Pistorius: Reeva Steenkamp was just a chapter in a scary story

Independent on Sunday, 14 September 2014

Pistorius is already on his way to rehabilitation in a country where three women a day are killed by a husband or boyfriend

The process of rehabilitation has already begun. The Paralympic athlete Oscar Pistorius has been cleared of murdering his girlfriend, Reeva Steenkamp, who died behind the locked door of a toilet at his home in South Africa last year. He was convicted of culpable homicide and a separate firearms charge, but he is out on bail amid speculation that he could even get a suspended sentence when he appears in court next month.

These events are shocking but not surprising. From the outset, Pistorius was given an easy ride by much of the world’s media, who uncritically repeated his controversial defence that he accidentally shot Steenkamp after mistaking her for a burglar. This is what happens when events involving famous people are viewed in isolation, as riveting individual dramas rather than belonging to a wider narrative. Why would an internationally famous runner kill his girlfriend? He says it was a mistake, but the question needs to be seen in context: why did no fewer than 1,024 South African men kill their current or former partners in 2009?

This is not a country, in other words, where such events are rare. A woman is killed by a husband or boyfriend every eight hours, according to a study published two years ago by the South African Medical Research Council. This translates to three women a day, and the study actually showed an improvement on the situation in South Africa 10 years earlier, when four women were dying every day. It has “the highest reported rate globally of females murdered by shooting in a country not engaged in war”, according to an article published in the South African Medical Journal (SAMJ).

Unsurprisingly, South Africa is on the list of countries where femicide – defined by the World Health Organisation as the intentional murder of women [simply] because they are women – is practised. Most victims are mixed race or black and their deaths receive little publicity, despite the dreadful injuries inflicted upon them. In that sense, Reeva Steenkamp – white, beautiful and well-known as a model in South Africa – was a far-from-typical victim (though, of course, Pistorius was cleared of murder). Hierarchies of victims are uncomfortable to contemplate but it might at least have been hoped that her death, at the hands of one of the country’s most admired men, would finally shame South Africa into acknowledging the scale of its problem with guns and violence. Instead, Steenkamp has been sidelined in the reporting of her own death, overshadowed by a man who is obsessed with lethal weapons, but who appears to consider himself the principal victim of this sequence of events.

For all the unusual features of the case, Steenkamp’s killing appears to fit a pattern of crime repeated over and over in South Africa. Women’s organisations, doctors and a handful of politicians know that much more needs to be done to tackle a macho culture aggravated by the role of guns as status symbols. Gun ownership “is a means to demonstrate manhood”, according to the SAMJ. The article goes on to remark that women “are most vulnerable behind closed doors, where guns are used to intimidate, control, hurt and kill intimate partners”.

Judge Thokozile Masipa, who presided over the murder trial, decided to ignore messages in which Steenkamp talked about the athlete’s volatile moods and said she was sometimes afraid of him. But Pistorius’s former girlfriend Samantha Taylor says she was so frightened of him that she hid one of his guns, which he later used to kill Steenkamp. Ms Taylor’s claims go some way towards establishing a history of domestic abuse, including her account of the athlete’s “angry and possessive rages” – an accusation that will ring true to anyone who witnessed his furious reaction when he lost a race at the 2012 Paralympics. And while the judge dismissed two firearms charges last week, she found Pistorius guilty of firing a gun in a crowded restaurant, just weeks before he killed Steenkamp.

Within hours of the fatal shooting, the model was becoming a footnote in her killer’s tear-sodden melodrama. He sobbed and retched his way through his trial, bursting into tears again on Thursday when Judge Masipa cleared him of murder. It is not uncommon for victims of crime to break down when asked to recall traumatic events, such as being beaten or raped, but it is rare for an alleged perpetrator to indulge in such boundless displays of self-pity. Pistorius’s tears lent weight to the prosecution case that he was volatile – almost entirely devoid of self-control.

Pistorius shot Steenkamp through a door, using a 9mm pistol and hollow-point ammunition which mushrooms inside body tissue. Her injuries were so devastating that a forensics expert suggested that one shot to her arm would have acted “like an instant amputation”. In the most puzzling and controversial section of her judgment, Judge Masipa said the athlete’s intention was to shoot, not to kill, and the prosecution had failed to establish that he “accepted the possibility of killing someone”.  It is hard to believe that Pistorius, who had had weapons training, did not understand the damage that this ammunition would cause, regardless of who was cowering behind the locked door. “How can you shoot four bullets through a door and not foresee their death?’ a South African legal expert, Professor Stephen Tuson, asked.

Even so, shooting a terrified woman four times with expanding bullets is no obstacle to a successful sporting career. Within hours of the verdicts, the International Paralympic Committee announced that Pistorius “had done a great deal” for the movement and would be allowed to compete again. But he has already won the most significant contest of his life in a country where men, guns and violence are regarded as natural companions.

