Archive | March 2012

Hideous Dam Destroying Beast Found in Bui, Ghana

Apparently this animal was found in the Bui Dam project in Ghana. It is thought that this horrific beast, not shoddy construction by the Chinese contractor building the dam, was responsible for a dam collapse the same day. It is reported to have the head of a human, two claws to pull itself along and the body of a snake. Though the video doesn’t seem to confirm it, reports indicated that it is more than 100m long.

We need to be on the lookout for beasts such as this all over the globe.

Did Lariam Cause U.S. Army Staff Sgt. Robert Bales to Kill Afghan Civilians?

Lariam: Brought to you buy Roche Pharma

Recently, U.S. Army Staff Sgt. Robert Bales left base in the middle of the night and allegedly killed 17 Afghan civilians (including children) in cold blood and wounded 6 others. Since then, the media has blamed multiple deployments, stress, a history of violence and alcohol consumption as contributing to the horrific killings. One possible cause I hadn’t considered (but should have) is the prescription of mefloquine (Lariam), assuming that the military is still prescribing it. If the press it to be believed, the military is still using it.

Psychotic episodes on Lariam are not uncommon. Reports go deep within the drug’s history (which is an interesting one), and problems have even been noted in military contexts. It was reported that Larium may have caused four military men to kill their wives in the summer of 2008. Killings in the UK in 2002 were also associated with Lariam. Even veterans groups have come out against the drug.

The NIH even notes that side effects of Lariam use include: “nervousness or extreme worry, depression, changes in mood, panic attack, forgetfulness, confusion, hallucinations (seeing things or hearing voices that do not exist), violent behavior, losing touch with reality, feeling that others want to harm you, thoughts of hurting or killing yourself.” They also note that these are rare events. However, as we in epidemiology know, rare events tend to occur more when larger numbers of people are at risk. If there is even a .1% chance of something happening, then likely, given 1000 people, there will be one event. More than 100,000 military members have gone to Afghanistan. Do the math.

Military deployments are characterized by stress, long periods of sleeplessness, a culture that rewards violence and the propensity for violence, and social hierarchy that leads to imbalance power differentials in interpersonal relationships. All of these things likely aggravate potential negative side effects of Larium.

It is perplexing that the military would still be using Lariam. The risks are well known to the military, who have been reported to overprescribe it to inmates at Guantanamo, likely as a form of torture. It is likely, that the daily schedule of the more benign (and effective) Malarone are prohibitive in extended combat missions.

Some researchers, noting the evidence of psychotic episodes and death associated with Lariam, also point to political and economic corruption as being the reason Lariam continues to be used. Interestingly, Lariam was unethically tested on American prisoners in the 1970’s, where negative effects were noted even then. The US military needs to reassess its malaria policy (as it appears to have done) and ask itself if the risks to civilians, both foreign and domestic, are worth the low cost and convenient dosage regimine. Reports have indicated, though, that the military is set to drop Lariam from its list of drugs. Whether this has happened yet, is unclear at this point.

Personally, I would never take Lariam. I would rather risk getting malaria, than take it. Even the more moderate Malarone, reportedly free of side effects, induces severe depression in me (in addition to my normal depression), to the point where I have to stop taking it.

Lariam does not get Sgt. Bales off the hook. My fear is that Sgt. Bales defense and war apologists may use the Lariam issue as a convenient defense. The fact is that he killed 17 civilians who all have names and people who love and miss them.

Breaking Tradition, a US President Appoints Human (and Rapper) to Head World Bank

It was announced to day that Barack Obama will appoint Dartmouth President and physician Jim Yong Kim to be the next head of the World Bank. This breaks a string of appointments of right wing demagogues including Paul Wolfowitz and Robert Zoellick, both part of the group which orchestrated the invasion of Iraq and the heavy handed response to 9/11 by the Bush admin. I saw Zoellick speak recently and felt kind of gross after it was over.

Jim Yong Kim has an impressive list of publications on global health, notably collaborating with Partners In Health founder and human advocate, Paul Farmer. In fact, Kim was also part of the group that founded PIH and is known for his work on “Social Medicine” (a broad signifier for social determinants of health with a focus on clinical delivery).

