Sunday, January 27, 2008

Shaquille and Haiti

Shaquille O'Neal is the center for the Miami Heat. Almost everyone knows that.

Shaq lives 90 minutes by air from the man and his son pictured above who are homeless on the streets of Haiti. Hardly anyone knows that.

Shaq's messy divorce proceedings and his checkbook were recently revealed.

Shaq's MONTHLY expenditures:

* $156,116 on mortgages
* $110,505 on vacations
* $60,417 on gifts
* $26,560 on babysitters
* $24,300 on gasoline
* $22,190 on maids
* $17,220 on clothes
* $12,775 on food
* $500,000 on income tax

Comparing those who have the most to those who have the least (and are very close neighbors in this hemisphere) is painful. (See Miami Herald article.)

Neither individual, Shaq nor the homeless Haitian man, are benefiting from their economic situations. I doubt either man is a "bad" man.

The inequity and the problems of what too little or too much cause is what is bad.

Saturday, January 26, 2008

It Really Doesn't Have To Be This Tonya Sneed

On 1/26/08, Tonya Sneed wrote:

January 26 is forever etched into my mind. Today is the anniversary of my cousin's death. I still remember where I was when I got the phone call from my mom. Jim was standing next to me in the lobby of my college dorm. I remember the shock, the unbelievable-ness of it all, taking pills to help myself sleep. I knew how deeply this affected her parents. I know how deeply it still affects them. No one can ever know the measure of their suffering.

Ya know, the Buddhists say that life is suffering.

Death and suffering are things that I never can quite get my arms around. I don't want to. Don't want to accept it as a natural part of life. It's too unnatural. That we are just here for this brief moment and then we're gone. I can't grasp that. That some people and animals spend most of that brief moment, even all of it, suffering, makes me feel insane in those dark moments when I try to ponder it. So I try not to ponder it. But I can never pretend for long. The darkness always comes back.

I suppose it's my own internal struggle against the forces of suffering and death that have led me to the causes that I now actively support. Animal rights, death penalty abolition, anti-war movement, etc., are all very much anti-death and anti-suffering endeavors. Indeed, even reforestation in Haiti is an anti-death effort. It is an attempt, however feeble, to create a world of life-giving trees.

Wednesday night Jim got upset as he told me about a picture of an Iraqi woman in the paper. She has her head in her hand and is crying, after having waited 3 days in line for gasoline for heating. It's cold in Iraq, and she's still in line, wearing these house slippers. There are U.S. soldiers with their maddening weapons stand next to her. It's an awful photo -- am surprised the A.P. let us see it. Jim said to me, "Tonya, it doesn't have to be this way! It doesn't have to be this way!"

I agree with him. I'm mad, too. But the moment reminds me why I love him so much. His ability to empathize, to see things from others' perspectives, is a rare and beautiful, though often painful gift.

This week we learned that Dhiaa's father was injured in a car accident -- he broke his leg when someone rammed his car just because Dhiaa's father is Shi'a. Dhiaa insists that before the war, being Shi'a or Sunni was a non-issue. In fact, his mother is Sunni. I learned the same lesson from an Iraqi woman who risked her life to come to the U.S. a couple of years ago. She told us that the Shi'a and Sunni regularly intermarried before the war. And, the blog Baghdad Burning attests to this. What we have in Iraq is business as usual by the U.S. military. Divide and conquer.

Thank you, all of you, for your efforts against suffering and death. It really doesn't have to be this way. I hope that together we can construct a different kind of world where hugging and dancing (did you get to see the You Tube video?) and sharing and justice and peace and the magical forces of love reign.


"The trouble is that once you see it, you can't unsee it. And once you've seen it, keeping quiet, saying nothing, becomes as political an act as speaking out. There's no innocence. Either way, you're accountable."

---Arundhati Roy

Friday, January 25, 2008

State of Denial

See comments at the bottom of Mud Pies in Soleil.

