Last Thursday, Dr. Harriet Washingtonconducted a seminar with the UAB Institute for Human Rights where she discussed the contents of her book, Medical Apartheid. Dr. Washington has been the recipient of the American Library Association Black Caucus Non-Fiction Award and currently teaches bioethics at Columbia University. The seminar was moderated by Dr. Kecia Thomas, the Dean of UAB’s College of Arts and Sciences.
Cover of Washington’s book. Source: Yahoo Images
In the discussion, Dr. Washington highlighted several aspects of medical treatment of black people that previously went unnoticed. Her motivation for her highly popular book, Medical Apartheid, was a file she discovered in the 1980s during her job at a hospital. At that time, talking about diversity was a taboo thing. But as she was working one day, she came across an old filing cabinet with patient files from the 1970s of people who needed kidneys. As she began sifting through the files, Dr. Washington analyzed the social profiles of those patients and observed a key difference — the files of ethnically white people were much thinner than that of black people. That was a precursor to her next discovery–one of the files of a black person had the word “Negro” underlined, and the health plan laid out was that of imminent demise, not for healthcare. In that moment, Dr. Washington grew acutely aware of racial plights within the healthcare system and of the inferior care that was being offered to marginalized communities.
In 2001, she was invited to an international conference on human medicine in Germany, where the only discussion of the mistreatment of African Americans in medicine was the Tuskegee crisis. This claim was boldly made by the international community because there were no other major records of such mistreatment in healthcare. In that moment, Dr. Washington decided to write Medical Apartheid “so no one can decline this ever happened in history.”
Why use “apartheid”?
According to Dr. Washington, that is precisely what her discovery is. Dr. Harold Freeman, a cancer surgeon in New York, found in 1990 that the men of Harlem, NY had medical profiles similar to the men of Bangladesh. Such a finding is shocking and very disturbing, but Ms. Washington described internalizing his information as an indication of a foundation that enables such actions to be discoverable. The reason why these medical disparities translate to an apartheid is because we have highly effective historical policies that have and continue to succeed in making us “two different Americas.”
While this history and factual information has been ignored for too long, people seem receptive to this information and have been utilizing the history in an attempt to correct it. That is why calling the movement what it is — an apartheid — and doing everything in one’s power, be it from the capacity of an educator or a student, use the information to actually influence a change.
Vaccine Hesitancy
Dr. Thomas shifted the focus of the conversation towards the COVID-19 pandemic and the speculations of vaccine hesitancy among black people being a consequence of the Tuskegee Scandal, an event where black people were given a placebo of the cure for syphilis. This myth, however, was quickly busted by Dr. Washington who first stated blatantly that the American healthcare system is untrustworthy, so blaming people for being untrustworthy of it is unfair to do. She continued to quote a study that founded that black people who have never heard of the Tuskegee scandal are more scared of vaccines than those who are familiar with the medical injustice; thus blaming Tuskegee, according to Dr. Washington, is a form of laziness. Rather than speculate on behalf of black people, and people of color (POC) in general, Dr. Washington’s suggestion is to ask and clarify why POC are less likely to participate in clinical trials. Her own research indicates that prioritizing an elderly age group in such trials is synonymous to penalizing POC, for POC tend to be younger populations while white people have a larger older population. The solution to this is creating more nuanced policies that take into consideration restrictions like not having insurance or limited internet access.
Harriet A. Washington. Source: Yahoo Images
Ethics and Informed Consent
Another area of medicine Dr. Washington specializes in is the ethics of clinical trials and the common violations of informed consent that researchers often engage in. Fraud and deceiving POC in trials is not a new concept; it happened in the Tuskegee trials and continues to happen, unfortunately. In 2006, only black people were given artificial blood to see if they would still heal from the disease treatment being tested; the subjects died of heart attacks because of this deception. While we know placebos exist in clinical trials, administering the placebo to a select group of people rather than across the tested subjects, irrespective of race, is something which is unethical and illegal.
