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Revolution Now

Teachings from the Global South for Revolutionaries in the Global North

Logo of The Federation Cuban Women
Howard Waitzkin is Distinguished Professor Emeritus of Sociology at the University of New Mexico and practices internal medicine part-time in New Mexico and Illinois. He is coauthor, with the Working Group for Health Beyond Capitalism, of Health Care Under the Knife, forthcoming from Monthly Review Press.

Seen from the global South, U.S. elections inspire jokes about the deeply flawed democracy that the United States seeks to impose on the rest of the world.1 When democratically elected governments try to challenge the global capitalist system, they become targets for military intervention, coups d’état, and furious attempts to destabilize their political and economic systems.2 So defects of the U.S. electoral system become glaring: scheduling election days on workdays rather than national holidays or Sundays; buying politicians through campaign contributions and other financial support; creation of false consciousness through manipulation of the media; and apathy, non-participation, intimidation, and exclusion of U.S. voters through complex voter registration requirements, insufficient polling places and staffing, and similar maneuvers that discourage voters from voting—leading in this case to Trump’s so-called triumph when he received votes from less than 25 percent of eligible voters and less than one-sixth of all citizens, lost the popular vote, and faced no run-off election.

From this vantage point, two conclusions emerge.

First, elections are not the point. Elections play only a small role in the struggle to transform oppressive social conditions, and the role that elections do play is to clarify the need for much more fundamental revolutionary strategy. As public health nurse and anarchist Emma Goldman pointed out long ago, elections are mostly symbolic actions that never in themselves bring fundamental change. She is often said to have remarked that “if voting changed anything, they’d have made it illegal long ago.”3

The understandable longing of voters for humane government and responsive leadership, chosen through elections, belongs in the proverbial dustbin of history, because that desire has been realized rarely if ever. Since the origins of so-called democracy during the Athenian empire, elections have remained the tool of rich and powerful elites. Capitalism has only magnified the inherent class characteristics of electoral processes.

With rare exceptions, what Karl Marx and others called “bourgeois democracy” prevails throughout the world. Such democracy enacts a symbolic ritual of voting. As the great left-wing Canadian politician Tommy Douglas put it, mice vote for white cats or black cats, but never for mice.4 So the problem we face now is not just Trump as neofascist, racist, sexist, and xenophobe, but rather a system that assures its elected leader will be Trump as lion or Clinton as lioness—either way a representative of the feline class. It is this system that must change, not the candidates who become the anthropomorphized symbols of the system. And decades before Douglas, according to Vladimir Lenin, Marx described the same process less metaphorically: “Every once in a while, the oppressed are allowed to decide which particular representatives of the oppressing class will represent them and oppress them.”5

Second, revolution is the point. One reason why we rodents, sometimes depicted as the 99 percent, find it so hard to recognize the lunacy of our aspirations to elect good people to run good governments involves our illusions about what government is and where it resides. The state in which elected government resides is the capitalist state; it is not a neutral state, let alone a state designed to benefit anyone other than the small group of those at the top of the pyramid of wealth and power who control the state. Time and again, political-economic realities have confirmed Marx and Frederick Engels’s claim that the main role of the capitalist state is to protect the capitalist system, or, to use their metaphor, the state is the “executive committee of the bourgeoisie.”6

We nevertheless cling to the illusion that the capitalist state can become a benevolent entity. National health programs, championed by activists like me, are components of a generous welfare state, as are public education, housing, livable wages, adequate food, transportation, and more.7 The modern welfare state took hold in several European countries after the Great Depression and further expanded after the Second World War, as an emerging Keynesian consensus encouraged high levels of government spending. These welfare states also became models for development in some countries of the global South.

But the capitalist welfare state has always suffered from inherent contradictions. First, its services and programs remain vulnerable to cuts or elimination during economic crises, as the recent turn toward austerity in much of Europe has shown.8 Important public programs of the welfare state shrink or disappear as that other key function of the capitalist state—protecting the capitalist economic system—gears up to address the system’s recurrent crises.

Second, these welfare services also contribute to a false consciousness and hegemonic beliefs about the capitalist state’s beneficent potentialities. This ideological impact has been called the state’s “legitimation function.”9 By providing helpful and even vital services, the capitalist welfare state legitimates the continuing inequality and exploitation inherent in the system.10

Many of us respond to the suffering we encounter everywhere by advocating for the expansion or, at least, the maintenance of the capitalist state’s welfare protections. We do so even though we understand that they remain perpetually vulnerable and legitimate a system that inherently causes exploitation, inequality, hunger, ill health, and early death. And we persist in advocating for the welfare state although we know that what people in the global South call “savage capitalism” has become weaker and more desperate amid deepening economic crises, a loss of political legitimacy, and environmental devastation that threatens the survival of humanity and other life forms.

In short, we have entered a period of history fraught with danger but also rich with revolutionary potential. It is time to move beyond our illusions that electoral politics and reforms of the capitalist state can achieve the revolutionary changes that we all know are urgently needed. What is the nature of that revolution, and what is its eventual aim? The recent history of the global South presents some important information and examples.

What Revolution?

In a conversation widely discussed in Latin America, which he later claimed not to remember, Steve Bannon, President Trump’s political advisor, claimed that his goal was the same as Lenin’s: to “destroy the state.”11 Later Bannon made a more limited promise to “deconstruct the administrative state.”12 Unlike Bannon, of course, Lenin wanted to destroy the capitalist state, in order to achieve a more just, equal, and humane society under socialism.13 Bannon instead wants to destroy only the regulatory and welfare functions of the capitalist state (what he terms the “administrative state”), but not those parts, especially its policing and military components, that protect the capitalist economic system.

Lenin’s work still inspires revolutionaries worldwide, even non-Leninists. A century ago, Lenin wrote that imperialism would become capitalism’s final historical stage, when, he accurately predicted, two realms would emerge as the key sources for capital accumulation.14 First, the capitalist economy would switch to the expansion of finance capital and away from production of useful goods and services. Financialization now creates fictions such as packages of risk, derivatives, and futures. These fictitious items involve gambles on the future valuation of an imaginary reality that does not correspond to any concrete economic good, service, or property. Second, during this late stage of “moribund capitalism,” Lenin predicted, perpetual war would become a second key source of capital accumulation. In what Naomi Klein and others have called “disaster capitalism,” perpetual war creates disasters, usually in the name of anti-terrorism, so that corporate actors can open new markets and opportunities for investment by strengthening “security” and reconstructing war-torn societies.15 In other words, global capitalism’s twin foundations are compulsive gambling and compulsive war.

