Search

Dr. Kramer contends that the current atmosphere of hard, factual-based medicine could benefit from the inclusion of anecdotal evidence. Especially in the fields of psychiatry and psychology, where parameters are still heavily undefined, anecdotes can aid physicians in providing appropriate treatment for a patient. While medicine demands an element of precision only acquired through lengthy, controlled studies, some cases benefit from expedited decisions based on past experience.

This study was published in 1998 in the American Journal of Community Psychology. It is a bimonthly, peer-reviewed academic journal focusing on research devoted to community psychology. Community psychology attempts to place an individual's context within communities/community structure and in society. This includes quality of life for certain individuals, populations, and communities. The impact factor is only about 2, indicating that the journal is infrequently cited and does not have the prowess of larger journal publications. 

The report encompasses reports on the proceedings of the UN Scientific Comittee during its 60th session, May 2013. The UN report presents an unbiased plethora of data surmising Fukushima radiation exposure to both human an biological life. It primarily focuses on 2 reports detailing aspects of radiation exposure during the 2011 nuclear accident. The first report gives estimated levels of radiation experienced by individuals and non-human biota. Human individuals estimates are based on age and ongoing proximity to the accident. Evacuated adult citizens had an estimated exposure <10 mSv, while workers experienced doses >10mSv, with the highest exposure  an estimated 100 mSv. It places these values within the context of lifelong anticipated exposure and international expected exposures. This first report also briefly discusses effects beyond radiation, including the adverse outcomes thousands faced by evacuating. The second report concentrates on radiation exposure of children during the accident. While it concludes longer epidemological studies are needed to accurately assess the prevailing biolgogical effects, several important facts are highlighted. At a given radiation dose, children are more at risk of tumor induction than adults. In addition to this increased radiosensitivity (partially due to physical factors such as size), children also demonstrate increased prevalence of several cancers. These include leaukemia, brain, and thyroid cancers, all of which show radiosensitivity. The report also suggests narrowing the scope of inquiry, as radiation-induced cancers can be influenced by factors such as age and gender.

The agency itself is an illustration of emergency response; before BSVAC ambulance response time averaged around thirty minutes-- a far cry from the standard eight minutes aimed for by ambulatory agencies around the Capital region. The original goal of BSVAC was to cut down these times, thereby increasing patient outcomes and creating a sense of safety in a community rippling with gang and drug violence. In addition to this initial goal, BSVAC also reaches out to the surrounding community, teaching CPR, first-aid, and BLS to Bed-Stuy residents. This aids in emergency response, as CPR and first-aid measures can be delivered quickly to a patient even before the ambulance arrives. 

The latter part of the piece addresses current plans to combat the cholera epidemic sparked during relief efforts post-quake. However, due to many of the factors discussed earlier in the article, donors are hesitant to put money towards efforts. Moreover, the UN's plan worked on a 10-year timeline given the appropriate funding; stalling finances have pushed that timeline out to almost 40 years. Currently a lawsuit is being put forth by the Haitian government to obtain the promised money and support from the UN.

1) Definition of humanitarian crisis: This article denotes a multitude of situations, all of which seem to have a drastic effect on human health and well-being. That being said, some crisis or armed conflicts are not deemed a humanitarian crisis. According to several sources, the definition is incredibly subjective, and must be event(s) which harm the health, safety, or well-being of a community or large group of people.

2) Humanitarian worker protections: At this time, there does not seem to be a true movement to legally prosecute those who harm humanitarian or aid workers. However, within the Geneva Convention and later Protocols, there are legal protections for non-combatants during armed conflicts; this is in addition to a UN Security Council Resolution (1502) which gives greater protection to aid workers, classifying attacks on them as a war crime.

3) Non-combatants: This is where definitions of humanitarian aid workers and their protections under both the Geneva Convention and UN Resolution fall apart. The current climate and disregard for international sanctions has left many aid workers at the mercy of those who do not recognize the UN or global entities. As such, they are faced with the choice to remain non-combatants (those who do not carry or use a weapon during a conflict) and most likely be harmed; or to carry defensive arms and proclaim themselves a combatant, and thus be a target. Hence, the difficulty in being a health care worker in an age of general militarization. This is also a topic heavily discussed in the book Trauma by Dr. James Cole. As a member of the special operations, Dr. Cole was always well within danger; he discusses the choice to carry or not carry a weapon, and how discharging the weapon (even in self-defense) changes the nature of the health care provider and their position in an armed conflict. 

The policy does not make any specific mentions of how to deal with vulnerable populations. However, if one were to consider the nature of New York, it can be argued that the city's entire population is vulnerable to outbreak. As a hub of trade, finance, travel, and business, New York is at a considerably higher risk than a city without this high metropolitan activity. The policy does include measures on how to treat individuals who show signs and symptoms in public locations, but does not mandate testing or health checks for individuals involved in transport, travel, or who have limited access to health care (the homeless).

1) EPA: what are the exact duties and responsibilities of the EPA after a disaster? While we mostly consider it to focus on pollutants and environmental conservation, both this article and FEMA training seem to indicate it holds a much larger role in emergency situations.

2) Christie Whitman: a former governor of New Jersey and Administrator of the EPA from 2001-2003, Whitman served during the 9/11 attacks. Despite pointed personal criticism about her time in the EPA (including legal action), Whitman historical demonstrated a pattern of moderatism, often putting her at odds with the administration she served. It would be interesting to see where in the 9/11 lapse emerged-- whether it be from judgement, misinformation, or disinterest.

3) 9/11 Health Effects: The release of millions of asbestos and concrete particles into the air certainly increases the odds of chronic respiratory issues for NYC populations. I would be interested in whether any other chronic issues or epidemics have been noted as a result of pollution from the Towers' collapse