and therefore prohibitively expensive, and involve huge scale human engineering in order to create deep organizations, which is partly why organizers use other tools like actions and demonstrations to achieve scale and create polarization.  There’s no better or more intensive process than home visits, the door-to-door work that was the ACORN hallmark.

For a long time I have found it fascinating the way similar systems have been successfully adapted in developing countries to provide health care, particularly preventive care.  In Lima and elsewhere many of our organizers were originally salud promodores or health promoters, similar to home health aides doing outreach.  In fact when I was consulting with Casa de Maryland they had an excellent program working among immigrant populations in the suburban counties outside of Washington, DC.  The role of barefoot doctors, who were home health organizers after the Chinese revolution, was well regarded and carefully studied in my generation as both hopeful and inspirational.  The huge explosive growth of home health workers in the USA was more about cost saving than prevention or intervention, but there’s no doubt that when the service worked it allowed better health and independence for millions.

It wasn’t surprising to that Dr. Aaron Shirley, a veteran doctor and civil rights activist in Mississippi, would be attracted to these kinds of programs in dealing with the persistent, scandalous, and tragic heath care crises in Mississippi, but the New York Times Magazine feature advocating a move to an Iranian model of health houses or mini-clinics serviced by promodores of sorts was fascinating.

The Iranians built ‘health houses’ to minister to 1500 people who lived within at most an hour’s walking distance.  Each house is a 1000-square foot hut equipped with examination rooms and sleeping quarters and staffed by community health workers – one man and one or more women who have been given basic training in preventive health care.  They advise on nutrition and family planning, take blood pressure, keep track of who needs prenatal care, provide immunization and monitor environmental conditions like water quality.  Crucially, in order to gain trust, the health workers come from the villages they serve.

All of that seems to make enormous good, common sense.  The article drifts a little towards the direction of being a solicitation for government or private funds for the $3 million the Mississippi organizers and advocates want to build 15 such “health houses” over three years, but it makes me wonder why this wouldn’t be a vital system in not only rural areas, but also cities, and why with some energy and ingenuity and community support versions of this couldn’t be created by community organizations using the talents all around them.  Given the costs of health care, the shrinking of the safety net, and the fact that it’s life-or-death if we don’t start embracing preventive care and create a real ground-level health care system, it seems like it’s worth some thought and work for community organizations to adapt something similar and do so PDQ.

salud promodores training

Joyce Miller: First Lady of Labor

Joyce Miller being honored (1983)

New Orleans   Meeting Joyce Miller was one of those happy coincidences.  Her son, Josh, was working as a researcher for ACORN in Arkansas in the 1970’s, which gave her an excuse to visit the state and the rest of us an opportunity to meet her.  The Coalition of Labor Union Women (CLUW) was something that mattered at the time, because they were the one established group of tough, savvy union women within the ranks of institutional labor that the staid, conservative building trades wing led by George Meany, didn’t embrace, but couldn’t shake off.  As vice-president of the once powerful and progressive union, the Amalgamated Clothing & Textile Workers Union (ACTWU), Joyce had been at the founding meetings of CLUW and an early officer of the organization, becoming in 1977, CLUW’s second national president.

Unions were decidedly “old school” at the time, even more so than now.  The old lions were still roaming the range, even as the membership and movement was sliding down a mountain, having crested without realizing it, and still grasping at this rock or that on the way down, as they tried to get a grip and denied the obvious at the same time.  Joyce was “old school,” too, which is partly what made her impossible to ignore for the old hands, frustrating for the young feminists, and effective in the backrooms in what she referred to as the “sea of men.”  She was from Chicago, had started working on auto assembly lines while in school there, and became an activist.  She first rose to prominence in the unions that became ACTWU as education director of the Joint Board in the Midwest.  Labor education in the old school of labor used to be part of the essential package that prepared leaders, trained stewards and bargaining committees, and, essentially provided the history and ideology that built the struggle “culture” of the labor movement.  This was the “soft side” of a hard movement.   And, not just the soft side either, because part of what went with the portfolio was strike support.  Joyce’s department had to be able to mobilize the social services, get the food stamps and unemployment that allowed the troops to hang on, provide the family support, and a hundred other things that could allow workers to make it “one day longer” and give them a chance to win.  A tall, sturdy woman with a hoarse, gruff voice, Joyce didn’t come off like a social worker.  She wasn’t a back down woman.  It wouldn’t have been hard imagining her puffing a cigar with the old guys if that had made a difference.

Joyce Miller in 1988 second from left with Evy Dubrow (far right), a CLUW founder.

