Laboratory for Microclimates

Under what circumstances would we become mindful stewards of living systems, not just their expoiters? The Dutch artist Annechien Meier re-connects us – viscerally, and emotionally – with our social and ecological surroundings.

LAB 01

[Above: De-paving begins in Arnhem. Photo: Laboratory for Microclimates]

Human beings are clever in many ways, but our attention is easily distracted from the support systems that our lives depend on – food, water, soil, and climate. Paved surfaces, and pervasive media, amplify our tendency to leave living systems out of sight, and out of mind. This prompts a question: Under what circumstances would we connect with, and look after, the living systems we depend on? Read More »

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Socially Smart Sanitation

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Above: Build it and they will come? In the world of toilets, it’s not so simple.  (Photo: Quicksand)

What if sanitation is not just about the kit? If sanitation solutions cannot be mass-produced at will, like a box of software, what, then, is the alternative? 

Nearly half the world’s population lacks access to a toilet, so the desire for scale is understandable. By some accounts, eighty percent of the world’s illnesses can be traced to untreated fecal matter, and the health consequences of open defection are especially dire for poor people forced to live in densely packed urban communities. Nobody disputes that something major must be done.

Given the scale of the challenge, large-scale solutions that will improve life for large numbers of people sound like good news. India’s government, in this spirit, has proclaimed that ‘toilets are more important than temples’ and is committed to build five million toilets by September – or one every second.

If a lack of equipment were an obstacle, big breakthroughs would be near. The Gates Foundation, for example, having invested tens of millions of dollars in an ambitious attempt to re-invent the toilet, has now embarked on a similar effort to re-invent the  sewage treatment plant. The Omniprocessor, an off-grid system developed for the foundation by Janicki Bioenergy, converts sludge into drinking water, electricity, and ash. The system features sensors and webcams so that engineers may monitor an installation remotely, diagnose any problems that come up, and communicate with technical support teams on the ground.

The technical prowess shown in these projects is admirable, but a tricky question has arisen: What if sanitation does not lend itself to omni solutions, and it’s not just about the kit? If sanitation solutions cannot be mass-produced at will, like a box of software, what, then, is the alternative?

Quicksand’s Ayush Chauhan and Babitha George, who have spent four years grappling with a toilet project called Sammaan, have learned the hard way that sanitation does not  lend itself to mass-producable solutions.

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Above: The toilet as artefact, however well-designed, is a relatively small part of the story. (Photo: Quicksand).

At last month’s Unbox Festival, in India, they told me that, because every context is different, so too will be every successful solution. The toilet as artefact, however well-designed, is a relatively small part of the story. Equally important threads in the narrative concern so-called ‘soft’ factors such as social conditions, cultural norms, business models, and governance.

For an installation to be sustainable over the long term, Chauhan explained, it needs to be ‘owned’ by the local community – and for this to happen, an effective framework for their participation needs to be put in place at the start. This foundational element is missing from the Indian government’s new-toilet-every-second campaign.

Toilets also also needs to be affordable, as well as functional, if local people are to use them two or three times a day. Pay-per-use is an obstacle to many poor people, Chauhan explained – but not all of them; different business models work in different contexts. Free public provision works sometimes, but many government supplied toilets, already built, have fallen into disuse. The use of microfinance to fund toilet business start-ups also works in some areas – but not all; in other contexts, a different mix of rewards and incentives have been found to work better.

For a community-led project to put the right mix of technical, social and economic components together, different local government departments – including water, public health, infrastructure, and education – need to be co-ordinated, too; but right now, local government silos seldom even talk to each other.

Simply telling officials to be supportive doesn’t work, so fostering their empathy and awareness is another priority. That’s a tough task by itself.

For Kris de Decker, toilets are a second-order question. The priority, for him, is a
social business organization of the kind that served China and Japan for centuries before the development of artificial fertilizer transformed sanitation systems for the worse.

Although they were large and densely populated even by today’s standards, pre-modern cities were served quite well without toilets at all. City-wide economic infrastructures, often based on boats and canals, collected waste, processed and stored it to kill microorganisms, and used it as fertilizer, with great efficiency. Because human byproducts had economic value as a key input to sustainable farming, Chinese cities were a lot healthier than their contemporary European ones, too.

