Saturday, January 08, 2005
Protocols and Ethics
One thing that is beginning to happen is a new tupe of protocol for organ donation.
Organ donation to begin with is almost always decided at a time of great sorrow for the loved ones involved. In the past, the organs were removed after the patient was declared brain dead. The new protocol is called non-heart beating organ donation.
It can be described as: the potential NHBD patient does not meet the brain death criteria but is termed "hopeless" or "vegetative" soon after suffering a devastating condition such as a severe stroke or trauma, and while still needing a ventilator to breathe...families or other surrogates then agree to have the ventilator turned off, a "do not resuscitate" order is written, and when the patient's breathing and heartbeat stops, the organs are removed.. This may be a perfectly valid situation. The real problem, as far as I can see is the subjectiveness of the diagnosis.
According to an article on this by George Isajiw, there is a lack of hard guidelines about this, and it is often up to the subjective diagnosis of the doctor that the patient is in a vegetative or terminal, hopeless state. He goes on to note:
A recent article in the New England Journal of Medicine illustrates the disturbing lack of objective medical standards for withdrawal of ventilators. This article, published in September of 2003, admits that no study was done to "validate physicians' predictions of patients' future functional status and cognitive function", and the researchers did not ask doctors to "justify their predictions of the likelihood of death or future function."
With such subjective standards being used for withdrawal of ventilators, it should not be surprising that the potential NHBD patient will unexpectedly continue to breathe for longer than the usual one hour time limit required for the organ transplant to be successful. In these cases of failed NHBD, the transplant is then cancelled but, rather than resuming care, the patient is just returned to his or her room to eventually die without any treatment or further life support.
There are some ethical questions here that need to be addressed. Is there a way to deal with incidents when the doctor guesses wrong and the person, who is horribly injured is refused treatment, but might have survived, is refused treatment after they don't die on schedule? Should there be a "provisional" do not ressucitate order? Is there a way to make a rational, non-subjective protocol on how to decide these cases? And how do we prevent the creeping movement to losen the standards to find more and more people usable for organ donorship?
Interesting area of ethical discussion - and one which needs real answers set up in advance, based on good science and ethical considerations, and not one meant to prey on the sorrows and weaknesses of family members at their most vunerable time.
Thursday, January 06, 2005
Sudan: Atrocities, Impunity Threaten Lasting Peace
African Union Should Deploy More Forces; U.N. Must Insist on Accountability
(New York, January 6, 2005) – Continuing atrocities in the western region of Darfur and impunity for war crimes in the south jeopardize prospects for peace in Sudan, Human Rights Watch warned today ahead of the January 9 signing of a peace agreement to end the 21-year conflict in the south.
But at the same time, the UN News Service says:
Welcoming the initialling of the final two protocols of a comprehensive peace deal to end the 21-year civil war in southern Sudan, the Security Council today voiced hope that the agreement will play a role in resolving the separate conflict engulfing the country's Darfur region in the west.
In a press statement read out today by Argentina's Ambassador César Mayoral, Council President for January, the 15 members said they hoped the agreement "would have a positive impact on the situation in Darfur," where tens of thousands of people have been killed and more than 1.85 million others live as refugees or internally displaced persons (IDPs).
Some real worries here:
The very forces doing ethnic cleansing have been incorporated to the army and police. There have been no guarantees or means of redress for those who have been so damaged by all the tribulations.
It is not a time to turn away, just because a piece of paper is being signed.
Wednesday, January 05, 2005
Be Silent No More
There are people who know this reality, and are trying to reach out.
Virtue Media is running an ad campaign to reach those women in need, who have hurt and unresolved issues following this experience.
See what they are doing here
If you know someone struggling with this issue, there are some excellent resources available.
I would start with a lovely blog called After Abortion run by two lovely women who know what it's all about.
Check out this book, Forbidden Grief by Theresa Burke
Know that there are people who care, and that the suffering doesn't have to happen.