Actions to Take
First, we must be willing to eradicate our generations of ignorance towards people of color, especially black populations, starting with valuing their lives. Having open conversations such as the one had with Dr. Washington is a great place to start because the only thing that is being presented is facts and evidence corroborating a painful yet honest history of medical apartheid. And implementing the information we learn in our research and education is one step we can all take to put an end to this apartheid. The second thing anyone can do is openly advocate for nuanced policies that are socially and economically aware of the implications and disadvantages current policies present to diverse populations. Urging our public servants to pay attention and take action against healthcare injustices is yet another change we can bring forward amid the pandemic, a time that has taught our global community the immense need for a united front against injustices.
The Texas Abortion Law, signed into law on May 19th, 2021, went into effect earlier this September, effectively banning abortions after the detection of fetal heartbeat. This law makes no exceptions even for victims of rape or incest.
Previous abortion bills introduced the state government and authorities to enforce abortion laws, but unlike anything seen before, Texas’s law awards the power to the citizens. Any private citizen in the country now has every right to sue anyone they suspect has had an abortion, took part in helping with an abortion, or in any way assisted an individual seeking an abortion in Texas. If the suit succeeds, the citizen will receive monetary compensation of at least $10,000. The intricacies of this law make it difficult to legally interpret since technically, abortion has not been criminalized.
History of the Heartbeat Bill
In 1973, the landmark Supreme Court case Roe vs. Wade federally legalized abortion in the first two trimesters of pregnancy but allowed states toban abortion in the 3rd trimester. Since then, several state legislatures have passed so-called “heartbeat bills,” which criminalize abortions after fetal cardiac activity has been detected—usually at 6 weeks. However, this is only a flutter of electricity, and the heart forms only after 17-18 weeks. Most individuals do not even know that they are pregnant at this point, because birth control, other forms of contraception, or not tracking menstrual cycles can mask pregnancies until the 8th week.
Up until now, the Supreme Court has adamantly upheld Roe vs Wade, and every state abortion ban signed into law has been struck down in federal courts.In a historic decision, the United States Supreme Court ruled to let Texas temporarily implement its Abortion Law Although the decision was made in consideration of the difficulty interpreting the law by the Constitution, the hesitancy has been raising alarms all over the country.
Despite the common misconception that abortion restrictions reduce abortions, they only increase unsafe abortions. Women and young girls use dangerous methods such as toxic chemicals, bodily harm, and relying on unlicensed abortion providers in their desperation to terminate a pregnancy. In fact, in the United States, the American College of Obstetricians and Gynecologists (ACOG) found that over 1.2 million women had unsafe abortions which resulted in nearly 5000 deaths, not including tens of thousands more left with long-term injuries and complications.
Source Unsplash: Protestor holding up a placard stating “Protect Roe” in an October 2021 protest against Anti- Abortion Laws.
Women in Texas Now
The state has clearly indicated that the law is “not against women” but against abortion providers who are breaking the law.
Already, women in Texas are traveling out to liberal states such as California or New York to get their abortions. The influx of cases has overburdened providers in other states, but even still, those who make it out of state to receive an abortion at least have the option. The majority of women, however, do not have the means or funds to obtain an abortion in another state, so they turn to abortion pills to self-induce abortions. This method has its own problems. The pills can get stuck in customs anywhere from 2 to 30 days which adds to the anxiety of pregnant individuals, because the pills must be taken before 10 weeks of gestation to avoid life-threatening complications such as massive hemorrhaging.
Political Reaction
The Texas Abortion Ban symbolizes the modern bodily autonomy movement on a precipice. Based on the Supreme Court’s current balance, it is possible that Roe vs. Wade could be struck down within the next two years. One thing must be made clear though: overturning Roe vs. Wade means that abortion will only become illegal within states that have chosen to do so—not across the country.
However, another aspect to consider about the abortion rights debate is voice. Women and minorities are more empowered than four decades earlier and have the platform to fight for their beliefs. In fact, 77% of people want the Supreme Court to uphold Roe vs. Wade. If Roe vs. Wade is overturned, an unprecedented amount of public outcry will occur in every state to fight, once again, for the right to bodily autonomy that women have fought for decades.
