Gaza’s health system close to collapse as electricity crisis threatens total blackout

World Health Organization warns hospitals could be plunged into darkness by end of February without fresh funding to keep emergency generators running

Hospitals in Gaza will face an almost total power blackout by the end of February unless funding is secured to keep emergency generators running, the World Health Organization has warned.

An ongoing electricity crisis in Gaza has left hospitals reliant on emergency generators for up to 20 hours a day, while medical staff have been forced to cut back on basic services such as equipment sterilisation and diagnostics. About 500,000 litres of fuel are required each month to sustain critical care in Gaza, but funding will only cover hospitals needs until the end of February.

Dr Mahmoud Daher, head of the WHOs Gaza sub-office, said the health system is on the edge of collapse. Without urgent fundraising, hospitals will face a disastrous situation, he said. There are at least 200 babies and people in intensive care units. It would be a really fatal situation for them. There are dozens of people who are going to surgical operations that would be affected.

Fears over the humanitarian situation intensified following a series of tweets by Donald Trump on Tuesday, in which he threatened to cut funding for the Palestinian Authority unless it recommences peace talks. The US ambassador to the UN, Nikki Haley, earlier said the US would cut funds to UNRWA, the UNs agency for Palestinian refugees, unless the authority went back to the negotiating table.

Dr Andy Ferguson, director of programmes for Medical Aid for Palestinians (Map), an organisation that works with hospitals and other healthcare providers across Gaza and the West Bank, said electricity outages in Gaza, combined with medical shortages and severe restrictions on freedom of movement, were creating a medical emergency.

Difficulties with sterilising equipment have caused a rise in hospital infections, he added, while power fluctuations have damaged sensitive medical equipment.

Worsening maternal malnutrition and increasing rates of premature and low-birthweight babies have led to instances of dangerous overcrowding in the neonatal intensive care unit in al-Shifa hosptial, said Ferguson.

Palestinian
Palestinian children do their homework by candlelight during a power cut in Gaza City. Photograph: Mahmud Hams/AFP/Getty Images

As a result, explained Ferguson, incubators designed to accommodate one baby were often occupied by several. Medical staff are having to look after as many as seven critically ill babies each at a time, compared to the UK standard of 1:1 or 1:2 care. Overcrowding of this type makes adequate monitoring and infection control impossible.

Generators are also in need maintenance, the WHO warned, but hospitals are unable to carry out repairs due to restrictions on moving goods into Gaza.

We have been told by doctors in a neonatal unit that there were periods when staff in the units were forced to make manual ventilation to patients in intensive care because the generators didnt function, said Daher. Its a matter of seconds sometimes.

The WHOs latest figures show hospitals are experiencing severe shortages of drugs and medical disposables. Of 516 medications on the essential drug list, 223 (43%) were at zero stock levels in November, which means central supplies will be totally depleted in less than a month. At the end of November, drugs used in the emergency departments and intensive care units were at 48% zero stock, while power shortages have made it harder for hospitals to collect and store large quantities of blood.

There are also dramatic decreases in the proportion of people securing permits to access healthcare outside Gaza, said Daher. In October, 45% of patients who applied to the Israeli authorities for such treatment were unsuccessful. Figures are expected to show that there were fewer exit permits granted in 2017 than in any year since the WHO began monitoring applications.

Map knows of at least 30 patients who died in 2017 after being either prevented from exiting by Israel or unable to secure financial coverage for their referral from the Palestine Authority, said Ferguson.

The Israeli government has yet to respond to a request for comment.

The UN will launch its humanitarian response plan for the occupied Palestinian territory later this month, and is expected to call for $374m (275m) to meet humanitarian needs in the Gaza Strip.

Read more: https://www.theguardian.com/global-development/2018/jan/03/gaza-health-system-collapse-electricity-crisis-threatens-total-blackout

Can a commune revival fix London housing crisis?

(CNN)Upper Street, Islington, is the heart of chic and cosmopolitan North London — a mile-long stretch of award-winning restaurants, boutiques and public gardens.

The iconic Georgian houses rank among the British capital’s most desirable and expensive, with prices reaching $10 million. Local residents include movie stars Colin Firth and Emma Watson.
But just off the main street, tucked away among the stylish facades, is a parallel universe.
While the borough has shot upmarket, one of London’s oldest communes has never strayed from the vision of Franciscan Monk Greg Moore, who founded Islington Park Street Community in 1976, as a refuge for the vulnerable and low-paid.
Eighteen housemates, aged 19 to 79, share four grand old houses with the partitions removed. They also share resources and responsibilities, each paying $43 a week for food and bills, which has allowed them to survive in this elite neighborhood over four decades.
“People receive what they need and give what they can,” summarizes Karen Grace, a care worker who has spent five years at the home.
Places here are allocated according to need, and applicants are filtered to maintain a balance of age, gender, ethnicity, sexuality and support needs — accommodating people that need care, and others that can provide it.
The community includes a victim of domestic abuse, an ex-prisoner, and people suffering with mental illnesses. Many have struggled to access social services outside, which are facing government cuts. “This is a place to have a sense of safety and support,” says Grace. “People here have experienced the opposite.”
Such an arrangement may seem more of a throwback to the idealism of swinging 1960s London than the modern metropolis with its surging skyline of luxury high-rise towers.
But in a city where the cost of living has shot up rapidly, the communal approach presents a potential solution for many struggling residents.