Ashya King: this story isn’t quite what it seems

Independent on Sunday, 7 September 2014

The five-year-old isn’t dying – but nor is he getting the urgent treatment he needs, despite Jeremy Hunt’s extraordinary offer

A British boy is dying of a brain tumour. His distressed parents discover a life-saving treatment, available only in another country. Heartless doctors refuse to refer the child to the foreign clinic. Instead, they insist on going ahead with conventional treatment which, the parents fear, will turn him into a “vegetable”. The distraught parents seize their son from the hospital and take him abroad. The UK authorities overreact wildly, issuing an international alert for the family. The parents are found in Spain and arrested, causing an outcry and interventions from leading politicians.

This sequence of events has been widely reported in the past week. It is what a great many people believe about the controversy over five-year-old Ashya King, who is currently in a hospital in Malaga. Many of them have signed internet petitions or written furious blogs, citing the case as an example of the authoritarian state or the arrogance of doctors. The problem is that the story I’ve outlined simply isn’t true, starting with this basic fact: Ashya isn’t dying. Despite headlines using the hugely emotive phrase, he isn’t “terminally ill”.

In fact, his chances of surviving five years are between 70 and 80 per cent, as long as he receives prompt chemotherapy followed by radiotherapy. His tumour, which is called a medulloblastoma, was removed at a major teaching hospital, Southampton General, just over six weeks ago. To maximise his chances of recovery, chemotherapy should have started within four to six weeks of surgery. It didn’t, because his parents fell out with doctors in Southampton. The treatment they want is available at a private clinic in Prague, but that isn’t where they headed when they left the UK. They actually returned to the south of Spain, where they have a holiday home, and where they were staying when Ashya first showed symptoms earlier in the summer.

Obviously, the diagnosis of a brain tumour in a young child is devastating for any family, and no one doubts that Brett and Naghemeh King want the best for their son. But it is possible, despite being an eventuality discounted by most of the people making inflammatory comments, that even the most loving parents will sometimes make bad decisions in moments of extreme stress.

In this instance, the Kings did their own research on the internet and read about a form of radiotherapy known as proton beam treatment, which isn’t available in the UK. There is no general ban on referring NHS patients to have this treatment, although it is very expensive; around 400 patients, most of them children, have been sent abroad to undergo it since 2008. In suitable cases, the NHS will pay for the family’s travel and accommodation as well as the treatment. But proton beam radiotherapy is recommended in only a tiny proportion of cancers – around 1 per cent, according to Cancer Research UK.

Ashya’s doctors insist they took a clinical (not financial) decision that it would not be better for him than conventional radiotherapy. Because his parents disagreed, the doctors referred his case to a body called the NHS Specialised Services Proton Clinical Reference Panel. The panel confirmed the hospital’s opinion that Ashya was not a suitable candidate, but even then his doctors in Southampton went on talking to the parents to try to establish what they would be happy with. The Kings suggested they would be able to fund the treatment themselves, by selling their holiday home, and discussions continued until just before they took him to Spain nine days ago.

Since they appeared in Spain, members of the family have made emotional videos and press statements denouncing the behaviour of doctors in the UK. Ironically, when Ashya first became ill, the Kings brought him back to England to be treated by the NHS. Now they’ve changed their minds, but it is worth remembering that they are desperate for good news. Last week, NHS Choices issued a clear warning about the marketing of “emerging” treatments, stating unequivocally that “some overseas clinics providing proton beam therapy heavily market their services to parents who are understandably desperate to get treatment for their children”. The statement added that it is “not clear whether all children treated privately abroad are treated appropriately”.

When the Kings first removed Ashya from hospital, it was widely reported that the family were Jehovah’s Witnesses. Southampton General Hospital denies releasing this information to the media, and it does not seem to have had any bearing on Ashya’s treatment to date. But the fact that his parents belong to a millenarian religious cult suggests that they might not be entirely open to rational argument. Maybe that is why they have not taken up an extraordinary offer from the Health Secretary, Jeremy Hunt, to fly an oncologist to Spain to reassure them about the treatment Ashya would receive in the UK.

British doctors say he needs to start chemotherapy as soon as possible. But Ashya is a ward of a British court, and he cannot be moved from the hospital in Malaga without the court’s permission. On Friday evening, a High Court judge decided that the Kings can take him to Prague, but his travel arrangements are unclear. Whatever happens, one thing is certain: a child who should be receiving urgent treatment isn’t getting it. Clearly, there is a great deal more to this case than emotive headlines about an uncaring NHS.

Motives for Murder

Sunday Times, 7 September 2014

Our crime fiction round-up features a terrifying novel about abductions in Sweden

The Icelandic author Arnaldur Indridason has created one of the most accomplished series of detective novels in modern crime fiction. His last book, Strange Shores, seemed to mark an end to the series but Indridason is too interested in his gloomy detective, Erlendur, to let him go. Reykjavik Nights, translated by Victoria Cribb (Harvill Secker £16.99), is a prequel to the series, set at the very beginning of Erlendur’s career.

Working mainly at night, the young Erlendur is called out to traffic accidents and burglaries. Always ready to offer an unofficial night in a cell to a homeless person, he is troubled when one of the recipients of his generosity is found dead in a quarry. ­Quietly pursuing his own investigation, Erlendur links the man’s death to the unsolved disappearance of a young woman. The novel fills in gaps in Erlendur’s biography, but the best thing about it is Indridason’s empathy with victims of crime.

