Voices of Disbelief - Sunday PM Marketing

I am all fired about about a really cool book Russell Blackford and I have been working on during the last couple of months. Wiley-Blackwell will publish it some time next year. It's great for us to have found such a large and prestigious international publisher for the book as this will give us quite a bit of marketing muscle to deploy!

Basically what Russell and I decided to do is to ask people on our respective electronic rolodexes why it is that they don't believe in an omniscient, omnipotent 'good' God running the universe. Call it a humanist/atheist coming out party if you wish. And you know what, I am well and truly thrilled about what we've got so far (which is 27 chapters out of about 50 or so - with some time to go for our deadline). Remarkable philosophers, science fiction writers, medical doctors, newspaper columnists, political activists from around the globe have gathered to tell the world in a way not only why they don't believe in God, but arguably also why you shouldn't buy into that clap-trap either. Very moving personal accounts, entertaining stories, philosophical analyses and so on and so forth will result in a most enlightening, entertaining and challenging book. I'm truthfully over the moon, seeing how great this project is coming together. I won't be mentioning any of the names of the contributors yet, but rest assured, most of them are household names in their respective fields of work.

Viva California

Both houses of the Californian legislature have passed a resolution that requests

all relevant California agencies to notify California-licensed health professionals (doctors, psychologists, and others) about their obligations under international law relating to torture,

those health professionals to be notified that if they participate in torture they may be subject to prosecution,

the Department of Defense and the Central Intelligence Agency to remove all California-licensed health professionals from participating in prisoner and detainee interrogations.

This comes in the wake of uncontrovertible evidence unearthed by US medical doctor Steve Miles, a bioethicist at the University of Minnesota, that health care professionals were involved in torturing prisoners in Guantanamo Bay. Here's a brief excerpt from an article Miles wrote in a bioethics journal, describing the torture of one detainee in Guantanamo Bay (based on heavily censored US army records):

The Interrogation of Prisoner 063

Two government documents detail medical and psychological participation with the interrogation of Prisoner 063, Mohammed al-Qahtani, at Guantanamo Bay between November 23, 2002 and January 11, 2003 (Zagorin and Duffy 2005). The first is an 83-page interrogation log (ORCON 2003). The second is an Army investigation of complaints of mistreatment of prisoners at Guantanamo Bay, including Prisoner 063 (United States Army 2005, 13–21). The third and fourth are notes taken in relation to that Army investigation (CTD Fly Team 2006; GITMO Investigation 2004). The second set of these notes extensively describes medical collaboration with one or more interrogations but the record is so heavily redacted that it is not possible to determine which, if any, of this material described the interrogation of Prisoner 063 (GITMO Investigation 2004).

According to the Army investigation, the log covers a period in the middle of al-Qahtani’s interrogation that began in the summer of 2002 and continued into 2003. For eleven days, beginning November 23, al-Qahtani was interrogated for twenty hours each day by interrogators working in shifts. He was kept awake with music, yelling, loud white noise or brief opportunities to stand. He then was subjected to eighty hours of nearly continuous interrogation until what was intended to be a 24-hour “recuperation.” This recuperation was entirely occupied by a hospitalization for hypothermia that had resulted from deliberately abusive use of an air conditioner. Army investigators reported that al-Qahtani’s body temperature had been cooled to 95 to 97 degrees Fahrenheit (35 to 36.1 degrees Celsius) and that his heart rate had slowed to thirty-five beats per minute. While hospitalized, his electrolytes were corrected and an ultrasound did not find venous thrombosis as a cause for the swelling of his leg. The prisoner slept through most of the 42-hour hospitalization after which he was hooded, shackled, put on a litter and taken by ambulance to an interrogation room for twelve more days of interrogation, punctuated by a few brief naps. He was then allowed to sleep for four hours before being interrogated for ten more days, except for naps of up to an hour. He was allowed 12 hours of sleep on January 1, but for the next eleven days, the exhausted and increasingly non-communicative prisoner was only allowed naps of one to four hours as he was interrogated. The log ends with a discharge for another “sleep period.”

Medical Treatment during Interrogation

Clinicians regularly visited the interrogation cell to assess and treat the prisoner. Medics and a female “medical representative” checked vital signs several times per day; they assessed for dehydration and suggested enemas for constipation or intravenous fluids for dehydration. The prisoner’s hands and feet became swollen as he was restrained in a chair. These extremities were inspected and wrapped by medics and a physician. One entry describes a physician checking “for abrasions from sitting in the metal chair for long periods of time. The doctor said everything was good.” Guards, medics and a physician offered palliative medications such as aspirin to treat his swollen feet.

