78 Book Rev~W8
What is interesting about the choice of case studies is that they represent, broadly speaking, two
different political persuasions, with China and Tanzania (socialist) on the one extreme and Kenya
(capitalist) on the other. The authors seem to suggest that the political ideology of a country isimportant
for popular participation to be successfully effected. For the overall development process, the political
dimension of popular participation is equally importantfor facilitating the attainment of socioeconomic
objectives (p16). However, if the examples looked at are anything to go by, then it might not be far
fetched to suggest that the application of popular participation as a method transcends political
ideologies. What should be viewed as paramount is the government's commitment to the idea.
Part 3 addresses the topic 'Participatory Practice: Local-level Experiences'. This is concerned with
attempts to translate the concept of popular participation into practice focusing on the participation of
disadvantaged groups in specific development programmes and projects as a means of improving their
well-being. In this section, experiences from different comers of the world, particularly Latin America
and Asia are highlighted. Perhaps an interesting lesson to emerge from the Latin American case study
is that the desire and demand for participation bydisadvantaged and oppressed groups could unfortunately
eventually be expressed in rather violent forms, especially when confronted with fierce opposition by
the elite who dominate the decision-making structures.
Another case study is that of China. In this case study, participation of Chinese women in the
development process is looked at. One of the main conclusions drawn from the case is that women in
China had to struggle to overcome discrimination based on traditional biases and prescriptive
, behaviomal norms in order to defend their rights.
Finally, participation is looked at vis-a-vis planning, and Bangladesh is used as a case study. A self-
I help canal digging project is selected for scrutiny and the experience here seems to show that without
, a significant degree of popular influence on decision-making it becomes extremely difficult to motivate
the poor to take an interest in such projects. Indeed, the poor, natmally, want to know what is in it for
them before they can be 'lmed' into participating in such projects as canal digging.
Perhaps the greatest contribution of the is book is that it dermes quite clearly not only the roles of
the state, the politicians and the administrators (and other technocrats) in effective mass participation
but that of the prospective beneficiaries, the peasantry, as well. On this score, the book urges that
vertically meaningful consultations be held between national, regional and local authorities and that
horizontal communication takes place between communities with regard to the identification of basic
needs, particularly where needs and interests might coincide. This will allow for the coordination of
development efforts with implications for the saving of scarce resources.
This book is a must for those interested in the topic of popular participation, empowerment and
capacity building among underprivileged groups. It is a well-thought out, focused, informative and
fairly well-balanced wor1c. It is good value for money.
Reviewed by R S Mupedziswa. School of Social Work, Harare.
Five Hundred Million Children. Poverty and Child Welfare in the Third World, Stewart
MacPherson, Wheatsheaf Books, Sussex, 1987 (226pp, £32,50 hbk).
"Four comma three million African children die every year", with little hope for improvement over the
next decade; "98% of the deaths of children under five are in the poorest countries"; "99% of allmatemal
deaths are in developing countries"; "there are between 100 and 200 million abandoned and street
children in the world".
These and other statistics aboundin Stewart MacPherson's book, Five Hundred MUllon Children.
Not that the book is a statistical dossier, but that such statistics constitute a question to which there are
BookReview8 79
no easy answers. Why is child welfare not such a topical issue in today's world? PoliticillIlll, economists
and social scientists spend their time discussing nuclear weapons, the Third World debt and AIDS.
Granted that these are all important issues in hlD1lan existence, it is hard to understand why
disproportionately little international effort is being directed towards alleviating the living conditions
of the majority of children across the globe.
MacPherson's book lays bare some startling facts about child welfare in the Third World. It
examines a broad spectrum of the main negative socioeconomic factors which are at play in the life of
the average child in the developing world, without pretending that there are easy solutions. The book .
relies mainly on empirical ewenences indeveloping countries in Asia and Latin America to put forward
its case, with minimal refelkmce to the African experience.
Traditional approaches to child welfare are strongly challenged. They are generally seen as alien
and western, urban-biased, expensive and therefore unable to provide a realistic answer in the cashstarved
societies of the developing world. Strategies which seek to build on what communities already
know and have have a greater chance to succeed, he argues.
MacPherson's book, while undoubtedly depressing, shows that itis possible, even in poorcountrles,
to improve the living conditions of the poorest. Tanzania, regarded as one of the world's poorest
countries, has been able to achieve what no other African nation has done in terms of bringing social
services to its population, thanks to government policy. But Tanzania is now experiencing its worst
economic crisis in history, resulting in the loss of some social gains. It is not clear whether there is any
relationship between the deteriorating economic conditions and the egalitarian policies of the past.
It is a pity that MacPherson does not attempt to look at the political and military context in which
some Third World children live. This is particularly relevant in Southern Africa where apartheid has
devastating consequences on the lives of millions of children, especially over the last decade. Coming
at a time when common sense seems to be h'eaking out throughout the world, this book raises issues
which deserve to be put in the forefront, on the agenda, of a more peaceful world. MacPherson's book
need not be another voice in the wilderness.
Laypeople, academics, child welfare activists, and all people interested in advancing one of the most
legitimate causes of the twentieth century will find this book both refreshing and stimulating.
Reviewed by Allan Masomere, Harare.
Development Psychiatry: Mental Health and Primary Health Care in Botswana, David Ben-
Tovim, Tavistock, London, 1987 (233W, £12.95 pbk).
This book can be seen as a milestone in the literature of mental health in Africa, describing, with
considerable empathy, skill and conciseness, the results of the author's experience in the integration of
primary health care and psychiatric services inrural areas, and as a lone psychiatrist with the Botswana
Ministry of Health. Until the late 19708 Botswana's only psychiatric facility was an isolated mental
hospital, which had become grossly overcrowded. After collaborative work with the WHO and other
international agencies, Botswana embarked on a programme of integration of psychiatric care with
existing primary health care services. Development Psychiatry places this bold experiment in a clear
perspective in a national, African and international context. •
It should, however, be said at the outset that although the work describes how a psychiatric system
can move from a curative and institutional health service to a wider service that incorporates primary
hellI.th care, it does so from an overt commitment to the physical diseasemode1 of mental dismders. "It
is my view that none [of the models] have been found to have a wider range of awlicability than the
[physical] disease model", and, Ben-Tovim goes on to say, that "treating psychiatric disorders II!