Jared Lee Loughner has mental health care now, the best that federal custody and lawyers can provide.
Is this really how we want to ration heath care?
If you live in a state with hotly contested elections, your mail was full of wretchedly negative and misleading flyers last month. But, around here at least, we rarely see political billboards. When I did see one, it was this:
and it made me wonder why the Democrats hadn’t used billboards to get out simple positive messages about issues where there was great potential public support.
Here are some I made up, just quick mock-ups of a campaign for single-payer health care, but they give you the idea. If Obama had gotten people thinking along these lines, instead of ceding the issue to the Republicans, we might have a true universal health care system by now.
“The United States provides health care to all senior citizens although children are the least expensive and most cost-effective group to cover.”
“Half of all respondents (49%) indicated that their foreclosure was caused in part by a medical problem, including illness or injuries (32%), unmanageable medical bills (23%), lost work due to a medical problem (27%), or caring for sick family members (14%). We also examined objective indicia of medical disruptions in the previous two years, including those respondents paying more than $2,000 of medical bills out of pocket (37%), those losing two or more weeks of work because of injury or illness (30%), those currently disabled and unable to work (8%), and those who used their home equity to pay medical bills (13%).
Altogether, seven in ten respondents (69%) reported at least one of these factors.” [from abstract of Christopher T. Robertson, Richard Egelhof, & Michael Hoke, “Get Sick, Get Out: The Medical Causes of Home Foreclosures” Health Matrix 18 (2008): 65-105.]
”Growing numbers of uninsured children have made it harder for educators to focus on classroom achievement without first addressing the medical needs of their students who lack health insurance or dental coverage. Instead of notifying parents when their children are ill, school officials increasingly must help find health care, arrange transportation for sick children and often advise beleaguered parents about the health consequences of their inaction. Schools that don’t accept the extra responsibility can lose those students to prolonged absences that jeopardize their academic advancement.“
And children who lack health insurance are unlikely to get help for conditions that interfere with learning, such as learning disabilities or vision and hearing problems.
An article about how people get happier as they get older, says it’s partly due to “resources that contribute to happiness, such as access to health care, Medicare and Medicaid”.
Inadequately treated health problems result in lower productivity, greater absenteeism and turnover, and become more severe over time. Concern about losing job-related health insurance causes individuals to stay in jobs for which they are unsuited when they could be more productive and successful at other work (a situation called “job lock”).
It’s shameful to see contribution jars and raffles in local stores collecting for sick people who would otherwise be untreated. Mostly these are for kids, since we are all more sympathetic toward sick children, but there are also spaghetti feeds and various benefits put on for adults who have brain tumors or other acute and potentially fatal illnesses. And every year at this time brings those holiday campaigns in the newspaper, raising money for individuals or families, and often there’s a medical need there. One of the ones I remember was a local young man who’d lost a leg to bone cancer when he was 11; now he was working full time at a job (with no insurance) that was mostly standing, and since he was off his mother’s insurance he could not get a replacement for his outgrown prosthetic leg.
“It’s estimated that 9 million children are completely uninsured. But the new study says 11.5 million more kids end up without medical care for part of the year. And another 3 million can’t get a ride to the doctor. That’s more than 23 million children.” (2008 figures)
I don’t have a picture for this one. What I’d like it to be is not yet invented, some visual-mental device that reflects back to the viewer’s brain an image of him/herself, struck by a wasting disease well before the age of 65 when Medicare begins.
I do have a few more bits of information about the effects of not being insured. “Two large national studies of hospital admissions found that when the uninsured are admitted to a hospital, it is for a more serious mix of diseases and conditions, based on expected mortality, than the privately insured.…A study in California found that uninsured newborns with medical problems had significantly shorter stays (by 1.8-5.9 days) and received significantly less care (measured by total hospital charges) than privately insured newborns for several specific medical diagnoses. Another study found that the uninsured are at much greater risk of substandard hospital care due to negligence or poor quality: 40.3 percent of adverse events among the uninsured were due to negligence, compared to 20.3 percent for the privately insured who experienced adverse events.“ [source]
So the uninsured person, who is likely to be sicker when arriving at the hospital, is twice as likely to be the victim of negligent care during the stay. (Maybe it’s a mercy that the stay itself will be shorter than for the insured patient.) And the uninsured receive less treatment, whether for injury in a car accident, heart attack, or being born prematurely. More of them die, than insured people with the same conditions.
