2019
July
10
Wednesday

Welcome to the Monitor Daily. Today's lineup includes a new legal challenge to “Obamacare,” the view from inside an abortion clinic, the quandary of immigration in a depopulating Japan, empowerment in Kenya, and a model of hope in the opioid crisis.

But first, at a time when a lot of the news in global economics is about rising tariffs and risks of trade war, here’s something completely different. It’s about Africa coming together – and it’s about the relevance of open trade as a lever of progress, even when globalization has lost its former shine

This week marks the formal launch of the African Continental Free Trade Agreement, which ultimately promises a free-trade zone for 1.2 billion people in more than 50 nations. Already, it represents transformed attitudes for many countries. 

“We are creating a new Africa. The Africa of dependence, we are putting it behind us.” That’s the aspiration as voiced recently by Albert Muchanga, African Union commissioner for the Department of Trade and Industry.

African nations currently have a very low rate of trade with one another. Most exports remain raw materials like oil and minerals. Freer trade won’t be a panacea for development challenges that range from poor infrastructure to corruption. But a key holdout nation, Nigeria, has signed on alongside smaller nations in the hope of developing the continent both from within and through external trade.

“When you do agro-processing Africa is going to transform itself from a net importer of food to a net exporter of food,” Mr. Muchanga predicts. He says, “It’s a cultural mindset that this is impossible. Nelson Mandela said, ‘It seems impossible until it’s done.’”

Also, before today’s stories, a quick promo: The Monitor is following the sex-trafficking allegations against multimillionaire Jeffrey Epstein, and the pressure on Labor Secretary Alex Acosta to resign over his handling of those allegations in his past career as a U.S. attorney. Stay tuned for our coverage.

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The Explainer

1. Another day, another legal battle? Why latest ‘Obamacare’ suit matters.

The latest legal challenge to the Affordable Care Act may seem like just another episode in an endless saga. Here’s why this case may be different.

Mark

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After nine years the Affordable Care Act is deeply embedded in the U.S. health system. It provides subsidized health insurance for low-income Americans, mandates coverage for those with preexisting health conditions, sets financial rules for all health insurance, and so on.

But “Obamacare” – as the law is widely known – is once again facing a lawsuit that could knock it out of existence. A case brought by a group of Republican-led states, and endorsed by the Justice Department, has made it up to the federal appeals court level. These plaintiffs are focusing on the individual mandate, which requires the purchase of health insurance. The 2017 GOP tax bill cut the tax penalty for ignoring this to zero. In essence, it’s gone – which means the law should fall too, the lawsuit argues.

A lower court judge agreed with this position. An appeals court panel heard oral arguments in the case Tuesday. The panel could reverse the lower court decision, or take an intermediate stance that doesn’t eliminate the entire law. Or it could endorse the elimination option. It’s possible the whole thing could wind up in the Supreme Court just prior to the 2020 election.

“It’s already a mess,” says Allison Hoffman, a professor and expert in health care law at the University of Pennsylvania Law School.

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Another day, another legal battle? Why latest ‘Obamacare’ suit matters.

An estimated 20 million people might lose their health insurance. Insurers would once again be able to deny coverage to people with preexisting health conditions. 

Calorie counts on restaurant menus could also disappear. Drug costs for Medicare enrollees might rise.

Overall, a big section of American economic activity may possibly be thrown into turmoil – right as the 2020 election season reaches its peak. That’s a possible consequence of yet another big lawsuit challenging the constitutionality of the Affordable Care Act that’s now rising through the federal courts.

It’s not yet certain that the case, Texas v. Azar, will make it to the Supreme Court level. On Tuesday the Fifth Circuit Court of Appeals in New Orleans heard oral arguments in the suit.

But if nothing else, it’s emblematic of the law’s extraordinary "Perils of Pauline" existence. More than nine years after President Barack Obama signed “Obamacare” into law, it has reworked a broad range of government health programs. Yet use hasn’t equaled bipartisan political acceptance. The ACA continues to face determined opposition and several times has come close to termination – an end that at this point could have far-reaching, unknown consequences.

“Billions of dollars of private and public investment – impacting every corner of the American health system – have been made based on the existence of the ACA,” says a friend-of-the-court brief in Texas v. Azar filed by a group of health economists and scholars.

At this point, a court decision striking down the system “would upend all of those settled expectations and throw healthcare markets, and 1/5 of the economy, into chaos,” added the brief.

Who are the combatants here?

A group of governors and attorneys general from Republican-led states are challenging the Affordable Care Act in Texas v. Azar. The Trump administration Justice Department has endorsed their position.

Typically when states sue the federal government, as they are here, the federal government defends existing law. Under the Trump administration, Justice declined to do so. So a group of 21 attorneys general from Democratic states have stepped in to act as the ACA’s defenders. The House of Representatives joined these states after Democrats won control of the chamber last November.

What is the central issue?

The heart of the case – as with so much about “Obamacare” – is the law’s individual mandate requiring most Americans to buy health insurance or pay a financial penalty.

