Finally it's loaded for me! Abbie, have you seen Salty [Current - ed.]'s accusation that you've been lying to us, "*I feel it necessary to mention one more time that her recent claims that the HPV vaccine is 100% effective against cervical cancer are FALSE"
Please stop irresponsibly spreading dangerous falsehoods about the HPV vaccine. You and your commenters continue to misunderstand basic facts, and you are misleading people. My sources include the same as yours. Read the CDC information you quoted. Notice the phrase “caused by the four vaccine types.” The two covered strains of HPV that can lead to cervical cancer cause about 70% of cervical cancers.* So even if the vaccine is taken by people prior to any exposure (efficacy declines with age due to greater probability of having been exposed, such that the FDA recently declined GSKMerck’s request to extend approval to women 27-45) and provides lifetime protection (which has not yet been established, of course), it is still not 100% effective against cervical cancer. Under the best conditions and assumptions, it will still only protect against 70% of cervical cancers.
The vaccines do not protect against all HPV types— so they will not prevent all cases of cervical cancer. About 30% of cervical cancers will not be prevented by the vaccines, so it will be important for women to continue getting screened for cervical cancer (regular Pap tests).
GARDASIL is the only human papillomavirus (HPV) vaccine that helps protect against 4 types of HPV. In girls and young women ages 9 to 26, GARDASIL helps protect against 2 types of HPV that cause about 75% of cervical cancer cases [other sources say about 70%],…
…GARDASIL may not fully protect everyone, nor will it protect against diseases caused by other HPV types or against diseases not caused by HPV. GARDASIL does not prevent all types of cervical cancer, so it’s important for women to continue routine cervical cancer screenings.
When you tell people the vaccine is 100% effective against cervical cancer, you give people a false sense of safety that might lead some later to forego regular Pap tests, which are demonstrably effective in preventing all cervical cancers in all women. Please correct this error.
My doctorate is from a highly respected university. I assume you’ll get your own real PhD in the future, but you fail the entrance exams for Google U.
SC
*Note that this does not mean that all infections with these four strains will lead to cervical cancer.
So I recently learned of a grant competition for projects on "The Uses and Abuses of Biology":
The aim of the interdisciplinary Programme is to investigate contemporary non-scientific uses and abuses of biological thought (beneficial, benign or negative) in the domains of philosophy, the social sciences, the media, religion and politics. Collaborative projects between those engaged in the biological sciences and investigators from other disciplines are particularly welcomed.
Sounds good, I thought. So I went to the web site...
The Grants Committee, in classic Templeton style, is comprised entirely (or almost) of members of the Templeton "family" who work on the the so-called intersection of science and religion (John Hedley Clarke, Nidhal Guessoum, Elaine Ecklund, David Livingstone, Ard Louis, Alister McGrath,...). I could have guessed the nature of the suggestions for sample projects without even looking, but it was fun to look. Here's a selection*:
•Does the teaching of biology convey implicit philosophies?
•Have the publications of the ‘new atheists’ in biology stimulated a rise in creationism and Intelligent Design?
•What is the sociological impact of notions of biological altruism on the interpretation of altruism within human societies?
•How does the field of biological complexity impact on ideas of human value and purpose?
•Are the biological sciences communicated in ways that are implicitly materialistic or teleological?
•Biology and the Imago Dei – an investigation into the ways in which the biological sciences have influenced interpretation of this theological concept.
•The impact of biology on the interpretation of Jewish food regulations. •Biology and natural theology - contemporary attempts to utilise biology in the justification of theological ideas.
•How does contemporary eugenics impact on notions of human freedom and spirituality?
*What's excluded is also interesting:
Topics excluded from the Programme include: bioethics, history (unless with strong contemporary relevance and application), ethical issues in the application of science, questions of sexual identity and policy, and race.
This last is especially strange as some of the reading suggestions are about race.
One of the more shocking aspects of the report I talked about in my previous post were the cigarette-sponsored concerts in Indonesia headlined by artists from North America, the UK, and Australia. (Well, not all that shocking, unfortunately.) I was disappointed to see that a public campaign and petition to get artists to pull out of the tobacco-sponsored Java Rockin' Land festival appear to have failed, and the concerts went off this summer as planned. (Other artists, like Alicia Keys and Kelly Clarkson, had previously heeded the message and changed course.)
Seriously, bands? You want to advertise for tobacco companies? You want to be part of getting kids hooked on smoking? You're OK with that suffering on your conscience? A while back I posted about the Sun City campaign by Artists United Against Apartheid,* in which musicians joined together to refuse to play a resort area in apartheid South Africa and produced an album sold to raise funds for the anti-apartheid cause. If the Cranberries and others are so shameless as to participate in this exercise in irresponsibility, other artists should come together to criticize these concerts and state publicly that they themselves would and will not participate.
I've been recommending Allan Brandt's The Cigarette Century since it came out. It's a superb history of science on a hugely important topic. Although the bulk concerns the history of science - and industry interference with it - in the US, the later segments dealing with the successful push to market cigarettes in other countries are some of the most disturbing. While smoking rates fortunately continue to plummet in the US, the number of smokers, especially children, is exploding in poor countries. Many of these people don't know the risks, and hundreds of millions of them will die terrible, preventable deaths. The costs to health care systems are staggering.
I was happy to see that Current TV's Vanguard has done an episode, "Sex, Lies, and Cigarettes," on the marketing of cigarettes in Indonesia and the work of anti-tobacco activists to educate and protect children there.
For those who get Current TV, they seem to be showing the episode fairly regularly. It and the other Vanguard reports are very good.
So I have a new camera [!!!] and have spent the past several days tormenting cats and kittens (for, generally, a good cause), amongst other activities. And they're unspeakably cute.
But I also went down by the river yesterday and found many an odd thing. I've done nothing to it and this is one of the best pictures I've ever taken. I love it, in every way. Don't? I don't care.
As Monnett attempted to explain in the interview, his influential paper included observations made flying over transects of a region of the polar ocean, as such:
Before a storm, 4 swimming polar bears observed / 11 percent of total region surveyed = about 36 expected swimming polar bears over entire region
After the storm, 3 dead floating polar bears observed / 11 percent of total region surveyed = about 27 expected dead floating polar bears over entire region
Thus, over the entire region, the rough estimate for the survival rate of swimming polar bears assuming they were caught in the storm is 9/36 = 25 percent.
The interview descends into farce as May reveals that he was incapable of understanding the very basic math behind the study:
ERIC MAY: Did they comment at all about any of the stats?
CHARLES MONNETT: Uh, there’s no stats in there.
ERIC MAY: Well, calculations, for, for example, the 25 percent survival rate.
CHARLES MONNETT: Oh, well, that’s just a mindless thing. That’s in the discussion. Um, that is not a statistic. Um, that’s a ratio estimator. It’s a, it’s a fifth grade procedure. Do you have kids?
ERIC MAY: No.
CHARLES MONNETT: Okay, well, if you had kids, you would know that in about fifth grade, they start doing a thing called cross multiplication. “X” is to “Y” as, you know, “N” is to “M.” And you can – there’s, there’s a little procedure you use to compare the proportions. And so that’s a, um, simply a calculation. It’s not a statistic.
May then tried to argue that there were actually 63 polar bears, because 4 live polar bears + 3 dead polar bears / 11% = 63. Dr. Monnett quickly grew frustrated at the innumeracy and illogic of this calculation:
CHARLES MONNETT: And so I, I don’t even still follow what they did to get the 60 percent. That, that’s –
ERIC MAY: The 63 percent.
CHARLES MONNETT: Yeah, that’s just goofy. [...]
ERIC MAY: Okay, and we’ll – let me, let – “of bears before the storm, then the total number of bears after the storm is 63,” and that’s where I came up with the sixty –
CHARLES MONNETT: That’s just stupid. I – did you do that?
ERIC MAY: No.
CHARLES MONNETT: That is stupid. …
CHARLES MONNETT: Somebody is deficient in fifth grade math.
ERIC MAY: (Laughing)
CHARLES MONNETT: Seriously. I mean, give me a break.
The head and founder of France's Servier laboratories was placed under investigation on Wednesday in a probe of the drug Mediator, which officials say has caused at least 500 deaths in France, and has sparked a public furore over drug regulation.