A Human Face to Disaster
The grimy 10-rupee bill is worth 25 cents. It has been folded several times so that it's small enough to hide in the clenched fist of a 3-year-old girl.
Sitalakshmi won't let go of it. For more than a week now, since the day of the killer waves, she has held the pittance tight in her tiny hand, as if her life depends on it.
The girl's mother gave it to her on the morning of Dec. 26 to keep her from crying. It was the last time she would soothe her daughter that way. Now the greasy banknote has become the child's hold on the way things used to be.
"She even sleeps with it," said Sister Neeta George, one of the nuns who run the basement orphanage where Sitalakshmi lives in the Missionaries of Charity convent, founded by Mother Teresa of Calcutta.
The waves that hammered India's remote Andaman and Nicobar Islands killed the girl's mother, father and three of her brothers.
Only she and her 14-year-old brother, Balamurugan Kannan, survived.
With the courage of a man, a boy not much taller than 4 feet and weighing less than 80 pounds swept his little sister up in his arms and ran hard for higher ground.
His mother and father and three older brothers couldn't outrun the waves. Like most of those killed here in the Andaman archipelago, about 700 miles east of the Indian mainland, their bodies may never be found.
All over the world, there are things like this. Diaster, man's wickedness to our fellow man, bad luck - lives forever shattered. Don't think of them as statistics. They could be you and yours.
Think about your actions. Is your impact helping or hurting? Are you part of the solution or part of the problem?
Sudan - one of the world's shames
Arbitrary Arrest, Detention, Ill-treatment and Torture of Children and Adults
World Organization Against Torture (Geneva)
January 4, 2005
Posted to the web January 4, 2005
The International Secretariat of OMCT requests your URGENT intervention in the following situation in Sudan.
Brief Description of the Situation
The International Secretariat of OMCT has been informed by the Sudan Organisation against Torture (SOAT), a member of the OMCT network, of the arrest and ill treatment and torture of twenty-four men and three children:
1. Adam Abaker Abdella, 33 Yrs, Tama, Student
2. Alsadig Ibraheam Ahmed, 24 Yrs, Zghawa, Student
3. Ali Mohamed Aldouma Adam, 22 Yrs, Shareefi, Student
4. Ibraheam Mohamed Yahya, 52 Yrs, Felata, Transport Agent
5. Abaker Yahya Omer, 33 Yrs, Fur
6. Abdel Razig Abdel Majeed, 65 Yrs, Fur
7. Fayiz Abdella Yagoyb, 22 Yrs, Fur
8. Adam Ahmed Abaker, 21 Yrs, Hawara
9. Mousa Hassan Abdella, 60 Yrs, Zaghawa, Farmer
10. Mousa Wadi Hassan, 50 Yrs, Zaghawa, Farmer
11. Abdel Hameed Neel Salim, 65 Yrs, Zaghawa
12. Ibraheem Hassan Musa, 58 Yrs, Zaghawa
13. Hassan Ibraheem Mohamed, 70 Yrs, Hawara, Farmer
14. Adam Douda Ismaeal, 52 Yrs, Zaghawa, Farmer
15. Shareif Adam Babikir, 25 Yrs, Tama, Farmer
16. Abdel Haleam Abdella Abaker, 45 Yrs, Birgid
17. Mohamed Ibraheem Tairab, 25 Yrs, Tama
18. Yasir Abdella Musa, 19 Yrs, Zaghawa
19. Moustafa Abaker Ali, 19 Yrs, Berti
20. Emam Ahmed Abdel Aziz, 35 Yrs , Birgid
21. Ahmed Ishag Omer, 45 Yrs, Zaghawa, Teacher
22. Soulieman Adam Tairab, 35 Yrs, Birgid
23. Yahya Abdella Tom, 25 Yrs, Tama
24. Abdel Jebbar Shareif, 20 Yrs, Zaghawa
1. Tarig Dawood Jouma, 12 Yrs, Dajo,
2. Ahmed Yousif Bourma, 10 Yrs, Dajo
3. Musa Ibraheam Mohamed, 17 Yrs, Fur
According to the information received, on 16-17 December 2004, during aerial bombardments on Marla village by the air forces, the armed forces arrested twenty-four men and three children from Marla, Domma, Labado and Belail villages in Nyala province, southern Darfur state.