When the Supreme Court upheld the ACA in a landmark 2012 ruling, it did so based on the power of Congress to impose taxes. The penalty was a tax, and thus constitutional, wrote Chief Justice John Roberts, who joined the court’s four more liberal members in the 5-4 ruling.

But the 2017 Republican tax bill effectively reduced this penalty to zero. A “tax” that has no value is no tax at all, and if the penalty is no longer a tax, it is unconstitutional, runs the GOP argument in Texas v. Azar.

Furthermore, the plaintiffs here argue that the Affordable Care Act cannot function without the penalty. It is designed to support the system by driving healthy people into the ACA insurance pool, helping pay for those with preexisting conditions and other health challenges.

So, if the penalty is unconstitutional, the whole apparatus of the law should be struck down, too. That’s the Justice Department and GOP position.

The law’s defenders reply that Congress clearly did not intend for this to be the case. It voted to reduce the penalty to zero but not to eliminate the law entirely. In legal terms there is “severability” between the penalty and other ACA provisions, they argue.

Where does the case stand?

Fort Worth federal district court Judge Reed O’Connor ruled in favor of the GOP plaintiffs last December, striking down the Affordable Care Act in its entirely. The ruling is stayed while the case wends its inevitable path though the appeals process. 

On Tuesday a three-person panel of Fifth Circuit Appeals Court judges heard oral testimony in the case. By the tone and substance of their questions, the two Republican-appointed judges on the panel sounded likely to uphold the lower court decision, according to observers. A Democratic-appointed judge remained largely silent.

“It’s always hazardous to read too much into oral argument. But it’s safe to say that the ACA’s defenders had a tough day in court,” wrote University of Michigan law professor Nicholas Bagley on The Incidental Economist, a health services research blog.

Now what?

Professor Bagley and a number of other academic experts consider the plaintiff’s legal position to be weak on a number of grounds. The case could be remanded to the lower court judge or dismissed for standing or other technical reasons.

But other ACA challenges thought weak have made it to the Supreme Court and come close to toppling the law. If the case of Texas v. Azar travels the same path, it could explode on the national level as the 2020 election cycle reaches its zenith.

If so it’s possible that much of the U.S. health system could be thrown into turmoil at a moment of maximum political intensity.

That’s because provisions of the ACA extend far beyond its core mission of subsidizing health insurance for low-income Americans. Perhaps most notably, the law requires insurers to accept those with pre-existing conditions. Children can stay on their parents’ insurance up to age 26. It reduces a “doughnut hole” payment gap for Medicare prescription drug payments. It mandates that restaurants post calorie information for their menu items.

The appeals judges won’t rule for some time, and they have a number of different options, says Allison Hoffman, a professor and health care law expert at the University of Pennsylvania Law School.

They could overturn the lower court ruling. They could decide on grounds of severability, or on the standing of either the GOP or Democratic state groups. They could take an intermediate position under which some “Obamacare” provisions, but not all, would fall along with the individual mandate.

There’s a decent chance it could produce a political mess as campaign season heats up, says Professor Hoffman.

“It’s already a mess,” she adds.

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Looking past Roe

How abortion shapes U.S. politics

2. Hard choices, sweet tea: A day at a Louisiana abortion clinic

It’s human nature to fear the unknown. But learning what motivates people’s actions can lead to understanding. Our reporters spent a day in a Louisiana abortion clinic to try to show what happens behind its doors. 

Mark
Ann Hermes/Staff
Kathaleen Pittman, administrator at Hope Medical Group For Women, stands in the waiting room on April 1, 2019, in Shreveport, Louisiana. Hope Medical Group For Women is one of the few remaining abortion clinics in the state of Louisiana.

Like many Southern states, Louisiana has sharply restricted access to abortion in recent years. Our reporters spent a day in one of the state’s last remaining abortion clinics, speaking to the staff and patients, and hearing their stories. Because the state mandates a 24-hour waiting period, women must go to the clinic at least one day before they can receive an abortion. They must also speak to a counselor about their options and receive an ultrasound exam, during which the nurses are legally required to describe the fetal development in detail and turn on the sound (unless the patient specifically requests no sound).  

Kathaleen Pittman, the clinic’s director, says there are a lot of misperceptions when it comes to the women who seek abortions. For example, many are already mothers. “Their primary concern is taking care of the child or children they already have,” Ms. Pittman says. 

That’s the case with a 30-year-old single mother of two who has come to the clinic and asks to remain anonymous. “I’ve always judged people who would tell you, ‘I’m getting an abortion,’” she says. But she doesn’t think she can go through with another unplanned pregnancy.

“I had a one-night stand. And I got pregnant with my son. That was the darkest period of my life,” she says softly. “I don’t want to face that again.” – Samantha Laine Perfas

Hard choices, sweet tea: A day at the abortion clinic

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3. Japan’s conundrum: It needs foreign workers. It doesn’t want immigrants.

Can you import workers without changing the social fabric? Japan keeps trying to square that circle. But the door may be opening – ever so slightly – to changes that could benefit newcomers and native-born Japanese alike.