Jacques Servier, the company's president, is being investigated in Paris on suspicion of dishonest practices, deception over the drug's quality, and of falsely obtaining authorisation to sell it, said his lawyer, Herve Temime.
Jacques Servier, chairman of France’s second-largest drugmaker, must post bail of 4 million euros ($5.51 million) and his freedom may be restricted as he faces charges that he helped hide the risks of a drug suspected of causing the deaths of as many as 2,000 people.
Servier, 89, was charged with involuntary manslaughter, aggravated deception and fraud, the newspaper Le Monde reported, citing his lawyer.
If he has actually been charged with involuntary manslaughter, it seems a strange detail for Reuters to leave out.
While there's been some attention to the ongoing trial of Italian scientists, developments in the case of Charles Monnett - author of a 2006 paper about drowned polar bear sightings - are receiving little. I haven't followed the case and wouldn't make any strong assertions about this being politically motivated (though Inhofe's involvement sets off alarm bells), but some of the recent developments - including that the IG's investigation is itself now being investigated, as well as revelations in PEER's rebuttal - leave me deeply suspicious.
In a letter recently sent to U.S. Senator James Inhofe (R-OK) on the case, Acting IG Mary Kendall claimed her agency would not “opine on the substance of the underlying science.” Yet during an August 9th interview, IG agents continued to press Dr. Monnett on details of the 2006 peer-reviewed article in the journal Polar Biology, including how the paper’s abstract was edited, how comments made by anonymous peer reviewers were resolved and whether a conservative estimate was within the bounds of good science.
Naomi Rose of the Humane Society International has prepared a report about the deleterious effects of captivity on orcas. The Orca Coalition reports that it's been submitted to the judge in Morgan's case. It's not a peer-reviewed article, but it does review the scientific literature. I haven't checked all of the references, but I don't know how many are needed to convince. This has been a disastrous experiment, and needs to be put in the past.
We maintain that the only logical conclusion, after considering the preceding evidence, is that orcas do not belong in captivity. They do not thrive: they are physically harmed, living shorter lives, and they are psychologically harmed, injuring each other and humans in a way rarely or never observed in the wild.
...It is not justified to continue their display for entertainment or even for education, especially when that education is biased toward information that supports a corporate narrative rather than good science.
As long as the public buys tickets to see orcas perform, oceanaria are unlikely to voluntarily close orca exhibits. Therefore it is up to the public, as well as the media, the regulatory agencies, and the scientific community, to consider and weigh the evidence and make the only logical deduction. Orcas are too large, too intelligent, and too behaviorally and socially complex to adequately provide for in concrete enclosures. No more orcas should have to die prematurely; no more trainers should be put at risk. It is time to accept that we have been wrong in our assumptions. The orcas deserve no less (pp. 8-11).
CRIN has announced the debut of a children's rights wiki, providing information on laws and conditions around the world (including in the US). From the Q&A:
Organisations and individuals working to advance children's rights can contribute to the Wiki. This includes international and national NGOs, Children's Ombudspersons, legal organisations, governmental organisations and academics, among others.
I had to stop in the middle of Green Is the New Red when I read about a certain report. ALEC has been in the news over the past several months, and its corporate agenda is of course well known. But I was still taken aback to read of their 2003 report about animal rights and environmental activism:
In 2003, ALEC issued a report titled “Animal & Ecological Terrorism in America.” The Private Enterprise Board Chairman at the time was Kurt L. Malmgren, a senior vice president of the Pharmaceutical Research and Manufacturers of America. The editor of the report, Sandy Liddy Bourne, would later become vice president for policy and strategy at the Heartland Institute, which calls climate change “scare-mongering.” In a section titled “From Books to Bombs,” the report outlines the history of animal rights and environmental extremism, beginning with Darwin’s publication of The Descent of Man. According to ALEC, the voyage of the Beagle charted a course that led to the Animal Welfare Act and then to the ALF. The next step, the report warns, is physical violence. The authors make this warning repeatedly and dishonestly… (p. 127).
They are hell-bent on revolutionizing a system of perceived abuse into one that abides by deeply rooted philosophies of fundamental animal equity and environmental preservation. Change has been slow to take root, both politically and within the psyche of the American public. Yet the movement has brought the nation from an understanding of the ethics of animal/ecological welfare to a presumption of fundamentally protected rights. Outlined below is a timeline of this historic and sustained struggle for animal rights organizations:
1859 – Philosophical roots bud as a result of Darwin’s publication of The Descent of Man where he claims, “There is no fundamental difference between man and the higher mammals in their mental faculties.”
...
From Darwin’s initial theories on the nature of animals and other scholarly works concerning environmental sustainability, these groups have progressed to the modern day firebombing of those institutions that have caused a breach in their vision of good society.
So the philosophical ancestor of today’s “radical” animal rights movement is Charles Darwin? On the surface, Darwin’s an odd choice. If his scientific ideas were so conducive to today’s radicalism, we’d expect him to have been a radical in his own time. But in fact the ideas quoted in the report were shared by many people over the centuries. His observations are accurate but not really original. The Animal Rights Library includes this selection from Darwin (and, incidentally, one from Richard Dawkins), but it also includes works from Tolstoy, Gandhi, Paley, and Schweitzer. Religious and secular arguments (and believers and atheists) have long been and still are found on both sides of animal rights questions around the world.* Anti-vivisectionist movements existed in Darwin’s time, but he was no anti-vivisectionist radical: see this excellent piece by Eric Michael Johnson.
But I think the theory of evolution, what it suggests about the inseparability of humans from other animals, and its rejection by the Religious Right are at the heart of why Darwin’s writing was selected in the report as the intellectual ancestor of the animal rights movement. It’s an interesting question to what extent evolutionary knowledge affects people’s thinking about our ethical-political relationships with other species. As I’ve said before, I think scientific knowledge can play a role in developing our ethical sensibilities concerning other animals. No ethical position, much less any set of tactics, automatically or inevitably follows from this knowledge, though. People with a deep appreciation of evolution can still be unmoved ethically to protect nonhuman animals.
The link made in the ALEC report, though, isn’t an intellectual or empirical one. It’s politically motivated – an attempt on behalf of corporations to appeal to the Religious Right, whose ideology we saw in action in the hilarious “Religiosity and Global Warming Advocacy” panel at the Big Footprint conference. By insinuating a nebulous link between the ToE and (a caricature of) the animal rights and environmental movement, they can smear both. By opposing to them a vision of religion that doesn’t recognize the mass exploitation and destruction of nonhuman animals by humans as a fundamental moral issue – or even celebrates it - and a minimalist animal “welfare” program in the interest of corporations, they can promote both.
*This is discussed in Paul Waldau’s Animal Rights:
So this morning's Today Show featured Dr. Roshini Raj talking about “Four Vaccinations That Every Woman Should Get.” These turn out to be the flu shot, DTAP, HPV, and Hepatitis B.
Guthrie: The next one is the vaccine for Human Papillomavirus, better known as HPV. Now, I was under the impression that you, a woman only needs to get this when, you either get it when you’re young or it’s not worth getting at all.
Raj: Well, right now it’s FDA approved for age, for women aged 12 [sic] until 26. And we think that after the age of 26 that most sexually active women have probably been exposed to most strains of HPV, so it won’t be as effective. However, it still could probably protect some women over the age of 26. But certainly if you’re under 26, sexually active, you should be getting this vaccine. This is a truly remarkable vaccine that could help prevent most cases of cervical cancer, so it’s really important. And by the way, men under the age of 26 should also think about getting it. It protects against genital warts, and would protect against passing this virus to other women.
Doesn’t the Today show have fact checkers to verify these claims before they’re aired? Raj’s remarks give the impression that FDA approval for older women is likely, so they should seriously consider it. In fact, in April the FDA denied Merck’s request to extend approval for the vaccine to women 27-45. It is not approved for women over 26. Why on earth is a health expert presenting it as a vaccine “all women” should get?
Merck would like to expand vaccination with Gardasil to much older women, but even if the FDA approved it, there are serious cost-benefit questions. Merck has suffered a regulatory setback of its owh this year, when the FDA rejected its application to legally extend the ages for which Gardasil can be marketed. Currently, it is approved for girls and women between the ages of 9 to 26. Merck wanted to extend that to age 45, and initial reports said Merck had data to support the extension that they would submit to the FDA by the end of this summer.