No-toilet sanitation solutions are not on the table in India right now, to put it mildly – but there are numerous efforts to turn human waste into viable social businesses.

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Above: Bangalore lacks a city-wide sewerage network , but these ‘honey-sucker’ trucks have emerged as a self-service alternative; private tankers empty holding and septic tanks and the faecal sludge is used productively by farmers in the fringes of the city. The honey-sucker service has emerged without any form of financial or technical assistance, but operates outside the legal framework.


For S Vishwanath, a thirty-year veteran of water stewardship projects in Bangalore, the key success factor – is that sanitation projects should be ‘hyper-local’ and led by local citizens – and a small but growing number of success stories  confirms that lesson.

Near Bangalore, for example, a community of 1,700 households in eight villages eliminated open defecation in a project that was led by a respected local woman and suppported by outside experts. For the eighteen months since the locally-owned plan was launched, the community’s infant mortality rate has been zero.

Local leadership is also key to the restoration of lakes and rivers. Bangalore, we heard from Vishwanath, was once called the city of a thousand lakes – but, thanks to the ravages of urbanization, sewage dumping, and encroachment, barely 34 remain in their original healthy state. Now, pioneering groups called Friends of the Lakes are coming together to in towns and cities across India and beyond, to help revive and protect rivers, lakes and watersheds.

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[Above: For volunteer groups working to restore Jakkur Lake, near Bangalore, educating communities about  the value of the ecological context is a priority. Information graphic by  Aajwanthi Baradwaj]

No-So-Ugly Indians

A hacking ethic inspires an inspiring anti-trash movement called The Ugly Indian. Started by design students in Bangalore, it’s all about cleaning up India’s sidewalks, bus stops, and illegal rubbish dumps. Small groups take unilateral action to clean up a stretch of sidewalk, for example, and then they talk to everyone involved in that street: the garbage collectors, shop-owners, municipal cleaning staff, office workers who dump trash on the street, and so on.

bove: Thanks to an Ugly Indian group, a former rubbish dump is now an urban park.

Each group uses the visible result of their initial action to start conversations – “look how clean our street could be” – and ask people who are part of the problem to imagine themselves as co-owners of a clean street, not a filthy one.

Ugly Indians don’t blame their fellow citizens, or politicians, or ‘the system’: They act first, and then they talk – to everyone.  They make it “our” problem, not “your” problem.

This combination of social smarts with systems thinking is remarkable. The Ugly Indian movement has spread to a dozen Indian cities, and a similar project has started in Karachi.

In another ultra-local project – in Shimla, the  capital of Himachal Pradesh – the focus is on the capability of local authorities to work with local communities. An EU-supported programme is helping 1,500 households from poorly served slums work together with city administrators, elected officials, and managers of various technical services, and some NGOs. Together, they are developing the plan for decentralised sanitation and water reuse in which low-cost sewerage systems are being implemented at a community level.


Suppose, as a thought experiment – and as experience seems to indicate – that the optimal size for a social change action is two to five thousand people – such as the group of villagers in Bangalore that Vishwanath mentioned; or the number of people who might have a shared interest in cleaning up an urban street, as practiced by The Ugly Indian movement.

In that case, for every 100 million people in need, 50,000 community stewards need to be identifed, trained, and supported – and on an ongoing basis. That sounds an especially tall order when one considers that Ashoka, which has a long-standing commitment to the development of local leaders, has been able to nurture  3,000 fellows since 1981.

But in other walks of life than sanitation, local mobilisations on a large scale have cropped up throughout history.  There must surely be some potential in adapting  their models to a waste and water stewardship context.

Religious orders such as the Benedictines, or the Jesuits, have grown huge congregations over centuries using a ProAm model in which priests and missionaries would recruit lay people around a shared belied system. In content terms, features of their agenda could be obnoxious – but their success in recruiting whole populations to a new social practice was phenomenal.

The growth model of religions has been updated to huge effect  in recent times  by the evangelical christian movement; at least forty million Americans participate at a local level today in a religiously based small groups. Rick Warren’s Saddleback Church, for example, is comprised of thousands of church cells in which groups of six or seven people who meet in one another’s homes during the week to worship and pray.

