Terminal cancer means I won’t see the other side of lockdown | Elliot Dallen

I imagined spending my last weeks with friends. Isolated in my flat, Im having to rethink what a good death might be, says Elliot Dallen

As I was lying in a hospital bed last July after complications arising from chemotherapy, my oncologist entered the room with my scan results. Hospital had become familiar to me but his next words werent. The treatment wasnt working. There was little else that could be done. I pressed him to be more specific and was told bluntly that I wouldnt last a year. I would be lucky to have half that time. This was nine months ago, before Covid-19, and Im very unlikely to be alive to see the other side of lockdown.

Almost two years ago, as summer in London was just beginning, an ultrasound to investigate a bladder infection found a large tumour on my right adrenal gland that had spread to my lungs. I was diagnosed with adrenocortical carcinoma, an extremely rare and aggressive cancer. It is in desperate need of research; when it is advanced there is very little effective treatment. This was not something I expected in my late 20s. Early on, after reading the bleak statistics, I started preparing myself for the inevitable. But treatment began positively and my focus changed to getting better. When death isnt staring you in the face, it is easy to push back the difficult thoughts and conversations. Dying was something to address later.

Now my oncologist has said I cannot have further treatment. His reasoning is that it would leave me vulnerable to becoming ill at a time when there are not enough resources to help, and also because the nurses normally available are busy helping others. Im still feeling good, better, in fact, without chemo. But I feel like Im living on borrowed time. I no longer look like the archetype of someone with cancer Im back to my natural weight and have a full head of hair. I often feel like the old me, except with an awful attempt at a moustache.

Last month, before all this started, I took the opportunity to go to Colombia. I explored that beautiful country, danced badly to reggaeton and met people from around the world. The sun was shining and most of the time everything felt normal. But the dark clouds of coronavirus were looming, and when I arrived home, the reality hit that this was the final stage of my journey.

Whenever I had thought about the last few weeks of life before, I always pictured them being surrounded by friends and family. Id eat at my favourite restaurants, go to south London parks where Ive shared kisses and lazy days. Id get to watch the bands that soundtracked my life in Londons festivals, and frequent the bars and beer gardens that, for better or worse, have defined my adulthood. Crucially, Id spend time with the people whom I had shared those experiences with; who made me the person I am today. When I became sicker, we would watch films, listen to music, laugh, cry, talk about both the big things and the little things. It would be a period that maybe only tends to come in times of tragedy, where vulnerability and urgency create connections at a higher level. Where the bittersweet feelings of love and loss exist simultaneously and we are at our most human.

None of this can happen right now. This good death described above is being denied to me due to the pandemic, and instead I face a steady decline into nothingness. Currently I am cut off from my family; my sister, who I live with, works for the NHS so is temporarily staying with friends to avoid bringing home any infection. I am one of the many vulnerable people being protected for their own benefit.Just stuck in my flat, alone. Waiting.

Im taking each day as it comes. I wake up and take a few moments to be grateful that Im still feeling well. I eat well, exercise and have days filled with video calls and Netflix, like everybody else. After many months of chemo Im quite used to being housebound. Im not bored; I oscillate between feeling pensive and flat. I cant help my thoughts sometimes running away and turning to everything I will miss out on. Planned weddings that I now cant attend. Friends children Ill never meet. People I thought Id grow old with that Ill never see again. Let alone what my own future would have brought. In these moments I feel devastated, and frustrated that there is no one to blame. Others feel time is standing still right now, but for me it is slipping through my fingers.

I do expect to spend some quality time with my family soon. I still plan to have conversations with friends so that when I go, nothing is left unsaid, even if they are not held face to face. On top of that, I am still grateful for so much within these four walls listening to music, learning new things or even simply looking at the beautiful view from my window.

Before cancer I considered myself very independent. This man was an island. It has been humbling to learn how much I depend on people, both physically and emotionally. I feel so fortunate to have had my people over this period, and facing the future without them is truly daunting. Whether times are good, bad, or worse, it is ultimately the people whom you love and care about that get you through. For me, these people didnt just get me through the last two years, but somehow made them two of the best years of my life.

Real connection is something that I think a lot of people in the country are missing right now. As much as possible, it is vital we keep that going, even if it is limited, and help those most in need of this for example, elderly and homeless people: those who suffer isolation outside of an enforced lockdown.

Politicians and medical experts talk about the light at the end of the tunnel. People will eventually open their doors again and restart their lives as the country attempts to move back to normality. For me, and Im sure plenty of others in a similar position, there is no light to give me hope. The tunnel is all that there is, and Im having to find my way in the dark.

Elliot Dallen is from Cardiff and has worked in finance in London since graduating

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Why we need worst-case thinking to prevent pandemics

The long read: Threats to humanity, and how we address them, define our time. Why are we still so complacent about facing up to existential risk?

The world is in the early stages of what may be the most deadly pandemic of the past 100 years. In China, thousands of people have already died; large outbreaks have begun in South Korea, Iran and Italy; and the rest of the world is bracing for impact. We do not yet know whether the final toll will be measured in thousands or hundreds of thousands. For all our advances in medicine, humanity remains much more vulnerable to pandemics than we would like to believe.

To understand our vulnerability, and to determine what steps must be taken to end it, it is useful to ask about the very worst-case scenarios. Just how bad could a pandemic be? In science fiction, we sometimes encounter the idea of a pandemic so severe that it could cause the end of civilisation, or even of humanity itself. Such a risk to humanitys entire future is known as an existential risk. We can say with certainty that the novel coronavirus, named Covid-19, does not pose such a risk. But could the next pandemic? To find out, and to put the current outbreak into greater context, let us turn to the past.

In 1347, death came to Europe. It entered through the Crimean town of Caffa, brought by the besieging Mongol army. Fleeing merchants unwittingly carried it back to Italy. From there, it spread to France, Spain and England. Then up as far as Norway and across the rest of Europe all the way to Moscow. Within six years, the Black Death had taken the continent.

Tens of millions fell gravely ill, their bodies succumbing to the disease in different ways. Some bore swollen buboes on their necks, armpits and thighs; some had their flesh turn black from haemorrhaging beneath the skin; some coughed blood from the necrotic inflammation of their throats and lungs. All forms involved fever, exhaustion and an intolerable stench from the material that exuded from the body.

There were so many dead that mass graves needed to be dug and, even then, cemeteries ran out of room for the bodies. The Black Death devastated Europe. In those six years, between a quarter and half of all Europeans were killed. The Middle East was ravaged, too, with the plague killing about one in three Egyptians and Syrians. And it may have also laid waste to parts of central Asia, India and China. Due to the scant records of the 14th century, we will never know the true toll, but our best estimates are that somewhere between 5% and 14% of all the worlds people were killed, in what may have been the greatest catastrophe humanity has seen.

The Black Death was not the only biological disaster to scar human history. It was not even the only great bubonic plague. In AD541 the plague of Justinian struck the Byzantine empire. Over three years, it took the lives of roughly 3% of the worlds people.

When Europeans reached the Americas in 1492, the two populations exposed each other to completely novel diseases. Over thousands of years, each population had built up resistance to their own set of diseases, but were extremely susceptible to the others. The American peoples got by far the worse end of the exchange, through diseases such as measles, influenza and, especially, smallpox.

Police
Police in Seattle during the 1918 Spanish flu pandemic. Photograph: Life/Getty

During the next 100 years, a combination of invasion and disease took an immense toll one whose scale may never be known, due to great uncertainty about the size of the pre-existing population. We cant rule out the loss of more than 90% of the population of the Americas during that century, though the number could also be much lower. And it is very difficult to tease out how much of this should be attributed to war and occupation, rather than disease. At a rough estimate, as many as 10% of the worlds people may have been killed.

Centuries later, the world had become so interconnected that a truly global pandemic was possible. Towards the end of the first world war, a devastating strain of influenza, known as the 1918 flu or Spanish flu, spread to six continents, and even remote Pacific islands. About a third of the worlds population were infected and between 3% and 6% were killed. This death toll outstripped that of the first world war.

Yet even events like these fall short of being a threat to humanitys long-term potential. In the great bubonic plagues we saw civilisation in the affected areas falter, but recover. The regional 25%-50% death rate was not enough to precipitate a continent-wide collapse. It changed the relative fortunes of empires, and may have substantially altered the course of history, but if anything, it gives us reason to believe that human civilisation is likely to make it through future events with similar death rates, even if they were global in scale.

The Spanish flu pandemic was remarkable in having very little apparent effect on the worlds development, despite its global reach. It looks as if it was lost in the wake of the first world war, which, despite a smaller death toll, seems to have had a much larger effect on the course of history.


The full history of humanity covers at least 200,000 years. While we have scarce records for most of these 2,000 centuries, there is a key lesson we can draw from the sheer length of our past. The chance of human extinction from natural catastrophes of any kind must have been very low for most of this time or we would not have made it so far. But could these risks have changed? Might the past provide false comfort?

Our population now is a thousand times greater than it was for most of human history, so there are vastly more opportunities for new human diseases to originate. And our farming practices have created vast numbers of animals living in unhealthy conditions within close proximity to humans. This increases the risk, as many major diseases originate in animals before crossing over to humans. Examples include HIV (chimpanzees), Ebola (bats), Sars (probably civets or bats) and influenza (usually pigs or birds). We do not yet know where Covid-19 came from, though it is very similar to coronaviruses found in bats and pangolins. Evidence suggests that diseases are crossing over into human populations from animals at an increasing rate.