Mark
Malcolm Foster/Reuters
Workers from Thailand work at Green Leaf farm, in Showa Village, Gunma prefecture, Japan, June 6, 2018. As Japan’s population shrinks and ages, foreign workers are becoming an important part of the economy.

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Fewer babies. More retirees. A shrinking population. That may sound like a list of reasons to boost immigration – but in Japan, it’s a hard sell.

Just 2% of people in Japan are foreigners, and ideas of cultural belonging are tightly tied to Japanese ethnicity. Politicians are loath to look as if they’re opening the door to more immigration, even as short-term foreign workers become more crucial to the economy. 

About 20% are here as part of a technical intern training program, created to provide training to workers from developing economies. But much of their work is mind-numbing – tasks Japanese workers don’t want to do – and often skills don’t translate back home. Worse, workers’ advocates say, is how few protections trainees have on the job. A government inspection office visited nearly 6,000 employers who accepted trainees, and found more than 4,200 violations.

Is that poised to change? A new policy attempts to correct for some of the abuses, and Prime Minister Abe Shinzo backs a plan that would help some workers to become permanent residents. 

Politician Keisuke Tsumura says the Japan of 10 years into the future will look very different.

“Japan will be more globalized,” Mr. Tsumura says, and its growth is limited if it “continues to stay homogeneous.”

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Japan’s conundrum: It needs foreign workers. It doesn’t want immigrants.

When it comes to foreign workers, Japan has a reputation to overcome.

Shi Jianhua has firsthand experience. In 2015, she migrated from China to Japan in search of life-transforming wages. “The agency told me going abroad for three years would change the economic situation of my family,” Ms. Shi says.

Back home in mountainous Hubei province, her husband worked in construction, and after the couple added a second child, expenses had begun to pile up. Ms. Shi’s plans to migrate had been methodical. She’d shelled out RMB 50,000 ($7,300) for Japanese language training, plus another RMB 38,000 ($5,500) in fees to a placement agency to enter Japan’s technical intern training program, created by the Japanese government to provide training and skills to workers from developing economies.

Once Ms. Shi landed at a quality control job at a Fuji City paper mill, the mirage quickly revealed itself. Her Japanese supervisor was verbally abusive and called her “stupid” on a daily basis, she says. Her Japanese co-workers were given overtime hours, while she was passed over. “The friendlier you are, the more they bully you,” Ms. Shi says.

Soon enough, it became clear she would earn less than half of the 200,000 monthly yen ($1,850) she says she was promised. 

“I felt totally desperate,” says Ms. Shi. Eventually, she attempted suicide, fracturing her spine and rendering her unable to work. Ms. Shi now lives in a shelter in Gifu Prefecture, and is working with Zhen Kai, head of a labor union there, to pursue approval to apply for workers’ compensation and a formal apology from the mill. 

Courtesy of Shi Jianhua
Shi Jianhua taking a midday break inside the mill where she worked in Fuji City, Japan. Ms. Shi, who is from China's Hubei province, came to work in Japan in hopes of better wages.

Ms. Shi’s story is extreme. Yet the same factors that shaped her experience give rise to the everyday indignities – sometimes escalating into abuse – that non-Japanese workers face in Japan, even as they become ever-more essential to the country’s economy. Foreigners compose only about 2% of the population, and ideas of cultural belonging are tightly tied to Japanese ethnicity; the government, meanwhile, offers migrants few protections.

“Sometimes, I see some Japanese talk to overseas workers as if they were second-class citizens,” says Miyawaki Toshiya, an economics professor at Tokuyama University who’s observed similar dynamics in his classroom. “I try ice-breaking exercises to encourage my Japanese students to mix with the foreign students.”

Such scenarios encapsulate a difficult conundrum. Japan is a country that’s rapidly aging, with a workforce that is shrinking in kind. Yet the Japanese have firmly resisted immigration as a salve for an intense labor shortage. What happens, then, when Japan’s economic future depends on rolling out the welcome mat to foreign workers?

‘Immigration policy’? Not so fast.

Nearly 90% of Japanese employers have a hard time finding enough skilled workers, the largest skills gap in the world. In the low-wage sector, a labor shortage persists in industries such as elder care, construction, welding, and food processing. Meanwhile, the number of children born in Japan has declined each of the past four decades.

Enter foreign workers. China has long been the top supplier of labor to Japan, with the number of workers from Vietnam growing at the fastest rates. The majority of workers hail from those two countries, along with the Philippines, Indonesia, Thailand, Cambodia, and Myanmar. 

The government intimates that it wants foreign workers, and has cracked the door open further. In April 2019, a new policy became effective that would draw an estimated 350,000 more workers over the next five years, via expanded opportunities in 14 industries, including nursing care, shipbuilding, and food service. It allows up to a five-year stay, with visas renewable annually. In short, this new “specified skills” program expands the trainee program by taking people in more industries, and also makes it easier for certain workers to stay in the country longer.

