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International Health Workers for People Over Profit
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Issue #1
November 17, 2008

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Blood money

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by Susan Rosenthal - Canada

After years of battling penny-pinching governments to get more funding for health care, I was amazed to see those same governments fling open the treasury doors to the corporate sector.

Why does the public purse open for them and not for us? WHERE’S THE MONEY FOR HEALTH CARE?

The government says it can’t afford to fully fund the medical system. But it sings a different tune when business comes calling. As a result, the needs of sick people are being sacrificed to support “sick” businesses.

Heather's kidney stone

Heather Caron is a 64-year-old retired teacher whose kidney is being sacrificed to the god of profit.

Thirty years ago, Heather developed a kidney stone large enough to block the flow of urine, so that her kidney became swollen and distressed. She went to the hospital, where a non-invasive attempt to remove the stone failed. Within 48 hours of being diagnosed, she had emergency surgery to remove the stone. She was kept in hospital for three weeks while she recovered. Fortunately, her kidney suffered no lasting damage.

On October 30 of this year, Heather developed another stone in the same kidney. Again, the stone was blocking the flow of urine. Again, her kidney was swollen and distressed. A CAT scan confirmed the diagnosis. And that’s where the similarity ends.

This time, the blocked kidney is not treated as an emergency, requiring immediate surgery. Instead, Heather is sent home with a prescription for powerful pain-killers and told to return on November 11, at which time the doctor will try to remove the stone using a non-invasive procedure. She anxiously inquires if waiting so long will damage her kidney. The doctor confirms that it will, but tells her there are no earlier appointments.

On November 11, Heather’s kidney stone is too large to be removed easily. She is scheduled for in-patient surgery on December 9, 40 days after her diagnosis! Not only that, Heather must find someone to transport her home the day of the surgery and take care of her at home, or her surgery will be canceled.

Heather is beyond stressed. When she explains that her previous blocked kidney was treated as an emergency, the doctors reply, “Things are different now.” When she goes to a different hospital, the doctor tells her, "We can’t help you any faster. We’ve got a line-up of people at our door for this surgery.  If you’re in pain, take drugs. If you develop an infection, take antibiotics. Good luck, and good bye."

Heather sits in my office shaking with fear. She feels trapped in a horrible nightmare where no one seems to care that her kidney is dying a little more each day. She wonders if she’s being neglected because she’s an older woman. She asks. “Do you think I’m expecting too much?” I can barely contain my rage.

A deficit of humanity

Things have changed. Thirty years ago, the Canadian medical system was funded well enough to provide Heather with timely treatment. Today, cost-cutting is more important than patient care. It’s true, the world economy is sinking into recession, and all governments face growing budget deficits. But that’s no reason to deny people essential services.

A budget deficit is simply the difference between what governments raise in taxes and what they spend. As we have seen, these two factors can be juggled to meet political needs.

In boom times, budget surpluses are spent on tax cuts and corporate subsidies. In hard times, business is subsidized by cutting social programs. And, at all times, the war machine is amply funded.

Financial deficits aren’t the problem. The problem is the deficit of humanity that favors profits over people.

The billions of dollars being lavished on banks and other corporations is blood money. It's available only because people like Heather are being robbed of their kidneys, their health and their lives.

Workers in the medical industry have no power to decide what services are funded. We are caught between desperate patients on one side and cost-cutting bureaucrats on the other. While we work to relieve human misery, our social role demands that we function within the system as it is. That's why most medical professionals accept rationing. But, it doesn't have to be that way.

We have a choice. We can become as heartless as the system we serve, or we can organize and fight for patients’ rights.

The people in power have created this crisis with THEIR short-sighted greed for profit. Now they’re demanding that WE sacrifice our health, our lives, our homes, our jobs and our futures to bail them out. Let them clean up their own mess!

People’s needs must come first! There’s no deficit of people willing to work to provide for one another. If capitalism cannot make human welfare a priority, then we need to organize a social system that can.