Modern civilisation may also make it much easier for a pandemic to spread. The higher density of people living together in cities increases the number of people each of us may infect. Rapid long-distance transport greatly increases the distance pathogens can spread, reducing the degrees of separation between any two people. Moreover, we are no longer divided into isolated populations as we were for most of the past 10,000 years.

Together these effects suggest that we might expect more new pandemics, for them to spread more quickly, and to reach a higher percentage of the worlds people.

Poultry
Poultry workers in Hong Kong being vaccinated during the 2004 bird flu crisis. Photograph: Kin Cheung/Reuters

But we have also changed the world in ways that offer protection. We have a healthier population; improved sanitation and hygiene; preventative and curative medicine; and a scientific understanding of disease. Perhaps most importantly, we have public health bodies to facilitate global communication and coordination in the face of new outbreaks. We have seen the benefits of this protection through the dramatic decline of endemic infectious disease over the past century (though we cant be sure pandemics will obey the same trend). Finally, we have spread to a range of locations and environments unprecedented for any mammalian species. This offers special protection from extinction events, because it requires the pathogen to be able to flourish in a vast range of environments and to reach exceptionally isolated populations such as uncontacted tribes, Antarctic researchers and nuclear submarine crews.

It is hard to know whether these combined effects have increased or decreased the existential risk from pandemics. This uncertainty is ultimately bad news: we were previously sitting on a powerful argument that the risk was tiny; now we are not.


We have seen the indirect ways that our actions aid and abet the origination and spread of pandemics. But what about cases where we have a much more direct hand in the process where we deliberately use, improve or create the pathogens?

Our understanding and control of pathogens is very recent. Just 200 years ago, we didnt even understand the basic cause of pandemics a leading theory in the west claimed that disease was produced by a kind of gas. In just two centuries, we discovered it was caused by a diverse variety of microscopic agents and we worked out how to grow them in the lab, to breed them for different traits, to sequence their genomes, to implant new genes and to create entire functional viruses from their written code.

This progress is continuing at a rapid pace. The past 10 years have seen major qualitative breakthroughs, such as the use of the gene editing tool Crispr to efficiently insert new genetic sequences into a genome, and the use of gene drives to efficiently replace populations of natural organisms in the wild with genetically modified versions.

This progress in biotechnology seems unlikely to fizzle out anytime soon: there are no insurmountable challenges looming; no fundamental laws blocking further developments. But it would be optimistic to assume that this uncharted new terrain holds only familiar dangers.

To start with, lets set aside the risks from malicious intent, and consider only the risks that can arise from well-intentioned research. Most scientific and medical research poses a negligible risk of harms at the scale we are considering. But there is a small fraction that uses live pathogens of kinds that are known to threaten global harm. These include the agents that cause the Spanish flu, smallpox, Sars and H5N1 or avian flu. And a small part of this research involves making strains of these pathogens that pose even more danger than the natural types, increasing their transmissibility, lethality or resistance to vaccination or treatment.

In 2012, a Dutch virologist, Ron Fouchier, published details of an experiment on the recent H5N1 strain of bird flu. This strain was extremely deadly, killing an estimated 60% of humans it infected far beyond even the Spanish flu. Yet its inability to pass from human to human had so far prevented a pandemic. Fouchier wanted to find out whether (and how) H5N1 could naturally develop this ability. He passed the disease through a series of 10 ferrets, which are commonly used as a model for how influenza affects humans. By the time it passed to the final ferret, his strain of H5N1 had become directly transmissible between mammals.

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The work caused fierce controversy. Much of this was focused on the information contained in his work. The US National Science Advisory Board for Biosecurity ruled that his paper had to be stripped of some of its technical details before publication, to limit the ability of bad actors to cause a pandemic. And the Dutch government claimed that the research broke EU law on exporting information useful for bioweapons. But it is not the possibility of misuse that concerns me here. Fouchiers research provides a clear example of well-intentioned scientists enhancing the destructive capabilities of pathogens known to threaten global catastrophe.

Of course, such experiments are done in secure labs, with stringent safety standards. It is highly unlikely that in any particular case the enhanced pathogens would escape into the wild. But just how unlikely? Unfortunately, we dont have good data, due to a lack of transparency about incident and escape rates. This prevents society from making well-informed decisions balancing the risks and benefits of this research, and it limits the ability of labs to learn from each others incidents.

Security for highly dangerous pathogens has been deeply flawed, and remains insufficient. In 2001, Britain was struck by a devastating outbreak of foot-and-mouth disease in livestock. Six million animals were killed in an attempt to halt its spread, and the economic damages totalled 8bn. Then, in 2007, there was another outbreak, which was traced to a lab working on the disease. Foot-and-mouth was considered a highest-category pathogen, and required the highest level of biosecurity. Yet the virus escaped from a badly maintained pipe, leaking into the groundwater at the facility. After an investigation, the labs licence was renewed only for another leak to occur two weeks later.

In my view, this track record of escapes shows that even the highest biosafety level (BSL-4) is insufficient for working on pathogens that pose a risk of global pandemics on the scale of the Spanish flu or worse. Thirteen years since the last publicly acknowledged outbreak from a BSL-4 facility is not good enough. It doesnt matter whether this is from insufficient standards, inspections, operations or penalties. What matters is the poor track record in the field, made worse by a lack of transparency and accountability. With current BSL-4 labs, an escape of a pandemic pathogen is only a matter of time.


One of the most exciting trends in biotechnology is its rapid democratisation the speed at which cutting-edge techniques can be adopted by students and amateurs. When a new breakthrough is achieved, the pool of people with the talent, training, resources and patience to reproduce it rapidly expands: from a handful of the worlds top biologists, to people with PhDs in the field, to millions of people with undergraduate-level biology.

The Human Genome Project was the largest ever scientific collaboration in biology. It took 13 years and $500m to produce the full DNA sequence of the human genome. Just 15 years later, a genome can be sequenced for under $1,000, and within a single hour. The reverse process has become much easier, too: online DNA synthesis services allow anyone to upload a DNA sequence of their choice then have it constructed and shipped to their address. While still expensive, the price of synthesis has fallen by a factor of 1,000 in the past two decades, and continues to drop. The first ever uses of Crispr and gene drives were the biotechnology achievements of the decade. But within just two years, each of these technologies were used successfully by bright students participating in science competitions.

Such democratisation promises to fuel a boom of entrepreneurial biotechnology. But since biotechnology can be misused to lethal effect, democratisation also means proliferation. As the pool of people with access to a technique grows, so does the chance it contains someone with malign intent.

People with the motivation to wreak global destruction are mercifully rare. But they exist. Perhaps the best example is the Aum Shinrikyo cult in Japan, active between 1984 and 1995, which sought to bring about the destruction of humanity. It attracted several thousand members, including people with advanced skills in chemistry and biology. And it demonstrated that it was not mere misanthropic ideation. It launched multiple lethal attacks using VX gas and sarin gas, killing more than 20 people and injuring thousands. It attempted to weaponise anthrax, but did not succeed. What happens when the circle of people able to create a global pandemic becomes wide enough to include members of such a group? Or members of a terrorist organisation or rogue state that could try to build an omnicidal weapon for the purposes of extortion or deterrence?

Romanian
Romanian workers prepare to slaughter birds infected with avian flu in 2005. Photograph: Marius Nemes/AFP/Getty

The main candidate for biological existential risk in the coming decades thus stems from technology particularly the risk of misuse by states or small groups. But this is not a case in which the world is blissfully unaware of the risks. Bertrand Russell wrote of the danger of extinction from biowarfare to Einstein in 1955. And, in 1969, the possibility was raised by the American Nobel laureate for medicine, Joshua Lederberg: As a scientist I am profoundly concerned about the continued involvement of the United States and other nations in the development of biological warfare. This process puts the very future of human life on earth in serious peril.

In response to such warnings, we have already begun national and international efforts to protect humanity. There is action through public health and international conventions, and self-regulation by biotechnology companies and the scientific community. Are they adequate?

National and international work in public health offers some protection from engineered pandemics, and its existing infrastructure could be adapted to better address them. Yet even for existing dangers this protection is uneven and under-provided.

Despite its importance, public health is underfunded worldwide, and poorer countries remain vulnerable to being overwhelmed by outbreaks. Biotechnology companies are working to limit the dark side of the democratisation of their field. For example, unrestricted DNA synthesis would help bad actors overcome a major hurdle in creating extremely deadly pathogens. It would allow them to get access to the DNA of controlled pathogens such as smallpox (whose genome is readily available online) and to create DNA with modifications to make the pathogen more dangerous. Therefore, many synthesis companies make voluntary efforts to manage this risk, screening their orders for dangerous sequences. But the screening methods are imperfect, and they only cover about 80% of orders. There is significant room for improving this process, and a strong case for making screening mandatory.

We might also look to the scientific community for careful management of biological risks. Many of the dangerous advances usable by states and small groups have come from open science. And weve seen that science produces substantial accident risk. The scientific community has tried to regulate its dangerous research, but with limited success. There are a variety of reasons why this is extremely hard, including difficulty in knowing where to draw the line, lack of central authorities to unify practice, a culture of openness and freedom to pursue whatever is of interest, and the rapid pace of science outpacing that of governance. It may be possible for the scientific community to overcome these challenges and provide strong management of global risks, but it would require a willingness to accept serious changes to its culture and governance such as treating the security around biotechnology more like that around nuclear power. And the scientific community would need to find this willingness before catastrophe strikes.


Threats to humanity, and how we address them, define our time. The advent of nuclear weapons posed a real risk of human extinction in the 20th century. There is strong reason to believe the risk will be higher this century, and increasing with each century that technological progress continues. Because these anthropogenic risks outstrip all natural risks combined, they set the clock on how long humanity has left to pull back from the brink.