Both of these departments have largely disappeared, but in the 1970’s and 1980’s there leaders at the cutting edge like Joyce could understand that a hybrid community union of sorts like ACORN, starting to expand from Arkansas to other states, could be a game changer as part of the larger progressive forces with their wider view of labor.  I can never forget in the late 70’s while trying to raise money one spring in New York, Joyce inviting me to have lunch in Union Square with some of her colleagues, including the organizing director of the union.  As Joyce moderated the discussion, they explained what they did.  I explained what we did.  The organizing director wanted to know all the specifics.  How many organizers?  What hours did they work?  What were they paid?  Finally at the end of the lunch, he turned to me and said that he would give anything if we could just do an even trade, his organizing staff for mine for a couple of years.  He honestly didn’t think the trade was a good deal for ACORN, but he thought he might save his union and the labor movement if we could make a deal.  Everyone laughed.  Joyce louder than others, feeling she had just stirred the pot.  He wasn’t serious unfortunately, but I was, and it made a different.

In 1980, I was 32 and Joyce Miller was 52.  That year she was named the first woman member of the AFL-CIO’s Executive Council.  Women by that time made up more than 7 million of the 13.5 million members of the federation, so it was fair to say that it was about damned time.  Now there are women running some of the largest unions within institutional labor from the AFT to the SEIU.   More than 30 years later women still don’t have a secure role in the union culture despite their increasing majority.  I can remember the fights in the late 1980’s to get women on the executive board of the Greater New Orleans AFL-CIO.  Women are still disproportionately represented at every level of the labor movement, and that issue alone has to be on the list when noting labor’s decline.

I got an email late last night from Josh Miller, now a long tenured professor at Lafayette College on the Pennsylvania/New Jersey border.  She was in her mid-80’s.  I had written about her in Social Policy in recent years which had given me a good excuse to have a couple of great phone conversations with her, sharp as a tack, and to the point as always.

He said Joyce had died the night before.  He knew I would want to know because “she was one of your greatest fans.”   And, I was one of hers!

I will be looking for Steven Greenhouse’s obituary for Joyce in the Times, because attention and respect must be paid.  Lessons in the special Joyce Miller school of labor education are still being taught and, more importantly, still need to be learned for women and men to lead the way in building the unions of the future.

Coalition of Labor Union Women (CLUW) supports organizing drive at the A&S department store in Brooklyn.

Is about Real Change or Just Pocket Change?

New Orleans    Like many progressives I get frequent solicitations from about this petition or that petition for this cause or that cause.  I’m not a big petition signing guy, just because it’s time I don’t really have and a tool that is not the first to my hand, but I monitor it all to keep up with what’s happening.  I started looking more closely when I read The Business column in the Wall Street Journal by John Bussey on June 8th that told me to my surprise that was a for-profit.  I had earlier reservations about and Moxy Vote.  Why in the world?

Bussey’s piece drifted around with interesting discussions on something called “B Corporations,” which are now allowed in half-dozen or so states and are worth further discussion but essentially are for profit companies that self-declare as social benefit operations that will use more of their profits for internal investment rather than stockholder benefits.  There were spinning rationalizations from the CEO of Ben Rattray, who argued that “the reason we’re making money is that it’s the necessary condition to having impact.”  None of these obfuscations seemed willing to address the real points.

A nonprofit can make money.  You don’t have to create a for profit structure to make money.  All of that is hooey.  A tax exempt nonprofit just doesn’t pay taxes to the government on income related to its mission.  A plain vanilla nonprofit, which is what ACORN was, can invest all of its excess revenues in building its organization (similar to the B Corporation claim), but if it ever had made big bucks (certainly wasn’t going to happen during the 38 years when I was Chief Organizer) it would have had to pay taxes.

Rattray and the others are trying to hide some simple facts behind the very important altar of self-sufficiency.  Inherent in their arguments are, yes, Virginia, it is critical to pay your bills for you to have a business plan and/or organizational model that arcs towards self-sufficiency.  I totally endorse that, and it has become an obsession for me after watching ACORN’s attack and demise less than 2 years ago.

But all of this is obfuscation.  The only thing you can’t do as a nonprofit is provide distributions to shareholders.  The only real reason that Rattray and others would chose any of for profit corporate structural formations is the hope and intention of personally cashing in or selling the business out at some point and making more for themselves (and any other possible stockholders) than were available from salaries and benefits paid or loans and investments returned.  Bussey makes the mistake abetted by Rattray and others who know better of assuming wrongly that nonprofits cannot make money, which of course they can, and confusing sustainability, taxes, and other issues, with the simplest truth that this is all about self-interest and stockholders.

It turns out that the business model is selling the aggregated email lists.  I didn’t know that either, which makes two strikes against transparency.  Sure a for-profit corporation can buy a .org website, since they are for sale, but to be so committed to not being transparent is a problem for me despite all of the good they are claiming to do.