As Malcom Gladwell recounted in a celebrated profile, Warren’s small groups ‘focus on practical applications of spirituality…not on abstract knowledge, nor even on ideas for the sake of ideas themselves’. His innovation was to improve and supercharge the recruitment, training and support of thousands of volunteer leaders that emerged from these small groups. His website,, supports this fast-growing learning network of local leaders.

Local churches, for Warren, are ‘the biggest distribution network in the world. Millions of them are spread out around the world. Even in villages which lack a school, a grocery store, or a fire department, they have a church’.

Water wisdom

For S Vishwanath, water stewardship in general, and sanitation projects in particular, are neither a spiritual nor a practical matter on their own. We need both. The prosaic, day-to-day management of waste and water needs to be organised at a hyper-local level; otherwise it will not be adaptive to the unique properties of each social and ecological context. At the same time, water stewardship requires the mobilisation of immense cultural commitment; for that, the spiritual dimension of water needs to be rediscovered, too.

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How to be a rock

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(Above: A forest skills workshop in Big Tree Country)

Last month I spent a day in a small town of 2,000 people in Perthshire, Scotland, with the following group of people: a blacksmith; a book maker; a soldier turned master mead maker; an artist whose work explores how we interact with the ecology of the earth; a student of the ecosystems to be found in dry stone walls; a curator of artist-led walks; a man who helps youth hostels reinvent themselves; a botanist who specialises in sphagnum moss; another artist who makes outfits that disguise you as a rock; a public arts funder; someone from a field studies centre where one can see the Clouded Drab (a rare moth); a fiddler who organises traditional music festivals; a nurse who leads healing walks; a designer of natural golf courses; a raspberry farmer; an outdoor education provider; the tutor at a forest school; a felter and knitter; a man who ”hated going to the potatoes”; a breeder if ill-disciplined Hebridean sheep; a man who studies lumps and bumps in the landscape; a digital arts producer; a bare foot walker; a designer of water cleaning systems; a book festival organiser; and a countryside steward.

Our task was to imagine new ways for residents and visitors to connect with the ecological and cultural assets of The Cateran Trail. This 64 mile (103 km) circular track, in the heart of ‘Big Tree Country’ in central Scotland, has no real beginning or end. It takes its name from the feared cattle thieves who once raided these rich lands. The burial place of Guinevere, Queen of King Arthur, and a setting of stones thought to be a Viking burial site, are both in the vicinity; so too, once, was the richest abbey in Scotland.
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(Above: Could this become a learning farm?)

Among the ideas we came up with were encounters in which people learn: how to be still; to perform as a choir on the Trail, or how to grow speciality Scottish chillies. One group proposed a learning farm; another, an apprenticeship in how to build a dry-stone dyke.

This workshop was a warm-up for Cateran’s Common Wealth, a two year programme of cultural and ecological activities at the intersection of active learning, creative place-making, and sustainable tourism. It  begins next year. Clare Cooper, its co-founder, explained the background: “Some things belong to all of us: the biosphere on which we all depend; our cultural heritage and history; our language; our skills in managing the land;  our myths and our musical traditions. The Cateran Trail exemplifies this common wealth. By connecting the physical presence of the Trail with the ancient metaphorical power inherent in path walking, and path making, we will revalue this shared inheritance and find new ways to sustain it for future generations”.    

On Saturday 12 December, together with Mansi Gupta, I’m running a workshop at the UnBox Festival in Delhi. We will develop the programme of a Lab, to be situated at the heart of India’s largest leather-producing region, that will develop products and services that combine clean forms of leather making with direct connections between between producers and customers. In preparation for UnBox, the leather ecosystem of Kanpur – its people, skills, and cultures – will be documented in a publication and short film.


aa GR17 Key
(Above: The key, actual size)

For the same price as a tiny bedsit in London, Stockholm or Paris, a big 400 year old townhouse  is for sale in South West France.

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Leathershed lab


On Saturday 12 December, together with Mansi Gupta, I’m running a workshop at the UnBox Festival in Delhi.

