Editors’ letter

The Report of the World Commission on Culture and Development published by Unesco in

1995 stated that the very understanding of ‘development’ is infused by culture:

It is culture that defines how people relate to nature and their physical environment, to the earth and to the

cosmos, and through which we express our attitudes to and beliefs in other forms of life. It is in this sense

that all forms of development, including human development, ultimately are determined by cultural

factors. Indeed, from this point of view it is meaningless to talk of the ‘relation between culture and

development’ as if they were two separate concepts, since development and the economy are part of, or an

aspect of, a people’s culture. Culture then is not a means to material progress: it is the end and aim of

‘development’ seen as the flourishing of human existence in all its forms and as a whole. (p. 24)

What constitutes ‘development’, or even what counts as ‘human development’, can thus never

be disentangled from culture. This issue of Maitreyee explores the relationship between

culture and human development.

1

Sakiko Fukuda-Parr starts by examining the interconnections between people’s cultures and

human freedoms, and argues that multicultural policies are key to human development. Jan

Nederveen Pieterse discusses some of the problems of taking cultural freedom as a central

concern of development. The authors of the 2004 Human Development Report on Cultural

Liberty offer their counter-response to his critique. Wim Hiemstra concludes the ‘Insight’

section by exploring the concept of ‘endogenous development’ and describing examples of

culturally embedded development initiatives.

‘In the Practice’ section reports two examples of (failure of) cultural embeddedness of

development policy. Francesca Panzeroni addresses the limits of so-called ‘culturally

appropriate’ measures of health provision among the Australian Aborigines. Agnes Apusigah

writes on the practice of female bondage (trokosi) in Ghana.

As usual, if you have any comments, or would like to make a contribution to forthcoming

issues of Maitreyee, do not hesitate to contact me.

Séverine Deneulin

E-mails: s.deneulin@bath.ac.uk

1

For a pedagogical overview of the literature on cultural and human development, see Sarah White’s chapter on

Culture in the ‘human development textbook’.

M a i t r e y e e

E-Bulletin of the Human Development and Capability Association

Number 15, October 2009

Insights

Cultural freedom and human development today

Sakiko Fukuda-Parr

New School, New York

Please refer to Sakiko Fukuda-Parr, ‘Human Development Today’, Daedalus, 133:3 (Summer

2004), pp. 37-45.

For reasons of copyrights, we cannot make the shortened version of the essay publicly

available.

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Development and Cultural Liberty

1

Jan Nederveen Pieterse

University of California at Santa Barbara

In view of the political spillover of ethnic and religious movements—as in former

Yugoslavia, Iraq, Afghanistan and several Muslim countries—the policy relevance of the

cultural dimensions of development is increasingly prominent. So it plays large in the 2004

Human Development Report devoted to culture. As its title indicates, Cultural Liberty in

Today’s Diverse World, the report deals not merely with cultural diversity but with cultural

liberty, which, it argues, is its novel contribution to the debate. Liberty or freedom is the

report’s Leitmotiv: ‘If what is ultimately important is cultural liberty, then the valuing of

cultural diversity must take a contingent and conditional form. Much will depend on how that

diversity is brought about and sustained’ (16). In often paraphrased wording it adopts ‘a

freedom-based defence of cultural diversity’ (23). From this premise follows a critique of

cultural conservatism:

Being born in a particular cultural milieu is not an exercise of freedom—quite the

contrary. It becomes aligned to cultural liberty only if the person chooses to continue to

live within the terms of that culture, and does so having had the opportunity of

considering other alternatives. The central issue in cultural liberty is the capability of

people to live as they would choose, with adequate opportunity to consider other options

(16-17).

The report reiterates that ‘tradition should not be confused with freedom of choice’ and

cautions that ‘defending tradition can hold back human development’ (88). On the same

premise the report criticizes identity politics and quotes Anthony Appiah on the ‘imperialism

of identity’: ‘it is crucial always to remember that we are not simply black or white or yellow

or brown, gay or straight or bisexual … but we are also brothers and sisters; parents and

children… let us not let our racial identities subject us to new tyrannies’ (18). The report,

rightly in my view, draws attention instead to multiple identities, but it carries this too far:

1

This article first appeared in an expanded version in Development and Change, 2005, 36(6): 1267-73. It has

been revised and included chapter 5 (‘The cultural turn in development: Questions of Power’) of the second

edition of Development Theory: Deconstructions/Reconstructions (London: Sage and TCS books) to be

published in 2010 (first edition in 2001).

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People must be free to choose how to define themselves and must be afforded the

same rights and opportunities that their neighbours enjoy. This Report asserts that a

main hope for harmony lies in promoting our multiple identities. … the recognition of

multiple and complementary identities—with individuals identifying themselves as

citizens of a state as well as members of ethnic, religious and other cultural groups—is

the cornerstone of cultural liberty (42, 73).

The report becomes unreal when it argues that identity is a matter of individual choice and it

is up to individuals to decide which of their identities matter most, which may be theoretically

true but ignores that most people live their lives as part of communities. Besides, dominant

discourses and structures of power often reinforce and perpetuate particular identities.

A chapter on ‘Confronting Movements for Cultural Domination’ discusses coercive

movements that oppose cultural liberty in the name of cultural superiority on ethnic or

religious basis. It discusses restrictive measures against them (such as institutional barriers

against coercive political parties, legislation and judicial intervention) but rightly argues that

the most effective way to marginalize extremism is to strengthen democratic processes; which

includes concerns such as paying attention to school curricula. The closing chapter focuses on

three policy challenges: indigenous peoples and extractive industries; trade in cultural goods;

and migration. Its contributions are generally what one would expect in a brief twenty page

treatment and further reiterate the cultural liberty approach: ‘globalization can expand cultural

freedoms only if all people develop multiple and complementary identities as citizens of the

world as well as citizens of a state and members of a cultural group’ (89).