I am not claiming that extinction is the inevitable conclusion of scientific progress, or even the most likely outcome. What I am claiming is that there has been a robust trend towards increases in the power of humanity, which has reached a point where we pose a serious risk to our own existence. How we react to this risk is up to us. Nor am I arguing against technology. Technology has proved itself immensely valuable in improving the human condition.

The problem is not so much an excess of technology as a lack of wisdom. Carl Sagan put this especially well: Many of the dangers we face indeed arise from science and technology but, more fundamentally, because we have become powerful without becoming commensurately wise. The world-altering powers that technology has delivered into our hands now require a degree of consideration and foresight that has never before been asked of us.

Because we cannot come back from extinction, we cannot wait until a threat strikes before acting we must be proactive. And because gaining wisdom takes time, we need to start now.

I think that we are likely to make it through this period. Not because the challenges are small, but because we will rise to them. The very fact that these risks stem from human action shows us that human action can address them. Defeatism would be both unwarranted and counterproductive a self-fulfilling prophecy. Instead, we must address these challenges head-on with clear and rigorous thinking, guided by a positive vision of the longterm future we are trying to protect.

This is an edited extract from The Precipice: Existential Risk and the Future of Humanity by Toby Ord, published by Bloomsbury and available at guardianbookshop.com

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Ex-NFL player Kellen Winslow Jr convicted of raping homeless woman

The former NFL player has been convicted of raping a 58-year-old homeless woman last year in his beach community of Encinitas, north of San Diego

Former NFL player Kellen Winslow Jr the son of a Hall of Famer who himself earned more than $40m during his career has been convicted of raping a 58-year-old homeless woman last year in Encinitas, north of San Diego.

A jury returned the verdict on Monday in San Diego superior court in Vista but was expected to continue to deliberate on two more counts of rape involving a 54-year-old hitchhiker and an unconscious teenage girl in 2003.

The jury also found the 35-year-old former tight end guilty of indecent exposure and lewd conduct involving two other women, but jurors found him not guilty of one count of a lewd act.

Winslow, who played for Cleveland, Tampa Bay, New England and the New York Jets, faces up to life in prison if convicted of all counts.

All five women testified during the nine-day trial. Winslow did not take the stand.

Defense attorneys pointed out inconsistencies in the accusers testimonies and argued the women invented the allegations to prey on the wealth of Winslow.

Prosecutors say the son of Hall of Famer Kellen Winslow felt empowered by his fame to abuse the most vulnerable.

Prosecutor Dan Owens told the jury of eight men and four women that Winslow is a wolf in sheeps clothing.

The homeless woman in Encinitas, who was 58 at the time, testified that he befriended her and attacked her next to his vehicle after inviting her for a coffee in May 2018.

A 54-year-old hitchhiker said he drove her to an Encinitas shopping center parking lot and raped her in his Hummer in March 2018.

A 57-year-old woman said he exposed himself to her while she tended to her garden in May of 2018. The jury found him guilty of that charge Monday.

After news of the attacks broke, a woman came forward and said Winslow had raped her when she was a 17-year-old high school student in 2003. He was 19 at the time and had come home from college for the summer. She said she passed out at a party in a San Diego suburb and woke up to find Winslow assaulting her.

A 77-year-old woman who went to the same gym as Winslow in the beach community of Carlsbad said he committed lewd acts in front of her, including touching himself, while Winslow was free on $2m bail in February. The jury found him guilty on the charge of touching himself in front of the woman at the gym, but not guilty of committing a lewd act while in the facilitys hot tub in front of the same woman who said it happened on a different occasion.

After the jury sent a note saying it was deadlocked on the eight other charges, the judge sent them back to deliberate. Jurors went home less than an hour later and were ordered to resume deliberating Tuesday.

The panel on Friday sent a note to the judge indicating it was possibly struggling to find agreement.

The jurors could benefit from an explanation as to what being under oath means, the note said. Additionally, how we should follow the law and not what we think the law means.

The judge told jurors being under oath means telling the whole truth and that they should follow the law how it is written.

Defense attorney Marc Carlos questioned the credibility of the womens claims, saying they had lied, misconstrued things or were unable to initially identify him correctly.

Defense lawyers also said the sex was consensual and that Winslow had cheated on his wife repeatedly with no-strings-attached sex.

Prosecutors said the crux of the womens stories didnt change and that evidence included traces of Winslows DNA on one of the accusers pants and GPS locations placing him where the women said the assaults occurred.

The five women testified that they didnt know Winslow was famous when they met him.

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I planned to kill myself at 27 now Im 28. Heres what happened | Ben Smoke

I used to think my bipolar disorder meant I had to suffer, like the tortured geniuses Kurt Cobain and Van Gogh, says Ben Smoke

When I was 21 I tried to kill myself. It was the evening of the 26 November 2012, at 5:52pm. I remember looking at the clock, aiming for 6pm before thinking what am I waiting for? I sent texts to loved ones, put up a pre-written Facebook status and attempted to take my own life. Two months later I tried to do it again. This time there was no status, no warning texts, just another brutal attempt. Two months later I tried to do it again. This time, I called an ambulance half way through alone and scared on the Euston Road.

I spent some time at my mums, pushing through the pain, surviving second by second. I looked into my future, and I couldnt see anything. It was dark. Cloudy and obscured. Drained of colour in the way that only a deep dark depression can do.

We tell ourselves stories to make peace with our present. In that moment, I told myself that I wouldnt live past 27. Having an expiration date suddenly made it easier to survive those seconds. They turned to minutes, the minutes to hours, hours to days until I was living through months without thinking about ending it all. At 21, having a use-by date that effectively extended my life by almost a third of what Id already lived seemed entirely logical. It was a way of getting through. Of pushing onwards. Of trying to squeeze a little more life out. It became something that defined me. Something I celebrated and leant in to, and so, what started as a tool to keep me alive slowly took over my life.

In February, I turned 28.

Its a weird thing, unravelling your own narrative simply by surviving. Whats even weirder is how wedded to the idea of your own demise you can become. How entrenched within your own mythology its possible to find oneself.

I have bipolar. As a group, we die younger, and often by our own hand. The average reduction in life expectancy for someone with bipolar is between 9 and 20 years. Bipolar increases the risk of suicide by 20 times and is named by the World Health Organization as one of the top causes of lost years and life in 15- to 44-year-olds. Despite this, its an illness that carries a certain element of mystique. It is the creatives disease one that sees us gripped with indefatigable energy for periods of our lives while crushed under the tortures of lifes gruesome reality at others.

As a child obsessed with the idea of making a mark or leaving a legacy in order to placate the scourge of self-loathing, the mysticism of it all sucked me in. Kurt Cobain was said to have bipolar. So did Jimi Hendrix, Ernest Hemingway, Carrie Fisher and Lou Reed. To me, the chaos and the torture, the erraticism and the self-destruction carried with it a coolness. The pain and the hollowed-out horror of the illness was a necessary evil. Something to be suffered, in order to be the best version of myself. But now I sit here, among the rubble of a life lived teetering on the edge for the best part of a decade, and I wonder how true that can be.

Australian
Australian comedian Hannah Gadsby. Photograph: Alamy

In her blistering Netflix special Nanette, comedian Hannah Gadsby touches on this. At one point, retelling the story of an interaction with a man who claims Van Gogh wouldnt have created Sunflowers without medication, she asks, What do you think, mate? That creativity means you must suffer? That that is the burden of creativity just so you can enjoy it? Later she talks more broadly on the subject, this whole romanticising of mental illness is ridiculous she proffers. Its not a ticket to genius, its a ticket to fucking nowhere.

Mental health provision in the UK is chronically and shamefully underfunded. It represents around 28% of the disease burden but received only around 10% of funding in 2017/18. As a society, creating and reinforcing this mythology around mental illness, we let off the hook a government that has consistently fallen short of its promises where mental health provision is concerned. Beyond that, we set up those with mental health difficulties to fail.

We relish in the desirable qualities that come with many mental health diagnoses, be that creative flair, wit, intellect, blue sky thinking or simply a penchant for partying hard. But when it comes to less desirable qualities, often we either ignore them, or wrap them up in a mythology without trying to offer concrete help or assistance.

As I begin to live a life without an expiration date, Im starting to realise that the legacy, that indelible mark I was so desperate to make on the world and those around me, wont be built of pain, it will be made in spite of it. If we dont start telling ourselves the truth about mental illness, instead of coating it in lies, we run the risk of generation after generation of young people believing they have to suffer, with swathes of kids not making it, simply because we told them they never would.

Ben Smoke is a freelance journalist and activist

In the UK, Samaritans can be contacted on 116 123 or email jo@samaritans.org. 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 www.befrienders.org

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Cancer will kill 9.6m people this year, experts predict

International Agency for Research on Cancer says a third of new cases are likely to be caused by smoking and obesity

One in five men and one in six women around the world develop cancer during their lifetime, according to the latest figures from the from the International Agency for Research on Cancer (IARC). One in eight men and one in 11 women die from the disease.

The rising toll of cancer is clear from the latest global estimates which predict there will be 18.1 million new cases this year and 9.6 million deaths. Four years ago, when the IARC last did the same exercise, there were 14.1 million cases and 8.2 million deaths.

In more affluent parts of the world with good healthcare systems, it is preventable cancers with causes rooted in our lifestyles and modern culture that dominate. Most lung cancers are caused by smoking, while the causes of breast cancer include obesity and alcohol.

