Doctors under the knife

With Bill Clinton's new reforms only a month away, the health-care system is on the operating table--and the doctors are under the knife. Americans have a love-hate relationship with physicians: they like the care that doctors provide but hold them to blame for the nation's health-care mess. NEWSWEEK looks at how the culture of medicine may change, assesses doctors' fears--and examines the brave new world of HMOs.     

Book reviews

Transcaucasian Boundaries John F. Wright, Suzanne Goldenberg and Richard Schofield (editors) London: UCL Press, 1996, 248pp, £40 and £14.95

The Russian Policy Debate on Central Asia Irina Zviagelskaia London: Royal Institute of International Affairs, 1995, X, 41 pp, £12.50

CIS Integration Trends: Russia and the Former Soviet South Mark Webber London: Royal Institute of International Affairs, 1997, IX, 72 pp, £12.50 Both distributed by Plimbridge Distributors Ltd, Estover Road, Plymouth. Devon PL6 7PZ, and in North America by the Brookings Institutional Press, Washington DC.

Russia and Azerbaijan: A Borderland in Transition Tadeusz Swietochowski New York: Columbia University Press, 1995, xvi, 290 pp, $34.95

The Soviet Socialist Republic of Iran, 1920–1921 Cosroe Chaqueri Pittsburgh, Pa: University of Pittsburgh Press, 1995, xvii, 649 pp, $75.00

Bibliography of Islamic Central Asia Yuri Bregel (editor and compiler) Bloomington, Indiana: Research Institute for Inner Asian Studies, Indiana University, 1995, in three volumes: Pt. I, LXXTV+773 pp; Pt. II, XLIII+774–1512 pp; Pt. III, XXXII+1513–2276 pp, $299

Mohieddin Alempour. A Tajik Visionary Baqer Moin (editor) London: BBC Persian Service, Bush House, 1997, illus, 140 pp, £20

Tatar Costume M. Zavyalova Kazan: Zaman Publishers Fund Turan, 1996, illus, 252 pp, $50     

Reviews

Orlando Figes, A People's Tragedy: The Russian Revolution 1891–1924. London: Jonathan Cape, 1996, xx + 923 pp., £25.00

Hafeez Malik (ed.), The Roles of the United States, Russia and China in the New World Order. Basingstoke: Macmillan, 1997, xvi + 333 pp., £47.50.

Leszek Buszynski, Russian Foreign Policy after the Cold War. Westport and London: Praeger, 1996, xiv + 243 pp., £46.95.

Mette Skak, From Empire to Anarchy: Postcommunist Foreign Policy and International Relations. London: C. Hurst & Company, 1996, x + 340 pp., £35.00 h/b, £14.95 p/b.

Hans von Zon, The Future of Industry in Central and Eastern Europe. Aldershot: Avebury, 1996, x + 164 pp., £35.00.

Bartlomiej Kaminski (ed.), Economic Transition in Russia and the New States of Eurasia. Armonk, New York: M.E. Sharpe, 1996, xviii + 430 pp.

Ben Fowkes, The Disintegration of the Soviet Union: A Study in the Rise and Triumph of Nationalism. Basingstoke: Macmillan, 1997, xii + 273 pp., £40.00

Juan J. Linz & Alfred Stepan, Problems of Democratic Transition and Consolidation. Southern Europe, South America, and Post‐Communist Europe. London: The Johns Hopkins University Press, 1996, xx + 479 pp., £15.50.

David Lane, The Rise and Fall of State Socialism. Cambridge: Polity Press, 1996, 233 pp., £12.95.

Reneo Lukic & Allen Lynch, Europe from the Balkans to the Urals: The Disintegration of Yugoslavia and the Soviet Union. Oxford: Oxford University Press, 1996, xvii + 436 pp.

Thomas Cushman & Stjepan G. Mestrovic (eds), This Time We Knew: Western Responses to Genocide in Bosnia. New York: New York University Press, 1996, ix + 412 pp., $50.00 h/b, $18.95 p/b.

Derek Hall & Darrick Danta (eds), Reconstructing the Balkans. A Geography of the New Southeast Europe. Chichester: John Wiley & Sons, 1996, xx + 260 pp., £45.00.

Ajay Patnaik. Central Asia. Between Modernity and Tradition. New Delhi: Konark Publishers, 1996, viii + 238 pp.