Intravenous fluids were regular administered over the prisoner’s objection. For example, on November 24, the prisoner refused water. A Captain-interrogator advised him that the medic “can administer IV [sic: the log’s contraction for intravenous fluids of an unspecified volume is used throughout this article] fluids once the Captain and the Doctor on duty are notified and agree to it.” Nine hours later, after taking vital signs, medical personnel administered “two bags” of intravenous fluids. Later that day, a physician evaluated al-Qahtani in the interrogation room and told him that he could not refuse medications or intravenous fluids, and that he would not be allowed to die.

The next day, interrogators told the prisoner that he would not be allowed to pray if he would not drink water. Neither a medic nor a physician could insert a standard intravenous catheter, so a physician inserted a “temporary shunt” to allow an intravenous infusion. The restrained prisoner asked to go the bathroom and was given a urinal instead. Thirty minutes later, he was given “three and one-half bags of IV [sic]” and he urinated twice in his pants. The next day, the physician came to the interrogation room and checked the restrained prisoner’s swollen extremities and the shunt. The shunt was removed and a soldier told al-Qahtani that he could pray on the floor where he had urinated.

From December 12 to 14, al-Qahtani’s weight went from 119 to 130 pounds (54 to 59 kilograms) after being given six IVs. On December 14, al-Qahtani’s pulse was 42 beats per minute. A physician was consulted by phone and said that “operations” could continue since there had been no significant change. Al-Qahtani received three more IVs on the December 15 and complained of costophrenic pain. A physician came to the interrogation cell, examined him, made a presumptive diagnosis of kidney stones and instructed the prisoner to take fluids. The next day blood was drawn in the cell.

Of course, treatment such as this is prohibited by the Geneva Convention which requires that prisoners be treated at all times humanely, not be tortured, and so on and so forth. While one can argue whether ot not the described actions of health care personnel constituted torture (they did not, to my mind), they did at a minimum enable the continuation of torture by means of keeping prisoners sufficiently fit to be able to be tortured again. They also enabled torture by way of declaring the prisoner fit enough to be tortured again.

Is it not remarkable that the American Medical Association has not come out with a strong statement condemning the participation of US medical doctors in the torturing of prisoners of war in Guantanamo Bay? Perhaps this is due to the fact that the AMA is always a little bit slow. It took the organisation only more than a hundred years to apologise for institutionalised racism that it practised for many years.Local AMA chapter had rules discriminating against black doctors as recent as the late 1960s. To be fair, it is not only the AMA that is dragging its feet on the issue, the American Psychological Association also can't decide where it stands on the issue. Very much unlike the American Psychiatric Association (ie medical professionals) which regulated against the participation of US psychiatrists in such activities in 2006. Since then the US military has replaced psychiatrists with psychologists to assist them in developing sound torture techniques. The US military is one of the the largest employers of psychologists in that country.

Correlation and causation

Just a correlation or possibly causation? Neither South Africa nor Canada, both countries I lived in, have managed so far to grab an Olympic medal. The wailing about their failing national teams is great in both these great nations. Let us hope that not too many people will commit suicide due to Olympic failures. Let us also hope that nobody thinks that there's more to this then just a correlation.

Hey, come to think of it, perhaps causality related suspicions might be the underlying rationale for the theft of my bike yesterday. Perhaps someone tried to punish me for the Canadian failure. I kind of doubt it, after all, had I not left it unlocked under a tree outside my house, quite likely it would still be there.

Does correct spelling matter?

There's an interesting debate raging in the UK currently, between a 'new' university lecturer, a Dr Smith and an 'old' university professor, a Dr Grayling. It is probably not entirely unfair to say that 'new' universities in the UK are organisations that are traditionally weak on the research side of things and strong on the teaching side of things. Equally, 'new' universities (ie usually ex polytechnics) tend to be less competitive institutions, attracting more often than not academically less gifted students or students coming to universities through less traditional routes (eg they mid attend university mid-career).

