Category Archives: health

healthcare, medicine, medical research, etc.

UN admits cholera in Haiti was caused by MINUSTAH

…but refuses to actually say it out loud. Instead, it’s “The Independent Panel concludes that the Haiti cholera outbreak was caused by the confluence of circumstances as described above, and was not the fault of, or deliberate action of, a group or individual.”

*sigh*

anyway, this is in relation to one of my previous posts on Haiti, and the way the media and assorted agencies have been treating the claims that the cholera virus was introduced by the UN forces. Now, the UN has concluded its investigation, and I’m willing to bet no one is going to be writing apologies to the Haitian people for smearing them in the press previously.

some quotes from the executive summary of the Final Report of the Independent Panel of Experts on the Cholera Outbreak in Haiti (emphasis mine):

The source of the cholera has been controversial, with hypotheses that the pathogen that causes cholera (Vibrio cholerae) arrived into Haiti from the Gulf of Mexico due to tectonic shifts resulting from the earthquake, evolved into disease-causing strains from non-pathogenic strains naturally present in Haiti, or originated from a human host who inadvertently introduced the strain into the Haitian environment. A specific form of the third hypothesis, that soldiers deployed from a cholera-endemic country to the Mirebalais MINUSTAH camp were the source of the cholera, is a commonly held belief in Haiti.

After establishing that the cases began in the upper reaches of the Artibonite River, potential sources of contamination that could have initiated the outbreak were investigated. MINUSTAH contracts with an outside contractor to handle human fecal waste. The sanitation conditions at the Mirebalais MINUSTAH camp were not sufficient to prevent fecal contamination of the Meye Tributary System of the Artibonite River.

[The independent researcher's] results uniformly indicate that: 1) the outbreak strains in Haiti are genetically identical, indicating a single source for the Haiti outbreak; and, 2) the bacteria is very similar, but not identical, to the South Asian strains of cholera currently circulating in Asia, confirming that the Haitian cholera bacteria did not originate from the native environs of Haiti.

These research findings indicate that the 2010 Haiti cholera outbreak was caused by bacteria introduced into Haiti as a result of human activity; more specifically by the contamination of the Meye Tributary System of the Artibonite River with a pathogenic strain of the current South Asian type Vibrio cholerae.

Guess the Haitians were right to be pissed at MINUSTAH. This cholera outbreak made 300 000 people ill, killed 4500, and it continues to spread.

Homework-blogging, episode one

since my brainpower is completely taken up with working on these class-papers, I figure I should repurpose at least a few of them for blogging; at least the ones from my Social Inequality class, since they’re relevant to my blogging in general. So, here’s the first one.

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Planned Parenthood in the Media: Dividing Gender and Class issues

The Media have become one of the biggest influences on how we perceive and interpret the world. In terms of the Dimensions of Oppression discussed by Patricia Hill Collins (2011, pp. 763-768), it has become an important social institution, as well as a producer and distributor of the symbols that create the Symbolic Dimension of Oppression. This is true both in its fiction as in its non-fiction: in his essay “Media Magic: Making Class Invisible”, Gregory Mantsios describes the ways in which the Poor and the causes of their poverty are disappeared and distorted in the Media in their news programs. These are narratives that create strong symbols and dichotomies between “them”, the poor and “us” the wealthy.

Most of the time, the poor don’t show up in the news-media at all, even if the issue under discussion affects them or relates to them in some way., because the story is written from an “us” perspective, and the “us” are middle-class and wealthy people. And if the poor are mentioned in the media at all, they’re usually either blamed for their condition, considered undeserving of help, or considered a problem to “us”.