Solidarity is the best medicine

 

Bridge to healthcare

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by Eileen Prendiville - USA

On a beautiful September day, I was one of approximately 1,000 registered nurses from CNA/NNOC* who marched across the Golden Gate Bridge in San Francisco to demand guaranteed healthcare for every American. It was empowering and energizing to cross this magnificent landmark with so many nurses and other healthcare activists calling for a complete overhaul of the U.S. medical system.

As we walked across the bridge, many motorists honked and waved at us in approval. Healthcare reform is a huge issue for voters, but many are confused about the best way forward.

Our job as healthcare activists is to educate the public about the merits of a single-payer system. The insurance industry perpetuates the myth that government can’t run things efficiently. The current financial meltdown and bailout by the government proves how "inefficient" for-profit corporations can be.

Our “Bridge to Healthcare” march was in support of HR-676 (Conyers) and California’s SB 840 (Kuehl) which would provide comprehensive, quality healthcare for all in the form of an expanded, single-payer Medicare system. Since the march, Governor Schwarzenegger has vetoed SB 840 for the second time. We have a tough fight ahead of us.

Nurses are highly trusted because we provide direct patient care. Every day, we see the inequities of our failed healthcare system, and we are becoming increasingly vocal about the need for fundamental change.

CNA/NNOC nurses believe that incremental reform will fail, especially if insurance companies continue to be involved in the delivery of services. These companies are bound by profit and are accountable only to their shareholders. In contrast, registered nurses are legally required (by their license) to be patient advocates. We will keep on fighting!

*CNA/NNOC – California Nurses Association/ National Nurses Organizing Committee

Watch the video of our march

No cuts!

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by Patricia Campbell, Brian Garvey & Barbara Martin -
Northern Ireland

More than 700 nursing posts and 450 social services positions are under threat in Northern Ireland as part of wider plans to cut 2,500 health-service jobs over the next three years.

While Prime Minister Gordon Brown was bailing out the UK banking sector with £500 billion, the Northern Ireland Assembly was deciding that front-line health care workers should join the unemployed. The vulnerable, hardest hit by a recession, are being told there will be fewer people in the health service to care for them.

This is not only an attack on our jobs, but on the health care system as a whole. An official document leaked last summer revealed that the health service was already cutting back by keeping posts vacant. This has increased the pressure on overworked nurses and put patients at risk.

Health care is a public service paid for and belonging to the people. Cuts to vital services must be opposed, and the minister’s claim that people can be cared for at home or in communities has to be rejected. We need investment, not cuts.

We urge all health-care workers to demand that their unions resist any and all cuts. Not one job should go. We must protect the National Health Service. Not to do so poses a risk to us all.

Universi Health Care Union Branch, Independent Workers Union

 

The orchestrated attack on health workers

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by Jane Edgett - Canada

During the 1990s, the federal and provincial governments of Canada orchestrated a two-pronged attack against health-care workers.

The first prong of this attack was the federal government cutting transfer payments to the provinces for health care. In response to decreased funding, provincial governments cut hospital staffing levels.

The second prong of this attack was to eliminate workers’ compensation for psychological stress injuries, like depression, that are caused by excessive workloads.

To avoid raising opposition, this change was made at an internal policy level rather than at a legislative level. Each province's policy was worded slightly differently. In Alberta, an “exception note” was added to disallow compensation if the stress is caused by a “labour relations” issue such as “workload.”

As a result of this policy change, workers can be denied compensation for any psychological ailment that is NOT caused by a traumatic incident, and excessive workload is not considered a traumatic incident.

This change enabled the provinces to cut hospital staff to save money, because they were no longer required to address workplace safety hazards caused by under-staffing (such as workload-related psychological stress injuries).

I worked in an Alberta hospital as a Respiratory Therapist, and I was denied compensation for depression caused by excessive workload, even though an independent psychologist confirmed that, "Work related events or stressors were the predominant cause of the injury."

