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Posts Tagged ‘Healthcare System’

The president who brought you No Child Left Behind seems hellbent on doing exactly the opposite; it appears George W. Bush would like to leave millions of children behind. Why else would he veto expanding the State Children’s Health Insurance Program (SCHIP), which currently ”funds insurance for 4 million children in families that earn too much to qualify for Medicaid but too little to buy private insurance?” According to the president, expanding SCHIP is tantamount to “socialized medicine,” which we are supposed to believe is a greater evil than millions of kids going without adequate health insurance. The proposed expansion would have provided coverage for an additional nine million children nationwide but the president’s veto has made sure those nine million children will not be getting SCHIP coverage. For now anyway. Supporters of SCHIP’s expansion are already fighting back.

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During last week’s Miss Teen USA pageant, eighteen-year-old Lauren Caitlin Upton—now better-known as Miss Teen South Carolina—fumbled her way into infamy with a rambling, disjointed, and generally appalling response to a simple question, demonstrating to me that she is neither well-informed nor well-educated. But Caitlin Upton is merely a symptom of a larger problem.

That larger problem, my friends, is that Caitlin lives in a country where knowledge—especially the kind that may be acquired through schooling—is not valued. That’s why the most popular kids in school are never the top students. That’s why the smart kids get picked on. That’s why millions of people who can’t name the capital of Burundi flock to their TVs to watch beauty pageants instead of the international news. And that’s why, as a nation, Americans are woefully deficient in their knowledge of the outside world. Only 21 percent of Americans follow international news closely, while 65 percent admit they lack the background to follow overseas news. Ignorance is part of the American way of life and people like Caitlin Upton merely serve to illustrate this.

Basically, Caitlin’s ignorant because she can get away with it. How else could she have reached the age of 18 without having acquired sufficient English or logic or rhetoric or whatever other foundational skills one needs to answer a question as simple as the one she was asked? Clearly, she’s never had to! She’s pretty, she’s blonde, and that’s enough to have gotten her this far. Her inability to think or articulate opinions is irrelevant to her day-to-day life. As the Young Turks point out, Caitlin took fourth place in the pageant, despite her moronic response!!! Obviously, the message is that nobody cares that this woman is an idiot, as long as she’s pretty. Millions of Americans are getting that message loud and clear.

Caitlin is not unique. She’s not a bad apple or an anomaly or a black sheep. On the contrary, she’s a typical American teenager. Even worse, she’s an archetypal American teenager. She is the American teenager that millions of other American teenagers aspire to be like. And our values do little to help. Beauty pageants are elegant, elaborate affairs that showcase beautiful people wearing exotic costumes. Geography bees, on the other hand, are far less glamorous and receive far less publicity. How many high schoolers would rather win a geography bee than be Miss Teen USA?

Popular culture provides even more prosaic examples. Take country music legend Alan Jackson, for example, who proudly proclaims in a hit song that:

I’m just a singer of simple songs.
I’m not a real political man.
I watch CNN, but I’m not sure I can tell you
The difference in Iraq and Iran.

But country singers are by no means the only Americans who revel in knowing nothing about the outside world. The system is rotten from the top down, and even political figures go out of their way to prove how provincial they are. How many of our political figures can speak a language other than English? How many of them have lived or traveled abroad? In fact, to have done so is considered a political liability. Remember Sen. John Kerry, who challenged George Bush for the presidency in 2004? He caught flack for having lived in Europe, for being a Europhile, and for “looking French.”

Our ignorance of the outside world is not only a part of our way of life, it is an essential component of our very understanding of how we live. Ignorance allows Americans to believe that the US healthcare system is the best in the world, despite studies that rank it far behind those found in other countries. If the majority of Americans don’t even know the names of other countries or where on the map to find them, how can they be expected to know about social and economic systems in those countries? This same ignorance allows us to defend our petroleum-based economy while the rest of the industrialized world is exploring clean and renewable energy alternatives.

Most seriously, this ignorance enabled the Bush administration to successfully conflate Osama bin-Laden’s Al-Qaeda network with all Muslims and all Arabs. Only ignorant people could have been led to believe that a secular Ba’athist like Saddam Hussein would ever collaborate with a theocratic zealot like Osama bin-Laden. Yet this is precisely the argument put forward by the Bush Administration as a pretext for invading Iraq, and the majority of Americans—knowing next to nothing about the Arab and Islamic worlds—swallowed it hook, line, and sinker. Today, the people of Iraq are paying the price for our ignorance and gullibility.

In Caitlin’s case, the worst consequence of her ignorance was humiliation. For millions of other people the world over, the consequences of Americans’ ignorance may be far more dire.