Well, the 'raging' (I am exaggerating!) debate is about the question of whether or not we as academics should punish students for spelling errors and such or whether we should accept those as legitimate 'variants' of English as 'new' university Dr Smith suggests. 'Old' university Dr Grayling duly makes a mockery of Dr Smith's views by producing a coherent commentary relying on proper English that rapidly disintegrates into incoherent ramblings and random accumulations of letters that don't make sense at all anymore. His point: proper English matters. In a way you'd say that probably he is a snob, albeit a leftish one (writing for the GUARDIAN). Surely there is a big difference between someone who ignores minor spelling mistakes students make (yes, there's plenty of them in 'new' and 'old' universities alike) and someone who passes essays even though they are incomprehensible because the words can't be made sense of any longer as they do not resemble existing words; or someone who passes essays where the sentence structure is such that the meaning cannot be ascertained any longer.

Mind you, this is not just a problem in English speaking countries. Long suffering colleagues in Germany tell similar tales. German language instruction that focuses these days more on 'interpretation' of poems and 'critical thinking' skills then grammar and spelling seems to have wrecked many students ability to express themselves properly in that language.

Difficult one: I have to be honest, with English not being my first language, it annoys me hugely having to read essays by students whose first language is English, yet whose English is MUCH worse than mine. And yes, I have come across essays by students whose first language is English that were to a large extent incomprehensible, because the English was so terrible. - I have no idea how those folks managed to get through high-school, and indeed how they managed to sail through their undergraduate years, but yes, such students do exist! - My take on this has always been to ignore mistakes that do not impact on content, but I can see that that might be problematic. After all, prospective employers of our graduates have every reason to assume that students we graduate have a proper command of the language of instruction that we use in our teaching, or don't they? On the other hand, should I really give a higher grade to a native English speaker over an English-as-second language speaker just because the latter's English is worse, while the actual critical content of both essays is of fairly comparable quality?

What's your take on this?

Intl AIDS Conference Calls for Decriminalisation of HIV Transmission

Various activists, academics and politicians during the International AIDS Conference criticized that many countries these days criminalize HIV transmission. The argument is essentially that the law is a bad means to deploy in order to achieve public health objectives. One reason for criminalizing HIV transmission is of course the hope that one might be able to deter some infected people from having unsafe sex. The folks wanting to decriminalize HIV transmission believe that the deterrence effect doesn't work. Frankly, I cannot see how that could be demonstrated one way or another. The deterrence effect of the criminal law has been demonstrated time and again, so I wonder why we should buy into the claim that in the case of sex it doesn't work.

Hey, perhaps it doesn't, but if that is so, what's so terribly wrong with society deciding to punish someone who knowingly subjected someone else to the risk of catching a serious chronic illness? I could see that an argument could probably be made for sexual encounters among consenting adults that, say, pick each other up in a bar some night, where both volunteer to have unsafe sex, no deception re one's HIV status takes place, no questions are being asked and a transmission takes place. I think here we'd probably have a case of harm to self. At the very least we have a case where someone arguably consented to the risk of catching a sexually transmitted illness (as AIDS is). These sorts of happenstances seem to make up the bulk of transmissions and I have not yet seen anyone running to police in order to get their one-night-stand encounter prosecuted. By and large people accept responsibility for their conduct in such circumstances, and so they should.

Truth be told the few cases that have been prosecuted across the world had to do with folks who behaved overwhelmingly truly appallingly to their partners (and not in the sense of one-night stand partner, but in the sense of husband, wife, long-term boyfriend, long-term girlfriend). You know, stories like a 25 year old guy who knew to be HIV infected and insisted on not using condoms with his 15 year old girlfriend. I am at a loss why human rights types folks think that it is a bad idea to criminalize such conduct. For the sake of the argument, even if the deterrence effect of such punishment would really fail, why would it be so unjust to punish such conduct? What's so different about HIV and AIDS that we should not aim to police such harm to others?

One thing I find truly annoying about these campaigners: With a straight face they'd pronounce variously that we shouldn't 'criminalize HIV' or we shouldn't 'criminalize people with HIV'. It goes without saying that nobody anywhere in the world has as yet attempted to either criminalize HIV or people living with the virus. What people in most countries have been saying is this: if you got the bug and you behave in harmful ways towards uninfected people by means of subjecting them to unreasonable risks through reckless behavior, we will punish you. So, what is punished is the harmful conduct, not the virus itself or anyone who happens to be infected but behaves sensibly.

African Union at it again and again and again

That useless outfit of African diplomacy, the African Union is at it again. It has put on hold Mauritania's membership due to the coup that took place there. Any wild guess why the coup (plural, coups) that took place in Zimbabwe never led to a suspension of that country and its kleptocratic leadership? Same ol same ol I'd think...