August, however, saw a flurry of news stories and medical journal articles that cast serious doubt on the efficacy and cost-effectiveness of vaccinating women later in life. The August 21, 2008 issue of the New England Journal of Medicine (NEJM) carried both an editorial and a lengthy study on HPV vaccines. The editorial was written by Dr. Charlotte J. Haug, editor of The Journal of the Norwegian Medical Association. She directly challenged the claim that HPV vaccination is effective at preventing cervical cancer. "Despite great expectations and promising results of clinical trials, we still lack sufficient evidence of an effective vaccine against cervical cancer," she wrote. "With so many essential questions still unanswered, there is good reason to be cautious."
The accompanying NEJM study, "Health and Economic Implications of HPV Vaccination in the United States," looks specifically at the cost-effectiveness of the HPV vaccine. Anytime someone raises the question of cost-effectiveness, of course, someone is bound to object that we can't put a price tag on human life. In reality, however, cost-benefit considerations always play a role in health decisions. With respect to cervical cancer in particular, the high cost of Gardasil compares poorly against simple Pap smears, which provide a time-tested, reliable and inexpensive diagnostic tool that can detect premalignant processes early and thereby prevent cervical cancer. It seems, therefore, that financial and public health sense should favor programs to ensure that all women, but especially those most at risk from cervical cancer, receive consistent and appropriate screening.
As for Gardasil, the NEJM study concluded that while the cost benefit of vaccinating twelve-year old girls falls within accepted guidelines for wealthy countries, the cost benefit declines rapidly as age increases. This finding is a major blow to Merck's efforts to promote intensive "catch up" vaccinations of girls and women who are over the age targeted by schools and proposed mandates. The benefit drops dramatically by the time women reach the maximum approved vaccination age of 26. In the even higher age range of 27 to 45 for which Merck is seeking additional approval, the calculated cost benefit is far outside the accepted range.
This information might seem to suggest that it is all the more important to vaccinate girls at the youngest age possible. Merck's Dr. Richard Haupt told the New York Times that the NEJM study "underscores the value of vaccinating pre-adolescent girls." But there is a big hitch. The NEJM study states clearly that its cost-benefit ratios are based on an assumption that the vaccine provides lifetime immunity to HPV. There is no evidence that this is actually the case. In fact, a number of indicators suggest one or more boosters will be needed during the recipients' lifetimes.
Even in the best-case scenario, HPV vaccines would only prevent 70% of cervical cancer cases, which means that regular and consistent screening, such as tried and true Pap smears, will remain critical for women's protection against cervical cancer. This means that the significant costs of the three shot initial Gardasil vaccination series (with a price tag of $450-$1,000, not including a possible booster) will be in addition to the existing costs of screening.
The NEJM article spelled out the bottom line: "If vaccine-induced immunity lasted only ten years, the vaccination of preadolescent girls provide only 2% marginal improvement in the reduction of the risk of cervical cancer as compared with screening alone."
It is irresponsible for those who are supposed to be educating the public about vaccines to make scientifically unsupported claims about them. It is also irresponsible to present HPV vaccines as a means of cancer prevention without noting declining effectiveness with age, the unknown duration of protection, the unknown long-term risks, and especially the fact that even the people who’ve received the vaccine prior to any exposure to HPV (and even if it turned out that the vaccine provided lifetime protection) still need to have regular Pap smears, as the vaccine only prevents the strains that cause 70% and not 100% of cervical cancers. There is a very real risk that people who’ve received the vaccine will believe themselves fully protected and forego regular cancer screenings. There’s also a risk that attention and resources will be diverted from screening, which is an extremely effective method of prevention (for all women and for all cervical cancers), educating about and reducing disparities in which could prevent the relatively few cases of cervical cancer that still occur in the US.
I have no medical expertise, so if anyone who does notices any errors in what I've prevented here I would appreciate the corrections.]
The other day, the Today show featured a health segment with Dr. Nancy Snyderman talking to Natalie Morales about the importance of early detection of various conditions, including depression.
Snyderman: But the hallmark for depression versus just having a lousy day is hopelessness. People say it's like being in a steel can where you just can't claw yourself up the sides. If you're irritable, you no longer like to do the things you like to do, and I mean reduced sex drive, like nothing brings you satisfaction anymore, sometimes fatigue, you'll hear women say I just don't want to get out of bed in the morning. Or difficulty concentrating. Any of those alone may not be enough, but put them together and it's important. And for you and I who have children, you have to really look at transitional times in a child's life. Pre-adolescents can really become depressed and when you see it as a parent you may not notice it. But changing grades, friends at school.
Morales: Hormones.
Snyderman: All of that stuff. We even know that in utero we can start to pick up on depressed babies based on how they respond to music and what their overall environment is like. This is not something to be worried about; it's not something to be chastised. It is really something to understand, because there are phenomenal treatments, including therapy.
Morales: And it's usually lower levels of serotonin that triggers depression?
Snyderman: The whole neurotransmitters. And a lot of times it's medicine. Increasingly we believe it's medicine and some kind of therapy.
Now, there’s so much wrong here I wouldn’t know where to begin (how exciting for pharmaceutical companies to have that vast in-utero market still to exploit!), but this last response struck me. In the past couple of months, I’ve noted Abraham Nussbaum asserting that he “know[s] of no serious psychiatrist who believes that psychotropic drugs ‘fix chemical imbalances in the brains’ of their patients” and NIMH head Thomas Insel conceding that notions of neurotransmitter imbalances as the cause of depression are “beginning to look antiquated.” The subject also arose in the recent exchange about Marcia Angell’s article, in which her interlocutors Friedman and Nierenberg refer to serotonin deficiency as “an outdated and disproven chemical imbalance theory of depression.”*
I just read Bruce Levine’s Surviving America's Depression Epidemic: How to Find Morale, Energy, and Community in a World Gone Crazy,** which is a few years old, and was surprised [?] to discover that Insel’s been saying this since at least 2007 (making his recent “beginning to believe” sound rather odd). Despite the fact that the monoamine hypothesis has long been discredited,
…the general public continues to hear (through antidepressant commercials and from many mental health authorities) about the neurotransmitter deficiency theory of depression, and so it was news to many Americans when Newsweek, in a February 26, 2007, cover story about depression, reported: "For decades, scientists believed the main cause of depression was low levels of the neurotransmitters serotonin and norepinephrine.... [However, a] depressed brain is not necessarily underproducing something, says Dr. Thomas Insel, head of the National Institute of Mental Health - it's doing too much.... Instead of focusing on boosting neurotransmitters (the function of the antidepressants in the popular SSRI category such as Prozac and Zoloft), scientists are developing medications that block the production of excess stress chemicals."
Pharmaceutical companies, however, have been so effective at marketing the neurotransmitter deficiency theory of depression that even though the NIMH has now retreated from this view, the general public and many doctors continue to believe it. The mental health establishment has not yet zealously publicized its newer depression theory - that excess stress chemicals (such as cortisol) can cause nerve cell damage - perhaps because it would confuse millions of patients who continue taking neurotransmitter-enhancing drugs (it would certainly upset the pharmaceutical companies that manufacture them) (p. 23).
Amusingly (OK, darkly amusingly), the newest depression “theory” from Insel is completely different from the 2007 “theory,” but that this absurd situation continues year after year – the repeated acknowledgements that the alleged mechanism for the alleged efficacy of antidepressants is wrong with at the same time no real effort made to correct widespread public misperceptions stemming from doctors and from advertising - is amazing and unacceptable. The public has a right to know what the science has shown about this important question, and it’s well past time for people who obviously know the facts to set them out plainly and honestly.
* As Nussbaum does with Whitaker, Friedman and Nierenberg suggest that Angell is ignorantly or disingenuously setting up a straw man by pointing out the scientific discrediting of the chemical imbalance idea: “Angell uses an outdated and disproven chemical imbalance theory of depression (i.e., serotonin deficiency) as a straw man to deny that depression has any biological basis at all.”
Angell replies: “Contrary to Friedman and Nierenberg, I do not 'deny that depression has any biological basis at all'. I know very well that all thoughts, emotions, and behaviors have their origin in the brain. But it is a great leap from recognizing the obvious fact that mental states arise in the brain to knowing why and how they arise. …As for the chemical imbalance theory of depression being a straw man, I still hear it invoked frequently. Even Oldham seems to entertain it in his letter, saying ‘…there is no consensus on whether these imbalances are causes of mental disorders or symptoms of them’.”