We will develop the programme of a Lab, to be situated at the heart of India’s largest leather-producing region, that will develop products and services that combine clean forms of leather making with direct connections between between producers and customers. Read More »

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Shelter Without A Concrete Roof

Public performance in Kisangani. Image © Studios Kabako
Public performance in Kisangani. Image © Studios Kabako

Studios Kabako, a dance company from Africa, is the winner of this year’s 2014 Curry Stone Design Prize, an important international award. Using dance, theater, and music, Studios Kabako help local communities envision positive alternatives in a city that has known devastating armed conflict over many years. The company has pioneered a form of development that is based on social creativity rather than real estate plays.

Based in Kinsangani, the Congolese performance and theater studio was founded by Faustin Linyekula in 2001 to address social memory, fear, and hope in the aftermath of civil war. During a decade of urban interventions and cultural activities, the studio has enabled a flourishing an ecosystem of dance activities. Studios Kabako are pioneers of a new way to practice ‘rebuilding’ that ‘s based far more on human energy than on pouring concrete.

“Many world regions face terrible fratricidal wars” explained Emiliano Gandolfi, director of the Curry Stone Prize. “We must learn to envisage an alternative to the culture of destruction”. Faustin Linyekula’s work demonstrates the remarkable results that can happen when the transformative power of art is applied to the ways we practically create a sustainable future.

When Linyekula founded the studio young Congolese people, especially, were living without hope –  too preoccupied by daily survival to imagine an alternative. As recounted by the renowned theater and opera director, Peter Sellars,“Faustin is training a generation of kids to challenge everything about their surroundings. He has created an energy among youth in Kisangani that insists on moving forward. His work is never self-pitying, there’s always this alertness, this awakeness, that has the spirit of challenge in it. It refuses to say ‘Oh, poor Africa.’ It says, ‘OK, pull your life together. Lift your own game’.”

As a platform, Studios Kabako is light and mobile. Although the studio maintains studios in the city centre, it takes its work to the rural fringes and to vacant areas of Kisangani in the form mobile performances. Studio Kabako is currently working on plans for more facilities within the city that combine environmentally friendly technologies, communal living systems and new educational models, all of which are unprecedented in this region.

“Culture is one of the most powerful means of providing a shelter for a community. That shelter doesn’t have to be a concrete roof.” Synthetized Suad Amiry, founder of RIWAQ, winner of the CSDP award in 2012, and member of this year’s jury.

(The author, John Thackara, was also a member of the jury).

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Housing Without Building

The family of swallows that spent the summer in the eaves behind my office here in France have headed south for the winter. Soon, as Christmas beckons, they’ll reach their destinations: Botswana, Namibia or South Africa. After just two months gorging on insects, they’ll begin the epic journey back. The strongest among them will make it back in just five weeks, traveling 200 miles a day.

And I thought my air travel was profligate.

As an artefact, the swallows’ nest is not exactly the Taj Mahal. It’s a ramshackle structure, made of mud pellets and straw, stuck crookedly to the wall. But it seems to suit them well – or rather, the surrounding habitat does. Their physical abode is a safe enough place to park their young – but it’s not a gated community. What brings the swallows back every year is not their house but the surrounding environment as whole: open air for easy flight; fresh water from the river; flying insects to feed their ravenous young. I have come to envy how lightly they manage to live. We humans burn through billions of tons of resources, to support our our own structures and lifestyles. Swallows throw their nests together from found materials.

Preoccupied by swallows, I posed the following question last month to a meeting of Nordic Housing Association managers: Do we really need to build more boxes? Is it beyond our creativity to provide our fellow humans with shelter and sustenance without covering more of the world in concrete?

To be candid, I did not expect an easy ride from this group of experts. They have a ton of financial, legal and political issues to deal with in managing 2.4 million housing units across the Nordic countries. At the event, I was surprised: Many of these professionals shared my concern at the baleful influence of the Real Estate Industrial Complex. Manufacturing boxes may be good for GDP and construction firms, some agreed, but we can surely meet the social need for shelter in ways that that improve the habitat, not wreck it.