Tale of two cities

London’s property market has become increasingly unaffordable for many on middle and low incomes.
The average house price in the English capital recently passed $800,000 — Monaco and Hong Kong are the only more expensive cities, according to Knight Frank — and the year to 2014 saw a record 18% rise. Properties deemed “uninhabitable” by estate agents can fetch almost $1 million.
The rental sector offers little relief. British tenants pay the highest rents in Europe, both in absolute terms and as a proportion of wages, according to the National Housing Federation. A separate study found that Londoners pay around 60% of their incomes in rent, while some councils have even been forced to re-house low income residents outside the city.

London’s luxury underground living.

“For 30 years we have not built enough homes,” says Tom Copley, chair of the Housing Committee at the London Assembly. “We need 49,000 new homes a year to meet demand and fewer than half are being built. Many of these are luxury homes being bought by speculators that don’t serve the needs of the majority of Londoners.”
“We’re seeing huge overcrowding, people living in poor conditions, sky-high rents…and unfortunately these trends will continue.”
Islington Park Street is not immune to this harsh climate. Property owner One Housing Group — which acquired it from a philanthropic trust — is seeking to “decant” residents ahead of “potential sale of the land and property.”
Residents are fighting a legal battle to protect their community, and their campaign has struck a nerve with activists, politicians and celebrities.
“The wider issue is people being priced out of London and someone needs to bring attention to it,” says Grace. “It is social cleansing…I hope we can win our case and become a symbol of hope for the housing movement.”

New adventures in communal living

Yet the lack of affordable housing has also fostered creativity among struggling Londoners and new forms of communal living are emerging to relieve the pressure.
Property guardians‘ pay cheaper rent to stay in empty buildings, including office blocks and schools that can accommodate dozens. Inter-generational housing offers another solution, connecting struggling younger people with senior citizens that appreciate the company.
For those seeking more than just affordability, however, converted industrial zones have proved appealing by offering creative live-and-work spaces. Jose Castroviejo made the leap to a former textile factory in East London after months of couch surfing and “rip off rents.”
“I was attracted by the ethic and environment,” says Castroviejo, an events producer, originally from Madrid. “There is a sense of community…it’s tremendously creative and one of the only places in London where you say ‘hi’ to people on the street.”
Several hundred young, artistic people inhabit a network of converted spaces through an arrangement that makes one tenant a leaseholder that can sublet to dozens of housemates at lower than market rates.
Collective responsibilities are minimal, but spaces and resources are available to the community, and events such as the Hackney Wicked festival are undertaken collectively.
“There is a ‘freecycle’ element,” says Castroviejo. “Anything you don’t want that’s reusable is left in a hallway and usually within 24 hours it is re-absorbed into the community.”

The next top model

London also recently gained its first cohousing project — already a popular concept in Germany — which involves residents planning their own community with shared resources, spaces, and decision-making.
The Copper Lane development is home to 13 people, who spent six years and $3 million converting a disused nursery site into energy-efficient homes with communal gardens and a rooftop courtyard.
“We were looking for a way to retain our own self-contained living spaces, combined with indoor and outdoor spaces which would encourage different forms of interaction,” the residents explained in a statement.
Activists anticipate Copper Lane will be followed by many similar but diverse projects.
“We have over 75 groups (in Britain) who are developing,” says Sarah Hewitt of the UK Cohousing Network. “It’s growing fast… groups have different priorities, whether it’s about being eco-friendly, spiritual or affordable.”
Housing campaigner Leslie Barson is at the forefront of the movement in London. As a leader of the London Community Housing Co-operative (LCHC), she is developing a self-build project in the central borough of Westminster for dozens of families. She hopes the venture will tackle affordability and host social spaces for education and urban agriculture.
“Housing is just seen as a way of making money and it is driving people out,” says Barson. “People can’t afford enormous rents so they fall into housing benefit (welfare) and our tax money goes to subsidizing private landlords. We say rent should be no more than one-third of average earnings for the area.”
The LCHC hopes to eventually launch several new communities around the city, harnessing innovations such as straw bale building material to manage costs and sustainability.
The major obstacle is securing land, which generally goes to the highest bidder. Developers are obliged to provide a proportion of affordable housing, but rules can be skirted, and the definition of affordable housing has been questioned by leading charities.

Winning hearts and minds

The UK government has given qualified support to community development schemes through its ‘right to build’ initiative, which encourages local authorities to provide land for them, although it remains an uphill struggle.
“If you’re in a bidding war with a commercial operator you lose,” says Gavin Smart, director of policy and practice at the Chartered Institute for Housing. “Public sector finances are under intense pressure, and if local authorities let land go cheaper they take a loss.”
Barson wants more active support: “The Mayor should be telling councils to facilitate passing land to community builders. We’re entering new territory and need goodwill on all sides.”
The activist believes there is huge demand for these projects, which should provide leverage. If the authorities prove un-responsive, Barson says a rent strike is one option to convince them.
But if land is secured, there is still a psychological challenge for communal models. Proponents must overcome the aversion that many feel to the distinct lifestyle, and even veterans admit that adjustment takes time.
“People are used to living as individuals,” says Professor Paul Chatterton, founder of a cohousing community and author of “Low Impact Living“. “You need training to understand how to live and work together.”
Yet the luxury of choice may not last. If the pressure on London housing keeps growing, more of the city’s beleaguered residents could need each other to survive.

