Why Black Marxism, Why Now? | Boston Review

Why Black Marxism, Why Now?

The threat of fascism has grown before our eyes. Black Marxism helps us to fight it with greater clarity, with a more expansive conception of the task before us, and with ever more questions.

ROBIN D. G. KELLEY

Image: Flickr / Doc Searls

The inspiration to bring out a new edition of Cedric Robinson’s classic, Black Marxism: The Making of the Black Radical Tradition, came from the estimated 26 million people who took to the streets during the spring and summer of 2020 to protest the killings of George Floyd, Breonna Taylor, Ahmaud Arbery, and the many others who lost their lives to the police. During this time, the world bore witness to the Black radical tradition in motion, driving what was arguably the most dynamic mass rebellion against state-sanctioned violence and racial capitalism we have seen in North America since the 1960s—maybe the 1860s. The boldest activists demanded that we abolish police and prisons and shift the resources funding police and prisons to housing, universal healthcare, living-wage jobs, universal basic income, green energy, and a system of restorative justice. These new abolitionists are not interested in making capitalism fairer, safer, and less racist—they know this is impossible. They want to bring an end to “racial capitalism.”

The threat of fascism is no longer rhetorical, a hollow epithet. It is real.

The state’s reaction to these protests has also brought us to the precipice of fascism. The organized protests in the streets and places of public assembly, on campuses, inside prisons, in state houses and courtrooms and police stations, portended the rise of a police state in the United States. For the past several years, the Movement for Black Lives and its dozens of allied organizations warned the country that we were headed for a fascist state if we did not end racist state-sanctioned violence and the mass caging of Black and brown people. They issued these warnings before Trump’s election. As the protests waned and COVID-19 entered a second, deadlier wave, the fascist threat grew right before our eyes. We’ve seen armed white militias gun down protesters; Trump and his acolytes attempt to hold on to power despite losing the presidential election; the federal government deploy armed force to suppress dissent, round up and deport undocumented workers, and intimidate the public; and, most recently the violent insurrection at the U.S. Capitol by members of the alt-right, racists, Neo-Nazis, and assorted fascist gangs whose ranks included off-duty cops, active military members, and veterans. The threat of fascism is no longer rhetorical, a hollow epithet. It is real.

The crossroads where Black revolt and fascism meet is precisely the space where Cedric’s main interlocutors find the Black radical tradition. Black Marxism is, in part, about an earlier generation of Black antifascists, written at the dawn of a global right-wing, neoliberal order that one political theorist called the era of “friendly fascism.”

Black Marxism was primarily about Black revolt, not racial capitalism. The Black radical tradition defies racial capitalism’s efforts to generate new categories of human experience stripped bare of the historical consciousness embedded in culture.

What did Robinson mean by the Black radical tradition, and why is it relevant now? Contrary to popular belief, Black Marxism was primarily about Black revolt, not racial capitalism. Robinson takes Marx and Engels to task for underestimating the material force of racial ideology on proletarian consciousness, and for conflating the English working class with the workers of the world. In his preface to the 2000 edition of Black Marxism, Cedric wrote, “Marxism’s internationalism was not global; its materialism was exposed as an insufficient explanator of cultural and social forces; and its economic determinism too often politically compromised freedom struggles beyond or outside of the metropole.” It is a damning observation. Many would counter by pointing to Marx’s writings on India, the United States, Russia, slavery, colonialism, imperialism, and peasants. Others would argue that Marx himself only ever claimed to understand capitalist development in Western Europe. But because neither Marx nor Engels considered the colonies and their plantations central to modern capitalist processes, class struggles within the slave regime or peasant rebellions within the colonial order were ignored or dismissed as underdeveloped or peripheral—especially since they looked nothing like the secular radical humanism of 1848 or 1789.

Cedric’s point is that Marx and Engels missed the significance of revolt in the rest of the world, specifically by non-Western peoples who made up the vast majority of the world’s unfree and nonindustrial labor force. Unfree laborers in Africa, the Americas, Asia, and the islands of the sea were producing the lion’s share of surplus value for a world system of racial capitalism, but the ideological source of their revolts was not the mode of production. Africans kidnapped and drawn into this system were ripped from “superstructures” with radically different beliefs, moralities, cosmologies, metaphysics, and intellectual traditions. Robinson observes,

Marx had not realized fully that the cargoes of laborers also contained African cultures, critical mixes and admixtures of language and thought, of cosmology and metaphysics, of habits, beliefs and morality. These were the actual terms of their humanity. These cargoes, then, did not consist of intellectual isolates or decultured blanks—men, women, and children separated from their previous universe. African labor brought the past with it, a past that had produced it and settled on it the first elements of consciousness and comprehension.

With this observation Robinson unveils the secret history of the Black radical tradition, which he describes as “a revolutionary consciousness that proceeded from the whole historical experience of Black people.” The Black radical tradition defies racial capitalism’s efforts to remake African social life and generate new categories of human experience stripped bare of the historical consciousness embedded in culture. Robinson traces the roots of Black radical thought to a shared epistemology among diverse African people, arguing that the first waves of African New World revolts were governed not by a critique rooted in Western conceptions of freedom but by a total rejection of enslavement and racism as it was experienced. Behind these revolts were not charismatic men but, more often than not, women. In fact, the female and queer-led horizontal formations that are currently at the forefront of resisting state violence and racial capitalism are more in line with the Black radical tradition than traditional civil rights organizations.

Africans chose flight and marronage because they were not interested in transforming Western society but in finding a way “home,” even if it meant death. Yet, the advent of formal colonialism and the incorporation of Black labor into a fully governed social structure produced the “native bourgeoisie,” the Black intellectuals whose positions within the political, educational, and bureaucratic structures of the dominant racial and colonial order gave them greater access to European life and thought. Their contradictory role as descendants of the enslaved, victims of racial domination, and tools of empire compelled some of these men and women to rebel, thus producing the radical Black intelligentsia. This intelligentsia occupies the last section of Black Marxism. Robinson reveals how W. E. B. Du Bois, C. L. R. James, and Richard Wright, by confronting Black mass movements, revised Western Marxism or broke with it altogether. The way they came to the Black radical tradition was more an act of recognition than of invention; they divined a theory of Black radicalism through what they found in the movements of the Black masses.

The final section has also been a source of confusion and misapprehension. Black Marxism is not a book about “Black Marxists” or the ways in which Black intellectuals “improved” Marxism by attending to race. This is a fundamental misunderstanding that has led even the most sympathetic readers to treat the Black radical tradition as a checklist of our favorite Black radical intellectuals. Isn’t Frantz Fanon part of the Black radical tradition? What about Claudia Jones? Why not Walter Rodney? Where are the African Marxists? Of course Cedric would agree that these and other figures were products of, and contributors to, the Black radical tradition. As he humbly closed his preface to the 2000 edition, “It was never my purpose to exhaust the subject, only to suggest that it was there.”

Black Marxism is neither Marxist nor anti-Marxist. It is a dialectical critique of Marxism that turns to the long history of Black revolt to construct a wholly original theory of revolution.

The Black radical tradition is not a greatest hits list. Cedric was clear that the Black intellectuals at the center of this work were not the Black radical tradition, nor did they stand outside it—through praxis they discovered it. Or, better yet, they were overtaken by it. And, as far as Cedric was concerned, sometimes the Black intellectuals about whom he writes fell short. Marxism was their path toward discovery, but apprehending the Black radical tradition required a break with Marx and Engels’s historical materialism.

Black Marxism is neither Marxist nor anti-Marxist. It is a dialectical critique of Marxism that turns to the long history of Black revolt—and to Black radical intellectuals who also turned to the history of Black revolt—to construct a wholly original theory of revolution and interpretation of the history of the modern world.

When the London-based Zed Press published Black Marxism in 1983, few could have predicted the impact it would have on political theory, political economy, historical analysis, Black studies, Marxist studies, and our broader understanding of the rise of the modern world. It appeared with little fanfare. For years it was treated as a curiosity, grossly misunderstood or simply ignored. Given its current “rebirth,” some may argue that Black Marxism was simply ahead of its time. Or, to paraphrase the sociologist George Lipsitz quoting the late activist Ivory Perry, perhaps Cedric was on time but the rest of us are late? Indeed, how we determine where we are depends on our conception of time.

In thinking of the Black radical tradition as generative rather than prefigurative, not only is the future uncertain, but the road is constantly changing.

Cedric took Marx’s historical materialism to task in part for its conception of time and temporality. From The Terms of Order to An Anthropology of Marxism, he consistently critiqued Marxism for its fidelity to a stadial view of history and linear time or teleology, and dismissed the belief that revolts occur at certain stages or only when the objective conditions are “ripe.” And yet there was something in Cedric—perhaps his grandfather’s notion of faith—that related to some utopian elements of Marxism, notably the commitment to eschatological time, or the idea of “end times” rooted in earlier Christian notions of prophecy. Anyone who has read the Communist Manifesto or sang “The Internationale” will recognize the promise of proletarian victory and a socialist future. On the one hand, Robinson considered the absence of “the promise of a certain future” a unique feature of Black radicalism. “Only when that radicalism is costumed or achieves an envelope in Black Christianity,” he explained in a 2012 lecture, “is there a certainty to it. Otherwise it is about a kind of resistance that does not promise triumph or victory at the end, only liberation. No nice package at the end, only that you would be free. . . . Only the promise of liberation, only the promise of liberation!”

