Volume 14 1987 Issue 38

Editorial A central concern of this Journal is to bridge the area between radical scholarship and practical politics. But one area where a long span is needed at the moment is in the discussion of imperialism. Indeed, the word has virtually dropped out of intellectual discourse in the attempt to develop a 'proper' Marxist framework to replace the mechanistic 'crudities' of dependency theory. The term has certainly not dropped out of popular discussion of the present state of Africa, however. Rather, there one of the 'crudities' to be overcome is to avoid explanations of the present predicament that so entirely attribute it to outside forces, thus fueling a kind of ultra-left fatalism, that nothing could be done. Our return to the theme of imperialism is a call to bridge this gap and to update where Africa fits into global patterns. But our position is that for imperialism to maintain its grip on the neo- colonies the role of the indigenous governing classes has also to be brought into the equation. Several contributors to this Issue deal with imperialism — admittedly not by reformulating theory, but at a level that the American Marxist, Paul Baran, had in mind when he talked about 'imperialism having an address': i.e. it needs to be understood not just at an abstract level, of the working out of a certain logic of capitalism, but, as the actions of specific actors operating from concrete locations. The Debates piece by Zwingina does in fact deal with the more general level when it argues that Africa cannot expect any significant scale of aid in the present crisis as US imperialism in decline accords the continent a low priority. Further debates along these lines would be valuable — both in questioning the current dynamics of Western capital and US foreign policy, and also as to whether and how any 'disinterest' affect involvements in 'strategic' areas like southern Africa and the Horn. This discussion prompts two questions: whether any disinterest is necessarily shared by the European Economic Community (EEC), and thus the implications and extent of US-EEC contradictions; and whether any 'neglect' should not be seen as an opportunity to be seized. Other pieces deal with the main international institutional forms of economic imperialism, the International Monetary Fund (IMF) and the World Bank (WB), and the current stabilisation medicine they are forcing down the throats of African countries. Davies and Saunders juxtapose data about economic and health in a careful assessment of how stabilisation measures affect children. In the most considered and measured tones they are objectively showing that the IMF kills! Two short but lively Briefings document the effects of stabilisation measures in Sierra Leone. Parfitt's highlights attempts to turn Sierra Leone into a conduit for sanction busting for Pretoria in the event of sanctions being imposed against that 2 REVIEW OF AFRICAN POLITICAL ECONOMY regime. Hoogvelt points to the devastation which IMF conditionally has brought on Sierra Leone: wiping out small savings, intensifying poverty, and producing a process of involution. Seddon's article on Morocco's annexation of Western Sahara deals with a second important institutional level of imperialism — the role of regional bullies in what some have termed 'sub-imperialism'. As we write, this protracted conflict seems to be entering a new stage with major Polisario offensives against the Moroccan defensive walls. This article is thus especially timely. It builds on and updates other detailed accounts like Hodge's useful volume, to offer a comprehensive survey of the origins, stages and present state of the conflict, the international involvement in it, and the impact on Morocco, which we hope will give an overview of an arena we have recently neglected. In keeping with our opening statement that 'imperialism' should not be seen as a purely 'external' phenomenon, we publish two interesting and provocative discussions about a third level, the state in Africa, which has to be one of the key mechanisms giving the forces of imperialism some purchase over African peoples and economies — whatever other forces are expressed through the state. Charney's contribution puts this kind of perspective back into the debate on the state by reasserting a view of it which had gone out of fashion — that it is 'neo-colonial' — and seeks to spell out rigorously what that implies for its social character, the forms it takes, and its style of rule. He does so by an imaginative synthesis of much earlier work bringing together insights from the French as well as the English-language material. Forrest's Briefing offers an opposed and challenging perspective. He usefully takes the reader through a very comprehensive survey of different positions about the class character of the post-colonial state and then casts doubt on all of them for assuming that a state always reflects some coherent 'class' interests rather than its own. Lionel Cliffe Alfred Zack-Williams CONFERENCE OF SOCIALIST ECONOMISTS NEITHER MILTON NOR KEYNES • A NEW SOCIALIST ECONOMY * • CSE CONFERENCE 1987 * SHEFFIELD POLY. JULY 10-12 ********* Theories and strategies of socialist intervention Pacific rim economy * Union strategies at British Telecom * Jobs from Peace * A Ministry for Women + Flexible specialisation * A new economics? * Local economic intervention * Social ownership * Theories of development * International labour & capital * Value and state theory * Technology * Gender, race and labour market restructuring * Quantitative Marxism DETAILS/BOOKING: CSE, 25 HORSELL RD. LONDON NS (607 9615) Stabilisation Policies and the Effects on Child Health in Zimbabwe Rob Davies and David Saunders The purpose of this article is to assess the likely impact of stabilisation policies on the health of children in Zimbabwe. It begins with a discussion of some of the general methodological issues involved in this kind of measurement before going on to outline Zimbabwe's recent stabilisation experiences. It considers how policies adopted have affected, first, general determinants of health status and, second, specific health sector inputs. Finally it attempts to assess the extent to which these factors have affected the health status of children. At independence in 1980 Zimbabwe, inherited a typical underdeveloped economy further distorted by racial inequalities. These inequalities were reflected in the disease pattern of the black majority. The predominant health problems are nutritional deficiencies, communicable diseases and conditions related to pregnancy, childbirth and the new-born period. They particularly affect two vulnerable groups of the population: young children and women in the child-bearing years. Malnutrition underlines much of the morbidity and mortality. In pregnant women it is an important factor in causing low birth weight with its attendant morbidity and mortality in the early months of life. In young children, as well as being an important cause of mortality in itself, it forms the basis for the frequency and severity of many infections: the most important are diarrhoea, and the immunisable diseases of measles and tuburculosis. Other communicable diseases such as pneumonia and other respiratory infections, tetanus, meningitis, whooping cough and malaria also constitute important causes of childhood disease and death. The health of children is determined by many factors. It is useful to distinguish between those factors, such as provision of hospitals, immunisation programmes and medical personnel, which lie inside the health sector and those, such as levels of real income, educational standards and food subsidy programmes, which lie outside it. By making this distinction it immediately becomes clear that stabilisation policies are likely to affect the health of children both indirectly, by affecting the general economic environment, and directly, by affecting the health sector. Although the direct effects may be the most immediately obvious, the indirect effects are likely to be most important — unfortunately they are also the hardest to identify from available data. It is particularly difficult to separate out the impact of stabilisation policies from that of other concurrent influences on the economy. In Zimbabwe at the same time that stabilisation policies were being operated there was also a severe drought which clearly had an impact on health and nutrition levels. So even if it is possible to provide evidence of a particular change in health status, such as weight for age, it is extremely difficult to ascribe such changes to a 4 REVIEW OF AFRICAN POLITICAL ECONOMY particular source. It is impossible even to determine the relative importance of alternative influences. It is relatively easy to achieve rapid improvements in health as measured by the standard quantitative indicators, but sustained improvements in the quality of life are more difficult to produce — and also more difficult to measure. For instance, certain indicators, such as infant and young child mortality rates, may be rapidly improved by selective primary health care interventions targeted at these high risk groups. But there is little evidence to suggest that improved nutrition levels can be maintained by the application of this technical package in the absence of more general improvements in access to resources. In the context of stabilisation policies, we will argue that changes in patterns of health service provision consequent upon reductions in the overall level of provision can maintain health status

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