One in five men and one in six women will get cancer in their lifetimes
while one in eight men and one in eleven women will die from it

In high income countries, says IARC in its Globocan 2018 report, from one-third to two-fifths of new cancer cases could be avoided by eliminating or reducing exposure to known lifestyle and environmental risk factors.

Age is also an important factor, however. More people develop cancer because they live longer and will die of the disease, as other conditions, such as heart attacks and stroke, are prevented or better treated.

Nearly a quarter 23.4% of all cancer cases are in Europe, which has 20.3% of the deaths although it has only 9% of the global population. The Americas have 13.3% of the global population and account for 21% of cases and 14.4% of deaths.

Asia has a heavy burden, with 48.4% of the global cases and a bigger proportion still of deaths 57.3%. Africa also has a bigger proportion of global deaths than cases, at 7.3% and 5.8% respectively.

Cancer is an important cause of morbidity and mortality worldwide, in every world region, and irrespective of the level of human development, says the report.

Lung, breast and bowel cancer are responsible for a third of global deaths between them. The largest number of deaths (1.8 million) are a result of lung cancer, because the prognosis is so poor. Breast cancer is fifth, with 627,000 deaths, because diagnosis tends to be earlier and treatments are good in high income countries.

These new figures highlight that much remains to be done to address the alarming rise in the cancer burden globally and that prevention has a key role to play, said IARC director Dr Christopher Wild. Efficient prevention and early detection policies must be implemented urgently to complement treatments in order to control this devastating disease across the world.

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Welcome to suburbia: the millennials done with city life and city prices

Despite their urban image, millennials are looking to suburbs and the country for a quieter, and cheaper, lifestyle

A green sign with a horse-drawn carriage marks the turn in the road: Townes at Covington, it reads, a nod to the management company running properties in this quiet cul-de-sac 30 minutes outside Washington DC.

Of course, there arent any horse-drawn carriages here. There arent even really any pedestrians. I drive up to a cheerful cream-colored house with blue shutters. I park.

Its high summer in the Washington metro area the Fourth of July and neither I nor the couple Ive come to interview seem to mind meeting on the holiday. There is, after all, a reason they left the District and bought a big airy townhouse in Bowie, Maryland, last year. The last place any of us want to be in the 90F (32C) heat is barbequing on a concrete city roof.

Charla Freeland, 27, and Brian Freeland, 32, are graduates of Howard University in Washington, and both still work in the city for the radio station Sirius XM. But they came here to escape DCs soaring real estate prices and the stresses of city life. As Brian puts it when were seated in the living room: I like my space.

Here theres plenty of space: parking for their two cars, a deck overlooking a leafy park, a reservoir with birds nearby, and a room upstairs where, Charla says, we keep our shoes.

All that for less than the price of a one-bedroom condo in Washington. Thats not lost on Brian, whose view of the homeownership is, like other members of the millennial generation, still shaped by the 2008 housing crash and ensuing Great Recession.

At its sale price of $289,000, their three-storey townhouse cost around a quarter of what it would in their old stomping grounds of Shaw a historically black neighborhood where median home prices have more than quintupled since 1995, making it one of DCs fastest-appreciating real estate markets in recent years.

They havent made new friends yet and Charla misses her old ones in the city, whom she now drives half an hour just to meet for brunch. She doesnt expect to be doing it long.

Most of her friends are still single and they give her no grief for leaving. I was lucky, she says of meeting Brian as an undergrad. When they find someone, theyll be out in the suburbs too.

Suburban life may be once again in ascendance, as millennials, pushed away from exorbitant city prices and finally able to afford their first houses, are rediscovering suburbs spacious charms.

Brian
Brian and Charla Freeland stand inside their kitchen. Photograph: Jocelyn Augustino for the Guardian

While theres no official data on the number of millennials moving away from cities, the recent census suggests some suburban revival is afoot, driven by millennials.

Population change gives you a crude sense of flow, says William Frey of the Brookings Institution, a demographer who has studied city migration patterns for decades, when I meet him at his downtown office. Smaller cities are growing and large cities are not growing as fast.

Flipping open his 2018 report on the millennial cohort, Frey runs a finger over the chart showing age distribution in the United States, pointing to the bulge in population that tells him millennials are largely responsible for the suburban trend.

If such patterns continue, he argues, they could upend the 2010s stereotype of millennials all wanting to live in a Brooklyn-like urban jungle.

Frey has called the period from 2010 to 2020 the decade of the city. And, while the citys reign doesnt seem to be lasting as long as he predicted, in a sense he was right: the citys rule will be temporary, not an unstoppable drive toward urbanization.

I want to know whats driving young people in and out of cities, and the answer seems to be politics, gentrification and the economy, not vague notions of city coolness or millennial personality traits.

Sure, millennials like aspects of city living, Frey says. But the shift to cities came three years after the housing market crash and recession. He doesnt think thats a coincidence larger economic forces are afoot.

The youngest millennials have more options economically while the oldest millennials are starting to think about what their next stage of life looks like and making decisions that look more similar to what wed expect that age group to do, Jeannette Chapman, the deputy director of the Stephen S Fuller Institute, tells me later in a phone call. Theyre growing up.

Patrick Sterns, 35, formerly of Oakland, California, recently came to the realization he couldnt buy a house where he grew up.

Not long ago, much of downtown Oakland was still considered an affordable alternative to San Francisco, home to the countrys priciest real estate. The Oakland hills of Patricks youth have always been desirable, but now the soaring cost of housing has become prohibitive there, too.

On the one hand its thriving, on the other hand its really expensive, Patrick says.

The problem is that a home is worth what someone is willing to pay for it, and for Patrick who works in the clean energy sector, like his 34-year-old MBA graduate wife, Martha Serianz there is always someone in Oakland with deeper pockets.

Patrick
Patrick Sterns and Martha Serianz at home outside of Oakland. Photograph: Supplied

Thats how they ended up half an hours drive north of the city in a neighborhood thats technically Richmond but functionally, they say, El Sobrante. And how in the spring of 2016 they bought the 1,300 sq-ft of house they dreamed of having as mid-30s professionals: three beds, two baths and on a corner lot. The list price was $435,000.

If we could have afforded Temescal and being in the hip area where a lot of our friends are, it would have been nice, Martha says.

But walking to cool bars in trendy neighborhoods, she adds, wasnt really an option. Wed have to double the cost of our mortgage, she explains.

It used to be you get a high school degree and you can get a good job with a union, Patrick says. Now the right is dismantling unions, you get a tertiary degree and you still cant get a job.

He adds: Were inheriting this highly toxic system that really only favors rich people. Cities are becoming unaffordable and, at the same time, theres no solution on the table to help with housing.

If were bitter, he says of millennials, its because we have to live somewhere.

Martha adds: Were saddled with so many financial responsibilities. Buy a house but you have thousands of dollars of student loan debts! Or find a great job but older people with more experience will get it!

Combined with the high costs of childcare, and the difficulty of saving for retirement, the situation becomes crippling. City living was supposed to be the future, she says. It certainly isnt anymore.

Suburbs offering traditionally urban attributes appear to be on the rise.

A lot of suburban areas are thinking about how they can be more city-like, says Steven Pedigo, a professor at New York University who directs the Urban Lab at the schools Schack Institute of Real Estate. Similarly, cities, as they lose young people, will be looking at suburban amenities they can provide.

Such closer-in, cluster-style suburbs have already arrived in many places. And Pedigo who chose his town of residence for its diversity, good coffee shops, transit and walkability would know because he lives in one.

My students always say: Youre a city guy who lives in the suburbs!? Pedigo says.

Where things are headed, with many suburbs ranking high in walkability and other public amenities once considered the province of cities, he doesnt think it is a contradiction in terms.

Anything above a certain walk score, we didnt even consider, he says, of moving to South Orange, New Jersey, with his husband.

Its a world apart from more traditional tract-housing-style suburbs (where the buildings are nearly identical), or places where public transit may be non-existent but you can get a lot more house.

Its the tale of two suburbs, Pedigo says. He expects to see more millennials weighing these factors as they make their exodus from cities a practical calculation that, as a suburb-loving urbanist, he admires.

Whats interesting is millennials are, more than anyone else, able to make true place decisions.

It used to be that people moved one of two places: where they could get a job or where their family lived. Instead, he says, millennials ask: which place can provide me with the best quality of life?

If most of us were any good at predicting what will make us happy or provide the best quality of life, self-help wouldnt be the booming industry it is today. But a recent paper published in the journal Regional Studies may offer guidance.

Beyond showing millennials are happiest in cities, the study found that millennials were least happy in rural areas, and, specifically, that they suffered most from isolation, in contrast to older generations who preferred the quiet.

Some anecdotal evidence bears that out. Another Oakland couple I spoke to had moved an hour and a half north of the Bay Area to pursue a rural homesteading dream in Forestville only to move back five years later with the hard-earned self-knowledge that they are city people after all.

They have plenty of company in that. Not only are millennials the exception, theyre the exact opposite of other generations, says the co-author Adam Okulicz-Kozaryn of his papers finding on young people and rural isolation.

But there is a spectrum of urban-to-rural living, and plenty of options for millennials who want a country lifestyle without the sense of isolation.

Scott Beauchamp and his wife Nika had been living in Brooklyn, New York, when they decided to take a road trip to find their future home.

Theyd been living in New York for years, but couldnt afford to buy there. Other people seemed emotionally invested in living in Brooklyn or being a New Yorker, he says, but he and Nika never really were.

Scott
Scott and Nika Beauchamp. Photograph: Handout

Her mom had a house on a lake in New Hampshire where they went to stay in the summer of 2014. After that they spent some time driving around New England, and fell in love with coastal Maine.