See article below from the Miami Herald.

Posted on Tue, Jan. 29, 2008

Poor Haitians resort to eating dirt

It was lunchtime in one of Haiti's worst slums, and Charlene Dumas was eating mud. With food prices rising, Haiti's poorest can't afford even a daily plate of rice, and some take desperate measures to fill their bellies. Charlene, 16 with a 1-month-old son, has come to rely on a traditional Haitian remedy for hunger pangs: cookies made of dried yellow dirt from the country's central plateau.

The mud has long been prized by pregnant women and children here as an antacid and source of calcium. But in places like Cite Soleil, the oceanside slum where Charlene shares a two-room house with her baby, five siblings and two unemployed parents, cookies made of dirt, salt and vegetable shortening have become a regular meal.

"When my mother does not cook anything, I have to eat them three times a day," Charlene said. Her baby, named Woodson, lay still across her lap, looking even thinner than the slim 6 pounds 3 ounces he weighed at birth.

Though she likes their buttery, salty taste, Charlene said the cookies also give her stomach pains. "When I nurse, the baby sometimes seems colicky too," she said.

Food prices around the world have spiked because of higher oil prices, needed for fertilizer, irrigation and transportation. Prices for basic ingredients such as corn and wheat are also up sharply, and the increasing global demand for biofuels is pressuring food markets as well.

The problem is particularly dire in the Caribbean, where island nations depend on imports and food prices are up 40 percent in places.

The global price hikes, together with floods and crop damage from the 2007 hurricane season, prompted the U.N. Food and Agriculture Agency to declare states of emergency in Haiti and several other Caribbean countries. Caribbean leaders held an emergency summit in December to discuss cutting food taxes and creating large regional farms to reduce dependence on imports.

At the market in the La Saline slum, two cups of rice now sell for 60 cents, up 10 cents from December and 50 percent from a year ago. Beans, condensed milk and fruit have gone up at a similar rate, and even the price of the edible clay has risen over the past year by almost $1.50. Dirt to make 100 cookies now costs $5, the cookie makers say.

Still, at about 5 cents apiece, the cookies are a bargain compared to food staples. About 80 percent of people in Haiti live on less than $2 a day and a tiny elite controls the economy.

Merchants truck the dirt from the central town of Hinche to the La Saline market, a maze of tables of vegetables and meat swarming with flies. Women buy the dirt, then process it into mud cookies in places such as Fort Dimanche, a nearby shanty town.

Carrying buckets of dirt and water up ladders to the roof of the former prison for which the slum is named, they strain out rocks and clumps on a sheet, and stir in shortening and salt. Then they pat the mixture into mud cookies and leave them to dry under the scorching sun.

The finished cookies are carried in buckets to markets or sold on the streets.

A reporter sampling a cookie found that it had a smooth consistency and sucked all the moisture out of the mouth as soon as it touched the tongue. For hours, an unpleasant taste of dirt lingered.

Assessments of the health effects are mixed. Dirt can contain deadly parasites or toxins, but can also strengthen the immunity of fetuses in the womb to certain diseases, said Gerald N. Callahan, an immunology professor at Colorado State University who has studied geophagy, the scientific name for dirt-eating.

Haitian doctors say depending on the cookies for sustenance risks malnutrition.

"Trust me, if I see someone eating those cookies, I will discourage it," said Dr. Gabriel Thimothee, executive director of Haiti's health ministry.

Marie Noel, 40, sells the cookies in a market to provide for her seven children. Her family also eats them.

"I'm hoping one day I'll have enough food to eat, so I can stop eating these," she said. "I know it's not good for me."


© 2008 Miami Herald Media Company. All Rights Reserved.

Haitians, Pregnancy, and HIV...What can be Done? Alot.

Please see the article below. This article is not addressing the pregnant patient with obvious HIV. This article is about ACUTE HIV in pregnant women and what can be done about it.