Currently, the importance of the news media as a symbol-making institution is best represented by the way the issues surrounding a bill that would defund Planned Parenthood are being presented in the news, and how that presentation shapes any discussion and defense of Planned Parenthood is being held in society. Planned Parenthood is a non-profit organization that provides various services to women, and it discounts them or even provides them for free for low-income women. It also provides some services to men (cancer screening and STD treatment and diagnosis, for example), which are similarly discounted for poor men. On February 11th, the US House of Representatives voted in favor of banning all federal funding for the organization. The media and politicians have been discussing this event in one of two ways, either focusing on abortion and women’s sexuality, or on fiscal responsibility that requires cutting the budget. An excellent example of that framing is evident in Judson Berger’s article from February 5th, in which he writes “Republicans are trying to juggle the abortion issue as they wage a separate, and more high-profile, battle in Congress over spending.” Another article on CNN.com mentions that proponents of the ban are saying that current restrictions on abortion funding aren’t enough because “applying the government’s money to other procedures leaves more of the group’s own cash on hand to allocate to abortion-related services”. The same article says that the cuts are “part of a continuing resolution that included dramatic spending cuts across a range of programs” (Political Ticker, 2011). In other words, the media uses the symbols of an innocent, righteous, and victimized “us” (the middle class, the men, the “morally responsible” women) who are being asked to shoulder an ethical and financial burden on behalf of a “them” (the non-taxpaying poor, sexually irresponsible women) that is demanding an unethical service to be provided from “our” taxpayer money, even though they brought the problem on themselves (see Mantsios’ “The Poor Have Only Themselves To Blame” narrative, p. 95) and who are undeserving of help because of their immoral behavior both in terms of what led to their situation and the service they demand (Mantsios’ “The Poor Are Undeserving”, p. 94). The best example of this particular line of argument could in fact be seen when Rep. Steve King (R-Iowa) debated the defunding of Planned Parenthood, as broadcast on C-SPAN and distributed on the internet via YouTube and MediaMatters: his argument for defunding Planned Parenthood was that “they” were “invested in promiscuity” and that “we” needed to “stand on principle” and not fund them. The narratives are those Mantsios describes as being used against the poor, but in this case they are strengthened, in terms of the othering they do, because they’re used for not one but two of the opressive categories identified by Collins: class and gender. The othered aren’t just undeserving and guilty poor, they are undeserving and guilty poor women, making the “them” an even smaller, even more marginalized, and even more easily ignorable group less likely to be in any way connected to “us” and “our” problems and needs.

The fact that Planned Parenthood is a health-care provider for the poor for such things as cancer screening, UTI treatments, and even diabetes testing is not mentioned in either article. Neither is the fact that the tax-burden is minimal, and that tax-payers themselves often either use their services themselves, or have within their communities people who do. The effects on the health of those people from various backgrounds who might now lose access are ignored entirely by the Media coverage of the discussion. No mentions are made of what will happen to people from a wide section of the population, including plenty of people belonging to the “us” category (middle-class students, married women with children, men who go for cancer testing) if clinics have to close, or if they won’t be able to provide their services at reduced cost or for free any longer. These realities have been excised from Media discussion in favor of the negative, dichotomous symbolism.

Understanding the narratives Mantsios describes can help see past the narratives trying to frame people who use Planned Parenthood as “the other”. But that alone is not enough, because Mantsios essay focuses only one one dimension of oppression, i.e. class, while the issues surrounding a defunding of Planned Parenthood involves both class and gender oppression.

Patricia Hill Collins’ essay “Toward a New Vision: Race, Class, and Gender as Categories of Analysis” can help broaden the perspective and make it possible to understand the issues surrounding Planned Parenthood not in terms of divisive “othering” and entrenched interests, but rather as an issue that spans the different dimensions of oppression. This may enable people to look at the services Planned Parenthood provides as being beneficial to people in all sorts of different groups, groups that maybe wouldn’t otherwise be able to see each others as allies in the provision and maintenance of health-care access. Her suggestion of how to find new ways to conceptualize race, class, and gender away from dichotomous either/or categories that classify someone as either oppressed or oppressor(2011, p. 762) can help feminists fighting for women’s reproductive rights see poor men and conservative charities for the poor not as oppressors withing the Patriarchy, and conversely can help organizations trying to help the poor see middle-class feminists not as oppressors within the class-structure. Similarly, her description of how to transcend the barriers that were erected in identity-politics by splitting people into distinct categories by race, gender, and class and form alliances on common causes(2011, pp. 770-771) provides useful advice on how to overcome social and cultural differences of opinion on issues that divide people, in order to make it possible for all of them to work together on issues that they share in common. Her example of a inner-city school in which people from all sorts of different spheres came together with the common goal of educating Black children can very well be transferred to the discussion about Planned Parenthood. The same goes for her suggestions for how to build empathy between people who are affected differently by the different oppressive structures of society. Instead of focusing on Planned Parenthood as a place where “the other” (“immoral women”, “non-taxpaying poor”) receive services, such discussions would be able to focus on the very broad range of services provided, as well as the very broad range of people using them: affordable cancer screenings for men and women, birth-control for poor families who can’t afford any more children, regular health-checkups for students and poor women and men, etc.

