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Community Archiving: Evocative Quotes

tschuetz

Archiving is always political

"Observers of community archives have tended to distinguish between those politically and culturally motivated endeavours acting to counter to the absences and misrepresentations relating to a particular group or community in mainstream archives and other heritage narratives and those whose the inspiration is not so directly or overtly political or cultural, but rather is a manifestation of a shared enthusiasm for the history of a place, occupation or interest. Whilst it is an important distinction, the authors would also contend that even in the most nostalgic and leisure-orientated community archive projects there is something inherently political in individuals and communities taking an active role in the re-telling of their own history." (2013, 5)

Archivial imaginaries and futures:"Community-based archives may act as sites of resistance and subversion in the present and a map for future aspiration as much they are interested in documenting the past (Appadurai 2003)." (2013, 9)Independence as vulnerability

"One of the consequences and dimensions of this commitment to independence and sustaining autonomy is the resulting dependence on the significant personal sacrifice (financial, physical and mental) of key activists and a network of volunteers, arising from great emotional and political commitment to the collections and their impacts. As we have already noted this commitment is both an enormous benefit to the archive but also a potential vulnerability with regard to the long term stability, succession and sustainability." (2013, 12)

Second wave community archiving

"[D]evelopments in the web and social technology were a significant factor in what in the UK we might term the second wave of community-based archives and heritage activities in the late 1990s and early 2000s." (2013, 13)

Search for definitions and the 'institutional gaze'

"[W]hy are “we” (and here we are referring not only to academics in archival studies, but also to archival practitioners) so focused on formulating definitions of and making distinctions between mainstream and community archives and their endeavors? For the most part, “we” are not the voices of, or even representing “community archives”– although that line is becoming more blurred with increased numbers of professionally-trained archivists coming from and returning to these communities. We are the ones applying the term “community archives” to these diverse social, political and cultural initiatives and we are the ones viewing their inception and flourishing as some kind of phenomenon or movement. But are they really, or is that our projection, possibly because we recognize how these initiatives address the shortcomings of our more traditional archival constructions and practices?" (2013, 14)

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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.

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Sara_Nesheiwat

It is said that EMTALA doesn't apply to ambulance services, technically this would be true. Yet, EMTALA does indeed effect our patients, and anything that effects our patients can effect us and should be a concern of ours as EMS providers. If EMTs are spending time in the hospital sorting out insurance issues and payment, that is more time they are out of service. Also, if the patient's treatment time is delayed, not only will the hospital be blamed, but so will EMS. If a patient is in cardiac arrest, EMTs will not be stopping and wasting time to find out insurance and payment issues from family members, that will be the last thought on their mind. They will be transporting and attempting to stabilize the patient. EMTs and EMS will not compromise the health of a patient due to insurance or payment issues, just like hospitals are now mandated to do.