Despite these structural weaknesses, the capitalist class will fight ferociously to preserve its power and wealth, but the highly touted resilience of capitalism cannot persist much longer. The feared collapse of world capitalism leads to calls among its proponents to address such contradictions as climate change, worsening inequality that reduces consumers’ ability to buy products and services, and so forth. Such patchwork proposals to save capitalism by reforming it will not succeed, because they do not resolve the fundamental contradictions underlying the system, especially its requirement for economic growth that places insatiable demands on the planet’s natural resources, leading to ecological disasters like climate change.

So the time for revolution has arrived, and it is time to act. But how?

Lenin’s revolutionary proposals and actions were contradictory.16 Sometimes he advocated decentralized, democratic decision-making at the community level. For Lenin, this model of local revolutionary action would become the process of governance after the capitalist state ceased to exist. It also was the model of “permanent revolution” advocated by Leon Trotsky when he was collaborating with Lenin. This model included some principles stemming from anarchism, whose leaders including Mikhail Bakunin and Peter Kropotkin, had called for decentralized, community-focused governance without an overarching state. But in the specific context of the Bolshevik Revolution, Lenin also put forward the model of the “vanguard party,” which provided top-down leadership during a transitional period, when a centralized state still was necessary mainly to deal with counterrevolutionaries. After Lenin’s death, Joseph Stalin co-opted the vanguard party to consolidate a pseudo-socialist state, a ruthless elite, a new class privilege, and repression that stifled local governance.

Through subsequent decades, the same struggles have emerged in essentially all revolutionary struggles. In China, Vietnam, multiple countries of Africa, and throughout Latin America, revolutions have vacillated between tendencies to implement top-down, elite governance by self-appointed leaders considering themselves a vanguard, versus tendencies to implement decentralized, participatory, equalitarian, and more radically democratic governance. When they have failed, revolutions aiming to replace capitalism usually have collapsed due to a combination of external destabilization or direct military invasion by countries of the global North, and/or inability to resolve the dialectic of top-down versus bottom-up governance.

But not all revolutions have failed, and there is much to learn from recent struggles in the global South. These lessons come especially from countries where revolutions have achieved large redistributions of wealth and improvements in health, life expectancy, education, nutrition, and overall standard of living. Yet all countries making such revolutionary changes have remained vulnerable to external and internal destabilization campaigns, corruption, and difficult concessions to the world capitalist system, and these weaknesses or outright failures also have much to teach.

First, the dialectic of top-down versus bottom-up governance persists, and the most successful situations involve welcoming the inherent conflicts of the dialectic rather than rejecting them. From my own experience, Cuba and Bolivia provide favorable though imperfect examples. In Cuba, local elections happen as part of Poder Popular (People’s Power), at the level of municipalities. These elections often involve hotly contested electoral campaigns, in which people who are not members of the Communist Party (CP) compete with CP activists and frequently win seats on the municipal councils that implement day-to-day governance. The prominence of women and Afro-Cuban leaders at all levels of the Cuban Revolution has fostered local activism, stimulated especially by people like Wilma Espín, Celia Sánchez, Haydée Santamaría, Mariela Castro, and others who spearheaded the Federation of Cuban Women, the Committees for the Defense of the Revolution, the community-level cultural programs of Casa de las Américas, and the movement for LGBTQ rights. The municipal councils elect representatives to the regional assemblies and from there to the national assembly that makes domestic and foreign policy decisions for the country. In recent Poder Popular elections, prominent dissidents have run for office and generally have lost by large margins. Many of Cuba’s most important policy shifts, such as permitting foreign travel, earning income abroad, small business development, access to the internet, and selling and buying homes, have emerged from pressures exerted from the municipal councils of Poder Popular.17 A tremendous irony in the depiction of Cuba by the U.S. media and government involves the erasure of this participatory democracy, contrasting with relative apathy and non-participation under U.S. bourgeois electoral democracy.

Some Bolivian activists who struggled during the “water wars,” which blocked the privatization of indigenous water supplies and ultimately led to Evo Morales’s election as president, have declined to participate in the government. Instead, they have formed coalitions, which have functioned in advisory roles and also intermittently as a kind of supportive opposition to government policies. The Bolivian constitution, which resulted from a broad interactive process between the Morales government and community-based groups, explicitly grants rights of self-determination and autonomy to indigenous organizations, women and children, and even Pachamama (Mother Earth). Environmental concerns also have generated explicit resistance in Bolivia, as noted below. In Bolivia as in Cuba, such ongoing dialectic processes of national leadership versus community-based governance appear to be deepening rather than dissipating.

A second lesson from the global South is that revolution does not involve a dichotomous choice between violent versus non-violent paths. Most revolutions involve both military and non-military components, but the non-military components always move beyond electoral politics to include direct actions that cripple business as usual in the economic and political realms. Usually, when we consider violent revolutions to overthrow oppressive regimes, we think of countries like Cuba, Nicaragua, Vietnam, and Angola, as well as the bigger predecessors of China and Russia. Before turning to violence, the leaders of all those revolutions had agitated through political struggles that did not initially involve arms. But the brutality of the dictatorial regimes proved so great that no option other than armed struggle appeared viable. In all those countries, the revolutionary movements developed military and political wings. The political wings engaged in courageous non-violent actions and civil disobedience to stop business as usual. And those raising arms did so with the usual ambivalences about injuring and killing other beings, usually those conscripted or hired to fight on behalf of rulers who rarely risk making their bodies vulnerable in battle. The human psyche usually justifies this kind of violence by invoking some variant of what Che Guevara called the revolutionary motivation of love.

Other countries were able to pursue the so-called peaceful road of revolution, with little or no military action and with a predominance of non-violent activism. For many years, Chile’s peaceful road stood as a painful reminder that the transnational capitalist class will not surrender its privileges willingly. As a result, the peaceful road creates a deep vulnerability to military coups as well as non-military interventions to undermine revolutionary governments through economic sanctions, paying opposition media and organizations to demonstrate and to sabotage programs, and a host of other tactics financed and choreographed by the CIA and other intelligence agencies, international financial institutions like the World Bank and International Monetary Fund, and multinational corporations.