The men and the children were initially taken into military custody in Nyala where they were detained for 2 days. During the arrest and along the way from Douma and Marla to Nyala, the twenty-four men and three children were allegedly tortured by the armed forces. They were beaten with sticks all over their bodies, flogged on their backs and chests and kicked with military boots on both their faces and sides.
On 19 December 2004, the detainees were moved to Nyala Wasat (central) police station where they were officially charged under articles 51 (Waging War against the State), and 53 (Espionage against the country) of the 1991 Penal Code. On 20 December 2004, the 24 men and 3 children were transferred to Nyala prison where they remain in detention.
SOAT lawyers in Nyala visited the detainees in Nyala Prison and submitted an application to the Attorney General requesting medical examination of the detainees. The medical reports confirm that the men and the children were subjected to torture. The wounded detainees are receiving medical treatment from Amel Medical Centre for Rehabilitation of Torture Victims in Nyala, SOAT partner organisation in Nyala.
The International Secretariat of OMCT is gravely concerned about the physical and psychological integrity of the afore-mentioned individuals, including children and urges the Sudanese authorities to immediately release them in the absence of legal charges consistent with international law standards.
Regarding the three minors, Tariq Dawood Joumaa, Ahmed Yousif Bourma and Musa Ibraheam Mohamed, OMCT recalls that Sudan, as a state party to the Convention on the Rights of the Child, is bound by the provisions that a child shall only be deprived of liberty "(…) as a measure of last resort and for the shortest appropriate period of time" (Art. 37 (b)), as well as the "guarantee to be presumed innocent until proven guilty according to law (i) and to have the matter determined without delay by a competent, independent and impartial authority or judicial body in a fair hearing according to law (iii)" (Art. 40, §2.(b)). Moreover under article 37(a), (b) of the Convention on the Rights of the Child, "no child shall be subjected to torture or other cruel, inhuman or degrading treatment or punishment [and that] no child shall be deprived of his or her liberty unlawfully or arbitrarily." OMCT calls on the authorities to launch prompt, thorough and impartial investigations into the allegations of torture and ill treatment in order to find those responsible for any violations of human rights and to bring them to justice. Finally, OMCT calls on the authorities to guarantee that adequate compensation is awarded to all victims.
Please write to the authorities in Sudan urging them to:
i. take all measures necessary to guarantee the physical and psychological integrity of all detainees, in particular Tariq Dawood Joumaa, Ahmed Yousif Bourma and Musa Ibraheam Mohamed;
ii. order the immediate release of all detainees in absence of legal charges consistent with international law standards, or, if such charges exist, bring them before an impartial and competent tribunal and guarantee their procedural rights at all times;
iii. order a thorough and impartial investigation into the circumstances of these events, notably the allegations of ill-treatment and torture, in order to identify those responsible and bring them to trial and apply the penal, civil and/or administrative sanctions as provided by law;
iv. guarantee that adequate compensation would be awarded to all victims;
v. guarantee the respect of human rights and the fundamental freedoms throughout the country in accordance with national laws and international human rights standards.