** A mixed bag, ranging from the science-based and truly insightful to the borderline wooish and irritating. I recommend…the good parts. I can’t be too harsh as it was through him that I read about Ignacio Martín-Baró.
First of all we would like to thank you for the wonderful support we have received from the moment Morgan was taken from the sea. This has meant a lot to us but also to Morgan. This support is what keeps us going and gives us the extra energy to keep up the fight day after day.
We would also like to give you an update on the current situation. Unfortunately we cannot go into the details on some parts, but hopefully this gives more clarity.
This last week the Orca Coalition has been writing and collecting additional documents that we could submit to the Ministry following the hearing on 9 September. These documents serve to support our arguments for Morgan's release.
In the near future it should become clear what the Ministry will decide. Will it be Loro Parque in Tenerife, or will they finally decide that Morgan can return to her family in the wild? Because we certainly take into account a negative decision, we are preparing ourselves for a possible subsequent lawsuit. Also raising funds to cover the legal expenses is badly needed.
Of course we hope that the Ministry will make the right decision, allowing Morgan to finally begin her rehabilitation and a life of freedom in the prospect, from which much can be learned. If the Ministry decides to release Morgan we will continue to work on her rehabilitation and we will give support where needed.
We hope to be able to give you more information soon.
The story is unbelievable, but it would be worth it for the sailing footage alone. I wish there had been a bit more information about the subsequent fates of the other sailors and their family members.
Saw it last night on PBS. You can watch it on their site for a few weeks (unfortunately, I don't know if that holds outside the US). I thought it was pretty well done, though it didn't devote sufficient attention to the radical and irreversible destruction carried out by corporations. It happens that I had just started Will Potter's Green Is the New Red: An Insider's Account of a Social Movement Under Siege
last week, and it appears more comprehensive. But I recommend the film as well.
...Honduras is party to several international treaties, including the American Convention on Human Rights. These treaties obligate countries to deter and prevent rights violations, investigate and prosecute offenders, and provide remedies to victims.
The Inter-American Commission on Human Rights has held that “the State has the obligation to use all the legal means at its disposal to combat [impunity], since impunity fosters chronic recidivism of human rights violations and total defenselessness of victims and their relatives.”
I read Susan Davis’ Spectacular Nature: Corporate Culture and the Sea World Experience
a couple of months ago, and it seems useful to write a bit about it now in light of the Morgan case. The book is from 1997 – I may have attended one of the Shamu shows she writes about in the early ‘90s – though it doesn’t feel dated. It covers a range of aspects of SeaWorld, from working conditions and marketing research to the context of urbanizing San Diego, but one of the most important themes is the corporate vision of nature and conservation promoted by the parks, “one of the most popular and available versions of the wild that contemporary American and international tourists can encounter” (p. 9).
As Davis notes,
Sea World's versions of nature - carefully produced, manufactured, and coordinated from a mega-corporate point of view - are, of course, not the only ones available. But never before have images of nature had such a direct and powerful link to corporate capitalism or such wide dissemination through the mass media. The same forces involved in the biosphere's exploitation have an important stake in nature's definition and representation (p. 18).
So SeaWorld and its displays are key sites of corporate political management. In a model founded on individual consumption, nature is represented to SeaWorld’s largely white, wealthier audience as “a commodity for sale in its own right, in order to sell other things and to help people feel good about larger social projects and arrangements, including the high-consumption economy typified by the theme park itself” (p. 30). Indeed, “in the late twentieth century, American business has worked hard to define consumption as a form of concern, political action, and participation,” leading many people to regard the act of visiting the park itself as an “act of caring” (p. 39).
The orcas, referred to by management as the parks’ “core product” (p. 28), are the main attraction. The animal shows grow out of a “genteel history of nature appreciation,” imperial conquest and its representation, and the tawdry world of circuses and side shows. While other marine mammals have a longer history of performance, killer whales have only been performing since Shamu*’s arrival in 1965. There has long been protest of SeaWorld’s capture and display of animals. The passage of the Marine Mammal Protection Act in 1972 – “[t]he park bitterly resisted the National Marine Fisheries Service's interpretation of the Act and other animal protection legislation as "anti-zoo," "irrational," and "needless over-regulation" (p. 68) - made matters more difficult for SeaWorld, particularly after they lost important legal battles in 1985. “The whaling issue,” Davis argues, “forced Sea World to undertake a public relations offensive to convince their regional and national audience that they had the orcas' best interests at heart” (p. 69).
Their response to public protest and legislation was to put a scientific veneer on their activities: “The managers hoped that a more rational image of study and science would help counter the activists' assertions that keeping whales in captivity was simply commercialism pushed to its cruelest limit” (p. 69). Sea World beefed up the research institute, spinning its purpose as scientific and educational. Davis calls it largely “a new kind of theme park performance. Frequent mention of the institute in theme park exhibits constructs Sea World as a place of responsible scientific investigation and unfolding knowledge, and emphatically not a site of animal exploitation” (p. 70). As she notes, research is conducted there – often funded by corporations and government – but much is applied research seeking to serve both clients’ needs and SeaWorld’s own (e.g., research on captive animals).
SeaWorld also became very active in education and “outreach,” both in the media and through programs for students in public education. These programs have been closely tied (in fact subservient) to company PR, are generally unrelated to any research conducted, and present – as the parks do in general – a corporate-endorsed vision of science and conservation. SeaWorld’s materials
show or tell very little about the complex patterns of animal life and society in the wild. To do so might emphasize how far from the wild the animals are at Sea World. To see some version of real "wildness," the audience would have to see something potentially complex and confusing, something perhaps not transparently visible or harmonious or colorful at all (p. 116).
The view is far from comprehensive or ecological:
The audience's good feelings about animals, then, support judicious stewardship and ratify the dominant managerial role of humanity. But Sea World's explicit educational philosophy doesn't extend much beyond fact delivery and cultivation of feeling, since very little time or energy are spent actually explaining complex ecosystemic relations (or even what an ecosystem is), or exploring relations between humans and the nonhuman living world outside the theme park (p. 146).
Disturbingly, at the time of Davis’ writing, virtually no mention was made of evolution, and these references had actually declined over time. As she writes of the Shamu shows:
Some slight mentions of evolutionary history could be found in past scripts. For instance, one show mentioned the fact that whales developed from an archaic land mammal and so retain the nub of a digit in the pectoral fin. By the time of "Shamu New Visions," these vestigial mentions had been selected out, since Sea World now scrupulously avoids any mention of evolutionary theory in its education or entertainment programs (p. 221).
Davis quotes from a 1991 training manual obtained by the Orlando Sentinel and quoted in Harper’s magazine in 1992**, which advised: "Evolve: because evolution is a controversial theory, use the word `adapt."' As Davis argues, “This is one measure of how serious Sea World's science education is, so exquisitely sensitive is it to market pressures. Sea World may be sensitive not only to antievolutionists among its commercial audience, but to the growing number of private Christian schools in its education market” (pp. 298-299). As she makes clear, this is but an illustration of the broader problems with corporate influenced science education: they seek, of course, not primarily to convey scientific knowledge but to market the company to a target population.
In general, through these efforts the corporation seeks to present itself as a responsible environmental steward: “Research puts a gentle face on the human penetration and control of nature, and conversely, human penetration of the natural world and environment can be seen only as rational investigation” (p. 230). As with scientific research, so with conservation. SeaWorld presents itself through all of these activities as a force for meaningful conservation. In keeping with the corporate message, environmental destruction is shown divorced from corporate action (at the time Davis wrote and until 2009, SeaWorld was owned by Anheuser-Busch) or government policy and presented as simply a matter of individual habits. SeaWorld, itself a generator of massive amounts of waste, “educates”*** children and adults that their primary means of marine environmental action is better personal habits. “Of course,” Davis notes,
a careful outlining of the issues involved with marine pollution would mean discussing agricultural and industrial runoff, toxic waste dumping, the trash explosion, oil spills, and undersea nuclear testing, to name a few controversial issues. As the entertainment arm of a huge corporation with extensive agribusiness operations, Sea World can appear environmental but it can't point fingers or even name issues. It can, however, suggest to its audience that corporate America has the best interests of animals and the environment at heart (p. 150).