Source: Unsplash; An Abortion Rights billboard titled “Forward Together for Abortion Justice” at a protest in October 2021.
Future
Later this year, the Federal Courts will hear Mississippi’s case to let their heartbeat law stand for 15 weeks. More conservative states will likely use Texas’s law to support their legislations. Thus, the outcome of these hearings will give the country an understanding of how the federal judicial system will respond to future abortion and women’s health legislation.
In the Senate and House of Representatives sits a bill titled the Women’s Health Protection Act, which could provide universal abortion rights and remove the damaging restrictions women are subjected to for abortions. One of the goals of women’s rights activists is to see this bill passed in Congress, and the time has come for Congress and the Executive Branch to collaborate and alleviate any detrimental decision that the judicial system may make. The public can help with this goal by proactively voting for legislators that will turn bills into reality and supporting many nonprofit organizations and charities such as NARAL Pro-Choice American and Planned Parenthood through volunteer work or donations.
In the United States sex education has historically been underfunded and often used as a tool to shame people for their sexuality. Currently, only 29 states in the United States mandate sex education; however, this still does not ensure that children are taught medical sex education in school. In fact, 37 states within the United States require abstinence to be taught as the only way to prevent sexually transmitted diseases and unwanted pregnancy. Even worse, up until April 2021, seven states in the South prohibited educators from discussing LGBTQ+ identities and relationships, which further stigmatizes youth and puts them at a higher risk of contracting sexually transmitted diseases. Currently, now that Alabama has passed a new bill which removed homophobic language forbidding schools from teaching LGBTQ+ sex education, teachers are able to create sex education curriculum as they please, as long as parents are sent an overview of the curriculum and agree to let their children learn said material.
How U.S. Sex Education Policies Measure Up to the ICPD
Yahoo Images, A woman is holding a poster which states “A woman’s place is in the resistance”
Ways to Get Involved
Thanks to the work of activists, legislatures, and constituents alike, Alabama’s laws have been updated so that they no longer criminalize LGBTQ+ individuals within the states schools’ sex education curriculum. Yet, the work is not over, and schools are still able to refuse to educate students on safe sex practices for non-heteronormative relationships, as long as parents of students consent to the curriculum proposed by staff. This continuation of the lack of medical sex education in our school systems is still leaving children vulnerable to ignorance, and exacerbating the current health issues which are prevalent amongst marginalized groups, especially within the South. Certain organizations, such as the Alabama Campaign for Adolescent Sexual Health and Advocates for Youth Sex Education, are currently advocating for proper sex education. If you are interested in getting involved, sign up to be an advocate for proper seed education through AMAZE, or with WISE (Working to Institutionalize Sex Education), to help aid in the fight for proper sexual education for our youth. Furthermore, if you would like to learn more about the rights of LGBTQ+ individuals and current issues within the LGBTQ+ community, then click this link.
The United States is one of three countries in the world, and the only first world country, that does not provide paid time off upon the welcoming of a new child into the home. Today, eighty-two percent of U.S. voters, across party lines, support implementation of a national paid family and medical leave policy. However, only thirteen percent of American workers have access to such privileges. Much of the debate surrounding the topic involves who will pay for such policies, and who exactly should be eligible to receive the benefits. Whether you have personally been put at a disadvantage by this situation or have the privilege of merely learning about it from media outlets, such as Senator Bernie Sander’s audacious Instagram posts, it is quite difficult to ignore the prevalent issue of the lack of paid parental leave in America.
Paid Parental Leave as a Human Right
The scarcity of paid parental leave is a violation of various aspects of the Universal Declaration of Human Rights.Article 23 of the UDHR states that everyone has the right to “just and favorable conditions of work” and “remuneration ensuring for himself and his family an existence worthy of human dignity and supplemented, if necessary, by other means of social protection.” The definitions of adequate work conditions and social protections can and will obviously be interpreted by society in different ways over time; however, Article 25 goes on to state:
“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including…medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
Motherhood and childhood are entitled to particular care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.”