It’s a national disgrace and a drag on the economy; it’s contrary to our ideals and a terrible waste of the possibilities of human lives; it condemns many, from birth or before, to short and painful lives. It’s not open to compromise, Mr. President. You should have stood up for it and the issue should have been fully discussed before the people. If you think our attention spans are too short for extended discourse, you’re welcome to my billboard ideas.
In the previous post, I described the one known mouse with a human brain. He’s named Clyven, and you can talk to him on the website of the hospital where research led to his creation. Or go direct to his page, here.
Well, imagine my surprise when Clyven himself posted a comment on that post. He was, as usual, brief and to the point:
Of course I rang Clyven up, and found him unengaged and ready to talk. He did not seem to remember our previous conversation but when I raised the subject of Christine O’Donnell, he became more animated. Here’s that portion of the brief interview:
ME: Clyven, I’d like to hear what you have to say about Ms. O’Donnell.
CLYVEN: I’m ever so pleased Christine O’Donnell spoke about me on the O’Reilly Factor back in 2007.
ME: What do you think of what she said?
CLYVEN: Aspiring Senator O’Donnell could perhaps learn a thing or two from a mouse with human cognition.
ME: And Christine O’Donnell as a person, how did she strike you?
CLYVEN: She’s funny. I think she is a witch!
ME: What are your political principles, Clyven?
CLYVEN: You should check out the main RYT Hospital web site for that: RYTHospital.com.
ME: A very politic answer, Clyven! Thank you for talking to us.
Clyven is a mouse of few words, which makes those few even more important. His gratitude for Ms. O’Donnell’s mentioning him on O’Reilly’s show may indicate that he would like to play a part on a wider stage himself. He is a native-born American, of American parents, but his crucial role in advanced biomedical research may rule out a run for office. A panel discussion, perhaps, with the two Delaware senatorial candidates? I can only hope that those whose job it is to plan such events and bring new points of view to the public, will be contacting him as soon as they’ve read this post.
O’Reilly, are you listening?
Poor would-be senator Christine O’Donnell has been ridiculed for her comment about mice with human brains:
O’DONNELL: … these groups admitted that the report that said, “Hey, yay, we cloned a monkey. Now we’re using this to start cloning humans.” We have to keep…
O’REILLY: Let them admit anything they want. But they won’t do that here in the United States unless all craziness is going on.
O’DONNELL: They are — they are doing that here in the United States. American scientific companies are cross-breeding humans and animals and coming up with mice with fully functioning human brains. So they’re already into this experiment.
From transcript of O’Reilly show, Friday, November 16, 2007.
Why would Ms. O’Donnell (or someone who informed her) believe this?
It doesn’t take much to find some of the “evidence” that may have convinced her or her informant. As others have noted, there have been experiments in which human cells were injected into embryo mice, and became part of their brains. A bit different than “cross-breeding humans and animals and coming up with mice with fully functioning human brains”, but all rumors have to start somewhere.
Bad reporting may be to blame: here’s the headline and first line of the 2005 article on the National Geographic site:
In case that last line is too small to read, it says “Researchers in California have created living mice with functioning human stem cells in their brains.”
Earlier that same year (2005) another article on the NatGeo site briefly referred to the same research (before it had occurred) this way “And at Stanford University in California an experiment might be done later this year to create mice with human brains.” The title of this misleading article was Animal-Human Hybrids Spark Controversy. Yes, plenty of controversy, but in the article no hybridization is being talked about, only the use of stem cells to demonstrate their potential to be re-purposed. In biology, a hybrid is the offspring of two plants or animals of different species or varieties, such as a mule (a hybrid of a donkey and a horse), and that is the popular understanding as well. Few would consider a mouse with a few cells of human origin, all functioning as mouse cells, to be a hybrid.
But wait, it’s not all down to irresponsible journalism; perhaps Ms. O’Donnell got her information from this page, on the site of the prestigious RYT Hospital, about “Clyven: The World’s First Transgenic Mouse with Human Intelligence” :
Here’s the explanatory text from that page.
Margaret A. Keyes, M.D., Ph.D., is a researcher in genetic medicine and Professor of Cell Biology and Genetics at RYT Hospital-Dwayne Medical Center. She is exploring the use of embryonic stem cells as a means to cure neurological conditions such as Alzheimer’s Disease and Creutzfeldt-Jakob Disease.