The report follows the World Commission on Culture and Development Report, Our Creative

Diversity published by UNESCO in 1996, but it bears little relation to the culture and

development literature. Earlier work examined the cultural assumptions of development

thinking and cooperation, from Eurocentrism to racial bias. This literature is reflexive and

self-critical and its major concern is to make development efforts more effective and

participatory by taking into account social diversity and local culture (Schech and Haggis

2000). Gone in this report is the reflexive and self-critical character, gone is the critique of

Orientalism; instead criticism squarely targets cultural conservatism and extremism—the

opponents of cultural liberty.

About development the report is brief: ‘there is no clear relationship between culture and

development’. ‘Work ethic, thrift, honesty and openness to strangers can play a role in

economic growth… But there is no grand cultural theory of development here’, as

econometric evidence shows (38, 39). The report rejects cultural determinism to explain

economic development—from Weber’s Protestant ethic (at times Catholic countries were

growing faster than Protestant countries) to claims made in Harrison and Huntington’s work

Culture Matters (2000). It rightly rejects the cliché of western liberty and Oriental despotism:

‘The history of the world does not suggest anything like a division between a long-run history

of Western toleration and that of non-Western despotism… the very idea of democracy, in the

form of participatory public reasoning, has appeared in different civilizations at different

periods in world history’ (21).

The report notes the difficulties of measuring cultural liberty and developing a cultural liberty

index because of limited data and conceptual and methodological problems. It attempts to

operationalize cultural liberty by measuring its opposites in two forms of exclusion: living

mode exclusion (‘when the state or social custom denigrates or suppresses a group’s culture,

including its language, religion or traditional customs or lifestyles’) and participation

exclusion (‘social, economic and political exclusion along ethnic, linguistic or religious

lines’).

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The report rejects as myths that cultural diversity inevitably leads to clashes over values and

that cultural diversity is an obstacle to development. Fair enough; but would it not be

appropriate in a Human Development Report on cultural diversity to take a further step and at

least explore that cultural diversity may be conducive to development? Yet the economics of

cultural diversity barely come up. The strongest claim is ‘As this Report argues from

beginning to end, attempts to suppress and assimilate diverse cultural groups are not only

morally wrong—they are often ineffective, heightening tensions’ (44). Two pillars that

remain are moral considerations and preventing or managing conflict. Precisely where one

would have expected a reflection on correlations between multiculturalism and development

it is entirely absent, bar a passing mention of the economic benefits of migration.

There would be several routes toward a political economy of multiculturalism and develop-

ment. Keith Griffin, a member of the World Commission on Culture and Development, makes

a strong case that cultural diversity, past and present, is conducive to development particularly

with a view to the innovative contributions of migrants (Griffin 2000). Another option is to

link up with the learning approach in development economics, including ‘learning what one is

good at producing’ as well as ‘learning to learn’ (Rodrik and Hausman 2003) and under which

conditions combining diverse cultural databases and institutional practices enhances investment

decisions and economic performance. This also involves taking up questions of intercultural

social capital (Nederveen Pieterse 2007). Cultural economy approaches hold that economics is

not merely a social and political but also a cultural phenomenon (Amin and Thrift 2004), which

points to a political economy of multiculturalism. This human development report, however, is

long on norms and policy prescriptions and short on economics.

According to the report, ‘human development aims at expanding an individual’s choices’ (93),

which is odd because one would think that development is above all a social, not an individual

project; though it is consistent with the analytical roots of the human development approach in

liberalism (Nederveen Pieterse, 2010, chapter 8). Like most development studies the report is

short on history and on theory. It makes selective references to the massive literature on

ethnicity, ethnic conflict, religion and multiculturalism. The argument for cultural liberty is an

odd duck in the massive literature on religion, ethnicity and ethnic conflict and novel in this

debate. It does fit Amartya Sen’s argument of Development as Freedom and its functionalist

application of a rights-based liberalism. To this report Sen contributed a background paper on

‘Cultural Freedom and Human Development’. As a broadsheet against exclusion the report

doesn’t discuss the exclusions and shortcomings of liberalism itself, which are well on record,

for instance in the history of colonialism (Mehta 1997; Metcalf 1998) and in relation to

multiculturalism (see Parekh 2000, 2008).

The core problem of liberal multiculturalism is that it provides a solution for which there is no

problem and a remedy for which there is no ailment; a world of optional multiple identities in

which individuals can choose their identity is a world that doesn’t need multicultural policies

(Nederveen Pieterse 2007). The central paradox of this report is that it wants all-round

cultural inclusion—but not cultural conservatism; it wants multicultural democracy—but not

cultural conservatism. But who can define and decree what is conservative? In effect, this

takes the politics out of culture and identity. Campaigns against extremism usually target the

extremism of ‘others’ and are oblivious to one’s own extremism.