And we can see even more clearly now that marine pollution of this sort is only one factor, added to ocean acidification, corporate industrial fishing, and numerous forms of habitat destruction. Davis concludes:
Not least among the things missing is a broad understanding that environmental problems are problems of whole economies and ways of life, and that solutions must go far beyond "don't litter" lectures and beach cleanups (p. 243).
In sum, then, SeaWorld shares the problems associated with theme parks in general, and adds to them both the capture and exploitation of marine animals and the propagation of a vision of nature and the human and corporate role within it that obscures the real problems and leads people to accept corporate claims to environmental stewardship and to misunderstand what needs to done.
*There have been and continue to be several whales, male and female, playing the “Shamu” role.
**The article’s title, appropriately, was “Chickens of the Sea.”
***I use the past tense aware that the book was published several years ago. Although the rhetoric of “corporate social responsibility” has become more sophisticated over the past decade, including giving lip service to some of the issues raised by Davis and others, there have been no significant changes in basic corporate practices or their preferred model of environmental (in)action.
Kenya follows a number of African governments in outlawing the practice. According to the Pan African news agency, at the time of the African Union summit in June, which proposed prohibition of FGM, Benin, Ivory Coast, Djibouti, Egypt, Eritrea, Ethiopia, Ghana, Guinea, Niger, Nigeria, Kenya, Central African Republic, Senegal, Chad, Tanzania, Togo and Uganda already had legislation against it.
But in nine countries (including some of those where it is illegal) it is still widely practised. In Djibouti, Egypt, Eritrea, Ethiopia, Guinea, Mali, Sierra Leone, Somalia and Sudan, 85% of women undergo mutilation.
(No citations given, it should be noted.) Can't say I'm thrilled that "the law even prohibits derogatory remarks about women who have not undergone FGM," though I suspect that's more symbolic than meant to be meaningfully enforced.
No updates about Morgan the Orca, but I give you this video (Tim Zimmermann called it "a bit overcooked," and I have to agree, but it makes its point):
I talked in a recent post about the efforts of the Catholic Church to deny reproductive rights in Poland. I've learned of another WikiLeaks US cable from 2009, this one concluding that "Polish society and the Polish Government have a long way to go toward ending discrimination on the basis of sexual orientation" and citing the RCC as a major "source of anti-gay views":
Gays and lesbians face discrimination in the educational system, in the workplace, when renting or buying property, and in access to health services. Some have been subject to or threatened with physical violence on the basis of their sexual orientation....
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The Catholic Church plays a significant role in the formation and propagation of anti-gay attitudes in Polish society, especially in rural areas. In a society that is 94 percent Catholic, the Church is widely recognized as a political and moral force. While the Polish Episcopate has condemned violence and discrimination against gays and lesbians, this message is often ignored - and sometimes contradicted - by parish priests in small towns and villages, some of whom present homosexuality as a deviant condition. Moreover, the Church continues to label homosexual acts as sins and calls on homosexuals to practice abstinence. Most Polish opponents of gay rights cite "Catholic values" and "natural law" to support their views. In November 2008, for example, users of the internet forum "Fronda" launched a boycott campaign against IKEA in response to its gay-friendly advertising. The campaign was named "I'm a Catholic and I don't shop in IKEA."
I'm troubled that the story of these cables and the dismal situation of sexual and reproductive rights in Poland (this article places it within a broader context of pro-natalist policies in the region that have disproportionately harmed women) has appeared of late almost exclusively on rightwing Catholic blogs and sites - I found the most recent cable through a link to something called LifeSiteNews, which I won't link to. It does seem to be under discussion to some extent elsewhere. A conference earlier this week was apparently organized to foster acceptance of the role of the Church in Polish politics: "'The goal of this conference is a mutual discussion about what is missing in our current political system and what values politics should serve,' conference organizer Wladyslaw Zuziak was quoted as saying by the Catholic News Agency." At the event, though, German president Christian Wulff warned against people with "convictions that divide people into 'us' and 'them' based on culture, religion or nationality" coming to power and that "fanatical Christianity can bring suffering."
I'm probably not the first to say this, but... I hear almost constant references to "what makes us human," "what separates us from the animals," and the like, including in contexts that have nothing to do with other animals or living things. I've even done it myself fairly recently, I believe. There's enormous variety in the specific characteristic mentioned, and they're all debatable. They also have a dark history of excluding certain humans from full moral consideration. Which leads me to wonder, what's the purpose of these alleged distinctions? Why is it so important to try to draw this specific line? What do they say about our attitudes towards the non-human?
My previous post discussed the battle being waged for the freedom of Morgan, the young rescued orca. You can follow events on Twitter - @orkacoalitie - or on FB. What the court in the Netherlands decided yesterday is still unclear to me, but from the most recent tweet appears generally positive for Morgan.
Tim Zimmermann has posted "A Close-Up Look At Loro Parque," following up on his earlier work. This first part of his exposé includes the full text of the report he received from a former AV supervisor in the park's killer whale section. Loro Parque is the Canary Islands facility where SeaWorld transferred four of "their" orcas several years ago and where they are now pushing to have Morgan sent to breed and perform.
Dawn Brancheau's family is suing in federal court asking that OSHA, which investigated her 2010 killing by Tilikum (they recently fined the theme park for violations, which SeaWorld is contesting), not release images of the event.
Visser's organization the Orca Research Trust reports that a program about Morgan co-produced by the BBC and the Discovery Channel was to begin airing last week in the UK, but I can't find any information about it on the Discovery Channel's site. Is it a simple delay, or is someone blocking its airing in the US? Any information would be much appreciated.
***CORRECTION***: Ah. The documentary isn't about Morgan but more generally about their work and a NZ orca they rescued.
until I'd finished it (it's quite long), but I noticed The Big Picture's interview with Graeber was just put up a few days ago. I've read enough of the book to be able to recommend it highly and without reservations.
Retraction Watchreports that Anil Potti (who's had five papers retracted to date) didn't disclose his corporate relationships at the time he published papers in JAMA which haven't been retracted.
It happens that this was reported on the same day as this announcement from ProPublica (I love the PR response from PhRMA):
Tonight, ProPublica will be posting a significant update to its Dollars for Docs database [1], adding new payment reports from 12 drug companies that comprise more than 40 percent of U.S. drug sales. Hundreds of thousands of doctors will be added to the database.
JAMA and other journals rely on self reports. Is someone going to go through the database and verify that all of these payments/relationships were disclosed in any publications by these individuals?
Although conservationists are concerned about tropical forest mammals, there is very little information on what is actually happening to most of these mammal communities as the threats of climate change and deforestation loom over them. But now we have system to gather it: the Tropical Ecology Assessment and Monitoring (TEAM) Network.
TEAM has the largest monitoring system for terrestrial vertebrates on the planet. Instead of having people walking around the forest looking for mammals — which is very inefficient, as these animals are usually rare and hard to spot — TEAM deploys camera traps over large areas of forest all over the tropics (eight monitoring sites in Latin America, five in Africa and Madagascar and four in Southeast Asia).
They have 52,000 photos, and the ones they've made publicly available are cool:
The part that worries me is what follows:
At each monitoring site, these camera traps work 24/7 for one month, taking pictures of everything that crosses their path — including hunters. These hunter images could potentially be used by park authorities to help control poaching in these areas.
This picture is labelled "Poacher caught on camera in Uganda":
First, I don't know about the legality of photographing people in this way or using the photos for this purpose. More generally, though, I'm concerned about the identification of these people as criminal "poachers." I worry that some may be (not that these are necessarily mutually exclusive categories) local people, including members of indigenous groups who've been forced off their lands, trying to survive. I have a problem with wealthy BINGOs like CI, who themselves partner with the very corporations responsible for massive environmental destruction in these areas, portraying poor local people as villains for local governments and their international audience. I recommend Mark Dowie's Conservation Refugees. From an article by Dowie about the book:
“We are arrogant,” was the confession of a CI executive working in South America, who asked me not to identify her. I was heartened by her admission until she went on to suggest that this was merely a minor character flaw. In fact, arrogance was cited by almost all of the nearly one hundred indigenous leaders I met with as a major impediment to constructive communication with big conservation.