Yet, Japanese leaders are in the unenviable position of needing to bring in more foreign workers while – bowing to societal pressures – insisting they are “not” adopting a so-called immigration policy, as Prime Minister Abe Shinzo informed parliament last year. Even so, Mr. Abe backs a plan to assist guest workers of certain skill categories to become permanent residents.

At the end of 2018, roughly 308,000 trainees were working in Japan, constituting about 20% of total foreign workers in Japan, with many more expected in the coming years. 

Dubious ‘training’: pickles and fish-packing

Once they arrive, many trainees in the technical intern program have found little protection for abuses on the job. Their visas are tied to a single employer, who is allowed to deduct costs such as room and board from salaries. Sometimes, workers face occupational hazards, while other times, pay is lower than what’s promised. 

Meanwhile, the number of cases accepted for permanent residency has actually been decreasing, says Ando Makiko, vice secretary of the nongovernmental organization Solidarity Network with Migrants Japan.

The verdict is clear: “Japan does not want foreigners to stay here for a long time,” says Ms. Ando. “They just want temporary workers.”

In 2017, the Labor Standards Inspections Office visited nearly 6,000 employers who accepted trainees, and found more than 4,200 violations. That’s a rate of more than 70%. 

Trainees can also owe significant fees to agencies or brokers, sinking them into debt before they even land in Japan. For example, a typical Vietnamese migrant to Japan might pay a broker fee of 1 million yen ($9,300), says labor rights attorney Takai Nobuya. That’s three to four times the average annual salary in Vietnam. 

Meanwhile, Japan bills its trainee program as the country’s investment in the development of other countries. In actuality, the work can be intense, mind-numbing, and repellent. They’re jobs many Japanese won’t do, and the skills imparted don’t always transfer back home. 

What’s a Chinese from landlocked Xian going to do with fish-packing skills, asks Mr. Takai, or a Vietnamese worker who learns to make Japanese pickles?

“There’s a gap between what the government says – and reality,” says Mr. Takai. “The government is cheating.” 

Oftentimes, trainees see little way out. The Justice Ministry reported more than 9,000 foreign trainees “missing” in 2018 alone, with some thought to be working illegally. There were also 171 trainee deaths from 2015 to 2017.

The new policy that went into effect in April attempts to correct for some past abuses; for example, it centralizes oversight to private companies rather than a scattered number of supervisory bodies, requires employers to submit proof of proper wages, and allows for paid holidays. The Justice Ministry also states it won’t accept applications from workers who use brokers, in an attempt to stamp out the middlemen.

‘They love Japan’

Professor Miyawaki says that when the trainee system works, it can work well. “Many trainees come to Japan because they love Japan,” the economist says. “It’s the brokers that are ‘wicked.’” 

And the trainee program can indeed impart skills to be used back home. A Vietnamese who returns to Vietnam with good Japanese language skills can get a job in certain industries that pays three to four times the salary of an ordinary worker, says labor attorney Mr. Takai, though he admits few trainees pick up fluency.

For some foreigners, migrating to Japan still makes sense. For one, Chinese student Hu Jun Chen attests he’s had a fine time studying psychology at Tokyo Metropolitan University.

As a youngster growing up in China’s northern Shanxi province, Mr. Chen became interested in Japan via Japanese comic books. Today, he is able to fully cover his tuition by working part time at a drugstore in central Tokyo. 

“If I were in China, I’d make 2,000 RMB a month – in Japan I can make four times as much working less time,” Mr. Chen says. Ultimately, his sights are set on university in America. 

Politician Keisuke Tsumura, a vice president of the centrist Democratic Party for the People, says the Japan of 10 years into the future will look very different.

“Japan will be more globalized,” Mr. Tsumura says. “There will be more international marriage, and at some time in the future English could be our national language.”

Japanese society is aware, he says, that there is a limit to Japan’s growth if it “continues to stay homogeneous.”

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4. Their shack settlement was told to move. Move us together, they said.

“Home” usually doesn’t just mean a building; it means a community. When governments need to relocate residents for development projects, does their responsibility include more than money for individuals to find a new house?

Mark
Halima Gikandi
Children walk on burning garbage in Deep Sea, an informal settlement that is home to some 12,000 people in Nairobi, Kenya. A planned road project would slice through the center of the community and displace many of its residents.

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Nairobi, a city of 3 million, is a study in the extremes of urbanization. New buildings sprout up like weeds, while informal shack communities expand just as quickly – fueled, in part, by wealthier residents’ desire for low-cost workers.

More than half of the city’s residents live in such off-the-grid settlements, including Deep Sea, a community of some 12,000 people. Technically, its residents have no ownership of the land. In 2009, the country’s roads authority announced a major new construction project that would displace at least 2,000 of them. In most shack communities in Nairobi, that would have been the end of the story.

But Deep Sea residents have done something no similar settlements have managed this long: resisting, arguing that the government should relocate them safely, and together, as a community. To some, Deep Sea’s members are simply squatters. To others, their experience is a test of the Kenyan Constitution’s recognition of the right to accessible housing.