Roberto Costantini writes huge novels, both in terms of length and the ambition of his plots. The Root of All Evil, translated by NS Thompson (Quercus £18.99/ebook £9.49), is the second volume of his Commissario Balistreri trilogy, harking back to when his detective was growing up in post-colonial Libya. Balistreri’s father was a successful businessman in Tripoli, involved in the machinations that brought Colonel Gadaffi to power.

The first book in the trilogy, The Deliverance of Evil, was set in Rome many years later and showed Balistreri making a mess of a murder investigation. He is hard to like —sexist and careless of other people’s feelings — but the new novel reveals he was traumatised by the murder of a neighbour’s daughter and the death of his mother in Libya. The plot races along, even if his female characters never really come to life.

The West Virginia coal mines were cramped places, leaving some ex-miners unable to stand upright. Julia Keller has used a true story, about a miner’s wife who tried to create a refuge for her husband under the kitchen table, in her powerful new novel, Summer of the Dead (Headline £14.99). Lindy lives with her widowed father in Acker’s Gap, where she has turned their basement into a replica of the mine he used to work in. Lindy works in a petrol station, but she reads avidly and does her best to cope with her father’s increasing dementia. When a couple of local people are murdered, her father becomes a suspect. Keller knows small-town life inside out, and the book is full of memorable ­characters and plot twists.

One of the most difficult tasks for a crime writer is coming up with an original motive. The Swedish author Lars Kepler (actually the pen name of writers, ­Alexander Ahndoril and Alexandra Coelho Ahndoril) pulls it off in The Sandman, translated by Neil Smith (Blue Door £16.99). Jurek Walter is a serial killer, serving a life sentence in the secure wing of a hospital. His modus operandi was to kidnap his victims and keep them in excruciating conditions before they died or were dispatched.

The book begins with one of Walter’s victims, an emaciated young man, staggering across a bridge near Stockholm during a blizzard. The boy and his sister disappeared, presumed drowned, seven years earlier. Now it seems that the youngsters have been held in a concrete bunker all this time. Kepler’s plots are always thrilling, but The Sandman is one of the most hair-­raising crime novels published this year.

Anthony Quinn’s widely anticipated second novel Disappeared (Head of Zeus £12.99) is set in Northern Ireland. A former detective vanishes from the remote cottage he shares with his sister. Another man, who used to be an informer, is tortured to death. This is a tough yet lyrical novel, evoking a desperate period of Irish history when paramilitaries “disappeared” people they suspected of cooperating with the authorities.

Posing naked is one of the ultimate feminist acts

The Guardian, Wednesday 3 September 2014

It’s not always, or only, about sex. For me it was a liberation from the body anxiety that afflicts so many women

A few years ago, shortly after ending a long relationship, I asked a photographer to take some nude photographs. I know her well, so it was not as daunting as posing for a total stranger. It was not even the first time I had posed without clothes, but on this occasion it definitely had something to do with being single and not needing male approval.

Nude pictures, in other words, are not always, or not only, about sex.

There is a big difference between photographs taken for private and public consumption. This should not need to be said: pictures taken for a magazine or to publicise a film have a very different purpose from intimate photographs that are intended to be shared with close friends or partners. Our bodies are an important part of our identity, a fact that is often overlooked in a culture that is queasy about them; it is hard to imagine a moment in history when images of women’s bodies have been so plentiful, yet also the source of such extreme anxiety. If you are a woman, exploring your feelings about your naked body has seldom been more difficult. When you take your clothes off in front of a photographer, you risk deciding that you’re too thin, too fat, too pale, too brown, or just too old.

Amid this cacophony of critical voices, one reaction to the theft of “nude pics” – the tabloid shorthand makes them sound so much worse, doesn’t it? – has been to ask why any woman would pose naked. The implication is that the singers and actors concerned have “asked for it” if the pictures are stolen, which is as fine a piece of victim-blaming as I’ve heard in a long time. Apparently, the punishment for “vanity” is publication, and some newspapers that didn’t publish the stolen photographs offered a handy guide to where on the internet they had appeared.

This is not just to misunderstand the meaning of privacy. The body is a feminist issue, if ever there was one, and the struggle to own it is never-ending. I first posed nude in my 20s, when it seemed important to me to explore the meaning of nakedness. As a young woman, I was acutely aware of the vulnerability of the unclothed female body; a naked woman might be decorative, stretched out on a chaise longue in high art, but she might also be a potential victim of male violence. For a time I looked at men’s magazines, which appeared to be the only source of representations of women’s naked bodies, but all I found were pictures taken for the pleasure of male readers.

So I decided to pose nude myself, to see what it felt like. Could I take off all my clothes and feel not just unembarrassed but powerful? It was surprisingly easy, perhaps because I was reading so much feminist material and I felt as if I was throwing off years of conditioning. I didn’t do it for publication or any reason other than curiosity, but I think it’s one of the reasons I’ve escaped the body anxiety that is so common among women of all ages.