What is alarming, from a health worker's perspective, is that our employer – the provincial government – functions as BOTH the employer in charge of staffing levels AND as the body that sets workers’ compensation policy. This dual role has enabled provincial governments to force health-care workers to bear the burden of under-funding the medical system.

This conflict-of-interest also affects public safety. Under-staffing is the main contributor to “accidental” patient deaths in hospital. It’s also responsible for the “nursing crisis,” because both the failure to retain experienced nurses and the inability to recruit new ones are the result of under-staffing and overwork.

ALL workers are affected

This policy change benefits all employers, because they no longer have to pay workers’ compensation for workload-induced mental-stress injuries. Provincial governments have used the lure of lower workers’ compensation fees to attract more business.

Workers in high-stress occupations are especially susceptible to psychological injuries due to overwork. Denied compensation, they are further stressed at a time when they most need relief. Many are plunged into financial crisis, even bankruptcy, losing their homes, pensions and savings. A downward spiral is created, as poverty causes additional health problems, putting more demands on an understaffed health-care system.

Denying compensation for chronic psychological stress discriminates against psychologically-injured workers. This discrimination is being actively promoted despite the Mental Health Commission's mandate to decrease stigma against those who suffer mental health problems!

We need to pressure the Mental Health Commission of Canada to examine the issue of mental health in the workplace, including workers’ compensation for chronic stress diseases.

Ending discrimination against psychologically-injured workers would help us to fight under-staffing and over-work.

Canadian Injured Workers’ Society

 

In Palestine, not even the birds are free

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by Patricia Campbell - Northern Ireland

In mid-October, my colleague and I traveled to Palestine to attend a conference organized by the Gaza Community Mental Health Programme (GCMHP) and the World Health Organization (WHO). The theme of the conference was Siege and Mental Health: Walls vs Bridges. We were presenting a paper examining how the war in Northern Ireland has affected the mental health of our patients in Belfast. This is my personal account of that experience.

It was the middle of the night as the taxi drove along the unlit barren roads from Tel Aviv, Israel, to Ramallah in the West Bank. As we approached Ramallah, I noticed the familiar sight of what looked like a prison alongside the road. The driver confirmed that it was Atranout Prison, which holds those who “illegally” cross the many Israeli-imposed borders that fragment Palestine in order to see their families and look for work.

As we entered Ramallah, we were stopped at a Palestinian police checkpoint. We were not hassled. A military-style figure shone a torch into the taxi, viewed two Western women in the back and signaled for us to proceed.

Blocked from Gaza

It was not so easy to enter Gaza. Two weeks before our conference was scheduled to begin, the Israeli authorities denied entry visas to all the foreign clinicians, medics and academics who had been invited to the conference.

To protest Israel’s efforts to deny them entry, conference participants assembled at the Erez/Gaza Crossing. I was struck by the heavily-fortified concrete wall that imprisons the people of Gaza. I wanted to see beyond that wall. What are the Israelis trying to hide?

I continued to observe. To my right were large rocks surrounded by garbage - empty drinks cans and food wrappings - an indication of disdain for this restricted area. The rocks were topped with winding and tangled razor wire. A little bird flew into the wire and got tangled. As it struggled in vain to escape, I looked away to avoid witnessing its miserable fate. I thought, not even the birds are free in Palestine

I saw a small group of adults and children waiting to return to Gaza after having been given special permission to leave. One man was allowed to leave for medical treatment. A woman sat patiently on a concrete slab, showing no expression in her eyes. I was especially moved by the sight of little children playing like children in any other part of the world, but in a place without colour or any facilities to stimulate their young imaginations. Trapped in grey concrete surroundings, they seemed oblivious to the draconian measures being imposed on them, perhaps because they knew nothing else.

