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Archive for the month “February, 2012”

Food Aid: is it a good thing? By Kristina Bruno

In the article Hunger, Healing, and Citizenship in Central Tanzania, Kristin D. Philips describes now central Tanzanian villagers’ accessed food aid from the state during the East African food crisis of 2006. Though this seems like an act of the villagers claiming their rights, it is through these exchanges that the state was able to convert food aid into political power. Philips argues that this ritualized “gift of food aid naturalizes a contemporary political and economic order.” Food purchased as well as food donated is funneled through local patrons and the state, giving them a sense of political power and the receivers of aid a sense of servitude.

The BBC news article, Can food Aid do more harm than Good, addresses the issue of food aid for different reasons, criticizing the motives of the international donors and gives 3 recommendations to halt the negative effects of food aide: providing compensation to local farmers, making sure aid stops when things improve, and giving hungry families cash rather than food. 

When we think about the concept of intersectionality, we can see how this topic relates to depression, or mental health in general. The effects of hunger and the political structures that effect well-being, we can see how these things can bring about deterioration of mental health as well.

Hunger, Healing and Citizenship in Central Tanzania

http://www.newstimeafrica.com/archives/22414

The article describes how the central Tanzanian villagers accessed food aid from the state during the east African food crisis of 2006. They rallied together to improve their rights but in doing so the state converted food aid into political power. I think it is sickening how the government will not help their own people. It is unacceptable to make people dying of starvation wait several days to receive rations when the food is already there. Even the food that was being set apart for school children was being sold! The area was given a mere 30 sacks of grain to feed all of the people. The poorest of the poor were given 12 kilos at no charge and everyone else was allowed to buy 12 kilos of grain at 50 shillings (5 cents) per kilo. Although this policy spread the aid more widely to include middle households, it meant that those in the most dire situations received very little relief. The article also addressed how the most vulnerable households are female-headed. Hospitality and selflessness is difficult to abide by due to the crisis situation. Politicians were described as “eating the rights” of villagers,consuming or profiting from the sale of foodstuffs intended for hungry communities. They also pointed out hois food aid often arrives after prices have fallen or food has become available. All that the villagers want is to minimize the loss of life and improve health and assets during food shortages. This is just another example of government corruption and the costly effects to its people.

Depression is prevalent among the villagers suffering from starvation.

Ethical Issues by Kristina Bruno

In chapter 8 “New Malaise: Medical Ethics and social rights in the Global Era,” of Pathologies of Power, Paul Farmer talks about how with globalizing world, there are rapid developments in communications that are changing the way we understand, experience and manage social inequality and how there are double standards of medical ethics for the developing world. It seems as though medical ethics ignores the third world sick altogether. Furthermore, global health equity desperately needs to be addressed.

As a solution, Paul Farmer suggests that medical ethics should resocialize the way we see ethical dilemmas in medicine so that everybody in the world and especially the most marginalized individuals of the world receive proper and ethical treatment.

Like the example that Paul Farmer gave about unethical research experiments on AIDS and its transition, the website Ethical Concerns associated with Childhood depression is an example of how ethical concerns come in to play with all types of research.

Denaturalizing Disaster By Kristina Bruno

In the article, Denaturalizing Disaster: A social Autopsy of the 1995 Chicago Heat Wave, Eric Klinenberg discusses the Chicago heat wave and the structural violence it emulates. Deaths from the heat were readily preventable. Public health experts know the risk factors associated with heat related illness and mortality as long as the responsible parties can take to reduce them. This 1995 heat wave was a sign and symptom of the new and dangerous forms of marginality and neglect endemic to contemporary American big cities and it highlights the relationship between poverty and suffering due to power structures.  This disaster should have been a wake up call to Americans, and although it was in some ways, the existence of structural violence is all around us and more times than not, it goes unnoticed. for further reading, here is an article about the Heat wave at the time it was happening from the Chicago Tribune: The 1995 Chicago Heat Wave: Record temperatures and Humidity result in a deadly weekend.