We discussed a variety of life-enhacing ways to inhabit the city:  the re-use of empty buildings; the potential of food hubs to improve a community’s health; the need for a micro-brewery in every neighbourhood; the benefits of pollinator pathways through built-up areas; the potential of de-paving to improve a town’s porosity to rain; how citizen action is improving the health of rivers, creeks and watersheds; how to de-motorise the movement of freight through towns and cities.

This metabolic concept of development was in stark contrast to a newsletter I received this morning. It announced that “60% of the area projected to be urban in 2030 has not yet been built”. This passive-submissive acceptance of unchecked urbanisation has become tiresome. Sure, yes, urbanisation will devour the biosphere if no alternatives are on offer – but that’s not the case. There are thousands of ways to improve life – and not just human life – in the cities we already have. Let’s draw a line in the (de-paved) sand and agree that the real-estate model of ‘development’ is over.


Why is it that shocking stories and images fail to change things? Are there different ways of knowing the world, than merely looking? I’ve posted a list here of the writers who have helped this writer understand this overarching dilemma. Susan Sontag’s conclusion stays with me: “People don’t become inured to what they are shown — if that’s the right way to describe what happens — because of the quantity of images dumped on them. It is passivity that dulls feeling”.


“Our ancestors’ children didn’t go to school:  School surrounded them. Nature was a living teacher”. Under the umbrella title of Wild Learning, I’ve also posted a rough-and-ready list of of the nature-based education, biodiversity initiatives, and edible school gardens that are trying in diverse ways to reconnect children – and the rest of us – with the living systems of which we are a part.


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How Does This Forest Think?

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Xskool on Grinda
UnBox in India

Forthcoming events


Fifty designers, artists and architects spent a week at our Xskool on Grinda last month to explore two questions: What does this food system taste like? and, How does this forest think?

One team invented the Soil Tasting Ceremony shown above. They made infusions from ten different berries on the island and displayed them next to soil samples taken from each plant’s location; the soils were displayed in wine glasses. We were then invited to compare the tastes of the teas and soils in silence. It was a powerful moment. (There are more images here).

Ahead of the event I thought soil health would be hard to sell to a cerebral group of (mostly) grad students. Today’s designers think far more about connecting with each other, I assumed, than about connecting with the soil. Why would they? Fewer than half of us ever see or touch the stuff.

My concern that living soil would not engage designers proved unfounded. It was like pushing at an open door. Xskoolers went scrabbling around the forest of Grinda like so many voles. They found ways to catch the taste of the forest and put it in a pot. They made cookies with forest berries and bartered these with tourists. They created tactile pathways so we could we feel the forest through our feet. A Latvian designer made pine cone syrup and gave it to Teacher, who was mightily pleased.

This positive energy was welcome, but unexpected. In searching for an explanation I came across a wonderful book called Soil and Soul by Alastair McIntosh.“We yearn for connection with one another, and with the soul” McIntosh writes, “but we forget that, like the earthworm, we too are an organism of the soil. We too need grounding”.

Resilience and systems thinking, I concluded from McIntosh’s book, will never be transformational in the absence of systems feeling. But how? Asking researchers to empathise with earthworms feels like a big ask. For every designer learning how to think like a forest by tasting one, as we did on Grinda, thousands more spend most of their time in studios, online, or within the rarefied walls of the research economy.

Perhaps my search for a ‘solution’ to the ecoliteracy ‘problem’ is old-fashioned. In a post-Xskool reflection, Helen Silvander wrote: “If we truly want people to value nature and food from a sustainable point of view, maybe we should allow them to fight for it a bit. Instead of simplifying, maybe we should de-organise. Instead of widening the path, maybe we should explore what happens when we erase it, and let time be the currency of payment”.

Here is the Xskool Facebook page.  I also gave this year’s Xskoolers a Food Systems ReaderXskool  was a partnership between Doors of Perception, Konstfack, and FuturePerfect Festival. This event builds on a series of experimental Xskool encounters over the last three years including Xskool Grinda 2013.