Regardless of not being stated specifically, it is a common belief that paid parental leave exists within the realms of the above stated rights and is an ethical standard to which society should be held. Pushing personal opinions aside, a recent article from The Guardian says “The American College of Obstetricians and Gynecologists (ACOG) recommends women take at least six weeks off work following childbirth. But with no federally mandated paid family leave, for many women maternity leave is an unaffordable luxury.”
The Reality of a Working Mother without Parental Leave
Source: Unsplash
As the participation of women in the workforce has steadily increased since post-World War II, the modern era expects women to work full-time as if they are not raising children, yet also expects women to raise children as if they are not working full-time jobs. This concept is evident in many American women’s lives who push off having a career until their children are grown or wait to have children until they are settled in their career. With the knowledge that many women do not have access to parental leave, another question is evoked: what happens to working women when a child is born? Those who are lucky enough to have a planned pregnancy may opt to save as many sick days as possible before their delivery date to be used during their recovery. But unfortunately, in many cases women can be forced to leave their jobs because of choosing to give birth.
Not all Families are Impacted the Same
In addition to women being disproportionately affected on a large scale, there are various other societal groups which are put at a greater disadvantage. According to a June 2021 article on BBC, “workers in blue-collar jobs are less likely to get paid parental leave than those with corporate jobs.” This not only affects the lower-income spectrum of the working class, but therefore largely affects BIPOC women and families at a higher rate than their white counterparts. Specifically in the post-war years, resistance formed through the idea that granting universal leave to all workers would encourage the “wrong” families to have the ability to produce. The UDHR lays out in Article 2 that all persons should have access to such human rights without any distinction regarding not only sex and gender, but race and social status as well.
What does the fight towards ensured parental leave in America look like today?
Source: Yahoo Images
The fight for paid parental leave is not new to the agenda of human rights crises. In November of 1919, The International Labor Organization was quoted by the International Congress for Working Women in stating 12 weeks of paid parental leave is a “medical necessity and social right.”
Today, lawmakers across America’s political spectrum voice their support for paid parental leave. Regarding the public, advocating for paid parental leave should be accompanied by voting for politicians at a federal and state level that will bring action to further implementing this agenda into legislation. There are also various activist organizations nationwide that can be further magnified by volunteers or monetary donations, including the PL+US and the National Partnership for Women and Families.
Source: Yahoo Images; People experiencing homelessness sleeping under a bridge
The homeless population in America tends to be neglected by the society they live in. They are among the most vulnerable, belonging to already marginalized communities that struggle to meet their day to day needs. As a result, the unhoused have little to no power or influence on social norms and affairs. As someone who has experienced homelessness both in India and in America, I have come to distinguish some of the common misconceptions society holds about the unhoused population. There are a lot of stereotypes and social stigma that surrounds the discussions around homelessness, which often blames the victims of systemic issues, instead of restructuring the conversation around how we as society can best help these marginalized groups realize their basic human rights to shelter. In order to do so, we must first understand what it really means to be homeless in America.
History of Homelessness in America
Homelessness is not an issue unique to the United States, as it can be found in countries all over the world. While homelessness in America can be found as early as the colonial times, modern homelessness rose as a response to the Great Depression, where people experienced high levels of unemployment and poverty. Especially interesting is the relationship between the growth of urban cities and the rise in homelessness. Coupled with low-wages and higher costs of living, people found it more expensive to find places to live in urban centers, such as New York and California. The aftermath of the Great Depression put a lot of people in desperate need of employment, and as the economy took to the service industry, more and more undereducated, impoverished people had no other choice but to turn to these low-income jobs. The country’s shift to a service economy meant that laborers were now being paid lower wages, leaving service industry employees unable to afford the rising costs of housing. Coupled with higher housing costs and lower wages, when people turned to social welfare programs, they found these programs to be lacking in funds as well.