Being able to visualize such common-ground issues affecting a broad intersection of people could make it possible for more people to feel invested in the organization and look past the divisive Media narrative. It could enable them to cooperate with others in the fight against the ban. Building empathy between women who feel their reproductive choices attacked, and the poor who have their access to basic health-services limited, can also foster discussion about the real dimensions of whom Planned Parenthood is helping, and in what ways. And it can diminish the effect of the two-pronged attack on Planned Parenthood, on the one hand from the moralistic stance on women (targeted at conservative groups and men), and on the other from the fiscal stance against poor people (targeted at middle class and wealthy people). Only if we learn to empathize with the experiences of people in group to which we do not belong ourselves, understand that many people fall within both categories, and understand that while everyone is affected by issues of gender and class (as well as race) differently, with different aspect being visible and salient to them to different degrees (Hill Collins, 2011, p.763), no one is unaffected entirely, can we begin to look pas the single-focus divisive Media narratives and instead look on the actual range of effects of defunding Planned Parenthood. Effects that aren’t shown in the narratives provided by the Media, which prefers to ignore the poor altogether and prefers to show those who use Planned Parenthood’s services specifically and solely as women seeking abortion, usually portraying it as a moral failing.

References

Berger, J. (2011, Feb 5th). Abortion Debate Returns to Capitol Hill as Lawmakers Weigh New Restrictions. FoxNews.com. Retrieved from http://www.foxnews.com/politics/2011/02/05/abortion-debate-returns-capitol-hill-proposed-restrictions-advance/

Hill Collins, P. (2011) Towards a New Vision: Race, Class, and Gender as Categories of Analysis and Connection. In T. Ore (ed.), The Social Construction of Difference & Inequality(5th ed.) (pp. 760-774). New York, NY: McGraw-Hill

King, Steve (2011). MediaMattersAction YouTube-Channel. Retrieved from http://www.youtube.com/watch?v=Vex77n65nJ0

Mantsios, G. (2011) Media Magic: Making Class Invisible. In T. Ore (ed.), The Social Construction of Difference & Inequality(5th ed.) (pp. 93-101). New York, NY: McGraw-Hill

Political Ticker (2011, Feb. 28th). Boehner in ‘war’ against Planned Parenthood. CNN Politics. Retrieved from http://politicalticker.blogs.cnn.com/2011/02/28/boehner-in-war-against-planned-parenthood/

The UN in Haiti

The reports of the “Cholera Riots” in Haiti are ubiquitous now. A lot of them touch on the many issues that lead to this, but most of them seem to want to say that it’s street gangs, or it’s because “It’s a tradition in Haiti to have violence before the elections”, with the claim that MINUSTAH is responsible for the cholera outbreak being treated as if it was the same as the claims by African witchdoctors that polio vaccines were meant to sterilize the population. The articles seem to all focus on the (rather undisputable) fact that the riots and barricades are blocking or hindering supplies of medicine, fresh water, and water filters.

This line of reporting misses the entire context of the situation. Would you trust an organization that was brought into your country with the official mission to “restore a secure and stable environment, to promote the political process, to strengthen Haiti’s Government institutions and rule-of-law-structures” at the same time that the most powerful country in the world, and undeniably the most powerful force in the UN, kidnaps and deposes your democratically elected president, after having destabilized your country in the first place? Would you trust an organization that was supposed to “promote and to protect human rights”, but instead has been guilty of , among other things, violently suppressing protests, massacres, individual killings, and rape? Would you trust an organization of “peacekeepers” from countries with similar or higher homicide rates (Jamaica 54 per 100 000; Brazil 25.2; Sri Lanka 6.69; Argentina 5.45; USA 5.0) than Haiti itself (estimated at around 5.6 per 100 000 according to the UN’s own data), and which have at least as bad a Human Rights record as Haiti?