All of this makes a mockery of progressive movements, progressive causes, and the base of regular people of good faith who are joining these efforts without realization and therefore knowingly being fleeced like so many sheep to the slaughter.  There is role for in this movement without a doubt, but we’re I’m at two strikes (for profit, list selling) and the third for me is wanting a true explanation from Rattray about his real intentions for which means a real story about why it is not constituted as a nonprofit?

Raising and Indexing the Federal Minimum Wage

New Orleans   There was a picture in the New York Times claiming to be Dan Cantor (sure didn’t look like him?) of the New York State Working Families Party who was advocating an increase in the state minimum wage.  Jen Kern, a career minimum wage expert as former coordinator of ACORN’s Minimum Wage Resource Center and now with the National Employment Law Project in DC, was also quoted at length on the benefits of raising the minimum.  It felt like old home week and the calendar turning back a decade.  One of those, the more things change the more they stay the same stories.

There is too much déjà vu in this campaign.

Once again, just like in the Clinton first term, we have a Democratic President that has not raised the federal minimum wage. Despite Jen’s skills and other voices rising, there won’t be an increase in the federal minimum wage this year on the eve of an election.  There may be 1.8 million workers as Steven Greenhouse points out who are stuck at the minimum wage with another 2.5 million trapped beneath $7.25, but if this part of the vote is registered and not too suppressed, these are people voting more with their feet than with ballots and if they make it there, most will vote for Obama anyway, so little sweat will be expended in this direction.  Once again our only real hope will be that if Obama is re-elected, then perhaps there will be a bump before the end of the 2nd term following the Clinton pattern.

Looking at the 18 states with minimums over the federal level, it is surprising to me how narrow the compression is between what states have done and what Congress has allowed.  I need to do more research on this in coming days.  In some cases I fear that I have not kept up and the erosion of power at the state level by organizations and the surge by the right and groups like ALEC, may have erased some of the victories around citizen wealth won in recent years.  Florida in 2004 for example voted for an increase $1 over the federal minimum with an index.  Now, the index to inflation seems to have survived, but the dollar seems to have disappeared with Florida at $7.67 only a bit more than $0.40 over the federal level.  It also appears that we may have erred in withdrawing ballot initiatives in states like Arkansas and Michigan and accepting legislative increases, which now have allowed those states to simply pay the same rate as the federal level.

The Working Families Party is right.  The changes have to come at the state level if there is going to be real progress, but we finally have to make permanent indexing to inflation part of the package, or we need to step aside and let others carry the weight.

We won a statewide initiative in Missouri to increase the minimum wage after losing an earlier effort.  Now reportedly yet another coalition is amassing signatures to once again try to raise the wage now stuck at the federal $7.25 level.  We can’t keep doing this over and over again and now managing to make change permanent.

We need to look to make these changes at the state level, but we need to add indexing and we need to embed language that would require any rollback in the minimum wage to go to the voters, rather than allowing counter revolutions to wipe away these gains for working families.

Time to learn some lessons!

Little Rock Reminders of the Shoulders Where We All Stand

Little Rock    One of the interesting things about a city the size of Little Rock, and perhaps one of the little understood secrets of ACORN’s growth and success there after its founding in 1970, is that it is just big enough to be a city and just small enough that you can fairly easily see the moving pieces.  I was reminded of this talking to University of Arkansas at Little Rock (UALR) History Professor John Kirk about a wide variety of subjects.  Kirk is a United Kingdom (Manchester) bred expert of civil rights history in Arkansas and was apropos of my general theme here was introduced to me by Occupy activist and UALR student, Robert Nunn, who I met as the son of an ACORN leader in the Oak Forest neighborhood in the early 1970’s where we fought a huge anti-blockbusting campaign against real estate racial manipulation of pricing and integration.

As ex-ACORN and current Arkansas Community Organizations staffer, Neil Sealy, and I visited with John and Robert, we hit on subject after subject where threads of continuity were woven endlessly.  Kirk had written a definitive book on the “Arsnick” or Arkansas SNCC movement including the incidents in Gould, where a family was burned out that housed the SNCC workers, and of course one of the first organizers I hired for ACORN was Bobbie Cox, whose grandmother owned the house in that story.  The SNCC story led to a discussion of the threads which ran through Gould and then onto ACORN from the Southern Tenant Farmers’ Union and H. L. Mitchell.  For an hour we seemed to move from one free association to another.  Mention the KABF radio station and the earlier voter registration history of ACORN, and there is Pat House former chair of the board and long time ACORN stalwart as a silent and invaluable friend and advisor, along with Mamie Ruth Williams, both of whom Kirk immediately recognized as members of the Women’s Emergency Committee more than a decade earlier than ACORN during the 1957 Central High School integration crisis including Eisenhower’s use of the troops to achieve integration.  Later Kirk sent me a draft of a piece he has in an upcoming book on that looks at the preconditions that established the scenario’s that led to the 1957 crisis much of which focused on the role of urban removal in creating the hardrock residential segregation that forced 1957.  The rogue’s gallery of real estate moguls like Billy Rector and Housing Authority officials who were later bankers like Finley Vinson was sobering and disturbing.