Don't buy anymore Random House (US) books and products

The US based publishing house Random House (owned by German conglomerate Bertelsmann) has just pulled the book 'The Jewel of Medina' by Sherry Jones off the shelves. It's essentially a story about the Prophet Muhammad's child bride A'isha. As with all novels (as opposed to history books) the author reportedly described some sex scenes between M and A'isha. Of course nobody as been there when/if it happened, so nobody could possibly know. It's a novel after all. For what it's worth the bits and piece that I have seen seemed innocent enough, but then, I'm a small 'l' liberal when it comes to matters sex. The reason given for withdrawing the book is not that it's a bad novel, but that it could (sic!) be (according to Random House) offensive to some (sic!) Muslims, and that it "could incite acts of violence by a small, radical segment".

One wonders ... most atheists probably couldn't publish with Random House any longer either, after all, there could always be a small fanatic minority of believers that could react violently. If that is sufficient these days for a mainstream publishing house to execute censorship, we might as well call it a day as far as freedom of expression in liberal democracies is concerned!

Worse in a way, the impact of this decision on writers surely must be some kind of self-censorship. After all, if you know that your content covering religions or religious figureheads could be controversial, you also know that likely you won't be able to sell it to mainstream publishers - well, at least you'd have to be stupid trying to sell it to Random House. My conclusion: for the time being I won't be buying any Random House products (ironically, Rushdie's stuff is still among them - well, I assume that his work could not possible incite violence among a small minority of religious fundamentalists ... or something like that).

Enjoy

• http://www.silobreaker.com/DocumentReader.aspx?Item=5_888363532
• http://www.nytimes.com/2008/07/31/sports/olympics/31china.html
• http://china.hrw.org/
• http://www.hrw.org/english/docs/2008/07/31/china19517.htm
  
• http://www.amnesty.org/en/china-olympics
• http://www.rsf.org/rubrique.php3?id_rubrique=174
• http://www.olympicwatch.org/
  

An HIV Vaccine and Big Pharma

Wow, 22,000 AIDS scientists, operatives and activists are gathering in Mexico to celebrate their disease. Well, good on them, of all the jobs that they could have chosen, AIDS is not an entirely worthless kinda thing, and yet, ain't it odd the role that big pharma plays in it all? Many, if not most AIDS NGOs are to a significant extent (or entirely) funded by big pharma. All sorts of panelists are flown in by big pharma to speak. Scientists' research more often than not is funded by big pharma. You might say that that's bothersome, but not such a big deal, given that big pharma and the activists have a lot in common these days. Initially big pharma was hated because it priced drugs out of many peoples' research, today it offers cheaper drugs that in turn are guaranteed huge sales thru programmes such as PEPFAR. Still, about 70%of people who could clinically benefit from AIDS medicines have no affordable and reliable access. It is entirely unclear whether the roll-out of medicines in developing countries will be sustainable over generations to come. In a way this l ooks like a win-win situation for big pharma, ever more people get on their medicines, many of them in the global south, funded by taxpayers in Western countries. All is well then, or isn't it? Well, it only looks like it.

There is one area where big pharmas investment has been negligible: HIV vaccine and microbicide research. There's no big surprise in that. You can't seriously expect these companies to produce an HIV vaccine, given that they know full-well that that would rob them of millions of customers requiring life-long care. No way they will ever meaningfully contribute to HIV vaccine development. It's a bit like asking OPEC to invent an alternative to oil for us . And so it's left to the haphazard activities of the Global Fund, the two Bill's and their friends and other such groups. We neither have a serious concerted global effort funded by the governments of the world (our representatives...) nor by big pharma.

No wonder the participants of the international AIDS travel circus can look forward to many more such events to come. Courtesy of government and industry inaction we won't be seeing a vaccine any time soon. Even better, with treatment activists mostly in the backpocket of international organizations and funded to a large extent by industry, don't expect too much pressure from them either. Hey, and while I'm at it, the same holds true for plenty of other ailments that could be prevented efficiently if a vaccine was around. Serious rethinking is required as far as drug R&D financing is concerned.

Sex between strangers

Here's a true story my friend Anita Kleinsmidt kindly forwarded to me... enjoy

Was it rape or was it not? That was the question the Pretoria High
Court had to deal with.