When I did it again, three or four years ago, I was a lot older and it raised different questions; I’m a size 12 but the body gets less elastic over time, no matter how often you go to the gym. It was about being comfortable in my skin as an older woman who continues to see herself as a sexual being, regardless of cultural messages to the contrary. This time I wore high heels for some of the pictures, something I wouldn’t have dreamed of doing in my 20s when I rejected many of the traditional trappings of femininity. I don’t think I’m supposed to say this, but I was delighted with the result.

There is another factor to consider here. On the one hand, commercial porn and Page 3 push images of women that are passive and degrading; on the other, reactionary religious leaders tell women they have to cover up. Somewhere in between, ordinary women and celebrities alike struggle to feel OK about themselves, worrying about showing too little or too much. Stealing intimate private pictures is a new front in this battle, but the women have nothing to be ashamed of. Posing nude, in my experience, is one of the ultimate feminist acts.

Lessons from the Rotherham child abuse scandal: Asian women’s voices go unheard

Independent on Sunday, 31 August 2014

The Jay report showed the Labour Party’s willingness to listen only to male community leaders

Here is the story of a young woman who was abused in Rotherham. For six years, she suffered threats and beatings, using make-up to hide her injuries. She had no money, could not buy her own clothes and was not allowed to go out alone. She could not even go to the corner shop unaccompanied and was never permitted to use the phone. “Basically,” she said, “I lived like a prisoner.”

In a week when a report exposing the scale of abuse of children and teenagers in Rotherham has rightly caused shock waves, you will not have read about this young women or others like her. Most of the victims mentioned in Professor Alexis Jay’s damning report were white and their abusers men of Pakistani origin, who subjected them to almost unimaginable sexual torture. It is a dreadful scandal, exposing the failure of one agency after another which should have stepped in to protect vulnerable young people.

Between 2002 and 2006, the council failed to act on three reports about child sexual abuse, while another report published last week revealed that South Yorkshire police went out of their way to try to “disprove” allegations of rape and sexual violence.

But it would be wrong to frame this solely as a story about race. The young woman I’ve just mentioned is Asian, and she suffered years of abuse after being brought from Pakistan and forced to marry her cousin. Some men whose parents came to this country from conservative areas of Pakistan have grown up with appalling attitudes towards women, sometimes but not always connected to strict interpretations of Islam. They have ended up abusing both white girls and women from their own community.

The problem is about power and gender as much as ethnicity, posing difficult questions for the Labour Party in towns and cities with sizeable Asian populations. From Yorkshire to some areas of London, the party has embraced self-appointed “community leaders” without asking questions about their attitudes to women, gay rights and equality. Many of these men have suffered discrimination – the BNP won three council seats in Rotherham at one point – and Labour has always seen itself as the champion of victims of racism. Up and down the country, it has found allies in the Asian community, even though some of them are small-scale entrepreneurs whose values seem more in tune with the Conservative Party. Along the way, Labour seems not to have noticed – or turned a blind eye – to a different equality problem.

Six or seven years ago, when I first visited Rotherham with my then partner Denis MacShane (who was the town’s MP), I noticed that most of the British-Asian activists in the local party, and all the Asian councillors, were men. I didn’t think this was peculiar to Rotherham but it made me uneasy; on one occasion, I refused to go to a wedding reception for a councillor’s daughter when I discovered that men and women would be segregated. I don’t think separation by gender is any more acceptable than separation by race, and the fact that some people on the left tolerate or even defend it is profoundly shocking.

What this meant, in practice, was that crucial voices were missed in discussions about the extent of both domestic and child abuse in Rotherham. As the Jay report points out, women from a Pakistani background felt there was “wholesale denial” of child sexual abuse within their community, despite 12 cases of forced marriage coming to light in 2005, many involving young girls. The report has no doubts about how this came about: “There was too much reliance by agencies on traditional community leaders such as elected members and imams being the primary conduit of communication with the Pakistani-heritage community.”

Like other towns and cities with a sizeable ethnic-minority population, Rotherham has an Asian women’s organisation which could have provided a very different view of what was going on in the community. A few years ago I met Zlakha Ahmed, founder of Apna Haq, an organisation which helps black, Asian and Muslim victims of domestic violence in South Yorkshire. From her, I first heard about a network of Asian taxi drivers who hunt down girls who have run away from abusive families; this is what happened to 17-year-old Shafilea Ahmed, who was murdered by her parents in Warrington. Her father, who is serving a life sentence, was a taxi driver.

The story of the Asian woman who is a prisoner in her own home appears on Apna Haq’s website. It lists forms of domestic abuse including beatings and rape, which happen in every community, but also types of behaviour specific to British-Asian families, such as being threatened with deportation and being told that “white women are much better”. It is a telling detail, debunking the widely held assumption that Asian men who abuse white girls behave better towards women in their own community. Of course, not all Asian men are abusers, but those who are despise all women; the difference is that their wives and daughters are subjected to forms of abuse associated with pernicious notions of “honour”. The common factor, whether they are keeping wives in isolation or taking part in a gang rape, is control.