“Our lives are here,” says resident Jacinta Njeri. “I don’t have anything to inherit; I don’t have somewhere else to go.”

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Their shack settlement was told to move. Move us together, they said.

It was 1997, and Jacinta Njeri had nowhere to go. The family of her child’s father had kicked her out of her home a few years earlier, and she was sleeping on the streets of downtown Nairobi. Each evening, she stood on a quiet street corner and offered her services to men who passed by, hoping to scrounge enough to feed herself and her children that day.

Then one day, the mother of three stumbled across Deep Sea: an informal settlement named for the open, cavernous space it inhabits between the wealthy suburbs of Parklands and Muthaiga. 

To outsiders, it didn’t look like much. Few people owned the land they lived on. Sewage pooled in narrow passageways between corrugated tin homes, and in the rainy season, unpaved paths became dangerously slick with mud.

But Ms. Njeri, like many of the settlement’s estimated 12,000 residents, saw something else: a clean slate.

Before coming here “I wanted to kill myself,” says Ms. Njeri, citing the consistent lack of food, safety, and dignity when she was living on the streets. “Deep Sea is where my life began.”  

But for the past 10 years, Deep Sea, like many informal settlements across the Kenyan capital, has been at risk of forced eviction, with its prime location coveted by both private developers and local government. In 2009, the Kenya Urban Roads Authority (KURA) announced a major road construction project would slice through the center of the community, displacing at least 2,000 of its residents.

In many shack communities in Nairobi – and around the world, where 1 in 8 people lives in similar conditions – that likely would have been the end of the story. Residents would have been handed a small sum of “relocation” money and told to get out before the bulldozers rumbled in. 

But so far, Deep Sea has managed to resist for longer than any other informal settlement in Nairobi, drawing on local activism, legal support, and international pressure. 

“The community pushed KURA to negotiation, consultation, and the law – told them to put away the guns,” says Naomi Barasa, who runs Amnesty International Kenya’s campaign on the right to adequate housing and has supported the Deep Sea community in its negotiations with the road authority. “The government is not used to negotiating.”

Halima Gikandi
Jacinta Njeri (r.) is working to save Deep Sea, an informal settlement at risk of eviction. The community is named for the open, cavernous space it inhabits between the wealthy suburbs of Parklands and Muthaiga in Nairobi, Kenya.

City of extremes

Like many African cities, Nairobi is a study in the extremes of urbanization.

Across the city of 3 million, new buildings – from office blocks to high-rises to apartments – sprout like weeds in vacant lots and brush land. 

But alongside these new developments, informal shack communities are expanding just as quickly, fueled by middle-class residents’ desire for low-cost workers like nannies, security guards, and gardeners, and those same workers’ need for affordable housing of their own. More than half the city’s residents live in creaky shack settlements off the government grid, according to a 2014 report by the African Population and Health Research Center.

“It’s no surprise that every middle-class or upper-class suburb is cheek to jowl with an informal settlement,” says Ambreena Manji, a law professor at Cardiff University in Wales who studies land reform in eastern Africa. Wealthier residents “have demands that this type of work be done and then don’t want to actually see where these people have to live.”

As Nairobi’s population has doubled over the past three decades, regular conflicts have emerged between residents of these informal settlements and wealthier residents, private developers, and the government.

Rumors of development rippled through Deep Sea for years, until 2009, when the country’s roads authority announced a new, European Union-funded project called Missing Links to connect two major roads near the settlement. The initiative was an effort to ease the city’s notorious traffic, which is estimated to cost about half a million dollars in lost productivity per day. And a quarter-mile of the road would run directly through Deep Sea. 

More than 1,000 affected residents were offered sums between $50 and $150 to move out, according to community members and Amnesty International – an amount KURA says is in line with the typical process for evicting communities that don’t hold title deeds to their land. Much of the community’s land is owned by the government.

“If there’s space, it’s OK; people can live there for the time being,” says John Cheboi, chief of corporate communications at KURA. “But the challenge is ... Nairobi has become congested, and since it has become congested we have to build roads wherever it is possible so we can have people moving from one end of the city to the other.”

Staying put

But Deep Sea residents balked at the idea. They asked, Where could they go with such a small amount of money? And what about the community they had built? Leaders including Ms. Njeri encouraged residents to reject the compensation offer. If they could convince the entire community not to move, they reasoned, it would give them more bargaining power.

They were soon joined by outside supporters: legal and housing groups like Amnesty International and Kenyan nonprofit Hakiijamii, some of which encouraged Deep Sea’s residents to bring Kenya’s new constitution to the fight. In 2010, that constitution went into effect, spelling out the right of every citizen to “accessible and adequate housing.”

On top of that, the Missing Links road project was partially funded by the EU.

“The involvement of the EU gives the negotiations some strength and some standing,” says Professor Manji. Kenyan officials “feel like they have to abide by the international standards.” (The EU Delegation to Kenya did not provide comment by time of publication. In a statement, however, the delegation writes that it “takes concerns about the implementation of this subproject very seriously” and “is fully committed to ensuring that human rights standards are fully respected.”) 