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Today, 50 Sierra Leoneans drowned (100 are still missing) when their boat capsized shortly after hitting rough water at the mouth of the Great Scarcies river. The boat was travelling from the capital, Freetown, to the northern village of Rokupr. Of the undetermined number of passengers who departed the capital, only two have been found alive. Last week, another boat capsized in northern Sierra Leone, killing all 30 people on board. In spite of the shocking casualty figures, I am sure nobody will be held accountable for these disasters. People die, nobody answers for their deaths and nothing is done to prevent future deaths. In this way, Sierra Leone’s leaders continue to get away with murder.

Sure, the boat that collapsed today was—like all other means of motorized transport in Sierra Leone—old and rickety, overloaded with passengers and cargo. Sure, the water was rough where the Great Scarcies, swollen by recent rains, met the Atlantic. And sure, when God calls you, you can’t avoid it. Nonetheless, somebody should take responsibility for all this loss of life. Somebody should be held accountable. Somebody must be punished so that this sort of thing doesn’t happen again. But nobody will be.

Ultimately, no matter how this story is sliced or diced, one thing is certain. The government—the people who are supposed to be responsible for the welfare of the nation—bears responsibility for this catastrophe. But one question will not be asked: “Why were there so many people packed into a rickety, overloaded boat traveling up the Atlantic coast during the rainy season?” The answer is simple. They have no choice.

And why do they have no choice? Because the government has not bothered to try to make sure that people can travel from one part of the country to another without taking  their lives into their hands. And because there is virtually no public transportation network in Sierra Leone. Or in most of West Africa. The old colonial highways (and I use “highway” loosely because these roads are seldom wider than one lane in either direction) are in poor condition, unpaved, bumpy and barely navigable at speeds greater than 20 miles an hour. To go by land, would-be passengers have to cram themselves into . . . you guessed it . . . old, rickety, and overloaded minibuses. Secondly, there are no major roads that run from Freetown due north. Passengers would have to go towards the center of the country and transfer at one of the major junctions. Finally, the transportation system is a neoliberal freemarketeer’s wet dream come true. Drivers only go where there is demand, and the evidence of demand is a full vehicle. Passengers wait, sometimes longer than an hour, until the vehicle cannot hold another person or item of luggage. If you’re traveling from Freetown to another part of Sierra Leone, it doesn’t matter how you decide to get there. Traveling by sea or road is a costly, crowded, and uncomfortable experience. And you may not survive the trip.

Since independence, the country’s infrastructure has slowly been falling apart. Official corruption and public apathy—more accurately fatalism—have resulted in the literal and physical deterioration of every aspect of social life: housing, health care, education, transportation. Everything is falling apart. The recently ended civil war, which raged for a decade and a half, did nothing to improve the situation.

Now the war is over. It’s been over since 2003. And what has this meant for infrastructure in Sierra Leone? Not much, except that the international community has done a good job of rebuilding and refurbishing the main commercial and administrative buildings in the capital’s city center. When I was there last September, my guide pointed out all the buildings that had been rebuilt by the British, the French, the EU, the UN but I didn’t see a single building that had been rebuilt by the Sierra Leonean government.

“But,” I hear you say, “isn’t it a lot to ask of the fragile new administration of a post-conflict-country to invest huge sums of revenue into reconstruction?” Fair enough. But if they can’t or don’t spend money on rebuilding the country, what can or do they spend revenues on? Last time I checked, it was the duty of a government to provide for the wellbeing of its people. Certainly I’m not naive enough to believe that the government must do so out of altruism but the Sierra Leonean government is failing at performing its basic role even if we look at it from purely economic terms. How can the country progress economically without a reliable and comprehensive transportation system, a requirement for even the most primitive systems of trade and commerce?

Besides, not having enough money is no excuse. Isn’t it part of the government’s job to have money? Whether through loans or foreign aid or domestic revenue generation, it is up to the government to generate revenue, which can then be reinvested into the economy. Despite what we hear about the role of government in the US, this is actually how modern, industrialized and—dare I say it—civilized countries function. Sure there’s a role for the market and the entrepreneur and all that good stuff but even the most die-hard advocates of the free market would never claim that the market exists to serve the public good. Entrepreneurs will tell you that they are in the business of seeking profits, not serving the public good. So, if the market won’t do it, who should? I say the government should. Find me one modern, industrialized, civilized country in which the government does nothing to provide for the public good.