By implanting human brain cells (grown from a human embryo’s stem cells) into a mouse engineered to have Alzheimer’s, Dr. Keyes inadvertently made a remarkable and startling discovery: she not only cured the mouse’s Alzheimer’s Disease, but the animal soon developed the relative intelligence of a human being.
After extensive consideration by RYT Hospital’s Institutional Review Board (IRB) and Institutional Animal Care and Use Committee (IACUC), it was decided that this mouse would be placed under a new study led by Dr. Keyes’ lab.
As part of this new facility (pictured to the right), Clyven is placed inside a light-sensitive box with electrodes attached to him. He is able to communicate and interact with people via this neuro interface. He is able to communicate and interact with people via this neuro interface. [sic] To hear a live audio feed of Clyven inside his box, please click here.
© RYT Hospital-Dwayne Medical Center
Evidently RYT Hospital has a very understanding Ethics Committee; they approve of confining an animal with a human brain in a little box and punching his head full of electrodes. But Clyven is not bored—in fact, you are invited to chat with him or play a game against him.
Unfortunately, Clyven’s conversation is limited and repetitious—maybe he himself wrote that quoted passage above, that has the repeated sentence. My best conversation with him was this one,
ME: Hi Clyven.
ME: Do you know that a tea party candidate is talking about you?
MOUSE: That’s pretty silly.
MOUSE: Tell me more.
ME: I don’t want you to know how dumb people can get.
MOUSE: I’m sorry. I hope to get smarter as time goes on. Please be patient with me. I will be receiving additional neurological treatments next week.
On the other hand, don’t let him persuade you to bet money on that CheezeMaze contest, he’ll beat you paws down.
It’s surprising we haven’t heard more about this RYT Hospital, with the amazingly advanced and useful research that is being done there. Elsewhere on the site, you can read about a new drug, Revitalex
about successful gene therapy for back pain, and about “NanoDocs”, nanobots that circulate throughout the body repairing tissues.
Okay, so it’s not a real site but the project of an artist named Virgil Wong. He’s a painter, film-maker, and head of web design for two real hospitals.
Still, can’t you see how anybody might be taken in by the slick style, and accept that there really is a mouse with human intelligence, and nanobots that can tidy up your blood vessels?
No? You say anyone beyond the stage of believing in the Tooth Fairy should have seen through this? and through the distorted reports of growing human brains in mice?
I think so too.
Wherever Christine O’Donnell may have gotten her “information” about mice with human brains, the real problem is minds like hers that are unprepared to question things that most of us would find outlandish. They also believe that Obama is Hitler, Stalin, and a Kenyan anti-colonialist, all at the same time! which would explain why, as I have heard on good authority, Obama has three heads, a fact cleverly concealed by camera angles and good tailoring.
Eastern Newt (Notophthalmus viridescens), Red Eft Stage. Etymological note: Notophthalamus from the Greek noto (a mark) and ophthalmus (eye), presumably in reference to the eye spots on the sides and back; viridescens from the Latin, (slightly green) referring to the greenish color of the adults. Source.
Where do these credulous people come from? I don’t mean people like Newt Gingrich, who will repeat anything—no matter how preposterous—if it seems advantageous. No, demagogues use untruths consciously, with calculated intent. The power of the demagogue depends upon there being enough people who cannot distinguish between the likely, the possible, and the absurd, and therefore won’t laugh him off his soapbox. And where do they come from?
The beginning preparation for most credulous people of otherwise normal intelligence is, I think, being raised with a huge area of life and thought which is categorically excluded from rational examination. Now, every culture and sub-culture has some areas like that, because they are essential as part of the group’s self-definition. In this Land of the Unquestioned reside things like appropriate behavior (manners), kinship rules, dress codes, what we eat and how we cook it, all that sort of thing. That’s why our way of life seems so logical and natural, and other groups’ ways seem bizarre and senseless.
No problem when it’s a question of the relative merits of haggis or corn on the cob, but in the area of exclusion there are more significant topics also, such as attitudes to the “Other” (women, outsiders, those in your own group who don’t conform), and toward violence. That’s the cultural “Don’t think about these things” list. Then there’s religion and its list.
Religion is the really big no-fly zone for human reason. It covers a much wider area of life than ordinary cultural indoctrination, often upon a foundation of dogmatic zeal which asserts sole possession of truth, and enforces details of the dogma with extreme fervor.