The neglect and vulnerability that structural violence creates for certain groups of individuals translates into both physical and mental health problems. This fact also illustrates the large theme of intersectionality we face daily. Though giant steps are being taken towards a world that recognizes and protect human rights, we still have a great deal of work ahead of us.

“Denaturalizing Disaster: A social autopsy of the 1995 Chicago Heat Wave”

http://www.chicagotribune.com/news/politics/chi-chicagodays-1995heat-story,0,4201565.story

In the case of the Chicago heat wave, there was no clear cut person or entity on which to place the blame. The government was most at fault in the opinions of many because the state of Chicago failed to issue a state of emergency although it clearly was one with dozens of people dying daily due to the heat. In turn, the government tried to place some of the blame on the family members of victims. They believed that if the family members of the elderly that died had maybe called to check on them or taken them somewhere cool that they may not have perished. The other obvious blame is placed upon Mother Nature. For the most part, we do not have the power to control our environment. Temperatures soared upwards of 106 degrees for several days straight. However, studies showed that the differences in the mortality rates in the 1995 heat wave versus other heat waves is not normal. The weather was not responsible for the large amount of deaths. Still, the individuals that were not affected heavily by the heat wave are those that hold power within the society. The people that cannot afford air conditioning or other luxuries and are marginalized in society are almost all of the ones that passed away during this crisis. Therefore, when the author titles it a “social autopsy of the 1995 Chicago heat wave” he is illustrating how a person’s status in society played a role in whether or not they survived through the heat crisis.

A person that suffered from depression likely could have been one of the dead because they would be considered part of the group of people that lived on the margins. Depression often hinders people from taking proper care of themselves and the overwhelming heat amplifies the condition.

“When Wounds and Corpses Fail to Speak: Narratives of Violence and Rape in Congo”

http://www.warchild.org.uk/issues/sexual-violence-in-congo

I am outraged that sexual violence persists in the world today. With all of our modern thinking and enlightenment on how all people deserve to be treated with dignity and respect, I am saddened to see women and children especially, suffer due to the inhumane nature of seemingly powerful individuals. According to the article, human rights discourse “diminishes pain in its very act of expressing it”. I was somewhat shocked to discover that human rights reports do not target all countries in a similar manner. The article calls for reform in the human rights reports because as they currently stand, “it fails to convey and protect the social and economic aspirations and values of all people and states”. Human rights are increasingly defined by market discipline and end up serving the powerful people versus serving those that do not have a voice. With the case of Democratic Republic of Congo, the international community has not come to aid of the people suffering massacres, rapes, displacements of population, assassinations, and Hutu genocide all due in part to Rwandan genocide. The article also brings up the point that “some wounds are empowered to speak while others are constrained”.The marginalized, oppressed, and silent dead are all suffering from the atrocities imposed on them by those in power. It is unbelievable that a war that had killed so many people could go unnoticed and that so few people were interested in coming to the aid of these people. The laws that govern the Congolese nation are also extremely out-dated and in a way they perpetuate the rape and violence against women. In Congo, women are seen as objects in the market economy with their sexuality seen as capital. They are mutilated, disfigured, and essentially left to die. Nothing can ever fix the damage that has been done but little progress has been made in making this injustice known to the world.

Depression is related in that the victims of rape and other injustices often develop depression due to the helplessness that they feel and the traumatic abuse they have experienced.

Silenced Stories of the Congo by Kristina Bruno

In the article, When wounds and corpses Fail to Speak: Narratives of violence and Rape in Congo (DRC), Ngwarsungu Chiwengo begins by quoting The body in Pain, by saying that “the language of pain in incommensurable, inexpressible, and unsharable.” To build of this, she then explains how the medical field tries to use the linguistic register of its patients to objectify internal pain and that Human rights discourse takes on this same sort of difficulty. This leads to a barrier in the investigation of human rights violations due to the political manipulation of the discourse, as demonstrated in the silenced stories of women in the Congo.