Rates of perinatal tranmission of HIV in the United States have decreased from >25% before 1994 to <2% in 2006. This is due to the use of maternal antiretroviral treatment and infant prophylaxis.

The HIV scourge for Haitian newborns could be diminished dramatically with better effort to screen their mothers.

Detecting Acute HIV Infection During Pregnancy

Five pregnant women with acute HIV infection were identified at publicly funded testing sites in North Carolina and subsequently treated; none transmitted HIV to their infants.

Prevention of mother-to-child HIV transmission has been a major success in the U.S. However, a small number of infants still are born infected in this country each year. To address this problem, the CDC has renewed its efforts to ensure that all pregnant women are tested for HIV antibodies (ACC Oct 6 2006), but, even if this strategy is fully implemented, cases of acute HIV infection will still be missed. Now, researchers describe the detection of acute HIV infection among pregnant women in North Carolina, where nucleic-acid amplification testing was added to standard antibody testing at publicly funded sites in 2002 (for more details on this testing strategy, see ACC May 11 2005).

From November 2002 through April 2005, 187,135 women were tested for HIV at such sites. Of these women, 443 (0.2%) were found to be HIV infected; most were black and were probably infected heterosexually. Fifteen of the women had acute HIV infection (i.e., were HIV-antibody negative but HIV-RNA positive) at the time of testing, including 5 who were pregnant (median, 15 weeks’ gestation; median viral load, 88,787 copies/mL). Antiretroviral therapy was prescribed for all five women within 14 days of diagnosis. Four of the women were adherent and had viral loads <400 copies/mL at delivery; the other woman had a viral load >40,000 copies/mL at delivery, necessitating a cesarean section. None of the infants tested positive for HIV DNA during the first 4 to 6 months of life.

Comment: In this study, 3.4% of women with newly diagnosed HIV infection were acutely infected, and one third of these women were pregnant at the time of diagnosis. The cost of adding HIV RNA testing to antibody testing was minimal: $3.63 per specimen tested. North Carolina has taken the lead in implementing a new approach to HIV testing that has proven to be effective. Isn’t it time for all states to start doing the same thing?

— Carlos del Rio, MD

Published in AIDS Clinical Care January 18, 2008

Patterson KB et al. Frequent detection of acute HIV infection in pregnant women. AIDS 2007 Nov; 21:2303.

Thursday, January 24, 2008

Culture of Death

Was Henry Hyde debating the Partial-Birth Abortion Act or discussing the treatment of Haitians? "Partially-born" human beings and the Haitian people seem to have much in common.

"This is not a debate about religious doctine or even about public policy options.
It is a debate about our understanding of human dignity, what it means to be a member of the human family, even though tiny, powerless and unwanted. We are knee deep in a culture of death...Look, in this advanced democracy, in the year 2000, is it our crowning achievement that we have learned to treat people as things? Our moment in history is marked by a mortal conflict between a culture of life and a culture of death. God put us in the world to do noble things, to love and to cherish our fellow human beings, not to destroy them. Today we must choose sides.

---Henry Hyde during House floor debate on the Partial-Birth Abortion Ban Act, 2000.

Friday, January 18, 2008

The Tormented

"We must always take sides. Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented."

--Elie Wiesel

Haitians Equal Courage

Jhiny is 13 years old and was born with heart disease.

Jhiny, her mom, and brothers and sisters (all eight of them) live in a tiny one room cinder block house in Port-au-Prince.

They have no stove, running water, or toilet. They have occasional electricity when the State of Haiti turns it on.

Jhiny has gone to school for seven years with her sick heart. She is an excellent student.

Jhiny speaks and writes French and Haitian Creole.

Jhiny came to the United States without any family members or friends. She speaks very little English.

Jhiny is polite and industrious. Her host family in the United States love her.

Last night Jhiny spoke with confidence about her date today with the Bard-Parker knife.