Which brings me to my greater point. The government of Sierra Leone does not give a sh*t about the people of Sierra Leone. Since indepencence—46 years ago—Sierra Leone’s leaders (like the leaders of much of the “developing” world) have been busy enriching themselves. Sure, colonialism left homogenous, un-diversified economies throughout sub-Saharan Africa that were dependent on European economies for their survival. And yes, structural adjustments took a grievous toll on social welfare programs in developing countries but the time has come to call a spade a spade. African leaders don’t care about their people. They have never cared about their people. In the ’60s and ’70s, Sierra Leone was a decent place to live, with passable roads, round-the-clock electricity, and running water in the capital (the “provinces” were always a different story).

On my recent trip, however, Freetown had become like the provinces. Roads in the once-affluent western suburbs were now rutted and potholed, the asphalt broken up by tank treads from the days of the war and the soil underneath washed away by rain. Where there were once sidewalks, I saw deep ravines and gullies where water had eroded the soil on the side of the road. In some places, so much of the road had been washed away that two cars traveling in opposite directions could not pass each other along the same narrow stretch of road. And the roads are just the most visible part of the decay. Schools, hospitals, homes are all in a deplorable state of disrepair. More and more people live in slums and shanties.

Not everyone lives in dilapidation, though. I saw the president’s house. It’s a mansion that sits on a hillside overlooking the capital. Paved driveway, fence, swimming pool. But this man presides over a country that is slipping further and further backwards. But here’s the rub. The very poverty of Sierra Leone is what keeps these people in business. Millions of dollars and euros in foreign and development aid are funnelled into Sierra Leone—and many other impoverished countries—but how much of that money gets to the people who really need it? Having seen the president’s mansion, I have to say, not much.

The government of Sierra Leone is parasitic, and that corrupting mentality trickles all the way down through the society as low-level civil servants, underpaid and undertrained, scrounge around for scraps—bribes and other forms of official theft. How many people get into government because they want to make a difference, to help lift their country out of poverty? Not many, I imagine. After all, why has it taken so long to make that difference, and why is the country so much worse than it was at independence? Yes I know, colonialism and the international financial institutions must bear some of the blame but let’s not forget, Africa was not the only colonized continent. Yet today, Africa is by far the most impoverished region in the world.

Why do so many Sierra Leoneans who have attained professional and financial success abroad give it all up to pursue a political career in Sierra Leone? Because that’s where the money is. Take the former ambassador to the US, who had been a successful attorney and businessman prior to his appointment. Why did he go to Sierra Leone to try to get involved in politics? Why not lecture at the university there? He has a law degree and legal experience after all. Why not find investors and open a factory or some other revenue-generating business? After all, he had worked in the private sector before. Because he was not interested in doing anything to make Sierra Leone a safer, cleaner, or more comfortable place for its citizens to live. But he’s not alone.

Post-independence administrations—from Siaka Stevens’ on—have demonstrated a stunning lack of vision and imagination. As the rest of the world has moved forwards, Sierra Leone has slipped backwards. Why has no post-independence government implemented any policies for sustainable development? No large-scale, industrialized agriculture; no modern land, sea, or river transportation network; no new schoolhouses; no new hospitals; no modern air- or seaport; nothing! Just a government that maintains form without function.

When the president travels abroad, he is treated with all the respect befitting a dignitary. But every day in Sierra Leone, and in much of Africa, how many people die daily from easily preventable accidents and diseases? How many lives could be saved if the government committed itself to improving road networks and making transportation a faster and less dangerous business? Would the president be treated with such respect if he had lined the casualties of today’s boat catastrophe up against a wall and shot them all in the head? Sierra Leone boasts the world’s highest rates of infant mortality, with measles and malaria respectively accounting for 48 and 33 percent of all under-five deaths. What if, instead of having succumbed to easily prevented diseases, all these children had been gassed to death on the orders of the present government? There would be an international outcry, that’s what! No member of the Sierra Leonean government could travel abroad as smugly and proudly as they do now.

However, these people are not dying from accidents and disease. They are dying because the people who were elected or appointed to provide the basic amenities that would prevent their deaths are failing to do their jobs. Not having enough money to fix roads, build hospitals, or educate children should no longer be an acceptable excuse! Finding the money is part of the job description. Using the money to improve the country for everyone is another part of the job. Failing to do either of these things is the same as failing in the job. And failing to do one’s job is negligence. Every day, in Sierra Leone and all around Africa, people are dying from government negligence. But because they are dying from negligence instead of deliberate government action, the world looks the other way. Nobody is held accountable. The negligence goes unpunished.

Today, as 50 people go to their watery graves, we have seen one more demonstration of this negligence. With elections around the corner, let’s hope the next government is better than the previous ones. Let’s hope the next government values the lives of Sierra Leoneans enough to actively attempt to prevent such catastrophic accidents.

But I’m not holding my breath.

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So, I just found out that Christy Freeman, the Ocean City, Maryland, woman who is being charged with murder for what looks to me like a self-performed—or at the very least self-induced—abortion may, if convicted, be sentenced to death!

