Analyze

I found the part where the healthcare worker relates to the difficulty of his position most compelling and persuasive. A man on the burial team talks about some of the challenges he faced. He says that they are in denial about the disease. For example, a man’s wife died from the disease. They took the body and marked the room with the health tattoo, do not enter and barricaded the door. A health team was tasked to disinfect the building but the moment they left the husband bust the door down and went inside. He died as well. “You see the challenges? You tell people, don’t do this, they pass behind you go do it, don’t do this, they say we are eating free money, the government is lying”.

                I was probably influenced by the fact that I am a healthcare worker and while not the same situation, I can relate to his dilemma. 

Dr. Knowles points out the structural failures of the World Trade Center due to steel beams and poor fireproofing material. Dr. Knowles connects the burning of the Capitol Building in 1814, the 1850 Hague Street boiler explosion in NYC, and Chicago’s Iroquois Theater Fire of 1903 to convey the different aspects of a structural disaster. The Capital Building focused on the investigation, the importance of the sentimental value of the building, and rebuild it as well as the difficulties involved with doing so. The Hague Street Explosion investigation attempted to pinpoint the root cause of the disaster, but after thorough investigation there were many failures at many different levels which led to the ultimate failure. The Iroquois theater fire revealed issues with public policy, regulation compliance, and public perception in addition to its investigation.

1) “The logic of state soverignty in the control of migration clearly prevailed over the universality of the principle of the right to life.”

2) “By analogy with the therapeutic mesasures applied at the end of life for patients suffering from illness deemed incurable, we can describe the measures and procedures devised to allow foreign patients without residence rights to stay in France, receive treatment, and have their living costs paid, as a compassion protocol.”

3) “Precisely because he or she is illegally resident, the sick immigrant may undertake medical tests or seek treatment under a different name, so that the cost of treatment is coverd, or simply to avoid being denounced and deported.”

1)            Personal trauma: this includes not only the direct, immediate effects of the disaster but also the long-term mental and physical effects from the disaster.

2)            Way of life disrupted “disaster capitalism”: the next part of the syndrome includes business taking advantage of the situation for profits; the main case being private companies profiting off of federal funding to rebuild the homes and lives of the citizens who were affected.

3)            Displacement: the well-off are able to relocated after the disaster has ended but for those less fortunate, there permanent effects are worse, and there is little they can do to relocated to their homes and communities after the superficial aspect of the disaster have ended.

The assessments that patients take are not visible to the public so I can not elaborate on it. This is what is quoted from the company’s website about the “Easy Clinical Screenings”:

“Patients take digital, gamified mental health assessments conveniently on their mobile device to learn their actual diagnosis and become more self aware. Providers can deploy customized assessment questions specific to each patient. Patients can see their charted progress over time. Assessments are reimbursable by insurers.”

The bibliography is not included in the excerpt that we received. Based on the text it appears that many other research articles and outside studies were used as well as interviews.

The author uses a wide variety of news and journal sources to make their point. Everything from the New York Times to East Asian Science. It also cites many volumes on disaster preparedness. For example, “The Chernobyl Accident: a Case Study in International Law Regulation State Responsibility for Transboundary”. The sources tell me that the article was developed around the news at the time and works that dealt with handling of disasters from the past. For me, this furthers the case that the author is making: that the way we have been doing things in the past is not working.

I looked into how EMS operates in situations that are beyond protocols, standing orders, and medical control. I also looked into how story cases are used by other medical professionals. Further I looked into how “evidence” based approaches are formulated for studies and research.

1) “…what would happen if race and insurance status no longer determined who had access to the standard of care?

…in addition to removing some of the obvious economic barriers at the point of care, the clinicians and researchers considered paying for transportation costs and other incentives as well as addressing comorbid conditions ranging from drug addiction to mental illness. They also implemented improvements in community-based care, conceived to make AIDS care more convenient and socially acceptable for patients. The goal was to make sure that nothing within the medical system or the surrounding community prevented poor and otherwise marginalized patients from receiving the standard of care.

The results registered just a few years later were dramatic: racial, gender, injection-drug use, and socioeconomic disparities in outcomes largely disappeared within the study population [35].”

2)            “This model [PIH’s model], with conventional clinic-based (distal) services complemented by home-based (more proximal) care, is deemed by some to be the world's most effective way of removing structural barriers to quality care for AIDS and other chronic diseases.”

3)            “While some interventions are straightforward, we also have to recognize that there is an enormous flaw in the dominant model of medical care: as long as medical services are sold as commodities, they will remain available only to those who can purchase them.”

I had difficulty finding direct discussion of that particular chapter, but according to Google Scholar there are 22 citations of the larger work, some of which cite this particular chapter.