If field observations and field workers’ sentiments trickle up to the headquarters of CI and the other BINGOs, there could be a happy ending to this story. There are already positive working models of socially sensitive conservation on every continent, particularly in Australia, Bolivia, Nepal, and Canada, where national laws that protect native land rights leave foreign conservationists no choice but to join hands with indigenous communities and work out creative ways to protect wildlife habitat and sustain biodiversity while allowing indigenous citizens to thrive in their traditional settlements.
Neoliberalism is the political and economic framework based on privatizing public works, removing rules and regulations over businesses that protect citizens, and tax cuts for the wealthy. You might wonder why anyone outside of the wealthiest 1% would support such policies. Here’s my theory: neoliberalism was made possible by a racialized language of privatization that defined all things private as “white” and all things public as “black.”
...The reality is that white resentment towards blacks has made neoliberalism possible despite 30 years of failed policy and to the detriment of whites and blacks.
The site itself and its companion site lead kids to homosexual pornography and homosexual groups with a history of targeting kids with graphic homosexual material. Far from "helping" troubled kids, these sites would add considerably to their psychological and medical trauma.
…
But worse, the Boston Red Sox are helping the radical homosexual movement push their depraved agenda on troubled kids, many of whom probably need real help. They seem fine with that. By any rational measure, this is simply evil.
The other day I posted about the IISG's public collection of graphic materials related to contested tourist destinations. It turns out, if this report is to be believed, that the Romanian Ministry of Tourism hopes to encourage nostalgic police-state tourism:
More than 20 years after the fall of Nicolae Ceauşescu, the country’s ministry of tourism has announced the creation of a "propaganda itinerary," which will take in specific places that figured large in the life of the "Conducător." According to the minister concerned, the initiative is justified, among other reasons, by the fact that "50 per cent of Romanians, who believe that life was better under his rule, regret the passing of the dictator," while "40 per cent believe that Communism was a good thing."
The tourist paradise and the police state may very well go hand and hand. A flourishing tourist sector adds to the economy and the international prestige of a country, political prisoners, concentration camps, ethnic cleansing, murder, and disappearances, notwithstanding. The tourist usually remains unaware of the signs of violence and repression. In many cases this ignorance is a matter of choice. The adversaries of the police state are well aware of the impact of tourism and try to mobilize public opinion on this very point. They advocate international sanctions and boycotts, morally appeal to the individual traveler or organize bomb attacks to frighten tourists.
As retirees colonize the shorelines of Central American and Caribbean countries at breakneck speed, the best deals are reserved for those who buy in early. Which helps explain why poverty-plagued Honduras, still recovering from the 2009 coup that deposed its former president, is at the cutting edge. Taking its cue from development on the nearby island of Roatan, Mississauga, Ont. Based Life Vision Properties is luring retirees to the mainland city of Trujillo with bargain prices and picturesque vistas. The firm has already sold some 500 properties.
(By the way, the IISG now has a Latin America desk, and will step up its efforts to gather materials from truth commissions and leftwing movements in the region.)
...And sometimes delayed feed-reading is a problem. I didn't catch this coincidental announcement for a talk by Steve Brouwer in New York until today. Unfortunately, the event was the other day. Happily, though, for anyone interested, the post links to a couple of articles from Social Medicine about Barrio Adentro.
Sometimes it’s good that I don’t read all of my feeds in real time, only getting to some posts after the urgency of the situation they describe has passed. That was the case with a post by HRW a few days ago – “Poland: Reject Blanket Ban on Abortion.” I was relieved to find that the law had failed. On the other hand, the state of reproductive rights in Poland is dismal. Abortions are only legal under three circumstances: the pregnancy poses a threat to the health or life of the woman or results from rape, or the fetus is severely deformed or sick. And even under these circumstances, it seems they’re nearly impossible to obtain. Legal abortions numbered a mere 583 (in a population of 11 million women of childbearing age) in 2010. It’s estimated that well more than 100,000 abortions actually occurred, not counting those obtained in foreign countries; these were illegal and expensive (a veritable racket), beyond the reach of many poor women.
It’s difficult to estimate the suffering and death this has caused, and it’s especially perverse given that abortion was legal under Communism. The denial of human rights to women in Poland does not simply reflect cultural attitudes. It results from the long-term targeted interference of the Catholic Church in the country’s politics. As Wikileaks documents have revealed, the Vatican has looked upon Poland as a place to realize their authoritarian, misogynistic fantasies in the 21st century and a fortress against secular Europe. I hope this law’s failure signals that the Vatican is losing its grip on Poland and that the country will make progress on reproductive rights.
Unfortunately, many US states are determined to outdo them. The Guttmacher Institute reports that
In the first six months of 2011, states enacted 162 new provisions related to reproductive health and rights. Fully 49% of these new laws seek to restrict access to abortion services, a sharp increase from 2010, when 26% of new laws restricted abortion. The 80 abortion restrictions enacted this year are more than double the previous record of 34 abortion restrictions enacted in 2005—and more than triple the 23 enacted in 2010. All of these new provisions were enacted in just 19 states.
Venezuela provides an example of how revolutionary social change, even that which challenges the Church and leads to important gains for women in some respects, can leave behind women’s most basic human rights. I was unpleasantly surprised to read in Revolutionary Doctors Brouwer’s description of a local health committee meeting:
…There was a short discussion about birth control, with everyone lauding the free contraception available in various forms at each walk-in clinic and asking for even more information to be provided by both doctors and health committee volunteers. No one, however, brought up the subject of abortion, which generally is not accepted by most lower-class Venezuelan women. For this reason, I was told, the Cuban doctors, who are used to providing abortion on demand in their own country, do not proselytize about the subject to their Venezuelan patients. (KL 1489-1493).
It should be noted that this was several years ago, but it’s probable that Brouwer is underestimating the strength of desire for reproductive rights in the country even then. Women continue to be sacrificed by politicians and governments who claim to be fighting for justice. It should be discussed in this context, as the criminalization of abortion is not just a denial of human rights but a serious public health concern. Estrella Gutiérrez reports that unsafe abortions are the second leading cause of maternal mortality in the region. The Catholic hierarchyhates Chávez anyway and would like nothing better than to get rid of him (as they helped do with Aristide). I don’t care if many politicians, including Chávez, see themselves and their movements as in part inspired by Christianity. No church should have any role in government policy.
The Day for the Decriminalization of Abortion in Latin America and the Caribbean is the 28th of this month, and I plan to post more at that time. There is movement, and I’m optimistic for the expansion of reproductive rights globally, including in the three countries just discussed. But a major element in effecting that expansion has to be getting religious, and especially Vatican, influence out of policy.
(I had to use "Nerd Scare" - yesterday was the first time I heard it and it made me laugh.)
The National Lawyers Guild last month put up a page, AnoNLG, for cyberactivists* with "Know Your Rights" resources and contact information for those targeted by the government. It's a strange looking site - so much so that I had to confirm that it is indeed a product of the NLG - and I hope it'll be improved over time, but the links to pamphlets and other information on the right look useful and their twitter feed on the left from what I've seen has some interesting notices.
As part of the negotiations over keeping US troops in Iraq, Washington is demanding immunity for all US military personnel. But Maliki's spokesman, Ali al-Moussawi, said: "We will not give up the rights of the Iraqi people, and this subject will be followed."
The leaked state department memo, dated 27 March, 12 days after the incident, says that the US mission in Geneva had received a letter from Alston, the UN special rapporteur on extrajudicial, summary or arbitrary executions. In his letter, Alston said he had received various reports on the killings, and the dead included Faiz Hratt Khalaf, 28, his wife, three children, his mother, sister, two nieces, a three-year-old and a visiting relative.
"According to the information received, American troops approached Mr Faiz's home in the early hours of 15 March 2006. It would appear that when the MNF [multinational forces] approached the house, shots were fired from it and a confrontation ensued for some 25 minutes. The MNF troops entered the house, handcuffed all residents and executed all of them. After the initial MNF intervention, a US air raid ensued that destroyed the house," Alston wrote. He added: "Iraqi TV stations broadcast from the scene and showed bodies of the victims (ie five children and four women) in the morgue of Tikrit. Autopsies carried out at the Tikrit hospital's morgue revealed that all corpses were shot in the head and handcuffed."
“The age limit is effectively a ban for those of us who circumcise our children on the eighth day. Circumcision is an existential question, and therefore the Ombudsman’s proposal is dramatic and serious for us,” said Ervin Kohn, leader of the Jewish community in Norway.