Would you really trust that organization now to actually want to help? Even if we assume that this is indeed what MINUSTAH is doing, the average Haitian has very little reason to believe that this time, they’ll really be there to help, or that accepting this help will make things better instead of worse, regardless of whether this is actually true.
Now add to that already untrustworthy mix the story about the origin of the cholera outbreak. Like I said, the news seems to want to make look like the anti-polio rumors that had been spread by religious leaders in some African countries. However, this one is different. Cholera isn’t endemic to the Caribbean (as a matter of fact, I couldn’t find any information about cholera outbreaks in that region at all, not even in the WHO report(pdf file) on cholera), and some outside sources seem to have confirmed that the strain came from Nepal. At the very least then, there’s reasonable cause to believe that the disease came from the troops. It certainly didn’t magically appear in the region by itself, so if not MINUSTAH, then some other outsider must have dragged it in.

In that context, I think, the protests no longer look like what a lot of the media wants to portray them as. And in any case, if the world really wanted to help Haitians as well as other places in which cholera has been pandemic for ages, they’d push for funding for increased production and distribution of the cholera vaccine. But the world doesn’t care THAT much about Haitians, or the other 100,000-130,000 people who die from it every year worldwide

The glories of the US Healthcare System

So I went to my appointment at the “poor people’s clinic” (i.e. the university-affiliated clinic) to get the test to see if I still have immunity against Measles, Mumps, and Rubella. I’m fairly certain I do, but without my Immunisation Record, I figured getting the blood test would be easiest.

Well, turns out doing the test is $300, while the vaccine itself is subsidized and apparently free (I don’t get itemized receipts, and I also got the flu vaccine and a tetanus shot, plus the visit itself costs money, but AFAICT the MMR was free). So I got one round of MMR today, and will have to go back for another round just before Christmas, because I don’t have any record of previous immunization.

So, due to the fucked up way the US subsidizes medicine, I’m about to potentially waste two rounds of MMR vaccine. Whee.

No, it’s not my job to teach you

“It’s your job to teach me about feminism. Now do it.” is a square on the sexist-bingo card, and it’s a trope that pops up in just about any other subject of the culture wars, be it racism or evolution (think of all the e-mails PZ and other famous atheists get that basically demand that the whole universe be explained to the writers of the emails, personally)or any number of other topics. When being a n00b, the attitude of feminists/atheists/etc of linking to previous discussions, suggesting reading material, or just flat-out refusing to get into the discussion can be frustrating*, and look very arrogant, cowardly, and generally off-putting. But it is a necessary tactic, since one’s free time is a limited resource, and having the same conversations over and over, for the benefit of just one individual, is neither an enjoyable nor an efficient use of one’s time.

For that reason alone, places like Pharyngula are so very precious and important. It might be the culture of valuing evidence-based discussion, or the knowledge that the discussion there is read by many people (so that any argument can inform more than just that one individual being adressed), or something else entirely, but a place where many knowledgeable people are willing to share their knowledge in personal discussion, and where these discussions are archived for posterity, is a very valuable resource. Similarly, places like the feminism101 blog, or the TalkOrigins Archive make it possible to shortcut many conversations by simply referring the person to already existing, laboriously collected, answers to their n00b questions.

What I really wish we had were similar repositories for links to, and summaries of, various scientific papers that support many of the feminist points (the name-on-resume study, various scholastic achievement studies, etc.). I used to have a vast collection of links to such studies, but I misplaced a lot of them, and sometimes finding them again is impossible, or at least very time-consuming. A nicely alphabetically sorted archive of feminist causes and the science to explain/support them would be epically useful, and linking to the whole archive would be a nice little “I’ve got science, what have YOU got” Fuck You to those who insist that feminists argue from emotion alone.

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*I admit freely to feeling that frustration as well. For example, I would not be opposed at all if SC just stopped doing anything else and taught me everything she knows. But unfortunately, I’ll have to do it myself, and just be grateful for the book suggestions :-)

Farmers in developing countries reject GMO’s. Why?