And so Deep Sea’s residents, led by a committee of 12, began to demand that they be relocated together, somewhere safe and well located – and they wanted the Kenyan government to foot the bill.

It was a simple-sounding request, but also, experts say, a revolutionary one.

“There are very, very few precedents for resettlement” instead of payment, Professor Manji says. Indeed, shack communities are still regularly evicted by the city. In July 2018, for instance, residents of shacks in the Kibera neighborhood woke to bulldozers crushing their homes. Many had been sent eviction notices, but critics said residents had not had sufficient notice, and the United Nations’ human rights body condemned the move. More than 30,000 people were expected to be left homeless, according to a statement from the U.N. refugee agency.

The government says those it evicts are squatters and never had a right to live on the land. 

“This was not your land in the first place,” says Mr. Cheboi of KURA. “Why are you asking for land when you are just squatting?”

Legal activists, however, argue the constitution’s promise of affordable housing means even those occupying land they don’t own have a right to a place to live.

Meanwhile, in Deep Sea itself, years of fighting to stay put have taken their toll. Negotiations with the city have stalled and restarted multiple times. Most recently, in January of this year, the city served the community yet another eviction notice. But so far, almost no one has left. 

“Our lives are here,” says Ms. Njeri. “I don’t have anything to inherit; I don’t have somewhere else to go.”

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Conversations on hope

5. With compassion and faith, a mayor leads his city through the opioid crisis

Mayor Steve Williams has made Huntington, West Virginia, a model for tackling drug addiction. Part 2 in a summer series on people who are facing – and successfully navigating – America’s most intractable challenges.

Mark

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“I’m not going to let you fail.” That was the lifeline a boss extended to Steve Williams when he was floundering as a rookie investment broker. Years later, Mayor Williams made the same promise to the city of Huntington, West Virginia, when it was hit hard by the national opioid crisis. With only modest funding at its disposal, the city of about 50,000 had to tap into deeper resources – humanity, community, and faith. 

As mayor, he spearheaded a pioneering approach that drew on everyone from the fire department to faith leaders and succeeded in stemming the tide of overdoses and deaths. He worked closely with drug czars from both the Obama and Trump administrations, and has made Huntington a model for other cities around the country.

He’s hopeful not only about his city’s progress, but the whole country’s trajectory – not because of what’s happening in Washington, but because of what’s happening in America. “I’m not placing my faith in who’s in office,” says Mayor Williams. “I’m placing my faith in the person I’m standing next to.”

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With compassion and faith, a mayor leads his city through the opioid crisis

Steve Williams of Huntington, West Virginia, may be the most successful mayor on the front lines of America’s opioid crisis. And he would tell you, it’s failure that helped him get there.

In the 1990s, he quit a 15-year career in public service after burning bridges as a state legislator and getting skunked in the Huntington mayoral race.

He went to work at a bank brokerage, but after a year he was the second-worst performer in the company and on the verge of getting fired. His manager came to him and said, “I’m not going to let you fail” – and then gave him a higher vision for his job.

“All of a sudden, the light turned on: I don’t need to sell anything to anybody. I just need to help them,” says Mayor Williams. Help them plan for their children’s college tuition. Help them navigate their retirement. The next year, he was one of the top 30 brokers in the country for his company.

So when he became mayor in 2013, and the opioid crisis hit, he knew the power of reaching out to people in despair – of taking them by the hand and telling them, “I’m not going to let go.”

It was a bleak picture. West Virginia had the highest overdose rate in the country, and Huntington was hit hard. People were calling his office saying they didn’t feel safe letting their children play in the yard anymore.

At one of the first public hearings he attended, people were talking about the need for intervention, prevention, treatment, and law enforcement, while emphasizing that there was no silver bullet. The mayor piped up. “I don’t know about any of you,” he remembers saying, “but I know, for me, I’ve experienced the power of prayer – and I haven’t heard one person mention the power of prayer.”

Faith leaders responded, coordinating a time for their congregations across the city to pray that those struggling with addiction would be delivered, that those dealing drugs would leave crime behind, and that law enforcement authorities would be protected in their fight against opioid abuse. A short video Mayor Williams made garnered 1 million views in just a few weeks, prompting emails of support from as far away as Germany and India.

Christa Case Bryant/The Christian Science Monitor
Firefighters with Huntington Fire Department's Station 4 hang out on an April evening in 2017, shortly before the station's sirens went off after someone called 911 about a suspected drug overdose. At the time, the fire department was getting an average of 10 overdose calls per day in the city of about 50,000.

But overdoses continued to rise.

“I’d be less than honest if I didn’t say that throughout this time, there was some doubt and discouragement,” says Mayor Williams. “There’s a patient prayerfulness that I’ve learned to hold on to,” he adds. “That small quiet voice that’s telling me what I need to do.”

