Civil Society Unbound

MOSCOW – The challenges facing civil-society organizations are greater in Russia than in many parts of the world, but the challenges facing civil society itself are similar everywhere. Indeed, around the world there is a gap between civil-society organizations and the societies they profess to serve.

Civil-society organizations do not gain power through elections (legitimate or otherwise), but through reaching the broader world. In short, their goal is to build civil society itself. 

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They are most successful when people behave as part of civil society without necessarily being “civil-society” professionals. That is, they will do such things as take care of their own health, engage in public discussions or blog about safety conditions in their community, rate school performance, organize weekly runs for dog owners, care for their local forests or rivers- as part of their lives, not as part of their jobs.

One area of concern for civil society nowadays is the press and new media. In many places today information is flowing more than ever, but mass media are under both political and financial pressure. 

Most people think of a free press as a way to keep track of what governments are doing – and so it is. That is why the press as a whole, and journalists in particular, are so frequently targeted by the authorities. When media outlets aren’t owned – and tamed – by the authorities or people close to them, they still face censorship, intimidation, tax audits, and occasionally assassination of their journalists and editors.

In Russia in particular, the situation is mixed. The government owns or controls most of the mass media – the major newspapers and television stations – but there is an abundance of mostly marginalized publications and radio stations (to say nothing of the Internet) that retain a remarkable degree of independence. They are not directly censored, but they operate under the chilling knowledge that they can be shut down on vague charges at any moment. And, of course, most of them are struggling to survive financially.

Yet there’s more to journalism than keeping an eye on the government. Journalism’s other task is to reflect a society back to itself – to spread an accurate picture of its current situation, to share information about the activities of private citizens and businesses as they build civil society, and to encourage citizens to become active in improving their own lives and developing their communities.

Consider health care. As far as I’m concerned, the ultimate goal should be not so much a better health care system, but a population so healthy that it hardly needs health care. Health problems may take you to a clinic, but many of them start with how you behave at home – what you eat and drink, whether you smoke or exercise or sleep enough, etc.

This is the kind of thinking that was driving us at a recent health care working group gathered as part of the recent Civil Society Summit organized in Moscow by the Eurasia Foundation, the New Eurasia Foundation and the CSIS.  (I was there as a Eurasia Foundation board member.)

To tackle these problems, we came up with an “open data/information liquidity” project, which will advocate and organize the publication, exchange, aggregation, and analysis of health data – not just general statistics, but specific data about health outcomes in terms of drugs and treatments, hospital performance, and the like.

Of course, many of those statistics are not even collected, yet alone published. But we can start with what exists, and by so doing create demand for the rest. In the United States, people are already rating their own doctors at sites such as RateMDs.com and vitals.com; third-party doctor and hospital ratings are available at HealthGrades.com.

Civil-society groups don’t often run hospitals directly, but they can make their performance more transparent. So there are plans afoot to develop and distribute tools to analyze information, discover correlations (data-mining), and display the results as graphs and charts.

But, again, health really begins at home, so the real victory – and one where such civil-society cooperation may have a more immediate impact – is to give people better data about themselves and what they should be doing for their own health.

That includes everything from nutritional information and baby care, to (ultimately) records of each person’s own health and treatments, and it starts with using new media to reach people where they live, with content that’s relevant.  In the Soviet Union, they used to call this “sanitary propaganda,” but it was widely disregarded. One Russian friend told me, “Whenever we would read an article about the health dangers of butter, we would immediately run out and buy as much butter as we could find, because we knew it meant there would be a butter shortage.”

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Today, that type of information is called “healthy lifestyle promotion.” We are also working on a project along these lines, reaching out to target populations with two-way new media such as the Internet and mobile phones, rather than harangues in newspapers and TV. Imagine a program where pregnant women could sign up by cell phone for weekly reminders and updates, and to answer questions such as, “Is the baby kicking?” If not, she could be referred to a local clinic.

When I made those same points in a wrap-up to the Civil Society Summit as a whole, I was interrupted by none other than US president Barack Obama, who was in Moscow for his summit with President Dmitry Medvedev but also took the time to listen our gathering of civil-society organizations. Obama apologized for arriving late, and added: “That’s why we have civil society. You just can’t rely on politicians!”