Despite this painful precedent, the decline of U.S. imperialism and its inability to intervene militarily in every country where elected governments reject the capitalist model contributed to a resurgence of peaceful revolutions in Latin America, with subsequent attempts led by the United States to subvert elected governments with non-military methods. Electoral victories of the left occurred in (listed arbitrarily from north to south) El Salvador, Honduras, Venezuela, Brazil, Ecuador, Bolivia, Paraguay, Uruguay, Chile, and Argentina. In Mexico, electoral fraud and right-wing media orchestrated by the same operatives who stole two presidential elections for George W. Bush prevented a leftist electoral transition, and similar events occurred in Colombia and later in Argentina. Legislative coups heavily supported by U.S. tax dollars and orchestrated by the CIA and State Department under Hillary Clinton and John Kerry resulted in the ouster of elected left-wing presidents in Honduras, Paraguay, and most recently Brazil. Falling oil prices have deeply hurt the progressive agendas of several Latin American oil producing countries, especially Venezuela, Ecuador, and Brazil.18 As predictably happens with such destabilization campaigns, setbacks occur in the voting that remains as a constitutional relic of bourgeois electoral democracy.

In all these countries, however, electoral politics have become a small part of revolutionary struggle, which persists and grows despite the ebbs and flows of election results. Instead, non-violent but disruptive strategies have become the main engine of social change. Such tactics stop capitalist business as usual by blocking transportation, utilities, and needed services. Historically, these tactics occurred in countries where progressive governments later were elected. For instance, in El Salvador, doctors and other health professionals successfully blocked the World Bank’s proposal to privatize the country’s public hospitals and clinics; they did so by going on strike for months and organizing massive demonstrations while continuing to provide emergency services. In Bolivia’s water wars, indigenous communities blocked transportation links and occupied urban centers.19

Militant, nonviolent resistance advances in other countries, as indicated by only a few examples. Massive mobilizations by students and their supporters in Chile have blocked proposals by the government of Michelle Bachelet for tuition hikes and privatized components of public educational institutions. Strikes increasingly have paralyzed economic production under newly installed right-wing governments in Argentina and Brazil. In Mexico, demonstrations halted at least temporarily further increases in gasoline prices (gasolinazos) that resulted from privatizing much of the Mexican oil industry; the practice of “milking” (ordeña) gasoline from pipelines has increased rapidly at more than 1,800 local siphoning sites; the Zapatistas still exercise military control unofficially in a vast swath of southern Mexico; and the Movement of National Regeneration (Movimiento Regeneración Nacional, MORENA) has organized popular resistance, educational and health projects, cooperative food production and distribution, and similar actions outside the traditional capitalist economy.20

Importantly, such nonviolent but disruptive protests have continued under the elected progressive governments in Latin America. In Bolivia, indigenous communities again have blocked transportation and communication links to resist mining, oil and gas extraction, and highway construction.21 This struggle has focused partly on the Isiboro Sécure National Park and Indigenous Territory (Territorio Indígena y Parque Nacional Isiboro Sécure, TIPNIS). The territory includes northern Cochabamba province, where Morales emerged as one leader in the water wars. Intense conflicts have occurred between some indigenous communities in the TIPNIS and the Movimiento al Socialismo (Movement for Socialism, MAS) led by Morales.

Since 2006, MAS has proposed development projects for TIPNIS. In addition to engineering collaboration between the Bolivian and Venezuelan militaries in building a highway, state-owned energy corporations in Venezuela, Argentina, and Brazil are participating, as well as private corporations in Spain and France. Arguments for such “extractivist” projects refer to “resource nationalism,” portrayed as an anti-imperialist policy to increase public revenues that permit redistribution of wealth and improvement of public services.

In the poorest country of South America, MAS has received accolades for achievements in reducing poverty and improving indicators of health, education, housing, and nutrition. But criticisms focus on threats to Bolivia’s fragile ecology and emergence of a new indigenous bourgeoisie (burguesía chola). A cynical environmentalism also has arisen among elements of Bolivia’s aristocracy, who have supported TIPNIS activists and have aligned with Bolivia’s Green Party against MAS. As a largely indigenous movement for socialism struggles with indigenous communities carrying out demonstrations, marches, and civil disobedience on behalf of the environment, the dialectical cauldron of Bolivia’s revolution continues to simmer.

Similar mobilizations by indigenous communities and their supporters have resisted petroleum extraction and mining in Ecuador.22 Like Bolivia, Ecuador enacted a new constitution that protected the rights of Pachamama and also officially prioritized Sumak Kawsay, which in Quechua signifies “good living” in harmony with nature (buen vivir in Spanish). Ecuador also has achieved impressive improvements in poverty and quality of life indicators.

In 2007, Ecuador’s president, Rafael Correa, announced the Yasuní-ITT initiative. Located in the region where the Amazon River basin meets the Andes, the Yasuní National Park is a biodiverse rainforest that reportedly contains the largest variety of tree and insect species on the planet. Yasuní also holds three huge oil deposits (Ishpingo, Tiputini, and Tambococha, “ITT”). Correa proposed leaving this oil in the ground, thereby preventing 410 metric tons of carbon dioxide from reaching the atmosphere, in exchange for $3.6 billion, which equaled half the estimated revenues lost by not extracting the oil. International donors responded by pledging $336 million, of which $13.3 million was delivered. In 2013, referring to donors’ hypocrisy, Ecuador’s government abandoned the Yasuní-ITT initiative and permitted some oil extraction by Chinese state corporations.

Indigenous communities and activist organizations responded with anger and sustained opposition. Demonstrations and civil disobedience have taken place within and near Yasuní, in regions affected by mining, and in urban areas where indigenous organizations and ecology-oriented supporters have protested. The Correa-led government reacted with harsh police and military actions and tried to shut down environmentalist organizations. Criticism mounted when documents revealed that the government had been negotiating secretly about Chinese participation if the Yasuní initiative failed.

In the 2017 presidential election, many indigenous communities and environmental organizations refused to vote for Correa’s vice president, Lenín Moreno, who won by a close margin. Social medicine activists also recommended voting against him, due to the Correa administration’s accommodation of multinational pharmaceutical and health insurance corporations. Moreno’s track record includes activism for the environment, indigenous rights, redistributional economic policies, and struggles against neoliberalism. Early in Moreno’s presidency, he has initiated pardons and dialogue with indigenous and environmentalist groups that had experienced repression for resisting policies of the Correa administration.23 He has promised to protect Julian Assange, still living in asylum since 2012 within Ecuador’s London embassy. Moreno’s parents, living in the Ecuadorian Amazon, named him to honor Vladimir Lenin. As a psychologist and disability rights activist, himself paraplegic and wheelchair bound after getting shot in a robbery, Moreno attributes his own healing to laughter therapy and has published widely on the therapeutic benefits of humor. So “the world’s best jokes” now enter Ecuador’s intense revolutionary process.24

A third lesson from the global South concerns transition from the capitalist state. I already have considered the models of Poder Popular in Cuba and the consultative relationships between government and community-based groups in Bolivia. However, the transition to a non-capitalist state attempted in Venezuela, even if it does not succeed, gives the most explicit attention to this very challenging transition.