“Only the promise of liberation” captures the essence of Black revolt and introduces a completely different temporality: blues time. Blues time eschews any reassurance that the path to liberation is preordained. Blues time is flexible and improvisatory; it is simultaneously in the moment, the past, the future, and the timeless space of the imagination. As the geographer Clyde Woods taught us, the blues is not a lament but a clear-eyed way of knowing and revealing the world that recognizes the tragedy and humor in everyday life, as well as the capacity of people to survive, think, and resist in the face of adversity. Blues time resembles what the anarchist theorist Uri Gordon calls a “generative temporality,” a temporality that treats the future itself as indeterminate and full of contingencies. In thinking of the Black radical tradition as generative rather than prefigurative, not only is the future uncertain, but the road is constantly changing, along with new social relations that require new visions and expose new contradictions and challenges.

Cedric reminded us repeatedly that the forces we face are not as strong as we think. They are held together by guns, tanks, and fictions. They can be disassembled.

What we are witnessing now, across the country and around the world, is a struggle to interrupt historical processes leading to catastrophe. These struggles are not doomed, nor are they guaranteed. Thanks in no small measure to this book, we fight with greater clarity, with a more expansive conception of the task before us, and with ever more questions. Cedric reminded us repeatedly that the forces we face are not as strong as we think. They are held together by guns, tanks, and fictions. They can be disassembled, though that is easier said than done. In the meantime, we need to be prepared to fight for our collective lives.


Adapted from the foreword to the third and updated edition of Black Marxism: The Making of a Radical Tradition, Copyright © 1983 by Cedric Robinson. Foreword Copyright © 2021 by Robin D. G. Kelley. Used by permission of the publisher.

Source: Why Black Marxism, Why Now? | Boston Review

“Aligning Black Policy Priorities Into the Game of Electoral Politics” ::: S.C. Professor Emeritus, Willie Legette :: Sat., March 6, 2021 :: 10 pm ET

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“Aligning Black Policy Priorities Into the Game of Electoral Politics”

Professor Willie Legette

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The coalition Democrats brought together in 2020 was enough to beat Trump—but it’s insufficient for the long-term fights ahead. If 2020 was, as Biden put it, a fight “for the soul of the nation,” the next task for the progressives is even harder: build a multiracial working-class majority big enough to win a transformative agenda that lifts America out of 2020s roiling crises and truly transform people’s lives. That’s how progressives win for the next generation.

We talk with Professor Willie Legette, political analyst, as to how we might resolve the conflicts and problems of voting for who we “like”, votes that are often divorced from policies that address our political, economic, and community needs. Are we voting electoral race politics and needing class-basis policies? Just how does the “Black vote” calculate? Though we think of ourselves as on a winning team, are we winning? Is there credence to what we call “ the Black vote”? What does it mean? A whole new way of thinking is required. That and a “resistance campaign” against voter suppression.

With his co-author, Adolph Reed, Legette writes that “The disjunction between candidate choices and issue concerns reflects how people are accustomed to making their short-term electoral calculations and how they understand the issues that affect their lives. People take different criteria to candidate selection than to their estimations of the issues that most concern them. In part that is the result of decades of bipartisan neoliberal hegemony in which electoral politics has been drained of serious policy differences. For more than forty years neither Republicans nor Democrats have sought to address Americans’ decreasing standard of living and increasing economic insecurity. Both parties have subordinated voters’ concerns to the interests of Wall Street and corporations. Therefore, in states like South Carolina Democratic party politics is fundamentally transactional, where people are habituated to making electoral choices based on considerations like personal relationships or more local concerns that do not center so much on national policy issues. In effect politics—or at least electoral politics—has been redefined as not the appropriate domain for trying to pursue policies that address people’s actual material concerns like health care, education, jobs, and wages, or housing.

Legette asserts that a narrow view of politics was on display regarding the “black vote” in particular in the runup to the 2016 South Carolina primary when Congressmen James Clyburn (D-SC), John Lewis (D-GA), and Cedric Richmond (D-LA) denounced calls for free public higher education as “irresponsible” because “there are no free lunches.” When Clyburn endorsed Biden in 2020, he took a swipe at Medicare for All, another issue with strong black American support, indicating that the choice this year is Biden vs. Medicare for All. (It may be worth noting that Clyburn, between 2008 and 2018, took more than $1 million from the pharmaceutical industry.)”

“. . . is not the election of a president but the transformation of the country into a place that is more egalitarian, just, and humane, a society where poverty is not possible and where real freedom is enjoyed by all… The kind of popular pressure we need to advance some of the best of Sanders’s platform—free higher education, postal banking, public works, a single-payer health care system, stronger financial regulation, and so on—cannot be built in an election cycle.” – Cedric Johnson, Jacobin magazine,” Fear and Pandering in the Palmetto State”

Johnson problematizes that “black politics” as a framework for understanding either black Americans’ electoral behavior or their class and political interests. He points out that “voting for a presidential candidate… is only a proxy for political interests, which are again multifaceted and shifting.” Black politics, in fact, is a historically specific phenomenon, as Johnson argues elsewhere. It is a label attached to the racialized black interest-group politics that consolidated after the great victories of the 1960s. It is thoroughly a class politics that rests on a premise—and one asserted with increasing intensity as class differences among black Americans become clearer in political debate—that all black Americans converge around a racial agenda defined arbitrarily by political elites and others in the stratum of freelance Racial Voices. We talk with Professor Legette about these assertions and more. As well, I continue to ask where is the Black political infrastructure to move us either in or out of the game?

ABOUT Professor Legette

Willie Legette is Professor Emeritus of Political Science, South Carolina State University; Lead Organizer, Medicare for All-South Carolina; Labor Party candidate for SC Senate;

Common Dreams contributor; journalist and activist.

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Reflections On Recent Controversy And The Case For #PureReparations | Actify Press

This is longer than a 140-character Tweet, but I respectfully ask that all who participated in exchanges over a statement I made on Twitter on February 4, 2021 concerning #PureReparations, that aroused a firestorm of responses, please read this from start to finish.

Background

This is longer than a 140-character Tweet, but I respectfully ask that all who participated in exchanges over a statement I made on Twitter on February 4, 2021, concerning #PureReparations, that aroused a firestorm of responses, please read this from start to finish. Some of the responses to my statement were serious, thoughtful, and critical, but others were so hostile. I am convinced many of them were written by people who only had, at best, second- or third-hand knowledge of the content of my message.

Let me be clear, I remain steadfast that African American reparations in the United States should be designated specifically for black Americans who are descendants of persons enslaved in the United States. It is a position that I have maintained for upwards of 20 years, first articulated with the eligibility criteria I presented in an article published with Dania Frank in 2003 in the American Economic Review. 

The criteria expressed at the time were twofold: 1. An American citizen would have to demonstrate they have at least one ancestor enslaved in the United States. 2. An American citizen would have to demonstrate that for at least ten years before the adoption of a reparations program they self-classified as black, negro, or African American. The first criterion is a lineage standard; the second is an identity standard. Both standards must be met to merit receipt of reparations payments.

Lineage Criteria

In our recent book, From Here to Equality (FHTE)Kirsten Mullen and I modify the identity standard to lengthen the time to at least twelve years (two Senatorial terms) and to include the adoption of a study commission for reparations as one of two events that would trigger the time count on self-classification.

The core objective always has been to include all persons, and their descendants, who have been subjected to the cumulative, intergenerational effects of slavery, legal segregation and white terrorist violence, and post-Civil Rights Era mass incarceration, police executions of unarmed blacks, and ongoing discrimination in the justice claim. This is the community whose ancestors were denied the promised 40 acres as restitution for the years of bondage and as a material springboard for entry into full citizenship in the United States.

Kirsten and I argue further, in FHTE, the best economic indicator of the combined effects of these atrocities is the racial wealth gap.  We propose that elimination of the gap yields the baseline value for a reparations plan—demanding a federal government expenditure of $10 to $12 trillion.  It is a key aspect of our project to generate a research-based standard for determining the size of the bill that is due. We do not identify an upper bound for the bill.

We also insist that priority be given to mobilization of the funds in the form of direct payments to eligible recipients, whether cash transfers, trust accounts, other types of endowments, or some combination thereof.

Necessary Exclusions

The two eligibility criteria necessarily exclude many Americans. The lineage standard will exclude all blacks in the United States who migrated to the United States and became citizens after the end of the Civil War. Their descendants also will not be eligible, in the absence of a parent’s or grandparent’s intermarriage with black Americans having ancestry anchored in US slaveryCounting among blacks excluded would be the relatively small group that migrated to the United States during the Jim Crow years (estimated to be, according to a Smithsonian study, to the right of the decimal point). Also excluded is a much larger group of black immigrants (now approaching ten percent of the nation’s black population) who arrived after 1964, especially coming in large numbers from the 1980s onward.