Rudolf L. Tokes, Hungary's Negotiated Revolution: Economic Reform, Social Change and Political Succession, 1957–1990. Cambridge: Cambridge University Press, 1996, xxiii + 544 pp., £19.95.

John D. H. Downing, Internationalizing Media Theory, Transition, Power, Culture, Reflections on Media in Russia, Poland and Hungary 1980–95. London: Sage, 1996, xviii + 269 pp., £45.00 h/b, £13.95 p/b.

Rogers Brubaker, Nationalism Reframed: Nationhood and the National Question in the New Europe. Cambridge: Cambridge University Press, 1996, xi + 202 pp., £35.00 h/b, £12.95 p/b.

Donald P. Steury (ed.), Intentions and Capabilities: Estimates on Soviet Strategic Forces, 1950–1983. Washington DC: Center for the Study of Intelligence, 1996, xxii + 504 pp.

R. W. Davies, Crisis and Progress in the Soviet Economy, 1931–1933. Basingstoke: Macmillan, 1996, xviii + 612 pp., £65.00.

William Chase, Jeffrey Burds, S. V. Praslova, A. K. Sokolov & E. A. Tiurina (eds), Russian Stale Archive of the Economy: A Research Guide: I. Guide to Collections. Moscow: Blagovest, 1994, xx + 679 pp.

V. P. Butt, A. B. Murphy, N. A. Myshov & G. R. Swain (eds), The Russian Civil War. Documents from the Soviet Archives. London: Macmillan, 1996, xvii + 217 pp., £15.99.

Ilya Somin, Stillborn Crusade: The Tragic Failure of Western Intervention in the Russian Civil War, 1918–1920. New Brunswick, NJ: Transaction Publishers, 1996, ix + 236 pp., £21.95, $32.99.

David R. Shearer, Industry, State, and Society in Stalin's Russia, 1926–1934. Ithaca: Cornell University Press, 1996, xiv + 263 pp., £33.50 h/b, £14.95 p/b.

Peter H. Solomon Jr., Soviet Criminal Justice under Stalin. Cambridge: Cambridge University Press, 1997, xvii + 494 pp., £55.00 h/b, £19.95 p/b.

Richard G. Hovannisian, The Republic of Armenia, Volume III, From London to Sèvres, February‐August 1920, xx + 534 pp., and Volume IV, Between Crescent and Sickle: Partition and Sovietization, xii + 496 pp. Berkeley, University of California Press, 1996. £35.00 each volume.

Ian D. Thatcher & James D. White (eds), Journal of Trotsky Studies. Glasgow: Institute of Russian & East European Studies, 1993–1996, Nos. 1–4, £10.00 (Institutions), £5.00 (Individuals).

Mikhail Baitalsky, Notebooks for the Grandchildren. Recollections of a Trotskyist Who Survived the Stalin Terror, Edited and translated by Marilyn Vogt‐Downey. Atlantic Highlands, New Jersey, 1996, xviii + 447 pp.

Leopoldina Plut‐Pregelj & Carole Rogel, Historical Dictionary of Slovenia. London: The Scarecrow Press, Inc, 1996, xxvii + 345 pp., £63.65.     

Participatory development: an approach sensitive to class and gender

This article begins by presenting development experience gained in the Indonesian province of Irian Jaya as a means of highlighting the centrality of popular participation to the development process. Important lessons from the ongoing development work in Irian Jaya were that it is not sufficient to consult beneficiaries and then act on their behalf or to engage in a development process unless the participants understand the project's conceptual orientation and language and have the tools to assess their needs and options for constructive change effectively. Also, developers must supply participants with information about the larger economic and political context in which they are operating. The article continues with an exploration of the ways in which a focus on class and gender raises participatory development to a new level. Constraints on transformative participation are then defined as 1) the political conditions and power structures existing in the country and community, 2) administrative opposition, 3) sociocultural impediments, and 4) limitations imposed by daily life. While it may be impossible to avoid the effects of such constraints, development agents can help villagers anticipate their impact and support efforts to cope with them. Participatory development challenges the status quo by enhancing economic equity and social equality and, if effective, will engender opposition, especially when a large amount of funding is at stake. Opposition can take many forms, including ridicule or resistance and can get personal. The demand to produce quick results also creates restraints on development agents. It is concluded that the development agent must engage key sectors of the local population in the development process and nurture this participation. Development agents should act as facilitators rather than independent initiators telling people what is best for them. Development agents must become very familiar with the community to earn the trust that is needed to guide people toward self-analysis and priority-setting.