Hugo Chávez and comrades tried to develop a road on which the capitalist state would transform. The goal was a socialist state rooted in community-based power but not linked to the symbolic elections of bourgeois democracy. In this effort, Venezuelan revolutionaries studied and sought advice from many around the world, but particularly István Mészáros. Chávez frequently referred to Mészáros’s book Beyond Capital as a model for Venezuela’s Bolivarian Revolution.25

Mészáros’s vision of transition involves the creation of local communes that govern through radical democratic principles of communication, debate, and consensus. As Mészáros recognizes but does not emphasize, the vision resembles that of Lenin and Trotsky when they spearheaded the development of local communal governance in the Soviet Union, before Lenin’s death, Stalin’s usurpation of power, and Trotsky’s murder. Local governance also occurs in Cuba under Poder Popular, and communal structures are evolving there as well, especially through agricultural cooperatives. Ironically, such communal structures also resemble those advocated by Bakunin, Kropotkin, and others in the anarchist tradition. As envisioned by Mészáros, Chávez, and revolutionaries influenced by them, the local communes eventually assume the main responsibility for governance in the post-capitalist state and choose the national leaders who implement policies shaped mostly from below.26

In Venezuela, the Bolivarian Revolution led by Chávez supported financially and logistically the formation of local communes, eventually numbering in the thousands. Among other criteria, the approval process involved formalized planning that specified how decision-making would occur and what productivity goals the communes would meet. The communal structure in Venezuela meshed with community-based initiatives, called misiones (missions); the best known has been Misión Barrio Adentro (Mission of the Neighborhood Within), which focuses on improving accessibility of health services, partly in collaboration with Cuban physicians.

Communal development in Venezuela has faced tremendous challenges. Low productivity and corruption have plagued some of the communes. Communal transition has suffered from hostile actions by the United States and the transnational capitalist class, reduced oil prices, Chávez’s death from cancer, and questionable directions under the government led by Nicolás Maduro. Yet the communes remain one reason that elements of the Bolivarian Revolution endure, despite elections whose symbolism no longer corresponds to the social realities of struggle.

Ways to Make a Revolution in the United States

Is there a military route to revolution in the United States? We do see at least one predominantly positive example of a post-capitalist state created through violent revolution: Cuba. Sadly, other countries transitioning from capitalism through military means have wound up implementing systems involving strong elements of a capitalist economy. That said, some of the countries in this group (for instance Nicaragua, China, Vietnam, and Angola) have improved health outcomes, education, housing, and other quality of life indicators for large parts of their populations. Also, taking up arms as a defensive strategy comprises a crucial part of the U.S. experience.27 For these and other reasons, a military wing of a revolutionary movement in the United States may arise, as it has in many countries of the global South and some in the global North.

For those, including myself, who oppose violence or who cannot bring ourselves to injure or kill other human beings, the non-military wing of revolutionary action opens up exciting possibilities. Surprisingly, research shows that a small proportion of a country’s population, estimated at 3.5 to 5 percent, can achieve revolutionary change through nonviolent resistance, even in countries with dictatorial regimes much more brutal than the neofascist Trump administration.28 But these non-violent actions must move far beyond electoral politics to include direct action, whose conscious aim is to shut down the capitalist economic system and the state that protects that system.

Mass protests in the United States often involve huge, peaceful demonstrations, carried out with permits from the local police. The tremendous accomplishment of the women’s marches on Washington, D.C., and other cities around the world on the day after Trump’s inauguration, counts as probably the largest single protest action in the world’s history. Coordinated marches against war taxes, for science, and for the environment followed, as will others. Despite their importance, such actions do nothing to threaten, much less shut down, the capitalist system. Neither did the smaller protests on Inauguration Day that destroyed some property and led to felony arrests that will incapacitate key activists with legal proceedings and jail time for months or years to come. And neither did most of the Occupy actions in which many subjected ourselves to police brutality in order to hold a public space. These important non-violent actions reverberate mostly in the realm of symbolic politics.

What actions do slow or shut down the capitalist system? The heroic struggle to stop the Dakota Access Pipeline by indigenous communities is one such action. Here the explicit purpose has not been just to demonstrate against a monstrous, last-ditch effort to accumulate massive profits by robbing indigenous lands, polluting water supplies, and worsening climate change by burning oil. The purpose has been to stop the pipeline’s construction and to block transport of oil to refineries and eventually to “consumers.” Similar heroic struggles by indigenous communities to block oil transport have happened in Canada and Latin American countries including Bolivia and Ecuador.

So how might Latin American revolutionaries advise revolutionaries in the United States? Focusing on oil transportation, they would explain for starters that the Dakota Access Pipeline, as only one of many petroleum pipelines that traverse North America, lies four to five feet underground along 1,134 miles of geographically isolated territory in North Dakota, South Dakota, Iowa, and Illinois, vulnerable and largely unprotected from direct actions of many types. The pipeline originates in the Bakken shale oil fields in northwest North Dakota and terminates at the oil storage facility at Patoka Township in southern Illinois.29

Patoka probably would interest Latin American revolutionaries eager to shut down sectors of the capitalist economy and to block flow of fossil fuels. Google Maps and other sources show a quaint and sparsely populated agricultural area, with a highly concentrated collection of huge oil tanks that contrast with the surrounding farmlands, schools, shops, eateries, and pristine lakes used by folks who like to fish. The Dakota Access Pipeline and the BNSF rail yards where Bakken oil arrives by train are not the only interesting oil transport facilities that converge here. Patoka also is a main terminus for the Keystone and Keystone XL Pipelines, as well as the hub for existing pipelines used by Exxon Mobil, Marathon, and Shell. Energy Transfer Partners owns much of the storage infrastructure in Patoka, as well as pipelines carrying oil there and then to refineries mainly in Louisiana and Texas.30

