Tag: Doctors Without Borders

As quickly as it opened its doors and our eyes to fraudulent televangelism, Our Lady of Perpetual Exemptions has closed. John Oliver, pastor and host of HBO’s “Last Week Tonight,” announced the end of his church’s mission not because they had to, they were perfectly legal, but because, as his “wife” Wanda Jo put it, “when someone send you jizz in the mail, its time to stop whatever you’re doing..”  

Warning the video below contains NSFW material.

One of the biggest drivers of health care costs to the patient is medication. Pharmaceutical companies who hold the patents often make minor changes in the drug to gain a new patent and applying for a new patent on essentially the same drug. This is called “evergreening.” A paper in PLOS examined the economic impact of this practice:

The researchers identified prescriptions of eight follow-on drugs issued by hospital and community pharmacists in Geneva between 2000 and 2008. To analyze the impact of evergreening strategies on healthcare spending, they calculated the market share score (an indicator of market competitiveness) for all prescriptions of the originally patented (brand) drug, the follow-on drug, and generic versions of the drug. The researchers then used hospital and community databases to analyze the costs of replacing brand and/or follow-on drugs with a corresponding generic drug (when available) under three scenarios (1) replacing all brand drug prescriptions, (2) replacing all follow-on drug prescriptions, and (3) replacing both follow-on and brand prescriptions. [..]

Using these methods, the researchers found that over the study period, the number of patients receiving either a brand or follow-on drug increased from 56,686 patients in 2001 to 131,193 patients in 2008. The total cost for all studied drugs was €171.5 million, of which €103.2 million was for brand drugs, €41.1 million was for follow-on drugs, and €27.2 million was for generic drugs. Based on scenario 1 (all brand drugs being replaced by generics) and scenario 2 (all follow-on drugs being replaced by generics), over the study period, the healthcare system could have saved €15.9 million and €14.4 million in extra costs, respectively. The researchers also found some evidence that hospital prescribing patterns (through a restrictive drug formulary [RDF]) influenced prescribing in the community: over the study period, the influence of hospital prescription patterns on the community resulted in an extra cost of €503,600 (mainly attributable to two drugs, esomeprazole and escitalopram). However, this influence also resulted in some savings because of a generic drug listed in the hospital formulary: use of the generic version of the drug cetirizine resulted in savings of €7,700.

(emphasis mine).

In a post at his blog, law professor Jonathan Turley explains how President Barack Obama has yielded to the pressures of the pharmaceutical industry and pushed to block access the inexpensive generic drugs, demanding India, one of the world’s largest suppliers of generic drugs, block production of the low cost medications:

Millions of Americans struggle on a daily basis to afford medicine in the United States which is the highest in the world. Many seek affordable drugs by driving to Canada or seeking medicine (as well as medical care) in India. Yet, one of the first things that President Obama did in the new health care law was to cave to a demand by the powerful pharmaceutical lobby to drop provisions guaranteeing cheaper medicine. The lobby then got Congress to block two measures to guarantee affordable medicine. With billions at stake, Congress and the White House again yielded to the demands of this industry, which is sapping the life savings away of millions of families. Given this history, many are concerned about a meeting planned between Obama and the Prime Minister of India. Public interest groups object that Obama is threatening retaliation against India in the hopes of blocking one of the major alternatives for families in acquiring affordable medicine. Congress has also again responded to industry demands for pressure in India to change its laws and, as a result, raise the cost of medicine. Doctors Without Borders, a highly respected medical group, has denounced the effort of the Obama Administration as threatening basic health care for its own citizens and those around the world.

From Doctors Without Boarders press release:

On the eve of a meeting between US president Barack Obama and Indian prime minister Manmohan Singh at the White House, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) today warned that India faces retaliatory political pressure from the US government and pharmaceutical industry for its efforts to legally limit abusive patenting practices and to increase access to affordable generic medicines.

Pharmaceutical companies are aggressively lobbying congress and the Obama administration in a broad campaign to press India into changing its intellectual property laws. India is a critical producer of affordable medicines, and competition among generic drug manufacturers there has brought down the price of medicines for HIV, TB, and cancer by more than 90 percent. [..]

The pharmaceutical lobby, led by Pfizer, is currently engaged in a concerted effort to pressure India to change its intellectual property laws. In June, 170 members of US congress wrote a letter to President Obama urging him to send a “strong signal” to India’s high-level officials about its intellectual property policies, and numerous congressional hearings have been held in the past year designed in part to criticize India’s robust defense of public health. Several interest groups have been created to lobby the US government about India’s policies and in early September, US congressional trade leaders requested that the US International Trade Commission initiate an official investigation on India’s intellectual property laws. [..]