The identity standard excludes all persons who self-identified as non-black, inclusive of all white Americans, at a point where there was no apparent financial benefit from classifying oneself as black.

Meeting the lineage standard necessitates serious genealogical research. As a result, in FHTE, Kirsten Mullen and I recommend the federal government establish an agency with genealogists with expertise in African American ancestry to provide free services to all persons seeking to establish their reparations claim. Despite that recommendation, we continue to get substantial push back from those who say many black Americans with ancestors enslaved in the US will hit a wall in getting past the 1870 Census to identify their particular ancestors who were held in bondage before 1865. Therefore, I have been giving more thought to modifications in the criterion that would make it easier for all black American descendants of U.S. slavery to be assured of inclusion.

Balloon Reasoning

One possibility that seemed reasonable is the one I advanced that stirred the pot to a boil—include black immigrants who came during the Jim Crow years on the eligibility list. Let me emphasize, I advanced this to prompt discussion. I even referred to this in a later post as a “trial balloon,” which left me open to the somewhat humorous charges that the balloon popped or, quite the opposite, the balloon was made of lead.

Here is the thinking that I pursued: Allowing pre-1950s black immigrants onto the reparations roll eases genealogical proof required of black American descendants of U.S. slavery to establish their lineage claim. You necessarily have a tradeoff between letting a small number of otherwise excluded black folk in the door versus keeping the strong genealogical standard that will demand going past the 1870 “wall.”  Under the former case, with the relaxed lineage standard, a person would have to demonstrate, say, that they have at least two black ancestors who were citizens of the USA before 1950 or 1960.

Then, eligibility would be much easier to establish for all black American descendants of U.S. slavery at the “price” of including a small number of black immigrants who arrived during legal segregation. Let a few in who do not meet the original lineage standard to ensure that all make it in who meet the original lineage standard.

No Mission Creep

I reject the “slippery slope” argument that has it that making this exception opens the gates for every other group to piggyback onto the reparations’ claim. Conditions can be drawn so precisely that no additional groups will become eligible.

Nevertheless, I do take seriously, the following critical response to my “trial balloon”: The limitation of African American reparations to black American descendants of US slavery is a matter of principle that should not be compromised. America’s history of racial injustice has targeted this community so consistently and with such ferocity that we should brook no modification in the criteria, even it remains more difficult for each individual to establish eligibility for the merited compensation.

In fact, I take it so seriously, in a later message, I indicate that I would not advance as an option the proposal any longer, and I will stand committed solely to the original criterion. Unlike what is suggested in a number of messages on Twitter, I never proposed that recent black immigrants should be eligible for reparations from the U.S. government. Nor do I anticipate reneging on that position. . . ”

Additional Considerations

Source: Reflections On Recent Controversy And The Case For #PureReparations | Actify Press

How a Legacy of Organizing Among Domestic Workers Helped Turn Georgia Blue – Mother Jones

How a Legacy of Organizing Among Domestic Workers Helped Turn Georgia Blue

“Georgia is about to save our whole democracy, so we’re all in.”

“You ever been here?” Yterenickia Bell asks me as we wait for the door to the Cascade Skating Rink to be unlocked. “It’s historic,” she says, ushering me out of the December rain and into the fluorescent-lit roller-skating spot in west Atlanta’s Adamsville neighborhood. “People have been gathering here for years.”

The rink is awaiting the night crowd. Video games sit silent in a corner. The snack bar is dark except for a flashing neon sign. But it’s not empty: a handful of people in orange shirts and masks are chatting at the other end of the rink before braving the rain to get out the vote for Senate candidate Raphael Warnock. Bell is the GOTV director for Care in Action, an advocacy group whose members are mostly nannies, housecleaners, and home health workers. “We operate out of here because we have everyday folks that are workers that may have lost their jobs due to COVID, and a saturation of them live in this area,” she says. “It’s the community helping the community.”

I’d come to Georgia to see Democrats’ ground game ahead of the Senate runoff, and in particular, to understand the role that this group of domestic workers, most of whom are women of color, has had in turning the state purple. Right now the rink is the center of the action. From here, Bell has been organizing 250 door-knockers a day to get the word out about the race and voting logistics. “It takes people who are committed to this work, who know what’s at stake,” she says. “They have to get up every morning at eight o’clock to be here by nine for training and then go out to their specific turf and knock on people’s doors.” In the two months leading up to the runoff, Care in Action reached out to 5.85 million voters, either by phone, by mail, or in person, including more than 1 million door knocks. “Georgia is about to save our whole democracy, so we’re all in,” Bell says.

Those efforts paid off. Just after Georgians elected a Democrat for president for the first time in 30 years, they went on to pick Warnock, a Black preacher, and Jon Ossoff, a Jewish millennial, to represent them in the Senate, clinching Democrats’ narrow control of the chamber. In majority-Black precincts, early numbers indicated that the turnout in the January runoff would surpass that of November 2020 and reach a level not seen since Barack Obama’s 2012 reelection. Republican turnout was also strong, but not enough to turn back a second blue wave in so many months.

Though Care in Action is not affiliated with Stacey Abrams, who has been widely credited with turning Georgia blue, its work is a direct extension of Democrats’ decade-long effort to reshape the state by organizing voters of color. “What it takes to win in Georgia is a multiracial coalition,” says Rep. Nikema Williams, who served as Care in Action’s deputy director in 2018 and now holds the US House seat formerly held by Rep. John Lewis. And just as that coalition did not come together overnight, it also drew upon generations of organizing by Black domestic workers. “I do believe that investment in long-term, community-based organizing and power building does pay off,” says Ai-jen Poo, Care in Action’s senior adviser and the founder of the National Domestic Workers Alliance. “Throughout our history, Black domestic workers have organized and have really asserted their dignity through organizing.”

Atlanta is the birthplace of that movement. The first recorded domestic workers’ strike was in 1881, when Black women in Atlanta left their posts to demand better wages. Dorothy Lee Bolden helped create the National Domestic Workers Union of America (a precursor to NDWA) in the city in 1968. It was less a formal union than an education and advocacy effort, which Bolden led for nearly three decades. She built an infrastructure that took the union directly to the people it represented, using public buses to hold informal meetings and recruit domestic workers during their daily commute. There were two requirements to join the union: Members had to be domestic workers, and they had to vote.

The NDWU eventually spread to 10 more states, won workers’ compensation and Social Security benefits, and helped raise the minimum wage in Atlanta by 33 percent. Bolden also had an influential voice that affected national policy; her expertise was sought by presidents Nixon, Ford, and Carter.

The movement fizzled a bit in the ’80s as union power declined but it was revived a decade ago when Poo began organizing home care workers to push for greater labor protections. After notching win after win, she realized that the women she’d helped bring together were an untapped voting bloc. In 2018, she launched Care in Action to get out the vote for women candidates who stand by policies that domestic workers could benefit from. That same year, Abrams ran for governor of Georgia while pushing an unabashedly progressive agenda that included expanding Medicaid, raising the minimum wage, and ensuring quality public education. Abrams received Care in Action’s first endorsement, and the group mobilized 300 domestic workers to canvass for her.

People who worked on that campaign recall there was a beautiful synergy in domestic workers rallying for the possibility of Abrams becoming Georgia’s first Black governor. “We were very intentional about running a program that reached out to people that have been overlooked in the political process for way too long,” Williams recalls. “Our unique skill set was having our membership actually do the canvassing. It really changed the game for us and the way we were able to expand the electorate.”

Though Abrams lost her bid, thanks in no small part to the voter suppression tactics of her opponent, then–Secretary of State Brian Kemp, Poo and others felt they had bottled lightning. Indeed, in terms of people pounding the pavement, Care in Action was the largest independently funded grassroots effort in Georgia during the 2018 election cycle. Since then, it has expanded into Virginia, North Carolina, South Carolina, Nevada, Arizona, and Michigan. It started small, focusing on a few state candidates and the presidential election, with an eye toward expanding its operations in Georgia.

Despite the challenges presented by a pandemic that forced a rethink of its campaign outreach and infrastructure, Care in Action was able to carry the energy from 2018 through two more hard-fought races in 2020. “I think that [Abrams’ loss] was the momentum that we needed, that propelled us to be ready and to be able to launch for the Senate runoff as well as engage in a general,” Bell says. “We were able to essentially flip our state blue.”

The stakes are clear to Melanie Jackson, a domestic worker in the Atlanta area who tells me that canvassing with Care in Action made her feel like she was making a difference in a state whose elections have deep repercussions for the rest of the country. She recalls a recent conversation she’d had with a Black man in his 30s who told her he wasn’t planning to vote—he just didn’t feel like there was any point. She says she stared at him, incredulous. “You’re gonna miss the first opportunity to send a Black man from Georgia to the United States Senate?” she asked him.

He responded, “Sister, just because you said that, I’m going to go vote for the guy.”

“We locked eyes,” she told me. “I know that he went and followed through on that, and he probably thought about me as he was pressing those buttons. No doubt in my mind.”

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Source: How a Legacy of Organizing Among Domestic Workers Helped Turn Georgia Blue – Mother Jones

“The History of Black Political Movements in America” ::: Four-Week Lecture Series ::: An OUR COMMON GROUND BHM Special :::

An OUR COMMON GROUND Black History Month 2021

Special

“A History of Black Political Movements”

A Four-Week Lecture Series

Presenter, Dr. James L. Taylor, Ph.D.

