Freakos 1. Civilization 0

There are mentions that some other parts of the city have had more reconstruction since the revolution, but a lot of other districts are described as slums too.

Map Wall - To the east, rolling hillsides: Le Jardin, Stella Maris, the suburbs of Saint-Batiste, swallowed up into the megacity. They sound *rich* to you. This is Revachol East.

You - And west of the river?

Map Wall - Couron. It's somewhere to live. Not bad. Then there's Jamrock -- it's *bad*. People shouldn't live there, but they do. Then Faubourg -- it's almost *as* bad and much larger. Then Coal City. It's the worst.

You - And Martinaise?

Map Wall - It's so small you can't even see it on the map. No... wait. There it is! North of Jamrock, the strip of coast next to the Greater Revachol Industrial Harbour. It looks downright despondent. It's almost Coal City, to be honest.

There are a lot of characters with health issues who can't get proper treatment. In the apartment block, we meet the cleaning lady and Cuno's dad:

Cleaning Lady - "Give me a moment." An elderly woman is leaning on her broom, her knuckles white as bone. She seems to be having difficulty breathing.

Cleaning Lady - "The cold never does any good for my bronchitis..." She sneezes into a dirty handkerchief.

Endurance - This woman's health is failing her. There's not much to do, not in this damp.

You - "Are you alright? Should I call a doctor?"

Cleaning Lady - "I'm fine, fine, don't you worry about me!" She starts coughing, red spots appearing on her cheeks.

Empathy - You're still worried. It's very worrying.

Bronchitis is treatable anywhere with a decent standard of living. This woman works and can't afford to live somewhere less damp that would allow her to recover.

Rosemary in the union of moribund alcoholics establishes that healthcare is a mix of private doctors and substandard charities:

Rosemary - "In a week the goddamned kidneys started giving me all kinds of hell. Finally the missus took me to a private doctor's office -- not a charity, the real thing..."

He only needed a relatively minor procedure, to remove an ampoule that was inserted a week before as an anti-drinking measure.

The charity options seem to involve some support groups for those trying to quit drinking, like the one George attends in Harry's ultraliberal path. Temperance is a popular cause among charities.

Idiot Doom Spiral - He sighs. "It isn't that easy... But I'm working on it. I really am. I even signed up for this evening group in Jamrock."

The options seem to be very limited for anyone needing more help. If Harry hasn't met the Hardies by the time he meets The Pigs, this is how Kim ends up dealing with her:

You - "Should we just arrest her?" (Proceed.)

Kim Kitsuragi - "I don't think there's any need for that. In her current state -- and without the gun -- she isn't really a threat to anyone."

Kim Kitsuragi - "I guess I'll just notify my station. They'll contact the Sanitarium and handle the logistics."

There's a lot of material around about the horrors of real-world asylums, which are infamous for keeping patients too sedated to 'bother anyone' or engage with their surroundings, in institutions rife with neglect and abuse. They don't operate with the same goals as short-term hospital and rehab visits, where people are treated with the intention of helping them recover and function independently again. That sort of hosptial treatment is an expensive private service in Revachol. When discussing what to do with Cuno's dad:

Kim Kitsuragi - "We could take him to Remedie or Saint Batiste, but he doesn't have money for medical services. The Almshouse would turn him down..."

Almshouses in medieval times were typically funded by landowners or religious charities to house a select group of residents, who had to meet the criteria of being established locals who were unable to support themselves, and not being prone to bad habits such as drunkenness or gambling. The elderly and disabled, especially the blind, were prioritised. Rules set by the founders governed the selection of applicants, and they supported relatively small numbers, playing a limited role within wider systems of poor relief.

Countries with modern welfare systems would have other options for dealing with someone like Cuno's dad. Social services could get involved, as an intervention in between the binary of 'doing absolutely nothing' or 'there's an orphanage'.

In real world modern europe, if someone with a drugs problem that had reached a near-fatal stage managed to get themselves to a hospital, they'd get taxpayer-funded treatment even if they weren't able to immediately quit. For some substances, quitting cold turkey can be fatal, and the NHS treatment involves substitution therapy with less dangerous drugs, taking several stages to get people to the point where they have the option of quitting a substance with survivable withdrawal symptoms. Rehab treatments can also involve sedation to manage the risk of withdrawal seizures. With alcohol, there is evidence that the risk of seizures increases as an individual undergoes repeated withdrawals (see https://www.sciencedirect.com/topics/medicine-and-dentistry/withdrawal-seizure ) - so for anyone like Harry who has made previous attempts to get sober, future attempts become more dangerous without medical help. And in Revachol, that help is unaffordable for a lot of people. The support groups are free, but the hospitals aren't.

Noid - "Has anything like this happened to you before? Like... a *seizure*?"

Endurance - It's not your moves that are at fault, per se. You almost certainly had a seizure just now -- and a much more massive one a few days ago, when you lost your memory.

Heart problems also typically need help from doctors, not charities that apparently don't provide the same standard of healthcare as real doctors. It's a fandom meme that Harry can die of a heart attack on day one by failing to get his tie down from the ceiling fan, and even if he passes that check, he stays fragile all week. He can lose HP by kicking things or sitting uncomfortably, and he never has so much HP that he doesn't have to worry about too many of those incidents in a row killing him. In the mercenary tribunal, part of the reason he falls unconscious when shot is because of his heart problems:

Kim Kitsuragi - "Back there, on the plaza? I think you very nearly had a heart attack. Alcoholism has damaged you more than bullets have..." There's a small pause. "We should go."

Harry's gunshot wound became infected, and still is even after Kim treated it to the best of his ability for several days:

Kim Kitsuragi - "I had Garte open the door to your room." He closes the notes. "You were running a low bacterial fever the first night."