Read more: http://www.cnn.com/2015/10/02/business/commune-london/index.html

Logan Paul has behaved despicably. But hes part of a wider trend | Emily Reynolds

The YouTube star claimed he was trying to raise awareness of mental health issues by filming a dead body. Its time to stop using this meaningless phrase, says Emily Reynolds, who writes regularly about mental health

The words outcry as YouTube star posts video of dead body in Japan are so ludicrous, almost nonsensical, that they may as well have come from a random 2017 headline generator. Unfortunately, they dont.

Logan Paul, a 22-year-old vlogger, has been castigated across the internet for publishing a video showing the body of a suicide victim in Aokigahara, a forest near Mount Fuji notorious as a site for multiple suicides every year. Breaking Bad star Aaron Paul (no relation) told Paul he should rot in hell; even Piers Morgan described him as a sick, twisted, heartless little prick.

Pauls YouTube channel has over 15 million subscribers, so its no surprise that a number of fans are already attempting to explain away his behaviour, many with the hashtag #Logan_you_are_forgiven. These fans are in the minority, though, and rightly so. Filming the body of a victim of suicide and posting it online for all to see is unforgivable behaviour refusing to give the victim any dignity in death, completely disregarding the distress it may cause their loved ones, failing to take into consideration the millions of young viewers exposed to the scene, and displaying a very disturbing lack of empathy in the process.

His excuse? He was trying to raise awareness.

Thats obvious nonsense. Media guidelines on reporting suicide are clear: the Samaritans guide on reporting standards plainly state that outlets must exercise caution when referring to the methods and context of a suicide a point that includes not giving too much detail on specific methods. Dignity and decency aside, Pauls video clearly fails to live up to these standards. But there is something in his use of raising awareness that speaks to something beyond this single incident.

Awareness raising came into its own in 2017, with decades worth of campaigns by mental health charities and activists finally gaining mainstream attention. So far, so good: its undeniable that testimonies from those with long-term mental health conditions have started to massively destigmatise elements of mental illness, depression and anxiety, particularly. But, somehow, awareness raising became a behemoth. In recent months Ive had coffee shop windows and soap packaging exhort me to be aware of mental illness, and its even been used in workplaces across the country as a way to improve the efficiency and productivity of workers not quite the stigma-busting change of heart that many of us had in mind when we first started campaigning for awareness.

The primary goal of much visible mental health activism became raising awareness, and it completely dominated the media: articles, books, TV shows all firmly focused on the idea of breaking down stigma. The actual day-to-day realities of people with chronic mental illness were seemingly unimportant it didnt seem to matter what they needed or how they felt, just as long as we knew they were there. The politics of mental health the impact that austerity has on the lives of mentally ill people, as well as poverty, racism, lack of access to services have broadly been ignored in favour of simply encouraging people to talk.

Its now reached the point where awareness raising is used to excuse all sorts of problematic behaviours. Hundreds of articles are published every year making sweeping, unverified statements about mental illness and giving potentially dangerous advice; the NMEs unapproved use of Stormzy as a poster boy for depression was apparently an attempt to raise awareness of an issue that weve been inspired to talk about following your comments; and Theresa May claimed that her government would reduce stigma while simultaneously placing services under obscene pressure via unrelenting cuts to the NHS.

Pauls claim is a similarly transparent attempt to get himself off the hook to excuse his despicable behaviour and, probably most pertinently for him, to prevent the loss of his 15 million YouTube subscribers. But though his excuse is undeniably galling, its also now par for the course. Awareness raising is so ubiquitous a phrase that it has been rendered utterly meaningless.

Genuine awareness raising thoughtful, responsible testimonies from people living with mental illness or disability is invaluable. But when a term can be so easily utilised to justify even the most horrifying behaviour, its probably time we found a new one.

Emily Reynolds is a freelance journalist based in Berlin

  • In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at http://www.befrienders.org.

Read more: https://www.theguardian.com/commentisfree/2018/jan/03/logan-paul-youtube-suicide-mental-health-raise-awareness

‘186m needless emails’: NHS-wide test message (and replies) crash system

Some users prevented from accessing email system after IT contractor at Croydon NHS messages all 1.2 million employees

Sending an email to everyone in the company is usually a guaranteed way of making yourself unpopular, but the potential for annoyance is even greater if you have 1.2 million colleagues.

On Monday, NHS staff complained on Twitter about a test email sent by an IT contractor at Croydon NHS to everyone in the organisation, as well as replies to all in response to the message, leading to claims that the entire email system had crashed.

One health service statistician estimated that at least 186m emails, including replies to all asking to be taken off the distribution list, had been sent, clogging up peoples inboxes. NHS digital said 840,000 accounts were affected.

