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Posted in honor of nurses during National Nurses Week!

“The best type of nursing girl is one who is tall, strong, and has a suppleness of movement. … If she can dance, it is a great advantage. … If she is favoured [sic] with good looks, it is all[the better] … .”  So claimed a 19th century British medical manual. The Journal of the American Medical Association added its two cents in 1902: “Nurses are often conceited and too unconscious of the due subordination [they] owe to the medical profession, of which she is sort of a useful parasite.”

Thankfully, nursing has come a long way since then.  But even in the days when disrespect was the norm nurses were making a difference in health care delivery, policy, ethics, and more. Florence Nightingale, for example, redesigned health care during the Crimean War so that mortality declined dramatically. Margaret Sanger worked with poor women in New York tenements who died from self-induced abortions, leading her to launch what is now Planned Parenthood. Mary Breckenridge started Kentucky’s Frontier Nursing Service in 1925 to serve women and children in rural areas.

More recently Cicely Saunders founded the first modern Hospice in London in 1967, fostering the culture of palliative care. And in our own time Mary Naylor’s research helped lead to the design of a Transitional Care Model that addresses “common breakdowns in care when older adults with complex needs transition from acute care settings to other care settings or their homes,” while Linda Aikens’ work addressed patient safety and its relation to nursing care.  She is credited with the term “failure to rescue,” defined as the “inability to save a hospitalized patient’s life when he experiences a complication.”  

Today “there has never been a more exciting time to be a nurse,” says Pat Donehower, a lecturer at the University of Vermont (UVM) College of Nursing and Health Sciences. “There are fabulous job opportunities in administration, research or practice settings.”

Mari Cordes, Vice President for Health Care with the American Federation of Teachers/Vermont, agrees.  “I’m so proud of my profession,” she says. Specializing in vascular nursing she has seen major changes in her profession over the past 25 years. “I’ve witnessed many of us stepping forward to demand our rightful place in health care,” the labor activist says. “That was our responsibility. No one was going to hand it to us. And the more we demanded the more respect we received.  Now most physicians want nurses’ distinct input.”

Some of the new respect for nurses may be in place because increasingly, nurses are getting advance degrees enabling them to take on leadership roles in research, on hospital boards, and in continuing dialogues around such issues as cost containment, ethics, and training. Dr. Linda Aiken’s research demonstrated that hospital nurses with a bachelor’s degree or higher gave patients a “substantial survival advantage.” She found that a 10 percent increase in the proportion of nurses with a BSN in hospitals decreased the risk of patient death and failure to rescue by five percent. If the proportion of BSN nurses in all hospitals was 60 rather than 20 percent, 18 fewer deaths per 1,000 surgical patients would be expected.

This kind of finding is supported by a 2010 report, The Future of Nursing, by the Institute of Medicine (IOM) that called for increasing the number of baccalaureate-prepared nurses in the workforce to 80 percent and doubling the population of nurses with doctorates in order to respond “to the demands of an evolving health care system and meet the changing needs of patients…”

Nurses are also taking their rightful place when the high cost of health care is addressed. While traditionally nurses have been viewed as a labor cost whereas physicians are seen as revenue generators, studies show that while improved nurse-to-patient ratios do increase cost they don’t impact overall profitability.

Cost-related issues are often connected to ethical dimensions of health care policy and practice. As Betty Rambur, professor of nursing at UVM puts it, “Nurses go beyond the biomedical. We’re holistic in our approach. That impacts the ethics of health economics. It’s opened the door to exciting models that include thinking about broader systems of care.”  

Another challenge with ethical implications is keeping up with necessary technology while not losing sight of important interpersonal contact and communication.  “The advent of the computer has helped in many ways,” says Felicia Robinson, a labor and delivery nurse at Brattleboro Memorial Hospital’s birthing center. “It’s easier to assess someone’s medical record or to see labs. But the computer can be a barrier between the clinician and the patient.  I review the medical record before entering the room. I sit facing the patient and make eye contact. When I turn to the computer I read her what I’ve written. So my patient is involved in the process. She feels confident I have ‘heard’ her.”

Ever evolving policies, practice norms and financing mechanisms coupled with institutional systems changes mean new opportunities as well as challenges for the country’s nearly 3 million registered nurses. Clearly it’s an awesome time to be a nurse.


This essay is excerpted from an article that appeared in Vermont Woman, April/May, 2015. Cross-posted with OpEdNews.

Discuss

Last year when author Marianne Williamson posted an open letter to Hillary Clinton, many left-leaning Democrats nodded in agreement.  “I want a woman president,” Williamson wrote, … “and you’d know what to do from Day 1. … But none of that is enough to get the vote of a lot of people …Stop cozying up to the banks, the chemical companies, the military-industrial complex, the party machine, and all the various financiers who make up the plutocracy now ruining this country,” she continued. “If we have a sense that you’d be just another puppet of the elite, then I don’t believe you will win.”

Williamson’s message resonated. I’d chosen Barack Obama over Hillary Clinton when he won his first term, much to the consternation of my feminist friends. But in addition to being against political dynasties, right or left, there was too much about Hillary that worried me, including her relationship to corporations, Wall Street, and an inbred group of “experts” who would likely become her advisers.

I was reminded of that time of testy political discourse during a recent online conversation with a group of women I hold in high regard. One woman wrote, “We’ll never get out of the two-party system and we’ll never get out of big-money politics unless we can demonstrate that we will no longer play their game. I get frustrated hearing that I ‘have’ to vote for the Dems or else the Reps will win. It just continues to support the current paradigm. We have to re-frame the game…”

Another woman added, “Not even entertaining the idea of another party, or independent, is why we are in this mess. If we don’t change how we do things, we are doomed to the same result. Change is needed: Truth to Power!”

I appreciate the point these women are making. But as I responded, “I just shudder to think of having one of the Republican Neanderthals as president. I would like to see Hillary get elected [if she is the Democratic nominee now that Bernie Sanders is running] and then hold her accountable to the choices she makes as President. In light of current realities, that’s the time to hold her feet to the fire, in addition to asking tough questions when she is campaigning, but we just can’t lose this one!”