I know that in reality, the chances of Christy Freeman actually being executed are pretty slim but I think it’s outrageous that the judge would even tell her that she might be. I mean, all this woman did was abort a fetus, for crying out loud!! Have we gone so crazy that we would kill a living, adult woman who supports four children because she decided, 26 weeks into her pregnancy, that she didn’t need any more children? Have we really reached the point where we demonstrate that the potential life of an unborn fetus is more valuable than the actual life of the living human being in whose womb that fetus grows? This is madness!!!

What this case proves is that, regardless of societal or legal restrictions on abortion, the need will always remain. The fact that some people think women shouldn’t be allowed to have abortions does not mean that every woman who gets impregnated will want to give birth. The law may take away the choice but it can never take away the need. But the whole point of choice is that women should choose whether, when, and under what conditions to have children.

When the anti-abortion wackos figure out a way to spontaneously generate children without the need for living women, they can dictate whether, when, and under what conditions children should be born. Until they can find a way to produce children without using women’s wombs, I maintain that the rights of the woman always supercede those of the fetus growing in her uterus.

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I’m frustrated by the media’s coverage of the case of an Ocean City, Maryland, woman who has been arrested and charged with first degree murder in the death of her unborn child. I feel like the media’s coverage of this story is leaving a lot of questions un-asked and unaswered. As far as I’m concerned, this case is more about abortion and abortion rights than it is about murder. For me, the possibility raised by this case that abortion is being driven back underground through legislation and social convention is far more troubling than the gruesome details of the investigation.

Christy Freeman, a local businesswoman and mother of four, was admitted to hospital after her live-in boyfriend found her in the bathroom, unconscious and bleeding. Hospital staff then discovered that Freeman’s uterus contained a 36-week-old placenta, but no fetus. Freeman initially denied having been pregnant or knowing she had been pregnant, but she later confessed to police that she had given birth to a “gloopity glop,” which she flushed down the toilet. Police searched her home anyway and found a fetus wrapped in a towel and hidden under the sink in the bathroom vanity. Police also found the remains of three other fetuses in the home Freeman shared with her boyfriend and in an RV parked on their property.

It’s as yet unclear how the other fetal remains ended up in the Freeman home and how old they were at the time of death but I assume they, like the most recent fetus, were all delivered premature and stillborn by Freeman, who has been charged with murder only in the case of the most recent fetus. She is being charged under a 2005 state law that makes it illegal to kill a viable fetus. The viability of the fetus found under the sink has yet to be establised, however, as it was only 26 weeks old and appeared to have been stillborn. But according to State’s Attorney Joel Todd, Freeman admitted to having done something to terminate the pregnancy and, while her exact words were not released or quoted, they were enough to earn her a first-degree murder charge.

Because of the media’s coverage of this story, I don’t know enough about the issue or the law to comment on the merits of the state’s case. This makes no difference to me since I am more interested in this woman’s background, where she was raised, what she believed, etc. because I believe that information would shed a lot more light on this case than police reports and quotes from neighbors and prosecutors.

There’s a strong possibility that Christy Freeman is a crazy person. I mean, she lists her four children on her website among her hobbies. But she is also someone who definitely needs sex ed and contraception counseling. After all, this woman had already delivered four children and the four fetal remains clearly indicate that she didn’t want to raise any more kids. But why didn’t she get on the pill, use condoms, a sponge, a diaphragm, spermicidal gel, an IUD or any of the host of other contraceptive combinations available? Did she not know of these things? Or was she just morally opposed to contraception? And, after she got pregnant each of those four times, why didn’t she just pay a visit to the local Planned Parenthood? I know abortion is never an easy choice but it sure beats the hell out of delivering a dead baby in your bathtub, wrapping it in a towel, stashing it under the sink, and waiting for the profuse bleeding to stop. And, it’s a thousand times more disturbing if it turns out that the four fetal remains—essentially multiple miscarriages—were the result of her performing abortions on herself.

Since the media isn’t asking the really important questions in this case, I’m going to speculate on what went down. It’s possible Christy Freeman is completely ignorant of contraceptive methods, but this is unlikely because even in backwards Ocean City, you can find condoms in every gas station and convenience store. More likely, she was raised in a conservative environment where there was little talk of sex or contraception, and where abortion was the ultimate taboo. Why else would this owner of a popular and successful taxicab company endure the horrific ordeal of giving birth to dead or dying babies and then hide the remains in her home? Besides the aforementioned possibility that she’s crazy, of course. Christy Freeman probably did not want anyone to know she had had an abortion because she did not want to be stigmatized. And why would the state’s attorney charge her with first-degree murder? Because the state has decreed that killing a viable fetus (read having an abortion) is tantamount to murder. It seems that Christy Freeman, having found herself trapped between state law and social stigma, had more than enough reason to not seek a safe and professional—but perhaps not 100% secret—abortion.