In direct actions that target transport of fossil fuels, toxic chemicals, conventional and nuclear weapons, military equipment, precious metals, timber, and other items that keep the capitalist system afloat, revolutionaries may focus on pipelines, roads, waterways, air facilities, and so forth, many of them far from existing population centers and their associated security operations. The geographical distances and wide variety of potential targets means that activists need not restrict themselves to a small number of locations, where gatherings over periods of time increase vulnerability. Instead, fast actions that avoid what the U.S. military calls collateral damage to living beings and that move from place to place quickly interrupt the system’s smooth flow more than demonstrations that risk arrest and injuries for the sake of non-disruptive symbolism.31

Tactically, experiences in Latin America lead to the realization that actions can disrupt business as usual, even if disrupters disperse when they receive warnings that they are about to be arrested. Despite right-wing efforts to restrict demonstrations in several states, U.S. legalities do require warnings by police and military forces before arrests or physical attacks begin. Latin American revolutionaries have shown that blocking a highway, railway, port, or airport for quite a long time does not necessarily imply the need to block it until arrest or injury. One misconception about non-violent resistance involves the vision that one ethically needs to hang around until incarcerated, injured, or both.

Besides direct action, revolutionaries can change what we do with our money, especially in the realms of taxes, investments, and local economic activities. Such changes can disrupt, undermine, and create space for further revolutionary actions. We in the 99 percent persist as the main funders of the capitalist state, which passes our money on to corporations that exploit workers, destroy nature, raise the earth’s temperature, and keep us in permanent war and perpetual inequality. We need to change our habits of giving up our money, and if enough of us do so, the capitalist state no longer will be able to prop up the capitalist economy for the benefit of the ultra-rich.

Tax resistance can take several forms. For more than a century, pacifists in the United States have resisted taxes that pay for war, some eventually going to prison but the vast majority, like me, suffering no substantial harm as a result. As a card-carrying conscientious objector, I openly resisted half of my income taxes for more than a decade during and after the Vietnam War. If one honestly declares one’s income, there is nothing illegal about claiming a war deduction of 50 percent, which is the approximate percentage of the federal budget that pays for past, present, and future wars. Later, with a young daughter, I was starting to feel inconvenienced and a little bored by appeal procedures inside and outside the Internal Revenue Service because of open tax resistance. So I reluctantly made the same decision that Trump and his ilk make, to avoid taxes through loopholes rather than resistance of conscience.

The problem with either explicit or implicit tax resistance is that we number in the thousands rather than millions. “Death and taxes,” the two inevitabilities, as we are taught, seem hard to resist, but corporations and rich individuals understand very well that at least taxes actually are not inevitable. In Latin America, tax resistance usually proceeds according to the Trump model for corporations and the rich, but ordinary people can succeed in massive tax resistance through non-reporting or under-reporting of income. During the dictatorships in the Southern Cone, the autocratic governments had trouble raising sufficient tax revenues, despite extensive attempts through bureaucratic and police surveillance, and tax resistance became one of many tactics to bring down those regimes. Ironically, a major motivation in Cuba for allowing expansion of private small businesses involves a perception that private-sector business activities were expanding anyway, along with rampant tax evasion; if permitted officially, small businesses could generate substantial taxes for social programs. Even in Cuba, tax resistance has interacted with political organizing in Poder Popular and community-based organizations to enhance popular participation. As a revolutionary strategy in the United States, tax resistance must flourish, so millions of us stop functioning as the main financiers for the capitalist state.

Our investments also help corporations achieve the goals we despise. What happens to the money we save in our little bank or retirement accounts and pay for our mortgages, car loans, and credit card bills? Off that money goes to big banks that give loans to corporations for the Dakota Access Pipeline, arms manufacturing, privatized prisons and schools, pharmaceutical and for-profit health insurance companies, and more. Even if we invest in “socially conscious” funds, that usually means substituting “clean” drug, insurance, and technology companies for “dirty” tobacco and oil companies in our portfolios.

The movement to compel cities, universities, and other institutional investors to divest from banks that support pipelines, companies that sell fossil fuels, Israel, and a host of other destructive entities, while helpful, misses the point that we as millions of individuals and families are actually more important as aggregated investors than any of the institutional investors that we try to influence. Collectively, we need to seize control and move our investments into organizations that protect our planet, help our communities, and nurture non-capitalist economic enterprises. In Latin America, several companies taken over by workers follow these guidelines. And just as capitalists can “offshore” their investments, we can invest some of our earnings in radical organizations that do very well in the global South.

We also need to move our money into locally controlled economies not linked to the global capitalist system. Local responses to neoliberal austerity policies in Latin America and southern Europe have led to a clear understanding that communities can produce and consume most of the goods and services that they need through non-capitalist forms of cooperative social organization. Communities can develop markets, bartering procedures, and even currency so that participants create and share with each other on the basis of use value rather than exchange value, while drastically reducing the flow of their earnings into the global capitalist economy. As many affected by austerity already have learned, we really do not need global capitalism. We can live and thrive without the 1 percent easier than they can without us.

So what stands in our way? We ourselves stand in our way. Actions like these usually entail very small risk of bodily harm and a somewhat larger risk of inconvenience such as arrest. Reasons for inaction include emotions like fear, especially when we feel a need to protect those who depend on us, including children. Comfort and our illusions also slow us down, especially when believe we can make a big difference by winning the next round of elections in bourgeois democracy, or try to create a single payer health program within the capitalist state, or protect the environment, fight militarism, and so forth, all the while preserving a system whose inherently exploitative structure makes inevitable the weakening or reversal of whatever we accomplish.

As usual, it is wonderful to communicate about fear, comfort, and illusions with Latin American revolutionaries. For these comrades, fears about physical safety give way to confidence in the nurturance they receive from others and the pride of a life worth living. Worries about revolution yield to pleasures of the moment—eating and drinking with friends who are also comrades, knowing that on a deep level “mi casa es tu casa,” and dancing late into the night. And about illusions, they understand that a central characteristic of revolution involves counter-hegemonic struggle, in this case rejecting the crippling ideology that reforming small parts of a destructive system without changing the destructive system itself is somehow okay.