But as it turned out, it was in fact a case of mistaken identity, says a report in The Star. The 'victim' is a Pretoria woman in her 20s. The man had received a 10-year jail sentence for the one night of passion he had with her, but the High Court intervened and acquitted him of any wrong-doing. About three years ago a man in a car asked the woman for her telephone number. Without looking at him, she gave him her number and walked on. This was the start of a phone relationship. They eventually agreed to meet and the man, known as Jacky, arranged to pick up his new love. She in turn - without knowing what Jacky looked like as they had never met - waited for him at the restaurant with her overnight bag in tow. It emerged during the trial in the Pretoria Magistrates' Court that a man walked towards her and hugged her. She testified that they later had repeated sex that night and when she switched on her phone the next morning, she discovered a message from the 'real Jacky'. Kenneth Vilakazi (30) was subsequently arrested and later convicted for the rape in the lower court. He received a 10-year jail sentence, but turned to the High Court to appeal his conviction.

Vilakazi maintained that they had consensual sex. The woman said he was not the man she thought he was. She claimed he misrepresented himself to her, but the court disagreed. Judge Cathy Satchwell and Acting Judge JC Labuschagne found that the 'victim' had made the
mistake herself. The court found that they were all strangers and it was a case of one stranger having sex with another stranger.

AIDS Talkfest on the Road

The International AIDS Conference is again on the road, this time in Mexico City (watch carefully whether the surplus sero-conversions that go with that event match those resulting from the last AIDS conference, or whether they're higher or lower - funny counting game). Anyway, more seriously, there are some interesting issues the talk fest crowd is going on about.

For starters, 150+ HIV vaccine trials crashed not exactly without a trace, rather in quite a few of them those participants randomized into the active arm were becoming more (instead of less) susceptible to picking up HIV. So, both HIV vaccine and HIV microbicide trials have hit a wall of sorts.

Interestingly, however, there's possibly some light at the end of the tunnel. A few months back a team of HIV specialists in Switzerland announced that in their opinion people on antiretrovirals are no more likely to transmit HIV than are people who use condoms. The reason for this is that the medicines reduce an infected person's viral load to such low levels that it's next to impossible to pass the bug on to sexual partners. There's all sorts of caveats, but this matters in the face of rising STI rates among people in high HIV prevalence groups in a whole bunch of countries, including Germany, the USA and many others.

Well, fascinating ethical questions abound: Should one tell people on HIV medicines that their risk is that low or would that mean that they would take unreasonable risks - eg by having more unsafe sex with more people than they would otherwise have? Should we put people very early on in their infection on HIV medicines, for public health reasons as opposed to reasons to do with their medical care? What should we do if there ever arose a conflict between public health interests and patient care? Considering that a substantial number of people on medicines are not as compliant in terms of how they should be taking them, and considering that this leads to more drug resistant mutations of the virus, at what point in time would the early introduction of drugs be outweighed by these undesirable consequences? What are the implications for the criminalization of HIV transmission? If someone duly takes her anti HIV drugs and her partner - not knowing about her infection -picks up the bug anyway, would it be acceptable to punish her?

Difficult new questions to ponder.

Help - Hilfe - Hannes Wader

I'm sure outside German speaking countries nobody has ever heard of an old unreconstructed Communist German folk musician by the name Hannes Wader. Well, for better or worse, being the hopeless romantic that I am, I have been trying forever to get my hands on a digital copy of one particular song 'Leben einzeln und frei', but I am seemingly unable to download the thing. Anyone able to help?

Those Nigerian scam artists are so funny...

Check out the message that I received today! It is truly hilarious!

You got to give it to these Nigerian scam artists, they know how to make involuntarily fun even of themselves!

Mind you, it's probably an open question as to whether Nigerian scam artists or the UN's notoriously corrupt system have creamed more money off the world community...
-----------------------------------------------------------------------------------------------------------------


FROM THE DESK OF
DR BAN KI-MOON
Secretary-General (UNITED NATIONS)

Attn: Beneficiary,

How are you today? Hope all is well with you and family?, You may not understand why this mail came to you.

We have been having a meeting for the passed 7 months which ended 2 days ago with United Nations, European Union and all the other concern parties whose citizens has lost million of Dollars to Nigerian/African Scam Known as 419. This email is to all the people that have been scammed in any part of the world, the UNITED NATIONS have agreed to compensate them with the sum of US$750,000.00(US$.75Million)

This includes every foreign contractors that may have not received their contract sum, and people that have had an unfinished transaction or international businesses that failed due to Government problems etc. We found your name in our list and that is why we are contacting you, this have been agreed upon and have been signed.

You are advised to contact Dr Justin Williams, Director Legal Services of DUE PROCESS COMMISSION Nigeria for your check to be issued, the check will be drawn from J.P MORGAN CHASE BANK. as he is our representative in Nigeria, contact him immediately for your Check/ International Bank Draft of US$750,000.00 This funds are in a Bank Draft for security purpose Ok? so he will send it to you and you can clear it in any bank of your choice.

