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International Health Workers for People Over Profit
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Issue #12
November 5, 2009

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  A Call for Action on World Mental Health Day

       submitted by Marwan A. Diab – Palestine

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Nine months after a ferocious military onslaught and more than two years into an unrelenting siege, Gaza has reached the edge of an abyss. No aspect of private and public experience has escaped the ravages of war, poverty, unemployment, destruction and isolation.

Israel’s war on Gaza targeted everything and everyone. Twenty thousand homes and the entire civilian infrastructure were destroyed or damaged. More than 1,400 Palestinians were killed and 5,000 were injured, most of them civilians. Hundreds of parents and children were shot, blown apart or burned to death with white phosphorous chemicals.

An enraged, bereaved and traumatized population struggles to cope with agonizing loss. The scale of the suffering has outstripped institutional capacity to deliver therapeutic support.  Psycho-social treatment is in short supply, one of the many vital resources that people go without.

Bombardment and blockade have reduced Gaza to an economic wasteland. Factories lie in ruins; crops are uprooted by Israeli bulldozers; fisherman are kept close to shore and are shot at by naval patrols if they venture too far. An overwhelming majority of residents are jobless, and 80 percent depend on food donated through international relief organizations.

Beyond a wage, gainful employment is a key to personal pride, marriage, a home and family. Such normal expectations have become luxuries that are now out of reach for all but a few.

The shift from self-sufficiency to dependency has unleashed a cascade of social problems, including an epidemic of domestic violence. Boys, who see their fathers idle and humiliated rather than proud and productive, find a model of potency in the armed resistance fighter.

So many schools were damaged or destroyed that classrooms are severely overcrowded. Teachers are underpaid and demoralized. With no resources, they can do little more than impose discipline. 

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University students face rising tuition fees their families cannot afford. The siege has stopped cross-border faculty exchange, keeping students and professionals intellectually isolated. Fewer than one per cent are able to study abroad.

The siege of Gaza has literally forced the economy underground. A steady flow of smuggled goods passes through a vast tunnel system between Rafah and Egypt. While the black market provides necessary goods, it has spawned an entrepreneurial elite that profits from chaos, cuts corners and makes its own rules. Tunnel operators seeking cheap labour coerce deprived children to work long and dangerous hours, often under the influence of drugs to keep them alert.

Collective Punishment

None of this suffering is accidental. Israel waged a savage war and continues to impose a suffocating siege to degrade, intimidate and isolate a million and a half people in the hope that they will accept utter defeat. The Goldstone Report documented the criminal nature of this collective punishment.

Powerful interests have tried to ignore, minimize and dismiss this report along with the desperate situation in Gaza. Our task is to press for accountability, for an end to impunity and for the full enforcement of international law.

Mental health practitioners understand the pathological nature of cruelty and its terrible long-term effects on both victims and perpetrators. On World Mental Health Day, we call for your help to bring an immediate end to the Israeli siege, emergency aid to rebuild Gaza and reparations for the people of Palestine.

See also: Amnesty International Report

Photographs by Eman Mohammad for the GCMHP

Marwan A. Diab is a Mental Health Worker and Public Relations Director of the Gaza Community Mental Health Programme (GCMHP)
 

    Workers Demand a Say Over Conditions

             by Patricia Campbell - Northern Ireland
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A group of social support workers in Dungannon, Northern Ireland, employed by the Southern Health & Social Service Trust, joined the Independent Workers Union (IWU) after they discovered that their former union had colluded with their employer to reduce their ability to service vulnerable children and families.

The previous union had not consulted the workers about these changes to the terms and conditions of their employment.

These support workers are female, low paid, work part time and are responsible for childcare and other care-taking duties within their own families. The proposed changes to their established work patterns will make it more difficult for them to maintain their existing care-giver arrangements.

As their new union representative, I sent a letter to the Trust instructing it to stay the proposed changes until the members are properly consulted. The workers also initiated a formal grievance.

The Trust replied that the previous union had agreed to the proposed changes. The Trust refused to recognize the IWU and was not prepared to discuss the matter with us.

I informed the employer that I am an accredited Trade Union representative for all purposes required by article 12(3)(b) of the Employers Relations (NI) order 1999 and will be representing our members.

I also stated that our union is deeply concerned that the proposed changes will not only have a negative impact on our members but will also adversely affect the needs of the vulnerable families under their care. The grievance initiated by our members requires the employer to investigate this matter.

The Trust had no choice but to recognize us, and we finally attended a hearing which was no more than an insulting charade. We withdrew from the hearing and will continue to press our demands in other ways.

Our members are extremely angry that established rights were signed away with a stroke of a bureaucratic pen, behind their backs and without their consent. These rights were won over many years of struggle, and no employer and no union has the right to take them away.

Patricia Campbell works as a community psychiatric nurse in Belfast, Northern Ireland. She is also president of the Independent Workers Union and a co-founder of its affiliate, UNIVERSI, a health workers’ union.