For this year’s UnBox Festival in New Delhi (12-14 December) I’ll be joining Mansi Gupta for a workshop to develop the programme of the Kanpur Design Innovation Lab. The project embodies, in Mansi’s words, “a new story about the leather industry and the people who work in it”. The Lab, situated at the heart of India’s largest leather-producing region, will develop products and services that combine clean forms of leather making with direct connections between between producers and customers. If I have any say in the matter, I’ll also be re-visiting the subject of cycle commerce  and my modest proposal for the de-motorisation of Delhi. 


Reyjkjavik, 11 September, Nordic Housing Association
Reyjkjavik, 12 September, Iceland Academy of Arts, MA Design Workshop (Tel +354 552 4000)
Eindhoven, 15 September, Plaza Futura at Club Natlab
Växjö, Sweden, 24 September, Linnaeus University
Oslo 15 October System Oriented Design Conference
Dundee, 22 October Chiasma, Sustaining Rural Scotland
Buenos Aires, 28 October, International Design Festival
Amsterdam, 20 November, Pakhuis de Zwijger, De energieke samenleving


Contact me by email at  john (at) doorsofperception (dot) com
Twitter @johnthackara


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Reading Small Signals



We’ve invested huge resources over the ages to keep the man-made world, and nature, separate – but there are signs everywhere that those those priorities are changing. Working through the consequences of that is a challenge for us all.

Many signals of change are small on their own but, taken together, tell a new story. There’s the new scheme in England, called Hummingtree, that connects office-bound workers with living systems by means of a ‘wild mirror’; each workspace is twinned with an equivalent patch of forest that’s being regenerated. In gritty Oakland, I learned that urban forests, living walls, and green roofs are being used to filter air, water and soil in and around its ports. I also saw the ad for a ‘wildflower farm apprentice’ to help a social enterprise trade wildflower seeds; that kind of work didn’t exist a few years ago. Neither did de-paving, food co-ops, river restoration, edible forestry, or pollinator pathways – but examples like these are cropping up all over. At multiple scales, this combination of social and ecolgical innovation adds up to living concepts of infrastructure.

The how is as important as the why. Back in England there’s the small farm that has 8000 landlords. Shares in the farm cannot be traded on the open market, but this shared ownership model enables the community to share responsibility – with the farmer – for growing food. This approach would be a great addition to a project I visited in California called The Food Commons. Launched at the epicentre of global agribusiness, this inspiring prototype combines social, political and technical innovation.

Other signals of change are so scattered that they can go unnoticed. In China, so-called ‘battery-bikes’ are outselling cars by four-to-one – but this story is missing from Western media. In The Two-Wheeled City I argue that a system-wide phase-shift in transportation is gathering pace. In Belgium, a project called Mobilotoop, about cloud commuting, is further evidence of an asset-light mobility ecosystem in which networks are used to share equipment and infrastructure. (I describe other ingredients to help a cycle commerce ecosystem flourish in Cycle Commerce: The Red Blood Cells of a Smart City).

Some signals of change point in contradictory directions. In Ethiopia, an inspiring social enterprise called Sole Rebels –  the world’s first Fair Trade shoe brand – employs and trains highly marginalized people; uses organic and bio-based materials; and obtains its leather from free-range cattle herders. But Sole Rebels must compete with a vast new project called Shoe City, also in Ethiopia, whose 200,000 guest workers are paid ten times less than workers on China.

Two recent texts of mine – A Whole New Cloth: Politics and the Fashion System, and Keep Your Stuff Alive – explore this core dilemma for fashion: despite more than 400 eco labels, an incremental ‘do less harm’ approach has addressed the symptoms, but not the principal cause, of our difficulties – a perpetual growth economy.

Some brightly flashing signals divert our attention from more important developments. Last December’s G8 Dementia Summit, for example, grumpeted the fact that one hundred million pounds will now be spent in a race to identify a cure or a ‘disease-modifying therapy’ for dementia. In The Dementia Care Economy I argue that the likely outcome will be the creation of a Dementia Industrial Complex – and the mass production of un-met expectations. Recent personal experience has reinforced my strong belief that the presence of human beings – not labour-saving technology – should be the priority.

The most promising innovations in the ways we care for each other – from child care, to dementia support – involve collaborative service networks. These empower family members and volunteers to work in equal and reciprocal relationship with professionals. In a conversation with Michel Bauwens, founder of the P2P network, I learned that the rise of social co-operatives represents a new frontier in the shifting boundaries of public, private, and commercial spheres. In global law and governance, too, the concept of Buen Vivir or “good living” manifests a political concept of citizenship that includes all life, not just human life.