The report reads as a compendium of liberal multiculturalism policies—straightforward, plain

speaking, but mostly obvious and difficult to implement. The report acknowledges the

problems that arise from integrating multicultural policies into human development strategies

and from its liberal policy recommendations. Thus while education in one’s mother tongue is

no doubt a value, it notes that there are practical and economic impediments to doing so. Yet

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these reservations don’t feedback to the recommendations: ‘In the big picture the arguments

for these policies are clear. But for policy-makers the contradictions, trade-offs and clashes

with other aspects of human development can monopolize their attention’ (45). These

fundamental problems are discussed in throwaway lines on ‘a history of power relations’ that

leave matters open and to which there is no follow up. Thus, for all its plain speaking clarity

this is actually a confused and confusing document. At times its pronouncements seem to

address a parallel universe: ‘The central issue in cultural liberty is the capability of people to

live as they would choose, with adequate opportunity to consider other options. The

normative weight of freedom can hardly be invoked when no choice—real or potential—is

actually considered’ (17).

In sum, this report presents problems. First, when it claims that ‘defending tradition can hold

back human development’ it restates the old-fashioned modernization vs. tradition approach.

Second, when it poses cultural liberty as the framework for culture and development, it views

developing countries’ cultures through the lens of western values. Third, by offering freedom

as the answer to every problem it places the cart before the horse. Policies informed by norms

rather than by the difficult trade-offs of actual development policy belong to the world of

ideology.

The report brings us into an arena of freedom and its opponents. In approach and language it

reads like an American take on culture and matches an American policy agenda. If one would

want to align development cooperation with, say, the war on terrorism, this would be the way

to go. One would first declare the aim of development to be freedom; second, one would aim

to defend and spread a ‘culture of freedom’ and oppose any form of cultural conservatism. To

demonstrate even handedness one would also roundly criticize extremism in the west such as

extreme rightwing parties and Christian fundamentalism. Third, one would weave this into

development cooperation and conditionality. Thus the promotion of cultural liberty and the

struggle against extremism would become strands of good governance.

Turning to culture and development generally, a key point made in this chapter is the

significance of cultural difference within developing countries. A trend in many culture and

development discussions is to focus on north-south relations and northern cultural bias, as in

classic discussions of Eurocentrism and Orientalism. But, of course, ethnic stratification and

cultural ‘divisions of labour’ within developing societies is at least as important, if not more

for it may involve institutionalized racism on the part of elites and bureaucracies (Jonsson

1999; Nederveen Pieterse 2007). Culture is charged with power at every turn.

References

Amin, A. and N. Thrift N. (eds), The Blackwell Cultural Economy Reader, Oxford: Blackwell

Griffin, K. (2000), ‘Culture and Economic Growth’, in J. Nederveen Pieterse (ed), Global Futures, London: Zed

Harrisson, L.E. and S. Huntington (eds) (2000), Culture Matters, New York: Basic Books

Jonsson, I. (1999), ‘Development, learning-processes and institutionalized racism’, Ethnic and Racial

Studies, 22(1):113-35.

Metclaf, Th. (1998), Ideologies of the Raj, Cambridge University Press

Metha, U. (1997), ‘Liberal Strategies of Exclusion’, in F. Cooper and A. L. Stoler (eds), Tensions of Empire:

Colonial Cultures in a Bourgeois World, Berkeley: University of California Press

Nederveen Pieterse, J. (2007), Ethnicities and Global Multiculture: Pants for an Octopus, Lanham, MD,

Rowman & Littlefield

Parekh, Bikhu (2000), Rethinking Multiculturalism, London: Macmillan

_____ (2008), A New Politics of Identity, Basingstoke: Palgrave

Rodrik, D. and R. Hausman (2003), ‘Economic Development as Self Discovery’, Journal of Development

Economics 72: 603-33.

Scheh, S. and J. Haggis (2000), Culture and Development: A Critical Introduction, Oxford: Blackwell

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Response to Nederveen Pieterse by 2004 HDR authors Sakiko Fukuda-Parr and

Arunabha Ghosh

In his review of the Human Development Report 2004, Jan Nederveen Pieterse finds

problematic that the main concerns of mainstream debates about culture and development,

such as north-south relations and northern cultural bias, and the role of cultural diversity in

economic development do not form the core of the analysis. These gaps are not omissions; the

main purpose was to clarify culture as an aspect of human development and capabilities

expansion and to consider policy options that would promote cultural liberty as the prevailing

approaches are problematic because they do not take account of individual choice. These

include the instrumental approach that sees culture as a facilitator or obstacle to economic

growth; the cultural diversity approach that sees diversity as an end in itself; and the

communitarian approach that sees the conservation of cultures and identities as an end. All of

these approaches pose serious contradictions with human development and capabilities

priorities. The instrumental approach does not recognize culture as an important aspect of

human life, and could be used to justify development that would destroy language, history,

and so on. The cultural diversity approach would not recognize that individuals might wish to

be free with respect to their way of life and identity with respect to such matters as religious

affiliation. The communitarian approach could be used to justify development that would

entrench traditional practices that restrict freedoms such as oppression of women. The central

claim of the Report rests on two points argued in chapter 1 authored by Amartya Sen: first

that choice in areas of culture is an important capability; and second that individuals have

multiple – not single – identities. On this basis, the Report elaborates on appropriate

development policies that see cultural liberty as an end, not a means, to development.

Expansion of cultural liberty needs to be a fourth pillar of the human development policy

approach in addition to equitable growth, expansion of social opportunities, and democratic

governance.

In particular:

1. Nederveen Pieterse is wrong to suggest that human development is ‘above all a social, not

an individual project’. It is indeed about expanding the choices and opportunities for

individuals to lead lives that they value.

