What Happened to Participation? Urban Development and Authoritarian Upgrading in Cairo's Informal Neighbourhoods

Participation appeared in development discourses for the first time in the 1970s, as a generic call for the involvement of the poor in development initiatives. Over the last three decades, the initial perspectives on participation intended as a project method for poverty reduction have evolved into a coherent and articulated theoretical elaboration, in which participation figures among the paraphernalia of good governance promotion: participation has acquired the status of “new orthodoxy”. Nevertheless, the experience of the implementation of participatory approaches in development projects seemed to be in the majority of cases rather disappointing, since the transformative potential of ‘participation in development’ depends on a series of factors in which every project can actually differ from others: the ultimate aim of the approach promoted, its forms and contents and, last but not least, the socio-political context in which the participatory initiative is embedded. In Egypt, the signature of a project agreement between the Arab Republic of Egypt and the Federal Republic of Germany, in 1998, inaugurated a Participatory Urban Management Programme (PUMP) to be implemented in Greater Cairo by the German Technical Cooperation (Deutsche Gesellschaft für Technische Zusammenarbeit, GTZ) and the Ministry of Planning (now Ministry of Local Development) and the Governorates of Giza and Cairo as the main counterparts. Now, ten years after the beginning of the PUMP/PDP and close to its end (December 2010), it is possible to draw some conclusions about the scope, the significance and the effects of the participatory approach adopted by GTZ and appropriated by the Egyptian counterparts in dealing with the issue of informal areas and, more generally, of urban development. Our analysis follows three sets of questions: the first set regards the way ‘participation’ has been interpreted and concretised by PUMP and PDP. The second is about the emancipating potential of the ‘participatory approach’ and its ability to ‘empower’ the ‘marginalised’. The third focuses on one hand on the efficacy of GTZ strategy to lead to an improvement of the delivery service in informal areas (especially in terms of planning and policies), and on the other hand on the potential of GTZ development intervention to trigger an incremental process of ‘democratisation’ from below.

Il monitoraggio della qualità di vita e dei bisogni di pazienti oncologici e caregiver: il caso ANT

La Fondazione ANT rappresenta una delle più ampie esperienze al mondo di assistenza socio-sanitaria gratuita a domicilio ai malati di tumore, tramite équipe di specialisti costituite da medici, psicologi e infermieri. La patologia oncologica ha un enorme impatto sul benessere dei pazienti. Un modo per raggruppare i diversi sintomi di disagio psicologico è utilizzare il concetto di distress, che sarebbe importante monitorare in modo semplice e veloce. Primo studio: 66 pazienti oncologici (40% uomini; età media 54 anni) in cure palliative domiciliari. Il 79% dei pazienti ha mostrato livelli clinicamente significativi di distress. Il 55% dei partecipanti allo studio ha riportato alti livelli di ansia, e l'81% dei pazienti ha riportato alti livelli di depressione. Dall'analisi delle curve ROC il singolo item del Distress Thermometer, con un cut-off maggiore o uguale a 4, è stato in grado di rilevare il 97% dei soggetti con punteggi clinici di ansia e depressione, quindi può essere utilizzato anche come uno strumento di screening precoce rapido ed affidabile per i disturbi dell'umore. I familiari sono la prima risorsa dei malati di tumore, e l'identificazione dei loro bisogni è utile per individuare chi ha maggiore necessità di aiuto ed in quali aree. Secondo studio: 115 caregiver di pazienti oncologici (37% uomini; età media 52 anni). Di seguito i bisogni più frequenti. Salute psicofisica: “preoccupazioni circa il/la paziente” (72%), ansia (53%) e rabbia (52%). Informazioni: “come prendersi cura del paziente” (64%), “terapie alternative e/o complementari” (64%) e “come gestire lo stress” (57%). Servizi e strutture sanitarie: “un operatore di riferimento”, (65%), “cure infermieristiche a domicilio” (62%), “indicazioni su servizi ospedalieri” (57%), ed “assistenza per caregiver, ad esempio consulenza psicologica” (55%). Il monitoraggio dei bisogni consentirebbe un'ottimizzazione dell'assistenza, prevenendo situazioni che potrebbero compromettere il benessere della famiglia e la qualità dell'assistenza fornita al paziente.

Law, Informal Institutions and Trust: an Experimental Perspective

This dissertation has studied how legal and non-legal mechanisms affect the levels of trust and trustworthiness in an economy, and whether and when subtle psychological factors are crucial for establishing trust and even for recovering trust from a breach of contract. The first Chapter has addressed the question of whether formal legal enforcement crowds out or crowds in the amount of trust in a society. We find that formal legal mechanisms, especially formal contracts backed by a powerful authority, normally undermine trust except when they are perceived as legitimate, or when there are no strong social norms of fairness (i.e. the population in a society is considerably heterogeneous), or when the environment in which repeated commercial relationships take place becomes highly uncertain. The second Chapter has examined whether the endogenous adoption of a collective punishment institution can help a society coordinate on an efficient outcome, characterized by high levels of trust and trustworthiness. The experimental results show that the endogenous introduction of collective punishment by means of a majority-voting rule does not significantly improve coordination on the efficient equilibrium. Not all subjects seem to be able to anticipate the change in behavior induced by the introduction of the mechanism, and a majority of them vote against it. The third Chapter has explored whether high-trustors adapt their behavior in response to others’ trustworthiness or untrustworthiness more quickly, which in turn supports them to maintain higher default expectations of others’ trustworthiness relative to low-trustors. Our experimental results reveal that high-trustors are better than low-trustors at predicting others’ trustworthiness because they are less susceptible to the anticipated aversive emotions aroused by the potential betrayal and thereby have a higher willingness to acquire the valuable information about their partner’s actions.