Gavin (@68_gavin)

Another waste of a working day due to some pillick in #nhsmail sending email to entire directory, unable to connect and do my job #epicfail

November 14, 2016

James Andrews (@aptaim)

Hmmmm… wonder if this is why I can’t log in to #NHSmail at the moment ?! https://t.co/wBvuREsB6X

November 14, 2016

Project iHypE (@PIhype)

If you’re trying to get in touch with us today, please be patient, it seems #NHSmail has gone down for the time being. We’ll reply ASAP. A

November 14, 2016

Colin McDonnell (@Malignanthero)

Slow handclap for the individual that sent a test email to the entire NHSMail user base, and bravo to those that “replied to all”… pic.twitter.com/zkg5uG7t2M

November 14, 2016

Graham Hyde (@GrahamHyde)

#nhsmail 1.2 million people have received approx 151 emails in error this morning. That’s 186 million needless emails so far today.

November 14, 2016

A message to NHSmail users described the global email as a high severity service incident. It said: An issue with a distribution list has meant that several test emails have been widely received by users. This has been exacerbated by recipients replying in response and increasing the volume of emails associated with the list.

The impact of this issue has meant that some users are unable to access OWA [Outlook web access] due to the volume of emails being circulated. The distribution list has been removed and associated emails are being traced and cleared. In the meantime, users will experience slow performance with OWA and email delivery delays from internal and external sources to nhs.net addresses.

In a statement dictated over the phone due to the problems with the email system, an NHS Digital spokeswoman said: Some users have experienced short delays in the NHSmail system this morning. Action has been taken to resolve this issue.

A number of email accounts have been operating slower than normal due to an NHSmail user setting up an email distribution list which inadvertently included everyone on the NHSmail system. As soon as we became aware of the issue, we deleted the distribution list so that no one else could respond to it. We anticipate that the issue will be rectified very soon.

Complaints to the NHSmail helpdesk have trebled since the email system was introduced in May. The secure email service is approved by the Department of Health for sharing patient-identifiable and sensitive information.

Read more: https://www.theguardian.com/society/2016/nov/14/186m-needless-emails-nhs-wide-test-message-and-replies-to-all-crash-system

A moment that changed me: listening to, rather than trying to fix, my suicidal wife | Mark Lukach

Teacher and writer Mark Lukach was terrified each time Giulia spoke about killing herself. But one day he was too tired to respond

One afternoon my wife, Giulia, asked me: Mark, if I kill myself, will you promise me that you will find a new wife so that you can still be happy? I sighed and leaned back into the chair next to her, unsure of what to say.

Actually, thats not entirely true. I knew exactly what I wanted to say. I had been saying it for eight months. Its just that at that moment, I was so tired tired from work, tired from worry, tired from so many conversations about suicide that I didnt have the energy for it again. So I sat in silence.

My wife had been hospitalised eight months previously with a psychotic break. It started with a new job, which made Giulia more stressed than she had ever been, to the point of work paralysis, loss of appetite and inability to sleep. The slide into psychosis was rapid and entirely unexpected. Sure, she had been stressed out before, but nothing like this. Out of desperation, I took her to the emergency room, where they admitted her to the psych ward for 23 days to address her escalating paranoia and delusions.

She came home from the hospital heavily medicated and suicidally depressed. She had little to no energy for anything, and spent much of her time wishing that she could kill herself.

This was terrifying for me. I took a few months off work, so that she wouldnt be alone all day, a prospect that worried me and her doctors. When she brought up suicide, which was all the time, I panicked. I treated her feelings like a fire, and I was the extinguisher. I had to act quickly, otherwise the warning sparks could grow.

Her first fixation was on overdosing on her medication, so I concocted a plan to hide the pills. I changed the hiding place every few days, and retrieved the medication each night as she waited for me in the bathroom, and then hid them again after she took them. Cant overdose on pills if you cant find them.

Mark
Mark and Giulia Lukach, on their wedding day.

Then her focus shifted to the Golden Gate Bridge. She wanted to drive there on our scooter and jump off, and she told me about this, over and over again. I couldnt hide a bridge.

She told me these things when we were walking on the beach together, or at home cooking dinner, but I was so afraid that I responded in full emergency mode, as if we were up on the bridge, Giulia on one side of the railing and me on the other. I couldnt not see it that way. Someone I loved was in pain, and I needed to do something about it.

Doing something meant reminding her of all the reasons it was worth staying alive how good we had it, how much our families loved us, how much there was to look forward to. It almost became a script, a choreographed dance: she told me she felt suicidal; I tried to overwhelm her feelings with why she shouldnt feel that way. It never convinced her of anything. But on that afternoon, exhaustion had beaten me down into shutting up. I sat quietly and held her hand.

She looked at me in surprise. Cautiously, she ventured with another thought. I hate myself so much, and I want to die, she said, and I said nothing.

I wish I had never been born, she said.

More silence.

She continued through her tortured feelings. I listened, and hated what I heard, but I knew that at this moment she was safe. We werent actually there on the bridge railing. We were at home, together, and there was no way she could act upon her pain. These were just words.

