Pré-Publication, Document De Travail Année : 2009

Medicina Democratica and the Seveso Disaster: lights and shadows of the Italian movement for environmental health in the 70's

Résumé

The season of social movements activism and policy reforms that characterized the years straddling the decades of the 60's and 70's in Italy had in occupational health one of its main issues. Starting from the denunciation of hidden costs of industrial development in terms of workers illness caused by the way industrial production was organised, the struggle for occupational health extended to encompass a more broad idea of environmental health. Health issues inside factories were thus directly linked with those emerging outside, i.e. in the territory. In fact, Italy was witnessing in those years an "epidemiologic turn" (Carnevale and Baldasseroni, 1999) with the increasing statistical relevance of forms of illness directly linked to new industrial hazardous substances and new ways to organise work and, more in general, life in an industrialized society. In this struggle -that saw mobilizing together a wide array of different social actors, like workers, unionists, physicians, intellectuals, students- the way in which health was traditionally conceptualized underwent a change. Health was no more defined as a state of absence of illness (definition in negative terms) but as good quality of life (definition in positive terms). The shift from a negative to a positive definition of health entailed two important changes in the way health issues were usually approached (Tonelli, 2007). First of all, since health was now framed as "good quality of life", the very starting point from which setting the standards for health had to become the subjective experience of workers and citizens. As a consequence, the role of "expert knowledge" in the definition of health and illness was challenged. Second, health was no more considered a question of healing individuals affected by diseases but mostly of prevention, through modifying environmental conditions recognized as sources of harms. This implied a shift from a logic of compensation of damages (through their monetization) towards enforce structural transformations. The Law 833, approved in 1978 and reforming the Italian health system, represents the higher accomplishment of this mobilization, with the creation of a universalistic National Health Service based on local public health services units (USL) in charge of health quality, both inside and outside factories. At the same time, the obstacles encountered in implementing the Law 833, with the following adjustments required, showed the difficulties in translating into actual practice the most innovative principles incorporated into the reform design (Berlinguer, 1991; Luzzi, 2004). As pointed out by Barca (2006, p.18) an important role in weakening the broad reform project, in particular concerning environmental health, was played not only by "strong resilience within bureaucracy and serious fund deficit" but as well by "the dialectics of the changing conditions of the Italian economy (and power relations among social groups), and within a broader international business cycle": more precisely, "starting from 1976-77, economic stagnation and recession posed the conditions for the insurgence of the 'job blackmail' as a powerful employers' strategy to lower business costs by shifting them on labor and society". Besides these macro-economic and institutional factors, other, more endogenous reasons contributed to the weakening of the Italian movement for environmental health. In particular, we propose to investigate the controversial role played by the framing of the struggle for environmental health in terms of class struggle, with a central role attributed to workers, as "political avant-garde" of the movement, and to the social critique of the capitalistic system as main issue at stake. On the one hand, the link established between environmental health and class struggle made clearly visible how social inequalities produced by the capitalistic system were relevant in explaining the occurrence of diseases that was usually presented as accident, fatality or individual destiny. An interpretation of health as individual experience, yet social fact originating in the human and environmental exploitation induced by capitalistic organisation of production, has been then propitious to address structural causes accounting for health and illness. On the other hand, being this frame strongly ideological, it was confronted to unexpected resistances when trying to extend the mobilisation to other social actors beside workers and leftist intellectual elites. In order to discuss the relevance of this endogenous limit, and the interplay with exogenous factors, in the next paragraph we start by analyzing one of the most important organised groups that emerged in the '70s from the mobilisation on environmental health: "Medicina Democratica". After tracing the origins of this movement, we focus on the failure of Medicina Democratica's effort to mobilise the victims of the dioxin contamination caused by the chemical factory ICMESA in the town of Seveso (10th of July 1976). This event was a turning point for the movement and brought activists to partially question movement's programme and strategies. In the concluding part, we are going to highlight an issue whose importance for the mobilisation of Seveso victims went unnoticed by activists of environmental health, that is, the importance of the environment as a territory to which a community is attached. More in general, the ideological frame informing Medicina Democratica's mobilisation in Seveso prevented activists from recognizing the importance of other ways to understand environmental problems, in particular in terms of problems touching proximity relations, and the need for composing this pluralism in a shared and consensual approach to environmental health.

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hal-01070132 , version 1 (30-09-2014)

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Laura Centemeri. Medicina Democratica and the Seveso Disaster: lights and shadows of the Italian movement for environmental health in the 70's. 2009. ⟨hal-01070132⟩
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