Totalitarianism and extremist religions share two fundamental principles: there is only one true way, and everyone must be forced to acknowledge it. It is not enough for the non-believer to refrain from critical expression and deviant action: he or she must be made to believe. Hence the show trials held by the Soviets, the Chinese Cultural Revolution, and the Inquisition, in which tortured inmates confess their nonexistent sins; hence the death penalty for apostasy in Islam, and the roasting alive of unrepentant Christians by the Romans and doggedly heathen Native Americans by the Christians. The Other must be brought within the fold or die, and it should be done in a public and painful way to present a compelling example to everyone else.
Children are born enquirers (non-believers), and about the age of three they start to ask “Why?” about everything, with irritating persistence. Give an answer and they ask for more details or ask “Why?” again. (Offer a non-answer like “I don’t know” or “Be quiet” and they repeat the original question or say nothing; curiosity discouraged begins to shut down.) Their brains are making and pruning connexions, they’re constructing an internal model of the world, and they want and need to know more and to discuss their own thoughts. They are also learning how to learn, how to figure things out.
A child who gets yelled at for asking about talking snakes, or smacked for asking why the God of Love is such a bloody-handed war-approving tyrant in the Old Testament (see note 1), will learn to accept what he or she is told and not think about it. The lesson is to avoid questioning—especially the things in life that seem illogical, cruel, unfair, out of sync with reality. And that “respect for authority” (actually, it is only respect for power and avoidance of punishment) carries over into other parts of life. The more intensely the “No Questions Zone” is defended, the more timid the young mind’s reason becomes.
Curiosity is inborn, but logic is learned. When children are exposed to illogical conclusions, such as “You got a cold right after you ate that ice cream, so no more ice cream” or “I know the Bible is the Word of God because the preacher says so and the Bible says to follow what the preacher says” they won’t learn the basic rules of logic that help humans sort true from false, as well as “probably true” from “probably false”. Ignorance of logic is of course a good thing for those enforcing a monolithic belief system.
Our country’s culture has an equivocal position on learning. Along with its tradition of independence and individualism, the US also has a strong anti-intellectual tradition, because of its religious foundations and the pragmatic demands of survival on successive frontiers from New England to the Pacific coast. When book-larnin’ is seen as irrelevant, perhaps un-masculine, some will make a positive virtue of ignorance. Also, study is hard, ignorance is effortless. Entropy prevails.
Logic and critical thinking are not enough. In order to winnow the wheat from the chaff reliably, it’s necessary to have some actual knowledge. When a statement is made, the hearers check it against their relevant knowledge base. This process is usually instant and automatic. The new information may directly conflict with existing knowledge, or it may just appear quite unlikely based on what is already known. A certain stock of knowledge, reliable because it has been tested or was provided by a trusted authority, is needed to get through life. Yet even some of this knowledge may be false—blondes are dumb, bankers are trustworthy, a barking dog never bites—and individuals must also possess the willingness to re-examine beliefs based on new experience. Except in the No Thinking Zone, where the only safe course is to agree with authority and otherwise keep your mouth shut.
When politics is the subject, then history must have special prominence among relevant areas of knowledge. Just like more workaday fields of endeavor, political systems embody responses to real needs and problems. If I were re-designing the internal combustion engine, I would first need to know why each part had been designed as it was; what earlier mechanisms were tried for mixing the fuel or timing the ignition, and what were their flaws?
It is history which answers these questions in politics, and must be consulted before tinkering or throwing away parts. For example, decades of controversy about the constitutional provision in the First Amendment usually referred to as “separation of church and state” have distorted public understanding of the law’s intent by framing it as a dispute between agnostics or atheists, vs. religious people. In fact it was enacted to defend all religions from government, and from a preference being shown for a single church, as well as to protect government (or non-religious persons) from religion. And the history of state-established religions illustrates the many repressions and disenfranchisements which are imposed upon members of the non-official religions, even including banishment and death. Only modern ignorance permits the discussion of this subject to be framed entirely as a conflict between religion and irreligion. [Christine O’Donnell, in a recent debate, was ignorant of the provision entirely. After the phrase “Government shall make no law respecting establishment of religion” was quoted to her, she asked “That is in the First Amendment?” Yes, it is, though the exact words are “Congress shall make no…”.]