Early this morning she crawled onto an operating table and went to sleep. Alone.

Her heart was fixed this morning by a very good pediatric heart surgeon and an experienced cardiac team of nurses and perfusionists.

Jhiny is off the bypass pump as I post.

Jhiny is courageous.

Jhiny is Haitian.

(Jhiny is in the blue dress holding her little sister.)

Sunday, January 13, 2008

Should Saint Francis Medical Center Remain Catholic? Part VI

Directive Number 6 of the Ethical and Religious Directives for Catholic Health Care Services:

"A Catholic health care organization should be a responsible steward of the health care resources available to it. Collaboration with other health care providers, in ways that do not compromise Catholic social and moral teaching, can be an effective means of such stewardship."

Therefore, why wasn't Directive Number 6 followed by Bishop Jenky and Monsignor Rohlfs, the OSF Sisters, and OSF-SFMC administration?

When the Diocese lost their nerve regarding "social responsibility" for sick and dying Haitian Hearts children, why did the Diocese not "collaborate" with other children's hospitals around the U.S. and Canada and elsewhere, to help us find the kids medical care? Why did OSF not "collaborate" with other medical centers? It would have been very easy to do.

Just because OSF in Peoria wouldn't help these children any longer, did not give the Diocese an out. The Diocese (Bishop Jenky and Monsignor Rohlfs) should have publically stated that Haitian Hearts and the Diocese would collaborate with other medical centers even if OSF did not want to participate. And they could have thanked OSF for what they had done for Haitian children and said that it was time to move on.

But this was just too hard for the Diocese to do. They did not want to embarrass OSF in any way. The Diocese stated in the media that all parties worked in good faith which was obviously not correct. When Monsignor Rohlfs threatened me and stated that the Diocese would come out in the media against me if I filed a petition for a Tribunal Court, this was not good faith on his part. And when Bishop Jenky told me that I needed to come to confession to him for "killing 18 Haitian children" if I pursued the Tribunal Court, this did not seem to be in good faith either.

And Catholics wonder how the church sex abuse scandal happened over the past 50 years??

Finally, Directive Number 9 states:

"Employees of a Catholic health care institution must respect and uphold the religious mission of the institution and adhere to these Directives. They should mantain professional standards and promote the institution's commitment to human dignity and the common good."

OSF has fallen short of this Directive also and our Catholic Diocese is a big part of the problem.

Friday, January 11, 2008

Tuesday, January 08, 2008

Should Saint Francis Medical Center Remain Catholic? Part V

The Bishop's Synod of 1971 summed up the reason for the church's intense concern for matters of social justice:

"Action on behalf of justice and participation in the transformation of the world fully appear to be a constitutive dimension of the preaching of the Gospel, or, in other words, of the church's mission for the redemption of the human race, and its liberation from every oppressive situation."

The Ethical and Religious Directives for Catholic Health Care Services (Directives) place great emphasis on social justice. The Directives have set forth several principles:

1. Sacredness of Life: Catholic health care is dedicated to promoting human dignity and the sacredness of life, from the moment of conception until death. Derived from this principle is the right to life and the right to protect it through adequate health care. In the bishops' view, this first principle is not a religious principle; that is, it is not derived primarily and fundamentally from the teaching of Christ, though it is certainly in accord with that teaching. The principle is based on human experience and human reason.

2. The Option for the Poor: The second principle, to have "an option for the poor", is derived primarily from the teaching and tradition of the church. Indeed the Directives refer to caring for the poor as "a biblical mandate".

How is OSF-SFMC following the Directives when they:

1. Refuse to accept Haitian Hearts patients that were operated at OSF in the past and need repeat surgery, even when full funding or partial funding is offered for their care? Where is responsible stewardship exercised while Haitian children are dying during OSF's 500 million dollar campus renovation in Peoria?