Each Session: Thursdays 8- 10 pm EST ::: February 4, 11, 18, 25, 2021

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The Black Power movement grew out of the CIVIL RIGHTS MOVEMENT that had steadily gained momentum through the 1950s and 1960s. It was not a formal movement, however, the Black Power movement marked a turning point in Black-white relations in the United States and also in how Black people saw themselves. Both movements were hailed as significant struggles of Blacks to achieve full equality. They were complex events that took place at a time when society and culture were being transformed throughout the United States, and its legacy reflects that complexity. But what of the legacy political movements that occurred right after the Emancipation of slavery? We need to know and understand the networks that compose the many Black struggles and movement that brought us to our current political struggles.

This course of study will review the history of the many Black struggle movements and events that brought us to the election of Barack Obama resistance that brings us to the white supremacy insurrection and riots on January 6, 2021. We hope that you will join us.

Series SCHEDULE

February 4, 2021

   Session 1: Overview of significant historical Black political movements and events.

  • Black Politics and the Reconstruction Era

  • Black Politics of the Jim Crow Era

  • Black Politics creating the Civil Rights Era

  • Black Political development during the Black Power Era

      Reading Recommendations

      Timeline References

February 11, 2021

   Session 2: Review of Syllabus Examine why certain sources are most helpful to us to understand the continuum and projection of history forming new                               generations of struggle. How history informs strategic directions of each of the major movements.

February 18, 2021

   Session 3: Black political diversities and ideologies. Examining class, economics, religion, spirituality, art, gender, sexuality, and how they have factored in                         Black movement history.

February 25, 2021

    Session 4: Practical Strategies for 21st Century Black and Peoples’ movements.

 

About Dr. James L. Taylor, Ph.D.

Chair, Department of Politics, former President of the National Conference of Black Political Scientists (NCOBPS), an important organization of African American, African, and Afro Caribbean political scientist community in the United States, 2009-2011. 

Professor James Lance Taylor is from Glen Cove, Long Island. He is the author of the book “Black Nationalism in the United States: From Malcolm X to Barack Obama”, which earned 2012 “Outstanding Academic Title” – Choice: Current Reviews for Academic Libraries. (Ranked top 2 percent of 25,000 books submitted and top 8 percent of 7,300 actually accepted for review by the American Library Association). Rated “Best of the Best.” The hardback version sold out in the U.S. and the paperback version was published in 2014.

He is a former President of the National Conference of Black Political Scientists (NCOBPS), an important organization of African American, African, and Afro Caribbean political scientists in the United States, 2009-2011. Taylor also served as Chair of the Department of Politics at the University of San Francisco from 2012-2015, and Faculty Coordinator of the African American Studies Program for 2015-2017. He served as the Chair for the “Committee on the Status of Blacks” in Political Science for the American Political Science Association (APSA), 2016-2017.

Professor Taylor is currently writing and researching a book with the working title, Peoples Temple, Jim Jones, and California Black Politics. He expects the book to be completed with a 2018-2019 publication range. The book is a study of the Peoples Temple movement and African American political history in the state of California.

His teaching and research scholarly interests are in religion and politics in the United States, race and ethnic politics, African American political history, social movements, political ideology, law and public policy, Black political leadership, and the U.S. Presidency. He lives with his family in Oakland, California.

 

A Broadcast Product of OUR COMMON GROUND Media

The Black American Amputation Epidemic

The doctor put up billboards in the Mississippi Delta.

Amputation Prevention Institute, they read.

He could save their limbs, if it wasn’t too late.

The Black American Amputation Epidemic

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

IT WAS A FRIDAY EVENING in the hospital after a particularly grueling week when Dr. Foluso Fakorede, the only cardiologist in Bolivar County, Mississippi, walked into Room 336. Henry Dotstry lay on a cot, his gray curls puffed on a pillow. Fakorede smelled the circumstances — a rancid whiff, like dead mice. He asked a nurse to undress the wound on Dotstry’s left foot, then slipped on nitrile gloves to examine the damage. Dotstry’s calf had swelled to nearly the size of his thigh. The tops of his toes were dark; his sole was yellow, oozing. Fakorede’s gut clenched. Fuck, he thought. It’s rotten.

Fakorede, who’d been asked to consult on the case, peeled off his gloves and read over Dotstry’s chart: He was 67, never smoked. His ultrasound results showed that the circulation in his legs was poor. Uncontrolled diabetes, it seemed, had constricted the blood flow to his foot, and without it, the infection would not heal. A surgeon had typed up his recommendation. It began: “Mr. Dotstry has limited options.”

Fakorede scanned the room. He has quick, piercing eyes, a shaved head and, at 38, the frame of an amateur bodybuilder. Dotstry was still. His mouth arched downward, and faint eyebrows sat high above his lids, giving him a look of disbelief. Next to his cot stood a flesh-colored prosthetic, balancing in a black sneaker.

Fakorede explained that he wasn’t the kind of doctor who cuts. He was there because he could test circulation, get blood flowing, try to prevent any amputation that wasn’t necessary. He hated that doctors hadn’t screened Dotstry earlier — when he’d had the stroke or lost his leg. “Your legs are twins,” he said. “What happens in one happens in the other.”

Dotstry needed an immediate angiogram, an imaging test that would show blockages in his arteries. He also needed a revascularization procedure to clean them out, with a thin catheter that shaves plaque and tiny balloons to widen blood vessels. His foot was decaying, fast. Though Fakorede ran an outpatient practice nearby, when doctors consulted him on inpatients at Bolivar Medical Center, the local hospital, he expected to use its facilities.

He asked his nurse to schedule the procedures. But by the time he had driven home to his ranch house on the northern edge of town, he hadn’t received an answer. Nor had he when he woke up on Saturday at 3:30 a.m., as he did every morning. By sunrise, he was restless at his kitchen counter, texting the hospital’s radiology director, explaining the need for an intervention on Monday, Martin Luther King Jr. Day. Within a few hours, he got a response: “I don’t have the staff or the supplies. I’m sorry.”

Now Fakorede was mad, walking briskly into his office, dialing friends on speaker phone, pacing around his conference room. He’d been raised in Nigeria, moved to New Jersey as a teenager and had come to practice in Mississippi five years earlier. He’d grown obsessed with legs, infuriated by the toll of amputations on African Americans. His billboards on Highway 61, running up the Delta, announced his ambitions: “Amputation Prevention Institute.”

Nobody knew it in January, but within months, the new coronavirus would sweep the United States, killing tens of thousands of people, a disproportionately high number of them black and diabetic. They were at a disadvantage, put at risk by an array of factors, from unequal health care access to racist biases to cuts in public health funding. These elements have long driven disparities, particularly across the South. One of the clearest ways to see them is by tracking who suffers diabetic amputations, which are, by one measure, the most preventable surgery in the country.

Look closely enough, and those seemingly intractable barriers are made up of crucial decisions, which layer onto one another: A panel of experts decides not to endorse screening for vascular disease in the legs; so the law allows insurance providers not to cover the tests. The federal government forgives the student loans of some doctors in underserved areas, but not certain specialists; so the physicians most critical to treating diabetic complications are in short supply. Policies written by hospitals, insurers and the government don’t require surgeons to consider limb-saving options before applying a blade; amputations increase, particularly among the poor.

Despite the great scientific strides in diabetes care, the rate of amputations across the country grew by 50% between 2009 and 2015. Diabetics undergo 130,000 amputations each year, often in low-income and underinsured neighborhoods. Black patients lose limbs at a rate triple that of others. It is the cardinal sin of the American health system in a single surgery: save on preventive care, pay big on the backend, and let the chronically sick and underprivileged feel the extreme consequences.

Henry Dotstry, Dr. Foluso Fakorede’s patient. (Ruddy Roye for ProPublica)

Fakorede grabbed his car keys and headed to the hospital. He walked straight to the lab. As he suspected, it had all the supplies that he needed. Why won’t they give me staff? he wondered. They wouldn’t do that to a surgeon.

He has little tolerance for this kind of transgression. He is militaristic, to an extreme. To him, nonhealing wounds are like heart attacks. “Time is muscle,” he repeats. He calls huddles when nurses forget to check a patient’s ankles: “If you haven’t assessed both legs, I don’t want to walk into that room.” He considers each of his procedures an act of war. When people stand in his way, he sends a barrage of text messages, punctuated by exclamation marks. And he uses his cellphone to collect evidence that the system is working against his patients, and his efforts.

He pulled out his iPhone and photographed the hospital’s wires and catheters, IVs and port protectors. He shot the images over to the hospital’s radiology director. Fakorede’s private practice was closed for the holiday weekend. He calculated that he had only a few days to carry out some plan before Dotstry’s remaining leg was amputated.


TWO MAPS EXPLAIN why Fakorede has stayed in the Mississippi Delta. One shows America’s amputations from vascular disease. The second shows the enslaved population before the Civil War; he saw it at a plantation museum and was stunned by how closely they tracked. On his phone, he pulls up the images, showing doctors, or history buffs, or anyone who will listen. “Look familiar?” he asks, toggling between the maps. He watches the realization set in that amputations are a form of racial oppression, dating back to slavery.