Therefore, you should send him your full Name and telephone number your correct mailing address where you want him to send the Draft to you.Contact DR JUSTIN WILLIAMS For him to sent you your check immediately.

Person to Contact: DR JUSTIN WILLIAMS

Email: drjustinwilliams11@gmail.com

Phone: 234-702-5339391

note: you will only be request to send the sum of US$78 for shipment and delivery of the bank draft to Dr Justin Williams.

Thanks and God bless you and your family. Hoping to hear from you as soon as you cash your Bank Draft. with kindest regards from United Nations: making the world a better place.

Regards,


Ban Ki-Moon.
Secretary-General
United Nations

Free Doctors Kamiar and Arash Alaei

Physicians for Human Rights is running a campaign on behalf of two physicians who are experts on HIV prevention. The two have been detained without charges by Iranian security forces since late June. Their whereabouts are unknown.

Campaign information and a petition are at: http://actnow-phr.org/campaign/iran_free_the_docs/

Ode to Via Rail

There's great news in Canada. That miserable excuse for an airline, Air Canada, is closing quite a few of its bases. Terrible enough for its employees, but no doubt the chickens come home to roost for an organisation that has made offensively bad customer service the hallmark of its operations. These days there's plenty of desperate airlines out there and customers don't have to put up with Air Canada's nonsense. I wonder how many Canadians, quietly or not so quietly, are pro-actively boycotting Air Canada (as I do) after one too many bad experiences.

Anyway, compare that to Via Rail, that delightful Canadian rail company. I love Via Rail to bits. Mind you, the trains are not what us spoiled Europeans expect in terms of high-tech and speed, but they take you faster to your destination than a trip in the car, the food is nice, service usually impeccable, and they're remarkably frequently on time. Unlike Air Canada, which these days thinks nothing of cancelling your long-haul flight a few hours before your departure, using 'Act of God' as its rationale for not reimbursing you for additional expenses and inconvenience, Via staff here in Kingston were hugely apologetic for a 10 min delay of a Toronto - Montreal train. - 10 min... that's nothing.

The only nasty thing Via Rail has done recently is to replace a delightful red wine (Ontario produced at that) that came in little glass bottles with overseas made Tetra Pak products. Now, if that's done for environmental reasons, let's get some facts straight: transporting wine all the way from Spain to Canada is probably environmentally worse than using Ontario made produce. Also, 90% of bottles these days are being reccycled in Canada, while much less of the Tetra Pack stuff is finding its way into recycling schemes. In short: it is doubtful that the 'green' Tetra Pack scheme Via has come up with works.

However, unlike Air Canada, which happily SELLS you stinking hamburgers on long distance flights, Via Rail offers sandwiches these days that even have your 1:5 portion of veggies included. Good on ya Via. The other thing about Via is hat their frequent traveller points system actually works. I called them the other day and asked that some of my accumulated miles be used for a free trip to Montreal. No problem, did it on the phone in less than 5 min. Try the same with Air Canada frequent flyer miles. Almost certainly you won't be going where you'd like to go. But then, that's even true if you buy a ticket from that outfit. Guess what, Via didn't even levy fuel, taxes, looking-at-train and touching-seat surcharges on my free trip, as Air Canada would have done.

So, people, use the train whenever you can. It's environmentally friendlier than any other alternative that we have currently and you don't have to put up with the kind of crap airlines like Air Canada heap on you.

Rainbow nation in action ... ctd

A survey of about 270,000 school kids in South Africa, aka the Rainbow Nation, published today in the International Journal for Equity in Health revealed some pretty devastating figures. Of the male respondents (about 130,000) 44% reported to have been raped.

The medical industrial complex hates losing control over patients

Germans have an apt word to describe the knowledge professionals of all colors deploy to maintain their stranglehold on patients and clients. It's essentially about control. Lawyers would hate nothing more than if we suddenly understood their legal jargon. Medical doctors and the authorities maintaining their Herrschaftswissen (loosely translated with 'knowledge to rule' I presume) are similar creatures. I have recently investigated to what extent people at risk for HIV infection can take some control over their risks and lives back. What's happening in Canada is not very different to many other countries, but no less unjustifiable.