37% of Americans believe that houses can be haunted, and 25% believe in astrology, i.e. that the position of the stars and planets can affect people’s lives.
Fewer than a third can identify DNA as a key to heredity, only about 10% know what radiation is, and 20% think the Sun revolves around the Earth, an idea science abandoned by the 17th century.
50% of our fellow citizens believe in alien abductions, though happily only 7% say they or someone they know has been abducted.
39% of Americans could not name any of the freedoms in the First Amendment.
Two-thirds of 1,000 American adults polled couldn’t name a single current justice of the Supreme Court. In the same survey, more than a third did not know the century in which the American Revolution took place, and half of respondents believed that either the Civil War, the Emancipation Proclamation or the War of 1812 occurred before the American Revolution.
And 21% believe in witchcraft, so O’Donnell’s “I’m not a witch” ad did have its audience.
When you look through these and other poll results it seems that at least 10% to 25% of Americans believe in just about any unproven concept you can imagine. A larger percentage is very ignorant of history and public affairs.
If you’re reading this, and have been apathetic about getting to the polls, you better think again.
One final poll result: in 2009, 19% percent of Americans agreed that the First Amendment goes too far in the rights it guarantees, and 39% said the press has too much freedom.
NOTE 1: I cite only two examples, both from the same holy book, for the sake of brevity, but every religion seems to have its own set of magical events and unquestioned cruelties which must be accepted in order to belong. Belong, get along, go along.
The first version of this was written a few weeks after the January 2010 earthquake in Haiti, but I felt it was a grim scene to put before others. As events have unfolded after July’s floods in Pakistan, I changed my mind.
As of September 3, 2010, the total aid supplied to Haiti by USAID, State, and DoD Humanitarian Assistance to Haiti for the Earthquake, in fiscal year 2010, was $1,139,632,618. Over one billion dollars, for an estimated 3 million people affected.
For the relief of the 20 million homeless victims of the Pakistan floods, “the U.S. has provided some $345 million in governmental assistance,” having more than doubled the contribution from the amount a month ago”. [as of Sept. 21, 2010].
Why the disparity?
Politicians and pundits have various reasons and excuses, from “it’s too big to comprehend” (“this is a disaster on a scale that people are struggling to understand. One-fifth of the area of Pakistan is reported to be devastated by the current floods, yet aid pledges are slow to appear. The flooded area is the same size as England”, Nick Clegg, Deputy Prime Minister, UK), to Pakistan’s bad international rep (“Pakistan is always the bad guy,” Mosharraf Zaidi says in Foreign Policy, to the floods being “a disaster which has unfolded quite gradually” instead of suddenly like an earthquake or a tsunami (UK International Development Secretary Andrew Mitchell). Then there’s the unmentionable elephant-in-the-room reasons, “because they’re Muslims” and “they’re helping the Taliban kill our troops in Afghanistan”. These last two carry some weight with certain elements of the general public in, say, America, but not so much with governments which recognize that keeping Pakistan from being further destabilized is important for the West’s own strategic and security purposes. And it’s the response, or lack of it, from governments that is the primary issue.
None of these is of significant importance, I believe, but they’re put forth because the real causes are too distressing to admit. Here is my list of reasons, and they’re not happy reading.
When you rescue a drowning quadriplegic, you can’t just pull him out of the water, lay him down on the riverbank, and leave.
Haiti rubbed our faces in it, a glaring example: “relief” aid is not enough. Haiti was not a functioning country before the earthquake, and restoring the status quo isn’t really an option. Infrastructure, education, commerce, effective and honest government—all were anemic or non-existent. Worse yet: if the West waved some magic wand to conjure them up upon the ruins of Port-au-Prince, Haiti lacks the trained people, legal structure, and culture to maintain them. So the rescuer takes round his neck the millstone of deep long-term involvement, perhaps for a generation, as in the supposed Chinese proverb about how when you save a man’s life, you become responsible for it.
Afghanistan, Iraq, and pre-flood Pakistan are examples of the same situation: regions upon whom nationhood has been forced, now flying apart from tensions both internal and external, without the resources, desire or culture to transform themselves. And indeed why should they do so, to join a foreign world that would gladly ignore them as it did pre-earthquake Haiti, if it were not for oil and Middle East politics?
Climate change will likely bring more frequent severe weather events and natural disasters (floods, droughts, famines, hurricanes, cyclones, wildfires). As world population increases and clumps together in cities, disasters can affect more people.