After more comments ensued, I added, “I really get scared when progressives (like me) divide the vote because of what I will call ‘political posturing’ at crucial times, thus handing the result to Republicans. That’s how we got a Republican governor in Vermont, and it’s how we got a disastrous Republican president when Gore lost.

“It’s so important to be realistic about the political world,” I continued. “Yes, we need to change the system and I hope we can somehow, but the fact is that we are a two-party system (controlled by big money). In light of that reality we must be smart about how and when we work for change. A desperately important election is not the time to take risks because we always lose ‘the game!’ Please, let’s be careful. In my view neither Bernie Sanders nor Elizabeth Warren has a chance of winning and we need to keep the White House!”

To those arguments I would add that we are living in a time when dangerous demagogues are rattling sabers, revealing incipient racism and other prejudices, and exerting a newly malicious misogyny. The actions of some Republican governors and members of Congress during recent weeks and over the course of the Obama administration shine a terrifying light on what would likely become law in America should a Republican win the next election. And it’s not just about the legislative branch of government. We would be choosing federal judges and Supreme Court justices. We would be voting on the future of the planet. We would be deciding not if but when to go to war, and where. And that’s just for starters.

That’s why I am pleading with my progressive friends to be realistic and to get behind Hillary assuming she does emerge as the Democratic candidate. This is not a time for political polemics. Neither is it a time to be divided among ourselves or to engage in brinksmanship. Rather it is a time to be forward thinking, street–smart, united and decisive. That may be an argument for the lesser of two evils but we don’t have a lot of choice right now. The time to take on Hillary and her party will come, and it should. I just hope we don’t end up shooting ourselves in the foot yet again before then.

Like Marianne Williamson, “I’d love to clamor for [Hillary], to work for [her], to cheer [her] on,” and to see her “name the real problems so we can trust [she’d] provide some real solutions.” But I too have reservations.  

I just have a lot more of them when I envision any of the Republicans on the horizon moving into 1600 Pennsylvania Avenue. The very thought of it chills me to the bone.

Discuss

Everyone knows that being in prison is no picnic. But few people realize that for many inmates, it can be a matter of life or death, no matter the reasons for incarceration.

I have corresponded for twenty years with a woman in the country’s largest prison for women, the Central California Women’s Facility (CCWF), which houses nearly 7,000 inmates. I know she is honest, intelligent and a model prisoner.  She is also an “in-house” advocate who knows her stuff when it comes to holding the prison accountable for misdeeds and maltreatment.

When she wrote me that there could be a measles outbreak in the prison, which is near the heart of the California outbreak, I took her seriously. She had been told by medical staff that despite the risks inherent in proximity, overcrowding and contact with people from “outside,” inmates could not be tested for immunity or be vaccinated. I began trying to find out what was going on.

After a run-around with California’s bureaucracy, I reached a public information officer at the California Department of Corrections and Rehabilitation (CDCR) who informed me that “anyone who requests a measles check or vaccine will receive one.” This was verified by a memo from the Chief Medical Executive. However, inmates continued to be denied immunity testing or vaccination. My friend filed a formal complaint. My contact at CDCR said that according to staff, “no complaints had been filed” despite a document I have which affirms that my friend’s complaint was received. Two letters I’ve written to the warden remain unanswered. I have turned the matter over to the ABC affiliate in Fresno in hopes they will do some investigative reporting.

So far there has been no measles outbreak in the prison.  But the matter prompted me to look further into health care in America’s prisons. What I found wasn’t pretty. In 2011, for example, CCWF was singled out in a report cited in the Huffington Post.  Over the course of 12 years, according to a former inmate, hundreds of untreated women had died in CCWF. One woman with liver disease was told at the prison clinic to return to work despite profuse bleeding. “Within a week the woman was dead.” Another morbidly obese diabetic woman, denied adequate treatment, lapsed into a coma and nearly died.

In 2011 the Supreme Court ruled that overcrowding in California’s prison system constituted cruel and unusual treatment and violated the 8th Amendment.  Oddly, the Court’s ruling largely ignored what was going on in California’s three female facilities where about 12,000 women lived in crowded, unsanitary conditions. In addition to sexual abuse by guards and increasing levels of violence among women because of overcrowding, these women navigated a world of insufficient and often dangerous medical care, neglect and mistreatment.

Women’s health needs are often gender-specific causing them to require medical attention more than men. Beyond care for acute and chronic illnesses, they have specific reproductive health needs. And in prison, because of overcrowding and sparse allotments of menstrual supplies, they are exposed to blood that can put them at risk for HIV and Hepatitis-C.  According to the United Nations Special Rapporteur on Violence Against Women, “female-specific care has been absent in the California system for decades…illustrating the ‘invisible’ state of women inmates.”

Between 2006 and 2010 more than 100 women were unknowingly sterilized after giving birth, a practice that violates federal and California state law.  California Prison Health Care Services, which has been under federal receivership since 2006, acknowledges this claim.  In addition, women have been shackled during labor and deliver, even when an epidural renders them incapable of moving. Perhaps most insidiously, medical rape is a common occurrence.

“At the core of these health concerns is an inadequate system which is insufficiently responsive to gender-specific needs, including the reproductive health needs of women,” the UN report concluded.

Here’s how some women at CCWF put it in a newsletter published by the California Coalition for Women Prisoners:  

“I had to ‘prove’ that I was incontinent. They made me urinate in bed. They would not give me enough catheters.”

“There are rules about being seen for only one issue at a time. It means a lot of issues are never dealt with. It takes 4-6 months to be seen if you need medications for more than one problem.”

“I have been given a diagnosis of six months to live. It’s horrible fighting cancer and not being able to do full treatment.”

 Madelon Finkel, Ph.D., professor of clinical public health at Cornell Medical Center, points out that the 1929 Geneva Convention and more recently Amnesty International, the International Red Cross, and the Council of Europe have directed that “prisoners should have the same access to health care as the non-incarcerated population and that health care provided to prisoners should be equivalent to that provided to the non-incarcerated population.”