And then she left me stunned. Thank you for listening to me, she said, pulling my hands to her lips to kiss. Its so nice to talk to you. I feel a lot better.

I hadnt said a word. It dawned on me how little I had been listening to her, without judgment or rush to action. She didnt need me to tell her that everything was going to be OK. That didnt help. She needed me to hear her pain. Being heard somehow made it more manageable.

On that afternoon I finally learned that when any of us is in pain, the greatest gift you can give is to listen, patiently and purely.

In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here.

Read more: https://www.theguardian.com/commentisfree/2017/jul/14/moment-changed-me-listening-suicidal-wife

Jonathan Raban: I felt pretty happy that I was still alive

The author on his recovery after a stroke and his fears for a dis-United States

On 11 June 2011, a few days before his 69th birthday, Jonathan Raban was sitting with his daughter Julia at home in Seattle. Hed felt foggy and out of sorts since waking. Having reheated a casserole, he looked down to see that, try as he might, he couldnt make the knife in his right hand touch the food on his plate.

His voice lifts in remembered surprise. It was very strange. I said to Julia: I think Im having a stroke.

He was. A few hours later, Raban was in a hospital in the north of the city, looking at scans of his brain. The stroke was haemorrhagic, and massive: the damage to the right side of his body would be impossible to erase.

Carefully balancing a glass of red wine with his good hand, he gestures down at the wheelchair he now uses. Not quite instantly, but within a very few weeks, I was transformed into an old man. A second later, he concedes gruffly: I did feel pretty happy that I was still alive.

Appropriately for a man best known for his nautical writing, Rabans home feels rather like the upturned hull of a boat, with coffee-coloured redwood beams and a clutter of charts, sailing photos, engravings and mock-ups of the covers of his books. Every so often theres the drone of a seaplane coming in to land.

As soon as he got home from rehab,Raban did what he has always done: he began to write, and to research accounts of other peoples strokes (mostly unreadable, he grunts), English social history, his parents letters; searching for a way to braid the experience with the other skeins of his life.

I remember a doctor came to the rehabilitation ward, about my age, and said: Oh, youre the one who used to be a writer. I told him: Im still a writer, and I intend to write about this.

Raban talks in unhurried, intricately woven sentences, languid vowels barely touched by two decades in the US; it feels a little surreal to encounter him here in the Pacific Northwest. But Seattle, he goes on to explain, is as close to a home as he has found. Born in Norfolk in 1942 and educated at the University of Hull where he became friendly with Philip Larkin he started out as an academic. But as his anthology-cum-memoir For Love and Money (1989) attests, he lasted only a few years, writing fiction and journalism during University of East Anglia vacations and trying to gain a ticket of entrance to the city at the end of the line. He launched himself as a freelance writer in London in 1969, lodging with the poet Robert Lowell and becoming part of the bibulous in-crowd that centred on Ian Hamiltons magazine New Review.

The
The Mississippi river, the subject of Old Glory. Photograph: Macduff Everton/Getty Images

Even the capital seems to have been a temporary halt. Within a few years Raban was flitting around the Middle East, as recorded in Arabia: Through the Looking Glass (1979); then floating down the Mississippi in an open-topped boat (Old Glory, 1981). Soon after that adventure, be bought a larger boat and piloted it around the British Isles. The project became Coasting (1986), which is as sui generis as Rabans other books part memoir, part rite of passage, part discourse on fluid mechanics, part sly satire on British islomania during the Falklands campaign. In the wake of Brexit, it is a salutary read.

Afloat, Raban writes, he found a sea-distance that matched his sense of estrangement from Britain, and the grounding stability that eluded him on land. But the thing that genuinely fascinates him, and makes his prose leap and surge, is water an eerily still North Sea off East Anglia, as calm and full of mercurial colour as a pool of motor oil; a corner of the north Pacific off British Columbia, like a bolt of grey silk, lightly undulating, that seeps its way into his brooding travelogue Passage to Juneau (1999).

The love affair began early, Raban recalls. Water, one way or another, hasbeen a means of escape for me from pretty much infancy. When Isawa river or a pond or a lake, Isawfreedom and solitude. I could behappy in those places, in a way that I couldnt be at home.

Raban has often written about his tussles with his father, an army captain-cum-cleric whose return from the second world war he brusquely resented as a child, and whose dog collar and cassock, with its greasy antique patina like the sheen on a blowfly, represented everything to rebel against. But his interest in literature is something he owes to his mother, who once wrote short stories for womens magazines.

The
The thing that fascinates Jonathan Raban is water. Photograph: Alamy

She taught me to read, which was my one proficiency. My father gets all the attention, but partly thats because he intruded on this relationship with my mother. There is a curt laugh. I harboured the usual fantasy.

It seems not insignificant that his first published work, printed in John Londons Weekly when he was 17, concerned a child whose father is presented with a shattered china dog as a gift after returning from the war. Rabans writing has grown infinitely more sophisticated since then, but its leitmotifs struggles with overbearing authority, a search for refuge in a world that seems aslant have remained.