Experiences such as rape bring about both mental and physical pain that cannot be verbalized or described justifiably. Because of this, it is difficult to see the proper treatment take forth for complete healing of persons. The following link gives some information on the impact that the traumatic experience of rape has on mental health: Mental Health and Impact of Rape

 

“Mild Traumatic Brain Injury in U.S. Soldiers Returning from Iraq”

http://www.msnbc.msn.com/id/22711522/ns/health-mental_health/t/returning-troops-may-have-brain-injury/#.T0ZU-JhTpSo

The article was published in The New England Journal of Medicine and therefore is stating facts and hypotheses that have been studied scientifically. It said that head and neck injuries including severe brain trauma have been reported in one quarter of service members and 18% have been reported as having mild traumatic brain injury. Shockingly, the article stated that little is known about how to recognize and treat Traumatic Brain Injury in the combat environment as well as after deployment. In the war zone, they expressed that it is difficult to differentiate TBI versus acute stress disorder or PTSD because the symptoms are so similar. In order to try and tackle the problem, surveys were given to the soldiers asking them questions such as whether or not they have been injured during deployment involving the head, their rating of their overall health, if they possibly suffered from depression or PTSD, etc. PTSD was found to be closely tied with mild TBI. In this particular study, nearly 15% of soldiers reported having an injury that involved a loss of consciousness or altered mental status. Because TBI is do difficult to diagnose due to the similarities of the symptoms with other disorders, evidence-based studies of the management of symptom-based disorders and collaborative approaches to the evaluation and treatment of coexisting mental disorders will be crucial in tackling this problem.

Depression is very closely related to this topic because it is often a coexisting problem that many people suffer from in addition or in conjunction with PTSD and TBI.

A Multidisciplinary Approach to Mild Traumatic Brain Injury By Kristina Bruno

In the article Mild Traumatic Brain Injury in U.S. soldiers returning from Iraq, Charles Hoge, et. Al. explains the study they conducted due to the medical concern and rarely understood issue of the Iraq war and its potential long-term effect of brain injury. For example, mild traumatic brain injury is strongly associated with post traumatic stress disorder. However, after adjustment for PTSD and depression, those who suffered from brain injuries were not associated with physical health outcomes or symptoms. The results of this study suggest the reinforcement of the need for a multidisciplinary approach in primary care.

The article, An Interdisciplinary Treatment Approach for Soldiers With TBI/PTSD: Issues and Outcomes, the importance of an interdisciplinary approach is discussed and looked at even further. The video linked below also discussed some statistics and data about PTSD in soldiers, as well as the difficulties associated with treating it in today’s medical world.

Listening for Prophetic Voices: A Critique of Market-Based Medicine

http://www.pharmalot.com/2010/01/the-rise-of-marketing-based-medicine/

In “Pathologies of Power” Farmer states that the gaps of inequality across sectors of people has only continued to grow over the past two or three decades. A perfect example of this is an issue that Americans are currently facing which is unequal access to health care. The U.S has the most expensive health care system in the world and yet most Americans are denied basic access to health care. For a country that is considered to be one of the global powers, this is simply unacceptable. People are being exploited to the point that the pharmaceutical industry is the most profitable of all major industries. Sadly, many doctors have acquired a disconnect from their patients. The overall health and well being of the patient is no longer the priority an instead the bottom line is how much money they can make from that person. Therefore, for those that cannot afford health care, they are turned away and left to die. If we pride ourselves on being fair and equal according to the constitution, how can we continue to allow this to happen? I was especially taken by the grisly story of “organs stolen or coerced from the poor for transplant to the bodies of those who can pay.” Stories like that are what keep me from signing up to be an organ donor. I know that people in developing countries are in much worse shape when it comes to receiving health care or even basic human rights such as clean water and sanitation. However, I feel that the U.S. should worry about its own problems before trying to fix the problems of others. We need to be less concerned with turning profit and more concerned with the welfare of our nation’s people.

Depression is an illness that requires medical attention and many people are not receiving the help that they need which further adds to the societal problems that we face today.

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