Beauchamp, a freelance writer, grew up in what he calls postwar strip-mall suburbia in St Louis, Missouri. And the experience was enough to tell him he didnt want more of that. He also knew he didnt want to forgo community.

He and his wife were charmed by Portland, Maine, and lived there for a year, but ultimately they wanted to move somewhere where they were getting a better deal.

We knew we wanted to stay on the coast, he says, adding we like being by the ocean. So they kept shrinking their budget and traveling north, trying to get more for less money.

They found the house theyd buy in the shipbuilding town of Bath. It was 1,400 sq ft with four bedrooms for $180,000. The town has several very cool bookstores, Scott says, a walkable downtown, a beautiful waterfront, an outdoor farmers market, and an endless string of trails.

Theyve lived there since March of 2016, and for Scott, 34, and Nika, 31, its been a pretty perfect fit.

My wife has gotten into native plants, repopulating our yard with them, Scott says, adding that she has a mind to someday buy a plot of land and have a completely environmentally sound homestead.

He doesnt plan to move anytime soon, but its still a bit unclear whether the existential search for home is over.

Living closer to nature has made us more conscious of our relationship to it and its importance to us, he explains. I foresee us living in this house another decade and then probably moving. My wife now that she has a taste, shes hungry for the country life and wants to move even further out.

Back in Bowie, Brian and Charla are perfectly content with their place, and theyve taken pride in showing it off to me. But like Scott and Nika and a lot of millennials, it seems theyve never stopped looking for a house.

The whole time Im interviewing them, the TV is on and though its set to silent, sometimes their eyes will flicker up. Theyre watching The Deed, a show about flipping houses in New Orleans and Chicago. Charlas hometown is New Orleans, and the place where her two sisters and nearly everyone in her family still lives.

She was living there during Hurricane Katrina and tells me early in the interview about how the builders who came in afterward overdid things, erecting million-dollar houses in places that will likely flood again.

The house being flipped, Charla tells me, part excitement in her voice, part horror, is just 15 minutes from her parents place. Its going for $1.23m six times what her parents house is valued.

Would they move back there?

I think I know Charlas answer, but its Brian who doesnt hesitate. In a heartbeat, he says.

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Ireland has changed utterly: the cruel eighth amendment is history | Ivana Bacik

An end to our 35-year struggle for safe, legal abortion is at last in sight, writes senator and campaigner Ivana Bacik

Ireland has spoken and we have made history. The clause inserted into our constitution in 1983 that bestowed on the unborn a right to life equal to that of a pregnant woman can at last be removed. Exit polls project and official results are expected to confirm later on Saturday that the referendum to repeal the eighth amendment has been passed by a resounding majority.

After 35 years, we will now be able to reform our abortion laws and provide women in Ireland with access to the reproductive healthcare we need. We will end what has been described as an English solution to an Irish problem. Our women will no longer need to travel abroad to access abortions, and we will no longer need to import abortion pills illegally and without access to medical care or support.

How did we succeed in achieving such a result? Over the many weeks of this long campaign, I have been out canvassing extensively for a yes, in Dublin and elsewhere. The growing public awareness of the immense harm and hardship caused by the eighth amendment became increasingly apparent to me over the campaign. That awareness explains the immensely significant referendum vote in support of reform on Friday.

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‘A monumental day for women in Ireland’, says Orla O’Connor video

In truth, many people in Ireland had already recognised the reality that the eighth amendment represented an absolute bar to any lifting of the prohibition on abortion even in cases of rape, risk to womens health or fatal foetal abnormality. The constitutional clause had generated or been implicated in a series of tragic cases. These included the 1992 X case, where a pregnant 14-year-old rape victim was denied the right to travel to the UK to terminate her pregnancy. This case led to a ruling by the supreme court which said that where pregnancy posed a real and substantial risk to a womans life, in the case of X the risk that she would take her own life, abortion should be allowed.

A more recent, and utterly tragic, case was the death in 2012 of Savita Halappanavar. Here was a young woman whose request for a termination of pregnancy when she presented while miscarrying at Galway University hospital was denied on grounds that the risk was only to her health and not to her life until it was too late. She died of sepsis as a result.

Over the years, public opinion had thus shifted towards supporting repeal of the constitutional ban and for legal abortion to take place in Ireland. This change was also influenced by a number of international law cases in which the Irish state was found to have breached womens human rights by forcing them to carry pregnancies to term even in cases where they knew their babies would not be born alive.

The political momentum for change led to the establishment in 2017 of two processes to review the amendment: a citizens assembly and a cross-party parliamentary committee. Both recommended repeal and called for the Irish parliament to bring in legislation enabling doctors to offer compassion and care to women in crisis pregnancies.

As a result, the referendum was announced, and the government also proposed a framework for legislation based on the findings of the committee. This legislation would provide for legal abortion up to 12 weeks without restriction as to reasons; and for abortion to be legally available after that point only on grounds of risk to life, serious risk to health or fatal foetal abnormality. The introduction of such a law was vociferously opposed by no campaigners, who argued that it would lead to abortion on demand and asserted that it would be dangerous to leave the job of making law to elected legislators, on the basis that politicians cant be trusted a profoundly populist and anti-democratic argument.

The resounding yes vote we appear to have now achieved shows that the majority of Irish citizens simply rejected the scaremongering tactics of the no side. It shows that as a society we recognise the need for our democratically elected legislators to introduce an appropriate legal framework for the regulation of lawful termination of pregnancy. We can now proceed to legislate.

As a student campaigner in the 1980s I was taken to court and threatened with prison for distributing information to Irish women on where to access abortion. I am very grateful to my fellow Irish citizens who appear to have voted so overwhelmingly for a more democratic, equal and progressive Ireland.

  • Ivana Bacik is an Irish Labour party senator and campaigner for abortion rights

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Muslim foster parents: We’d never had a Christmas tree – it made them so happy

News that a Christian child was forced into Muslim foster care caused a furore earlier this year. But, despite the challenges, these families play a vital role in bringing up vulnerable children, says Sarfraz Manzoor

About 100,000 young people go through the fostering system every year. In recent years an increasing number of these have been child refugees from Muslim-majority countries such as Syria and Afghanistan, many arriving here traumatised and in need of care.

We estimate there is a shortage of 8,000 foster carers, says Kevin Williams, chief executive of the Fostering Network, and there is a particular shortage of Muslim foster carers.

Those featured here were nervous that their stories would be misreported, an issue highlighted recently in the story about a white Christian girl supposedly forced into Muslim foster care. The story was cited as emblematic of a greater clash between Islam and Christianity. It has also provoked fears that the media storm could deter Muslims from fostering at a time when the need for a more diverse pool of carers has never been greater.

Sajjad and Riffat

Just before Christmas seven years ago, Riffat and Sajjad were at home when the phone rang. It was the foster agency letting them know that three children theyd never met would be arriving shortly. The children two sisters and a brother were in urgent need of short-term care. Sajjad and Riffat had been approved as foster carers only two months earlier and these would be their first placements.

We were excited, but I was also a bit nervous, recalls Sajjad, 50. The couple had tried to start a family after they married, but fertility problems led to six failed cycles of IVF. They considered adopting, but eventually decided to sign up as foster carers.

Both are observant Muslims of Pakistani heritage. Riffat, 46, was wearing a headscarf when we met, and prays five times a day. How did they cope with the arrival of three white English children raised in a Christian household?

I will never forget that day, recalls Riffat, who grew up in Pakistan and moved to Britain after marrying in 1997. It really was like being thrown in the deep end. They bought chicken and chips from the local takeaway for the children and the support worker told the couple about the childrens bedtime routine.

Once the children were asleep, Sajjad headed out on an urgent shopping mission. We are Muslims and wed never had a Christmas tree in our home, says Riffat. But these children were Christian and we wanted them to feel connected to their culture. So he bought a Christmas tree, decorations and presents. The couple worked until the early hours putting the tree up and wrapping presents. The first thing the children saw the next morning was the tree.

I had never seen that kind of extra happiness and excitement on a childs face, remembers Riffat. The children were meant to stay for two weeks seven years later two of the three siblings are still living with them.

Riffat has grown used to surprised looks from strangers and people asking if the reason she has such fair-skinned children is because she married a white man. But she focuses on the positives in particular how fostering has given her and Sajjad an insight into a world that had been so unfamiliar. We have learned so much about English culture and religion, Sajjad says. Riffat would read Bible stories to the children at night and took the girls to church on Sundays. When I read about Christianity, I dont think there is much difference, she says. It all comes from God.

The girls, 15 and 12, have also introduced Riffat and Sajjad to the world of after-school ballet, theatre classes and going to pop concerts. I wouldnt see many Asian parents at those places, she says. But I now tell my extended family you should involve your children in these activities because it is good for their confidence. Having the girls in her life has also made Riffat reflect on her own childhood. I had never spent even an hour outside my home without my siblings or parents until my wedding day, she says.

Just as Riffat and Sajjad have learned about Christianity, the girls have come to look forward to Eid and the traditions of henna. Ive taught them how to make potato curry, pakoras and samosas, Riffat says. But their spice levels are not quite the same as ours yet. The girls can also sing Bollywood songs and speak Urdu.

I now look forward to going home. I have two girls and my wife waiting, says Sajjad. Its been such a blessing for me, adds Riffat. It fulfilled the maternal gap.

Shareen

Shareen
Shareens longest foster placement is a young boy from Syria: He was 14 and had hidden inside a lorry. Photograph: Karen Robinson for the Observer

A British Pakistani, Shareen (and her husband Asif, 47), began fostering three years ago after three failed rounds of IVF. She has looked after children from many nationalities including Afro-Caribbean, Syrian, Egyptian and Pakistani.