Given broken systems like California’s, that mandate seems a prison pipe dream. Until it is real vs. rhetorical, women will die unnecessarily, have their reproductive rights ignored, and possibly suffer a massive measles outbreak that never had to happen.

Discuss

She was a 14-year old girl in foster care when she was kidnapped and held hostage for nearly a year. Sold to at least ten men a night after being “broken in,” she says she forgot what it felt like to be human. At age 15 she was arrested for prostitution.  This is a true story, and every year the same thing happens to approximately a thousand girls just like her in the U.S.

That’s why Republicans who tried to sneak anti-abortion language into the proposed Justice for Victims of Trafficking Act of 2015 are despicable. Originally the bill had received bipartisan support because it was aimed at strengthening law enforcement’s ability to pursue anyone who bought sex from trafficked women and girls with criminal fines used to establish a fund to help victims.

But then the usual cast of characters on the right snuck in anti-abortion language that essentially reprised Hyde Act restrictions on the use of federal funds for abortions to the victim restitution fund.  Think about that: Were these powerbrokers so heartless that they were actually going to make sex-trafficked victims, some still children themselves, bear babies conceived in rape and violence as if they had not already endured enough punishment for one lifetime? The very idea boggles the mind.

At the eleventh hour, the bill was stalled by Senate Democrats upset by the stealth language inserted into the bill at the last minute.  It remains to be seen whether lawmakers from both sides of the aisle will join forces to reach a compromise on the abortion language before the bill dies altogether. Meanwhile, the confirmation of Loretta Lynch for Attorney General is being held hostage by the Senate Majority Leader, who claims the Senate can’t proceed with that nomination until this bill is resolved.

Here are just some of the gruesome facts about human trafficking, which the United Nations defines as the “recruitment, transportation, transfer, harboring or receipt of persons, by means of threat or use of force or other forms of coercion, abduction, fraud, deception, abuse of power or a position of vulnerability or the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation:”

Human trafficking exists all over the U.S. (and the world) with California being a hot spot for domestic and international trafficking.  The average entry age of American minors into the sex trade is 12 – 14 years old.  Approximately 300,000 American children are at risk for commercial sexual exploitation and sex trafficking annually, according to the FBI.

There are more human slaves in the world today than ever before in history.  An estimated 27 million adults and 13 million children are victims of human trafficking, which involves not only sex and labor but organ harvesting. Each year about 30,000 sex trafficking victims die from abuse, disease, torture and neglect. Eighty percent of those sold into sexual slavery are under 24 and some are as young as six years old.

Sex traffickers use many ways to “condition” victims including starvation, rape, torture, isolated confinement, threats of violence to family members, forced drug use and shame. Traffickers are part of a global market estimated to generate profits of up to $31 billion a year.

International and federal law requires that children in the commercial sex trade be treated as victims of trafficking and not prostitutes. However, most U.S. states and localities fail to apply the law and every year more than 1,000 children are arrested here for prostitution, most of them not even of legal age to consent to sex.

It is significant to note that it was both Democratic and Republican women in the Senate who led the move to take on what Barbara Mikulski (D-Md.) called “the despicable, vile issue of human trafficking.” All twenty women in the Senate signed a letter to the Republican chairman and ranking member of the Senate Judiciary Committee urging a hearing on sex trafficking in the U.S. After a hearing was held the Senate committee unanimously passed several bills related to sex trafficking that had already passed in the House.

According to the U.S. Department of Health and Human Services, human trafficking is the fastest growing and second largest criminal industry in the world (after drug trafficking and illegal arms).  A 2009 report issues by Shared Hope International revealed that using conservative estimates, a sex trafficking victim is likely to be raped by 6,000 buyers during the course of her victimization.

“The fact is human trafficking is happening right here, right now, in the U.S., probably in any city where anybody lives,” says the mother of one survivor. “Just because you don’t know anything about it doesn’t mean it’s not happening.”

The truth about human trafficking for sex is enough to make anyone sick – except, it seems, a few insensitive, self-righteous folks on Capital Hill.

Shame on them.

Discuss

“Every great social movement begins with a set of ideas validated, internalized, and then shared and amplified through media, grassroots organizations, and thousands, even millions, of conversations,” David Korten wrote in Yes! Magazine in 2011.  “A truth strikes a resonant chord, we hear it acknowledged by others, and we begin to discuss it with friends and associates. The new story spreads out in multiple ever-widening circles that begin to connect and intermingle.”

That was the spirit, post-Ferguson and the killing of Michael Brown, it seemed to me, that resonated with so many of us when the call came from many quarters for a new civil rights movement. We had seen again the incipient racism in America that remained unresolved by activism or legislation in the 1960s, racism that was fueled rather than dissipated by the election of our nation’s first Black president.  We saw another March on Washington and it reminded us of the days when Rosa Parks (and a pregnant teenager named Claudette Colvin) refused to sit in the back of the bus and Martin Luther King, Jr. had a dream.  We began to think that a new civil rights movement was being born, and that it would carry us forward to a new and better time. Maybe it still will.

Another civil rights movement started in the 1960s, aided by a book called The Feminine Mystique and other feminist truth-telling tales. That movement too needs to be resurrected as a new Congress tries to deny the elementary reality that women are people too.  In its first three days, three measures were proposed in the House of Representatives striving to deny women their reproductive (and constitutional) rights. Such repressive legislation is offered by uninformed, uncaring, and dare I say stupid people akin to the anti-woman gadabout Phyllis Schafly, who remains stuck in the 1950s notion that happiness for women resides in marrying the right man who will give her children, a frost-free refrigerator, and dinner out on a Saturday night.

Marches representing women’s fight for justice and equality also took place in the time of 20th century civil rights activism and they were just as powerful as those led by Rev. King and other Black leaders. The marches for women led by Bella Abzug, Gloria Steinem and others were attended by huge numbers of diverse people who thought it was time to end discrimination, second-class status, and state-sanctioned abrogation of human rights.  As the growing chorus for women grew to be global during the UN Decade for Women (1975 – 1985) women began to see themselves and the world through the lens of gender and were changed forever. They are still forcing legislation to catch up.