Earlier this year, Novartis lost a seven-year-battle to claim a patent on the salt form of the cancer drug imatinib, marketed as Gleevec. The Indian Supreme Court ruled that this new formulation did not meet the patentability requirement in Indian patent law, which limits the common pharmaceutical industry practice of “evergreening,” or extending drug patents on existing drugs in order to lengthen monopolies. [..]

These decisions by the Indian judiciary and government are compliant with all existing international law, including those rules outlined in the World Trade Organization Agreement on Trade Related Aspects of Intellectual Property (TRIPS) and the Doha Declaration on TRIPS and Public Health. Both defend access to existing medicines by allowing countries to use legal flexibilities such as patent oppositions and compulsory licenses to overcome intellectual property barriers. Nevertheless, some US pharmaceutical companies are crying foul, and wrongly accusing India’s patent system of not being consistent with TRIPS.

(all emphasis mine)

As Prof. Turley points out, India is forcing down the cost of drugs making life saving drugs available to millions. If Big Pharma is successful the impact will be life threatening to millions around the world.

On his show AC 360°, host Anderson Cooper interviewed Sophie Delaunay, the executive Director of Doctors Without Borders, on the organizations efforts to aid victims of Hurricane Sandy, especially in the Rockaways.

“We learned our lessons from Katrina when we thought the medical needs would be covered, and when we realized there were gaps it was too late for us to react,” says Sophie Delaunay.

She tells Anderson the most challenging place right now is the Rockaways in Queens where people who need help are homebound in high-rise apartment buildings and have had little contact with the outside world since they lost their electricity. The group is helping with a variety of needs, but 60% of the consultations are to assist with prescription refills.

Calls it a ‘nice little Christmas present’ but has no answers for residents still struggling two weeks after Hurricane Sandy

Public tenants without heat, hot water and power for weeks will still have cough up their full rent before getting a credit in January – a refund that NYCHA Chairman John Rhea called “a nice little Christmas present.”

Rhea made the Scrooge-esque comment Monday when he showed up at the Red Hook Houses in Brooklyn, where tenants have lived in deplorable conditions since Hurricane Sandy hit Oct. 29.

He told one tenant, “Hang in there.” [..]

When Rhea showed up in Red Hook Monday, 4,015 residents there were still without heat and hot water and 2,125 were without power. Twenty-two of the project’s 32 buildings were either without heat and hot water or power. [..]

As of Monday, 4,400 NYCHA tenants in Red Hook, Coney Island and Far Rockaway, Queens, were still without power, while 18,000 residents in 14 developments in Brooklyn, Queens and Manhattan still had no hot water or heat.

NYCHA turned off elevators, hot water and heat two days before the storm hit in 26 low-lying developments near waterfronts and ordered tenants to evacuate.

The situation in public housing projects in Coney Island, Brooklyn remains a “humanitarian crisis” in which the government and the Red Cross have been nearly completely absent, according to Eric Moed, a volunteer aid worker with Occupy Sandy. [..]

The projects in Coney Island remain without power, and often without water and necessities in the wake of Hurricane Sandy. Accounts of these conditions have been corroborated in the New York Daily News.

Moed says all of the supermarkets on Coney Island have been flooded or looted.

The result is what Moed describes as a “humanitarian crisis.” Sick or older people may be vulnerable to death without heat, or food and water.

Moed routinely meets elderly residents who have been trapped alone in their dark, cold apartments since the storm hit. The elevators often do not work, and residents willing to brave the stairwells face darkness, human waste, and even crime. [..]

Whatever response there has been from the government — city, state, or federal — or the Red Cross, Moed says their presence in and around the Coney Island projects is non-existent, inadequate, or counterproductive. FEMA has set up a solitary aid trailer on what Moed calls the “sexy area” of Coney Island — near the famous amusement park and Nathan’s — which was not hit very hard. It awaits people seeking help, when those who most need it are stranded in high-rise buildings a few blocks away.

Moed insists that he does not assume anything about the government and Red Cross’s lack of a response, but says their absence is indisputable. “They’re literally not there. It’s not a criticism, it’s literally a fact,” he said. “I’ve been on the ground here for four days. I’ve seen zero FEMA people. Occasionally a Red Cross truck will come through with hot meals. But there’ll be one truck for 15-20 buildings.” [..]

