Category Archives: do gooders

global / local

local hospital helps the King County poor using health care strategies gleaned from sub-Saharan Africa. Do I understand correctly? We’re one of the 50 richest counties* in America, allegedly the world’s most prosperous nation, but if you’re sick / poor you might as well live in Botswana?

Well. The full story is that an executive-level RN at Seattle’s Swedish Hospital will be training community health workers for neighborhoods in Sea Tac and Tukwila. These health workers will connect down-and-out folks with appropriate medical care plus services that help connect the dots, like transit passes, legal assistance, even microloans.

Integrating services is a slick thing to do, for two reasons: 1) it works, and 2) because health depends on more than access to good medical care. Better shelter and nutrition worked wonders for Paul Farmer’s tuberculosis campaign in Haiti, for example. Can it work here in the most literate city in America? Sure sounds promising. So stay tuned.

* as determined by personal per capita income

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in the trenches

Last week I visited with a local book club, and one of the members was a nurse practitioner working in the trenches herself. She’s at a nearby community health center, a joint that will take care of anybody who walks in the door, where the charge is $15 for those with the lowest income. It’s a critical piece of the local safety net.

Anyway, she told us that finances are forcing her patients to lapse on their medication on a regular basis, and mental illness has gotten out of control in so many. And then there is the occasional patient who becomes insured and asks whether they’re still allowed to see her for medical care.

The nurse practitioner smiled but shook her head. Somewhere along the way we came to believe that those with health insurance don’t get health care at the same places as those without. Like all community health centers, this one is desperate for even the tiniest bits of income, so she says “yes please,” and all but begs her insured patients to keep coming back.

Community health centers provide a tremendous amount of primary medical care and doing so keep people out of Emergency Rooms. The reward? These unsung folks work incredibly hard and make less money than pretty much any other outfit in town. It’s yet another striking example of how sorely misaligned incentives are under our current system.

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remembering the reverend

“History will record that the greatest tragedy of our period of social transition was not the strident clamor of the bad people, but the appalling silence of the good people.

-Martin Luther King, Jr.

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helping haiti

Hearing about Haiti’s latest catastrophe, with homes and hospitals reduced to rubble, mountains of corpses decomposing in the 90-degree humidity, dwindling food and clean water supplies — who doesn’t feel compelled to hop on an airplane headed for Toussaint Louverture International Airport? The impulse to do something, anything, feels overwhelming.

But then what? Let’s face it — this is not a time when just showing up is enough. The most effective rescue and repair efforts here will come from organizations that run a tight ship, with the structure and experience to roll out operations quickly. We saw that with Wal-Mart in the Hurricane Katrina aftermath. We’re now seeing that in Haiti with the U.S. military, and with smaller non-profit groups like Zanmi Lasante, aka Partners in Health, Paul Farmer’s organization, that already have infrastructure in place.

Zanmi Lasante has helped to bring clean water and basic medical care to rural Haiti for twenty years and, importantly, has trained locals to operate and staff a network of ten small town hospitals and clinics. According to Tracy Kidder, Z.L. may be the largest functioning health system in Haiti at the moment, being located in areas not as badly affected by the quake.

So be smart in how you decide to help. Give money to organizations with a long track record of working towards social justice in Haiti such as Partners in Health, Fonkoze, or Yele Haiti, to quickly bolster their resources. If you’re a trauma surgeon, anesthetist, or surgical nurse, if you have large quantities of surgical supplies to give, or yes, a private plane that can get skilled hands and supplies to Haiti, volunteer or donate now.

And if learning about Haiti is “all” you can do, do that, and support efforts towards basic sanitation, schools, health care, and local economies even after the country fades from the headlines. Favorite Haiti readings are Edwidge Danticat’s Brother, I’m Dying, a story of growing up in Haiti apart from immigrant parents, and of our flawed border operations, and Tracy Kidder’s “The Good Doctor”, with reporting on how American agriculture policy in Haiti wrecked small local producers.

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does it make a difference?

Poverty and inequality are so ingrained in the fabric of our society that it sometimes seems like only grand gestures make an impact. Gestures like leaving your entire fortune to solve malaria and tuberculosis. Or abandoning your family and moving to the poorest country in Africa to personally deliver medical care.

For the rest of us, there are two ways to look at the problem. You can decide the problems are so monumental, there’s nothing you personally can do to change the status quo. Or you can decide it’s OK to chip away a bit at a time, even if the results don’t seem very impressive. A couple of years ago I started helping our community garden grow vegetables for a local food bank. Last year we donated 163 pounds of fresh produce — believe me, that isn’t much. Delivered all at once, our summer’s worth of fresh food would be gone in less than an hour. So did we make a difference? Hard to say.

But if you count food bank donations from all of the city’s 63 community gardens, you get more than 30,000 pounds of fresh food donated last year. Which makes it harder to argue that small actions don’t make a difference.

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