I entered the first one and will likely submit a poem this year as well. I look forward to reading this year's entries, and hope they're as wonderful as last year's.
In Revolutionary Doctors: How Venezuela and Cuba Are Changing the World’s Conception of Health Care,
Steve Brouwer talks about the misrepresentation of the ALBA countries in the corporate media, noting that “they have an even more effective way to hurt the images of Cuba, Venezuela, and the ALBA nations: when it comes to Cuban/Venezuelan cooperation and medical internationalism in the region, they do not report the news at all. That is, they can generally be relied upon never to publish or broadcast favorable stories that feature the extraordinary accomplishments in health care and education” (KL 3193-3198). He illustrates this with the paucity of positive coverage of Cuban and Venezuelan medical efforts in Haiti surrounding the 2010 earthquake, acknowledging that a few reports managed to slip through. I had seen a couple of these, but even before that I had read in a little in alternative sources about these accomplishments and was very interested in both Cuban medicine and in how the new Latin American constitutions that put the right to health care front and center were playing out. Until I read Brouwer’s book, I wasn’t aware of the extent of the transformations, the reach of the programs, or the breadth of cooperation amongst countries.
Almost every chapter of Brouwer’s book begins with a quotation from Che Guevara, most from his 1960 “On Revolutionary Medicine.” He gives an account of the development of Cuban medicine from the revolution to the present, particularly the cooperation between the Cuban and Venezuelan governments in building the latter’s health care system since Hugo Chávez was first elected and their work in other poor countries in Latin America and the Caribbean and around the world. These systems and projects are radically transforming the way medicine is taught and practiced in a large part of the planet, and form part of larger visions of social change.
Health care in Cuba was dramatically transformed from immediately after the revolution. From the ‘60s, medical school graduates became part of a free public system. The Cuban approach was further developed as a result of the 1978 international Alma-Ata conference, which put together guidelines for “new health delivery systems built around the primacy of primary care, with family practitioners trained to integrate medical treatment with public health initiatives and preventive education.” While these goals were SAPped by the IMF in many countries, they remained the basis for the Cuban system, which emphasized the provision of health care to poor communities.
The Cubans also revolutionized medical education. Since the 1990s, medical students have done a 3-year residency in family medicine prior to specializing. Instead of the Flexnerian model used in the US and elsewhere, the program of study that continues to include classroom instruction is combined with an extensive program of experiential learning in which students apprentice to experienced doctor/teachers attending to patients in family medicine settings right from the start. The content of the curriculum (which makes use of DVDs and other technology) remains the same as elsewhere, but is combined in novel interdisciplinary courses. Throughout, the curriculum includes a Community Health and Medicine component, which involves such subjects as the history of health, epidemiology and hygiene, community intervention and health analysis, Latin American political thought, medical ethics, community rehabilitation, administration, disaster medicine, and the principles of medical research. Cuba’s Latin American School of Medicine (Escuela Latinoamericana de Medicina, or ELAM), opened in 1999 and now trains students from over 20 countries, most from poor families, who are expected to return to work in their communities. Nurses and other medical professionals receive similar community-based instruction.
Doctors often do residencies in community medicine in poor countries. Cuba sends large numbers of doctors, nurses, and other medical specialists to work in countries around the world – 185,000 worked in 103 countries through 2008. These professionals go abroad for shorter-term disaster relief efforts (the highly experienced Henry Reeve Medical Brigade) and longer-term (usually two years at a time) efforts aiding in the development of the primary health care systems of other countries. Cuban medical specialists, who’ve been working in Haiti for years and, as noted above, were among the most important responders after the 2010 earthquake are now helping Haiti (re)build its health care system.
Cuban medical personnel have been central to Venezuela’s efforts in this direction. Articles 82-86 of Venezuela’s popular 1999 constitution guarantee the right to proper medical care. From the beginning of the century, and financed with oil revenues after 2003, the government began building a network of social missions to improve conditions and avenues for participation for poor and working people, urban and rural. The massive social spending on these projects operated in the context of substantial reductions in inequality:
Among the many non-cash sources of income supplied through the social missions and not accounted for in assessing income redistribution are free health care, free education programs, free food for millions of children at school and the most impoverished adults, heavily subsidized food available at more than 15,000 Mercal food stores, tens of thousands of free neighborhood recreation and sports programs, free housing grants or interest-free loans, and free work-training programs. In addition there are a great many public works that often benefit poor and working-class people more than the rich, such as the new subway and bus lines added to the Caracas public transportation system. (KL 1142-1146).
Central in the social missions has been Barrio Adentro, which began delivering primary care in poor areas throughout the country in 2003. Through this system doctors (as well as dentists, nurses, sports specialists, and other medical professionals) go to live and work in poor communities – the name means “inside the neighborhood.” Barrio Adentro has consisted of four phases: the creation of a network of clinics for primary care, the formation of a network of secondary clinics, improvements to the existing hospitals, and the building of a set of hospitals specializing in research into and treatment of special problems.
The community health program got off to a slow start in Venezuela, but received a shot in the arm with the arrival of thousands of Cuban medical professionals. Hosted – and often guarded – by local health committees, the doctors lived in sparse and difficult conditions among the communities they served, working long hours and continuously available to serve people’s medical needs. According to Brouwer, “Their services are available to all Venezuelans for free at almost 7,000 walk-in offices and over 500 larger diagnostic clinics, and they have been very effective in meeting the needs of 80 percent of the population that had been ill-served or not served at all by the old health care system” (KL 158-162).
But the Cuban doctors have done more than provide primary care. They've helped Venezuela to construct its own system of health care through teaching, training, and mentoring thousands of Venezuelan medical students. Through the Comprehensive Community Medicine program (Medicina Integral Comunitaria, or MIC), medical students are taught and trained in their home communities by experienced doctors. The Venezuelans, who study for six years in the methods developed in Cuba, followed by a two-year residency in community medicine, will replace the Cuban workers.
Medical education is part of a broader effort at enhancing access to education at all levels. Through Mission Sucre, for example, people have been able to study a range of fields at the university level. As medical students are instructed in the “socio-medical sciences,” so social science students study community issues, including public health problems:
[E]very student who is matriculating in social science has to work as part of a team that identifies a problem or concern of a local community. Aside from their conventional course work, the student’s team has to build their final thesis around a problem identified in meetings with this community, then researches the social science literature for analysis of this particular problem, and concludes with written and audiovisual material that suggests possible solutions for the community (KL 2207-2210).
Through ALBA (the Bolivarian Alliance for the Peoples of the Americas, which includes Venezuela, Bolivia, Ecuador, and Nicaragua), the Cuban/Venezuelan model continues to spread in Latin America and the Caribbean as well as Asia and Africa. Brouwer reports that
Fidel Castro, speaking at the first graduation of doctors from ELAM in 2005, announced the solution: Cuba and Venezuela were going to join forces to educate 100,000 more doctors over the next ten years: 30,000 Venezuelans, 60,000 coming from other countries in Latin America and the Caribbean, and another 10,000 from nations in Africa and Asia.
The community medicine and experiential-tutorial methods developed in Cuba and Venezuela are spreading to other countries, notably Bolivia. Connected to this, Miracle Mission (Misión Milagro), funded by Venezuela, has provided free eye surgeries to more than a million and a half people throughout the region.
Brouwer offers statistical evidence of the effectiveness of these programs, at home and abroad. As noted above, though generally invisible in the corporate media, the Cubans’ key role in disaster relief efforts like the humanitarian responses to Hurricanes George and Mitch in 1998 and the Haitian earthquake in 2010 is recognized by many.
Despite brief declines during the “Special Period” of the mid-1990s, and despite a lack of resources, Cuba’s domestic health statistics have continued to improve:
Cuba’s egalitarian medical system is the envy of most developing countries, and many developed nations as well. Its medical performance, as measured by global statistical standards such as infant and child mortality rates and adult longevity, bears this out, as does an educational system that has been able to produce more physicians per capita than any other nation on earth. By 2009, Cuba had 74,880 physicians, or one doctor for every 150 citizens, compared to one for every 330 in Western Europe, and one for every 417 in the United States. (KL 752-756).
Cuba has twice as many doctors per capita as the US, and “[a]s of 2008, there were twenty-five medical schools in Cuba, and 29,000 Cuban students of medicine, who were just a small fraction of the 202,000 students enrolled in all medical fields, among them dentistry, nursing, medical technology, and rehabilitation.”