Many of the fastest-growing cities are coastal and therefore more at risk for big storms, and “of the 33 cities projected to have at least 8 million residents by 2015, at least 21 are coastal cities that will have to contend with sea-level rise from climate change” as well. (State of the World 2007) In 1994, two-thirds of the world’s mega-cities were located in less developed nations, and the trend was “rapidly accelerating”. The UN predicted in 2008 that in Africa and Asia “the urban population will double between 2000 and 2030: That is, the accumulated urban growth of these two regions during the whole span of history will be duplicated in a single generation. By 2030, the towns and cities of the developing world will make up 81 per cent of urban humanity.” [emphasis mine]
According to UN figures, 324 global cities with a population of over 750,000 experienced rapid growth of more than 20.0% between 2000 and 2010. The fastest-growing city was Abuja in Nigeria (139.7% increase) followed by the Yemenite cities al-Hudayda (108.1% increase) and Ta’izz (94.0%). Of the 324 fastest-growing cities, 53.1% were located in Asia Pacific, 24.4% in Africa and the Middle East, 16.0% in Latin America and the remaining 6.5% in North America, Australasia and Western Europe.
Don’t think that the vaunted free-market expansion to developing nations will result in cities with adequate infrastructure and living-wage jobs for everyone. Just as in our own country, the free market is not a tide that lifts all boats. It can be thought of as a rising tide all right, but one flooding an island, where only the rich have the means to get to high ground, while the poorer you are the closer you come to drowning.
The economic growth we hear of in some cities, like Mumbai, does not extend to the ever-more numerous poor. Slums and high-tech companies in high-rises go on side by side. Both of the views below are of Mumbai. The slum occupants and their children are vanishingly unlikely to become participants in the high-tech boom. Rare exceptions, like the poor village-born protagonist in The White Tiger: A Novel by Aravind Adiga, get a chance to claw their way up by committing a crime to get capital, or by an act of fate as rare as a lightning-strike.[Slumdog Millionaire may be a feel-good film (I haven’t seen it) but that would be because it soothes us “Haves” by showing hope for people who as a group really have no chance of significant betterment. But that’s another subject. For a fictional synopsis of rural life, electoral practices, education of the poor, and other aspects of the “world’s largest democracy”, The White Tiger is worth a read. It reminded me of the works of early 20th C. American writers, the “muckrakers” and others, such as Frank Norris, Upton Sinclair, and Theodore Dreiser.]
In fact, most of Mumbai is slums, as seen in the census map below. Dark red indicates 60% or more of the area is slum. Light yellow areas are composed of 15% or less slum. The very pale blue areas are mud, and are larger than the white (no slum) portions of the city.
A disaster affecting any of these huge aggregations of people—who already live without safe housing, running water, sewage treatment, education, and so on—will, as in Haiti, defy traditional relief efforts and require extraordinary commitments. In Haiti, for example, “A preliminary study by Inter-American Development Bank economists indicates that it could cost as much as $14 billion to rebuild Haiti’s homes, schools, roads and other structures damaged” in the earthquake.
Poorer nations will be mostly on their own to deal with natural disasters, and the concomitant unrest of their own people. Highly contagious plagues will bring quick reactions from the developed nations, for obvious reasons. Likewise, if the developed nations’ interests or integrity are threatened by mass movements of millions fleeing starvation and lack of water, they will act, though one hesitates to imagine exactly how since meaningful relief of the suffering people is not feasible. I’d expect a return to the old policy of “containment”, this time against populations of defenseless refugees rather than communist ideology.
Today we have, according to the UN, 43.3 million refugees, internally displaced persons, and asylum-seekers worldwide. Pakistan has 1.7 million Afghan refugees, many of whom have been displaced since 1979. In a final blow, less developed nations will continue to be the battlegrounds of choice for wars begun by industrial nations for perceived national security purposes (resource control, demonstrating military dominance, justifying and testing new weapons, etc.).