He insists his arrival in the US, tracked with droll self-scrutiny in Hunting Mister Heartbreak (1990), wasnt intended to be permanent he retains British citizenship but it seems appropriate that he alighted on the West Coast, the favoured destination for people wanting to slough off old lives and try on new ones for size. One of that books most moving chapters chronicles the time Raban spent with Korean immigrants to Seattle, whose travel-shocked recalibration to wide wide wide America is partly, one senses, his own. The section closes with Raban setting himself up downtown in a former luxury hotel; in his room is a gold-painted desk that had once been used by Elvis, and a name label reading Rainbird on the door.

Marriage to Jean, a dance critic and journalist in the city, swiftly followed; Julia was born not long after that, and is now in her mid-20s. Among the cavalcade of identities Raban has tried out during his 74 years, the one that really seems to fit him is fatherhood, which came late. Its a role he still seems enjoyably astonished by, and which has provided some much-needed anchorage. Though the relationship with Jean came to an end, Julia now lives nearby and the two see each other nearly every day.

Im interested in his thoughts on genre; though his books are filed in the travel sections of bookshops, does he feel himself to be a travel writer? He snorts. I see a travel writer as someone whos sampling other peoples holidays and writing a bright little piece about the glories of Weston-super-Mare or something. Bruce Chatwin bridled at being called a travel writer; when Songlines was shortlisted for the Thomas Cook award, he wrote a stiff letter saying that it was impossible for it to be entered because it was most certainly an invented journey. I feel sympathetic to that.

A
A protest march against President-elect Donald Trump in Seattle, Washington, 14 November 2016. Photograph: Jason Redmond/AFP/Getty Images

Wait didnt Raban himself win the Thomas Cook? His grin is lizardish. Twice. But I was hungry for prizes.

Though travel often features in his non-fiction and the three novels Raban has so far written, he most often uses the verb intransitively, with no obvious destination in mind. I always thought of it as escaping from genre together, the mixture of memoir and travelling not going to get anywhere, but going for the goings sake. Perhaps the notion is pretentious, but its of what a journey could really be: a miniature scale-model life, which you would survive miraculously at the end.

Though he talks with wit and candour, there is a reserve about him that Englishness, perhaps that seems at odds with the intimate scrutiny of his prose. I ask if hes ever regretted committing something to the page. The grin reappears. I want to say, je ne regrette rien. Not much.

Even in Passage to Juneau, which chronicles in agonising detail the death of his father and the collapse of his marriage to Jean? Even that.

The books only begin to make sense in long recollection, he adds: Writing about journeys, I have to forget the memory in its too-precise form and dive into the experience as if it were happening almost fictionally. Its a getting away from the experience in order to be able to write about it.

Im curious about what happened to the boat. Oh, it was sold, even before the stroke. Id written as much as Icould about sailing. Also, my appetite for it diminished sharply after 2001. Want to meet Republicans in this part of the world? They all have boats.

It is impossible to avoid the subject of Donald Trump, whose victory Raban had been dreading for months, and which still plainly nauseates him. Hes been rereading Ian Kershaws biography of Hitler, an unlikely but nevertheless effective source of consolation: The consolation comes in the very different state of Weimar Germany and the contemporary US. For all Trumps blustering authoritarianism, he would run straight into the checks and balances of Americas state and city governments.

Jonathan
Jonathan Raban is best known for hs nautical writing. Photograph: Ulf Andersen/Getty Images

Soon after the election, Seattles mayor, Ed Murray, held a press conference to say that the city would remain a sanctuary city for undocumented immigrants, and similar statements have been made in New York, Chicago, San Francisco, Los Angeles and elsewhere.

So hes optimistic, in a way?

Trump may well turn out to be more of a danger for the rest of the world than for the dis-United States. But whatever happens is going to be abloody, bloody mess.

These days his journeys may be moreimaginative than real, but he fights shy of the idea that Ive encountered Raban at rest. His thinking is as restless and ambulatory as ever; the wheelchair is another kind of narrative vehicle, a fine place in which to write and read. When we meet hes halfway through the proofs of a biography of Jan Morris, whom heencountered in Cairo: A proper traveller, he writes in Arabia, atouchruefully.

Most of all, though, hes mapping out the territory of the new book, and the connections he wants to draw between his early life and the lightning bolt that hit him in 2011. Progress is slower than hed like; more meandering. There are far too many threads.

He sighs faintly, and reaches for thebottle of red. But then, a friend reminded me over email, there alwaysare.

Read more: https://www.theguardian.com/books/2016/dec/30/jonathan-raban-author-recovery-stroke-fears-dis-united-states

Homeless vote: 11 tent city dwellers on Clinton, Trump and choosing a president

In Seattle and Portland, camp residents discuss Hillary Clintons emails and whether Donald Trump would take us back to the dark ages

Amyann Darden believes Ronald Reagan was Americas last great president. This election, shes voting for Hillary Clinton.

Darden, 55, used to manage an accounting firm. But her life changed after a nervous breakdown. Now relying on social security, she was forced to leave her Seattle apartment when the rent went from $950 to $1,450 a month. Shes been staying outdoors at Tent City 3, an encampment operated by homeless residents, while trying to save for a rental deposit.