2. He is also wrong to interpret the report as suggesting that a world of ‘optional multiple

identities’ actually exists. The report argues that for individuals to exercise their freedom, the

choice must exist, not that it occurs in practice always. If that were so, then of course there

would be no problem and we would not have written the report in the first place. In reality, it

is true that many individuals and groups are constrained in exercising their identities or in

opting for different identities and the report documents how such constraints adversely impact

human development.

3. Nederveen Pieterse asks ‘who can define...what is conservative?’ and alleges that the report

suggests Western donors would do that. This is a misrepresentation of the report’s argument.

Even on the headscarf debate, the report discusses democratic processes, pointing out that

among French Muslim women, opinion was split. Nowhere does the report suggest that a

donor agency would go in and decree cultural freedoms in return for conditional lending.

4. He criticises the report for acknowledging that policies promoting cultural liberty would

face other trade-offs. Now, which approach would be more genuine? A report that hammers

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away at policy prescriptions or one that outlines preferred policy options but recognises that

different countries might choose different approaches even in the pursuit of seeking to

promote cultural liberties?

5. The ‘parallel universe’ that the report is meant to inhabit is the same universe that many

oppressed people would also prefer. If some people can choose the lives and identities and

luxuries they want, why cannot others?

6. The report is not a restatement of the modernisation versus tradition debate. That approach

would have recommended literally bulldozing through the lands of indigenous people, not the

much more complex and messy approach to designing co-beneficial modes of development in

indigenous peoples’ lands. To take another example, a ‘modernising’ approach would only

accommodate the teaching of a few international (colonial) languages, whereas the Report

draws attention to the need to adopt multilingual education policies, which have helped

children in many countries perform better in schools and also learn languages that would be

of use in the global marketplace.

7. The biggest misreading of the report is that it views the world through the lens of Western

values. At best, this criticism reflects ignorance of liberal and democratic traditions that have

existed in other parts of the world. At worst, it gives fodder to those who like to think of the

world as divided between liberal and illiberal civilisations. Just because Nederveen Pieterse

does not want to personally impose his liberal Western values on others does not make the

worldview of cultural relativism any less blinkered.

In sum, Nederveen Pierterse is right to point out that the report is more about norms and less

about economics. But this is deliberate. But he is wrong to say the offers no policy options.

We took a decision to go beyond some of the spurious ‘culture impacts development’

literature to think about what social, economic and political framework would promote human

development and the expansion of individual capabilities.

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Endogenous development as interface

Wim Hiemstra

COMPAS, Leusden, the Netherlands

1

In the film ‘The Age of Stupid’, on devastating effects of climate change, we see a man in the

year 2055, looking at old footage from 2008 and asking: why didn’t we stop climate change when

we had the chance? Where do we find inspiration to respond to the challenges? In the current

context of failing neoliberal development policies, the need to reduce carbon emissions and to

ensure food sovereignty for a growing population, where are alternative pathways emerging?

The COMPAS network was established 13 years ago to explore how endogenous

development approaches, based on people’s culture and worldviews, and intercultural

dialogue can contribute to equitable and sustainable development. During an evaluation in

2009, the relevance of alternative approaches such as endogenous development within current

development debates were deemed high. In the course of 13 years of action research, the

COMPAS partners have designed, applied and tested a variety of methods for enhancing

endogenous development, particularly methods for learning from and with local people, for

testing and improving indigenous practices, for networking and training. When addressing

ways of learning in endogenous development, it became clear that different ways of knowing

1

For more information about COMPAS, see www.compasnet.org

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co-exist. Different cultures have different ways of knowing and learning. In the Andes, the

spiral notion of time is not separated from space (territory). The first ordering principle is

‘relationship’: everything is related and this leads to a reciprocal relationship between people,

animals, plants, rocks, water, wind, sun, moon, and stars. The relations are re-lived in rituals

and festivals (Rist et al 1999). In African worldviews, the world is made up of ancestors, the

living and the yet unborn. Nature is sacred and there is a hierarchy between divine beings,

spiritual beings, ancestors, living human beings and nature. Nature provides habitat for human

as well as spiritual entities (Millar 2006). In the Vedic tradition of India, reality is a

continuum of matter, mind and consciousness. ‘Akasha’ refers to the unifying energy inherent

in nature and in every living creature (Shankar 1999). In the Western scientific worldview,

the world is conceived of as consisting of separate and autonomous entities, such as people

and nature. In the post-modern Western worldview, the world is seen as a more holistic entity

where uncertainty, diversity, chaos and self-regulation are seen as ordering principles

(Haverkort and Reijntjes 2006).

Endogenous development is defined as development from within, based mainly though not

exclusively on locally available resources, values, institutions and knowledge. By revitalising

ancestral and local ways of knowing and learning, and addressing their current relevance,

endogenous development aims to empower local communities to take control of their own

development process. External resources that best fit the local conditions are selected by the

communities. It is a participatory approach which takes the material, social and spiritual

wellbeing of peoples and their interactions into account. As spirituality is included, it allows

for an intercultural dialogue between different paradigms, between indigenous and rural

people and their worldviews on the one hand, and the worldviews related to (western-based)

development proposals on the other hand. The network consists of partnerships of

Community-Based Organisations representing indigenous and/or rural people, NGOs and

universities in 18 countries in Africa, Latin America and Asia. In 2002, a University

Consortium for Endogenous Development was added to the COMPAS network to assist field-

based organisations to document and systematise their approaches.

In order to further operationalise the approach of endogenous development, a focus on

wellbeing monitoring was agreed upon in 2007 in the COMPAS network. ‘Wellbeing’ is a

relatively new concept in development discourses, but is also central in the ‘economics of

happiness’ as in Gross National Happiness approaches in Bhutan. White (2009) defines

wellbeing as being comprised of three key dimensions: material, relational and subjective.