All of which reminds me of a universal and humbling truth about organizing in any workplace or any community:  there is always a history of struggle, if you but ask deeply and listen carefully.  No matter how unique each effort and individual, we always stand on strong shoulders even though time may have obscured and bowed them.  If we look we can find them, but it’s a comfort in organizing when you come to the realization that they are always there underneath you, steadying your progress, and saving you from a harder fall.

Clean Rivers, Working Families, and Big Ideas

Some of our group in Pittsburgh, oldest leader still in the fight at 102

Pittsburgh     Hit the United Association of Labor Educators conference running in Pittsburgh and then connected with Maryellen Hayden Deckard, former ACORN office director in Pittsburgh now doing the same for ACTION United.  In no time we were visiting with CWA and other union workers rallying at Verizon to support their contract fight, and then sitting down for lunch at Mexico City with a bunch of labor cartoonists.  It was going to be that kind of wild ride in Pittsburgh!

In the afternoon I stumbled into two very interesting developments.  Both are undoubtedly worth further discussion in more detail later, but give a sense of the excitement and potential in important directions these days.

When you first hear the term Clean River Campaign, it runs right by you.  Must be another environmental thing, so good luck to them, next please!  A long conversation with Barney Oursler, the executive director of Pittsburgh United, who is the driving force behind this campaign reveals something much, much different in my reckoning.  For years I have said that any organization that comes up with comprehensive solutions to “loose dogs, bad drainage, and crummy trash pickup” might just have the formula for creating power everywhere.  Well, the real deal on the Clean Rivers Campaign is coming to grip with the issues that lie at the heart of sewer, drainage, and wastewater systems.  Pittsburgh, like literally hundreds of other cities around the USA, is confronting EPA compliance agreements which require billions of dollars worth of infrastructure investment to appropriately assure clean water and upgrade deteriorating infrastructure suffering from age, lack of maintenance, and design problems.  In Pittsburgh, not unlike many other cities, the problems are magnified because of the three rivers but also the 526 different municipalities and other governmental structures that are in the watershed and have water in this race as well.  Barney and his partners, including ACTION United, are contending over coming years with pushing aside bad plans but also getting a good program which is “green,” provides community benefits, and is affordable, all of which are high barriers.  From experience fighting water privatization triggered by EPA compliance agreements, including in New Orleans where we are still in the throes of this mess, I think this is worth real study and investigation.

Discussion at Big Idea

I also ran into a team of organizers and canvassers with the Working Families Party who are now expanding into Pennsylvania.  This is fantastic news!  The Working Families Party in New York, Connecticut and elsewhere has emerged as an important ballot-line effort giving real tools to progressive issues and low-and-moderate income families.  This would be a wonderful development in Pennsylvania.  Need to find out more about this and see if you can get this Party building in a neighborhood near you!

The fun part of my day in Pittsburgh was two back to back discussions about politics, organizing, and the state of movements for change in these days and times first in the late afternoon at the Big Idea Bookstore & Café, which is a workers cooperative operating over the last 10 years and expanding, and then a more informal discussion with leaders, activists, and organizers with ACTION United in their offices over pizza.  The excuse for both of these great events were talking about my books, Citizen Wealth, Global Grassroots, and Battle for the Ninth Ward, but the conversations were fascinating on a variety of topics.

Just to share some of the pleasure at the Big Idea several folks around the circle had been active in the Occupy movement in Pittsburgh, and we had a provocative discussion about the emerging role for anarchism emerging in progressive work.  There was still a lot of mourning for the death of ACORN as well in these times when change is increasingly high on the “demand” list.  I was optimistic that a new formation might be possible, but not that we would ever be able to get the genie back in the bottle.  Similarly at ACTION United, there was deep interest in “citizen wealth” campaigns around credit card debt and collections and student debt.  People could palpably feel the future slipping away and see lives of running from debt collectors and harassment as central parts of their future.  They were groping for organizational response.

No such meeting is complete without a discussion of Fox News of course, and the first reaction when they heard I had agreed to be interviewed for a voting special they were doing on the issue of voter suppression, was that I was “crazy.”  Once I had conceded that point as factual, I made the case that we still had no choice but to try and communicate whenever we could and advance the right and just positions on issues as important as full citizen participation and the prospects for democracy.  How could we ever refuse to take the side of democracy in the debate when so many were so arrogantly now arguing for repression?

I left with lots to think about from my discussions with my new and old friends in Pittsburgh, but I left them thinking about some “big ideas” as well.