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content/research/maddeningrhythms.md

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 Maddening Rhythms is organized around 5 'factors', each centering one aspect of the Leboline's experiences and struggles and using it to introduce a broader reflection. We believe that reactivating some of the stories, techniques and imaginaries that came out of the struggles for health that took place in Italy in the 1960s and 1970s can be a useful exercise in our present days, in the aftermath of the Covid-19 syndemic, an event with a death poll that could have been, in large part, preventable. Connecting with the struggles that first obtained a public healthcare system might help us sharpen our demands for the future. 
 
 
-# Italian Healthcare struggles
 
-The aftermath of WWII saw a number of struggles for health to become recognised as a common good. Many people fought for health practices to be supported via the public sector, and for care to be made available universally and for free at the point of use (that is, paid for through general taxation).
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-Some of these struggles were more successful, other were less so, but whenever change came about it was not a top-down decision, but a result of complex mobilizations that often created transversal connections between those affected, organizers and professionals.
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-We focus on Italy not only because it is our context of origin, but also because during the decades 1960s and 1970s, it was an extremely lively political laboratory that became significant beyond its own context.
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-Italy in these decades was subjected to a fast industrialization that deeply altered the life and work patterns of many. Assembly line work, organised according to the principles of scientific management, was brutal, dangerous, poisonous and mentally alienating. It should come as no surprise therefore that the struggles for health were largely working class struggles, addressing simultaneously question related to conditions of labour at the workplace, environmental degradation, gender roles in the home and the desirability of technological innovation. 
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-In the aftermath of the decade-long neoliberal crisis of care and the more recent pandemic, many political imaginaries related to the protection of collective health rely on mutual aid and solidarity networks. Many of the initiatives that want care to be more accessible and inclusive are set up as self-organzised practices. Many activists and organizers are loudly critical of public healthcare provisions which are perceived as negligent and over-bureaucratic at best, incompetent and punitive at worst. 
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-Looking back at the Italian struggles for health of the 1960s and 1970s is a relevant tasks today as this history reminds us of a different possibility in orienting our political imaginaries. Rather than presenting autonomous and self-organzied practices as the opposite of languishing public infrastructures, they remind us that these very different alignment of forces is possible, as these  struggles led to the creation of a public health care system in 1978. 
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-The pressure for creating such public health care system was born from an unprecedented alliance between left political forces, advanced experiences renewing medical practice, radical health activism, struggles by trade unions, workers’ groups, student and feminist movements. The 1978 reform was a universal, public, free health service, offering a wide range of provision outside the market, largely modelled on the British NHS and reflecting the definition of health spelt out by the WHO in 1946.
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-Abandoning the tradition of a corporatist health system with its limited coverage of separate professional groups, Italy’s reform introduced a public and universal health service, financed through general taxation, freely available to all.
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-The link between the self-organized struggles and the new public system becomes apparent in the way it was designed in its original conception (albeit soon corrupted by a series of reactionary modification to the law).  In several areas – mental health, occupational health, women’s health, drug treatments - new knowledge on illness prevention, new practices of service delivery and innovative institutional arrangements emerged, with a strong emphasis on territorial services addressing together health and social needs. The movements' legacy was palpable in the integrated vision of health – physical and psychic, individual and collective, linked to the community and the territory – that emerged. The struggles were clear in their proposal: a new, less hierarchical type of doctor-patient relationship was needed; healthcare should be linked to territories and, as much as possible, conducted in participatory manner; preventive approaches, rather than curing, were central in this vision. This political strategy viewed health as combining a collective dimension and an individual condition; collective struggles were therefore needed to address the economic and social roots of disease and public health problems. This approach was paralleled by the feminist movement in addressing women’s health issues, including the important experiments in self-organized health clinics. As Giulio Maccacaro had argued in 1976, the strategy was a bottom-up “politicization of medicine”, challenging the way industrial capitalism was exploiting workers and undermining health and social conditions in the country.
 
 
 # Who we are