I recently found this article about Haitian farmers planning on destroying Monsanto seed. It reminded me of the stories of Indian farmers doing the same, and it stunned me that people in these extremely poor countries would be willing to destroy crops; especially Haiti, which just suffered a huge disaster, and where just a few years back people were eating mud. Now, I’m personally biased, but I wanted to really know whether these farmers were really acting in their best interest, based on experience with these crops, or whether they were like the teabaggers, talked by outsiders into acting against their own interests out of ignorance and fear.

After a little bit of digging, what I discovered was a massive discrepancy between scientific papers, which claim increased yields1, as well as reduced need for pesticide use2, and the writings of NGO’s and social workers which reported increased pesticide use and increased debts accumulated by the farmers. Usually I’d just go with the scientific studies, but I was having a hard time believing that thousands of Indian farmers would commit suicide if their financial situation weren’t as bad as reported. And eventually, I came across a somewhat comprehensive article3(pdf!) that explained the discrepancy at least in part: all the scientific studies are usually done within 1-3 years of adopting the GM crop; but a few studies showed that over a longer period, pesticide use between bt and non-bt crops evens out after longer periods of time either because of increase of secondary pests, or because of resistance:

‘Bt Technology Adoption, Bounded Rationality and the Outbreak of Secondary Pest Infestation in China’ claims that after seven years of Bt cotton introduction in China (1996 to 2004), the expenditure on pesticides for Bt and non­Bt was identical in 2004 at $101 per ha and the earnings from Bt cotton were lower [Mishra 2006]. Narayanamoorthy and Kalamkar (2006) reported the economical viability of Bt cotton for Indian farmers (Maharashtra). Contrary to expectations, the total quantity of pesticides used in Bt cotton variety MECH 162 was higher than non­Bt cotton varieties. The average net profit from Bt cotton was Rs 31,880 per ha, about 80 per cent higher than that from non­Bt cotton. There was no significant difference in pesticide use between Bt and non­Bt cotton varieties. However, it is too early to generalise in India, where four million small and marginal farmers have taken up cultivation of Bt cotton with estimated adoption rate of 50 per cent by the end of 2007 [Mishra 2006]. Illegal and spurious seeds coupled with non­maintenance of minimum 20 per cent refugia by these farmers may result in severe pest attack on Bt cotton due to selection pressure and outbreak of secondary pests like whitefly [Chari 2006]. The bollworm is expected to develop resistance in 2007­/08, where it was introduced in 2002 [Kranthi 2006][ed.:and indeed, it apparently has].

The same article also notes the significantly higher fertilizer reqirements of bt-cotton:

Fertiliser use was the highest in the case of Bt cotton, fol­lowed by hybrid cotton and was the least in the non­hybrid cotton varieties. The nitrogenous fertiliser use in Bt cotton was higher by 23 and 31 per cent when compared to the other hybrid and non­hybrid varieties, respectively. The respective phosphatic fertiliser use was higher by 17 and 50 per cent and the potashic fertiliser use was higher by 104 and 413 per cent. The use of zinc­sulphate was also higher in Bt cotton by 25 and 10 per cent, respectively.

Note also that at least the potash is an energy-intensive fertilizer, since it’s mined and then transported; phosphate is also usually mined. This means that as oil-prices rise, so will the cost of those fertilizers.

Anyway, the term “incorrect use” shows up in that article as well as a couple others that mention less-than-expected yields of GM-plants. I’m suspicious of that term, since it seems to mean that these crops can only grow in very specific circumstances. In wealthy countries where farmers can control the environment in which their crops grow more thoroughly and consistently, this might not be too big of a problem (though, with global warming and Peak Oil looming on the horizon, even wealthy Western farmers might loose control of conditions just enough to cause problems, maybe); but in poorer countries more prone to various environmental disruptions, and where the profit margins are smaller and income and financial relief in case of drought or other possible disasters is significantly less certain, it might be too difficult to expect the maintenance of the exactly necessary conditions by a sufficiently large percentage of farmers, year after year, to prevent these problems from eventually cropping up and rendering GM-plants unprofitable.