So, let me start with the easy and arguably uncontroversial one: Rapid HIV testing. People who, for on reason or other, have run an HIV infection risk can either go to their GP, get counselled and a prescription to do a test in a lab. So, first they have to wait to get a doctor's appointment. In the 150k people city where I live ten-thousands have no GP due to a shortage of doctors. Anyway, I digress. They finally get the prescription for the test. Well, next they need to go to a laboratory to get the testing done. Don't naively think they'd be able to get their test results straight from the lab. Nope, no chance. When the lab has eventually done its work it sends the result to the GP and the person who got tested needs to wait for another appointment to find out the result. Weeks will by now have passed, and so plenty of incentives have accumulated not to jump thru the various loops and hoops, and just not do the test or get the result. Testing is hugely important, because timely life-preserving treatment relies on knowledge of a given patient's infection.

There's a way around this, these days rapid tests exist that could permit you to get a result within half an hour. A perfectly reasonable ethical argument could be mounted in favor of having this test available OTC (over the counter, without prescription). If nothing else, such a move would hand control back to people at risk for HIV infection. This, however flies in the face of everything the medical-industrial complex stands for. So, no easy access to this test for you and me. -- As an aside, and I am talking from personal experience here, this is the country where acyclovir, a substance used to fight quite efficiently those bloody blisters many of us have on-and-off on their lips, cannot be bought OTC without a prescription either. I'm sure you'll appreciate the irony that One-Pounds shops in the UK sell it to you by the gallon if you wish. No all-important doctor's prescription necessary in the land of John Stuart Mill... -- Anyway, back to the rapid tests. You can do the rapid HIV test in Ontario at various anonymous testing sites. Access to the test is available through various public health facilities and clinics in the province. However, to ensure that nothing is ever as straightforward and as easy as it should be, that isn't made easy either (try finding information about testing facilities on the web at the time of me writing this ranting, and you'll see what I mean). I checked with one facility in Toronto, its waiting lists are more than 2 weeks long and they do not make appointments beyond that. In other words, there's a significant unmet demand by health conscious people who are at (self-identified) risk of HIV infection. The needs are nowhere met in any appreciable manner by Ontario's public health care system.

My hunch is that the reason for why these waiting lists exist has to do with the counselling hoops and loops people who want to get tested have to jump through each time they have a test. Historically, these hoops and loops were designed to ensure that people understood the test and its consequences, and, indeed, to give them an opportunity to say yay or nay to the test (informed consent or informed refusal). Ie they were an empowerment tool brought about essentially by AIDS activists. Indeed, there was a time where we had the test but no treatment, so it wasn't clear what the value of knowing was (at least knowing wasn't a cost neutral, or no-brainer type thing). Well, today we have good treatments available and it is in an infected person's best interest to know. For better or worse, the testing regime available in the public health care system falters in the face of very significant demand (even fails to inform those at risk about the availability of rapid testing). If you think that this is a problem in Canada alone... you're way off! Singaporeans struggle with the same problem of insufficient capacity to deliver rapid tests. All that's needed to be done really is to take the access control out of the hands of the health care system and permit access OTC. But that would mean relinquishing control. And that's not gonna happen in your or my lifetime.

Now, you may or may not have heard of post exposure (to HIV) prophylaxis (PEP). I have been working in medical schools for most of my academic life, so I learned that PEP is a pretty efficient means to reduce an infection risk AFTER exposure has taken place. Medical students at my school in Johannesburg got it frequently after needle stick injuries and so did many of my colleagues for the same reason. Btw, if there ever was an efficient tool of persuading people to protect themselves against HIV infection it's probably to let them have access to AIDS medicines for a couple of weeks (a typical course of PEP). Experience the side-effects of those medicines and ask yourself whether it's really really worth it :). Mind you, you will get over those at some point during the course of the treatment, but they will hit you first.

One way of taking control over one's life back, to some extent, would be to have PEP available as a last resort if one belonged to a high-risk group (ie people belonging to groups in society where the prevalence of HIV is significantly higher than among the rest of the population - eg gay men, IV drug users - possibly if you live in a developed country, migrants from subsaharan Africa). Say, you have sex with someone belonging to an identified group with a higher than average HIV prevalence. You duly use your condom, and, bummer, the thing breaks, slips off or does any number of unsafe things that ideally shouldn't have happened. Any GP worth her money would tell you that unless you can be certain that your sex partner is HIV negative, you MUST get on PEP ASAP, latest within 48 hours. So, the theory goes, you leave your bedroom (likely in the middle of the night) trek down to your local hospital and you pray that there is someone about who knows what to give to you. Common sense and respect for us as persons would demand that access to such medicines should be available by means of prescription (ie you could have it at home). Giving people easy and stress-free access to such means to protect themselves, of course, would be simply too easy and too obvious a solution, hence the required mid-nightly panic attack visit to the local hospital (if there's one where you live).