The absence of government or Red Cross presence has left a vacuum of authority and accountability at a time when stranded residents are seeking it most. “The projects have had nobody to talk to,” Moed says. “People literally have no power, no food, no water, no bathrooms–they’re defecating in buckets. And there is no one to answer to for it.” For lack of a higher-level city government presence, presidents of public housing blocks with few resources have been left to address residents’ grievances. [..]

You know you’re in trouble when The Weather Channel‘s Jim Cantore shows up in your neighborhood and stays for over a week. You’re in trouble when, nearly two weeks after the storm, you have international aid organizations start setting up medical clinics and groups like Occupy Sandy, an off shoot of Occupy Wall St., are more effective in helping in the worst stricken areas of the NYC than the mayor’s Office of Emergency Management, FEMA and the Red Cross. Thousands of people are still without power and heat. In many cases, they are trapped in highrise city housing projects with no water to even flush toilets, no where else to go and no sign of relief.

This is the first time that Doctor’s Without Borders has set up operations in the United States:

MSF And A “Global Disaster Zone” In The Rockaways

A block in from what remained of the beach and its shattered boardwalk, in a community meeting room on the ground floor of the darkened Ocean Village apartment towers, the international humanitarian-aid group Doctors Without Borders had set up an emergency clinic with a volunteer staff of a dozen or so doctors, nurses, and assorted health professionals. A folding table was piled high with medical supplies, and a sheet strung up in a corner created a makeshift private screening area. An empty Starbucks jug doubled as an ad hoc sharps disposal container. Misha Friedman, a Moldovan photographer in his thirties with a shaved head-a veteran of Doctors Without Borders missions from Sudan to Uzbekistan-was briefing a pair of volunteers about the dire health situation faced by 800 senior residents in a nearby housing complex who had had no running water or electricity for a week.

“No one’s been evacuated,” he told me. “There is no evacuation. Doctors have been flooded out, pharmacies have been closed. Some patients are on dozens of medications, and they kind of fall off the grid.”

All across Far Rockaway, high up in the darkened towers and out in the flooded houses, scores of sick and elderly people, cut off from access to their doctors and medical care, needed help. When the clinic door opened at 10 a.m., there was already a group of patients waiting. [..]

Prior to MSF’s arrival, much of the relief work was done by a highly organized group that had arrived on the scene earlier than most: Occupy Sandy. A new iteration of the lower Manhattan based anti-one-percent group, Occupy Sandy was incredibly fast and organized in its response, bringing food and supplies to hard-hit areas like New Dorp, Staten Island, and Red Hook, Brooklyn, as the official response only began. And it wasn’t slowing down; a week into the crisis, Occupy Sandy’s massive Rockaways relief effort looked like a DIY version of the Normandy landings. Its early reports of the dire medical need in Far Rockaway had helped stir Doctors Without Borders to action. The list of patients (Dr. Maureen) Suter was working from had been compiled by Occupy volunteers, who had canvassed the desolate blocks of the neighborhood and the darkened halls of housing projects, knocking on doors and assembling names of people with medical needs. Now Suter was taking that list to make some house calls. [..]

A disaster like Sandy reveals fractures in our public-health system. It pulls back the curtain on stark inequities and structural flaws, but long-term institution building is not MSF’s mission. It wants to get to an emergency quickly, and with a minimum of red tape, to fill the gaps in treatment while gargantuan institutions are just getting going. To foster that capability, Delaunay would like to see a sort of disaster waiver established that allows experienced organizations like MSF to do their work quickly and without fear of liability. As Delaunay put it, “We aim to have a very quick response, and a very brief presence.”

So MSF will not be staying long in the Rockaways. At a certain point, very soon, it will hand off the work it has done there to the larger governmental agencies responsible for maintaining public-health infrastructure. Delaunay was impressed by the size and scale of New York’s emergency system, their ability to get water and blankets to people. But as was shown by Sandy, a system so vast can be completely overwhelmed or overlook crucial deficiencies. “The continuum of care was not anticipated,” she says, and the city needs to rethink how to take care of its most vulnerable citizens during a large-scale and complex disaster.

Another MSF volunteer physician related what she encountered in one city highrise in the Rockaways:

DIRE SITUATION, 15 FLOORS UP

The situation in the Rockaways is dire: high-rises don’t have working elevators, street lights are dark and until a day or two ago, pharmacies had either been destroyed or were shuttered. The almost complete absence of police, coupled with the constant darkness, has left residents fearful of leaving their apartments.[..]

In one squalid building on the ocean’s edge that has been without power and heat for 11 days, the stairwell reeked of vomit and urine. And yet a steady stream or residents made the trek, some joking that at least they were getting exercise.

