Empowering governance for health equity
In 1978 in Niagara Falls, New York State, USA, more than 900 working class families were relocated away from a leaking toxic waste dump. The so-called Love Canal crisis triggered the development of a strong grassroots social justice movement that focused on protecting public health through building power to influence federal policies at the local as well as state level. It shows how common citizens through organization succeeded to translate knowledge into policy and practice (Gibbs, 2002). Also, the example of the Comites Comunales de Proteccion Civil in Acajutla, El Salvador (Carbonell, 2009) illustrates how local people and communities in the aftermath of Hurricane Mitch increased control over the way their cities are governed. (See Annex, Box 10)
On the other hand, Culley (2008:99) describes a community case study on power and public participation in a hazardous waste dispute and concludes that participation was limited. The real influence of citizens in this case was manipulated due to mechanisms such as agenda setting, control of resources, and the erecting of barriers to participation. In a similar vein, Zerah (2009:853), based upon a comparison of the differentiated impacts of participation in middle class colonies with those in slums, questions the participatory dimension of urban governance in Mumbai and concludes that it induced double standards of citizenship. New governance arrangements have contributed to empowerment of certain sectors of the population – the middle and upper middle class - who have expanded their claims on the city and the political space, while the urban poor have not benefited.
Zunino (2006) studied the differential capacity of actors to exert power in urban renewal and decision-making in Santiago, Chile. The paper concludes that the representatives from the central government and private investors controlled local redevelopment, while the local government and the people living near the urban renewal project ended up in non-influential positions. However, the initiative taken by the federation of the urban poor, in Phnom Penh and in Nairobi, appears to have induced a more positive outcome (ACHR, 2004).
Baccaro (2009:245) contributes with an analysis of formal deliberative bodies in South Africa, where discourses are mostly about the accommodation of existing interests, which will not easily contribute to coordination. Citizens are more likely to build communicative power in the informal public order in order to influence the formal decision-making process.