The leader of Rotherham council, which is Labour-controlled, has resigned. The South Yorkshire police commissioner, who used to be a Labour councillor, has resisted calls to go. But the Jay report contains tough lessons for the Labour Party nationally, which has been far too ready to listen to male “community leaders” who don’t share the party’s commitment to equality. Patriarchal attitudes are incredibly damaging to women of all backgrounds. They have no place in a progressive political party.

 

Killing as spectacle: torture, murder and ethical questions for the press

 


Hacked Off, 27 August 2014


Not long ago, a British jihadist posted a photograph of himself on Twitter, apparently holding up a severed head in his left hand. The same man is now one of the chief suspects in the murder of the American journalist, James Foley, who was beheaded in Syria last week after being forced to take part in a propaganda video.


Since Mr Foley’s murder, many British newspapers have published still photographs from the propaganda video on their front pages, showing the journalist kneeling in the sand while his killer rants beside him. Some have also published the earlier picture from Abdel-Majed Abdel Bary’s Twitter account (now closed), with the severed head pixilated out. In a testament to the psychotic mind-set of men fighting for the terrorist group which calls itself the Islamic State, Abdel Bary even wrote a jokey caption to accompany the horrifying photograph.


When pictures of murder victims are re-published by the UK press, it is clearly right to obscure their features, not least to avoid the possibility that they might be seen by friends or relatives. Many Syrians live in Britain and have friends and family members in the country, where they may find themselves at the mercy of torturers and murderers from the Islamic State. But these images, which are as horrifying in their own way as photographs of Nazi concentration camps, create significant ethical dilemmas for editors and newspapers. Repeated use of still photos from the video of Mr Foley, and references (probably over-hyped) to his killer supposedly being nick-named after one of The Beatles (http://www.express.co.uk/news/uk/501795/British-jihadist-said-to-lead-The-Beatles-terror-gang), suggest that the ethical questions raised by publication have barely been addressed.


At one level, this may be explained by the adrenaline rush that accompanies such a huge breaking story. On such occasions, the impulse is to get the news out, and one of the justifications for publication of shocking pictures is that they are “already on the internet”. Even so, the Editors’ Code of Conduct still applies, and newspapers claim to hold themselves to higher standards than individuals or social networking sites, as we pointed out in a post last week. The point of drawing up such a code, even though it is often ignored or breached, is that editors agree to abide by it knowing they will have to make lightning-fast editorial decisions – and that ‘the internet’ is not signed up to any such standards.


In this instance, Mr Foley’s killers posted the video on YouTube; this is killing as spectacle, turning a moment of individual agony into a propaganda weapon. As far as I know, no British newspaper published still pictures of the moment of Mr Foley’s apparent murder, but some did publish links to the video. That was an error of judgement and the links were later taken down, but editors continued to use photographs of Mr Foley, moments before his death, to illustrate front-page follow-ups.


To me, this is problematic. Unlike most of the pictures I’ve seen from Nazi death camps, they have been taken not by horrified outsiders – photographers accompanying the soldiers who liberated the camps, for instance – but by the actual perpetrators of terrible crimes. Their aim is to shock and instil fear in most of their imagined audience, but also to recruit other disaffected young men to the organisation. They are glorifying their crimes, and no doubt many thousands of words could be written about the brutalised mental state of the young men behaving in this way.


At the same time, the pictures raise questions about our duty towards victims of atrocities, whether they are anonymous – which is often the case when the victims are Syrian, Iraqi or Kurdish – or clearly identifiable like Mr Foley. My reaction to the pictures of him kneeling with his hands secured behind his back is that this is an image of someone undergoing extreme mental torture. He may have hoped that his captors were putting him through a mock execution, which is in itself a form of torture, but his state of fear and horror is almost unimaginable.


I don’t want to see such pictures on the front pages of newspapers, any more than I would want to see images of a woman who is about to be raped. I doubt whether Mr Foley’s relatives and colleagues had any choice in the matter, given how widely they were used in the press. His parents made available photographs of him doing his job and asked media outlets to use them rather than stills from the video, and that is how many people would have wanted to remember him.


The Editor’s Code does not directly cover matters of taste and decency (which are rightly deemed matters of editorial judgement or wrongly deemed slaves to the market-place), but it does contain clauses which bear on this issue. Privacy may seem an odd word to use in this context, but it is absolutely clear that Mr Foley did not consent to be filmed in these circumstances. The Editors’ Code says that ‘everyone is entitled to respect for his or her privacy’ while another clause deals specifically with ‘intrusion into grief or shock’, pointing out that publication should be handled ‘sensitively’. Such prominent use of still photos from the video is a prima facie breach of both these clauses, and there is an additional question about unintentional collusion with murderers. Part of the purpose of the video was humiliation, showing a Western journalist as a helpless victim, and the casual re-use of images from it performs exactly that function.