So what we have is a woman living in a conservative county, in a state that has decided some abortions are murders, who would rather give birth in her bathroom and stash fetal remains around her home than go to Planned Parenthood for an abortion. And, to make matters worse, she is now being charged with murder!

Like Majikthise, we should all be completely outraged! How much longer before we find ourselves back in the bad old days of wire hangers and back alley abortions?

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We’ve all heard of premenstrual syndrome (PMS) and it’s many negative effects on women’s moods and whatnot but now, it seems menstruation itself is being targeted as a medical condition; and of course, the pharmaceutical companies are lining up with their version of “the cure.”

Read on . . ..

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Yesterday, I watched with great delight as Michael Moore ripped Wolf Blitzer and his CNN colleague, Dr. Sanjay Gupta, a new you-know-what in response to the good doctor’s biased review of Moore’s latest film, Sicko.

Good for Michael Moore!

And shame on Dr. Gupta for trying to muddy the waters on a much-needed debate about the state of our country’s healthcare system. Michael Moore does a good job of rebutting Dr. Gupta’s review (with a few shots taken at CNN’s coverage of the lead-up to the Iraq war, to boot) so I’m not going to repeat any of it.

But I do feel the need to call the good doctor out on some other points.

According to a WHO report (see also my earlier post on how the US did against other industrialized nations), the US healthcare system ranks 37th in the world, behind all other industrialized nations. Rather than address this startling fact (made even more startling because the US is today the richest country in the world), Dr. Gupta chooses to elide by pointing out that Cuba (featured in Sicko) was ranked 39th!

Um . . . in case you hadn’t noticed, Doctor, Cuba is a small Caribbean island that has endured an economic embargo for the better part of the last half-century. You should be ashamed that this poor country was only two points behind the US in this WHO ranking. I mean, it’s not like when the Founding Fathers set out to build this country, their goal was to create a country with a better health care system than Cuba! And, last time I checked, the Cuban government was not proud enough of the way they do things to invade other countries and bring them a better way of life. We should be ashamed that, despite the wealth and power of the US, we only beat Cuba—which has neither the economic power nor physical infrastructure of the US—by two points!!!

Unlike Dr. Sanjay Gupta, I’m no brain surgeon so I can’t comment on how healthcare works here and abroad, but I do have some experience with the US and British healthcare systems. In the US, my health insurance contribution comes directly out of my paycheck because, unlike millions of other Americans, I’m lucky enough to have a job that provides me with subsidized health insurance. Then, every time I go to the doctor, I pay a $30 co-pay (because I was stupid enough to choose the HMO option). If I have to see a specialist after a visit to my primary-care doctor, I have to pay the specialist a $40 co-pay. Then, if I go the pharmacy to fill a prescription, I have to pay again for my medication. Finally, if I have any bloodwork or other tests done by a lab, I get a bill from the lab. At the end of the scenario outlined above (which happens with some regularity), I end up paying five times! And I’m one of the lucky ones who has health insurance through my work. We all know someone who’s been brought to the brink of financial ruin for failing to get pre-approval for an ambulance ride or an overnight stay in the hospital (as if these kinds of emergencies can ever be planned in advance!).

Compare this to the British healthcare system (NHS). I spent a year doing my Masters degree in London and went to the doctor a couple of times. The doctor’s visit was free and I was able to see him at my own convenience, within a few days of calling to make the appointment. My blood tests were free. My annual HIV test was free. I just walked into the clinic, wrote down my name on a clipboard and waited to be called. When I went to the pharmacy to fill out my prescription, the guy behind the counter took the Rx note and came right back with a bottle of pills and some other stuff. I started walking back to the door and realized I hadn’t paid him. I went back and asked him how much I owed. He asked me, “You’re diabetic, right?” I said I was. He then told me diabetes medication is free under NHS!!!

Granted I was studying in Britain and I had paid my tuition already (which by the way was much cheaper than tuition here) but that’s not why I was eligible for free NHS care. As a visitor on longer than a six-month visa, I was entitled to the same health benefits as British nationals! How many foreign students in the US get such a good deal?

So back to Dr. Sanjay Gupta, who proudly declared in his review of Sicko that waiting periods in European countries for procedures like hip replacements are longer than in the US. Fair enough. But how often does the average person go to the hospital for a hip replacement? And what about the millions of Americans who work part-time (often part-time at multiple jobs so they end up working more than 40-hour weeks) but don’t have health insurance through any one employer? They may not have to wait as long as their German counterparts to have their hips replaced but without health insurance, how do they pay for their hip replacements? Or for that matter, basic healthcare needs?