Although, taken together, these signals tell a new story about where we’re headed, the story remains stubbornly obscure. In The Desert Of The Real – my contribution to the Puma Sustainable Design Lecture series – I argue that we need to cultivate greater perceptual diversity, and new ways of knowing, if we’re to meet our ecological responsibility towards future generations.


My talks and Xskool workshops – which you can read more about here and here – explore the above questions in unique contexts: What are the key social-ecological systems in this place? how night one design in them? and, how does one get started?


Contact me (John Thackara, Doors of Perception) by email at  john (at) doorsofperception (dot) com
Twitter @johnthackara

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When Tech In Care Is Evil

I spent the last two weeks in-and-around a care home in England that looks after people with dementia and terminal illness, and their families – including, this time, mine.

In four wings, each with 12 residents, 24/7 care is provided by teams of trained professionals who work 12 hour shifts. During the day, for each wing, three carers and a qualified nurse work continuously within yards of the residents; at night, cover is provided by a carer and a nurse.

Their hour-by-hour duties include helping people eat and drink;  changing clothes and bed linen; helping people shower and clean; cutting finger and toe nails; helping people use toilets, bed pans, sanitation pads, and commodes; filling in forms; attending staff training sessions.

A lot of the time – a lot – carers sit and talk with the residents, reassure them, read books or magazines together, or simply hold their hands, or hug them.

Twice a day, it’s true, one of the nurses would tour each wing to give medicines to the residents; a few residents needed more intensive medical attention. But I reckon that ninety five per cent of this demanding, time-consuming and emotionally-draining work involved caring – not doctoring, and not ‘curing’.

In my family’s case, we saw a doctor twice during those weeks. The first was when a non-resident General Practitioner (family doctor) popped in for ten minutes, did not sit down, nor look any of us in the eye. He waved a Do Not Resuscitate form around like an election pamphlet, and then left. The second doctor, another GP, came later, at the end – as some regulation or other prescribed –  to pronounce my family member officially dead. He performed this service with grace and tact.

These discordant intrusions by doctors did not matter. Those final hours were peaceful, even beautiful, thanks to the quiet, attentive and  loving care of the people who surrounded us in the home.

A few hours later, when I turned on the television for the first time in weeks, it was to see the UK prime minister, in London, addressing a room full of people clad in smart suits and name badges.


Speaking in forceful, Churchillian, style, Mr Cameron declared that “we must fight dementia” and announced a £100 million global research project to find a cure. “I know some people will say that it’s not possible”, said Mr Cameron, “but I will not be defeatist. With a big global push we can beat this”.

As I wrote back in December, after the G8 Summit on dementia, the likely outcome of this so-called “race to identify a cure” for dementia will be the creation of a Dementia Industrial Complex. It will  run by-and-for the glossily-clad experts in Mr Cameron’s audience – and it will do literally nothing to support the low-paid care workers that supported my family and thousands of others like it  in recent weeks.

Neither patients nor carers are even represented – not at all – on the much trumpeted World Dementia Council that was set up after the G8 Summit.

It’s dispiriting, but not surprising, to witness politicians parroting the false promises of the Tech lobby. But it’s a tragedy to see that an organisation that once represented carers has jumped onto the same bandwagon.

With its Dementia Friendly Technology Charter, the Alzheimer’s Society has given its imprimateur to the implausible notion that technology – rather than the presence of human beings – is the best way to enable people with dementia to live independently.

It’s doubly depressing that the Society asked a for-profit tech company, Tunstall Heathcare, to write its ‘charter’. Write its own orders would be more accurate. It is Tunstall ‘s corporate mission that, when it comes to dementia care , we can and should, “buy” peace of mind. “Just press the button” promises Tunstall, “and one of our operators will be on the line.” 

And then?

I know I’m emotional right now, but I’ve reflected on this a lot over several years and believe it has to be said: The notion that technology can substitute for the presence and care of human beings in care is not just misguided. It’s evil.

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