All of these questions will arise again. The Islamic State is a horrible organisation, which shows neither compassion nor respect for human beings. It will commit more atrocities, both against people who live in the areas under its control in Syria and Iraq and against Western hostages. How the press should do its job of informing the public, when some of the images available are not just horrific but produced by the perpetrators of terrible crimes, is a subject that editors urgently need to consider.

Really, it’s as if Leveson never happened

Independent on Sunday, 17 August 2014

Lurid coverage of suicides, police alerting media to a search of a celebrity’s home – all this was supposed to be behind us

One morning last week, I woke to the solemn tones of the right-wing commentator Anne Atkins on Radio 4, offering her reflections on the suicide of the actor Robin Williams. Atkins opened with an anecdote from 1806, describing how a man consulted a doctor in London and asked for help with depression. The doctor’s advice was simple: go and see the great clown Grimaldi, who was appearing in pantomime in Covent Garden. According to Atkins, the man’s reply – and I think we need to imagine violins here – was “I am Grimaldi”.

In other versions of this story, the clown’s name is given as Pagliacci, which is the title role in an opera by Leoncavallo. The fact that both versions were repeated last week is evidence of the power of stereotype, showing just how many people want to believe that comedians are inherently sad. Existential angst featured heavily in Russell Brand’s Guardian column on Williams’s suicide, which displayed the comedian’s usual species of sixth-form analysis: “Is it melancholy to think that a world that Robin Williams can’t live in must be broken? To tie this sad event to the overarching misery of our times?”

Williams was not the only celebrity who made headlines for the wrong reasons in recent days. Reporters and a BBC crew were already outside an apartment in Berkshire belonging to Sir Cliff Richard when it was searched by police on Thursday, following an allegation of historical sex abuse at a rally in Sheffield in 1985.

The singer, who was out of the country, denied the allegation and issued a statement which accused the police of tipping off the press in advance. This practice was criticised in the Leveson report, which said such leaks “are not in the public interest” and that briefings to the press should be handled “through open and transparent procedures”. A day later, South Yorkshire Police issued a curiously worded statement admitting it had decided to work with an unnamed “media outlet” on being told that news of the raid had leaked to journalists.

Not for the first time, some sections of the press are behaving as though the Leveson inquiry never happened. The former boxing promoter Kellie Maloney has revealed that she went public about her new life as a woman only after two newspapers threatened to expose her. And it is only five months since several national newspapers were roundly criticised for providing too much detail about the suicide of the designer L’Wren Scott, including a Daily Mail column which offered a macabre fashion detail about the method she used to kill herself. Scott’s death promoted a raft of speculation about why this glamorous woman had ended her own life, citing the state of her finances and supposed tensions in her relationship with Sir Mick Jagger.

The same thing happened after Williams’s death, despite advance warnings to newspapers from the mental-health charity Mind and the Samaritans. When celebrities kill themselves, there is an obvious risk that vulnerable people will draw comparisons with their own lives and make copycat attempts. Yet the Daily Mirror’s front page threw caution to the winds and announced that Williams “hanged himself when money worries pushed him to despair”. The Daily Mail’s front page declared that Williams was “facing bankruptcy” and asked whether “money troubles” tipped him over the edge. Both The Sun and the London free newspaper, Metro, described on their front pages how Williams killed himself.

This lurid coverage involved so many apparent breaches of the Editors’ Code of Practice that it was hard to keep track. The code says that publication should be handled “sensitively” in cases involving grief or shock, while a clause on reporting suicide expressly advises against “excessive detail about the method used”. The chief executive of Mind, Paul Farmer, condemned “salacious speculation” about the cause of Williams’s suicide and offered this succinct summary of why journalists need to exercise caution: “In short it’s to keep people, who may be struggling with their mental health, safe.” Someone else put it even more starkly, declaring that editors have a duty not to kill their readers.

It was only a matter of time before all these voices urging caution were vindicated in a particularly grim manner. What none of the amateur psychologists knew when they produced a slew of sensational headlines was that Williams had been told he was suffering from Parkinson’s disease. The devastating diagnosis was revealed on Thursday by his wife, Susan Schneider, who said he was in the early stages of the degenerative condition. According to her statement, the actor was “not ready” to make the diagnosis public but his “sobriety was intact” at the time of his death, scotching rumours that he had starting drinking again.

Pictures then emerged of the actor at a reception at an art gallery in San Francisco last weekend, taken weeks after a widely published “last photo” of him posing with an employee at an ice-cream parlour in June. The Daily Mail described the photographs as “heartbreaking” even though one of them, taken from behind, simply showed the actor in a short-sleeved black shirt and trousers. A sculptor called Mark Jaeger, whose work was on display at the gallery, recalled that Williams was in high spirits, talking and laughing with other guests. Clearly, mental-health charities are right to warn that suicide has complex causes.

Williams’s premature death is tragic. He had suffered from depression in the past but a diagnosis of Parkinson’s would be hard for anyone to cope with, no matter how psychologically robust. Sadly, the revelation produced a fresh round of stereotypes, recasting Wednesday’s frail victim of addictions and money problems into Friday’s heroic patient “battling” a dreadful disease. Heartlessness and sentimentality go hand in hand, as sections of the British press never cease to remind us.