AVERAGE ANNUAL AMPUTATIONS, 2007–9

0–5
5–8
8–10
10–13
13+

The average number of amputations for peripheral artery disease per 10,000 patients per year. Source: Dartmouth Atlas of Healthcare

ENSLAVED POPULATION IN 1860

0%
0–10%
10–30%
30–50%
50%+

The percentage of the population enslaved in 1860. Source: IPUMS NHGIS, University of Minnesota

Fakorede was initially tempted to move to the Delta while practicing in Tennessee. He befriended a medical device sales rep named Maurice Hampton who had grown up in the Mississippi region. Hampton talked about how black families were leery of local hospitals and how few black doctors in the Delta specialized in vascular work. “It’s the norm to go to Walmart and see an amputation or a permacath in the neck,” he’d told Fakorede. “If you don’t see one, then you didn’t stay but two minutes.”

Then, a little over a year into his Tennessee job, Fakorede found himself at loose ends. He’d raised concerns that he was being billed for expenses that weren’t his and asked for an audit; though the audit later found that the clinic where he worked had claimed over $314,000 in improper expenses, he was quickly terminated. Fakorede sued the clinic for retaliation under the False Claims Act and lost. (The clinic’s lawyer said his client had no comment, but there were “numerous” reasons for Fakorede’s departure.) In the spring of 2015, he had a mortgage, a quarter of a million dollars in student debt and four months of severance pay. He also had an impulse to understand the Delta.

A highway in the Mississippi Delta. (Andrea Morales for ProPublica)

Fakorede spent four days driving through its long, flat stretches of farmland dotted with small towns and shotgun houses. The wood-slat homes and bumpy roads reminded him of his grandparents’ village in the Nigerian state of Ondo, where he’d spent summers as a kid. He drove scores of miles on the Mississippi highways without seeing a single grocery store; fast-food chains lit the busiest intersections. He was startled by the markers of disease — the missing limbs and rolling wheelchairs, the hand-built plywood ramps with metal rails. He thought of amputees like “an hourglass,” he said, “that was turned the day they had their amputation.” Mortality rates rise after the surgeries, in part, because many stop walking. Exercise improves circulation and controls blood sugar and weight. The less activity a person does, the higher the risk of heart attacks and strokes. Within five years, these patients were likely to be dead.

Fakorede weighed taking a lucrative job up north, near his parents, who had both been diagnosed with diabetes. He had professional connections there; he’d gone to Rutgers Robert Wood Johnson Medical School and done a residency at NewYork-Presbyterian Weill Cornell Medical Center. But the South, he felt, needed him. About 30 million people in America had diabetes, and Mississippi had some of the highest rates. The vast majority had Type 2; their bodies resisted insulin or their pancreas didn’t produce enough, making their blood sugar levels rise. Genetics played a role in the condition, but so did obesity and nutrition access: high-fat meals, sugary foods and not enough fiber, along with little exercise. Poverty can double the odds of developing diabetes, and it also dictates the chances of an amputation. One major study mapped diabetic amputations across California, and it found that the lowest-income neighborhoods had amputation rates 10 times higher than the richest.

The Delta was Mississippi’s poorest region, with the worst health outcomes. Fakorede had spent years studying health disparities: African Americans develop chronic diseases a decade earlier than their white counterparts; they are twice as likely to die from diabetes; they live, on average, three years fewer. In the Delta, Fakorede could treat patients who looked like him; he could find only one other black interventional cardiologist in the entire state. A growing body of evidence had shown how racial biases throughout the medical system meant worse results for African Americans. And he knew the research — black patients were more responsive to, and more trustful of, black doctors. He decided after his trip that he’d start a temporary practice in Mississippi, and he rented an apartment deep in the Delta.

He fantasized about building a cardiovascular institute and recruiting a multidisciplinary team, from electrophysiologists to podiatrists. But as he researched what it would take, he found a major barrier. Medical specialists with student debt, who graduate owing a median of $200,000, generally could not benefit from federal loan forgiveness programs unless they got jobs at nonprofit or public facilities. Only a few types of private practice providers — primary care, dentists, psychiatrists — qualified for national loan forgiveness. The Delta needed many other physicians. Though Bolivar County was at the center of a diabetes epidemic, there wasn’t a single diabetes specialist, an endocrinologist, within 100 miles.

Fakorede in his clinic with a patient. (Ruddy Roye for ProPublica)

Fakorede leased a windowless space in the Cleveland Medical Mall, a former shopping center that had been converted to doctors’ offices. People came to him with heart complaints, but he also asked them to remove their socks. Their legs alarmed him. Their toes were black and their pulses weak. Their calves were cold and hairless. Some had wounds but didn’t know it; diabetes had numbed their feet. Many had been misdiagnosed with arthritis or gout, but when Fakorede tested them, he found peripheral artery disease, in which clogged arteries in the legs limit the flow of blood.

This is what uncontrolled diabetes does to your body: Without enough insulin, or when your cells can’t use it properly, sugar courses through your bloodstream. Plaque builds up faster in your vessels’ walls, slowing the blood moving to your eyes and ankles and toes. Blindness can follow, or dead tissue. Many can’t feel the pain of blood-starved limbs; the condition destroys nerves. If arteries close in the neck, it can cause a stroke. If they close in the heart, a heart attack. And if they close in the legs, gangrene.

Within a month, Bolivar Medical Center had credentialed Fakorede, allowing him to consult on cases and do procedures in the hospital. His most complicated patients came in through the emergency room. Some arrived without any inkling that they had gangrene. One had maggots burrowing in sores. Another showed up after noticing his dog eating the dead flesh off the tips of his toes. Fakorede took a photo to add to his collection. “It was a public health crisis,” he told me. “And no one was talking about amputations and the fact that what was happening was criminal.”

On weekends, Fakorede had been driving back to his five-bedroom home in Tennessee, but in August of 2015, he decided to go all-in on Bolivar County. He sold his house and black Mercedes G-Wagon, and applied for funding to build a practice in the Delta: Cardiovascular Solutions of Central Mississippi. He pitched himself as a heart guy and a plumber, removing buildup in the arteries. Four banks denied him loans, so he borrowed money from friends. He gave himself a two-year window to reduce amputations and publish his outcomes.


The Delta was once a cotton empire. (Andrea Morales for ProPublica)

THE DELTA FLOOD PLAIN runs 7,000 square miles along the northwestern edge of the state, with sweet-smelling, clay-like soil cordoned between bluffs and the banks of the Mississippi River. By the 19th century, the primeval forests had been transformed into a cotton empire; at the start of the Civil War, more than 80% of people in many Delta counties were enslaved. Sharecropping emerged after emancipation, and black farmers cultivated small plots in return for a portion of their crop. They lived on credit — for food and feed and clothing — until the harvest, but even then, their earnings rarely covered their expenses.

For decades, African Americans in the South struggled to find and afford health care. The American Medical Association excluded black doctors, as did its constituent societies. Some hospitals admitted black patients through back doors and housed them in hot, crowded basements. Many required them to bring their own sheets and spoons, or even nurses. Before federal law mandated emergency services for all, hospitals regularly turned away African Americans, some in their final moments of life.

Fakorede was drawn to Bolivar County, in part, because of its history. He’d run out of gas there when he was first scouting the region, and later that evening, he’d Googled its background. For a brief moment, Bolivar was the center of a movement for public health care, driven by the conviction that racial equality was not possible without justice in health. In 1964, when a group of physician activists traveled to the Delta, Robert Smith, a black doctor from Jackson, saw rocketing rates of intestinal parasites and maternal death. “I understood for the first time what it truly meant to be black in Mississippi,” he told a magazine. Under President Lyndon B. Johnson’s War on Poverty, a Boston doctor secured funding to open a community health center in Bolivar, which he grew with the help of Smith. Clinicians worked with residents to take on housing, sanitation, exercise and nutrition. Its success spawned a national project of more than a thousand Federally Qualified Health Centers for the underserved. But funding shrank under President Richard Nixon, and the centers’ initiatives were scaled back to basic primary care.

By the time Fakorede moved to the Delta, in 2015, the state had the nation’s lowest number of physicians per capita. It had not expanded Medicaid to include the working poor. Across the country, 15% of African Americans were still uninsured, compared with 9% of white Americans. That year, Jennifer Smith, a professor at Florida A&M University College of Law, wrote in the National Lawyers Guild Review what Fakorede saw firsthand: “While the roots of unequal and inequitable health care for African Americans date back to the days of slavery, the modern mechanisms of discrimination in health care has shifted from legally sanctioned segregation to inferior or non-existent medical facilities due to market forces.”