Sure, Cuba may have a worse healthcare system than we do (but not by much, apparently) but that’s not something to gloat about. Despite that country’s small size and economic stagnation, their healthcare system is only slightly worse than ours. Nonetheless, according to the CIA World Factbook, Cuba has a lower infant mortality rate than Chile and Argentina, two of the most developed countries in Latin America, and a slightly lower infant mortality rate than the US. Before anyone dismisses these figures as Cuban government propaganda, let me remind you these figures come from the CIA. Why would the CIA lie in Cuba’s favor?

So Dr. Gupta—in a clear case of shooting the messenger—tries to undermine Michael Moore’s credibility rather than talk about the problems of our healthcare system. But the truth is, it doesn’t take a brain surgeon to know our system is messed up. Maybe Sanjay Gupta should take a break from playing doctor and devote some more time to being a journalist. It’s high time he and other people in the mainstream media started asking tough questions about the pressing issues of the day.

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I decided to give the first post of the day over to someone with more hands-on experience. Read on . . .

 

How to Destroy an African American City in
Thirty Three Steps – Lessons from Katrina
 
By Bill Quigley

 

Step One.  Delay. If there is one word that sums up the way to destroy an African-American city after a disaster, that word is DELAY. If you are in doubt about any of the following steps – just remember to delay and you will probably be doing the right thing.

Step Two. When a disaster is coming, do not arrange a public evacuation. Rely only on individual resources. People with cars and money for hotels will leave. The elderly, the disabled and the poor will not be able to leave. Most of those without cars – 25% of households of New Orleans, overwhelmingly African-Americans – will not be able to leave. Most of the working poor, overwhelmingly African-American, will not be able to leave. Many will then permanently accuse the victims who were left behind of creating their own human disaster because of their own poor planning. It is critical to start by having people blame the victims for their own problems.

Step Three. When the disaster hits, make certain the national response is overseen by someone who has no experience at all handling anything on a large scale, particularly disasters. In fact, you can even inject some humor into the response – have the disaster coordinator be someone whose last job was the head of a dancing horse association.

Step Four. Make sure that the President and national leaders remain aloof and only slightly concerned. This sends an important message to the rest of the country.

Step Five. Make certain the local, state, and national governments do not respond in a coordinated, effective way. This will create more chaos on the ground.

Step Six. Do not bring in food or water or communications right away. This will make everyone left behind more frantic and create incredible scenes for the media.

Step Seven. Make certain that the media focus of the disaster is not on the heroic community work of thousands of women, men and young people helping the elderly, the sick and the trapped survive, but mainly on acts of people looting. Also spread and repeat the rumors that people trapped on rooftops are shooting guns, not to attract attention and get help, but AT the helicopters. This will reinforce the message that “those people” left behind are different from the rest of us and are beyond help.

Step Eight. Refuse help from other countries. If we accept help, it looks like we cannot or choose not to handle this problem ourselves. This cannot be the message. The message we want to put out over and over is that we have plenty of resources and there is plenty of help. Then if people are not receiving help, it is their own fault. This should be done quietly.

Step Nine. Once the evacuation of those left behind actually starts, make sure people do not know where they are going or have any way to know where the rest of their family has gone. In fact, make sure that African-Americans end up much farther away from home than others.

Step Ten. Make sure that when government assistance finally has to be given out, it is given out in a totally arbitrary way. People will have lost their homes, jobs, churches, doctors, schools, neighbors and friends. Give them a little bit of money, but not too much. Make people dependent. Then cut off the money. Then give it to some and not others. Refuse to assist more than one person in every household. This will create conflicts where more than one generation live together. Make it impossible for people to get consistent answers to their questions. Long lines and busy phones will discourage people from looking for help.

Step Eleven. Insist the President suspend federal laws requiring living wages and affirmative action for contractors working on the disaster. While local workers are still displaced, import white workers from outside the city for the high-paying jobs like crane and bulldozer operators. Import Latino workers from outside the city for the low-paying dangerous jobs. Make sure to have elected officials, black and white, blame job problems on the lowest wage immigrant workers. This will create divisions between black and brown workers that can be exploited by those at the top. Because many of the brown workers do not have legal papers, those at the top will not have to worry about paying decent wages, providing health insurance, following safety laws, unemployment compensation, workers compensation, or union organizing. These become, essentially, disposable workers – use them, then lose them.

Step Twelve. Whatever you do, keep people away from their city for as long as possible. This is the key to long-term success in destroying the African-American city. Do not permit people to come home. Keep people guessing about what is going to happen and when it is going to happen. Set numerous deadlines and then break them. This will discourage people and make it increasingly difficult for people to return.