One case was especially concerning to the doctors was a couple living on the 15th floor. Victor Ocasio, 46, has chronic bronchitis, asthma and has been throwing up blood. His wife Lorraine Bryant, 42, is diabetic and obese and uses a walker. Both have been complaining of chest pains and wooziness.

“I’m scared to walk down those steps. I fell before and I’m scared I’ll fall again,” said Bryant. But she was resisting the idea of going to a shelter, where the doctors said she and her husband could get regular medical treatment.

“I’m scared to go into a shelter. Bad things happen there,” she said.

John Josey, 72, who has been bed bound since having a stroke some years ago, suffers from diabetes, high blood pressure and arthritis.

A home health aide who tends to him said the pharmacy where she normally fills his prescriptions washed away in the storm, and a family member had asked that a Doctors Without Borders volunteer visit to fill out new prescriptions.

This op-ed in The New York Times by Joe Nocera was a chilling indictment of the indifference of Mayor Michael Bloomberg and FEMA to the plight of the people in the hardest hit areas:

We drove farther east to Far Rockaway, a much poorer area. There were long lines at various churches that were serving as distribution centers. Although there were police officers everywhere, the hard work of getting Far Rockaway residents help had, once again, fallen to volunteers.

At the Church of the Nazarene in Far Rockaway, however, I did see a FEMA presence; I was told that FEMA had arrived on Thursday. You would think that FEMA, with all its expertise, would be coordinating the relief effort. But you would be wrong. When I asked one FEMA official what his workers were doing, he said they were mainly trying to make sure that residents applied for assistance. That is not insignificant, of course, but it’s not exactly leading the charge. [..]

When I called Mayor Michael Bloomberg’s office to ask why so much of the relief effort had been left to volunteers, I got immense pushback. Cas Holloway, one of Bloomberg’s deputy mayors, told me that the city had handed out two million meals. The city was coordinating with the Salvation Army, he said, and was a big presence in the Rockaways. It had set up five distribution centers there. It was paying food trucks to give out free food.

Be that as it may, I can tell you that that is not the experience of many volunteers – or residents – of the Rockaways. Before the storm hit, Mayor Bloomberg said that New York City didn’t need FEMA’s help because the city had “everything under control.” You don’t have to spend much time in Queens to realize that New York City needs all the help it can get. It is extremely fortunate that it is getting so much help from volunteers.

Before we left the Rockaways, (Nan) Shipley and I met a man who had come into (city councilman, James) Sanders’s office looking for help. He had two children, he said, including a 2-month-old baby who had had bronchitis and had just gotten out of the hospital. “Our house is too cold,” he kept saying, wiping tears from his eyes. “The baby will get sick again. We need a place to stay.”

After talking to the man, Shipley walked back to the Church of the Nazarene to see if one of the FEMA officials could do something.

A few minutes later, she came back frowning. “He said to call 911,” she said.

Here is how you can help.

Occupy Sandy is a coordinated relief effort to help distribute resources & volunteers to help neighborhoods and people affected by Hurricane Sandy. We are a coalition of people & organizations who are dedicated to implementing aid and establishing hubs for neighborhood resource distribution. Members of this coalition are from Occupy Wall Street, 350.org, recovers.org, InterOccupy.net and many individual volunteers.

Donate to Occupy Sandy in New York

Amount raised as of Nov. 10th: $378,610.00

Donate to Occupy Sandy in New Jersey

Amount raised as of Nov. 10th: $50.00

Occupy Sandy believes in mutual aid and the community that is formed through in-kind donations. In order to recognize that there is more than one form of capital, the money in this account will be invested in long-term disaster relief rebuilding projects and emergencies. All other needs will be filled through in-kind donations. The task of rebuilding communities is a marathon and not a sprint. We thank you for your donations and your support.

Current Needs – blankets (we have none) flashlights aaa batteries gallon ziplock bags cleaning hardware, especially brooms, flat shovels, mops masks and gloves hydrogen peroxide white vinegar any sort of baby/toddler food and formula duct and scotch tape tolitries (deoderents, tampons, soap, etc) can openers.

(WE NO LONGER NEED ANY GENERAL CLOTHING SUPPLIES)

Victims of Hurricane Sandy across the northeast need help immediately. Temperatures are plummeting and a Nor’easter is bearing down the coast.

Firedoglake’s Occupy Supply has many of the supplies these disaster victimes need, and we’re working with organizers at Occupy Sandy to get 1000 woobie, fleece and space blankets in the hands of those affected by the storm.

Can you chip in $20 to ship these blankets and get them to New York, so they can be distributed immediately?

