Archive for June, 2008|Monthly archive page

Is this gift returnable?

I gave an impromptu lecture to a class full of medical students about the American health care system a couple of weeks ago. The biggest reaction seemed to be their disbelief that there is no legal right to health care in the American constitution. Government obligation to health care is part of Argentina’s constitution and the country has also committed to a number of human right declarations and treaties. Continue reading

It’s a beautiful day in the neighborhood

The sun is shining and today is almost warm enough to walk around in only 2 layers. However, you walk to the center of town on Avenida 7 and the street is blocked. Last night, ruralistas, or people from the countryside in the province of Buenos Aires basically set up camp in the street last night. Burning tires provided some warmth and a few were cooking dinner for the many families that were sitting crowded together in bus shelters. Others seemingly impervious to the cold where yelling and waving large handmade fabric signs. I counted at least 6 different organizations that were standing in protest. The larger question last night was why all of the people had made the journey into the city to sleep in the cold amid the smell of burning rubber.

It turns out that the la presidenta de la nación de Argentina, Cristina Fernandez de Kirschner is in town today supporting a new provincial law or something to that effect. The ruralistas are demanding that the government reconsider social plans for the poor that include social welfare programs related to food and work among other essential needs. Until the government agrees, the ruralistas basically intend to hold Avenida 7 hostage. Just to paint a picture, Avenida 7 is THE primary artery through the center of the city. The blockage has almost paralyzed the town and there are riot police out in full protective gear, shields and batons included.

It’s hard to discount the ruralistas’ argument; they want to feed their families and they want work. Both are in short supply for them. I found myself blaming the government for not providing for its own people. After all, for the first two months that I was here, the news was consumed with a strike/standoff between the federal government and the heads of agricultural production. The government wanted to raise taxes on the soy farmers. Argentina is the world’s third most important exporter of soy and profit margins have been growing virtually exponentially in recent years.

Only in the last few days has the president offered a package of social works dedicated to reducing poverty and providing other social services. I think that the offer is not going to conciliate all of the people affected by this tax increase. At this point is seems to only be a politically expedient pander designed to clear the roadways and get things back to normal. I have been reading Paul Farmer’s Pathologies of Power lately, which has led me to think about the way that society contributes to the inequality that characterizes poverty and its stubborn endurance. When I see the ruralistas, I know that many of them have lives similar to the patients in Centro No. 13. They are struggling for even the most basic necessities, never managing to get ahead of the curve. Every setback is just another signal that they is no individual, group or institution to back them up and help them. I don’t know if these proposed social programs were the original intent of the tax increase, nor do I know if the government will follow through. I do know that the Argentine government has promised its people to protect their citizens’ human rights in both the national constitution and a number signed conventions and treaties aiming to uphold the Universal Declaration of Human Rights. The historical track record has been a failure to say the least. I can only hoped that things have changed.

Meme: Photo Mosaic

Thanks to Ali for the very cool photo mosaic meme!

1. Vanessa cardui, 2. Indian Spices #3, 3. Red.Petals, 4. Masjid Al-Noor, 5. John Legend 2.0, 6. Jack Daniel’s, 7. World Beer Caps, 8. Strawberry Shortcake, 9. citadel of women, 10. The Joy of Life, 11. The Great Escape, 12. In Hoc Signo Vinces

Here’s how to make one yourself:

a.) Type your answer to each of the questions below into Flickr Search.
b.) Using only the first page, pick an image.
c.) Copy and paste each of the URLs for the images into the fd’s Mosaic Maker.

The Questions:

1.) What is your first name?
2.) What is your favorite food?
3.) Where did you go to high school?
4.) What is your favorite color?
5.) Who is your celebrity crush?
6.) Favorite drink?
7.) Dream vacation?
8.) Favorite dessert?
9.) What do you want to be when you grow up?
10.) What do you love most in life?
11.) One word to describe you.
12.) Your Flickr name.

Give life 101 – Organ donation!

According to Wikipedia, organ donation is “the removal of the tissues of the human body from a person who has recently died, or from a living donor, for the purpose of transplanting.”

Now that I have written about Sylvia, I started thinking about what a Byzantine process organ donation lists are and how many restrictions there are for both donors and recipients. After a little research, I saw how much misinformation exists regarding the process in the general public. I wanted to show how easy the process is to encourage you to register as an organ donor.

Currently, there are about 98,000 people waiting on the list for an organ. Unfortunately, there are generally not enough donors to meet the demand for organs. About 18 people on average die every day for lack of organs. The lack of organs is especially punitive to minority groups such as blacks and Hispanics because generally the need is greater even though these groups donate at roughly the same rate as other demographic groups.

The list is fairly democratic in nature. A potential recipient’s position on the list is determined by age, severity of medical condition and other biological characteristics. Check out the FAQs below to learn about becoming an organ donor.