Fakorede understood that to reach patients, he needed referrals, so he met primary care providers at hospitals and clinics. He asked them to screen for vascular disease, measuring blood pressure at the ankle and the arm. Many didn’t have the time; given the shortage of local physicians, some were seeing up to 70 patients a day. Others didn’t know much about peripheral artery disease or why it was important to diagnose. Some were offended by Fakorede’s requests. Michael Montesi, a family doctor, was grateful for the help, but he found it brash for the new doctor in town to start telling the veterans what to do. He recalled thinking, “Where were you the first 12 years of my practice, when I needed a cardiologist, when I needed an OB-GYN, when I needed a surgeon, when I had to do an amputation in the ER, or deliver a baby that was 23 weeks and watch the baby die because there was nobody there that could take care of him?”

The brushoffs disturbed Fakorede, but when he dug deeper, he realized that the doctors weren’t only overwhelmed; they had no guaranteed payment for this vascular screening. The Affordable Care Act mandates that insurers cover all primary care screenings that are recommended by the U.S. Preventive Services Task Force, an independent panel of preventive care experts. The group, though, had not recommended testing anybody without symptoms, even the people most likely to develop vascular disease — older adults with diabetes, for example, or smokers. (Up to 50% of people who have the disease are believed to be asymptomatic.) As specialists, cardiologists are reimbursed if they screen patients with risk factors. But by the time patients got to Fakorede, the disease was sometimes too far along to treat. Many already had a nonhealing wound, what’s known as “end stage” peripheral artery disease, the last step before an amputation.

When Luvenia Stokes came to Fakorede, she had already lost her right leg at the age of 48. Like many Delta residents, she grew up in a food desert, and without money for fresh produce, she’d developed diabetes at a young age. She said that a pedicurist nicked her toe, and the small cut developed an infection. Without good blood flow, it began bubbling with pus. Stokes told Fakorede that no doctor had performed an angiogram to get a good look at the circulation or a revascularization to clean out the arteries. A surgeon removed her second toe. Without cleared vessels, though, the infection spread. Within weeks, a new surgeon removed her leg.

Luvenia Stokes. (Ruddy Roye for ProPublica)

Stokes lived in a single-wide trailer with her mother. Her wheelchair could not fit in the doorways, so she inched through sideways with a walker. Because she could hardly exercise, she gained 48 pounds in two years. The amputation hadn’t treated her vascular disease, and a stabbing pain soon engulfed her remaining leg, “like something is clawing down on you,” she said. When she finally made it to Fakorede, she told him that one doctor had prescribed neuropathy medication and another had diagnosed her with arthritis. “I’m not letting them get that other leg,” Fakorede told her. Stokes’ grandmother, Annie, who lives in a nearby trailer, had lost both her legs, above the knee, to diabetes. Her cousin Elmore had lost his right leg, too.

General surgeons have a financial incentive to amputate; they don’t get paid to operate if they recommend saving a limb. And many hospitals don’t direct doctors to order angiograms, the most reliable imaging to show if and precisely where blood flow is blocked, giving the clearest picture of whether an amputation is necessary and how much needs to be cut. Insurers don’t require the imaging, either. (A spokesperson for America’s Health Insurance Plans, a leading industry trade association, said, “This is not an area where there is likely to be unnecessary surgery.”) To Fakorede, this was like removing a woman’s breast after she felt a lump, without first ordering a mammogram.

Nationwide, more than half of patients do not get an angiogram before amputation; in the Delta, Fakorede found that the vast majority of the amputees he treated had never had one. Now, he was determined to make sure that no one else lost a limb before getting the test. This wasn’t a controversial view: The professional guidelines for vascular specialists — both surgeons and cardiologists — recommend imaging of the arteries before cutting, though many surgeons argue that in emergencies, noninvasive tests like ultrasounds are enough. Marie Gerhard-Herman, an associate professor of medicine at Harvard Medical School and a cardiologist at Brigham and Women’s Hospital, chaired the committee on guidelines for the American College of Cardiology and the American Heart Association. She told me that angiography before amputation “was a view that some of us thought was so obvious that it didn’t need to be stated.” She added: “But then I saw that there were pockets of the country where no one was getting angiograms, and it seemed to be along racial and socioeconomic lines. It made me sick to my stomach.”

Stokes wasn’t at immediate risk of losing her left leg when she met Fakorede, but pain prevented her from walking. She had a severe form of the disease, and Fakorede booked her for an angiogram and revascularization. He inserted a wire into her arteries and cleaned out the clogged vessels, letting oxygen-rich blood rush to her remaining foot. While she was recovering in Fakorede’s lab, she thought about her neighbors who had the same problems. “I really don’t like what’s happening to us,” she said to me. “They’re not doing the tests on us to see if they can save us. They’re just cutting us off.”

A wooden ramp and concrete steps outside Stokes’ trailer. (Ruddy Roye for ProPublica)

Patients didn’t know about vascular disease, or why their legs throbbed or their feet blackened, so Fakorede went to church. The sales rep, Hampton, introduced him to pastors, and several times each month, he stood before a pulpit. He told the crowds that what was happening was an injustice, that they didn’t need to accept it. He told them to get screened, and if any surgeon wanted to cut off their limbs, to get a second opinion. In the lofty Pilgrim Rest Baptist Church, in Greenville, he asked the congregation, “How many of you know someone or know of someone who’s had an amputation?” Almost everyone raised their hands.

At first, Fakorede took a confrontational approach with colleagues. Some seemed skeptical that he could “prevent” amputations; it’s a tall claim for a complex condition. Once, when a doctor had disregarded his advice, he’d logged it in the electronic health record, so the oversight would be on display for anyone who looked up his patient’s chart. Fakorede could fume when people questioned his authority; self-confidence carried him, but it sometimes blinded him to his missteps. Over time, though, Fakorede tried to rein in the arrogance. “You peel off a layer that may be comprised of: I’m from up North, I know it all, you should be thankful we’re here to provide services that you probably wouldn’t get before.” He picked up some Southern manners. Fakorede began texting doctors with photos of their patients’ feet along with X-rays of their arteries, before his intervention and afterward. Referrals picked up, and within a year, he’d seen more than 500 patients.

But Bolivar Medical Center, he learned, was turning away people who couldn’t pay a portion of their revascularization bill upfront. Several former employees told me the same. “It’s a for-profit hospital, it’s no secret, it’s the name of the game,” Fakorede said. “But a for-profit hospital is the only game in town in one of the most underserved areas. So what happens when a patient comes in and can’t afford a procedure that’s limb salvage? They eventually lose their limbs. They’ll present back to the emergency room with a rotten foot.” And a surgeon would have no choice but to amputate. (A hospital spokeswoman said that last year, it gave $25 million in charity care, uncompensated care and uninsured discounts. Asked if it turned away patients who couldn’t pay for revascularization, she did not respond directly: “We are dedicated to providing care to all people regardless of their ability to pay.”)

The practice was discriminatory, he reasoned, and also financially backward. At $237 billion in medical costs each year, diabetes is the most expensive chronic disease in the country; one of every four health care dollars is spent on a person with the condition. Left untreated, the costs pile on. Medicare spends more than $54,000 a year for an amputee, including follow-ups, wound care and hospitalizations; the government program is the country’s largest payer. Then come the uncounted tolls: lost jobs, a dependence on disability checks, relatives who sacrifice wages to help with cooking and bathing and driving.

By the time Carolyn Williams came to see Fakorede, in 2016, she’d been uninsured with diabetes for 20 years; she’d worked at a housing nonprofit and for a food assistance program, but neither had offered coverage. At the age of 36, she’d needed a triple bypass surgery, and at 44, she had three toes amputated. Untreated leg pain left her needing a wheelchair; she pulled out of Delta State University, where she was pursuing a degree in social work. Fakorede reconstituted blood flow in her legs and got her walking. But the diabetes was already destroying her kidneys. She joined the government’s disability rolls. She also went on dialysis, at a yearly cost to Medicare of $90,000.

On the days when Fakorede wanted to give up and leave, he drove to an Emmett Till memorial in Money, Mississippi. After 14-year-old Till was mutilated and murdered, in 1955, his mother had insisted on opening his casket. “Let the people see what I’ve seen,” she said, and his image brought national outrage to racist violence in the South. Fakorede thought often about how that decision sparked the Civil Rights movement. He thought about it as he exhibited his photos of rotten feet and limbless bodies, his own proof of what he considered a modern atrocity. He didn’t want to live by Bolivar Medical’s policies. He decided that in order to treat as many people as possible, irrespective of income or insurance, he needed to build a lab of his own.


THIS JANUARY, THAT LAB was now Dotstry’s best shot. The hospital’s consulting surgeon expected to amputate his leg below the knee. He had written that because Dotstry’s kidneys were impaired, the contrast dye in an angiogram would be dangerous. But Fakorede could replace the dye with a colorless gas, which wouldn’t jeopardize Dotstry’s health.

It would have made the most sense to perform the procedure at the hospital; Dotstry had been admitted and was occupying a bed. But after Fakorede opened his outpatient lab and hired away two techs and a nurse, a spokeswoman said the hospital stopped doing certain interventions. She told me it shouldn’t have surprised Fakorede that they couldn’t schedule Dotstry’s case, and that if he had been unable to treat a patient in his lab, the hospital could have worked with him to find another. Fakorede told me he’d never received such a message. When a doctor asks him to treat an inpatient with an acute condition, his responsibility, as he sees it, is to do it in the hospital. “If I don’t have a hospital that wants to coordinate,” he asked, “what do I do?”