· President of the Republic of Sudan,
His Excellency Lieutenant-General Omar Hassan al-Bashir,
President' s Palace,
PO Box 281,
Fax: +24911 771024 / 771651 / 779977
· First Vice-President,
Mr Ali Osman Mohamed Taha,
People's Palace PO Box 281,
Fax : + 249 11 779977 / 771025
· Mr Ali Mohamed Osman Yassin,
Minister of Justice and Attorney General,
Ministry of Justice,
Fax: + 249 11 771479
· Minister of Foreign Affairs,
Mr Mustafa Osman Ismail,
Ministry of Foreign Affairs,
PO Box 873,
Fax :+249 11 779383
· Advisory Council for Human Rights,
Dr Yasir Sid Ahmed,
PO Box 302,
Fax: +249 11 779173 / 770883
· Minister of Internal Affairs,
Major General Abdul-Rahim Muhammed Hussein,
Ministry of Interior,
PO Box 281,
Fax: +249 11 774339 / 776554 / 777900 / 773046 / 770186
· Minister of Federal Government,
Dr Nafie Ali Nafie,
Office of the Presidents People's Palace,
PO Box 281,
Fax : +24911 771651 / 783223
· Governor of North Darfur,
General Ibrahim Sulayman,
c/o People's Palace,
PO Box 281,
Fax: +249 731 42696
· His Excellency Ambassador Mr. Mohamed Al-Hassan Ahmed Al-Haj,
Permanent Mission of the Republic of Sudan to the United Nations in Geneva,
PO Box 335,
Fax: +4122 731 26 56,
E-mail: email@example.com; firstname.lastname@example.org.
Please also write to the embassies of Sudan in your respective country.
Kindly inform us of any action undertaken quoting the code of this appeal in your reply.
Comfort Quilts for Families of Fallen Military
Here's the info:
Marine Comfort Quilt Group is a not for profit ministry whose objective is to provide a memorial quilt of comfort to the next of kin of our fallen military. Our quilts are made from thirty quilt squares, each containing an inspirational message from it's donor or another serviceman.
Our quilts are stitches of love from those who want so badly to bring comfort, but don't know how to help.
Our Marine Comfort Quilt Group has now decided to take on a greater project. With the War on Iraq, we have lost many Marines.
Our initial project was to make one quilt for each family of a fallen Marine, but we have since expanded this project to include all members of our Armed Forces that gave their life in this war.
We are praying that soon these quilts will no longer be needed, but until then, we will not stop stitching until each family has been provided a small gift of comfort.
Here's a link to their web site: http://www.marinecomfortquilts.us/
Tuesday, January 04, 2005
The Almost Forgotten Crisis - Darfur
Forced evacuations and mass rapes; brutal ethnic killings and rampaging militias; oil profits and arms sales. The deadly mix of politics, economics, and insecurity has displaced 1.6 million people and killed tens of thousands in the Darfur region of western Sudan since early 2003. The United Nations recently described Darfur as the "world's worst humanitarian crisis."
This is not a humanitarian crisis. It is a war.
Thus says Sarah Kenyon Lischer. She makes a very important point:
The label "humanitarian crisis" conveniently absolves the rest of the world from taking political and military action in Darfur. By providing generous humanitarian assistance, governments and the UN claim to take meaningful action.
Stories have been coming out of the Sudan for a long time now, and yet nobody has really wanted to do much. There has been pressure put on the Sudanese government, but no real action taken, as the government there knew.
Yet this is a tragedy every bit as evil as the tsunami, and worse, because it is caused by human agency, and didn't have to be.
Get more information:
Save Darfur is a website with information about the situation, and information about what you might be able to do to help keep this in the public mind.
Human Rights Watch: If We Return, We Will Be Killed
CareUSA: Emergency Crisis in Sudan
Life in Banda Aceh
The World Health Organization (WHO) said cases of pneumonia, diarrhea, malaria and skin infections were emerging along with some cases of gangrene because survivors had been exposed to polluted water and not treated carefully enough.
Vijay Nath, a WHO medical officer supervising the emergency response program in Banda Aceh, said he had a fairly good picture of the health situation in the provincial capital and there had been no confirmed cases of cholera.
"But on the west coast, we just don't know what is happening," he said.
Parts of Banda Aceh city were deserted, especially the downtown area near the waterfront, where buildings were flattened by the massive Dec. 26 quake and killer waves. Small fires smoldered in a desperate attempt to burn stacks of debris.