Additionally, there was a campaign to “Deinstitutionalize” people held in mental asylums. While the campaign itself was well-intended, its applications were lacking in structure, and instead of providing patients with proper access to mental health resources, people with mental disabilities were released to fend for themselves. The neglect of these institutions led to the increasing numbers of mental health patients facing housing insecurity. To make matters worse, gentrification policies (made to bring in wealthy real-estate investors and high-income residents to underdeveloped parts of the city) led to the displacement of many low-income families, putting them out of their homes. These policies disproportionately affect people of color, something that has forced many marginalized communities to fall prey to an endless cycle of poverty and degradation.
Unfortunately, one of the most concerning additions to the homeless population is the disproportionate number of youths that identify as being part of the LGBTQ+ community. According to a recent study conducted by Chapin Hall at the University of Chicago, LGBTQ+ youth had a 120% higher risk of experiencing homelessness. These members who already belong to an ostracized community can become more vulnerable to harassment, violence and hate crimes.
Additionally, unable to find jobs after returning home from military service, many veterans end up homeless with nowhere else to go. Although places do exist to support veterans who experience homelessness, many are either unaware of the resources at hand, or too ashamed to use these resources. As a result of the social stigma surrounding the topic, people experiencing homelessness often become withdrawn from society.
Society’s Attitudes Toward the Homeless
Source: Yahoo Images; An example of hostile architecture that prevents the unhoused from sleeping on benches
Homelessness is received with wildly different attitudes among different cultures. America is a very diverse country, with people that share hundreds of different cultures and traditions, and these cultural attitudes can carry over in the way they respond to contemporary social issues. Different cultures share a varying definition of what a “home” means, and even more distinctions in their approach toward people experiencing homelessness. What the dominant White culture might consider to be a home, (an individual unit of space for nuclear families), might not be what someone who belongs to the Indigenous population believes. They might argue that a home is where you can interact with your community, a place to feel safe and share with friends and family. Even the attitudes toward helping people who are unhoused have strict cultural implications. As described in Islam, it is part of the every-day religious ritual of a Muslim to give alms and help the poor in their community. In Hinduism, while helping the poor with food and shelter is allowed, certain castes are not allowed to eat alongside with or sit beside people of lower castes. People experiencing homelessness have their own unique culture, where certain skills or strategies for survival on the streets are shared amongst each other.
Along with all these complexities, the unhoused also undergo various types of stigmas, including social stigma, and cultural stigma. Social stigma can be discrimination and harassment directed toward the homeless population by the institutions, systems and people that make up society. Cultural stigma can refer to the stigma expressed by friends and family members or other religious or cultural institutions that may shame and blame the victims for being homeless.
Unhoused people also have a hard time finding employment. This is partly due to the fact that the job application requires a home address for the application process to be completed. As a result, people who are dispossessed also experience difficulties when finding housing. The applications for apartments include a proof of income/employment section and applying for government housing takes months to be processed and reviewed. Many states have long and complicated application processes, and even then, it is not a guaranteed housing option. Nevertheless, applicants can be denied, and they would still need a place to stay while awaiting their application to be approved.
Adding to these difficulties, people in the homeless community are constantly harassed with wild stares or abuse, (both verbal and physical), from members of society. The law enforcement agency, an institution designed to serve and protect people of the community, may make matters worse by deteriorating the situation further. Without proper training, police approach the homeless defensively, ready to attack at the slightest “abnormal” reactions. What they haven’t been trained to realize is that many people experiencing homelessness are also at high-risk of developing mental health issues due to the stress and realities of being homeless. These altercations can turn deadly, and unfortunately, many people of the homeless community have either been locked up or even killed by officers of the law. Many of these instances were even caught on camera, yet these officers faced little to no accountability or legal punishment.
People experiencing homelessness are also easy targets to getting their possessions robbed, and many times, police will raid their camps and confiscate what few belongings they might acquire, including sleeping tents and toiletries. Society also treats the homeless population as a burden and blames them for being “lazy” or “druggies” or “criminals/suspicious,” without any provocation from the homeless community. It can be especially insulting for the people experiencing homelessness to be judged for their situation while society simultaneously fails to criticize the state’s inability to protect peoples’ fundamental human rights to food, shelter, and other basic needs.
