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pece_annotation_1475971072

ciera.williams

This article examines "chronic disaster syndrome," a situation that arises in the wake of a large-scale disaster that perpetuates the life in an emergency through government institutionalized and private-sector supported barriers. The article first looks at some of the physical and mental conditions that were created or exacerbated by the disaster. It then follows up with the government's betrayal of the people, first in providing support to the victims, and then actively barring victims from recovery. The article ends with the future in the wake of this disaster, including the "perpetuating of emergency" and continued institutions in place as a result of the hurricane. 

pece_annotation_1475970787

ciera.williams

“In particular, the syndrome articulates the powerful way in which displacement is simultaneously recognized as a cause, symptom, and, ultimately, false cure for disasters. Chronic disaster syndrome represents the health outcome of life in an ongoing state of “disaster” or “emergency” (Agamben 1998; Fassin and Vasquez 2005) that, as in this case, is perpetuated by industries of “disaster” capitalism (Klein 2007; Klinenberg and Frank 2005). The total collapse of infrastructure and social services initiated by storm and floods produced what Naomi Klein calls the perfect conditions of “shock”—a collapse so severe as to authorize a new government arrangement in which the state contracts with private firms to provide services it previously provided”

“One of the recurring themes that we heard from those who were still displaced in trailers or temporary living situations (e.g., with relatives), but more so from those who had returned and were, in a few cases, back in their homes, was that, even if the neighborhoods were being rebuilt, people had lost so much that nothing would never be the same.”

“We were, like I said, we were close. No more. Not anymore. And some of it too is that we got away from one another and we realized how little we got in common. Or else the storm took it away. I don’t know which it is, you know. Cause I’m an analyzing person and I’ll try to figure it all out sooner or later. But it’s either we just really don’t have anything to talk about anymore, or we never did, and we just thought we did. It’s weird. …”

“This chain of events prompted residents to say things like: “We all asked, ‘Who was meaner: Katrina, Rita or FEMA? And everybody’s pointing at FEMA.’ Which is worse— Katrina, Rita or FEMA? FEMA””

“Katrina offered an opportunity for disaster capitalism to become entrenched, supported fully by the U.S. government. But the failure of an effective recovery in New Orleans has created yet another kind of “disaster”—the ongoing disaster. New Orleans offers an example of the perpetuation of a “state of emergency” that was initiated by Katrina but has been sustained by ongoing politicoeconomic machinery—a machinery that ultimately needs to “have a disaster” to justify its existence.”

“Hurricane Katrina was an “event” disaster that mobilized a “state of emergency,” which subsequently led to the authorization of a military response to an “ongoing” disaster that the failure of bureaucratic machinery helped to prolong. The “state” was erased as a functioning buffer for the poorest sectors of the socioeconomic hierarchy, and in its place a “free market” in private-sector development contracts emerged. Just as those citizens who were living paycheck to paycheck or welfare check to welfare check were evicted first by the forces of nature and then by the force of the unfettered free market authorized by the “emergency,” so too were the social programs, previously offered by the government to provide safety nets to these populations, eviscerated”

pece_annotation_1475447988

ciera.williams

"... pathology, which previously aroused suspicion, has therefore become a source of social recognition"

"The issuing of a diagnosis and prognosis- an every-day act for the clinician, in principle involving no difficulties other than technical ones- became a problem of conscience that seemed like to invovle ideological of ethical issues" 

"The logic of state sovereignty in the control of immigration clearly prevailed over the universality of the priciple of the right to life. The compassion protocol had met its limit" 

pece_annotation_1475968582

ciera.williams

The article uses a combination of sources, such as research, epidemiology, and "ethnograpic portrayals" by affected individuals. These are compared to form a comprehensive view of the aftermath of Katrina, and how the government was not prepared to address the large scale relief efforts neccessary. 

pece_annotation_1475447818

ciera.williams

The author cites a number of cases in which the law proved difficult to enforce. One example is seen when looking at the difference in residency application acceptance rates between different locales/prefects. The much larger and metropolitan areas would accept down to 47% of the applications, indicating a possibly fair division of candidates reviewed. Other more rural areas would accept over 90% of the applications, showing almost no distiguishment between ailments. The question becomes whether this is reflective on the doctors' judgements of "serious ailment" given location, the political beliefs of the prefect, or simply the lack of caring whether someone emmigrates or not. Another example of the flaws in this law is highlighted by a personal anecdote from a patient. The patient was given a diagnosis when originially coming to France on a personal visa. They were told their condition was quite serious and would require ongoing care. However, when the doctor who diagnosed him was asked to sign for evaluation for the residency permit, the doctor changed his diagnosis to something much less serious. The political thought behind the poicy came into play and interrupted the normal proceedings, tearing doctors between their obligations to the law (and only allow exceptional cases) and to medicine (and err on the side of caution).  

The author also highlights the development of this law and its effects in three stages. Pre-1990: Serious illness was a factor in residency completely at the discretion of local government. Immigrants were seen as workers and they served that purpose only. If a worker was sick, they were of no use to society. 1990-1998: Illness was more often factored into the decision making process, but those allowed to stay received no paid employment or social wellfare benefits. Post 1998: Written into law, ill immigrants were allowed to stay with the opportunity for pay and legal status in France. 

pece_annotation_1475447106

ciera.williams

The main theme of this article is the conditions leading up to, during, and following a policy passed in France in 1998. The policy allowed residency to "any foreigner habitually resident in France and suffering from a serious medical condition requiring medical treatment, and for whom deportation would result in exceptionally serious consequences, provided that he or she would be unable to receive appropriate treatment in the country to which he or she is returned" The author likens the poicy to "compassion protocol" or palliative care. The law should only apply in extreme circumstances and is based on an emotional response to pain/suffering. 

This policy had good intentions, but led to a number of resulting issues, such as disparity in care due to ambiguity in the law. For the enforcers of the law, there was much interpretation which allowed for individuals to exercise "humanitarian reason" and decide what conditions were a "serious medical condition" and what was not. This politicized medical care for foreigners/immigrants, as medical proffessionals no longer diagnosed based on symptoms, but socioeconomic status as well.