When she first used to read the background reports about the children she looked after, Shareen, 48, was shocked at what theyd been through. I just could not believe that there could be children so deprived of love, she says. I was exposed to so much pain.

One 12-year-old boy she fostered, who had been diagnosed with ADHD, couldnt sleep each night. He would break the lightbulbs and chuck them in the neighbours garden. Whatever he could find in the room he would open up and unscrew and he would not come home at curfew time, she recalls. I would have to call the police every evening.

The key to coping, she says, was to try to understand the reasons behind the challenging behaviour. You have to look at the persons history, she says. No child is born to take drugs or join a gang. It has happened because nobody has cared for them. The boy ended up staying with Shareen for eight months.

She has also fostered children of Pakistani heritage and says there are some advantages. Two Pakistani children fitted right into the house because they understood our culture; we ate the same food and shared the same language, but when I had white children and I was out with them, people gave me funny looks.

Shareens longest foster placement arrived three years ago: a boy from Syria. He was 14 and had hidden inside a lorry all the way from Syria, she says. The boy was deeply traumatised. They had to communicate via Google Translate; Shareen later learned Arabic and he picked up English within six months. She read up on Syria and the political situation there to get an insight into the conditions he had left.

It took ages to gain his trust, she says. I got a picture dictionary that showed English and Arabic words and I remember one time when I pronounced an Arabic word wrong and he burst out laughing and told me I was saying it wrong that was the breakthrough.

The boy would run home from school and whenever they went shopping in town, he kept asking Shareen when they were going back home. She found out why: He told me that one day he left his house in Syria and when he had come back, there was no house. Now hes 18, speaks English fluently and is applying for apprenticeships. He could move out of Shareens home, but has decided to stay. He is a very different person to the boy who first came here, she says, and my relationship with him is that of a mother to her son.

Fostering has, she says, helped her to be more resilient, patient and confident. I used to worry about who was doing better than me or earning more money, she says. But after meeting these children, those things just dont matter to me anymore.

Homayun and Parvin

Homa
We thought we had done well and it was time we paid something back to society: Homayun and Parvin. Photograph: Karen Robinson for the Observer

Two years ago Homayun, who came to the UK from Afghanistan in 1979, was watching the news when he saw the footage of a three-year-old Syrian boy washed up on a beach in Turkey. I thought to myself that we had done well in this society. We had been educated, got jobs and we also had a spare room. It was time we paid something back to society.

So he and his wife, Parvin, 44, applied to become foster carers. The process took 12 months and, at the start of this year, they welcomed two boys from Afghanistan and Kuwait now 15 and 12. We would have welcomed children from anywhere, including Britain, says Homayun, but I was especially interested in caring for children from war-torn countries because that was the experience I had been through.

Homayun, 51, owns a garage business and the couple have their own son, 16. My father was an activist and he was under house arrest, he says. We fled to Britain a few months before the Russians invaded the country. I know what it is like to live in a country that doesnt have freedom, human rights and a right to education I had that in common with the boys we were fostering. His Afghan foster son had travelled from Afghanistan to Iran and then to Turkey, where he had boarded a boat to Greece. From there he travelled to France before finally reaching Britain. His Kuwaiti foster son had been smuggled on to a plane using false identification. When he first met them Homayun was struck by how quiet the children were.

They would not speak and it took a few months to bring them out of themselves and get them to open up. The boys did not speak each others languages and relied on Google Translate. It was very challenging and difficult at first, says Homayun. But now the younger boy goes to school on his own, and uses public transport.

Although they share the same Muslim background, he would never force his own beliefs on his foster children. If I had a Christian child and they wanted to go to church, I would take them to church. If I had a Jewish child who wanted to go a synagogue, I would make sure they go there.

Homayun also encourages them to talk to their families back in their own countries. In Afghanistan the parents talk to their son regularly via Skype. They want him to receive something here that he never had there an education, he says. Leaving Afghanistan is a gamble; sometimes it pays off and other times it doesnt and parents can lose their children.

Both boys now call him Uncle or Baba and are starting to speak English well. If they can leave my house and go and achieve something in their lives, says Homayun, something that they could not have done in their own countries, that would be a satisfying job done.

Homayun chose to foster as a way of giving something back to society, but in fact both he and his wife found that the experience has enriched all of them in ways they could not have predicted.

Their son, who has autism, is now learning to share and communicate, and has started speaking in sentences. He enjoys having the two boys in the house and they go cycling and play football, he says. Fostering has done the whole family so much good.

Read more: http://www.theguardian.com/us

A journey through a land of extreme poverty: welcome to America

The UNs Philip Alston is an expert on deprivation and he wants to know why 41m Americans are living in poverty. The Guardian joined him on a special two-week mission into the dark heart of the worlds richest nation

Los Angeles, California, 5 December

You got a choice to make, man. You could go straight on to heaven. Or you could turn right, into that.

We are in Los Angeles, in the heart of one of Americas wealthiest cities, and General Dogon, dressed in black, is our tour guide. Alongside him strolls another tall man, grey-haired and sprucely decked out in jeans and suit jacket. Professor Philip Alston is an Australian academic with a formal title: UN special rapporteur on extreme poverty and human rights.

General Dogon, himself a veteran of these Skid Row streets, strides along, stepping over a dead rat without comment and skirting round a body wrapped in a worn orange blanket lying on the sidewalk.

The two men carry on for block after block after block of tatty tents and improvised tarpaulin shelters. Men and women are gathered outside the structures, squatting or sleeping, some in groups, most alone like extras in a low-budget dystopian movie.

We come to an intersection, which is when General Dogon stops and presents his guest with the choice. He points straight ahead to the end of the street, where the glistening skyscrapers of downtown LA rise up in a promise of divine riches.

Heaven.

Then he turns to the right, revealing the black power tattoo on his neck, and leads our gaze back into Skid Row bang in the center of LAs downtown. That way lies 50 blocks of concentrated human humiliation. A nightmare in plain view, in the city of dreams.

Alston turns right.

Philip
Philip Alston in downtown LA. Photograph: Dan Tuffs for the Guardian

So begins a two-week journey into the dark side of the American Dream. The spotlight of the UN monitor, an independent arbiter of human rights standards across the globe, has fallen on this occasion on the US, culminating on Friday with the release of his initial report in Washington.

His fact-finding mission into the richest nation the world has ever known has led him to investigate the tragedy at its core: the 41 million people who officially live in poverty.

Of those, nine million have zero cash income they do not receive a cent in sustenance.

Alstons epic journey has taken him from coast to coast, deprivation to deprivation. Starting in LA and San Francisco, sweeping through the Deep South, traveling on to the colonial stain of Puerto Rico then back to the stricken coal country of West Virginia, he has explored the collateral damage of Americas reliance on private enterprise to the exclusion of public help.

The Guardian had unprecedented access to the UN envoy, following him as he crossed the country, attending all his main stops and witnessing the extreme poverty he is investigating firsthand.

Think of it as payback time. As the UN special rapporteur himself put it: Washington is very keen for me to point out the poverty and human rights failings in other countries. This time Im in the US.

David
David Busch, who is currently homeless on Venice beach, in Los Angeles. Photograph: Dan Tuffs for the Guardian

The tour comes at a critical moment for America and the world. It began on the day that Republicans in the US Senate voted for sweeping tax cuts that will deliver a bonanza for the super wealthy while in time raising taxes on many lower-income families. The changes will exacerbate wealth inequality that is already the most extreme in any industrialized nation, with three men Bill Gates, Jeff Bezos and Warren Buffet owning as much as half of the entire American people.

A few days into the UN visit, Republican leaders took a giant leap further. They announced plans to slash key social programs in what amounts to an assault on the already threadbare welfare state.

Look up! Look at those banks, the cranes, the luxury condos going up, exclaimed General Dogon, who used to be homeless on Skid Row and now works as a local activist with Lacan. Down here, theres nothing. You see the tents back to back, theres no place for folks to go.

California made a suitable starting point for the UN visit. It epitomizes both the vast wealth generated in the tech boom for the 0.001%, and the resulting surge in housing costs that has sent homelessness soaring. Los Angeles, the city with by far the largest population of street dwellers in the country, is grappling with crisis numbers that increased 25% this past year to 55,000.

Ressy Finley, 41, was busy sterilizing the white bucket she uses to slop out in her tent in which she has lived on and off for more than a decade. She keeps her living area, a mass of worn mattresses and blankets and a few motley possessions, as clean as she can in a losing battle against rats and cockroaches. She also endures waves of bed bugs, and has large welts on her shoulder to prove it.

She receives no formal income, and what she makes on recycling bottles and cans is no way enough to afford the average rents of $1,400 a month for a tiny one-bedroom. A friend brings her food every couple of days, the rest of the time she relies on nearby missions.

She cried twice in the course of our short conversation, once when she recalled how her infant son was taken from her arms by social workers because of her drug habit (he is now 14; she has never seen him again). The second time was when she alluded to the sexual abuse that set her as a child on the path towards drugs and homelessness.

Given all that, its remarkable how positive Finley remains. What does she think of the American Dream, the idea that everyone can make it if they try hard enough? She replies instantly: I know Im going to make it.

A 41-year-old woman living on the sidewalk in Skid Row going to make it?

Sure I will, so long as I keep the faith.

What does making it mean to her?

I want to be a writer, a poet, an entrepreneur, a therapist.

Ressy
Ressy Finley, who lives in a tent on 6th Street in Downtown LA. Photograph: Dan Tuffs for the Guardian

Robert Chambers occupies the next patch of sidewalk along from Finleys. Hes created an area around his tent out of wooden pallets, what passes in Skid Row for a cottage garden.