For confidential support call the Samaritans in the UK on 08457 90 90 90, visit a local Samaritans branch or click here for details

Joan Smith is executive director of ‘Hacked Off’

The Girl Next Door by Ruth Rendell

Sunday Times, 10 August 2014

Hutchinson £18.99/ebook £9.99 pp288

Ruth Rendell is one of the world’s leading crime novelists. Since her first book was published in 1964, she has won dozens of awards, seen her work adapted for tele-vision and cinema, and become a life peer. This summer, she has chosen to mark her half century as an author with a novel — her 65th full-length one — that takes her back to her Essex roots.

Although her best-known novels are set in the fictional Sussex town of Kingsmarkham, Rendell has always been a superb observer of the suburbs. The Girl Next Door is set in Loughton, on the edge of Epping Forest, where she went to school. It is one of those liminal places, not quite London but not the “real” countryside either, which she writes about ­brilliantly. Her other great strength — small changes in language that reflect big changes in social attitudes — is on show in a novel that switches between the 1940s and the present.

The book opens during the Second World War. Some of the characters could easily have been Rendell’s school friends, and she effortlessly recalls the close-to-careless ­attitudes towards children in wartime. As adults come and go, a group of children play in a series of tunnels, not realising that they are the foundations of a half-built house. Rendell gets a couple of murders out of the way at the beginning, employing stark prose that reflects the casual ­dispatch of a wife and her lover by her psychopathic husband. The killer takes a gruesome souvenir, the couple’s severed hands, and conceals them in a biscuit tin that he buries in the children’s tunnels. The girl next door, Daphne Jones, sees the husband carry two heavy bundles into a summerhouse and set fire to them, but she is too scared to tell anyone what she has seen.

Seven decades later, the tin is found by builders and the police open a desultory inquiry. The investigation is an excuse to bring together the kids who played in the tunnels, most of them now grandparents or great-grandparents. They don’t think they have much to tell the police, but the reunion sets off dramatic events. One of the men is so bowled over by meeting Daphne again that he leaves his wife for her.

Rendell understands the difference between how people appear to outsiders and their turbulent inner worlds; it is this disjunction that leads to so many of the crimes in her fiction. She has always been acutely aware of the passage of time, and never more so than in this novel.

Rendell herself is in her mid-eighties. Fifty years on, the girl from Essex has become the unchallenged crime queen of suburbia. Her powers of observation are as acute as ever, and she writes about old age with as much gusto as any of the subjects she has tackled in her long career.

Priority for caregivers, not shareholders: why campaigners support a ban on Roche’s new cancer treatment

Independent on Sunday, 10 August 2014

Nice had ‘no option’ but to reject Kadcyla at its current price

Most of us know someone with breast cancer. Some of us have friends or relatives who have died of it. So any controversy about a new drug therapy is bound to raise strong feelings, especially if the headline news is about women in the late stages of the disease being denied treatment on grounds of cost. It happened again last week, when the National Institute for Health and Care Excellence (Nice) announced that a “revolutionary” new drug called Kadcyla was too expensive to be made available on the NHS. Nice said that the cost of the drug – £90,000 per patient – was prohibitive.

For the patients who would benefit from Kadcyla, this is disastrous news. It has been shown to extend life expectancy by six months in women in the late stages of the HER2-positive form of the disease. Some of them will almost certainly die while the row between Nice and the drug’s manufacturer, the Swiss-based pharmaceutical giant Roche, rumbles on. It doesn’t help that Nice has previously made questionable decisions, such as initially limiting access to another breast cancer drug, Herceptin, to women with advanced cancer.

Herceptin (also made by Roche) is much cheaper than Kadcyla, costing the NHS around £22,000 per patient per year. After a flood of appeals and the threat of court action, Nice did the right thing, changing its guidance and making Herceptin available to women who have just been diagnosed. Kadcyla contains the same ingredients as Herceptin but it also contains a chemotherapy element which acts directly on cancer cells, avoiding damage to healthy cells and causing fewer side-effects.

Even so, there is a great deal more to this story than the cash-strapped NHS making a mean decision and condemning desperate patients to a premature death. Roche would certainly like the public to believe that; it went on the offensive last week, making its arguments on news programmes and to health correspondents. It pointed out that Kadcyla has taken 30 years to develop and said that other European countries, including Switzerland and Austria, have not baulked at the enormous price tag.

What it didn’t talk about was the economics behind the company’s pricing decisions, which can be summarised quite starkly. Four of its five top-selling drugs are for cancer and they are showing healthy growth: sales of Herceptin are up by 6 per cent while Avastin, a treatment for several different cancers, is showing growth of 13 per cent. Hence a slew of headlines along these lines in the trade press: “Roche cancer drugs drive healthy sales rise” and “Sales of cancer drugs soar once again at Roche”.