The ‘material’ comprises assets, welfare and standards of living. The ‘relational’ dimension

deals with social relations. The ‘subjective’ relates to perceptions of wellbeing and cultural

values, ideologies and beliefs. COMPAS defines wellbeing as ‘real life’, where material,

social and spiritual wellbeing coincide. The niche of COMPAS partner organisations is to

show how endogenous development approaches deal with wellbeing in concrete field

programmes. How can outsiders such as ‘development workers’ - learn to - deal with the

different dimensions of wellbeing (material, social and spiritual) as expressed in the

worldviews of the people they work with?

2

In Sri Lanka, three COMPAS partner NGOs implement and coordinate their activities from

an endogenous development perspective, dealing with traditional organic farming,

ethnoveterinary practices and traditional architecture. Until recently, farmers practised

agriculture based on subsidised modern crop varieties, fertilisers and pesticides. Negative

2

Experiences of COMPAS partners in seven countries, where sacred natural sites are of importance for

community wellbeing and for global biocultural teachings in nature conservation, are described in a contribution

to the forthcoming IUCN book Precious Earth.

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effects of modern agriculture become clear: water pollution, changing consumption patterns

and related health problems such as kidney disease and diabetes. The farmers know that these

practices go against their worldview and the five precepts of Buddhism: refrain from killing,

stealing, sexual misconduct, lying and taking intoxicants. With external support from

COMPAS partner NGOs, they are now gradually moving back to traditional varieties and

organic farming practices. Within Sri Lanka, many scientists and policy makers currently

question the agricultural policy of the government. Endogenous development is proposed as a

relevant alternative as it mediates between ‘development’ and ‘indigenousness’.

In Ghana, COMPAS partner organisation CIKOD (Centre for Indigenous Knowledge and

Organisational Development) has been working since 2001 to develop methodologies to

strengthen traditional institutions: male (chiefs) and female (queens) traditional leaders,

elders, clan heads, earth priests, institutions for mobilisation, control or economic

development. CIKOD’s experience in revalorising local culture and on restoring indigenous

forms of natural resource management also has strong potential to address the crisis facing

peasant agriculture. In 2008, record numbers of Africa’s poor experienced hunger. The

‘Alliance for a Green Revolution for Africa’ (AGRA) has been proposed to solve poverty by

shifting African agriculture to a system dependent on expensive, harmful chemicals,

monocultures of hybrid seeds, and ultimately genetically modified organisms. From the

COMPAS perspective, there has to be room within AGRA to explore alternative approaches

based on food sovereignty

3

and agroecology on a large scale. Peasant farm leaders argue that

‘Agroecology is not just a collection of practices. Agroecology is a way of life.’ To survive, it

needs to be embedded in a cultural and organizational reality. The ambition of COMPAS

partners in Africa is to support a wider movement that strengthens farmer organizations,

enabling them to promote an innovative agroecology, mobilize grassroots support for

“countervailing” resistance to the neoliberal approach to agriculture, and advocate for policies

and practices that create an enabling environment for endogenous and culturally sensitive

development. Endogenous development also encourages its practitioners to address negative

aspects of a culture, with a view to reforming them and promoting positive aspects for

sustainable development. One example on female bondage is described elsewhere in this

bulletin. Endogenous development in this case means a process of reflection with the whole

community on the negative and positive aspects, and facilitating a search for alternatives.

The government of Bolivia approved a new constitution in 2009 that aims to empower the

country's indigenous majority. COMPAS partner AGRUCO (Agroecologia Universidad

Cochabamba) contributed to the constitutional process by proposing agroecological

alternatives and indicating how revitalised indigenous knowledge can be used as an asset.

AGRUCO has developed a methodology for intra- and intercultural dialogue. Intra-cultural

dialogue is exchange of experiences, ideas and values within a particular culture with the aim

of mutual learning and strengthening cultural identity. Inter-cultural dialogue refers to a

similar exchange between people from different cultural backgrounds with the aim of re-

evaluating knowledge and wisdom of people (Delgado and Mariscal, 2006). Endogenous

development emerges as an interface between the indigenous and the modern way of life

A broad range of alternatives is emerging from indigenous and/or civil society movements

across the globe, which can inspire us all. There is a great need to bring ordinary people’s

needs to the centre instead of market needs. COMPAS is working on one of those alternatives

3

Food Sovereignty was first defined in 1996 by the international peasant federation La Vía Campesina (The

Peasant Way) as ‘people’s right to healthy and culturally appropriate food produced through ecologically sound

and sustainable methods, and their right to define their own food and agriculture systems’. It is a much deeper

concept than food security because it proposes not just guaranteed access to food, but democratic control over

the food system—from production and processing, to distribution, marketing, and consumption.

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and, by living its mission and core values, respects spirituality as an essential component of

wellbeing. The basis for COMPAS remains to empower local communities to take control

over their own lives. The challenge is to demonstrate impact beyond isolated success stories

and to appeal to policy makers. COMPAS is currently working on tools for interfacing,

including capacity building, qualitative monitoring through most significant change stories to

complement quantitative monitoring, wellbeing assessments and policy dialogues to deal with

the challenges ahead. ‘Our response to climate change will define our generation, in the same

way that ending apartheid, overturning slavery or landing on the moon defined earlier generations’,

said ‘Age of Stupid’ film director Franny Armstrong. Time will tell whether our responses have

been successful.