He has a sign up saying Homeless Writers Coalition, the name of a group he runs to give homeless people dignity against what he calls the animalistic aspects of their lives. Hes referring not least to the lack of public bathrooms that forces people to relieve themselves on the streets.

LA authorities have promised to provide more access to toilets, a critical issue given the deadly outbreak of Hepatitis A that began in San Diego and is spreading on the west coast claiming 21 lives mainly through lack of sanitation in homeless encampments. At night local parks and amenities are closed specifically to keep homeless people out.

Skid Row has had the use of nine toilets at night for 1,800 street-faring people. Thats a ratio well below that mandated by the UN in its camps for Syrian refugees.

Its inhuman actually, and eventually in the end you will acquire animalistic psychology, Chambers said.

He has been living on the streets for almost a year, having violated his parole terms for drug possession and in turn being turfed out of his low-cost apartment. Theres no help for him now, he said, no question of making it.

The safety net? It has too many holes in it for me.

Of all the people who crossed paths with the UN monitor, Chambers was the most dismissive of the American Dream. People dont realize its never getting better, theres no recovery for people like us. Im 67, I have a heart condition, I shouldnt be out here. I might not be too much longer.

That was a lot of bad karma to absorb on day one, and it rattled even as seasoned a student of hardship as Alston. As UN special rapporteur, hes reported on dire poverty and its impact on human rights in Saudi Arabia and China among other places. But Skid Row?

I was feeling pretty depressed, he told the Guardian later. The endless drumbeat of horror stories. At a certain point you do wonder what can anyone do about this, let alone me.

And then he took a flight up to San Francisco, to the Tenderloin district where homeless people congregate, and walked into St Boniface church.

What he saw there was an analgesic for his soul.

San Francisco, California, 6 December

The
The Gubbio project at St Boniface in San Francisco. The church opens its doors every weekday at 6am to allow homeless people to rest until 3pm. Photograph: David Levene for the Guardian

About 70 homeless people were quietly sleeping in pews at the back of the church, as they are allowed to do every weekday morning, with worshippers praying harmoniously in front of them. The church welcomes them in as part of the Catholic concept of extending the helping hand.

I found the church surprisingly uplifting, Alston said. It was such a simple scene and such an obvious idea. It struck me Christianity, what the hell is it about if its not this?

It was a rare drop of altruism on the west coast, competing against a sea of hostility. More than 500 anti-homeless laws have been passed in Californian cities in recent years. At a federal level, Ben Carson, the neurosurgeon who Donald Trump appointed US housing secretary, is decimating government spending on affordable housing.

Perhaps the most telling detail: apart from St Boniface and its sister church, no other place of worship in San Francisco welcomes homeless people. In fact, many have begun, even at this season of goodwill, to lock their doors to all comers simply so as to exclude homeless people.

As Tiny Gray-Garcia, herself on the streets, described it to Alston, there is a prevailing attitude that she and her peers have to contend with every day. She called it the violence of looking away.

Coy
Coy Catley, 63, in her homeless box made of cardboard sheets on a sidewalk of Tenderloin, San Francisco. Photograph: Ed Pilkington for the Guardian

That cruel streak the violence of looking away has been a feature of American life since the nations founding. The casting off the yoke of overweening government (the British monarchy) came to be equated in the minds of many Americans with states rights and the individualistic idea of making it on your own a view that is fine for those fortunate enough to do so, less happy if youre born on the wrong side of the tracks.

Countering that has been the conviction that society must protect its own against the vagaries of hunger or unemployment that informed Franklin Roosevelts New Deal and the Great Society of Lyndon Johnson. But in recent times the prevailing winds have blown strongly in the youre on your own, buddy direction. Ronald Reagan set the trend with his 1980s tax cuts, followed by Bill Clinton, whose 1996 decision to scrap welfare payments for low-income families is still punishing millions of Americans.

The cumulative attack has left struggling families, including the 15 million children who are officially in poverty, with dramatically less support than in any other industrialized economy. Now they face perhaps the greatest threat of all.

As Alston himself has written in an essay on Trumps populism and the aggressive challenge it poses to human rights: These are extraordinarily dangerous times. Almost anything seems possible.

Lowndes County, Alabama, 9 December

Aaron
Aaron Thigpen discusses the poor sewage conditions in Butler County. Improper treatment has put the population at risk of diseases long believed to be extinct in the US. Photograph: Bob Miller for the Guardian

Trumps undermining of human rights, combined with the Republican threat to pare back welfare programs next year in order to pay for some of the tax cuts for the rich they are rushing through Congress, will hurt African Americans disproportionately.

Black people are 13% of the US population, but 23% of those officially in poverty and 39% of the homeless.

The racial element of Americas poverty crisis is seen nowhere more clearly than in the Deep South, where the open wounds of slavery continue to bleed. The UN special rapporteur chose as his next stop the Black Belt, the term that originally referred to the rich dark soil that exists in a band across Alabama but over time came to describe its majority African American population.

The link between soil type and demographics was not coincidental. Cotton was found to thrive in this fertile land, and that in turn spawned a trade in slaves to pick the crop. Their descendants still live in the Black Belt, still mired in poverty among the worst in the union.

You can trace the history of Americas shame, from slave times to the present day, in a set of simple graphs. The first shows the cotton-friendly soil of the Black Belt, then the slave population, followed by modern black residence and todays extreme poverty they all occupy the exact same half-moon across Alabama.

There are numerous ways you could parse the present parlous state of Alabamas black community. Perhaps the starkest is the fact that in the Black Belt so many families still have no access to sanitation. Thousands of people continue to live among open sewers of the sort normally associated with the developing world.

The crisis was revealed by the Guardian earlier this year to have led to an ongoing endemic of hookworm, an intestinal parasite that is transmitted through human waste. It is found in Africa and South Asia, but had been assumed eradicated in the US years ago.

Yet here the worm still is, sucking the blood of poor people, in the home state of Trumps US attorney general Jeff Sessions.

A disease of the developing world thriving in the worlds richest country.

The open sewerage problem is especially acute in Lowndes County, a majority black community that was an epicenter of the civil rights movement having been the setting of Martin Luther Kings Selma to Montgomery voting rights march in 1965.

Philp
Philp Alston talks to a resident. Many families in Butler and Lowndes counties choose to live with open sewer systems made from PVC pipe. Photograph: Bob Miller for the Guardian

Despite its proud history, Catherine Flowers estimates that 70% of households in the area either straight pipe their waste directly onto open ground, or have defective septic tanks incapable of dealing with heavy rains.

When her group, Alabama Center for Rural Enterprise (Acre), pressed local authorities to do something about it, officials invested $6m in extending waste treatment systems to primarily white-owned businesses while bypassing overwhelmingly black households.

Thats a glaring example of injustice, Flowers said. People who cannot afford their own systems are left to their own devices while businesses who do have the money are given public services.

Walter, a Lowndes County resident who asked not to give his last name for fear that his water supply would be cut off as a reprisal for speaking out, lives with the daily consequences of such public neglect. You get a good hard rain and it backs up into the house.

Thats a polite way of saying that sewage gurgles up into his kitchen sink, hand basin and bath, filling the house with a sickly-sweet stench.

Given these circumstances, what does he think of the ideology that anyone can make it if they try?

I suppose they could if they had the chance, Walter said. He paused, then added: Folks arent given the chance.

Had he been born white, would his sewerage problems have been fixed by now?

After another pause, he said: Not being racist, but yeah, they would.

Round the back of Walters house the true iniquity of the situation reveals itself. The yard is laced with small channels running from neighboring houses along which dark liquid flows. It congregates in viscous pools directly underneath the mobile home in which Walters son, daughter-in-law and 16-year-old granddaughter live.

It is the ultimate image of the lot of Alabamas impoverished rural black community. As American citizens they are as fully entitled to life, liberty and the pursuit of happiness. Its just that they are surrounded by pools of excrement.

This week, the Black Belt bit back. On Tuesday a new line was added to that simple graphic, showing exactly the same half-moon across Alabama except this time it was not black but blue.

blue belt south

It depicted the army of African American voters who turned out against the odds to send Doug Jones to the US Senate, the first Democrat from Alabama to do so in a generation. It delivered a bloody nose to his opponent, the alleged child molester Roy Moore, and his puppetmasters Steve Bannon and Donald Trump.

It was arguably the most important expression of black political muscle in the region since Kings 1965 march. If the previous entries in the graphic could be labeled soil, slavery and poverty, this one should be captioned empowerment.

Guayama, Puerto Rico, 10 December

So how does Alston view the role of UN rapporteur and his visit? His full report on the US will be released next May before being presented to the UN human rights council in Geneva.

Nobody expects much to come of that: the world body has no teeth with which to enforce good behavior on recalcitrant governments. But Alston hopes that his visit will have an impact by shaming the US into reflecting on its values.

My role is to hold governments to account, he said. If the US administration doesnt want to talk about the right to housing, healthcare or food, then there are still basic human rights standards that have to be met. Its my job to point that out.

Alstons previous investigations into extreme poverty in places like Mauritania pulled no punches. We can expect the same tough love when it comes to his analysis of Puerto Rico, the next stop on his journey into Americas dark side.

Three months after Maria, the devastation wrought by the hurricane has been well documented. It tore 70,000 homes to shreds, brought industry to a standstill and caused a total blackout of the island that continues to cause havoc.