Step Thirteen. When you finally have to reopen the city, make sure to reopen the African-American sections last. This will aggravate racial tensions in the city and create conflicts between those who are able to make it home and those who are not.

Step Fourteen. When the big money is given out, make sure it is all directed to homeowners and not to renters. This is particularly helpful in a town like New Orleans that was majority African-American and majority renter. Then, after you have excluded renters, mess up the program for the homeowners so that they must wait for years to get money to fix their homes.

Step Fifteen. Close down all the public schools for months. This will prevent families with children in the public school system, overwhelmingly African-Americans, from coming home.

Step Sixteen. Fire all the public school teachers, teacher aides, cafeteria workers and bus drivers and de-certify the teachers union – the largest in the state. This will primarily hurt middle class African Americans and make them look for jobs elsewhere.

Step Seventeen. Even better, take this opportunity to flip the public school system into a charter system and push foundations and the government for extra money to the new charter schools. Give the schools with the best test scores away first. Then give the least flooded schools away next. Turn 70% of schools into charters so that the kids with good test scores or solid parental involvement will go to the charters. That way, the kids with average scores, or learning disabilities, or single parent families, who are still displaced, are kept segregated away from the “good” kids. You will have to set up a few schools for those other kids, but make sure those schools do not get any extra money, do not have libraries, nor doors on the toilets, nor enough teachers. In fact, because of this, you better make certain there are more security guards than teachers.

Step Eighteen. Let the market do what it does best. When rent goes up 70%, say there is nothing we can do about it. This will have two great results: it will keep many former residents away from the city and it will make landlords happy. If wages go up, immediately import more outside workers and wages will settle down.

Step Nineteen. Make sure all the predominately white suburbs surrounding the African-American city make it very difficult for the people displaced from the city to return to the metro area. Have one suburb refuse to allow any new subsidized housing at all. Have the Sheriff of another threaten to stop and investigate anyone wearing dreadlocks. Throw in a little humor and have one nearly all-white suburb pass a law that makes it illegal for homeowners to rent to people other than their blood relatives! The courts may strike these down, but it will take time and the message will be clear – do not think about returning to the suburbs.

Step Twenty. Reduce public transportation by more than 80%. The people without cars will understand the message.

Step Twenty-One. Keep affordable housing to a minimum. Instead, use the money to reopen the Superdome and create tourism campaigns. Refuse to boldly create massive homeownership opportunities for former renters. Delay re-opening apartment complexes in African American neighborhoods. As long as less than half the renters can return to affordable housing, they will not return.

Step Twenty-Two. Keep all public housing closed. Since it is 100% African-American, this is a no-brainer. Make sure to have African-Americans be the people who deliver the message. This step will also help by putting more pressure on the rental market, as 5000 more families will then have to compete for rental housing with low-income workers. This will provide another opportunity for hundreds of millions of government funds to be funneled to corporations when these buildings are torn down and developers can build up other less-secure buildings in their place. Make sure to tell the 5000 families evicted from public housing that you are not letting them back for their own good. Tell them you are trying to save them from living in a segregated neighborhood. This will also send a good signal – if the government can refuse to allow people back, private concerns are free to do the same or worse.

Step Twenty-Three. Shut down as much public health as possible. Sick and elderly people and moms with little kids need access to public healthcare. Keep the public hospital, which hosted about 350,000 visits a year before the disaster, closed. Keep the neighborhood clinics closed. Put all the pressure on the private healthcare facilities and provoke economic and racial tensions there between the insured and uninsured.

Step Twenty-Four. Close as many public mental healthcare providers as possible. The trauma of the disaster will seriously increase stress on everyone. Left untreated, medical experts tell us this will dramatically increase domestic violence, self-medication and drug and alcohol abuse and, of course, crime.

Step Twenty-Five. Keep the city environment unfriendly to women. Women were already widely discriminated against before the storm. Make sure that you do not reopen day care centers. This, combined with the lack of healthcare, lack of affordable housing, and lack of transportation, will keep moms with kids away. If you can keep women with kids away, the city will destroy itself.

Step Twenty-Six. Create and maintain an environment where black on black crime will flourish. As long as you can keep parents out of town, keep the schools hostile to kids without parents, keep public healthcare closed, make only low-paying jobs available, not fund social workers or prosecutors or public defenders or police, and keep chaos the norm, young black men will certainly kill other young black men. To increase the visibility of the crime problem, bring in the National Guard in fatigues to patrol the streets in their camouflage hummers.

