Analyze

 In 1991, the Public Health Service articulated a vision for primary prevention in Strategic Plan for the Elimination of Childhood Lead Poisoning, a departure from previous federal policy focused on finding and treating lead-poisoned children. This publication detailed a 15-year strategy for primary prevention and offered a cost-benefit analysis to demonstrate the monetized benefits of this approach. A strong national effort to follow this strategy developed but was eventually abandoned.

The organized campaign against universal screening began in California, where letters questioning the reported prevalence of elevated BLL began appearing in pediatric journals and newspapers. These letters acknowledged receiving editorial assistance from Kaiser Permanente Foundation Hospitals and argued that money spent on screening, treatment and abatement would be harmful to more worthy public health efforts. The AAP president took up this attack on universal screening as well, and efforts for universal screening were gradually eroded. 

Needleman identifies racism and the belief that lead poisoning “is a product of poor mothering, not of environmental pollution” as a driving factor shaping lead detection and prevention efforts (or the lack thereof) … “this weighting of personal choice or behavior over environment is a tool used to shift responsibility away from health authorities or polluters and onto the victim” (1875).

TS: Kirsch discusses two international networks focused on the mining industry. Looking at these networks, particularly their organizational forms and histories offers comparative perspective on networks that have formed around Formosa Plastics and related industry. The analysis also illuminates how networks fit within Kirsch' framework of the "politics of space" and "politics of time". 

The first organizatin is the US-based Global Mining Campaign, with membership from over 40 countries. Kirsch argues that due to its "top-down" approach, the network didn't last long (2014, 194). The initative was focusing on blocking new mining projects, and is therefore representative of the politics of time (ibid).

The second organization is the Mines and Communities network, which he describes as a horizontal network where participants can contribute information about affected communities. He notes that unlike the top-down approaches, this organizational form seems more in line with the desire of activists. A search for Formosa Plastics on the website turns up newspaper articles about the Formosa Steel disaster in Vietnam.

He further elaborates:

"The signature contribution of the Mines and Communities network has been its ability to track and analyze the strategies of the mining industry, information that is posted on its website (www.minesandcommunities.org). Other mining websites tend to focus on specific mining projects, companies, or countries; technologies such as mountaintop removal; or particular commodities, such as coal, diamonds, or gold. The Mines and Communities website provides a more comprehensive overview of the mining industry by drawing on regional materials submitted and reviewed by its members, who contribute important contextual information and analysis. Participation in the editorial process for the website has been a two-way street for network members, enhancing the content posted on the website while providing the editors with a valuable comparative perspective on the mining industry. Although the original objective of the website was to provide information that could be used by indigenous communities affected by mining projects, it largely failed to reach its target audience" (2014, 196-7).

Kirsch states that the website is mostly frequentd by academics and other researchers, rather than affected communities. Based on my reading, I'm not sure why that is, but it raises questions about the "target audience" of the Formosa Plastics Archive. 

TS: According to Kirsch, an important strategy of a politics of time is centred around distributing information to affected communities. In his words, this includes "accelaration of the learning curve of communities facing the prospect of a new mining project" (2014, 192). He provides terms to characterize different approaches, as well as their shortcomings:

"NGOs have employed a variety of means to reduce the disparity in access to information between mining companies and local communities. The most common strategy for achieving this goal is the vertical transfer of information from metropolitan NGOs to rural communities by sharing materials about comparable mining projects or the track record of the relevant mining company. NGOs also facilitate horizontal information sharing between communities facing similar challenges (Appadurai 2002); this may involve sponsoring visits by local leaders or community representatives to comparable mining sites or attendance at conferences where they can learn about the experiences of other communities affected by mining. [...] NGOs also exploit new opportunities provided by the Internet to share information with people from communities affected by mining, although these efforts are constrained by both the problems of translation and the persistence of the digital divide. Nevertheless, NGO reports are generally more accessible to the public than academic publications, the digital forms of which are ordinarily locked behind expensive paywalls. And the information gap is shrinking as a result of increased attention to mining conflicts by traditional news media, as well as by new social media, including electronic mailing lists, websites, and online video." (Kirsch 2014, 193).