-

Kim Kitsuragi - "Reasonably bad. You were shot in the left quadriceps -- that's your thigh. The outer side thankfully, no major arteries were nicked. The bullet was removed and a bacterial infection treated with mercurochrome."

-

You - "Two days of sunshine? I just got a bacterial infection."

Lilienne, the Net Picker - "I'm sad to hear that. Take care of that with ether, will you? Don't get too many RCM men around here. Be sad to lose the first one."

The lack of a welfare state safety net is due to Revachol being an occupied territory without its own government, kept in a 'laissez faire' limbo by the foreign coalition that's occupying it.

Joyce Messier - "The RCM's responsibilities are defined by the Emergency, Wayfarer, and Aliments Acts -- three pieces of legislation keeping the city in a -- let's be honest -- laissez-faire stasis to the benefit of foreign capital."

The cut content 'the collapsing tenement' (see: https://www.tumblr.com/pyrholidon/674198053782175744/the-collapsing-tenement-a-case-file-cut-from-the ) establishes that there's no local government with any responsibility to look after the population, so when an apartment building is about to collapse, the residents officially have nowhere to turn.

Damaged Ledger: But, you see, it's *freezing* outside. And there is no municipal government in Revachol. Nowhere to put these people. Two hundred people can't go to their *aunt's for a couple of days*. And above all -- there is no one to *tell* the building is coming down. No authority but you.

-

Damaged Ledger: Your captain puts them in a half-burned building 10 km South. It's got black mould and no roof, but hey -- it's better than death.

Among the parts of the game that weren't cut, Acele tells us that Revachol doesn't have the tax base that it'd need for public services.

Acele - "Then you really haven't seen much of this *strange world*, because we literally haven't got any income taxes. Just a 20% value-added tax and that's, like... *it*."

The RCM have been trying to fill in for other services where they can, but they're donation funded, and chronically strapped for cash. They handle animal control, look for missing people, and sometimes get called by people with medical queries who presumably can't afford to see a doctor.

Esprit de Corps - Wanna hear what's stupid? Somewhere in a one room apartment on Boogie Street a young man shows Patrol Officer Tillbrook his genital warts, asking if they're *cancer*.

We've seen that some working people can't afford private healthcare in Revachol. There are some whose employers provide it as part of the job, but that's relatively priviledged, being part of what distinguishes Moralintern forces from the people they're oppressing:

Coalition Warship Archer - "Quite good. We enjoy all the standard benefits for Moralintern forces on active duty assignments: Excellent healthcare, foreign service pay, a fully funded pension system..."

Coalition Warship Archer - "... six-weeks paid leave, bilingual childcare, vocational certification credits. Really, it's quite a good career."

The RCM has a station doctor at the 41st, and a nurse at the 57th, so they send Kim to hospital if he's shot instead of treating him themselves. A police force wouldn't be able to operate without treating injuries, but the RCM seems to scrape by with the bare minimum.

Kim Kitsuragi - "The doctors will have to look at this. I hope your station has better medical personnel than 57. This is... a little advanced for a nurse."

When it comes to injuries - in the real world, employers have a legal duty of care to their employees, and one aspect of it is that people are protected from dismissal without being given reasonable time to recover from injuries sustained on the job. (See https://www.national-accident-helpline.co.uk/injury-and-accident-claims/accidents-at-work/duty-of-care ). Either the RCM doesn't have anything similar, or it does but flaunts it without consequence, since they can leave Harry in Martinaise while he's dealing with an infected gunshot wound, without giving him medical leave to recover first. (And without taking him home or to a hospital.) If he's left unemployed, he'd be in the same boat as a lot of other people in the neighborhood in struggling to access care - for the bullet wound, or the seizures, brain damage, heart problems, amnesia, mental health issues, or post-polio issues that are implied by the infant polio and the chronic pain.

In Harry's moralintern quest, Harry can get in contact with the Moralintern committee that has direct responsibility for Revachol, and the conversation can turn to how an interrim period is about to start, where Revacholians will be able to vote for Moralintern-selected candidates to form a government that will still answer to the coalition, as a step towards future full democracy. In the meantime, Harry can complain about the mass poverty and suffering, and the imminent bloodshed by the Krenel mercenaries, and that same committee will say that they won't take responsibility for local issues.

Coalition Warship Archer - "We're sorry, Firewalker. The Committee has declined your request for an emergency address..."

Coalition Warship Archer - "Specifically, they said that 'disputes of purely local concern' do not fall under their purview..."

Coalition Warship Archer - "I... cannot say we agree, speaking for a moment in strictly personal terms. You have convinced us that the situation in Martinaise is untenable, but we are only the second signaller, and there is no appealing the Committee's decision..."

Empathy - Something has cracked in her foundation. Her faith in the Moralintern is no longer as firm as it had been...

Coalition Warship Archer - "They added that they expect the RCM to fulfil its responsibilities 'to a high degree of satisfaction'..."

When the situation is untenable, revolution is imminent. Of course, if an uprising gains traction, things will get worse before they get better.

Evrart is kicking things off with the harbour takeover, but we find out at the end that his plan was to let most of the union die to the mercenaries, let bad press drive them off, and be the one to rebuild after it's all been burned down. He's not going to protect the neighborhood in the meantime - he's been treating everyone as meat shields, like the rich companies that he hates so much.

You - "So what's going to happen now?" (Conclude.)

Evrart Claire - "What was always going to happen. We take the harbour and she fucks off to Ozonne, uncorks a bottle of wine, calls her partners and says they need to distance themselves from this nasty business before the big shit spinner splashes everyone."

Evrart Claire - "Only difference is the Union doesn't have to lose 2,000 men to machine gun fire."