Kim is co-founder of The Global Health Delivery Project, a group at Harvard that seeks to improve the health and welfare of population in developing countries by focusing on issues of health care delivery.

Problems of delivery of health care in developing countries has been perhaps my number one interest as of late. In fact, I am even writing a paper on it. As researchers, we can develop effective and radical new clinical techniques and medicines, but they do no good if the systems aren’t in place to deliver them effectively. Issues of delivery will be the primary impediment to controlling and eventually eliminating devastating diseases such as malaria. It is encouraging that Kim has been selected to fill this position.

It is unsurprising that Columbia University development economist Jeff Sachs was not chosen (he has withdrawn his nomination), despite appealing to the world community to pressure the Obama admin to select him. However, it is a relief that the first choice, Larry Summers, has to forego stepping in to a leadership position at the WB. I can think of no WORSE choice. The entire world appeared to agree and it marked the first time that the international community has had a say in who heads the Bank, a welcome departure from past appointments.

Sachs himself even came out in support, likely aware of his role in having Kim picked: “Dr Jim Kim is a superb nominee for the World Bank presidency,” Sachs said in a statement. “I support his nomination 100 percent. I congratulate the administration for nominating a world-class development leader for this position.”

I am interested to learn more about Kim. He may certainly have some ideological skeletons in his closet, though his association with Farmer leads me to think not. Congratulations to the Obama admin for taking the high road on this one.

UPDATE: OK, so it appears that Kim will be the first WB President to ever be caught on film rapping and dancing at a Michael Jackson tribute:

Right Wing Advocacy Group Successfully Stifles Democracy

A couple of weeks ago, Gov. Rick Snyder (of Michigan, of course) signed a bill that prevents graduate student research assistants (GSRAs) from having a say in whether they want (as a group) to unionize.

For nearly the past 2 years, the Graduate Employees Organization (GEO) has been attempting to bring GSRAs into the union, which now only represents graduate student instructors (GSIs). GEO has been instrumental in guaranteeing fair wages for graduate employees, insuring that graduate employees receive that same health care package that all UM employees receive, and providing representation when disputes arise. Not many universities offer as generous a support package as the University of Michigan, which makes the U extremely competitive in the market for quality graduate students.

In the early 1980’s, the Michigan Employee Relations Committee (MERC) determined that GSRAs, who were a minority at the time, were not employees of the university (and thus of the state) and thus would not qualify for representation under the union. That situation has vastly changed. Now GSRAs outnumber GSIs and the U has morphed into a research behemoth. GSRAs play a pivotal role in the U’s status as a world class research institution and in Michigan’s fragile economy.

The conservative Mackinac Center, a non-profit public policy group that has made no secret of it’s stance against public employee unions, offered to pay for legal fees to challenge GEOs bid to allow GSRAs to vote whether to enter the union. With this backing, a rag tag group called Students Against GSRA Unionization, took the issue to the state and after months of wrangling, the issue manifested itself as a Republican led bill.

The bill, which Gov. Snyder signed, essentially codifies the MERC decision from the early 1980’s and quashes any arguments that GSRAs should enter GEO. Simply, GSRAs cannot vote to join any union and now have no right at all to collective bargaining or unionization.

Though this post is embarrassingly late, the issue fills me with rage. Certainly, I despise the Mackinac Center so I am biased in this regard. To critics of the decision to unionize GSRAs, I would remind you, that GEO was seeking merely a VOTE. If this isn’t “big government” at work, I’m not sure what is.

If the body of GSRAs decided that it was not in their interest to join the union, the it would not happen. Certainly SAGU and any other group could make the case against unionization and the issue could be put up to discussion. It was very possible that GEO would have lost in a public vote.

That idea seems to have escaped SAGU, which probably feared that they would lose such a vote. (FYI: This was an odd group. Their initial spokesperson, Melinda Day, was filmed snickering and rolling her eyes at a hearing before the Michigan Legislature, apparently oblivious to the presence of adults in the room.)