Many social critics, activists, and others - me among them - believe these movements for civil rights and women’s rights were the two greatest social movements of the 20th century.

But there was another movement during that time that we must remember and resurrect as well. I mean the environmental movement launched by Rachel Carson and her 1962 book Silent Spring.  The book prodded us to examine our relationship to nature and asked that we value the earth we inhabit because its resources are not infinite.  Carson singlehandedly awakened the world to the fact that it was imperative to take responsibility for protecting and conserving nature if we were to enjoy a safe, healthy collective future.

Each of these movements served to transform the way we live. So did the intercultural exchange that became inevitable with the jet age and now the Internet. As David Korten put it, “Together the great social movements of the 20th century and the expansion of international communication has unleashed global scale liberation of the human mind that transcends the barriers of race, class and religion and has enabled hundreds of millions of people to see themselves and the larger world in a new light.”

We need, rather urgently it seems to me, newly-resurrected movements that will take us further in the direction of healthy social change and lead us away from our growing collective despair.  Efforts like Occupy Wall Street, Black Lives Matter, Planned Parenthood’s Action Fund, organizations like Environmental Action and others represent good and necessary grassroots action.  But something even bigger has to happen, something on the scale of the civil rights and women’s movements that draws huge numbers of people together in solidarity and makes them visible and powerful enough to exert real influence on those who make policy and control purse strings.

What I’m talking about goes beyond post Gilded Age populism.  And it is not anarchy; it’s not even a call for – God forbid – socialism.  I’m simply wondering if we have what it takes to meet the urgent need for unified action that can move us toward the right to dignity, the right to safety in our own communities, the right to privacy in our personal decisions, the right to economic security, the right to a Congress, let alone a justice system, that is colorblind, fair and above all, just.

Just the thought of it goes a long way to altering a collective unconscious in despair.

Discuss

Mon Mar 09, 2015 at 06:11 PM PDT

The Myth of a Model Country

by eclift

Presidents and politicians in this country love to tout America as the best and the brightest nation on earth.  It’s in their DNA, their job descriptions and their speech writers Cliff Notes. They can’t say we’re the biggest nation on earth – that distinction goes to Russia. Nor can they say we’re the richest country on the globe. That would be Qatar, based on comparing countries’ 2014 GDP per capita.

They can claim, as President Obama did in his first inaugural address, that we are “indispensable” to the world and they would probably prove right by many measures.  
But by many other measures no responsible national leader can possibly position America as a model country and here’s why.

So long as the kind of racism we just saw at a frat house in Oklahoma - hot on the heels of the 50th anniversary of the historic march across Pettus Bridge - is still with us, we are not a model country.

So long as we continue to kill each other every day for lack of sensible gun laws no one can make sanctimonious statements about America being a model country.

 So long as our infant and maternal mortality rates remain embarrassingly high for a developed nation we are not a model country.  According to a 2013 Save the Children report, the US has the highest first-day death rate in the industrialized world. “An estimated 11,300 newborns die annually here on the day they are born – that’s 50 percent more first-day deaths than all other industrialized countries combined. And alarmingly, deaths related to pregnancy and childbearing have increased in the US over the past decade, putting maternal mortality at nearly its highest rate in a quarter century according to a recent report published in The Lancet. The US is one of just eight countries where maternal deaths increased between 2003 and 2013; the other nations in this dubious category include Afghanistan, El Salvador, Belize, and South Sudan.

So long as income inequality prevails we are not a model country. According to Laura Tyson, former chair of the U.S. President's Council of Economic Advisers, “during the last several decades, income inequality in the US has increased significantly -- and the trend shows no sign of reversing. … Such a high level of inequality is not only incompatible with widely held norms of social justice and equality of opportunity; it poses a serious threat to America's economy and democracy.” According to the Council of Economic Advisers, says Tyson, “if the share of income going to the bottom 90 percent was the same in 2013 as it was in 1973, median annual household income would be about $9,000, higher than it is now.” By comparison, “during the last three decades, middle-income households in most developed countries enjoyed larger increases in disposable income than comparable U.S. households. In 2014, the U.S. lost the distinction of having the ‘most affluent’ middle class to Canada, with several European countries not far behind.”

So long as we are not willing to invest in our crumbling infrastructure, we are not a model country.  Blogger Michael Snyder recently shared two dozen well-documented facts about our infrastructure crises. Among them were these startling facts: The American Society of Civil Engineers has given America’s crumbling infrastructure a grade of D, in part because close to a third of all highway fatalities are due “to substandard road conditions, obsolete road designs, or roadside hazards.” One out of every four bridges in America either carries more traffic than originally intended or is in need of repair. There are over 4,000 dams in the US at risk of failure, a number that has risen by more than 100 percent since 1999. Our aging sewer systems spill more than a trillion gallons of untreated sewage every single year; it costs more than 50 billion dollars annually to clean up that sewage. Further, estimates are that rolling blackouts and inefficiencies in the U.S. electrical grid cost the U.S. economy approximately 80 billion dollars a year. The World Economic Forum now ranks U.S. infrastructure 23rd in the world while we fall farther behind the rest of the developed world every day.

So long as the fact remains that it will take nearly 500 years for women to reach fair representation in US government at the current rate of progress, so long as political corruption prevails in America, so long as the US is ranked 32nd in press freedom by Reporters Without Borders, so long as we still have climate change deniers, and so long as we lead the world in rates of incarceration, we are not a model country.
And that’s not even a complete list of indicators by which one can judge mythical exceptionalism.

Despite the problems of its Nepalese refugees, perhaps we need to take a chapter from Bhutan’s playbook.  The little country with gorgeous green mountains promotes Gross National Happiness which resides in four main pillars: “equitable and equal socio-economic development, preservation and promotion of cultural and spiritual heritage, conservation of the environment, and good governance – all of which are interwoven, complementary, and consistent.”