In front of a collapsed shopping mall where food and water were being distributed, at least 1,000 people queued for water from a private aid station set up by businessmen.
Volunteers handed out rice, marking people's fingers with ink that would wash off after a day to allow them to collect more.
Residents said that, outside the huge makeshift refugee camps, it was still a struggle to get adequate food and water for their families, many of whom were injured or sick.
"If you don't live in a refugee camp, you have to queue like this. It's very hard for us also out here," Ramzi, 27, told Reuters as he queued for water. He said he and 15 relatives were living in a house undamaged by the tsunami.
The Health Ministry said nearly 400,000 people were refugees in Aceh, a province of about four million at the northern tip of Sumatra. More than 94,000 were killed in Indonesia, two thirds of the total toll of nearly 145,000.
When I was a kid in New Orleans, I went through the devastation of Hurricane Betsy...we had no power for days, contaminated water, rubble everywhere...people I knew were trapped for days in their attics waiting for the waters to go down. A few years later, I saw the power of water when we saw the scouring of what Hurricane Camille did to the nearby gulf coast. When I was grown, I discovered what it is like to come home and find your home destroyed by an arsonist. Yet these are small scale destructions compared to what these people are going through.
Don't forget them. It takes time to rebuild.
Monday, January 03, 2005
Help Is Reaching Banda Aceh
BANDA ACEH, Indonesia - The head of the US military’s relief operations in Indonesia’s tsunami-hit Aceh province said Monday the devastation was beyond belief, but that the American aid effort was “going great”.
“I’ve been down the coast and it’s just unbelievable what the force of this tsunami has caused to the villages,” Rear Admiral Doug Crowder told reporters at the Indonesian military airbase in the capital of Banda Aceh.
“Some places have been flattened for a mile and a half, (there are) mostly just foundations of homes and businesses left.”
US navy Sea Hawk helicopters have been airlifting supplies into the most isolated areas of Aceh’s west coast since Saturday and evacuating some survivors back to Banda Aceh.
Aceh’s west coast took the full force of the December 26 tsunamis, which killed more than 94,000 people in Indonesia and another 50,000 elsewhere.
Crowder, commander of the USS Abraham Lincoln which is stationed just off Aceh’s coast, said US helicopters had so far delivered 50,000 pounds (22,600 kilograms) of food and water, saying the operation as “going great”.
He said he was also inspired by the reaction of the survivors to the US operation.
“After we finished offloading what we had in that helicopter, one of the individuals, a young man, turned and gave me a wonderful smile and a thumbs up and for me I’ll remember that,” he said.
The head of the United Nation’s relief operations in Indonesia, Michael Elmquist, said on Saturday the US navy’s efforts in the isolated disaster areas were vital, as the near-starving survivors would not receive help otherwise.
“It’s absolutely life saving,” Elmquist, the chief of the UN’s Office for the Coordination of Humanitarian Affairs in Indonesia, told AFP.
“We are absolutely thrilled that Americans are doing that. They are the only ones who have the capacity to reach those parts of the population right now
Source: Khaleej Times
Help is reaching these poor people...but it will be a long time before we know the true count of lost lives, shattered lives, economic setbacks and destroyed dreams. These people, no matter what their race or religion, are our brothers. People in 12 nations were affected.
You can help. You can find a list of relief agencies and charities here.
Essence and the Culture Wars
Essence is taking on the slut images and verbal abuse projected onto black women by hip hop lyrics and videos.
The magazine is the first powerful presence in the black media with the courage to examine the cultural pollution that is too often excused because of the wealth it brings to knuckleheads and amoral executives.
This anything-goes-if-sells attitude comes at a cost. The elevation of pimps and pimp attitudes creates a sadomasochistic relationship with female fans. They support a popular idiom that consistently showers them with contempt. We are in a crisis, and Essence knows it.
There's more. Read it here.