2. Delayed surgery of at least one Haitian child that was in Peoria awaiting surgery?

3. Attempted to divert funds dedicated for Haitian children to OSF-Children's Hospital of Illinois?

Where is "social justice" here?

Where is the Catholic Diocese of Peoria? When Monsignor Rohlfs was notified that I felt Haitian surgery was delayed on a Haitian baby that suffered a cardiac arrest with his host family in the Peoria area, Monsignor Rohlfs looked unconcerned and asked me to "let me know if it happens again..."

Should Saint Francis Medical Center remain Catholic?

Monday, January 07, 2008

Should Saint Francis Medical Center Remain Catholic?--Part IV

In the last 15 years the Catholic Diocese of Peoria has been faced with circumstances that have been truly difficult for them.

OSF-SFMC pushed the Diocese hard to allow oral contraceptives to be written by OSF physicians under the guise of "limited private practice". This was presented by OSF Corporate Ethicist Joseph Piccione and others from OSF. Monsignor Steven Rohlfs and Bishop John Meyer were involved in making the decison.

What does "limited private practice" mean? Under this plan agreed upon by the Diocese and OSF, an OSF physician can write oral contraceptives when he/she suddenly is no longer an employee of OSF while he writes the prescription on his own prescription pad. This supposedly puts a "firewall" between the oral contraceptive and OSF. This plan is hard to believe by most people that hear about it for the first time, but functions in OSF facilites throughout the Midwest. Keeping OSF financially sound drove the plan in the 1990's when Mr. Piccione was hired by OSF.

When the Diocese and OSF go to such extremes regarding an issue so sacred and important to the Catholic Church (oral contraceptives), I do not believe it is difficult for OSF or the Diocese to ignore dying Haitian children.

The Ethical and Religious Directives intent is not to find ways around Humane Vitae or the teachings of the bible regarding the poor.

The Collection of Selected Readings referenced below states the following:

"If a Catholic health care facility were to fail to adhere to the Directives, it might lose its identification as Catholic. That is, if the Directives are not observed, affiliation with the Catholic Church in a particular diocese could be withdrawn by the diocesan bishop. Because some Catholic health care facilities are actually owned by a diocese or a religious congregation, the loss of Catholic identification could also result in the closing of the facility. In other cases, when the facility is owned by a board of trustees, the trustees might decide to continue to manage the facility even though it would no longer be affiliated with the Catholic Church."

(From Ethical and Religious Directives for Catholic Health Care Services: Seeking Understanding--A Collection of Selected Readings. The Catholic Health Association.)

Should Saint Francis Medical Center Remain Catholic?--Part III

The preamble to the Ethical and Religious Directives states:

The Directives “are concerned primarily with institutionally based Catholic health care services. They address the sponsors, trustees, administrators, chaplains, physicians, health care personnel, and patients or residents of these institutions and services.”

Therefore the Board of Directors at OSF, administrators at Saint Francis Medical Center (SFMC), chaplains at SFMC, and the ethicists at SFMC and OSF Corporate, and the OSF legal team, are all being called upon to follow the norms in the Directives.

Individuals at OSF included in the above would include Doug Marshall who is OSF’s attorney. Mr. Marshall has written that OSF-SFMC will not accept Haitian Hearts patients. Keith Steffen is OSF-SFMC CEO and Paul Kramer, Executive Director of Children’s Hospital of Illinois, acted in ways that were not supportive of sick Haitian children. Mr. Kramer delayed surgery in Peoria and also called the American Consulate in Haiti. OSF ethicists Joseph Piccione and Gerald McShane sent mixed messages or no messages supporting Haitian children in need of heart surgery.

As the source referenced below states, if the above named individuals to not want to follow the norms of the Directives, they are free to disaffiliate from the Catholic institution if they think their consciences would be violated.

The Catholic bishops state:

“The dialogue between medical science and Christian faith has for its primary purpose the common good of all human persons.”