Till then, the words of one beloved American president ring true. As FDR once said, “This is preeminently the time to speak the truth, the whole truth, frankly and boldly. Nor need we shrink from honestly facing conditions in our country today.”

Discuss

Fri Feb 27, 2015 at 11:42 AM PST

Vaccines, Crusades and Vicarious Thrills

by eclift

Ever since measles, a criticized speech by President Obama, and a network news scandal hit the media I’ve been trying to identify common denominators to the disparate stories, involving vaccine bundling, possible rhetorical bungling, and Brian Williams.

Each story is complex in ways that are ignored in the sound bytes that substitute for “breaking news.”   In the case of the measles outbreak and the debate about immunization, interesting legal and parental rights issues arise. But it’s also important to understand the facts about measles and vaccines used to prevent “the most deadly of all childhood rash or fever illnesses” as the CDC puts it.  

Measles spreads rapidly and is a disease that can kill.  Before widespread vaccination an estimated three to four million people got measles every year in the U.S. Nearly 500 of them died, 48,000 were hospitalized, and 4,000 developed encephalitis.  I understand the fear of links to autism (which may be reduced by unbundling vaccines) but international research has never established empirically a causal effect. People who don’t remember the sound of a child with whooping cough gasping for breath or the summer terror of polio have room to question immunization.  But for those of us who do remember, and for millions of children alive today in the developing world because of vaccinations, the jury seems to be in.

As for President Obama’s speech at the National Prayer Breakfast in February in which he invoked the Crusades and the Inquisition to point out that Islam should not be judged unique among religions that have fostered terrible acts, I am among those who saw nothing inflammatory in his honest assessment.  Let the right wing naysayers remember that, to cite a few examples of Christianity run amok, abortion clinics and the people who serve them have been bombed and murdered by zealous Christians, the KKK is predominantly Christian, and Hitler, a self-proclaimed Christian, said that eliminating Jews was “doing Christianity a great favor.”  

I believe the president “wanted to be provocative in his remarks” as his staff said, “because he wanted to make people think about the need to stand up against those who try to use faith to justify violence, no matter what religion they practice.” Could he have done it better or in a different forum? Perhaps. Still, to me, his motivation was right on.

The suspension of Brian Williams because he lied about being in a helicopter in Iraq, and possibly more, shook the news-cum-entertainment world.  A longtime NBC face, Williams had a distinguished, award-winning career.  Some people think he was too severely punished for possible failures of memory. Others, including me, see him as having betrayed all that is sacred and ethical in journalism.  

But the purpose of this piece is not to debate the merits of vaccines, presidential speeches or news people who mess up.  Rather, it is to reflect upon what these three news stories had in common. There seem to be several themes:  Credibility and Trust, Honesty, and Judgment.

Any government agency, especially one invested in keeping us healthy like the CDC, any president or other national leader, and any member of the Fourth Estate needs to be credible and trustworthy.  The skepticism Americans feel about government, politics and media is alarmingly high and growing, and for good reason. The fact is, a growing number of us no longer trust agencies, politicians, or news people to do their jobs, free of corruption and guided by moral decision-making because we’ve been betrayed too many times. It’s not just an American problem and it’s not new, but it’s something we need to recognize as serious in its implications.

Honesty is at the heart of behaving morally. That’s why I do not fault the president on his choice of venue or his remarks about religiously motivated violence. We need to recognize, as Mr. Obama has done, that terrible things have been done throughout history in the name of religion, because without that kind of truth there is no end to violence, and no reconciliation. And the critical issue of honesty is why I believe Mr. Williams cannot be exonerated.  You cannot lie to people and remain a trustworthy conveyer of what is happening in the world. We need to know that what you tell us is true and real, not from the perspective of a media star, but of a common man doing the common good.

In the end it all comes down to judgment.  Whether CDC scientists or the President of the United States, or a media golden boy, that’s what we rely on.  We need to trust that people in high places and public arenas to whom we look for sound information, carefully considered guidance, unadulterated facts and occasional reminders about our better selves will exercise good judgment. We need to know they will not cheat or manipulate us and that they will take risks, rhetorical or otherwise, to help make us alert and aware. That is the challenge of the laboratory, the oval office, and the newsroom. It is the challenge for all of us.

Discuss

I had just filed a book review about a woman who risked her life in 2013 trying to help people in the Congo suffering under the rule of Joseph Kono and the Lord’s Resistance Army (LRA) when I happened to see a journalist on CNN talking about Kayla Mueller, the young woman killed by IS in Syria.  The juxtaposition of what I’d written and what the journalist said about having met Kayla just before she entered Syria was striking, and could offer important lessons for other young idealists who want to head off to foreign lands to help people in war-torn zones.

The book I reviewed is called Mama Koko and the Hundred Gunmen by Lisa J. Shannon,
a young woman with courage, conviction and a craving for adventure. Shannon went to the Congo with a Congolese friend to tell the stories of what was happening there under Kono in the hope that their narratives would motivate governments and individuals to intervene and provide aid.

By weaving narratives of what life was like pre-LRA and what it had become, Shannon skillfully revealed a tapestry of events at once moving and frightful.  Central to the tale is Mama Koko, a matriarch who stays strong as her family loses everything and is driven into the bush with slim hopes of survival. One by one her relatives become victims of unimaginable cruelty.  Back in town Shannon lives with Mama Koko and other survivors. She hears their stories and films people she interviews, putting herself and her friend Francisca in harm’s way to capture what they are willing to share with her.

The question becomes, why?  When a UN security officer asks, “Who are you with? What is your function?” she struggles to answer that question for herself. “It was weird enough in the US answering questions about how I supported myself as a volunteer, the independent nature of my work. … The strangeness [in Congo] was exacerbated by the fact that I wasn’t sure I knew, even secretly, what my ‘function’ was.” It was a question that troubled Francisca the longer they remained in danger.