100% of your contribution to Occupy Supply will be used to purchase and ship blankets and other essential supplies to victims of Hurricane Sandy. All items are American-made.

Doctors Without Borders is not accepting any more donations for the Hurricane Sandy Disaster Relief. It has received more than enough to cover its operations in New York City Boroughs of Queens, Staten Island, Brooklyn, and Hoboken, New Jersey.

After the massive earthquake that struck Haiti on January 2010, the United Nations sent peace keeping troops from around the world to assist with keeping order during the recovery process, Unfortunately, some of those forces introduced a virulent strain of Cholera that was until October 2010 never seen in the Western Hemisphere. The faulty sanitation contaminated the Artibonite River, the longest and most important river in Haiti. The UN has refused to acknowledge its responsibility and has done little to help treat, prevent and control the disease.

The enormity of the epidemic is in the numbers that are increasing as this is written. Since October 2010, over 500,000 cases have been reported, including 7,000 deaths. In a New York Times Editorial on May 12, it was reported that this year’s toll could effect another 200,000 to 250,000 people:

Doctors Without Borders said this month that the country is unprepared for this spring’s expected resurgence of the disease. Nearly half the aid organizations that had been working in the rural Artibonite region, where this epidemic began and 20 percent of cases have been reported, have left, the organization said. “Additionally, health centers are short of drugs and some staff have not been paid since January.”

It gets worse: the Centers for Disease Control and Prevention released a report this month that cholera in Haiti was evolving into two strains, suggesting the disease would become much harder to uproot and that people who had already gotten sick and recovered would be vulnerable again.

From Doctors Without Borders press release:

While Haiti’s Ministry of Health and Populations claims to be in control of the situation, health facilities in many regions of the country remain incapable of responding to the seasonal fluctuations of the cholera epidemic. The surveillance system, which is supposed to monitor the situation and raise the alarm, is still dysfunctional, MSF said. The number of people treated by MSF alone in the capital, Port-au-Prince, has quadrupled in less than a month, reaching 1,600 cases in April. The organization has increased treatment capacity in the city and in the town of Léogâne, and is preparing to open additional treatment sites in the country. Nearly 200,000 cholera cases were reported during the rainy season last year, between May and October. [..]

An MSF study in the Artibonite region, where approximately 20 percent of cholera cases have been reported, has revealed a clear reduction of cholera prevention measures since 2011. More than half of the organizations working in the region last year are now gone. Additionally, health centers are short of drugs and some staff have not been paid since January. [..]

The majority of Haitians do not have access to latrines, and obtaining clean water is a daily challenge. Of the half-million survivors of the January, 2010 earthquake who continue to live in camps, less than one third are provided with clean drinking water and only one percent recently received soap, according to a April 2012 investigation by Haiti’s National Directorate of Water Supply and Sanitation.

The Center for Disease Control estimates that the cost of adequate water and sanitation systems will run from $800 million to $1.1 billion. That money is available from funds that were pledged from other nations.

Awareness needs to be raised. The Institute for Justice and Democracy in Haiti, a human rights group, has sued the United Nations on behalf of 5,000 cholera victims and there is a Congressional letter to US Ambassador to the UN Susan Rice urging UN authorities to play a central role in addressing the epidemic.

Just Foreign Policy has set up a petition pressing the UN to take formal responsibility for the epidemic and do more to alleviate the cholera epidemic:

The United Nations bears heavy responsibility for the ongoing cholera epidemic in Haiti-it has become widely accepted that UN troops introduced the disease into the country via the UN’s faulty sanitation system. Even a UN panel has conceded this point. Yet, the UN has done little to treat, prevent, and control the disease. Rep. John Conyers’ office is circulating a letter to Amb. Rice urging UN authorities to play a central role in addressing the ongoing cholera crisis in Haiti.

The effort to contain this epidemic needs support. There are lives to be saved.

Note: The photo by Frederik Matte is from the Doctors Without Borders web site of patients affected by cholera receive treatment at an MSF cholera treatment center in Port-au-Prince.

Haiti, ravaged for centuries and suffering long before its enormous, destructive earthquake, now braces for a huge cholera epidemic.  The cholera epidemic on Saturday had already killed more than 200 and there are more than 2600 reported cases.  Today the news is still bad.  The NY Times reports:

Diarrhea, while a common ailment here, is a symptom of cholera. And anxiety has been growing fiercely that the cholera epidemic, which began last week in the northwest of Haiti, will soon strike the earthquake-ravaged Port-au-Prince metropolitan area.