So, AIDS activists, if there's any left that are not salaried part of the very same medical-industrial complex, there's plenty of work to do!

Holy Catholic Agony

DSC00940
Originally uploaded by udo schuklenk.

As seen in Manhattan in 2008...

Selling out Universities

How about a Pfizer Chair in Bioethics? With Pfizer's track record in Nigeria and elsewhere, the company has fallen over itself by way of linking into biomedical ethics. For better or worse, I do know that the company has begun funding biomedical ethics positions in the developing world. Anyway, I'm not after Pfizer today really. I came across a post on a German language science blog indicating that the Charite, one of the country's most prestigious hospitals and the teaching hospital of Humboldt University's (Berlin) medical school, has just appointed a Chair (ie an externally funded professor in this case) in 'alternative medicine'. The appointee will dedicate her work to the study of homeopathy (a quack form of medicine that essentially relies on an active substance being sufficiently diluted in water till nothing is left of it), acupuncture and Quigong, some Chinese quackery. Well, the thing is that we know already from study after study that homeopathy offers nothing much other than a placebo effect, yet the Humboldt University in its press release indicates what its Chair is meant to achieve. The appointment of the Chair is meant to diminish the skepticism of mainstream medicine toward homeopathy. There's a reason for this, much like with Pfizer's bioethics sponsorship in developing countries, the Chair is funded by a vested interest group, the Karl and Veronica Carstens Foundation. The Foundation is named after the late German President Karl Carstens, much like Prince Charles in the UK a fan of anything 'alternative' and 'complementary'. The Foundation's main objective is to mainstream homeopathy and other methods of 'natural healing'.

What is remarkable about all of this is that a leading German university has agreed to establish a Chair in Medical Quackery that is designed to integrate medical quackery into mainstream medicine, because it received external funding for that specific purpose. Well, this at least according to the well referenced science blog entry I mentioned earlier. The question, of course, is whether this act of intellectual prostitution is any worse then the regular selling out of universities to pharmaceutical companies, religious foundations and others.

Justice heals

For your information an appeal by

"JUSTICE HEALS!"


Yesterday Paraguayan lawyer, Human Rights activist and torture survivor, Dr.
Martin Almada, declared to cease taking his medication, in protest against
several attempts to silence him, either through legal charges against him or
recently as well through questioning his mental abilities by the court.

Dr. Martín Almada, has been awarded with the alternative nobel prize, for
his outstanding revelations on the "Operation Condor", a transboundary
criminal network, run by Latin American security forces during the 70ies and
80ies, to localize, abduct, torture and kill their opponents. In 1992 Dr.
Almada located the so called "Archives of Terror", containing thousands of
files proving the operation.
Dr. Martín Almada, is a survivor of the Operation Condor. He has been
kidnapped and tortured by the joint security forces of the Southern Cone.
His wife Celestina Perez was killed by the Stroessner regime in 1974. Since
that time he suffers from the consequences of his traumatic experiences,
receiving medication for his relief.

Since two years former torturers, which have been denounced by Dr. Martín
Almada, try to persecute, harass and silence him through charges before the
Paraguayan courts. Now Juan Manuel Morales, having been denounced by Dr.
Martín Almada as being a former agent of the Stroessner dictatorship,
demanded a psyciatric examination of Dr. Almada within the frame of a court
case, Morales is running against Dr. Almada for so called "diffamation".

To protest against this attemt to pathologize him, and to question his
mental abilities, Dr. Almada declared to the judge and to the forensic
psychiatrist, that from now on he will stop taking any of the drugs he
used to take for his post-traumatic suffering.
Dr. Almada underlines his decision by reminding, that since more than 30
years he kept claiming an effective medicament to cure his wounds, a
medicament which is called: JUSTICE!
"It is not the past, which divides the Paraguayan and Latin American
family", Dr. Almada declared, "but the lack of justice." And he adds, that
JUSTICE IS THE ONLY SOURCE OF HEALTH FOR ALL THOSE WHO HAVE BEEN VICTIMS OF HUMAN RIGHTS VIOLATIONS.

For more details see attached declaration in Spanish.
For additional information on Dr. Martín Almada see:
http://www.gerechtigkeit-heilt.de/texte/vita_almada.html