Why put yourself and others in terrible danger when you have no sponsor, no media assignment, and no organizational support, I wondered.  What was the expected outcome and how, specifically, might what Shannon did help the victims of a long and vicious war? I questioned whether the author’s ego may have played a part in her altruism, a thought that was supported by what Shannon recalled about leaving the Congo. “The question [was] what now? I had decided how I wanted all of this to end. … Francisca would emerge a leader for her country. I had … suggestions for [her] future leadership role, the one I had built up in my head...”  

But years later, “Kony was still out there.” There were more deaths and greater shortages. And “for the people of [Mamma Koko’s town] there are all the things that are gone, that will never come back.”  

In no way am I suggesting that Kayla Mueller, that beautiful, budding young woman who loved life and wanted to do good things, had an over-sized ego.  Nor do I know if Lisa Shannon does. But like Shannon, Kayla was young and idealistic. It appears that she, like Shannon, acted independently in entering a war-torn country, without any of the rigorous and urgent training required by such groups as Doctors Without Borders, United Nations affiliates, or NGOs.  It also appears that she had no plan for how to translate her efforts into helpful action when she did leave Syria. She didn’t even have an exit plan.

The journalist who met Kayla on the Turkish border with Syria before she embarked on her self-appointed mission described Kayla as “young and naïve.” The seasoned professional who had worked in many terrifying conflict countries worried about what would happen to Kayla, especially in the absence of training and affiliation. She reaffirmed all that was good and true in Kayla and her motives. Then she warned other young idealists not to do foolish things.

During the years when I worked in international development I met a lot of Shannons and Kaylas.  They often came to me to ask for advice about how to implement their plans to “help people.” They were special young adults with a lot of stars in their eyes. I always found them inspiring. But very few of them knew the reality of aid work, affiliated or not. And that was in the days before terrorist groups like IS were even imagined.

So I honor Kayla Mueller, and I grieve her premature death.  Like other bright twenty-somethings, she gave us all hope for a better future when our kinder natures might prevail to prove that love conquers all. You only had to look at pictures of her bright, smiling face to know what she might have given the world had she made it out of Syria.

And therein lies the tragedy of Kayla’s untimely death, and the lessons it might hold for other young, vital idealists. Because the question is not only why? That’s not so difficult to answer. The hard questions are what is my plan and is it realistic, am I properly prepared, how dangerous is it and what are the costs and benefits, how will I make a difference, and maybe most important of all, who will have my back when I need to get out of there?

Discuss

On a recent visit to Sweden, I was struck by something having nothing to do with hair color, bike paths or the high cost of living.  It had to do with who takes care of the kids. I saw so many dads pushing strollers, holding toddlers on their shoulders, or talking to kids on their way to school that it stopped me short. The delight of observing male parenting led me to thoughts of other forms of child care, something that many countries can be proud of. Sadly, America is not among them.

Here is the sad reality of child care in this country.  A substantial number of daycare centers are poorly run and often unsafe, despite the fact that childcare now costs more than college tuition in most states while almost 20 percent of working moms with young children work in low-wage jobs.  

According to a 2013 story in the Washington Post, while experts recommend a ratio of one caregiver to every three infants, only a third of children are in settings meeting that standard.  Childcare providers are often poorly paid and trained. Some of them need only minimal or no training in health, safety or child development to get their jobs.  States often lack enough regulators to visit child centers as often as mandated so that even serious violations often go unrecorded or corrected.

At the same time, child care costs are expensive and rising. Child Care Aware of America (CCAA), the country’s leading voice for child care, reported in 2013 that families are paying a significant part of their earnings for the care of their children.  During 2012, for example, the cost of child care increased up to eight times the rate of increases in family income.  

Some family members work two or three jobs just to cover child care costs, and children are often placed in multiple child care arrangements, especially if parents work during non-traditional work hours.  Financial insecurity can lead some parents to remove their children from organized child care and simple “make do.”  The CCAA report concludes that “after six years of studying child care regulations and oversight, we still cannot say with confidence that America’s children are protected by state licensing and oversight systems. Nor can we say that child care policies are in place to help young children learn and be ready for school.”

That last point is important.  A National Institute of Child Health and Human Development (NICHD) found that high quality child care leads to more positive outcomes even during the teenage years. Even ten years after leaving child care young people experienced high academic achievement and other positive outcomes.

It’s not only child care experts who agree that investment in high quality early care pays off. Economists say that good preschools save future dollars for everyone.  Economic studies show that kids who have experienced high quality early learning environments are more likely to succeed at all levels of education and to gain stable employment, which correlates to lower crime rates.

President Obama raised the issue of childcare in his State of the Union speech last month, underscoring what experts have been saying: a national discussion on the importance of safe, affordable child care is urgently needed, along with an analysis of the true social cost of not providing quality child care.

Meanwhile, other countries already realize the importance and positive impact of carrying for their young. They treat day care as an absolute priority – as we did during WWII when women were needed in the factories and factory crèches were established. However, once Johnny came marching home again, American day care was returned to the realm of mothers who lost gainful employment, economic autonomy and all too often, their sanity in 1950s suburbs.  

It isn’t only Scandinavian countries that can be looked to for models.  France, for example, has a government run system considered by experts to be exemplary. Parents who stay at home to care for their children or hire their own caregivers receive generous tax breaks, which allows 80 percent of French women to work without worrying about their children.  While France spends more on care per child than we do, most French families pay far less out of pocket since the government subsidizes child care with tax dollars and sets fees according to a sliding scale based on income.  The French government allocates roughly one percent of its gross domestic product to child care; that’s more than twice as much as the U.S. does.  And as we all know, “you get what you pay for.”

Surely we should be willing to pay more to ensure the safety and healthy development of our nation’s children, right?  Somehow, given the new Congress, I doubt that the discussion will even take place.  In my book that constitutes a travesty, and a disaster waiting to happen.

Discuss

Wed Jan 28, 2015 at 08:17 AM PST

Time to End a Two-tiered Justice System

by eclift

In the wake of former Virginia Governor Bob McConnell’s measly two year sentence for corruption, and the fact that grand juries failed to indict police officers in the killings of Michael Brown and Eric Garner, is it any wonder that Deborah Foster wrote these words in 2013 in Politicus USA: “One would have to be exceptionally naïve to believe that the American criminal justice system doles out punishments fairly.”