Such revolutionaries also realize that revolution is good for health and mental health. Growing evidence shows that people who engage in revolutionary struggle enjoy better health and mental health than non-revolutionaries, especially those who constantly fret about how capitalism ruins their lives but do little to change that.32 Radical activism is an upper, and despite setbacks it generates a high that comes from living life according to one’s deepest values, with beloved comrades who share “mutual aid.”33

Not acting to change the system generates despair about continuing to live on planet earth. Consider U.S. militarism through the lens of 20 suicides a day for veterans and one a day for active duty military personnel. During the wars in Afghanistan and Iraq, many more military personnel will die from suicide than from combat. What happens when veterans and soldiers cannot find a reason for the suffering they have inflicted and themselves experienced? During the decade and a half in the current round of U.S. warfare, no meaningful military goals have been accomplished, certainly not the prevention of terrorism, and GIs know that. Paul Sweezy commented that the U.S. health care system makes no sense until its real purpose, the accumulation of capital, becomes clear and the same goes for U.S. militarism.34 Veterans and GIs often sense that accumulation of capital is the real motive for war and therefore suffer from the “moral injury” that leads to suicide.35

So rather than wallowing in despair and thinking about suicide, why not have some fun and make the second and much more meaningful U.S. revolution? If not now, when? If we do not, we will miss a chance to transform our world that may not happen again.

In January 2017, I received an invitation to join a group of young revolutionaries in the small Midwestern city where I live. Trump won the election here by a narrow margin, mostly due to disgruntled workers who lost their jobs when factories moved to Mexico or Asia. At least three such groups are active in the city. Among the thirty-five or so people who come to weekly meetings, only five of us are older than twenty-eight. More than a third of the group have been to Standing Rock, among many other direct actions. Each week, the first order of business is to collect cell phones, computers, and other digital devices in another room with a closed door, as part of a “culture of security”; people take notes with pencils and notebooks rather than computers. First-name introductions are the next agenda item, and one week each person was to say what he or she felt grateful for. The meeting’s facilitator described his lively four-year-old niece. A woman mentioned the maple tree in her yard whose sap was flowing and providing delicious maple syrup. For the next hour, the group planned two local direct actions. As usual, the meeting ended with passing a basket for contributions to the group’s legal fund for bail and lawyers’ fees in case of arrests.

From everything I’ve learned, such groups are happening all over the United States. Who knows where all this will end?