Over the last year, Portland, Seattle and the state of Hawaii have declared a state of emergency on homelessness, with other cities considering it. But in the presidential election, the issue is receiving minimal political attention. At homeless camps Hazelnut Grove in Portland and Tent City 3 in Seattle, the issues that led people to become homeless reflect on the issues facing many voters this election: soaring rent, debt, access to healthcare, discrimination.

We asked several camp residents for their thoughts.

Amyann Darden, 55: Retaining social security is an important issue to me


Amyann
Amyann Darden in Seattle. Photograph: Annabel Clark

I was going to vote Republican but when I watched the convention and saw what Trump stood for, I thought, No way. His platforms based on hatred and fear. Im horrified that some of my friends still support him.

So Im voting for Hillary. Retaining social security is an important issue to me. I worked for 30 years and paid into it and then became disabled. Im very afraid it will be phased out during a Trump presidency.

I was staying in motel rooms before I came to Tent City. I use my sons address for everything; hes in community living as he has schizophrenia. My ballot will be going there.

I want to stay in Seattle to be close to my children and grandchildren. My daughter doesnt know Im at the camp. She has a lot of money and has helped me pay off some medical bills to raise my credit score and I dont want to ask for further help right now; eventually I will be disabled to a point where I will need care and Ill need to ask then.

Zoe White, 34: Ill probably vote for Jill Stein


Zoe
Zoe White in Portland. Photograph: Annabel Clark

Ive voted every year Ive been eligible. Generally Green or Socialist, sometimes Democrat. Ill probably vote for Jill Stein this year. Theres no representation of ecologists, left causes or democratic socialism anywhere else.

I see Hillary Clinton as having a liberal wrapper around a traditionalist core. I dont know whose interests shes going to sell out to, but Im pretty sure shes going to sell out. I voted for Bernie Sanders in the primary election. Now hes telling people to vote for Hillary; Im disappointed in him.

There are many misconceptions of houseless people. First of all, that we dont work we do. I had a job for a long time at a country club. I would say through that Ive been subject to employment discrimination as a female whos trans.

There are also the insinuations that were lazy, use drugs, were all thieves. In Hazelnut Grove, where Im lucky enough to live, were an intentional community. If you steal from someone, youre run the hell out. Here theres the idea that if you put into the community, the community reciprocates. I feel like that type of culture is being squeezed out during the gentrification process [of Portland]. Property values are taking precedence over community.

Andrew Constantino, 41: I have to watch the train wreck


Andrew
Andrew Constantino in Seattle. Photograph: Annabel Clark

Im voting for Hillary. On her own merits, shes committed to social issues and doing good. I would never even consider voting for Trump. But I have to watch the train wreck; I cannot stop myself.

Some people think anyone getting government assistance automatically votes liberal, but thats absolutely not true. You hear all these Trump lovers here. I try telling them, Do you realize hes the type of person who doesnt care about anything thats ever happened to you? But its like being with your family at Thanksgiving; you try avoiding those conversations because they go nowhere.

Ive lived in Seattle for almost 20 years. Its become more and more expensive to survive. When my girlfriend and I lost our jobs very close together, we burned through our savings.

Were both working full time again, but its just that there are no good options. I refuse to pay some exorbitant amount of rent to live in absolute poverty. Id rather do this until theres a reasonable option.

Roxy Garske, 58: I dont trust Hillary after the emails


Roxy
Roxy Garske in Seattle. Photograph: Annabel Clark

Im voting for Gary Johnson because hes not one of the other two. I dont like Hillary because I dont believe what she says; I dont trust her after the emails. I think shes too rightwing. Shes more interested in the needs of the rich and powerful.

If I could only vote between her and Trump, Id choose her. The thought of him winning scares me, especially for women. Ive got two daughters and two granddaughters. If hes voted in, hell turn back the clock. Hes already stirring up trouble by getting people worried about immigrants.

None of the candidates are addressing homelessness. Its an invisible society. Lots of people here dont know they can vote. But when we had a voter drive, around 30 people registered and were excited to find they could vote.

I have peripheral neuropathy and spinal stenosis. This is the second time Ive been homeless. About five years ago, my husband said, Im going to get stuck taking care of you. He said he wanted a divorce, which is fine. I was homeless while I waited for the settlement but then I got a house. I had to go into hospital and while I was very unwell; I lost my house. It went into foreclosure in July. I stayed with friends but theyve got some other people staying there now, but Im going back when theyre gone. Im just here for a month.

Marvin Ross, 56: A woman will be better off running the country


Marvin
Marvin Ross in Portland. Photograph: Annabel Clark

Donald Trump is not important to me. Hes not down for the people. Hes got all this money so he doesnt care what happens to the United States. I dont see how being president is important to him. Why would he want to step down?

I think a woman will be better off running the country than a man anyway. Look at how long men have run this country and how theyve messed it up. I havent always voted but when I have, its been Democrat.

Right now, Im living in a big tent. Ive got a real bed. My clothes on hangers. All my CDs. Im here for the long term. Im building my own tiny house; Im just waiting for more wood. Ive never built a house before; Im learning from watching others. Ive got a criminal background for drug possession that keeps me from renting. But Ive never tried to rent. Ive lived with girlfriends and family members. I came here to be alone.