The old system still exists for the 20% of Venezuela's population that can afford it, but When Chávez was elected in 1998, more than two thirds of the population - 17 million people - lacked access to regular medical care. Half of the population was living in poverty (the lower fifth in extreme poverty), childhood malnutrition was a major problem, and higher education was out of reach for large numbers of people. According to Brouwer:
The increased medical attention paid off quickly in human terms during the first ten years of the revolution, as infant mortality fell from 19 to 13.9 deaths per 1000 live births between 1999 and 2008 and the mortality of all children under five fell from 26.5 to 16.7. Postneonatal mortality was cut by more than half, falling from 9.0 to 4.2 deaths per 1000 live births. The life span of the average Venezuelan increased by 1.5 years between 2000 and 2009.
The number of students in higher education has tripled since 1998 (“[S]ome of the most popular [fields of study] are social science, computer science, agro-ecology, law, nursing, sports training, scientific technology, and education”). There have been similar advances in Nicaragua and Bolivia in health, literacy, and education.
Brouwer says that the major participants and many leaders in the local health committees along with other neighborhood organizations are women, and that this participation has been enabling and encouraging women to be politically active and involved. Almost three quarters of the students in MIC are women (many with extensive family obligations), and Brouwer suggests that the Cuban doctors (since 1999 more than half of Cuban doctors have been women) have served as role models.
These systems have promoted, amongst medical workers, students, and communities, an appreciation of the environmental and social character of health and illness, and made them more able to address these problems and to participate in public health campaigns (as students have done with vaccinations, removing breeding areas for disease-carrying mosquitoes, and sex education). Brouwer also talks about a “general rejuvenation of the internationalist and revolutionary spirit in Cuba” stemming from these efforts (KL 1886-1887).
He suggests that “both nations have gained considerable respect from many other countries and international organizations, not only for the very real accomplishments of their programs, but also for the generosity, dedication, and competence demonstrated by individual doctors, nurses, teachers, and technicians” (KL 2974-2976). Other countries have been inspired to start similar programs, and to cooperate with their efforts (e.g., last year the Australian government announced that it would join with Cuba to work in Haiti and East Timor).
The success and public support gained by these efforts have enabled them to withstand organized opposition. Efforts in Honduras and Guatemala were initially threatened, then earned the praise of even some in the upper classes following public protest to keep them going, and have been promoted under more welcoming leadership. They came under attack again, however, after the coup in Honduras:
In the aftermath, soldiers harassed medical staff and threatened to close down the Garifuna hospital. The founder of the hospital, Dr. Luther Castillo, who had been the first Garifuna to graduate from ELAM, had to go into hiding to escape persecution and was forced to abandon the country. In 2010, he served as the coordinator of the first large contingent of ELAM graduates in the Henry Reeve Brigade when they rushed to Haiti to serve as medical volunteers after the earthquake. In Guatemala, the Cuban presence also provoked controversy and considerable opposition from right-wing elements (KL 718-722).
The rightwing opposition has been equally active in Venzuela and Bolivia:
In 2008, ORVEX, the Organization of Venezuelans in Exile, which was funded by rich expatriates in Miami, managed to issue the most outrageous reaction when it released a short film titled La Universidad del Terrorismo Patrocinada por del Gobierno de Venezuela. According to this piece of disinformation that appeared on YouTube, “a university of terrorism” had been created at the Latin American School of Medicine (ELAM) in Havana, where terrorist doctors were being prepared to attack the entire Western Hemisphere under the patronage of Hugo Chávez and the Venezuelan government. These verbal assaults on Barrio Adentro and Cuban medical training were accompanied by the refusal of some cities and states, still under the control of the political opposition, to allow the deployment of Barrio Adentro physicians (KL 2415-2421).
When Cuban doctors started treating the impoverished Bolivian majority, there were negative responses from local elites and protests from the Bolivian medical association that were similar to defamatory campaigns mounted in Venezuela and other parts of the Americas. They either disparaged Cuban doctors as inept, unqualified practitioners who could only disrupt health care delivery or portrayed them as immensely clever political/military agents who would brainwash the public with communist propaganda. Within a few months, as word of the quality of care circulated among grassroots communities, this kind of criticism dissipated. It was followed in some areas, such as the wealthy department of Santa Cruz, by direct actions by right-wing political forces that were assisted in their anti-government and separatist activities by officials and contractors of the U.S. State Department. Some with violent tendencies, emboldened by this support, decided to mount physical attacks on Cuban medical personnel.
As the above suggests, “local” opposition has been supported and encouraged by the US government. I’ve written about US interference in the region and its “war on ideas” propaganda many times before, but little could be more revealing of the callousness and cynicism of those in power in this country than the government’s actions in the context of these effective humanitarian efforts.
After refusing entry to the 1500+ of the highly trained Henry Reeve Brigade ready to fly to the Gulf Coast to aid in disaster relief after Hurricane Katrina in 2005 (a month later the Brigade flew to Pakistan following the earthquake there), in 2006 they tried to disrupt Cuban efforts abroad through the Cuban Medical Professional Parole Program, “a law specifically designed to lure Cuban doctors, nurses, and technicians away from their foreign assignments by offering them special immigration status and speedy entry into the United States” (KL 192-195). (Brouwer suggests that this has proved largely futile, that the percentage of people not returning to Cuba has been consistently very low, and that this small number is overwhelmed by the numbers willing to replace them or to serve on subsequent postings.) In 2008, the US embassy in Bolivia attempted to recruit Peace Corps volunteers and Fulbright scholars to spy on Cuban and Venezuelan doctors and other humanitarian workers.
Unlike in Honduras, the US-supported coup attempts in Venezuela and Bolivia have not been successful. In Haiti, though, after the kidnapping of Aristide, “The U.S. Marines overran the new Aristide medical school, chased out the doctors and students, and used the facility as their military headquarters. The medical school would remain closed until the spring of 2010, when, with aid and personnel supplied by ALBA, classes began once again” (KL 2930-2932).
Brower describes the shadowy government and corporate entities involved in US propaganda and other destabilization efforts. It would be one thing to suggest that these medical and humanitarian projects are themselves used as propaganda by the governments involved (which wouldn’t, of course, preclude real humanitarian commitments). But to try to discredit, sabotage, and shut down programs that are bringing desperately needed medical care to millions of poor people and training hundreds of thousands of medical professionals is despicable.
Brouwer offers a well-written and informational account - some sources better than others - including firsthand observations and perspectives from those involved (though perhaps too few and a bit superficial). I have some criticisms, though. First, the distinction he makes between the Cuban and capitalist (which he sometimes calls "European" models is rather strange. It holds for the US, but many European countries have health care systems that resemble the Cuban model in important ways. Second, to say that Brouwer is sympathetic to these governments would be an understatement. He does make a few criticisms, but the problems he notes explicitly – bureaucracy and low-level corruption – minimize the larger problems with the Cuban system especially, to which he barely alludes. He quotes Cintio Vitier - “a trench is not a parliament” – in suggesting that the embattled governments, due to hostility from without, haven't previously been able to realize a socialism characterized by the level of openness they would otherwise wish. While it is true that these movements and governments have been embattled, this by no means accounts entirely for the authoritarianism of the Castro regime (and would by no means justify it if it did), supposedly now able to begin to return to a more “authentic” socialism. The problems with Marxism as a political program were there from the start, and Brouwer’s own quoting of Chávez quoting one of Kropotkin’s letters to Lenin from 1920* shows that the best of what is now happening is a new flourishing of anarchist practices that had been marginalized, violently or otherwise, during the twentieth century (indeed, Kropotkin’s “Appeal to the Young” is likely as relevant as Guevara’s work). It is unnecessary and probably counterproductive (even in a continuing trench situation) to idealize things in this way. These programs are humanistic and effective. They are saving lives and changing societies for the better.
*He describes Chávez “explaining that socialism had to be a liberating process that allowed poor and working people to be the protagonists in building a new society and pursuing their own self-development. In one nationally broadcast talk in 2009, he quoted from a letter that the famous Russian anarchist, Peter Kropotkin, wrote to Lenin: ‘Without the participation of local forces, without organization from below by the workers and peasants themselves, it is impossible to build a new life’”(KL 3307-3311).