References

Delgado and Mariscal (2006), Educación Intra- e Intercultural: Alternativas a la Reforma Educativa

Neocolonizadora’. COMPAS series on Worldviews and Sciences, No.1, ETC/COMPAS, Leusden.

Haverkort and Rist (2007), ‘Endogenous Development and Biocultural Diversity. The interplay between

worldviews, globalization and locality’, ETC COMPAS/CDE.

Millar, D. (2006), ‘Ancestorcentrism: a basis for African sciences and learning epistemologies’, in African

Knowledges and Sciences, COMPAS-UDS-CTA.

Rist, S; J. San Martin and Nelson Tapia (1999), ‘Andean cosmovision and self-sustained development’, in B.

Haverkort and W. Hiemstra, Food for Thought, London: Zed.

Shankar, D. (1999), ‘Revitalising local health traditions’, in B. Haverkort and W. Hiemstra, Food for Thought,

London: Zed.

White, S. (2009), ‘Wellbeing in development practice’, WeD Working Paper 09/50, Wellbeing in Developing

countries, University of Bath, UK, www.welldev.org.uk

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In the Practice

Limits of culturally appropriate measures in Australia’s indigenous health

policies

Francesca Panzironi

University of New South Wales

The concept of culture permeates the development discourse in many and diverse ways. In

particular, the use of a ‘language of culture’ seems to resonate as a dominant mantra across

the diversified spectrum of development initiatives. Terms like ‘cultural awareness’, ‘cultural

appropriateness’, ‘cultural safety’ are often used to legitimize mainstream development policy

strategies against contexts of startling cultural diversity. I argue that the use of a ‘cultural

language’ in development policy frameworks often conceals the replication of a cultural

divide which lies at the foundation of development policy failures. The case study of

Australia’s indigenous health policy frameworks exemplifies how the use of concepts such as

‘cultural appropriateness’ or ‘cultural safety’ can indeed perpetuate the same cultural divide

that intends to overcome.

Australia, ranked among the wealthiest countries in the world, has been listed within the first

countries enjoying the highest human development index over the last years. In a country

where people enjoy the second highest life–expectancy among OECD countries, and one the

highest standards of living and well–being, Aboriginal and Torres Strait Islander peoples

continue to suffer health conditions comparable to some of the poorest countries in the world.

To illustrate, the life expectancy at birth for Aboriginal and Torres Strait Islander peoples is

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estimated to be 59.4 years for males and 64.8 for females, compared with 76.6 years for males

in the total population and 82 years of females in the total population. A significant gap of

approximately 17 years for both males and females exists between the indigenous and non–

indigenous population of Australia. This is only a glimpse of the devastatingly poor health

conditions of indigenous Australians, conditions which show the severe health inequality

between the indigenous and non-indigenous population of one of the most developed country

in the world.

Numerous questions continue to arise as to the causes of the widespread indigenous ill-health

and the adequacy of Australian governmental institutions’ responses to tackle the indigenous

health crisis. Central in the debate is the tremendous incidence that social determinants have

on people’s health status (WHO 2003). Socio-economic factors such as education, income,

employment and occupation, housing, legal exclusion, together with several risk factors,

impact significantly on the health status of Aboriginal and Torres Strait Islander peoples

(Altman 2003; Gray 2004).

Without ignoring the significance that socio-economic factors have on the ill-health status of

indigenous Australians, it is important to consider the unexpected ramifications deriving from

the adoption of the language and concept of ‘cultural appropriateness’ in Australia’s health

policy frameworks and service delivery. I argue that the concept of ‘cultural appropriateness’

in the delivery of health care services to Aboriginal communities and individuals is

inadequate to fully address their ‘cultural needs’ or cultural diversity. The reason lies in the

fact that the application of the concept of ‘culturally appropriateness’ to mainstream health

care services delivered to indigenous Australians tends to sanction a one-way medical

conceptual framework and medical response to illnesses. In other words, it ignores the

cultural complexities of the Aboriginal and non-Aboriginal health interface.

This line of argumentation can be better grasped if we consider the issue of ‘compliance/non

compliance’ in the context of Aboriginal health. This issue is in fact illustrative of the

predominance of the western medicine paradigm. The treatment failure as a result of ‘poor

compliance’, has significantly weighed down Aboriginal Australian health care (McConnel

2003; Hamrosi et al 2006). Evidence shows that compliance, that is, adherence to western

medical advice and services, is a key cause of the continuing dreadful state of health among

Aboriginal and Torres Strait Islander peoples. The failure to use prescribed medication is

reported to be a reality of daily life, a problem leading to continued or worsening Indigenous

health outcomes (Lucas 1997).

Alternatively, it is suggested that indigenous non–compliance is not the problem but rather a

measure of the real issue: the dissonance between two different belief systems, those of

Aboriginal patients and western medicine (McConnel 2003; Maher 1999: 235). ‘Strong

compliance’, or healthy behaviour, occurs when there is a strong cultural affinity between

patients and western medical advice and treatments, in particular, when the scientific concepts

of cause and effect, as well as statistical relationships such as predictability, are shared. ‘Poor

compliance’, or unhealthy behaviour, occurs when there is not a common understanding of

those fundamental concepts underlying the western medical system. Difficulties arise when

perceptions about the causes of ill-health are different, when health practitioners offer an

account of reality which is different from patients’ understanding and experience: the greater

the dissonance between the western medical explanatory model and patients’ belief systems,

the higher the impact on compliance (Maher 1999: 235).