Step Twenty-Seven. Strip the local elected, predominately African American government of its powers. Make certain the money that is coming in to fix up the region is not under their control. Privatize as much as you can as quickly as you can – housing, healthcare, and education for starters. When in doubt, privatize. Create an appointed commission of people who have no experience in government to make all the decisions. In fact, it is better to create several such commissions; that way, no one will really be sure who is in charge and there will be much more delay and conflict. Treat the local people like they are stupid; you know what is best for them much better than they do.

Step Twenty-Eight. Create lots of planning processes but give them no authority. Overlap them where possible. Give people conflicting signals whether their neighborhood will be allowed to rebuild or be turned into green space. This will create confusion, conflict and aggravation. People will blame the officials closest to them – the local African-American officials, even though they do not have any authority to do anything about these plans, since they do not control the rebuilding money.

Step Twenty-Nine. Hold an election but make it very difficult for displaced voters to participate. In fact, do not allow any voting in any place outside the state, even though we do it for Americans in other countries and even though hundreds of thousands of people are still displaced. This is very important because when people are not able to vote, those who have been able to return can say, “Well, they didn’t even vote, so I guess they are not interested in returning.”

Step Thirty. Get the elected officials out of the way and make room for corporations to make a profit. There are billions to be made in this process for well-connected national and international corporations. There is so much chaos that no one will be able to figure out, for a long time, exactly where the money went. There is no real attempt to make sure that local businesses, especially African-American businesses, get contracts – at best they get modest subcontracts from the corporations that got the big money. Make sure the authorities prosecute a couple of little people who ripped off $2,000 – that will temporarily satisfy people who know they are being ripped off and divert attention from the big money rip-offs. This will also provide another opportunity to blame the victims – as critics can say, “Well, we gave them lots of money, they must have wasted it, how much more can they expect from us?”

Step Thirty One. Keep people’s attention diverted from the African-American city. Pour money into Iraq instead of the Gulf Coast . Corporations have figured out how to make big bucks whether we are winning or losing the war. It is easier to convince the country to support war – support for cities is much, much tougher. When the war goes badly, you can change the focus of the message to supporting the troops. Everyone loves the troops. No one can say we all love African-Americans. Focus on terrorists – that always seems to work.

Step Thirty-Two. Refuse to talk about or look seriously at race. Condemn anyone who dares to challenge the racism of what is going on – accuse them of “playing the race card” or say they are paranoid. Criticize people who challenge the exclusion of African-Americans as people who “just want to go back to the bad old days.” Repeat the message that you want something better for everyone. Use African American spokespersons where possible.

Step Thirty-Three. Repeat these steps.

Note to readers: Every fact in this list actually happened and continues to happen in New Orleans, after Katrina.

Bill Quigley is a law professor and Director of the Law Clinic and the Gillis Long Poverty Law Center at Loyola University New Orleans. He has been an active public interest lawyer since 1977 and has served as counsel with a wide range of public interest organizations on issues including Katrina social justice issues, public housing, voting rights, death penalty, living wage, civil liberties, educational reform, constitutional rights and civil disobedience. He has litigated numerous cases with the NAACP Legal Defense and Educational Fund, Inc., the Advancement Project, and with the ACLU of Louisiana, for which he served as General Counsel for over 15 years.

This column was originally published on the Black Commentator.

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David Oluwale, a homeless Nigerian man was routinely abused and humiliated by Leeds police officers in the late ’60s. David’s body was eventually discovered in a river and ruled a drowning. A year-and-a-half later, the case was was re-investigated and two police officers were convicted for the death. It was revealed that “[t]hey beat him, urinated on him, smashed his head against the floor and took him to woods miles outside Leeds and left him there.”

Kester Aspden’s new book Nationality: Wog – The Hounding Of David Oluwale sheds new light on the life and death of David Oluwale, exposes the abuse he experienced at the hands of Leeds police officers, details his treatment at mental health institutions, and includes interviews with people who knew David Oluwale while he was alive.

Read a review of the book here and an interview with the author here in which he talks about David’s experience in the mental health care system and mental health providers’ prejudices towards Black people.

For those not familiar with British lingo, “wog” is a racial slur equivalent to “nigger” in the U.S.

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In an effort to reduce the astronomical number of annual maternal deaths in Mozambique, the government of that African state is considering making abortion legal.

According to the Ministry of Health, illegal abortions are the third leading killer of pregnant women, a horrific statistic in light of the fact that Mozambique has one of the highest maternal death rates in the world.

South Africa saw a 91% drop in maternal deaths in the 10 years since abortion was legalized there. Worldwide, the World Health Organization reports that 68,000 women die annually from unsafe abortions.

Hopefully more African countries will follow Mozambique’s lead and recognize a woman’s right to choose when and whether to have children.

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