Although we were barred from entering Gaza, the conference organizers had a "Plan B," and the conference proceeded by video link between Ramallah and Gaza.  

The conference

From Gaza, a 15-year-old girl gave a moving account of how she had taken on the role of mother to her younger siblings. Her mother is imprisoned in appalling conditions and has given birth to a brother they have never seen. She longs for the day when the family can reunite and the children can meet their new sibling.

Another report explained how Israeli authorities dehumanize Palestinians by imposing closed prison visits, which means that no human contact is allowed between prisoners and their loved ones. Moreover, the screen that separates the prisoner from the visitor is coloured so that the prisoner appears the same colour as the screen.
 
The impact of imprisonment and torture on mental health was addressed in a workshop that compared the plight of prisoners in various parts of the world. My colleague and I presented a small number of patients from Belfast. All had experienced imprisonment, maltreatment or torture, and they all suffer serious mental illness.

Powerful concluding remarks from two psychiatrists, Gaza-based Dr Ahmad Abu Tawahina and London-based Dr Derek Summerfield (who spoke from Ramallah) were broadcast to all the delegates.

Dr Ahmad spoke of the need for health-care professionals to promote the empowerment of people. He gave an analytical account of how the superiority complex of the Israeli regime influences Palestinians. He described constant efforts to frustrate and humiliate Palestinians, including a total disrespect for Palestinian Ministers who are kept waiting at checkpoints. Palestinians may internalize this oppression and unconsciously adopt the inferior role. For me, this was very poignant. I have always believed that we must empower our young people because they are the future negotiators in every aspect of life. Those who negotiate from a position of weakness and inferiority are more likely to accept less than they deserve.

Dr Summerfield spoke about professional ethics in conflict zones. He described how doctors are bound by ethics of responsibility (being accountable) and ethics of conviction (personal beliefs). He highlighted how some doctors ignore and collude with torture because their personal beliefs overrule their professional responsibilities.

Despite Israeli interference, the conference was a huge success. Thought-provoking workshops and an art exhibition helped to build bonds between international delegates who shared a common concern for health, peace and human rights. Our exchange of knowledge, experiences and ideas has laid the basis for future collaboration. I felt hopeful.

Divide and rule

After the conference, my colleague and I visited Jerusalem. Palestinians require permission to enter this beautiful city with its eight gates. An Israeli military checkpoint enforces this policy. As we sat waiting in traffic, I couldn’t help but compare this check point with Aughnacloy Checkpoint, which separated the British-controlled part of Ireland from the Republic of Ireland.

Being brought up in Northern Ireland, waiting at check points was not a new experience for me. The walls and heavy military presence in Palestine were all too familiar, as were many of the stories and experiences. I realized just how besieged the people of Palestine are, with their movement and choices restricted and their human rights constantly abused

Before departing from Ben Gurion Airport, we spent an evening in Tel Aviv, where I learned more about the Israeli way of life. We met an Israeli off-duty solider and heard his story. We met young men who had just completed their three years of compulsory military service. They all shared the same warped view, “Palestinians are terrorists and we need to protect ourselves.”

Our experience at the airport was shocking. Many people are strip-searched, interrogated and kept waiting for hours. My colleague and I were subjected to harassment, interrogation, theft of personal belongings and excessive security measures. We were asked to produce our badges from the conference, which the guards referred to as a ‘peace conference’ and a ‘human rights’ conference. They seemed threatened by peace and human rights. We were escorted to flight check-in and then separated. We were only able to find each other in their maze of security systems because we had mobile phones. Otherwise, we would have missed our flight.

This was a very important journey for me, personally and professionally. When I addressed my fellow delegates at the Erez Border protest, I explained, “I am here in a professional capacity. I am bound by a code of ethics. There is nothing more ethical than being here today. This is my opportunity to express my humanity.” I call on all health care professionals to do likewise. We have a responsibility to do what is right.

Universi Health Care Union Branch, Independent Workers Union 

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