Question #1: Will a hospital refuse to treat me to take my organs?

Contrary to urban legend in the United States, a hospital is not going to let you die so that they can harvest your organs. This is a little something called the Hippocratic oath as well as the law that prevents them from doing so. Donation is only proposed after death and in consultation with your family.

Question #2: Does it cost money to register? Does it hurt to register as an organ donor?

There is literally no cost to choosing to become an organ donor. Most if not all states permit you to register as a donor when receiving or renewing your driver’s license. I registered during a organ donation registry drive during college. It is as simple as checking a box and writing your contact information. It’s now even easier to register online. Quick and painless!

Question #3: So I registered as an organ donor. That’s all I have to do right?

Great! I told you that it was super easy! You do need to do one more thing – tell your family that you registered as an organ donor. In some states, their decision can nullify your registration. Other countries such as Spain use an opt-out system rather than an opt-in system. What does that mean in plain English? An opt-out system automatically registers everyone as an organ donor and requires those opposed to donation to register not be a donor; in other words, to opt out of the registry. Generally, rates of participation are higher with an opt-out system rather than an opt-in system. A legislator in Delaware recently has attempted to implement an opt-out system in the state to improve participation. Check out the links below for information about organ donation in your state.

More information: Donate Life America

Organ and Tissue Donation Initiative

Meet Sylvia

I had originally planned to post earlier this week but various issues with my project and work managed to get in the way.

I did want to tell you about what happened at work because I am still trying to wrap my head around it myself. The first few weeks working at the center felt like a blur. There was the obvious language barrier to contend with as many of the patients use expressions that I don’t encounter on a daily basis. They was also the crash course in learning about the patients’ lives that led up to the point that they were sitting in the chair in front of us.

One of those patients was Sylvia. When I first met Sylvia, she had her four year old son with her. It was a rather typical visit; Jorge checked her analysis results and asked how things were going. Her son is pretty gregarious so he would inject at various points. The next time I saw Sylvia was at the weekly group support group that the center offers every Friday. There are two psychologists and a psychiatrist on staff, so patients have ample access to both physical and mental support.

This particular Friday, Sylvia was the only patient and it was also my first time to observe the Friday session. Sylvia’s son was in the room also as she spoke about what had been going on in her life.

Sylvia is a good person that has been born into bad circumstances. Her entire family is addicted to drugs, and she was as well until a few years ago. She lives with her husband, his brothers, and their mother who also all are addicted to drugs. Unfortunately, she doesn’t have enough money to live elsewhere to distance herself from the temptation of the drugs and from the verbal abuse she suffers from her family. Her husband, who she has three kids with, has beaten her in the past. Sylvia also has HIV and hepatitis C.

Until about 6-8 months ago, Sylvia didn’t have custody of her three children. It took months of efforts on her part. While the initial removal of her children from the home was to protect them, Sylvia is a successfully recovering drug addict. (I say recovering because addicts don’t ever stop being addicts; they stop using the substance that they were using.) She has been sober for over 2 years and faithfully takes treatment for HIV and hepatitis C in spite the complete lack of social support from her family. She works whenever she find work. She comes the weekly group support session every Friday. For the two times that she has missed the session, she called to tell the psychologist before the session started.

Despite all of the positive steps that Sylvia had taken, the one obstacle that she faced in regaining custody was the judge assigned to the case. The judge refused to grant custody solely because she had HIV. The judge assumed that HIV was so deadly that Sylvia would die shortly after receiving custody of her children. Legal protection against discrimination due to HIV is fairly robust; however, people living with HIV face challenges in many levels of society and institutions in Argentina.

Now that she has all three of her children back, Sylvia has been taking concrete steps to further improve her life and the life of her children. Her youngest son almost never leaves her side because he is so happy to be with his mother. She has begun legal proceedings to revoke the custodial rights of her husband and initiated divorce proceedings. Once Sylvia is legally independent, she can receive additional benefits from the government so that she will be able to move out of the highly negative environment that she is in.

All of this virtually does not matter because Sylvia is dying. She came to the center on Monday, bringing her latest test results. Her HIV is under control; the hepatitis C is taking its toll and her liver is failing. You could see the jaundice had begun in her eyes that would only get worse. She can be placed on the organ transplant list. Given her medical history, it remains highly unlikely that she would be selected should a matching liver even become available.

This information is hard to reconcile with what I know about Sylvia. She has overcome so much in her life, largely through sheer willpower. On Monday, she behaved as though she knew what was coming, even though Jorge hadn’t said it directly. I am sure that Sylvia will handle it as she has managed every other major burden in her life. She will come to the weekly session this Friday with her youngest son to talk about what she can do to help her children.

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