In Peoria’s situation, the Directives have not been promulgated by Bishop Daniel Jenky. With this weakness, OSF-SFMC has been allowed to ignore certain aspects of the good will and good actions that the Directives implore be done by Catholic health care facilities.

Should Saint Francis Medical Center remain Catholic?

(From Ethical and Religious Directives for Catholic Health Care Services:Seeking Understanding--A Collection of Selected Readings. The Catholic Health Association.)

Friday, January 04, 2008

Should Saint Francis Medical Center Remain Catholic?--Part II

The Order of Saint Francis (OSF) advertises their Mission statements in the secular press and repeats these statements at many retreats and orientations given their thousands of employees.

Jesus is the one sent by God who came to reestablish God’s reign among all peoples. In Luke’s account of the Gospel, Jesus outlined what being God’s Mission in the world required of him by applying the words of the prophet Isaiah to himself: “The spirit of the Lord has anointed me and has sent me to proclaim good news to the poor, release to the captives, recovery of sight to the blind, liberty to the oppressed, to announce the year of the Lord’s favor.” (Lk 4:18-19).

Everything that Jesus did, that is, his ministry, was done as a means of making the substance of this declaration reality. Although his actions focused often on the physical needs of person, the effect of his activities in response to these needs had an impact and importance beyond mere intervention in the physical realm.

When Jesus cured the woman suffering from hemorrhage, for example, he did more than restore an individual to physical health. Through his interaction with the woman and the manner in which he healed her, Jesus declared to the community that had cast her out because of her affliction that the reign of God is inclusive of all persons without distinction.

Haitian patients are very similar to this biblical woman. Haitians have been marginalized by the world and suffer in every way possible. If Saint Francis Medical Center (SFMC) in Peoria were helping them, rather than ignoring them, SFMC would reveal that their mission was the same as Jesus. Those that have been excluded would be included. The ministry of Catholic health care facilities is charged to treat the marginalized and those that are bleeding.

The Ethical and Religious Directives seek to proclaim in contemporary terms those attitudes and behaviors that are most consistent with furthering God’s reign of love and justice (e.g., regard for the dignity of the person and the inviolability of innocent human life…)

Should Saint Francis Medical Center remain Catholic?

(From Ethical and Religious Directives for Catholic Health Care Services: Seeking Understanding— A Collection of Selected Readings— The Catholic Health Association of the United States)

Should Saint Francis Medical Center Remain Catholic?

Should Saint Francis Medical Center (SFMC) remain Catholic? What distinguishes Saint Francis as a Catholic medical center?

I went to mass yesterday at the OSF chapel on Jan 1. I think the OSF chapel is one of the most beautiful churches in Peoria.

But is SFMC truly acting like a Catholic medical center? Is it following the Ethical and Religious Directives for Catholic Health Care Services?

OSF is not caring for Haitian Hearts patients and they are dying.

The Ethical and Religious Directives for Catholic Health Care Services is the current official statement of ethical directives for the provision of health care in Catholic facilities in the United States.

The Directives were approved by the United States Conference of Catholic Bishops (USCCB) and the USCCB recommended their implementation by diocesan bishops. The Directives were written with the collaboration among the U.S. Catholic bishops, Catholic health care leaders, theologians and ethicists, and the Holy See (the Pope).

The Directives are a set of principles that inform the provision of health services under Catholic sponsorship. They are conclusions drawn from a faith-inspired vision of the human person and the experience gained from providing holistic health care.

We need to remember that the goal of the Directives is to promote consistency between what is done under the auspices of Catholic sponsorship and church teaching on moral matters as these relate to the provision of health services.

Taking care of the poor is emphasized by the Directives. SFMC has rejected Haitian children and young adults that were operated at OSF in the past and now need repeat surgery.

It seems very clear what the Directives would say about caring for Haitian Hearts patients? Would the Directives advise Saint Francis Medical Center to remain a Catholic health care facility?