  1. For the distinction between global South and global North, I like many others feel deeply indebted to the work of Samir Amin, who has illuminated the historical and contemporary importance of the exploited peripheries in the South and exploiting centers in the North. For instance, in this article I am trying to extend Amin’s recently expressed vision: “In the countries of the South, most people are victims of the system, whereas in the North, the majority are its beneficiaries…. The possible, but difficult, conjunction between the struggles of peoples in the South with those of peoples in the North is the only way to overcome the limitations of both.” See Samir Amin, “Revolution from North to South,” Monthly Review 69, no. 3 (July–August 2017): 113–27. I have established a tradition of experiencing U.S. presidential elections in the global South. In 2016, I watched from Paraguay and Argentina, where I attended the inspirational congress of the Latin American Association of Social Medicine and gave talks for students and unions of public-sector health workers.
  2. If we consider only Latin America since the 1950s, the United States has used direct military invasion or has supported military coups to overthrow elected governments in Guatemala, the Dominican Republic, Chile, Haiti, Grenada, and Panama. In addition, the United States has intervened with military action to suppress revolutionary movements in El Salvador, Nicaragua, and Bolivia. More recently, with a weakened economy and a military overextended in Afghanistan and Iraq, the United States has spent tax dollars to finance and help organize opposition groups and media in Honduras, Paraguay, and Brazil, leading to congressional impeachments of democratically elected presidents. Hillary Clinton presided over these efforts as Secretary of State in the Obama administration, which pursued the same pattern of destabilization in Venezuela, Ecuador, Argentina, Chile, and Bolivia.
  3. Emma Goldman, Anarchism and Other Essays, second ed. (New York: Mother Earth, 1911), available at These writings convey Goldman’s views about the futility of voting; the precise quotation, widely attributed to Goldman, actually does not appear in her published writings.
  4. Tommy Douglas – Mouseland,” YouTube, Douglas himself lived out his life as an attractive politician, frequently invoking class structure through the Mouseland metaphor but never moving the leftist Canadian New Democratic Party beyond efforts to reform capitalism. Still, the metaphor conveys the class-based, corrupt, and ineffective structure of bourgeois electoral democracy that must be transformed, rather than the appealing or revolting elected representatives of the moment.
  5. Vladimir I. Lenin, The State and Revolution (New York: International Publishers, 1935), chapter 5, available at
  6. Karl Marx and Frederick Engels, Manifesto of the Communist Party (New York: International Publishers, 1983). For instance, during the worldwide economic crisis of 2008, public-sector bailouts of the private sector created a type of socialism in the United States and other capitalist countries—public ownership to a substantial extent of the means of economic production and also of the system’s key financial institutions (Jon Meacham, “We Are All Socialists Now,” Newsweek, February 6, 2009). But it was a socialism for the rich, who then controlled even more wealth than they did before. By recent estimates, the concentration of wealth has increased in the United States to the point that the top 0.1 percent of the population controls as much wealth as the bottom 90 percent. Considering the world, as Oxfam has reported, eight men recently have controlled the same wealth as the bottom half of the world’s population (“Just 8 Men Own Same Wealth as Half the World,” Oxfam, January 15, 2017,, and “An Economy for the 99%” January 15, 2017); six months later, five men controlled this amount of wealth (Paul Buchheit, “Now Five Men Own Almost as Much Wealth as Half the World’s Population,” Nation of Change, June 12, 2017, http:// For a helpful overview, see Michael Yates, The Great Inequality (New York: Routledge, 2016).
  7. The neoliberal version involves programs like those of Colombia’s health reform of 1994, or Obamacare of 2010, or “universal health coverage” (the current darling of the World Bank, Rockefeller Foundation, Gates Foundation, and World Health Organization). Health activists in Latin America justifiably call such proposals “universal compulsory purchase of partial insurance coverage from private, for-profit corporations.” These proposals’ similar underlying structure allows rich and poor to continue receiving different coverage based on their ability to pay and private insurance corporations to make unprecedented profits due to public subsidies paid for by taxpayers. The non-neoliberal version of national health program proposals involves a single payer approach like Canada’s, where the payment system is socialized while most health care facilities remain privately owned, or a national health system like Sweden’s or Wales’, where all or almost all health care facilities are publicly owned. Both the single payer national health program and the national health system approaches allow rich and poor to receive the same health benefits. Howard Waitzkin and Ida Hellander, “Obamacare: The Neoliberal Model Comes Home to Roost in the United States—If We Let It,” Monthly Review 68, no. 1 (May 2016): 1-18; David Matthews, “The Battle for the National Health Service: England, Wales, and the Socialist Vision,” Monthly Review 68, no. 10 (March 2017): 25–35.
  8. Aaron Reeves, Martin McKee, and David Stuckler, “The Attack on Universal Health Coverage in Europe: Recession, Austerity and Unmet Needs,” European Journal of Public Health 25, no. 3 (2015): 364–65; Vicente Navarro and Carles Muntaner, eds., The Financial and Economic Crises and Their Impact on Health and Social Well-Being (Amityville, NY: Baywood, 2014); Adam Gaffney and Carles Muntaner, “Austerity and Health Care,” in Howard Waitzkin and the Working Group for Health Beyond Capitalism, Health Care Under the Knife (New York: Monthly Review Press, 2018, in press).
  9. Howard Waitzkin, Medicine and Public Health at the End of Empire (Boulder, CO: Paradigm, 2011), chapter 3, and The Second Sickness: Contradictions of Capitalist Health Care, revised ed. (Lanham, MD: Rowman and Littlefield, 2000), chapter 2; Claus Offe, Modernity and the State (Cambridge, MA: MIT Press, 1996).
  10. This legitimation function dates back to the initial traces of the welfare state in nineteenth-century Germany, as Chancellor Bismarck initiated the world’s first national health program explicitly as a method to win support from the working class and to prevent more fundamental revolutionary action. The “national socialism” of Nazi Germany actually functioned as a version of the welfare state, as it implemented a strong public sector that provided unprecedented benefits for its Aryan population (the so-called Volksgemeinschaft), including affordable housing, accessible education, food security, and even health services. Similarly, in the midst of massive unrest and episodes of revolt in the United States during the mid-1960s, Medicare and Medicaid became a tactic to prevent socialization of the entire health care system as part of a struggle to transform the capitalist economic system. Theodore Marmor, The Politics of Medicare, second ed. (Piscataway, NJ: Transaction, 2000); Francis Fox Piven and Richard Cloward, Regulating the Poor: The Functions of Public Welfare, second ed. (New York: Vintage, 1993).
  11. Ronald Radosh, “Steve Bannon, Trump’s Top Guy, Told Me He Was ‘A Leninist’ Who Wants To ‘Destroy the State,’” Daily Beast, August 22, 2016,
  12. Christopher Caldwell, “What Does Steve Bannon Want?New York Times, February 25, 2017.
  13. Lenin, The State and Revolution, chapters 1–2.
  14. Vladimir I. Lenin, Imperialism, the Highest Stage of Capitalism (Moscow: Progress Publishers, 1963), chapters 1, 3, 7, and 9, available at
  15. Naomi Klein, The Shock Doctrine (New York: Metropolitan, 2007), especially parts 3, 5–7.
  16. Two recent books respectfully clarify these and other contradictions in Lenin’s strategic work: Tamás Krausz, Reconstructing Lenin (New York: Monthly Review Press, 2015), chapters 3, 5–8; Tariq Ali, The Dilemmas of Lenin (London: Verso, 2017), section 3.
  17. For more on Poder Popular in Cuba, see: Richard Levins, “How to Visit a Socialist Country,” Monthly Review 61, no. 11 (April 2010): 1–27, and Peter Roman, People’s Power (Lanham, MD: Rowman and Littlefield, 2003). My own observations of People’s Power took place during 1978 in an industrial area of Havana during municipal debates on what Cuba’s policy should be toward Yemen, in a working-class neighborhood in Havana during 1988 as part of a study of how municipal People’s Power assisted primary care physicians in addressing social contextual problems that affected their patients’ health (Howard Waitzkin, The Politics of Medical Encounters: How Patients and Doctors Deal with Social Problems [New Haven, CT: Yale University Press, 1991], chapter 11), and in Santa Clara during 2008 in an intensely contested Poder Popular municipal election campaign.