The crucial thing about Kadcyla is that it is likely to be of use to far fewer patients than Herceptin. Every year, almost 50,000 patients are diagnosed with breast cancer in the UK and around 11,500 die of it. But Kadcyla would benefit only 1,500 British women per year, according to some estimates. This is not to question whether women with aggressive forms of breast cancer should in principle have access to the most modern and effective drugs. It is to raise questions about the corporate social responsibility of big pharmaceutical companies, which have a duty to patients as well as shareholders. Roche’s own code of conduct includes a commitment to maintaining “high ethical and social standards in our business dealings”. But the company’s “commitment to society” comes after this unequivocal statement: “We aim to continuously create value for our stakeholders and to achieve sustainable, high profitability”.

Nice has been negotiating with Roche over Kadcyla since April and the company says it offered a lower, but so far undisclosed, price in recent weeks. In the past, doctors and charities have criticised Nice for decisions which deny life-extending drugs to sick people, but this time the response has been markedly different. Sally Greenbrook of Breakthrough Breast Cancer described Kadcyla as a brilliant drug but said it was “incredibly expensive”. She credited Nice with going “over and above their usual processes” to try to approve it and called for the price of life-extending drugs to come down. Mia Rosenblatt, head of policy and campaigns at the Breast Cancer Campaign, said she was “hugely disappointed” by the decision but recognised that Nice had “no option” but to reject Kadcyla at its current price.

Mother country: the harrowing truth behind ‘fertility tourism’

Independent on Sunday, 3 August 2014

A surrogate Down’s syndrome baby, abandoned by an Australian couple, exposes the First World’s double standards

The websites show state-of-the-art equipment and laughing parents with babies. The couples are white, without exception, for the websites are aimed at Australians and Europeans who want to have fertility treatment in Thailand. The services on offer include not just IVF but treatments which are illegal in many developed countries, such as commercial surrogacy and gender selection. ‘Women in Thailand are the perfect candidates to become surrogate mothers’, promises one website, suggesting that clients might even like to combine treatment with a holiday. A ‘vacation with benefits’ is how the clinic describes it, but critics use harsher words. They call it ‘fertility tourism’.

According to an organisation called Families Through Surrogacy, there are usually about 20 Australian couples awaiting the birth of their child in Thailand at any one time. Surrogacy is legal in Thailand only when a married couple ask a blood relative to carry their baby but the law has not been widely enforced. The country has become an attractive destination for Australians who are unable to have children, including same-sex couples.

Last week, the result of one such arrangement between a Thai woman and an agency – not the one mentioned above – made headlines around the world, even though the details have not been independently verified. Pattaramon Chanbua, who lives about 60 miles from Bangkok, told reporters that she was struggling to look after a seven-month-old baby with Down’s syndrome after his Australian parents abandoned him. She said the couple took the boy’s twin sister, who was healthy, but left him behind when they returned home to Western Australia.

The circumstances of Chanbua’s pregnancy and its aftermath, as she tells them, are certainly harrowing. She is poor, works on a food stall and, at the age of 21, already has children aged six and three. She agreed to act as a surrogate for the Australian couple only because she needed money. She says: ‘I asked the agency, did I have to sleep with the man? The agent told me, “We are going to make a glass tube baby”, but I didn’t understand. My husband agreed because we didn’t have money to pay our debt and I didn’t need to have sex with another man’.

Her throwaway remark about preferring surrogacy to prostitution is telling. Thailand is notorious for its sex trade, which draws tourists from all over the world, as well as acting as a hub for trafficked women and girls from nearby countries. Sex tourism has now been joined by fertility tourism as a way for poor women and girls to make money, although it isn’t presented like that by the agencies which offer it. They paint a rosy picture in which surrogates ‘are mostly middle-class women, which [sic] view surrogate motherhood…as a way to safely and comfortably earn extra money’. The clinics present commercial surrogacy as a free choice, assuring potential clients that surrogates lead a healthy lifestyle and live in ‘ecologically clean neighbourhoods’.

It is disconcerting to hear young women described as if they were racehorses or pedigree dogs, but there is an occasional burst of candour; one clinic acknowledges that ‘the main focus of this medical clinic is of course the European customers’ who are attracted by the ‘affordable prices’. No wonder that little thought seems to have been given to the impact on young women of carrying a child to term, handing it over to strangers and never seeing it again. In this latest case, the Australian parents have remained anonymous and we don’t know why they took the extraordinary decision to separate twins.

This is not the only case in which a baby has been rejected by biological parents on grounds of health or disability, a circumstance which confirms the mercantile nature of the trade. Thai officials have now cracked down on illegal surrogacy, saying that anyone who tries to remove a child to another country without permission from the government is violating Thailand’s human trafficking laws. This may seem harsh to people who can’t have children but it puts the surrogacy business in a wider context, highlighting the way in which impoverished south-east Asian women are regarded by some foreigners simply as a useful resource. It is one thing for a woman to agree to carry a child for a close friend or relative, but quite another when the parties don’t know each other and there is an imbalance of wealth.

Many wealthy families in the Gulf States and Europe don’t give a second thought to employing Filipina women as domestic servants or nannies, assuming that they will leave their children at home to be cared for by relatives. I’m not sure that renting the womb of a young Thai woman is any better, but both practices say a great deal about the first world’s double standards towards motherhood.