Gov. Snyder’s and the Republican led state legislature’s decision however, robs GSRAs of the right to vote. Given the current pattern of Republican led efforts to deny the vote to Michigan’s citizenry through the enaction of EMF programs, this should be of absolutely no surprise at all. Republicans in the state of Michigan, who purport to believe in democracy, really only believe in the power of the vote when it suits their own ends. Certainly, this is endemic to political groups under any label, but the heavy handed, and unrestrained, actions of the state in this case make the problem so incredibly obvious as to defy explanation.

So here, I say, fuck you Gov. Snyder. You are an embarrassment not only to the State of Michigan, but to democracy itself, which you obviously don’t care about. I’ll see you in 2014.

Kony2012: Public Service or Shameless Self Promotion?

Democrats and Republicans finally kiss and make up.

I sat down and watched the Kony2012 video from the group “Invisible Children” which has been making the rounds in the popular press recently. Kony2012 is a group (or single individual, it’s not clear) which calls for immediate action to arrest and convict Joseph Kony, leader of the notorious Lord’s Resistance Army. The LRA, a quasi-religious rebelgroup, has been responsible for nearly 30 years of wanton violence, child abduction and rampant warfare in Northern Uganda, the DRC and South Sudan.

Filmmaker Jason Russell has put together a slick 30 minute feature on why the world should be concerned about Joseph Kony and the LRA. It is well done piece that documents Mr. Russell’s journey to Uganda and the events which led to his eventual commitment to the issue of the LRA and child soldiers. More than 60 million people have viewed the video, and has turned into a (likely temporary) viral sensation.

The intent of the film is obscure for the first ten minutes, starting out with a primer on how people in the United States spread videos of their kids on YouTube and Facebook. Soon, after several grueling and annoying minutes watching videos of Mr. Russell’s own child, we figure out what the video. All is explained in a conversation between Russell and his 4 year old son.

The video is not without critics. I am one of them. On the surface, the video is a call to action from a concerned filmmaker. Mostly, though, it is less documentary and more a shameless advertisement for the filmmaker himself. Russell even goes the extra step to try to sell the viewer Kony “Action Packs” (it sounds like something that comes out of a cereal box). For $30, you get a button and a couple of wristbands, one for yourself and one for a friend. For $30 you can feel like you did something for helpless kids in Uganda.

The trouble is, though, that Kony hasn’t been in Uganda since 2005 and Ugandan kids won’t likely see much of that money.

While Kony is a perfect evil-doer in the deeply scary continent of Africa, he is certainly not the scariest killer of children. More than one million kids senselessly die every year from malaria. Another million die even more senselessly of diarrheal diseases from drinking contaminated water. More than 30 million kids have been orphaned due to HIV. Worse yet, many millions of the kids that didn’t die after getting sick suffer from serious (though poorly researched) developmental problems. These not only pose incredible problems for the kids themselves, but are a serious impediment to the development of poor countries. If the video is any indication, Russell appears unconcerned.

Though not to discount the horror the man has committed, by comparison Kony is a small threat. The image of Kony, however, feeds into Western perceptions of Africa as being a really, really frightening place (despite the fact that people like Robert Mugabe kill more people than Kony through irrisponsible leadership). Africa is seen to be as a place of continual conflict and instability. The only way to fix it is to send in white people to protect African kids from African adults. Not only is it the only way, but we have a duty to act immediately, or more kids will die.

In the manner that it uses social media, slick production values and a sense of absolute immediacy and simplicity, it is quite similar to campaigns such as the One campaign and Product (RED). It is also similar in that it uses African crises to sell itself and its own products, while giving little to the subjects concerned. Worse yet, it gives little airtime to the numerous African led groups working day and night to solve Africa’s seemingly insurmountable problems.

To me, the real problem with groups like Invisible Children is that it presents a world where the individual, voluntary and one time actions of consumers are an easy solution to the complex problems of developing countries and global health issues. What this does is distract policy conversations from creating sustained and cooperative strategies for poverty alleviation. It allows corporate and government entities to operate with little scrutiny, despite being responsible for (and profit from) creating conditions of entrenched inequality around the world.

No doubt, Russell will have his supporters. Americans like to feel good and it makes them feel good to send in a little money, watch a video, wear a bracelet and save kids in Africa.