Fakorede prepares for a procedure. (Ruddy Roye for ProPublica)

The answer, at least this time, was to get his patient out of there. He called Dotstry’s doctor and convinced her to discharge him for the intervention. Then, at noon on Saturday, Fakorede walked back into Room 336. Dotstry’s sister, Judy, was standing by his bed. She wore tall leather boots over acid-washed jeans, with a thick, black wig in a braid down her back.

Fakorede handed over his card. “I called the hospital to see if we can do this case on Monday,” he said, “and they said no.”

Judy inhaled. “What now?”

Fakorede laid out the plan for a Monday morning angiogram in his own procedure room. He would open up as many vessels as he could. If he could get circulation to Dotstry’s foot, he might be able to save it. He wasn’t sure about the toes.

When Dotstry had suffered his stroke several years back, Judy had become his caregiver. She’d stopped taking jobs in home care and supported her brother without pay — shuttling him to doctors’ appointments, controlling his sugars, managing his medications. After his amputation, she’d helped him learn to walk again. In place of a salary, she’d drawn disability for an old work injury; she’d been electrocuted while operating a machine, and the nerves in her arm were damaged, making her hands tremble. But she couldn’t stay unemployed forever. This past fall, she had gone back to work, cleaning the local post office.

After Fakorede left, Judy looked over at her brother, who sat slumped over the side of the cot, a blue gown slipping off his bony shoulders. Their father had been a sharecropper, and Dotstry had dropped out of elementary school to help on the farm, harvesting soybeans, rice and cotton. Of 10 kids, he was the oldest boy, and he took care of the others, bringing in cash and cooking them dinner. They almost never saw a doctor. Instead, they’d relied on cod liver oil, or tea from hog hoofs, parched over a fire.

Dotstry had spent his career driving tractors, hauling crops and plowing fields, but he wasn’t insured and still rarely saw doctors. At 60, when he was diagnosed with Type 2 and prescribed insulin, he didn’t know how to manage the medicine properly; he had never learned to read. Insulin pumps were too expensive — more than $6,000. His blood sugar levels often dropped, and he sometimes passed out or fell on the job. Little by little, his employer cut back his duties. In 2015, he had a stroke; diabetes had raised his risk. A year later, his right foot blackened and was amputated at the ankle. The infection kept spreading, and soon, his lower leg went. He could no longer work.

Two of his sisters had died after complications of diabetes. Judy had stood over their beds like she was now standing over Dotstry’s. He’s still here, she reminded herself.

Dotstry with his niece Shequita, his girlfriend and his sister Judy. (Ruddy Roye for ProPublica)

She pulled out her phone and called another brother. “They gonna amputate his foot, cause it’s bad,” she said. “Toe’s rotted.”

Dotstry looked up from the bed. “No!” he shouted. “They can’t take that off. Why?”

“Why you think your foot look like that? Why you think it smells? It stinks!” she said. Dotstry reached down to unwind the gauze. Judy wondered why he hadn’t told her that his foot was infected sooner. She lowered her voice. “You were doing pretty good. If you wasn’t, I could have tried to get back in there and do something.”

Her daughter, Shequita, ran into the room, huffing. She was loud and pissed off. “Whose foot is that?” she shrieked. She kneeled by the cot and helped Dotstry scoot up onto his pillow, stretching out his legs. He was usually a prankster, a hard-headed contrarian, the uncle who’d picked her up and spun her around like an airplane. She was thrown off by how quiet he’d become.

“Your daughter wants to know if you want to come stay with her, if you want to come to Texas,” Shequita told him.

Dotstry knew the offer was on the table, but he hadn’t yet accepted. A few days earlier, a tornado had torn the roof from his trailer, and he was, for the moment, without a home.

“She said it’s a lot better doctors up there,” Shequita continued, “and if she gotta stop working to take care of you, she can do that.” She gripped her hands around the frame of the bed and leaned over it, locking her eyes with his. “I need you to be thinking hard about this, sir. This ain’t you. I need you to get back to you.”

“He ain’t gotta go to Texas,” Judy interrupted.

Shequita shot back: “You gonna take care of him?”

Judy was silent. She knew that she couldn’t, not like before. She needed her paycheck for home repairs; a flood had warped her wooden floors. But Dotstry’s daughter was younger, and Judy thought that if she quit her job at Walmart, she’d get restless. Besides, Dotstry knew no one in Texas. She pictured him in a wheelchair, staring off, confused about where he was. Judy figured if he went, he’d go on and die.

She crossed her arms. “He’ll be all right if they don’t have to amputate that leg,” she said.

Shequita looked at her mother. She walked over to where she stood, by a shaded window, and threw her arms around her neck. Then, she left the room. Judy hoisted herself up onto the foot of her brother’s cot. She swung her legs up so that she faced him, and she laid herself down.


ABOUT EVERY FIVE YEARS, the doctors and researchers who make up the U.S. Preventive Services Task Force reassess their screening guidelines. In 2018, the members returned to peripheral artery disease and the blood flow tests that Fakorede had asked local primary care doctors to conduct. Once again, the panel declined to endorse them, saying there was not enough evidence that the tests benefited the average asymptomatic American.

In their statement, they acknowledged that public commenters had raised concerns that the disease “is disproportionately higher among racial/ethnic minorities and low-socioeconomic populations” and that this recommendation “could perpetuate disparities in treatment and outcomes.” In response, the panel said it needed better evidence. But as the National Institutes of Health has found, minorities in America make up less than 10% of patients in clinical trials.

Dr. Joshua Beckman, the director of vascular medicine at Vanderbilt University Medical Center, was an expert reviewer of the evidence base for the task force, and its final report struck him as irresponsible. It hardly noted the advantages of treatment after screening; the benefits were right there in the data that he saw. The panel discounted the strongest study, a randomized control trial, which demonstrated that vascular screening, for men ages 65 to 74, reduced mortality and hospital days. (The study bundled peripheral artery disease screening with two other tests, but in Beckman’s eyes, the outcomes remained significant.) He was confused about why the task force had published its evaluation of screening the general public, when it was clear that the condition affects specific populations. Several American and European professional society guidelines recommended screening people with a higher risk. “You wouldn’t test a 25-year-old for breast cancer,” he told me. “Screening is targeted for the group of women who are likely to get it.”

Dr. Alex Krist, the chair of the task force, repeated the group’s position in an email that the data was not strong enough to endorse screening, even for at-risk patients. “The Task Force does not do its own research, so we can’t fix these research gaps, but we can — and did — ring the alarm bell to raise awareness of this vital issue among researchers and funders.”

Fakorede performs a revascularization procedure with an assistant. (Ruddy Roye for ProPublica)

Vascular surgeons who have spent their careers studying limb salvage have come to see preventive care as perhaps more important than their own last-ditch efforts to open blood vessels. Dr. Philip Goodney, a vascular surgeon and researcher at Dartmouth and White River Junction VA Medical Center, made a name for himself with research that showed how the regions of the country with the lowest levels of revascularization, like the Delta, also had the highest rates of amputation. But revascularizations aren’t silver bullets; patients still must manage their health to keep vessels open. Now, Goodney believes his energy is better spent studying preventive measures earlier in the disease’s progression, like blood sugar testing, foot checks and vascular screening. Many patients have mild or moderate disease, and they can be treated with medicine, counseled to quit nicotine, exercise and watch their diet. “We need to build a health system that supports people when they are at risk, when they are doing better and when they can keep the risk from coming back,” he told me. “And where there’s a hot spot, that’s where we need to focus.”

Fakorede scrolled through the task force’s statement. “You want more data? Really? Who has the highest amputation rates in America?” he asked. “That’s your data.” He had taken to the national stage, speaking at conferences about what he’d witnessed in Bolivar. On behalf of the Association of Black Cardiologists, he testified before Congress, convincing U.S. Rep. Donald M. Payne Jr., a Democrat from New Jersey, along with U.S. Rep. Gus Bilirakis, a Republican from Florida, to start a Congressional Peripheral Artery Disease Caucus. The group is pushing for the task force to reevaluate the evidence on screening at-risk patients, for federal insurers to start an amputation prevention program and for Medicare to ensure that no amputation is allowed before evaluating arteries. Other groups are advocating for legislation that would require hospitals to publicly report their amputation rates.

In Bolivar, Fakorede had seen more than 10,000 cardiovascular patients from around the Delta. Dr. DeGail Hadley, a primary care provider in town, told me that before Fakorede arrived, he wasn’t sure what was best to do for patients with rotting feet. “It was always a process of transferring the patients to Jackson or Memphis, which can be difficult.” Both cities were two hours away. Now, Fakorede was performing about 500 angiograms annually in town. Last year, he published a paper in Cath Lab Digest describing an 88% decrease in major amputations at Bolivar Medical Center, from 56 to seven. (Fakorede did not provide me with all of his sources.) The hospital has different internal figures, which also reflect a significant decrease. Between 2014 and 2017, the hospital recorded that major amputations had fallen 75% — from 24 to six.