He facilitated collaboration across sectors in Huntington, from researchers at the local university to data gurus in the police department. Those partnerships led to increased trust – and hope. In December 2017, the city began sending small teams of people to visit each person who had overdosed, a day or two after the sirens had quieted, to express compassion and offer help and resources. The initiative has been credited with helping to cut the overdose rate in half within its first six months. The trend line continues to be positive, with 2019 rates below those of 2018.

“What Steve is doing is bringing passion to this,” says Jim Carroll, head of the Trump administration’s Office of National Drug Control Policy. “He has a strong faith; he is committed to his town. ... And that’s what I’m trying to replicate – people like Steve, with his passion.”

The first person Mr. Carroll contacted after being confirmed by the Senate last year, apart from his relatives, was Mayor Williams – despite the fact that they come from different political parties. Indeed, the West Virginia mayor is now a go-to source not only for fellow mayors but also national authorities, and even international dignitaries. He is one of only four mayors on the National City-County Task Force on the Opioid Epidemic. The U.S. surgeon general, the British ambassador, and both Mr. Carroll and his predecessor in the Obama administration, Mike Botticelli, have visited Huntington, seeking to learn from the city’s success. First Lady Melania Trump visited Huntington on Monday to highlight its work on the opioid crisis, and met with the mayor, as well as West Virginia’s senators and governor and acting Department of Homeland Security chief Kevin McAleenan, who was also in town.

“What we’re able to show is yes, it can be replicated,” says Mayor Williams, who tells those overseeing larger metro areas that Huntington’s strategies can be scaled up. “The difference between your city and mine is zeroes.”

Still, the challenge is sobering. Even if Big Pharma stopped selling opioid pills today, and drug dealers never distributed another gram of heroin, Mayor Williams estimates it would still take three or four decades to deal with the effects of the current crisis.

He takes heart from an observation of Adm. James Stockdale, an American prisoner of war in Vietnam, recorded in the book “Good to Great.” The POWs who survived tended not to be those who thought they’d be released soon, but those who faced the brutal facts of the situation and nevertheless maintained a faith that they would prevail in the end.

“Where I’m optimistic is in our DNA here in this nation. ... We never give up,” he says. “And I think that’s the strength of America.”

That is true, he adds, regardless of who controls Washington.

“I’m not placing my faith in who’s in office,” says Mayor Williams. “I’m placing my faith in the person I’m standing next to, and we will identify ways to continue to move forward.”

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The Monitor's View

Quiet mediators in noisy places

Two ways to read the story

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  • Deep Read ( 2 Min. )

These are busy days for professional mediators in some of the world’s most dangerous conflicts, from Sudan to Venezuela. You don’t hear much about these globe-trotting interlocutors, however. That is the point. Their skill set includes the humility not to be visible, not to take credit, and not to push solutions on warring parties. The “soft” power of such honest brokers lies mainly in honest listening for shared concerns.

This week, for example, Norway will mediate in the Venezuelan standoff. In Sudan, the role of neutral mediation fell largely to Ethiopian Prime Minister Abiy Ahmed. He has a Ph.D. in conflict resolution. Last weekend, Germany and Qatar facilitated the first talks between the Taliban and officials of the Afghan government.

If mediators rely on force, it is the force of moral persuasion. That includes an ability to convince the parties to examine their own attitudes and actions. Negotiations are not always contentious. They can also be contemplative. Mediators, by their own nature, bring that quality to the table.

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Quiet mediators in noisy places

These are busy days for professional mediators in some of the world’s most dangerous conflicts, from Sudan to Venezuela. You don’t hear much about these globe-trotting interlocutors, however. That is the point. Their skill set includes the humility not to be visible, not to take credit, and not to push solutions on warring parties. The “soft” power of such honest brokers lies mainly in honest listening for shared concerns.

This week, for example, Norway will mediate between the Venezuelan regime of Nicolás Maduro and its main opponent, the internationally recognized president, Juan Guaidó, on neutral turf in Barbados. Norway has a long history in facilitating peace deals, such as the 1993 accords between Israel and Palestinian negotiators. Lately, Norwegian diplomat Dag Nylander was crucial in arranging a 2016 peace agreement that ended Colombia’s long civil conflict. Now his trust-building skills are being tested in Venezuela, where previous mediation efforts by Spain and the Vatican had failed.

Don’t expect to see the face of the self-effacing Mr. Nylander in news photos. A back channel mediator prefers to stay in the background, working behind closed doors to find openings for the parties to discover their own solutions.

In Sudan, which has witnessed seven months of a violent standoff between pro-democracy protesters and a military regime, the role of neutral mediation fell largely to Ethiopian Prime Minister Abiy Ahmed. He has a Ph.D. in conflict resolution. A tentative deal to restore democracy was reached last week after outside pressure from the United States and Gulf countries. Mr. Abiy has been instrumental in soothing other friction points in Africa.

Last weekend, Germany and Qatar facilitated the first talks between the Taliban and officials of the Afghanistan government. The German envoy to Afghanistan, Markus Potzel, says much of his work is managing expectations and waiting until all parties want to come to an agreement. Peace, he emphasizes, is not merely the absence of conflict. It requires including the views of all parties, narrowing the divide, and then looking for common ground.

