this post was submitted on 05 Sep 2024
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Well, no, certainly there could be cooperation. But operating a complex entity like a hospital or a sewage processing plant requires proper organization and a permanent dedicated staff. I don't see how you could do that in a decentralized way.
Parts of the communities interested in running a hospital can just band together and run a hospital. Decentralization doesn't mean no organization, but the freedom to move between and form organizations. (Anarchist contexts would also say "just no hierarchical organization".)
Sewage and stinky jobs are interesting problems. https://theanarchistlibrary.org/library/the-anarchist-faq-editorial-collective-an-anarchist-faq-full.html#text-amuse-label-seci413 offers a variety a solutions, including giving benefits to those who volunteer, community agreement on a rotation, etc.