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Analyze

What quotes from this text are exemplary or particularly evocative?

margauxf

“The large question this study addresses is the following: How do people make sense of (and cope with) toxic danger? The Martinezes’ story anticipates the complexity of the answer(s): physical and psychological suffering is compounded by doubts, disagreements, suspicions, fears, and endless waiting.” (4)

‘Flammable is a story of people’s confusion, mistakes and/or blindness regarding the toxicity that surrounds them. Flammable is also a story of silent habituation to contamination and of almost complete absence of mass protest against toxic onslaught’ (4)

“Schoolteachers, journalists, and lawyers are also part and parcel of daily life in Flammable. Together, all these actors contribute to what Flammable residents know about their place. They also influence what they ignore, what they want to know, and what they misrecognize. Government officials, company personnel, physicians, teachers, journalists, and lawyers jointly (but hardly cooperatively, given that their opinions don’t count equally) shape locals’ experiences of contamination and risk. This book examines how and why this production of shared knowledge (or lack thereof ) occurs.” (5)

“All in all, confusions, bewilderments, divisions, rumors, frustrations, and hopes are making Flammable residents wait—they wait for more testing, for further and better knowledge, for relocation, and for the “huge” settlement with one of the “powerful companies” that will, in the words of a neighbor, “allow us to move out.” This waiting is, as we will show, one of the ways in which Flammable residents experience submission.” (6) 

“We did our best to learn how to listen, look, and touch with respect and care, knowing with Nancy Scheper-Hughes (1992:28) that “seeing, listening, touching, recording, can be, if done with care and sensitivity, acts of fraternity and sisterhood, acts of solidarity. Above all, they are the work of recognition. Not to look, not to touch, not to record, can be the hostile act, the act of indifference and of turning away.” (14)

‘… the culture of toxic uncertainty is a complex web of meanings and shared understandings’ (108)

What concepts does this text build from and advance?

margauxf

Labor of confusion: “During the long period of slowly germinating contamination, the actions of government authorities toward pollution in the neighborhood were less consistent and more contradictory than either the denial or underestimation that has been documented in the existing literature. Those multiple incongruous actions gave shape to what we term, extending the insights of students of ideology and symbolic power (Thompson 1984; Eagleton 1991; Bourdieu 1991), a labor of confusion that has a decisive effect on shared (mis)understandings.” (10)

 Ulrich Beck, social invisibility, lack of “social thinking” about environmental issues (Beck 1992)

Bourdieu, symbolic violence - misrecognition of power structures on part of the oppressed enables domination

Toxic uncertainty: “a way of experiencing toxic suffering that is shaped by what we call, borrowing from Charles Tilly (1996), the interacting “invisible elbows” of external power forces and of everyday routine survival struggles” (6)

 

What is the main argument, narrative and effect of this text? What evidence and examples support these?

margauxf

Flammable is an account of how people in a particular place make sense of slow, invisible environmental pollution. The people of Flammable live in an Argentinean shantytown located next to petrochemical companies and storage facilities. They have been deeply affected by the rise in unemployment in the 1990s, with most residents subsisting on part-time manual jobs at one of the companies, retirement pensions, state welfare programmes and what else they can find. The area in which these residents live is known and recognized by government experts to be contaminated and unsafe for human habitation–and yet widespread confusion and uncertainty amongst residents and a lack of government actions means that the shantytown continues to exist. Auyero and Swistun explore the multitude of influences that ‘‘shape what people see, what they don’t see, what they know, what they don’t know, and what they would like to know, what they do and what they don’t do’’ (145). They show how residents gradually naturalize their situations, which, combined with the mystification of dominant discourses, contributes to their quiescence in the face of contamination. 

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Sara_Nesheiwat

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.

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Sara_Nesheiwat

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

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Sara_Nesheiwat

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.

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Sara_Nesheiwat

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…

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Sara_Nesheiwat

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.

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Sara_Nesheiwat

This policy was received in good light by the public for the most part. Patients were only to benefit from this, especially those who lacked insurance. Even those with insurance didn't have to waste time proving it any longer, they were treated and stabilized and insurance issues and payment were brought up later. Any ethically sound doctors, such as the ones working in hospitals that were already implementing the actions set forth by EMTALA (before it was law) had no issues with EMTALA. No doctor should have any issues with it due to their duty to act as well as ethical and moral standards they should be holding themselves up to, written in their oath they took to become doctor. The only people that would stand to receive this act negatively would be the doctors who were actively turning away patients in need, who are clearly morally compromised. Yet, media, patients, a majority of doctors and staff found and received this act positively or with little reservation.