Finally, one of the Middle East’s most effective mediators, Oman, joined the challenge to end the Syrian conflict. Its foreign minister made a rare visit to Damascus this week. Oman helped Iran and the U.S. achieve their 2015 nuclear deal.

If mediators rely on force, it is the force of moral persuasion. That includes an ability to convince the parties to examine their own attitudes and actions. Negotiations are not always contentious. They can also be contemplative. Mediators, by their own nature, bring that quality to the table. 

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A Christian Science Perspective

About this feature

Each weekday, the Monitor includes one clearly labeled religious article offering spiritual insight on contemporary issues, including the news. The publication – in its various forms – is produced for anyone who cares about the progress of the human endeavor around the world and seeks news reported with compassion, intelligence, and an essentially constructive lens. For many, that caring has religious roots. For many, it does not. The Monitor has always embraced both audiences. The Monitor is owned by a church – The First Church of Christ, Scientist, in Boston – whose founder was concerned with both the state of the world and the quality of available news.

Safety in following God’s guidance

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  • Read or Listen ( 3 Min. )

When we don’t know what to do – and even when we think we do – pausing to listen for inspiration from God, and then obeying it, can get us back on track. One man learned this firsthand when he and his hiking partner became separated in the Sierra Nevada some years ago.

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Safety in following God’s guidance

Today's Christian Science Perspective audio edition
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It had been about an hour and a half since I’d last seen her. My girlfriend and I were hiking in California’s Sierra Nevada. There in the forest, we’d gotten off a trail and become separated. The college we both attended was only about 50 miles away, but she had not spent a lot of time in the forest before, and I was concerned. In these same mountains, another friend of mine had become separated from his wife and a search party had reunited them two days later.

I came upon a trail and wondered if she’d found it, too. If she had, I could only guess which direction she might have taken; because it was rocky, there were no footprints.

I stood there for a few minutes just staring at the trail, before deciding that she must have gone to the right.

I took a few steps in that direction and stopped, feeling conflicted about my choice. Then I sat down on a large rock to do something I’d found very helpful in other situations: pray. My prayer, I decided, was going to be a time of listening for God’s direction.

I’ve always appreciated these verses in the Bible: “Thou hast possessed my reins. ... How precious also are thy thoughts unto me, O God!” (Psalms 139:13, 17). If I were a horse, the one who held my reins would matter quite a bit to me. When a horse really trusts the person who has its reins, everything is much more harmonious. God continuously sends us inspiration that helps us feel His care, and because He is entirely good, we can trust His guidance. But we need to be paying attention so we don’t miss it.

As I sat there listening and praying in this way, I got a clear feeling that my girlfriend had found the trail and had gone to the left.

But in a bullheaded way, I started walking to the right.

As logical as it had seemed to me to go right, as I went along – I must have gone a few hundred yards – it just felt more and more wrong. I could tell that the time had come for me to appreciate God much more – to let go of my own willful opinions and to not just listen for but actually pay attention to God’s guidance and follow it.

The Christian Science Monitor’s founder, Mary Baker Eddy, once wrote encouragingly: “The good cannot lose their God, their help in times of trouble. If they mistake the divine command, they will recover it, countermand their order, retrace their steps, and reinstate His orders, more assured to press on safely” (“Miscellaneous Writings 1883-1896,” p. 10).

That’s just what I did. Dropping my own opinions, I reversed my direction with a clear sense that this was the right way forward. It felt so good to feel God’s love and be enlightened by God’s guidance. And about a half-hour later, my girlfriend and I found each other.

Jesus said metaphorically, “If any man walk in the day, he stumbleth not, because he seeth the light of this world. But if a man walk in the night, he stumbleth, because there is no light in him” (John 11:9, 10). In the darkness of willfulness, which blinds us to divine inspiration, we stumble along, away from the right direction. However, in the light of God’s guidance and the humility to obey it, the path forward becomes clear and correct.

My takeaway from all of this is reflected in this beautiful Bible verse: “And thine ears shall hear a word behind thee, saying, This is the way, walk ye in it, when ye turn to the right hand, and when ye turn to the left” (Isaiah 30:21).

Yes, God shows the way. But our part is important: “Walk ye in it!” When we not only listen for divine guidance but follow it willingly, that’s when our prayers are most effective.

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Viewfinder

Canyon of heroes

Seth Wenig/AP
Members of the U.S. women’s soccer team were showered with confetti in New York on Wednesday to celebrate their victory in the FIFA Women’s World Cup. Team forward Megan Rapinoe (c.) told the crowd gathered at a rally at New York City Hall, ‘This is my charge to everyone: We have to be better. We have to love more and hate less, listen more and talk less. It is our responsibility to make this world a better place.’
( The illustrations in today's Monitor Daily are by Jacob Turcotte. )
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In Our Next Issue

( July 11th, 2019 )

That’s your Daily. We’ll see you tomorrow, with stories including a tribute by Columbus, Ohio, to humorist James Thurber.

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