“Justice is supposed to be blind,” Foster continued, “but the reality is that economic status, skin color, where you live, and who you hire as an attorney more likely determine your fate than the facts of your case.”

Carl Gibson wrote about “our fraudulent two-tiered justice system” in a 2014 Huffington Post piece. “The most glaring evidence of our fraudulent judicial branch is shown in the treatment of Credit Suisse’s admission that it helped up to 22,000 wealthy Americans hide approximately $12 billion in assets from the IRS. … . Credit Suisse…was allowed to slide back into good graces by paying a $2.6 billion fine…a lesser rate than lawful Americans pay in taxes.”

Think about that when you consider what happened to Cecily McMillan, whom Gibson cites by way of comparison. McMillan, a graduate student who attended an Occupy Wall Street protest in New York, testified that as she attempted to leave the protest a man who never identified himself as a plainclothes police officer grabbed her breast from behind. Reflexively, she struck him with her elbow for which she was beaten in the street, refused medical attention, and arrested on the charge of assaulting a police officer. At her trial the judge would not allow discussion of her attacker’s violent past, nor would he allow talk of the NYPD’s violent crackdown on nonviolent protests in the Occupy encampment. McMillan was sent to the notorious Rikers Island jail for three months (plus five years probation). She could have gotten seven years. Her attacker, whom many said was guilty of sexual assault, was never tried.

A December 2014 editorial in The New York Times revealed just how bad things are for people like McMillan - vs. Gov. McConnell or Wall Street bankers - who are sent to Rikers Island.  In “the quest to end the barbarism that has long dominated New York’s Rikers Island jail,” the Times editorial announced, the Justice Department plans “to join a pending class-action lawsuit that charges the Department of Correction with failing to discipline officers engaged in abuse.”

The jail’s “deep-seated culture of violence” was revealed in a “lacerating” report put out in December by the U.S. Attorney in Manhattan.  It cited in particular “bloodcurdling examples of sadistic violence” perpetrated against adolescent inmates and revealed that “inmates were sometimes …taken to isolated areas…where they were beaten by groups of officers” who were subsequently “promoted right up the line.”

Antonio Bascaro, who has been in prison for over 34 years (with no prior criminal record) for a non-violent first-time marijuana-only offence, is in Florida, not in Rikers Island, so maybe he doesn’t have to fear this kind of prison violence. That’s good because Mr. Bascaro, the longest serving marijuana prisoner in the history of the U.S., is eighty years old now and wheelchair-bound.

But Wall Street banker Jeffrey Epstein, the so-called “Gatsby of his time,” who was first arrested in 2005 for sexual trafficking to “prominent American politicians, powerful business executives, foreign presidents, a well-known prime minister, and other world leaders,” as The Guardian put it in January, is unlikely to see jail any time soon. His bevy of well-paid lawyers (one wonders if some of them were his clients) are sure to keep appealing any convictions he receives for years to come. Even if he does go to prison, it’s going to be one of those where white-collar criminals enjoy certain amenities that the Antonio Bascaros of the prison-world can’t even dream of.

When Attorney General Eric Holder expressed concern about Wall Street banks being too big to prosecute for fear of having “a negative impact on the national economy,” Federal Judge Jed Rakoff shot back, “To a federal judge, who takes an oath to apply the law equally to rich and poor, this excuse…is frankly disturbing for what it says about the department’s apparent disregard for equality under the law.  If you’re going to put people in jail for having a joint in their pocket…you cannot let people [at HSBC] who laundered $850 million for the worst drug offenders in the world walk.”

But perhaps it is Matt Taibbi, author of The Divide: American Injustice in the Age of the Wealth Gap, who says it best.  “It is grotesque to consider the non-enforcement of white collar criminals when you consider how incredibly aggressive law enforcement is with regard to everyone else.”

No doubt Cecily McMillan, the kids trapped on Rikers Island, Antonio Bascaro and so many more like them, agree and find a modicum of solace in knowing that a few of us get just how bad our two-tiered system of justice is, and are taking the trouble to call for reform.

Discuss

I can’t get them out of my mind.  Can’t stop wondering what has become of them? Can’t stop trying to imagine how they face day after day after day in captivity?   I’m talking about the 200 girls kidnapped by Boko Haram in Nigeria and the countless women and girls in Syria and Iraq subjected by ISIS to circumstances unbearable to contemplate, let alone endure.

The hope in October that the Nigerian girls might be freed was dashed when a Boko Haram leader declared triumphantly that the girls had been converted to Islam and married off soon after an announced ceasefire collapsed.  “The issue of the girls is long forgotten because I have long ago married them off,” he laughed in a video message.

According to Human Rights Watch as reported in USA TODAY recently, about 500 young women have been abducted in the past five years. In December over 100 more were taken from their village. Some kidnapped girls have managed to escape, but the majority of them remain in captivity. Victims and witnesses to the abductions report physical and sexual abuse, rape, forced labor and beatings.  We are talking about teenagers.

To make matters worse, the Nigerian government, headed by a president with a big black hat who goes by the name Goodluck Johnathan, has done little if anything to find out where the girls are.  According to Human Rights Watch, escaped girls have never been interviewed by government officials nor has any kind of rigorous government investigation taken place.  Meanwhile the president in the silly black hat hopes to be re-elected.

In Iraq and Syria the situation for women and girls is even more desperate.  Thousands of Yazidi women have been abducted and subjected to unspeakable physical and sexual violence.  According to Nazand Begikhani, a Senior Research Fellow at the University of Bristol’s Center for Gender and Violence Research in England, the horrific treatment of women by ISIS must be treated as genocide.

Here is just one 19-year old woman’s account as reported by CNN.  “They put us in trucks and drove us away. … They separated me along with other young ones and ordered us to stay while taking away the elderly women.  The man I was given to raped me several times and left me in the room on my on. I was shaking from pain and fear…Suddenly another man came and did what he wanted to do despite me crying and begging him, kissing his foot to leave me alone…”

Women like this are systematically separated by age and appearance, forced to convert to Islam, and subjected to various forms of physical and sexual violence, including sexual slavery.  They are sold like cattle, complete with price tags, in markets in Iraq and Syria. Their price ranges between $25 and $1,000. If they resist they are killed. Some become pregnant pariahs, open to honor killings. Many are subjected to genital mutilation. Some commit suicide.

