Skip to main content

Search

pece_annotation_1475973788

ciera.williams

The article explains how a team of medical staff treated (and consequently killed) a number of patients following the flooding of a hospital in New Orleans. The staff in question overdosed the patients to put them out of their pain as they saved other patients who were more likely to survive. The article calls into question the process of triage and how we go about it. Who has the authority to make these decisions, and what lines do we draw between ethics and compassion. The article provides a play-by-play of the events leading up to the flooding, and relevant policies that existed and have been created related to this incident. 

pece_annotation_1478486764

ciera.williams

The author seems to rely strongly on personal experience and belief to make broad statements about the situation following chernobyl. Most of the article is about the author and their experience with the issue, rather than the objective data and observations of others. This makes the arguments seem rather close-minded and almost biased. 

pece_annotation_1473043634

ciera.williams

The program was created in reaction to the disaster at Fukushima-Daiichi, with influence of the lessons learned post-bombing in Hiroshima. Hiroshima University specializes in radiation casualty medicine and works to improve medical care in response to nuclear emergencies. This program was specifically made to generate leaders capable of directing relief efforts while keeping the clear goal of reconstruction post-disaster. 

pece_annotation_1473631685

ciera.williams

In Baltimore, researchers found that racism and poverty especially affected African Americans without insurance. In order to address this, they removed boundaries to care within the medical system and community so that poor patients could receive the care they needed without economic trouble. Along with this, they also established a system that relied on the community as a whole for care, taking the social stigma away from AIDS/HIV care and building ties as a whole. Within a few years, many disparities disappeared among the studied population.

Another study in rural Haiti was used to develop the PIH model of care. This model relies on an accompagnateur who is trained in drug delivery and supportive care. This allows care to be given within a village, not a clinic, and improves access to care. This model has worked to improve patient care and outcome in Haiti, Peru, and Boston.

In Rwanda, structural violence has perpetuated to transmission of disease from mother to child for decades. Access to resources such as clean water and formula, along with public health agencies promoting the merits of breastfeeding, have made it challenging to address MTCT. However, when researchers asked mothers if they would like these resources, they were eager to receive them and wanted to help in preventing further transmission. 

pece_annotation_1473908346

ciera.williams

The data acquired in this study can be used not only for improvement in policies and training for healthcare workers, but also to examine the risk factors for the disease. One example is the age and gender disparities in those nfected. These could be explained by the typical age and gender of healthcare workers, but could also show a trend in risk when coupled with patient data. The data on the districts and their infection rates can be used to help pinpoint the origin of infection. 

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_1476986440

ciera.williams

Emily Goldmann is an Assistant Research Professor at NYU in the College of Global Public Health. Her research primarily focuses on the social and environmental factors affecting mental health. She has written several articles on the mental health conditions in soldiers, which can sometimes be extended to emergency responders in disaster zones. 

Sandro Galea is a professor and dean at Bostom University and former Chair of Epidemiology at Columbia University. He formerly was an emergency physician and served with MSF. His research primarily focuses on the causes of mood and anxiety disorders in realtion to urban populations. He also talks on inequality in health care and the consequences of traumatic events on specific populations.