The introduction of ‘culturally appropriate measures’ as a device to improve the accessibility

of the mainstream health delivery system, can be considered as a means to increase

compliance among Aboriginal and Torres Strait Islander peoples. The point I would like to

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make is that those measures operate only at one specific level of the ‘health interface’ in

which a lot of Aboriginal people live on a daily basis. To clarify, we can consider

‘compliance’ as a rate or a fraction with a numerator and denominator. In the context of

Aboriginal and Torres Strait Islander health, the numerator indicates adherence to medical

advice, whereas the denominator is the medical advice given according to the western

medical system. It follows that progress towards compliance can be achieved either by

manipulating the numerator or the denominator (McConnel 2003).

Efforts to improve compliance have focused on the numerator, that is increasing indigenous

peoples’ adherence, by encouraging patients to take responsibility for their health, increasing

personal and community autonomy, and changing ‘institutional attitudes and behaviour’ to

ensure ‘cultural safety’ through more ‘cultural appropriate’ measures aiming at

accommodating Indigenous Australians’ ‘cultural needs’ (Humphery and Weeramanthri

2001).

In all these ‘culturally appropriate measures’ the fundamental assumption is that the

denominator, that is the western medical system, remains unchanged and unchallenged. In

this way, western medicine is conceived of as a neutral construct, free from any ‘cultural

traits’. In contrast, I argue that cultural awareness should be applied not only to Aboriginal

and Torres Strait Islander peoples, but also to the western system of medicine. Western

medicine is deemed to have a culture, a set of attitudes, actions and a belief system. The most

significant feature is that western medical culture is science-based: scientific and evidence-

based knowledge underpins the whole conceptual fabric of western medicine. Accordingly, a

scientific view of health, illness and disease not only informs the whole cognitive apparatus of

the medical system, but also affects health professionals’ practices, attitudes, and advice given

to patients. It is precisely the distance between Indigenous Australians’ health belief system

and western medicine’s belief system, the root cause of the problematic issues in the cross-

cultural health service delivery setting (Maher 1999; McConnel 2003).

It is suggested that the immobility of the denominator indicates the foundational flaw of

Australia’s policy framework to address Aboriginal Australians health status: the recognition

and maintenance of the western medicine paradigm as the only system of medical knowledge

accepted and applied in the delivery of health care. It is evident that the adoption of ‘cultural

appropriate measures’ based on this model perpetuates an intrinsic dynamic of difference

which replicates, instead of overcoming a significant cultural divide between the indigenous

patients and the non-indigenous medical system and personnel.

The articulation of real ‘cultural sensitive’ health policies for indigenous Australians should

imply a broader and deeper understanding of cultural awareness operating at the ‘health

interface’. In the case of compliance this would translate into the manipulation of the

denominator through the elevation of Aboriginal traditional medicine to the same level as

western mainstream medicine. In other words, ‘cultural awareness’, ‘cultural safety’ and

‘cultural appropriateness’ in Australia’s indigenous health policy frameworks and strategies

should work both ways. As the traditional healers of the Ngaanyatjarra Pitjantjatjara

Yankunytjatjara Women’s Council, Andy Tjilari and Rupert Peter, declare ‘we want to work

together to improve the health and well–being of Anangu’.

The integration of Aboriginal traditional medicine into Australia’s health policy frameworks

would have far–reaching significance and implications. First of all, it would not be

exceptional from a worldwide perspective (Ryser 2006). Rather, it would harmonize

Australian health policy with the growing international interest and recognition of traditional

medicine and complementary/alternative medicine (WHO 2000, 2001, 2002; WHO-PAHO

2000). More importantly, its acknowledgement would involve the acceptance of the cultural

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paradigm underlying the whole indigenous knowledge and belief system. In other words, it

would represent a valuable alternative option not only to improve ‘compliance’, but to fulfil

the internationally recognised indigenous peoples’ right to health for Aboriginal Australians.

As article 24 of the UN Declaration on Indigenous Rights states, ‘Indigenous peoples have the

right to their traditional medicines and to maintain their health practices, including the

conservation of their vital medical plants, animals and minerals. Indigenous individuals also

have the right to access, without any discrimination, to all social and health services’.

References

Altman, Jon (2003), ‘The Economic and Social Context of Indigenous Health’, in Neil Thomson (ed), The

Health of Indigenous Australians, South Melbourne, Vic.: Oxford University Press.

Gray, Matthew (2004), Health Expenditure, Income and Health Status among Indigenous and Other Australians,

Canberra: Australian National University Press

Humphery K. and T. Weeramanthri (2001), Forgetting Compliance: Aboriginal Health and Medical Culture,

Darwin, NT: Northern Territory University Press.

Hamrosi, K., S. J. Taylor and P. Aslani (2006), ‘Issues with Prescribed Medications in Aboriginal Communities:

Aboriginal Health Workers’ Perspectives’, Rural and Remote Health 6 (557).

Lucas R. (1997), ‘Compliance issues in Central Australia’, Central Australian Rural

Practitioners Association Newsletter 14.

Maher, Patrick (1999), ‘A Review of Traditional Aboriginal Health Beliefs’, Australian Journal of Rural Health

7(229).

McConnel, Frederic (2003), ‘Compliance, Culture, and the Health of Indigenous People’, Rural and Remote

Health 3(190).

Ryser, Rudolph (2006), ‘Traditional Healers, HIV/AIDS and the Accra Declaration’, Center for World

Indigenous Studies and Center for Traditional Medicine Quarterly Newsletter 2(2), 5.

WHO (2000), General Guidelines for Methodologies on Research and Evaluation of

Traditional Medicine, Geneva: World Health Organization.