   Attacks Continue, Despite Healthy Profits

            by Ned MacDermott – USA
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Over the past year, Douglas Strong, Director and CEO of the University of Michigan Hospitals and Health Centers, has repeatedly invoked the economic crisis as a pretext for aggressive attacks on the wages, benefits and working conditions of hospital employees.

In fact, at no point has the U of M hospital been in financial deficit. In a recent letter to employees, Strong admitted that the hospital has enjoyed a healthy profit of about 3 percent for the past six months. Nevertheless, the attacks on workers continue.

A few months ago, part-time workers were told that their benefits would be cut significantly in January of 2010, and health insurance premiums would increase for all workers. More recently – just weeks before Strong boasted how strong the hospital's economic performance had been – the news came down that non-union employees would not receive their annual raises this year.

In mid-October, workers learned of changes to the hospital's overtime policy. Beginning in November, workers will be paid overtime only for time worked in excess of 40 hours a week. As it currently stands, workers are paid overtime for any time worked in excess of their normal shift of 8 or 12 hours.

When the threat of economic crisis was dangled over workers' heads, anger was deflected into feelings of hopeless resignation. The refrain of "At least I still have a job" was commonly heard, as the general economic devastation of the state left most feeling too powerless to fight back.

In recent weeks, however, the tide has begun to turn. Throughout the hospital, workers' long repressed anger is beginning to boil to the surface. It seems increasingly likely that the new provocations will be met with widespread resistance.

Ned MacDermott is a "non-patient-care" health worker at the University of Michigan Hospital in Ann Arbor, Michigan.

 

   Inequality: The Root Source of Sickness

          by Susan Rosenthal – Canada
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The United States spends more on health care than any other industrial nation, yet it has the highest infant death rates and the lowest life expectancy.

This problem is attributed to a fragmented, profit-oriented medical system that denies millions of people access to care.

While a national medical plan that covers everyone is desperately needed, improving the general health of the population requires more fundamental change.

Studies show that social inequality affects the health of populations more than any other factor – more than diet, smoking, exercise, and even more than access to medical care.

Americans suffer the worst health in the industrialized world because they live in the most unequal society in the industrialized world.

Poor health and lack of access to medical care are both rooted in social inequality. In 1970 the wealthiest 0.1 percent of Americans took in 100 times the average annual income. By 2001, they were taking 560 times the average annual income. In 1980, U.S. life expectancy ranked 14th in the world. By 2007, it ranked 29th.

Inequality is built into and generated by the capitalist system. Capital is created when employers pay workers less than the value of the goods and services they produce. The resulting profit, or capital, is used to extract more capital. As this process repeats over time, capital accumulates at the top of society and misery accumulates at the bottom. 

The strategy of divide-and-rule generates even more inequality: between men and women; White and Black; national and foreign-born; straight and gay; etc.

As social inequality grows, the health of the entire population suffers, not just those on the bottom.

Inequality Kills

A study of 282 metropolitan areas in the U.S. found that the greater the difference in income, the more the death rate rose for all income levels, not just for the poor.

Researchers calculated that if income inequality could be reduced to the lowest level found in the United States, it would save as many lives as would be saved by eradicating heart disease or by preventing all deaths from lung cancer, diabetes, motor vehicle crashes, HIV infection, suicide and homicide combined! We would see even greater benefits if we eliminated social inequality entirely.

Consider the lives that would be saved just by ending racial inequality.

Without racism, death rates for Black and White Americans would be the same. Yet, every year, Black Americans suffer 300 more deaths per 100,000 people than White Americans. Compare these 300 additional deaths with the 2005 U.S. homicide rate of fewer than 6 per 100,000. Do the math. Racism kills 50 times more people than die at the hands of individual murderers.

Inequality kills kids. Forty-two nations have lower infant death rates than the U.S. The infant death rate in the capital of the U.S. is more than double the infant death rate in the capital of China. In 25 nations, people live longer, on average, than they do in America.

Inequality is so destructive that it can even counter the benefit of higher incomes. Poorer people living in more equal nations tend to be healthier and live longer than more-affluent people living in more unequal nations. For example, middle-income people in Britain enjoy better health than wealthier Americans.

Men living in Bangladesh, one of the world’s poorest countries, are more likely to reach age 65 than Black American men living in Harlem. Harlem men have higher incomes than Bangladeshi men but live in a more unequal society. Black Americans tend to die prematurely from cardiovascular and other diseases that are linked with class and race inequality.

How does inequality do so much damage?  Continue reading...

Susan Rosenthal is a physician and the author of Engels and the WHO Report and The Myth of Scarcity, Managed Care and Modern Malthusians.

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International Health Workers for People Over Profit (IHWPOP) has joined the Boycott, Divestment and Sanctions Campaign against Israel. We oppose Israel’s repression of the Palestinians and support a single state in Israel/Palestine with equal rights for all.

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