Lori Perry, 39: If I dont vote, Ive got no right to bitch


Lori
Lori Perry in Seattle. Photograph: Annabel Clark

I dont think about politics much. My priorities are spending time with my husband, getting away from the camp, my kids and grandkids. Mostly what goes through my head is flashbacks.

I looked the candidates up on Google once. I cant really do news. Whats happening in front of me right now, today, is what matters. But its still important to me to cast my vote because if I dont vote, Ive got no right to bitch.

I want to vote for Bernie Sanders, so Im going to write his name in. If I had to choose between Trump and Clinton, Id choose Trump because Im not sure about a woman having that much control yet. I respect Trump because hes built everything from nothing. But I dont think hes the right guy for the job. Its all kind of confusing in my head.

I moved my husband and myself here in July. He has Parkinsons and this is where he gets treated. We came from Alaska where we could get housing but we were in drugs real bad. We were doing marijuana and meth. We cant afford rent here but if we return, I know hell go right back to it. Hes angry at me for keeping us homeless. But were doing good. Weve been sober since July. I still drink once in a while. We got a room on Monday and I got six beers.

Cierra Discher, 30: Im voting for Trump


Cierra
Cierra Discher in Seattle. Photograph: Annabel Clark

Im voting for Trump. A woman in charge is probably not what we need. But I dont know anything about it. Ive got bigger fish to fry. It really doesnt affect my immediate life. I mean if somebody else was president, would I still be sitting here? Probably. But I hear its better to vote for the wrong person than not at all. And Im registered.

Last night was my first night on the streets. I slept behind a building. This will be my first night at Tent City 3 theyve just given me a tent. I was staying at my boyfriends but I found out he was Mexican drug mafia. I left while he was at work and went to a hotel for two days.

I used meth yesterday so Im pretty emotional. Im about to go into treatment. Ive waited two months for that and hopefully it will get me on my feet.

My ballot will go to my moms house. We dont talk but I go to hers on the 10th of every month and she leaves me my mail.

Leashia McDaniels, 24: None of my friends vote


Leashia
Leashia McDaniels in Portland. Photograph: Annabel Clark

Im not registered to vote. Politics has always seemed kind of boring to me. I dont feel like it has an effect on my life. None of my friends vote. My moms side was more Republican but I dont think she votes any more. I dont know anything about my dads side. From what Ive heard of Donald Trump, hes an ass. I dont know too much about Hillary Clinton.

I became homeless three years ago. I got kicked out of my moms house because her boyfriend didnt approve of the relationship I was in. I started using meth and kept on it for almost two years.

Ive been at Hazelnut Grove since March. Being here has kept me clean. A lot of people have helped and supported me. If I was somewhere else Id be back where I was a year ago.

Im usually pretty much a loner; Ive never been much of a people person. But Im learning to get along with people better now.

Joseph Tequila Gordon, 36: This earth is our home but homes going to die


Joseph
Joseph Gordon in Portland. Photograph: Annabel Clark

Climate change is my number one issue. This earth is our home but homes going to die. And were stuck on what? Bathrooms?

Bernie Sanders was addressing the issues I was concerned with. He kept Hillary on her toes and changed her focus. I dont see her as a leader, though. I dont have anyone to vote for but Im still sending in the ballot. I always vote. My mothers white and my father was black. She always told us society is going to treat us black. Shed say: The way your people have been treated? Youre going to vote.

If theres a protest, Im there. I used to protest by myself in Cincinnati, where Im from. My first protest was in sixth grade to stop the drilling in Antarctica. Id watched something on PBS about it. I tried to join the International Socialist Organization when they started a chapter there. But it was pretty bougie. Theyd complain about the problems, then go to a coffee shop to buy a $7 latte, walking past a homeless person on the way out.

I love Portland. The people are awesome. But theres not enough housing for the population. And the housing policies are causing a lot of houselessness. Like no-cause evictions [in which a landlord can terminate a contract for no reason with 30 days notice] and the applications fee you have to pay every time you apply to rent somewhere. Some landlords keep a place vacant to take in lots of fees.

Cody, 24, and Isaiah, 25: We would go back to the dark ages with Trump


Cody
Cody and Isaiah in Seattle. Photograph: Annabel Clark

[Cody Bowen] Hillarys seen how people who are homeless are living. Shes helped non-profits that work with people in our situation. Trumps attitude is more like, If you dont have money, youre not worth anything.

I was 16 when I first became homeless. It was because of my life choices, being homosexual. I come from a Southern Baptist family, where my father is a preacher and a chaplain in the army. I came home one day and hed bought me a Greyhound ticket to Arizona, left my stuff on the front porch and changed the locks.

[Isaiah Thomas] Im voting for Hillary primarily to keep Trump out of office. I read that hes planning on supporting supreme court candidates who want to overturn the marriage equality bill, which were planning on taking advantage of ourselves pretty soon.

I never really cared much before about politics but as Ive got older and realized how it affects our lives, Ive started paying attention. Weve come a long way in American society and I think we would go back to the dark ages with Trump.

Read more: https://www.theguardian.com/us-news/2016/oct/19/homeless-vote-clinton-trump-stein-seattle-portland