WHO (2001), Legal Status of Traditional Medicine and Complementary/Alternative

Medicine: A Worldwide Review, Geneva: World Health Organization.

WHO (2003), Social Determinants of Health: the Solid Facts, edited by Richard Wilkinson

and Michael Marmot, Copenhagen: WHO Regional Office for Europe, 2

nd

ed.

WHO (2002), WHO Traditional Medicine Strategy 2002–2005, Geneva: World Health

Organization.

WHO/Pan American Health Organization (2000), Strategic Framework and 1999–2002 Action Plan: Health of

the Indigenous Peoples, Washington, D.C.: WHO/PAHO.

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Addressing the Controversial Practice of Female Bondage in Ghana

1

Agnes A. Apusigah

University for Development Studies, Wa, Ghana

Traditional values and beliefs are a unifying factor in local communities regardless of

people’s religious affiliations. Yet some of these may favour some members of a community

and disfavour others. They may promote some interests while undermining others. One of

COMPAS’ tasks is to examine cultural values (such as solidarity, hospitality, integrity) in

order to understand how they have evolved over time. The role of the Endogenous

Development intervener should therefore be to bring awareness around the issues of who

benefits and who loses in maintaining or abandoning a particular cultural resource. The key

word is self-awareness: the Endogenous Development intervener uses the empathic

engagement and critical dialogue tools to increase people’s awareness about their own

1

This is an article published in the magazine Endogenous Development, issue 4, June 2009. The magazine is

sponsored by the Compas programme in the Netherlands. For more information, see http://www.compasnet.org.

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resources, and the potentials and dangers of these with regard to the possibility of bringing

peace, harmony and prosperity to the community as a whole.

Gender lenses

A next step is ‘to wear gender lenses to engage with values’: why is a particular practice

promoted? Who gains from it? What are the gender implications? And does this practice limit

or enhance the liberties of either sex? Trokosi, popularly referred to as female bondage, a

cultural practice in parts of southern Ghana, served as an example during the workshop.

2

It is

practised as a form of atonement for the sins of an offending family. When a family offends

the gods, they are required to commit a young maiden to their service. This entails her

removal from her family to a shrine, where she receives her education, training and health

care outside the formal system. The maiden renders various services including cleaning,

cooking and farming as well as attending to priests, devotees and visitors. She may also

become the sexual partner of the priest. For some time now, anti-forced labour activists, anti-

slavery campaigners and human rights activists as well as child and women’s rights activists

have targeted the practice for its human rights breeches. The forced removal of children from

their families, denial of formal education and health care, use of labour and sexual

exploitation of young women have been highlighted as controversial. These forms of activism

come from external sources including UN agencies, NGOs and women’s rights organisations.

Priests and devotees have also initiated counter-activism, defending their cultural rights.

Cosmovision and gender

In the Uganda workshop, COMPAS partners were challenged to critically examine their

principles and practices by imagining how to deal with this controversial custom in their own

field localities using gender lenses. The participants were encouraged to ‘infuse’ gender

analysis in their operational tools and techniques. They reflected on and analysed cultural

practices to bring out the cosmovision aspects. The exercise was carried out by considering

the three dimensions of the ‘interacting worldviews’:

- Material: The young woman provides labour and sexual gratification to the chief priest, and

produces children. Her material needs are met. Other aspects of the exchange, such as the

position of children born within the contract are controversial issues that should be addressed.

- Social: The social significance is seen in the atonement, as a result of which the family

(re)gains acceptance within the community and freedom to associate with dignity. But what

happens to the girl when she is removed from her family? What types of association can she

maintain and on what terms? There are losses and gains to the family and the girl in the form

of socialisation, security and status. How might critical dialogue informed by gender analysis

address these questions?

- Spiritual: A sense of security and gratification is born from meeting spiritual obligations, as

the family and even the community achieves psychological peace of mind through cleansing

and appeasing the ancestors. The committed woman represents the family in the shrine,

interceding on their behalf while growing in her spirituality. Yet, the loss of a family member

to the shrine is a disconnection that upsets the balance of the family. How might the

operational tools help to enrich spirituality by effectively addressing the tensions? The other

side of the coin is the priests’ and devotees’ appreciation of the practice; what are their

motivations, modifications and compromises? Although this was not explored during the

workshop, it was agreed that a similar analysis could lead to a better understanding of why a

cultural practice persists; who benefits and how; the extent to which it is understood as

2

This was an Endogenous Development and Gender Equity workshop held by the African COMPAS partners in

Uganda in November 2008.

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positive or negative by the people who maintain the practice and those who condemn it; and

the appropriate interventions to make.

Bern Guri of COMPAS partner CIKOD from Ghana comments:

One criticism of the endogenous development approach is that it tends to lead to a position of

cultural relativism. However, it is not a question of condoning all practices simply because

they are part of a culture. Facilitating a process of reflection, in which the negative aspects are

acknowledged and the positive aspects are supported, can enable a community to make

informed choices. In the case of trokosi, human rights activists in Ghana have adopted the

sympathetic approach where they have clearly taken the side of rushing to the ‘rescue of the

enslaved girls’ without engaging the community in meaningful dialogue. The result is that

trokosi has been officially outlawed in Ghana but it still persists. On the other hand, if the

gender analysis presented in this article were carried out with the whole community, with the

aim of heightening the community’s awareness of the negative and positive aspects, and

offering alternatives, the community would probably be motivated to initiate their own

process to modify or change or even adopt other practices that would be more acceptable to

the community and the wider society.