Fakorede couldn’t catch everyone in time, and he was haunted by the patients who got to him too late. A week before he’d met Dotstry, Sandra Wade had come in with an open sore on her right big toe. She came from a family of diabetics. Her mother had died after a diabetic coma. Her cousin had just lost a leg. Her oldest sister, who’d raised her, had given up on walking when a tired, burning, itching sensation consumed her legs. Now, Wade felt it, too.

Sandra Wade. (Ruddy Roye for ProPublica)

“I don’t want to give up like that,” Wade had said, reclining in a cot in Fakorede’s pre-procedure room. “I want my toes. I don’t want to lose not one limb. I choose life.” She elongated her O’s. She was 55 and had a high, gentle voice, a wide smile and big, curled lashes under loose, curled hair. She had spent most of her career in food service and retail, recently managing a Family Dollar, but after diabetes took her eyesight, she’d had to quit. She wondered if the sodas and chips that had fueled her at the store had accelerated her disease. Or if she’d focused so much on her son, who was developmentally disabled, that she’d neglected herself. She didn’t like to offload blame onto her genes. “Somebody’s gotta try to change the cycle,” she’d said. “I really want to be the one.”

Fakorede inserted an IV into the top of her leg. He opened up each of her blocked arteries, one at a time, until he got to the most important one, which ran along her inner calf. It was supposed to supply blood to her open wound, and she needed it to heal. Without it, she’d likely lose her toe. If she didn’t control her sugars, she could lose her lower leg next. Fakorede was hopeful as he slid a wire through the vessel in her knee, and into that crucial artery in her calf. But then, about a third of the way down, it stopped. It was as if the vessel itself had evaporated.


UNDER A CRISP, WIDE SKY, on Martin Luther King Jr. Day, churches around town were opening their doors for services. Fakorede’s office was scheduled to be closed, but he’d called in his nurses and radiology technicians, even those out hunting deer, to staff Dotstry’s case.

“What’s up, young man?” Fakorede greeted Dotstry, who was slowly fading into his Ambien, and he handed Judy a diagram of a leg. “The prayer is that we can find this many vessels to open up,” he said, pointing to the paper. “As soon as I’m done, I’ll let you know what I find.”

In the procedure room, he put on his camouflage-patterned lead apron, and with an assistant, he inserted an IV near Dotstry’s waist. He wound a wire across Dotstry’s iliac artery, into the top of his left leg. The femoral artery was open, even though it had hardened around the edges, a common complication of diabetes. They shot a gas down the arteries in Dotstry’s lower leg so the X-ray could capture its flow. Fakorede looped his thumbs into the top of his vest, waiting for the image. Other than a small obstruction, circulation to the toes was good. “They don’t need to whack off the knee,” he said, staring at the screen. Dotstry would lose one toe.

After they’d cleaned out the plaque, Fakorede called Judy into the lab and pulled up the X-rays. Dotstry snored in the background. The doctor showed Judy a playback of the blood moving through the vessels. She could tell that his foot had enough flow. She folded over, running her palms along her thighs. “Y’all have done a miracle, Jesus.”

Dotstry would need aggressive wound care, help controlling his sugars and a month in rehab following his toe amputation. In the meantime, Judy and her daughter would have to learn to manage his antibiotics and find him an apartment. He’d still be able to tinker with his cars, as he did most afternoons. And as far as Judy was concerned, he wasn’t moving to Texas.

Fakorede scrubbed out. He sat at his desk to update Dotstry’s doctors. He called an infectious disease specialist, 35 miles south, to check on whether he could see Dotstry the following morning. Then, he dialed the hospital and asked for one of the nurses. He explained what he’d found: that Dotstry didn’t need a leg amputation.

“Oh, great,” the nurse replied. “The surgeon was calling and asking about that. He called and tried to schedule one.”

Fakorede had been typing up notes at the same time, but now he stopped. “He was trying to schedule it when?” he asked.

“He was trying to schedule it today.”


ABOUT THE REPORTING

For this story, Lizzie Presser spent over a month in Mississippi, in December and January, speaking with dozens of patients and shadowing doctors, in clinic and in procedures. She interviewed over a dozen medical professionals whose work has intersected with Fakorede’s, including nurses, limb-salvage specialists, primary care providers and the hospital’s consulting surgeon, Dr. Roger Blake, who corroborated all facts related to his treatment plan for Henry Dotstry. She asked Bolivar Medical Center if it believed it provided Dotstry with adequate care. Even with Dotstry’s permission, the hospital declined to comment on his case, citing patient privacy.

The scenes in the story are informed by her own observations and interviews with the subjects to fill in details, including their thoughts at the time.

To put her observed reporting into national context, she reviewed the salient medical research and interviewed more than a dozen experts in all corners of the health care system, from those who treat diabetic patients to those who inform and set policies around care.

Lizzie Presser covers health, inequality and how policy is experienced for ProPublica.

Benjamin Hardy contributed research to this story. Maps by Lena Groeger. Design and production by Jillian KumagaiAgnes Chang, and David Sleight.

Source: The Black American Amputation Epidemic

We Have To Stop Valorizing Black Cops | Black Agenda Report

We Have To Stop Valorizing Black Cops

The purpose of policing––to jail and kill Black folks––remains the same regardless of the officers’ race.

“Allowing Black people into inherently racist systems does not make those systems better, safer, or more equitable.”

Policing in America is facing a PR crisis. Following the May 25th murder of George Floyd by Minneapolis police officer Derek Chauvin, the term “defund the police” has become a rallying cry for thousands across the country. Six months later, however, America has not defunded its police force––and in fact, has in some cases taken steps to give police departments even more money. Instead, police forces across America have taken an insidious approach: painting their departments in blackface.

After the January 6th Trump riot at the Capitol building , Yoganda Pittman, a Black woman, was named the new Chief of Capitol Police. Her appointment followed the resignation of former Chief Steven Sund and the arrest and firing of several white police officers who were found to be in attendance at the MAGA riot. Pittman’s appointment appeased many liberals who falsely believe that allowing Black folks to infiltrate or run law enforcement agencies will lead to higher levels of safety for Black Americans. The termination of several officers  who took part in the riot has convinced many that we are one step closer to “reforming” the police by weeding out the racist, bad apples within the department.

“Pittman’s appointment appeased many liberals.”

This is a nice narrative, but a false one; in order to understand why, we must look at the history of policing in this country. Modern policing in America was originally created as a replacement for America’s slave patrol system wherein squadrons made up of white volunteers were empowered to use vigilante tactics to enforce laws related to slavery. These “enforcers” were in charge of locating and returning enslaved people who had escaped, crushing uprisings led by enslaved people, and punishing enslaved workers who were found or believed to have violated plantation rules. After slavery was legally abolished in 1865, America created its modern police force to do the exact thing under a different name: maintain the white supremacist hierarchy that is necessary under racial capitalism. The purpose of policing––to jail and kill Black folks––remains the same regardless of the officers’ race.

Liberal media has also contributed to the recent valorization of Black cops. In the days after the January 6th riot, many news outlets aggressively pushed a story about Eugene Goodman, a Black capitol police officer who led several rioters away from the Congress people’s hiding places while being chased by a white supremacist mob. Several news outlets published testimonials of Black police officers disclosing instances of racism within the department. A January 14th article in ProPublica  notes that over 250 Black cops have sued the department for racism since 2001: some Black cops have alleged that white officers used racial slurs or hung nooses in Black officer’s lockers, and one Black cop even claimed he heard a white officer say, “Obama monkey, go back to Africa.”

“Modern policing in America was originally created as a replacement for America’s slave patrol system.”

These white officers’ racism is unsurprising, and I am not denying any of these claims. But focusing on these singular, isolated moments of racism wherein white cops are painted as cruel and Black cops are the sympathetic victims grossly oversimplifies the narrative of structural racism that modern American policing was built upon. After hearing these slurs that they were allegedly so disgusted by, these Black cops still intentionally chose to put on their badge, don their guns, and work alongside these white police officers who insulted and demeaned them, laboring under a violent system with the sole purpose of harming and terrorizing Black and low-income communities. Similarly, while Goodman’s actions most likely saved many lives during the riot, we cannot allow one moment of decency to erase centuries of racist violence.

The great Zora Neale Hurston once said: “All my skinfolk ain’t kinfolk.” Her words ring ever true today, and these Black police officers are an excellent example of why. It’s tempting to believe that putting Black folks on the force will solve racial violence, but this is a liberal myth we must break free of. Allowing Black people into inherently racist systems does not make those systems better, safer, or more equitable: a quick look at many Black folks in power today, such as Barack Obama, Kamala Harris, Lori Lightfoot, and Keisha Lance Bottoms immediately prove this to be the case. Everyone supporting racial capitalism must be scrutinized and held accountable, regardless of their identity. We cannot on the one hand say that ‘all cops are bastards’ and then suddenly feel sympathy when those cops are not white. If we want to defund and abolish the police, we must resist the narrative that Black cops have anything to offer us.

Mary Retta is a writer, virgo, cartoon enthusiast — a queer Black writer for sites like Teen Vogue, The Nation, Bitch Media, and Vice.

This article previously appeared in HoodCommunist .

Source: We Have To Stop Valorizing Black Cops | Black Agenda Report