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Sara.Till

While there was criticism of the policy (see the Washington Post's rebuttal), the policy appeared to be well received until implementation of quarantine for returning health care workers. This, and the backlash, caused the policy to be revised and invited confusion about guidelines. Leaders may have lost political points by staying firm with their guidelines, but chose to revoke their initial decisions-- leading to confusion and worry in the general population. 

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Sara.Till

Preston's article mentions the EPA still had not formulated and enacted a plan for cleanup-- it should be noted the year of publication was 2006. She claims "After an expert panel failed last year to settle on a method for organizing an E.P.A. cleanup, the agency said it would proceed anyway with limited testing and cleaning". Moreover, in the 10 years since publication, several studies have indicated increased public health risks and chronic illness prevalence in populations near the disaster zone. It seems the approach of sit-and-wait did nothing but exacerbate the issue, leading me to believe this will serve as a symbol in any future pollutant-laden disasters.

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Sara.Till

The article pays tribute to the development of immigrants into French residency due to medical issues. Should an immigrant have a serious medical condition, and be unable to procure adequate medical care in their home nation, they would be given residency. This was a curious ascent for immigrants in status; the loss of immigrant workers as an integral portion of the economy had led to a general public distaste for immigration.

The very nature of the law made it very subject to individual interpretation-- creating divisions within the health care system. Fassin notes some instances where this interpretation caused the law to fail; discontinuity between medical professionals created situations where similar conditions were met with opposing decisions. Moreover, as cited by Fassin, this also led to several scenarios where doctors allowed their personal opinions on immigration to sway their decisions.

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Sara.Till

1) "Interventions in the acute phase directly following the disaster are designed to promote survivors’ safety and stability and to help them cope with their experiences (12). One such intervention, psychological debriefing or critical incident stress debriefing, was developed in the 1980s for emergency responders and has been used with other victims of trauma (46)."

2) "Exposure to potentially traumatic events is disaster-specific and often measured differently between studies, making it difficult to compare experiences and mental health consequences or to generalize findings to all disaster-affected populations (22). Additionally, most instruments that assess symptoms of mental disorder have been developed and validated in the United States (23, 48) and may lack cultural relevance and validity in areas impacted by disasters worldwide"

3) "These studies can help us understand what factors are associated with different courses of mental illness, which can help us identify the most vulnerable populations and inform tailored interventions"

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Sara.Till

Obviously, the individual testimonies hold enormous emotional power. Having a tearful mother share of her grief at losing two children, watching former marines such as Denita McCall fight for their lives against cancer, or seeing Mike Partain's massive spreadsheet of male breast cancer incidence all strike deeply. Yet, the most compelling piece was early on in the film. Ensingmer and Partain visit a cemetery near Camp Lejeune. While there, they note the sheer number of graves from between 1957-1987-- the vast majority belonging to infants and children. This, personally, was the most moving; witnessing the sheer number of lives  lost while hearing the excuses and lackluster responses of governing bodies demonstrated just how dire this situation was.

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Sara.Till

The article primarily asserts that how a patient narrates or describes their medical history is deeply rooted in their native culture. As such, physicians must be aware of how an individual's medical experiences can be altered based on this. In turn, physicians must recognize the importance of story-telling and anecdotes when receiving information directly from patients. Narratives project the patient's experience and events through their perspective, granting professionals a glimpse into their thought processes and action patterns.

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Sara.Till

The first portion of the article focuses on the shift of sexual violence from a woman's rights issue to the larger title of "gender-violence". From there, Dr. Ticktin argues the nuances of this transition necessitated medicalizing sexual violence, and turned it into a condition to be treated by tools within the humanitarian kit. Just as how we now attempt to treat polio by handing out vaccines and flyers, rape is covered by blanket protocols and procedures. In attempts to make this issue more respected, we sacrificed the nuances of care necessary for adequate treatment.

This is further exemplified in Dr. Ticktin's description of humanitarian aid-- the preservation of life itself, with disregard to the kind of life being lived. She goes on to contend that sexual violence is by its very definition a "kind" of life, thus creating an inherent conflict in the overarching goal of treating sexual violence and humanitarian interventions.

Dr. Ticktin also pays respect to the inherent difficulty in maintaining the typical principles used during humanitarian aid efforts, especially when attempting to treat gender violence. One of her primary examples is the work of MSF in the Congo Republic. During the conflict, roadblocks would be set by armed men, and thus MSF were forced to accept military escorts-- destroying the key humanitarian tenant of neutrality. Moreover, many of these militia men were perpetrators of the sexual violence, something MSF was seeking to treat. 

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Sara.Till

Emergency response is literally the main focus of the entire article. While it seems to be only a short chapter in a much larger collection of similar essays, the report fully analyzes past and present responses to nuclear emergencies. Moreover, Dr. Schmid builds a case for how future emergencies should be handled by an international team built on expertise. This includes expertise of nuclear energy, disaster response, and nuclear policy/regulation. While she refrains from commenting fully on whether the response mounted for Fukushima can be classified as "good" or "bad", her assertions indicates a need to shift focus from preventing emergencies to how nations respond to nuclear emergencies.

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Sara.Till

As an ambulatory agency, BSVAC obviously utilizes the typical EMS technologies, such as oxygen, BVM, ambulance, pulse oximetry, ect. However, it should be noted at the time of publication (2014), an article by the New York Times describing BSVAC's economic struggles, only 1 of the 6 functional rigs could be used due to lack of funding. At the time of the article, this rig had broken down-- and only through the volunteer maintenance by an EMT student's father had it been returned to commission. This leads me to believe that well BSVAC has all the available technologies, these may be dated or somewhat worn in nature.

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Sara.Till

The majority of the information obtained for this report comes from the work of the four authors. As members of Partners in Health or clinicians, these individuals have seen first hand the effects of social violence in patient care. Moreover, they have witnessed the effectiveness of addressing these ills to better patient outcomes. Some information was also gathered from past studies, including a report by Moore et al. detailing Baltimore's racial discrepancies in care and patient outcomes.