There were other reports of GM-plants failing (or not succeeding enough to be worth implementing): GM sweet potatoes in Africa and bt-cotton in Indonesia4; bt-cotton on small South African farms5 (their conclusion is especially noteworthy, since a lot of agriculture in developed countries consists of small farms, and any shift away from that has always resulted in massive misery, starvation, homelessness, etc. for the suddenly landless). There’s suspicion that GM-plants are toxic when consumed6. GM-companies are prone to stealing traditionally developed/discovered traits, patenting them, and therefore potentially depriving the original developers of the free use of those traits7. And lastly, the development of GM-plants is just another step in the arms-race that has, over the last 50 years or so, led to an explosive growth in use of herbicides and pesticides, which has impoverished and bankrupted many farmers, disrupted many ecosystems with its poisons, and even poisoned people themselves, while only modestly improving yields for short periods of time, while at the same time destroying top-soil and demanding increased fertilizer (which I already mentioned will be more and more of a problem in the future).

So, overall, I have to come to the conclusion that GMO’s are indeed not a good thing for farmers in developed countries; alternatives such as organic farming with local, non-patented seeds seems more promising than the participation in a race that makes agriculture more expensive, more fuel-intensive, more toxic to humans and the environment, more sensitive to any and all imperfections in implementation, and robs farmers of the freedom to use their seeds as they see fit. And sometimes, it robs them of their livelihood altogether.

boiz r stoopid…

at least as far as birth control goes, apparently. I just read this*, and I’m not sure if I should laugh or cry.

What I’d really love to know is whether this is a uniquely American phenomenon, what with the scarce to nonexistent sex-ed in schools, and zero popular and widespread alternatives, other than rumors spread among teenagers themselves. I have the vague impression that my High-School buddies were significantly better informed than that, but really only because we got the information from the same source, passed around in class under the tables and read religiously during school breaks. And the information in there was actually pretty accurate and often rather explicit, to a level that wouldn’t even be legal in the U.S., nevermind “morally” acceptable. I’ve no idea if this is still the case, since the magazine spawned a bunch of clones, and the original is probably not as widely read as it used to be (plus, I’ve no flaming clue about the current content). But anyway, I’ve never gotten into the weird situations described in that article, but since I never actually, explicitly asked any guys about what they know about birth control, I don’t actually know if they were/are that clueless, too.

The closest Americans seem to have to a resource for teens on sex is Scareleteen, but that’s not as easily findable, shareable, and hidable from potentially too conservative parents as a magazine would be. And resources for adults are… porn and self-help books? the article seems to suggest many men know as adults about as little as they did as teens, so whatever adult resources there are, men don’t seem interested in them, or don’t know they exist.

So anyway, this made me think of a couple different but related arguments about sex and knowledge I’ve had over the years. A lot of the “porn skews how young people think sex is supposed to be like” and “models on the runway and in playboy skew what both men and women think women are supposed to look like” arguments seem dependent on the fact that porn/playboy/model-photos are the only sources of information for how women’s bodies actually look like “in the wild”, and for what sex is, how it’s done, and how to find out what’s fun. So, would a good antidote to the nasty peer and social pressure perpetrated on people by these media sources be more access to information and openness about nudity and sex? No one over 15 thinks romantic comedies are really how people get into relationships, because real relationships are everywhere and they are visible. I’m sure most kids have at least heard from various family members about how they met their significant other, even when they themselves haven’t yet gotten into a relationship.

Especially annoying and intriguing is the problem of young women misjudging how “bad” they themselves look, because of how the women on TV and in magazines look like**. I mean, that a guy may not see that many nude women “in the wild” is believable, but how is that possible with women themselves? Don’t they ever go swimming, or to the gym? or do American women not shower after swimming/going to the gym? I certainly know that the annual trip with my mom to the nude sauna improves my self-image immensely, since being surrounded by unselfconsciously naked women of all shapes, sizes and ages makes me less freaked out about myself. Certainly such exposure can only be good? Is such exposure possible in the States, and other conservative(ish) countries?

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*extra special stupid quote from article: “I feel like girls should tell people.”
dude, girls ARE people! :-/

**I’ve not the faintest clue to what degree the same problem happens with guys. I get the vague impression from snipplets of conversations that at least in the gay community it is, but other than that, I’m clueless. However, the solution would be pretty much the same, right?