The article cites the merits and failures of the investigations following three disasters. These are the burning of the Capitol Building in 1814, a boiler explosion in 1850, and the Iroquois Theater Fire of 1903.
I followed up by looking at rape rates across the world, how rape is regarded in different countries, and when humanitarian aid started.
Research for this article comprised of interviews and recorded statements of dozens of police and fire personnel present at the towers and other officials who were tasked with investigating the response.
The article dicusses how the UN has caused major health issues but is not being held accountable by the court's decision, so that is a clear injustice for Haiti. Additionally, the only money that goes directly to Haitians to spend in the recovery has been spent on helping increase children's immunizations rates and increase HIV medical treatment, so they have shown some ability to help themselves when given the resources.
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.
There clearly need to be some policy changes in the healthcare system. I think Obamacare is not the answer and is way too much policy and not enough sense, but we need something. People need affordable coverage for the issues that make sense for their gender and age bracket, they need to be given more help when they are trying to work, and there needs to be more incentive to become a doctor so that there are more PCPs out there nipping a lot of these issues in the bud. So the ER is for emergencies and is a less stressful, long-wait, ridiculous situation.
The development of Twine was funded primarily through donations from individual investors interested in the data sharing aspects of the software and humanitarian aid organizations who benefit from the accessible data.
They researched a lot into tuberculosis/HIV and the social issues that were discussed. Articles on asthma were also reviewed and used, despite asthma not being directly discussed, as well as lead poisoning. This could indicate that more diseases are affected by social issues than discussed in the article, or maybe those diseases didn't show any correlation.
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.
The article has been referenced in several other published works that look at hurricane Katrina and the long term effects, including Aging Disaster: Mortality, Vulnerability, and Long-Term Recovery Among Katrina Survivors, on which Vincanne Adams and Taslim van Hattum both worked.