Facing poverty, academics turn to sex work and sleeping in cars

Adjunct professors in America face low pay and long hours without the security of full-time faculty. Some, on the brink of homelessness, take desperate measures

There is nothing she would rather do than teach. But after supplementing her career with tutoring and proofreading, the university lecturer decided to go to remarkable lengths to make her career financially viable.

She first opted for her side gig during a particularly rough patch, several years ago, when her course load was suddenly cut in half and her income plunged, putting her on the brink of eviction. In my mind I was like, Ive had one-night stands, how bad can it be? she said. And it wasnt that bad.

The wry but weary-sounding middle-aged woman, who lives in a large US city and asked to remain anonymous to protect her reputation, is an adjunct instructor, meaning she is not a full-time faculty member at any one institution and strings together a living by teaching individual courses, in her case at multiple colleges.

about

I feel committed to being the person whos there to help millennials, the next generation, go on to become critical thinkers, she said. And Im really good at it, and I really like it. And its heartbreaking to me it doesnt pay what I feel it should.

Sex work is one of the more unusual ways that adjuncts have avoided living in poverty, and perhaps even homelessness. A quarter of part-time college academics (many of whom are adjuncts, though its not uncommon for adjuncts to work 40 hours a week or more) are said to be enrolled in public assistance programs such as Medicaid.

They resort to food banks and Goodwill, and there is even an adjuncts cookbook that shows how to turn items like beef scraps, chicken bones and orange peel into meals. And then there are those who are either on the streets or teetering on the edge of losing stable housing. The Guardian has spoken to several such academics, including an adjunct living in a shack north of Miami, and another sleeping in her car in Silicon Valley.

The adjunct who turned to sex work makes several thousand dollars per course, and teaches about six per semester. She estimates that she puts in 60 hours a week. But she struggles to make ends meet after paying $1,500 in monthly rent and with student loans that, including interest, amount to a few hundred thousand dollars. Her income from teaching comes to $40,000 a year. Thats significantly more than most adjuncts: a 2014 survey found that the median income for adjuncts is only $22,041 a year, whereas for full-time faculty it is $47,500.

We take a kind of vow of poverty

Recent reports have revealed the extent of poverty among professors, but the issue is longstanding. Several years ago, it was thrust into the headlines in dramatic fashion when Mary-Faith Cerasoli, an adjunct professor of Romance languages in her 50s, revealed she was homeless and protested outside the New York state education department.

We take a kind of vow of poverty to continue practicing our profession, Debra Leigh Scott, who is working on a documentary about adjuncts, said in an email. We do it because we are dedicated to scholarship, to learning, to our students and to our disciplines.

Adjuncting has grown as funding for public universities has fallen by more than a quarterbetween 1990 and 2009. Private institutions also recognize the allure of part-time professors: generally they are cheaper than full-time staff, dont receive benefits or support for their personal research, and their hours can be carefully limited so they do not teach enough to qualify for health insurance.

This is why adjuncts have been called the fast-food workers of the academic world: among labor experts adjuncting is defined as precarious employment, a growing category that includes temping and sharing-economy gigs such as driving for Uber. An American Sociological Association taskforce focusing on precarious academic jobs, meanwhile, has suggested that faculty employment is no longer a stable middle-class career.

Adjunct
Adjunct English professor Ellen James-Penney and her husband live in a car with their two dogs. They have developed a system. Keep nothing on the dash, nothing on the floor you cant look like youre homeless, you cant dress like youre homeless. Photograph: Talia Herman for the Guardian

The struggle to stay in housing can take many forms, and a second job is one way adjuncts seek to buoy their finances. The professor who turned to sex work said it helps her keep her toehold in the rental market.

This is something I chose to do, she said, adding that for her it is preferable to, say, a six-hour shift at a bar after teaching all day. I dont want it to come across as, Oh, I had no other choice, this is how hard my life is.

Advertising online, she makes about $200 an hour for sex work. She sees clients only a handful of times during the semester, and more often during the summer, when classes end and she receives no income.

Im terrified that a student is going to come walking in, she said. And the financial concerns have not ceased. I constantly have tension in my neck from gritting my teeth all night.

To keep their homes, some adjuncts are forced to compromise on their living space.

Caprice Lawless, 65, a teacher of English composition and a campaigner for better working conditions for adjuncts, resides in an 1100 sq ft brick house near Boulder, Colorado. She bought it following a divorce two decades ago. But because her $18,000 income from teaching almost full time is so meager, she has remortgaged the property several times, and has had to rent her home to three other female housemates.

I live paycheck to paycheck and Im deeply in debt, she said, including from car repairs and a hospitalization for food poisoning.

Like every other adjunct, she says, she opted for the role thinking it would be a path to full-time work. She is so dependent on her job to maintain her living situation that when her mother died this summer, she didnt take time off in part because she has no bereavement leave. She turned up for work at 8am the next day, taught in a blur and, despite the cane she has used since a hip replacement, fell over in the parking lot.

If she were to lose her home her only hope, she says, would be government-subsidized housing.

Most of my colleagues are unjustifiably ashamed, she said. They take this personally, as if theyve failed, and Im always telling them, you havent failed, the system has failed you.

A precarious situation

Even more desperate are those adjuncts in substandard living spaces who cannot afford to fix them. Mindy Percival, 61, a lecturer with a doctorate from Columbia, teaches history at a state college in Florida and, in her words, lives in a shack which is in the woods in middle of nowhere.

Lecturer
Lecturer Mindy Percivals mobile home in Stuart, Florida. Her oven, shower and water heater dont work. Photograph: Courtesy of Mindy Percival

The mobile home she inhabits, located in the town of Stuart, north of Miami, was donated to her about eight years ago. It looks tidyon the outside, but inside there are holes in the floor and the paneling is peeling off the walls. She has no washing machine, and the oven, shower and water heater dont work. Im on the verge of homelessness, constantly on the verge, she said.

Percival once had a tenure-track job but left to care for her elderly mother, not expecting it would be impossible to find a similar position. Now, two weeks after being paid, I might have a can with $5 in change in it. Her 18-year-old car broke down after Hurricane Irma, and she is driven to school by a former student, paying $20 a day for gas.

I am trying to get out so terribly hard, she said.

Homelessness is a genuine prospect for adjuncts. When Ellen Tara James-Penney finishes work, teaching English composition and critical thinking at San Jose State University in Silicon Valley, her husband, Jim, picks her up. They have dinner and drive to a local church, where Jim pitches a tent by the car and sleeps there with one of their rescue dogs. In the car, James-Penney puts the car seats down and sleeps with another dog. She grades papers using a headlamp.

Over the years, she said, they have developed a system. Keep nothing on the dash, nothing on the floor you cant look like youre homeless, you cant dress like youre homeless. Dont park anywhere too long so the cops dont stop you.

James-Penney, 54, has struggled with homelessness since 2007, when she began studying for her bachelors degree. Jim, 64, used to be a trucker but cannot work owing to a herniated disk. Ellen made $28,000 last year, a chunk of which goes to debt repayments. The remainder is not enough to afford Silicon Valley rent.

At night, instead of a toilet they must use cups or plastic bags and baby wipes. To get clean, they find restrooms and we have what we call the sink-shower, James-Penney said. The couple keep their belongings in the back of the car and a roof container. All the while they deal with the consequences of ageing James-Penney has osteoporosis in a space too small to even stand up.

James-Penney does not hide her situation from her class. If her students complain about the homeless people who can sometimes be seen on campus, she will say:Youre looking at someone who is homeless.

That generally stops any kind of sound in the room, she says. I tell them, your parents could very well be one paycheck away, one illness away, from homelessness, so it is not something to be ashamed of.

Ellen
Ellen James-Penney teaching an English class at San Jose State University in California. She tells her students, youre looking at someone who is homeless. Photograph: Talia Herman for the Guardian

I hung on to the dream

Many adjuncts are seeking to change their lot by unionizing, and have done so at dozens of schools in recent years. They are notching successes; some have seen annual pay increases of about 5% to almost 20%, according to Julie Schmid, executive director of the American Association of University Professors.

Schools are often opposed to such efforts and say unions will result in higher costs for students. And for certain adjuncts, any gains will come too late.

Mary-Faith Cerasoli, 56, the homeless adjunct who captured the publics attention with her protest in New York three years ago, said that in the aftermath little changed in termsof her living situation. Two generous people, a retiree and then a nurse, offered her temporary accommodation, but she subsequently ended up in a tent pitched at a campground and, after that, a broken sailboat docked in the Hudson river.

But there was, however, one shift. All the moving around made it hard for her to make teaching commitments, and in any case the pay remained terrible, so she gave it up. She currently lives in a subsidized room in a shared house in a wealthy county north of New York.

For Rebecca Snow, 51, another adjunct who quit teaching after a succession of appalling living situations, there is a sense of having been freed, even though finances continue to be stressful.

Author
Author Rebecca Snow, now retired from adjuncting, has moved to a small apartment just north of Spokane, Washington. Photograph: Rajah Bose for the Guardian

She began teaching English composition at a community college in the Denver area in 2005, but the poor conditions of the homes she could afford meant she had to move every year or two. She left one place because of bedbugs, another when raw sewage flowed into her bathtub and the landlord failed to properly fix the pipes.

Sometimes her teenage son would have to stay with her ex-husband when she couldnt provide a stable home. Snow even published a poem about adjuncts housing difficulties.

In the end she left the profession when the housing and job insecurity became too much, and her bills too daunting. Today she lives in a quiet apartment above the garage of a friends home, located 15 miles outside Spokane, Washington. She has a view of a lake and forested hills and, with one novel under her belt, is working on a second.

Teaching was the fantasy, she said, but life on the brink of homelessness was the reality.

I realized I hung on to the dream for too long.

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