Haleh Esfandiari, director of the Middle East program at the Woodrow Wilson International Center for Scholars, (whom I had the privilege of interviewing after her 2007 release for solitary confinement in Tehran’s notorious Evin Prison) has asked why ISIS’s cruelty toward women gets such scant attention in the world’s media while beheadings and executions of captured men are front and center in the news.  “Why,” she asks, “are there no demonstrations in Western and Muslim societies against this barbaric onslaught on women and girls?”

Once again when it comes to resisting, exposing and ending violations of women and their human rights, women are taking the lead.  In both Iraq and Syria they have taken up arms, organized civil protests, and tried to warn the world about ISIS. According to Frida Ghitis, a columnist writing for CNN, a woman is leading Kurdish forces in Kobani and more than a third of Kurdish troops in Syria are women.  They do it, she says, “because women have more to lose than anyone else.”

They do it because of reports like this from a Kurdish woman who got hold of a cell phone.  “Please bomb us,” she begged. “There is no life after this. I’m going to kill myself anyway. …I’ve been raped 30 times and it’s not even lunchtime. I can’t go to the toilet. Please bomb us.”

Brutality such as the beheading of westerners needs to be reported, of course.  But where is this woman’s story being told?  Why do she, and multitudes more women like her, remain invisible in the story, and the stopping of unimaginable terrorism on a medieval scale?  As Haleh Esfandiari asks, “how much longer will the world watch these horrors against women and children before speaking out and acting forcefully to protect them and rid the [world] of such calamity?”

Discuss

Wed Dec 10, 2014 at 10:08 AM PST

Revisiting "The Banality of Evil"

by eclift

In the midst of troubling times that include police brutality, sexual abuse, and other acts of violence I happened to be reading about the German-born Jewish philosopher Hannah Arendt, best remembered for her phrase “the banality of evil.”  

Arendt was writing about Adolph Eichmann after having covered his trial in Jerusalem in 1961 when she wrote those words. “Eichmann in Jerusalem,” which first appeared as a five-part series in The New Yorker, was considered a “masterpiece” by many and is still widely studied and debated. It also continues to spawn vivid controversy about the meaning of her words and thoughts, which some consider to be wrong theoretically while others call them outrageously anti-Semitic.

What people thought – not about her but about how to live their lives – is a loaded word in the context of Arendt’s work.  Thinking – being a sentient human being - was central to Arendt’s thesis that Eichmann was not only “monstrous” but “terrifyingly normal.” In an attempt to explain intellectually the horrific times in which she lived she posited that Eichmann acted devoid of critical thought as much as ideology or other sinister factors in his character.  He was, she suggested, not very different from multitudes of others whose behavior may not be as hideous but who are all too willing to act without compunction, whether to succeed or to survive.

Arendt wrote later that she was “struck by a manifest shallowness in [Eichmann] which made it impossible to trace the incontestable evil of his deeds to any deeper level of roots or motives.  The deeds were monstrous, but [Eichmann] … was quite ordinary, commonplace…”  Eichmann was, she had said, “a leaf in the whirlwind of time.”

While Arendt may have been wrong about Eichmann in terms of his capacity for evil, her argument that ordinary people can be brutal seems to stands up.  As Yehuda Kurtzer pointed out in a November Times of Israel blog, most Germans went along with events that led to the Holocaust.  Even Jews assisted the SS to buy time in their own lives. Later, decent men bombed North Vietnam because they were unquestionably following orders from what Arendt called “desk murderers.”  

In Diving for Pearls: A Thinking Journey with Hannah Arendt, Kathleen B. Jones writes that what troubled Arendt most “was how many others were like [Eichmann] – terrifyingly normal, banal perpetrators of evil. What had happened, Hannah wondered, to make so many people thoughtless?”

After reading Eichmann in Jerusalem Jones wrote, “If I’d been born at another time, in another place, I could have been an Eichmann,” not because of any similarities in their lives or characters, but because of “the uniquely ordinary tale Hannah wove out of the facts of Eichmann’s life…I began to see I could no longer be certain I’d not only know the right thing to do but would do it.”  She continues: “I began to think the Eichmanns among us exist because the world has changed and there are no longer any simple formulae distinguishing right from wrong to turn to when we’re confronted with something unexpected. We have to decide all on our own what we should do and what we might have to risk doing it.  Thinking demands a burdensome kind of vigilant, imaginative observation of the world. Maybe that’s why many people prefer to avoid it.”

In a society in which police can shoot unarmed children and choke a man to death for selling cigarettes and not be indicted maybe we need to think about what Hannah Arendt was trying to tell the world.  When one out of five female college students is sexually assaulted on campus, when military women can’t report sexual abuse for fear of retaliation, and when famous men are alleged to have drugged and raped numerous women whose stories are doubted perhaps we need to think about how easily cruelty can enter our lives.  When politicians with an extraordinary lack of insight, compassion and intelligence can condone torture and legislate against ordinary people and when the ultra-wealthy spend untold amounts of money to buy those politicians, maybe it’s time to think about how quickly so many of us acquiesce and collude. Shouldn’t we be asking ourselves if this is a time to think again about “the banality of evil”?

In 2013, writing about “The Banality of Systemic Evil” on The New York Times Opinionator blog, Peter Ludlow made the observation that Hannah Arendt was making “a statement about what happens when people play their ‘proper’ roles within a system, following prescribed conduct with respect to that system, while remaining blind to the moral consequences of what the system was doing – or at least compartmentalizing and ignoring those consequences.”

It’s an observation that seems eerily prescient, and one that makes me suspect Hannah Arendt got a bad rap when what she was trying to do was simply make people think about some of the most urgent issues of the times in which we live.

Discuss
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