  18. There also is some evidence, incompletely confirmed, that the United States colluded with Saudi Arabia to keep oil production high so that prices would fall to the lowest levels in years. For instance, President Nicolás Maduro of Venezuela has referred to this probable collusion, whose goals were to weaken not only progressive Latin American countries but also Russia and Iran. Andrew Cawthorne, “Maduro Blames Plunging Oil Prices on U.S. ‘War’ vs Russia, Venezuela,” Reuters, December 29, 2014.
  19. For more on these examples of non-violent struggle and civil disobedience, see: Waitzkin, Medicine and Public Health at the End of Empire, chapter 14; and Rebeca Jasso-Aguilar and Howard Waitzkin, “Resisting the Imperial Order and Building an Alternative Future in Medicine and Public Health,” Monthly Review 67, no. 3 (July-August 2015): 129-42.
  20. Carlos Navarro, “Fuel Thefts Increase Significantly in the Triángulo Rojo Region of Puebla State,” SourceMex 27, no. 11 (2017): 4–7.
  21. In addition to my own interviews, I am indebted to Rebeca Jasso-Aguilar for sharing some observations from her own research and activism in Bolivia, as well as the following sources: Territorio Indígena y Parque Nacional Siboro Sécure,; Emily Achtenberg, “Morales Greenlights TIPNIS Road, Oil and Gas Extraction in Bolivia’s National Parks,” North American Congress on Latin America (NACLA), June 15, 2015,; Bret Gustafson, “Close the NGOs: Asserting Sovereignty or Eroding Democracy?” NACLA, December 31, 2013; Linda Farthing, “The Left in Power,” Jacobin 25 (2017): 79–83.
  22. For the following comments about Ecuador, I rely on my own work there with colleagues in social medicine, who focus especially on the health implications of capitalism’s impact on ecology, as well as several publications that offer varying perspectives, including those of indigenous and non-governmental organizations opposing the environmental policies of the government led by Rafael Correa: “The Yasuní-ITT Initiative,” Amazon Watch, 2010,; David Hill, “Ecuador Pursued China Oil Deal While Pledging to Protect Yasuni, Papers Show,” Guardian, February 19, 2014; “Sumak Kawsay: Ancient Teachings of Indigenous Peoples,” Pachamama Alliance,; Xavier Maldonado, Érika Arteaga, and Juan Cuvi, “Políticas Neoliberales de Salud en el Gobierno de Correa,” ALAMES Ecuador, June 2017,; Moira Birss, “‘Buen Vivir’ for Whom?” NACLA, January 26, 2017; Gregory Wilpert, “The Left Prevails in Ecuador,” NACLA, April 11, 2017.
  23. Beatriz Villarreal Tobar, “INREDH Frente al Indulto de Patricio Meza,” Fundación Regional de Asesoría en Derechos Humanos,
  24. In addition to Los Mejores Chistes del Mundo (The World’s Best Jokes), Moreno’s books include Filosofía para la Vida y el Trabajo (Philosophy for Life and Work), Teoría y Práctica del Humor (Theory and Practice of Humor), and Cuentos No Ecológicos (Non-Ecological Tales). For more on these themes, see “Lenin Moreno, the Vice-President Who Leaves a Legacy of Happiness, Optimism, and Good Humor,” Agencia Pública de Noticias del Ecuador y Suramérica, May 22, 2013,
  25. István Mészáros, Beyond Capital (New York: Monthly Review Press, 2010), especially chapters 13, 19, and 20. For very helpful discussions of the applications of Mészáros’s work in Venezuela’s Bolivarian Revolution, especially concerning the communal transition, see: John Bellamy Foster, “Chávez and the Communal State: On the Transition to Socialism in Venezuela,” Monthly Review 66, no. 11 (April 2015): 1–17; Michael Lebowitz, The Socialist Imperative (New York: Monthly Review Press, 2015), chapters 5–6; and Marta Harnecker, A World To Build (New York: Monthly Review Press, 2015), chapters 7–9.
  26. A similar model of communal governance but with more anarchist roots has emerged in the autonomous region of Rojava in northern Syria, as part of the so-called Rojava Revolution. See, for instance, Michael Knapp, Anja Flach, and Ercan Ayboga, Revolution in Rojava (London: Pluto, 2016), chapters 5–7, 11–13.
  27. Especially because so many people in the United States have easy access to guns and because deep-seated violence based on racism and on progressive politics are so much part of U.S. tradition, obtaining weapons for self-defense by the Black Panther Party, Puerto Rican independence groups, American Indian tribes, and others has happened as an understandable response. Those actions have led to repression by police and military forces, plus at least some policy reforms. See Piven and Cloward, Regulating the Poor.
  28. Erica Chenoweth and Maria J. Stephan, Why Civil Resistance Works (New York: Columbia University Press, 2012); Erica Chenoweth, “It May Only Take 3.5% of the Population to Topple a Dictator—with Civil Resistance,” Guardian, February 1, 2017. If the relevant population of the United States, the world’s third most populous country (total population 324,420,000), includes eligible voters (231,557,000), 5 percent would involve 11,578,000 nonviolently resisting individuals. If instead the relevant population includes registered voters who actually voted in the 2016 presidential election (138,885,000), fundamental change could happen through concerted nonviolent action by about seven million people.
  29. Until the pipeline’s completion, crude oil has traveled in tank cars from Bakken to Patoka, mainly along the tracks of the Burlington Northern and Santa Fe (BNSF) Railway. Train accidents leading to environment destruction and injuries have happened along that route, including a derailment in Galena, Illinois, during 2015 that narrowly missed contaminating the nearby Mississippi River. Similar train accidents involving Bakken crude during 2015 contaminated a river in West Virginia and during 2013 killed 47 people in a Quebec town.
  30. Such attempts to understand the vulnerability of pipelines to non-violent interruption have emerged as an ongoing methodology in several countries, including Mexico, where as noted above milking of pipelines has become more common with the attempted privatization of Mexico’s oil industry; see Navarro, “Fuel Thefts Increase Significantly.”
  31. Actions targeting the infrastructure of corporate capitalism resemble the “roaming strikes” that have become a component of a resurgent labor movement. As Steve Early and others have pointed out, the elite leadership of the largely debilitated labor unions in the United States will not likely spearhead militant direct actions, for instance a general strike. However, the militancy of non-unionized workers in Fast Food Forward, OUR Walmart, Warehouse Workers United, Warehouse Workers for Justice, Fight for 15, and many similar struggles can achieve powerful effects by slowing or stopping production through a roaming but escalating strategy. See Steve Early, Save Our Unions (New York: Monthly Review Press, 2013). For more on the history of direct action in the United States, see L. A. Kauffman, Direct Action (London: Verso, 2017), and for similar direct actions against the Dakota Access Pipeline in addition to Standing Rock, see “Meet the Two Catholic Workers Who Secretly Sabotaged the Dakota Access Pipeline to Halt Construction,” Democracy Now, July 28, 2017,
  32. For only some items in the growing literature on the psychotherapeutic advantages of resistance and revolution, in addition to the work of Lenín Moreno mentioned above, see James Petras, “Neo-Liberalism, Popular Resistance and Mental Health,” James Petras Website, December 17, 2002,; Ignacio Martín-Baró, Writings for a Liberation Psychology (Cambridge, MA: Harvard University Press, 1994), chapter 1; Chitra Nagarajan, Shannon Harvey, Adam Ramsay, and Ezekiel Incorrigible, “Activists Talk Mental Health,” Transformation, April 14, 2014,; Carl Ratner, “Overcoming Pathological Normalcy: Mental Health Challenges in the Coming Transformation,” in Waitzkin and the Working Group for Health Beyond Capitalism, Health Care Under the Knife; and, of course, Franz Fanon, The Wretched of the Earth (New York: Grove, 2004 [1961]).
  33. For Peter Kropotkin’s underappreciated observation in the anarchist tradition, see Mutual Aid (Boston: Extending Horizon, 1914), chapters 7 and 8.
  34. See Barbara Ehrenreich’s comment in “Happy Birthday, Paul!Monthly Review 51, no. 11 (April 2000): 47–48.
  35. For more than a decade, my colleagues and I have coordinated a volunteer, civilian program that tries to meet the unmet needs for mental and physical health services among active duty GIs ( We hope that we contribute to peace by providing the services we do, although evidence for this connection is weak, so the simple humanitarian purpose of helping military victims of war who cannot get help elsewhere also motivates us. Half of the GIs who contact us are suicidal, and 70 percent are severely depressed or suffering from PTSD. In 2014, I had the privilege of presenting our work in a panel on military health and mental health at the meeting of the Latin American Social Medicine Association in El Salvador. Also participating on the panel were several Salvadoran comrades, who had delivered medical services during the country’s revolution, also known as a civil war. They were astonished to learn about the suicidality of U.S. veterans and soldiers and said they had never experienced a suicide of a Salvadoran revolutionary. Although they might have forgotten a person or two, their response conveyed the huge difference in psychological suffering between those who fight for what they believe is a worthy cause and those who struggle without knowing why.
2017, Volume 69, Issue 06 (November 2017)
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