The economic condition of most Western nations today could charitably be described as precarious, with the US perhaps worse than most because of long-ignored needs ranging from public education to crime to infrastructure. With a frightening national debt, unconscionable political paralysis, and 10% unemployment that will feed new waves of house foreclosures, we can apparently only watch our country and its people in a race to the bottom where a new Great Depression awaits. In that climate, when word comes of millions starving overseas, the sententious will say “Charity begins at home” and the blunt will growl “Screw ‘em”. The politicians will make soft noises of sympathy when forced to by media exposure of death and destruction, and send token amounts of money and a couple of Navy ships full of surplus commodities and helicopters, to show the flag. Maybe Brazil and China, rising industrial stars, will then be the new cornucopias of aid to the developing world, but I rather doubt it. Unless it is in their national interest.
Corruption of every sort flourishes, in inverse proportion to the power of established transparent legal systems that serve all citizens. As we have seen in Iraq and Afghanistan, billions may be spent to build things that turn out to be unfinished, shoddy, or even never begun. “More than $5 billion in American taxpayer funds has been wasted — more than 10 percent of the some $50 billion the U.S. has spent on reconstruction in Iraq, according to audits from a U.S. watchdog agency.” The 2008 and 2010 earthquakes in China killed a disproportionate number of children, revealing that many schools were not built as designed because of corruption; built, for example, without re-bar because officials connived at resale of the materials by crooked builders. NGOs often get better value for their money because they send people to be on the spot and help with the work, but utilizing that approach to build, say, ten thousand bridges and 2 million houses in Pakistan hardly seems feasible.
The Kerry-Lugar-Berman Bill included efforts to enforce transparency and accountability as to how the money was spent, but enforcing that in Pakistan, over hundreds of locations, seems unlikely to succeed.
How has the US responded to the floods that have devastated Pakistan since July 2010? Administration sources have this very week been touting our allocation of $7.5 billion to Pakistan’s humanitarian needs. That sounds swell, but actually this money was dedicated to Pakistan last year in S. 1707, the Enhanced Partnership with Pakistan Act of 2009, also known as the Kerry-Lugar-Berman Bill. This bill was signed by President Obama back on Oct. 15, 2009. It provides $7.5 billion in mostly nonmilitary aid to Pakistan over five years,. (Mostly non-military: It does tie some funds to fighting militants, and all the money to a list of specified acts of cooperation with the US including giving the US relevant information from, or direct access to, Pakistani nationals associated with acquisition of nuclear weapons-related materials. [Text of bill here.] Because of such requirements, the bill is seen by Pakistani critics as violating their sovereignty.)
Recently parts of this already-committed money have been re-purposed, with ample publicity, to humanitarian assistance for the flood, and Kerry and Lugar have put forth another bill that would create a new fund to lure private enterprise to Pakistan, but it would use funds already appropriated in the previous aid bill.
How much new money has been directed to Pakistan by the US government, for flood relief and rebuilding? That is hard to know since reports lump re-direction of money already appropriated, in with new aid. According to the Toronto Sun on Aug. 30, 2010, “The United States is the single largest donor to the flood relief, contributing more than $200 million or over 20 percent of the total aid pledged so far”. At least $50 million of that appears to be already appropriated money re-directed from the Kerry-Lugar-Berman Bill of 2009. And, while I cannot look into the heart of any politician to see how they balanced compassionate response vs. US national security interests, it seems plain that the $7.5 billion of the 2009 Bill would not have been given to any country, however pitiful its condition, unless it had direct connexion with US national security. For the 2009 bill, the motives I would assign are 1) paying off Pakistan’s military and government for letting us cross their borders from Afghanistan to kill and abduct whomever we wish, and 2) heading off the further growth of extremist movements, and public sympathy with extremists, in Pakistan by improving conditions for the populace.
Now, after the floods, the money we are spending is for the second purpose, as various speakers including Sen. Kerry have made clear. Kerry visited Ghazi Air Base, a Pakistani military facility in the area first affected by the floods, met U.S. military personnel taking part in helicopter relief missions, and told reporters “we don’t want additional jihadists, extremists coming out of a crisis.” Again, I’m not accusing anyone of being heartless, only of not backing compassion with significant money except when there is a political payoff. Realpolitik.
Help from other countries has also been slow and small. “Donations to help with flood relief have been dismally low compared with those after other natural disasters, such as the Jan. 12 Haiti earthquake.” (Foreign Policy magazine, Aug. 19, 2010) A former U.N. relief coordinator who managed the international response to the tsunami in South Asia in 2004 said, “We got more in a single day just after the tsunami than Pakistan got in a month.” Muslim nations were not taking up the slack; until Saudi Arabia promised $20 million in late August, “no Muslim nation had given Pakistan more than the $5 million donation made by Kuwait, according to U.N. records”.