TS: The text "compares two different kinds of political movement. The first example is the politics of space, which makes use of resourcesthat are geographically distributed. It strives to create oppositional power through the development of extensive transnational alliances. The second is the politics of time, which pursues alternative strategies focused on the prevention of industrial activities that are almost certain to cause harm—activities that become very difficult to halt once set in motion given the huge capital investments they entail and the economic resources they provide to the state and other parties. The politics of space was characteristic of much of the environmental activism that emerged in the 1990s, which often addressed problems after the fact. In contrast, the politics of time leads to more hopeful forms of intervention given its potential to prevent harm from occurring" (Kirsch 2014, 226).

Kirsch notes that the recautionary principle is an example of the politics of time as discussed in his ethnography (Kirsch 2014, 260).

The Emergency Medical Treatment and Labor Act is a law requiring that anyone coming into the emergency department will be stabilized and treated no matter what their insurance situation is. In terms of women's health, it is important to note that this means for active labors, medical treatment is necessary and required, no matter the health insurance of the patient. The purpose of this law to prevent certain patients from being turned away in an emergency situation or refused medical treatments if they are unable to pay, putting their health at risk.

EMTALA was enacted by Congress in 1986 and was part of the Consolidated Omnibus Budget Reconciliation Acts of 1985. Congress saw different cases around America where doctors were refusing medical care to patients who could not make a deposit at the time of their admittance to the ER. An example of this is a patient Eugene Barnes, who in 1985 suffered a stab wound and ultimately ended up dying because 6+ doctors refused to help him without payment or some form of compensation. This made national news and other cases began to come to light, such as at Baptist Hospital in Miami and many other areas. News outlets began to follow these cases and this caught attention of government officials. Shortly after, EMTALA was enacted.

http://www.pitt.edu/~kconover/ftp/emtala-draft.pdf

This policy applies to American law and patients who are in need of emergency medical treatment and is to be followed by all emergency departments and personnel alike. 

This was touched upon a little in a previous question. Many cases of patient dumping were popping up around America. Patients in need  of emergency medical care were being cast aside, ignored and delayed due to their inability to pay. In addition to the stab patient, Eugene Barnes that sparked this law, there were dozens of other cases where patients needed to be transferred to larger hospitals but the hospital refused to take patients without insurance, so the patients died. There were cases of people being asked right before surgery for a deposit, and being unable to pay were discharged with no surgery. There was also a very high rate of dead babies that were arising due to the fact that mothers in labor were being turned away because the patient was uninsured. It was then realized by the government that there were no legal duties for a hospital to treat people who are in emergency situations but cannot pay, only ethical and moral duties, which apparently weren't enough in some cases. This led to the birth of the EMTALA, requiring medical attention to all ED patients as well as transfers if needed to stabilize, including mothers in labor.

This policy greatly helped sculpt emergency medicine and public health. By giving the right to the patient to have emergency medical treatment required without proof of insurance or payment, astronomically influenced the amount of patients being turned away and their possibilty of developing worse illnesses or dying. In a paper I read, a young doctor in the late 70s and early 80s remembers watching a woman in labor give birth in the doorway of the hospital and proceed to borht her child in the parking lot after being turned away for not having insurance. By requiring hospitals and doctors to see that all ED patients get care, no patient was at risk of dying or complicating their baby's health and birth due to a lack of insurance, ultimately increasing public health efforts. Not all hospitals turned away their patients, but enough did to make it a public health concern and get Congress involved. EMTALA changed emergency medicine protocols but also public health expectations and actions.

http://www.hhnmag.com/articles/5010-the-law-that-changed-everything-and…

This policy was explicitly made for vulnerable populations who couldn't afford or for whatever reason did not have health insurance. The vulnerable parties that did not have health insurance were at risk of being turned away at hospitals during crucial times of need and emergency situations. This act completely absolved the worries and fears of this vulnerable population without health insurance by making it a law that these ED patients were to receive care and stabilization. This act was made for this specific vulnerable population, to prevent discrimination.