Global Poverty Down: Does Everyone Win?

A new World Bank report on the state of poverty in the world suggests that the number of people living on $1.25 a day have declined over the past decade. Even raisig the bar to $2.00 a day indicates great gains in the world fight against poverty.

Much of the improvement in world poverty numbers come from Asia, specifically China, which can boast that nearly 662 million people now no longer live on less than $1.25 a day compared to 1981. In 1981, nearly 77% of people in East Asia lived in poverty. Now, only 14% do.

Though this is cause to celebrate, the world is not out of the woods yet. Africa, though slowly recovering from the disastrous structural adjustment era, which erased previous gains in poverty reduction, still provides home to large numbers of ultra poor households, particularly in rural areas. Nearly 45% of Africans live in poverty at present.

One should praise the great successes of economically emergent Sub-Saharan African countries. One should not forget to ask why Asia has been a success story and why Africa has not. Most relevant, the World Bank should at least make mention of their complicity in creating conditions of entrenched poverty in Sub-Saharan Africa.

When I saw Robert Zoellick of the World Bank last year, he only made passing mention of the programs which erased Africa’s past economic gains, dismissing the matter as a fringe concern of political freaks and over-reactionaries. The simple truth is that it is impossible to dismiss policies which have favored narrow US interests and reflected a narrow view of economics only appropriate for the most developed of countries, policies which have been implemented at the expense of the very poor.

Zoellick Steps Down as Head of the World Bank: Jeff Sachs Applies

Jeff Sachs

Robert Zoellick, current head of the World Bank, has indicated that he will not seek reinstatement once his term finishes in June. Zoellick is famous for being part of the group which laid out the plan to invade Iraq and general right wing hawk. He succeeded the equally vile ex-Defense Secretary Paul Wolfowitz. Honestly, I don’t understand how a Republican Defense Secretary is in any way qualified to head an organization which has as it main goal the alleviation of world poverty.

Jeff Sachs, world famous development economist and savior of developing countries the world over has offered to take the job. (Check out a hilarious set of videos of Jeff Sachs gallavanting around the world with Angelina Jolie, here, here and here).

We could do worse. Larry Summers, Secretary of the Treasury under Clinton, advisor to Presidents Bush and Obama, former head of Harvard University and vocal adherent to the idea that men are inherently smarter than women (which he lost his job for).

Larry Summers was complicite in the final negotiations of the 1993 WTO Uruguay Round of trade talks, (the largest international trade agreement since GATT), and which ceded many international trading powers regarding develeoping countries to large (and US/British controlled) financial institutions like the WTO. African countries were largely unaware what they were signing when they signed on. During the Uruguay round, African countries largely ceded their ability to participate in trade resolutions and put control on international markets in the hand of big guns such as the United States. Larry Summers was on hand to threaten to take away foreign aid if they didn’t sign on.

It would be a disaster for the developing world if Larry Summers were to head the World Bank.

Hillary Clinton has long been pegged to be next in line for the chair of the World Bank, though she herself has been cagey on the issue.

I doubt Sachs will get the job, given the track record of the US in selecting World Bank heads in the past. The United States has reserved the right to name the head of the The World Bank since its inception, despite being an international institution. That Sachs is American might help, but his lack of shady Washington connections count him out. His alleged brief track record of neo-liberalism, particularly his controversial role in East European economic “shock therapy”, might help his case.

Still, Sachs is not without his supporters and his critics as a potential head of the World Bank. Unfortunately, his critics can seem to come up with any better candidates.

I respect the man’s work. There aren’t many out there that have been willing to be so vocally critical of US policy toward developing countries and its impact on human health. He makes his case in a manner that is understandable by even those not familiar with global health and world economics, and the video with Jolie clearly shows that he’s more than willing to take his case to the American public.

Uniquely, Sachs has been more than willing to take the Obama administration to task for it’s policy of doing absolutely nothing for global health. I had the pleasure of seeing Sachs speak at the last meeting of the American Society of Tropical Medicine and Hygiene and spoke with him briefly afterward where I proceeded to ask him for a job. He laughed and kindly told me to email him.

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