Even NGO response is halting. “According to The Chronicle of Philanthropy, twenty-two U.S. aid groups have raised a total of $9.9-million [for Pakistan flood work] while within two-and-a-half weeks of the Haiti earthquake, 40 aid groups had brought in a total of $560-million [as of Aug. 24, 2010]”.
An appeal at the UN in mid-September asked for $2 billion, prompting increased pledges from nations including Britain – $210 million, the United States – $340 million and the European Union $350 million. Saudi Arabia said it has now donated $345 million in government and public funds (what is the distinction? public=Islamic charities?). Iran allotted $100 million for its neighbor. It was not clear if the goal had been met. $2 billion sounds like a lot of money (and other funds have been promised by regional development banks and so on), but how does it compare to the need?
It is difficult to establish exact statistics on the scope of the flood disaster there. The UN says 21 million people have been affected, of an estimated population of 170 million. Pakistan’s government now estimates that more than 1.2 million homes have been damaged or destroyed. In addition, crops and foodstuffs in storage have been destroyed, innumerable roads and bridges swept away, and over 17 million acres of Pakistan’s agricultural land has been flooded by often polluted waters.
This map shows conditions as of 9/2/2010 and 9/6/2010. Red indicates severe damage, yellow moderate damage; dark grey areas in northern Pakistan are mostly inaccessible tribal areas with known but unassessed flood damage in the west. Map by UN/OCHA (Office for the Coordination of Humanitarian Affairs), from MapAction.
How does the UN’s goal of $2 billion stack up against the need? A billion is a thousand million. If $2 billion were spent on 2 million flood victims, it would provide $2000 each. But there are 20 million “affected”, so $2 billion is only $200 each. Millions need shelter, food, medical care, and clean water, for an undetermined period. Over a huge area, most human-made constructions have vanished or been damaged beyond repair. It’s estimated that 70% of the bridges in the flooded areas are destroyed, as well as all or most of the roads, schools, water treatment plants, irrigation systems, wells, houses, clinics, stores, small businesses and manufactories, and so on. Of course other organizations have and will provide some money and aid-in-kind, augmenting the UN’s $2B, but even if they doubled the $2B it would be a paltry sum relative to the task.
Haiti may have benefited from greater international pledges of aid than Pakistan, but much of it is still “in the mail”. As of Sept. 29 2010,
Not a cent of the $1.15 billion the U.S. promised for rebuilding has arrived. The money was pledged by Secretary of State Hillary Rodham Clinton in March for use this year in rebuilding. The U.S. has already spent more than $1.1 billion on post-quake relief, but without long-term funds, the reconstruction of the wrecked capital cannot begin. With just a week to go before fiscal 2010 ends, the money is still tied up in Washington. At fault: bureaucracy, disorganization and a lack of urgency, The Associated Press learned in interviews with officials in the State Department, the Senate Foreign Relations Committee, the White House and the U.N. Office of the Special Envoy. One senator has held up a key authorization bill because of a $5 million provision he says will be wasteful.
Meanwhile, deaths in Port-au-Prince are mounting, as quake survivors scramble to live without shelter or food.
Nor is Haiti getting much from other donors. Some 50 other nations and organizations pledged a total of $8.75 billion for reconstruction, but just $686 million of that has reached Haiti so far — less than 15 percent of the total promised for 2010-11.
The lack of funds has all but halted reconstruction work by CHF International, the primary U.S.-funded group assigned to remove rubble and build temporary shelters. Just 2 percent of rubble has been cleared and 13,000 temporary shelters have been built — less than 10 percent of the number planned.
The Maryland-based agency is asking the U.S. government for $16.5 million to remove more than 21 million cubic feet (600,000 cubic meters) of additional rubble and build 4,000 more temporary houses out of wood and metal.
President Franklin Delano Roosevelt reflects on the “enemies of peace” with which he struggled in his first term:
“We had to struggle with the old enemies of peace—business and financial monopoly, speculation, reckless banking, class antagonism, sectionalism, war profiteering.
”They had begun to consider the Government of the United States as a mere appendage to their own affairs. We know now that Government by organized money is just as dangerous as Government by organized mob.”
Speech at Madison Square Garden (October 31, 1936)
Roosevelt in 1941, signing the Lend Lease Act. Photo source.