The Legal Response to Homelessness in America
Source: Yahoo Images; An example of hostile architecture to deter the homeless from sleeping under bridges
The legal response to the homelessness crisis in America has not been a heartwarming one either. Urban cities all over the United States have put in place anti-homelessness measures, otherwise known as hostile architecture. These include slanted benches, benches divided by armrests, spiked and rocky pavements to prevent people from sleeping there, and even boulders under bridges. Not only are these measures inhumane, they also cost the tax-payers a lot of money. These atrocious tactics are put in place to discourage homelessness, attempting to connect rising numbers of homelessness to increased crime rates. As recently as July of this year, Los Angeles even went so far as to make homelessness downright illegal, restricting homeless encampments in majority of the city. The city has even prohibited the homeless from sitting, sleeping, or laying in public. Due to the fact that homelessness overwhelmingly affects people who belong to already marginalized communities, a rights-based approach is necessary, one that addresses the existing systemic issues which need to be fixed first.
Covid-19 and How it Continues to Impact the Homeless Population
Source: Yahoo Images; Homeless shelters can be crowded, without proper social distancing measures in place
The Covid-19 pandemic continues to impact many different communities in a variety of ways. The pandemic hit especially hard among the homeless population, where access to hygienic products are often slim, if not non-existent. People experiencing homelessness may not have the ability to continuously wash and sanitize their hands, with limited access to clean water and soap products. They also been experience complications with social distancing measures, forced to be in crowded spaces like homeless shelters, which has only increased their risks of getting infected. Furthermore, even when infected, or exposed to the disease, the homeless population has very limited ability to quarantine, further allowing the spread of the disease to others in close proximity. The unhoused population has limited access to healthcare and medicinal treatments, and many are already immunocompromised or have pre-existing conditions, which increases their vulnerability of catching the disease. Stereotypes geared toward the homeless population labeling them as “junkies” or “druggies” has influenced the care they receive, leading to many cases of misdiagnoses or mistreatment as a result of biases held by healthcare professionals and others in the health care industry. Due to the rise in unemployment numbers during the economic shutdown as a response to the pandemic, millions of people who did not qualify for unemployment benefits, and could not make ends meet, also became homeless as a result.
Some Successful Approaches to Ending Homelessness
source: yahoo images; An unhoused person advocating against hostile architecture
There have been some successful attempts at ending homelessness in America as well as in other nations. Utah attempted to decrease its rates of homelessness back in 2015, which successfully reduced its homelessness by 91%. They executed a policy known as “Housing First,” which gave their chronically homeless populations free housing, a decision that cost the state less money than alternative anti-homelessness measures. This program unfortunately has not been a complete success, as people experiencing homelessness in other states have been migrating to Utah, making it too expensive for Utah alone to pay for the country’s increasing homelessness crisis. A national policy, on the other hand, that could implement the Housing First approach taken by Utah, may be the easiest, and essentially cheapest option to ending the homelessness crisis in America. This is essentially what Finland did. In 2019, Finland approached the homelessness issue with the most obvious of answers, by providing housing for all those who are unhoused. Like Utah, they applied the “Housing First” policy, (which came with no strings attached), recognizing that housing is an essential human right that should be protected and promoted. They also understand that in the long run, providing the homeless population with housing is the cheaper option to society. Also, as examined earlier, if applied in America, this Housing First policy will inevitably save more lives, with fewer interactions between the homeless and the police.
While homelessness is not something people are normally born into, the unhoused face discrimination, stigmatization, and marginalization from society just as much as any other group. Although people’s socioeconomic status is a major factor in determining who is most vulnerable to experiencing homelessness, as we’ve seen in the case of the LGBTQ+ youth, and older veterans as well, homelessness can impact people of any and all races, at various age levels, and at any given time. The pandemic itself has expanded the homeless population as people are unable to pay their backed-up rent or mortgage payments. While alternative approaches can assist to eradicate levels of homelessness in our society as implemented in Finland and Utah, it is crucial that we also continue to destigmatize being homeless in American society and take a rights-based approach to finding long-term solutions to end their suffering.
On February 10, 2021 the Alabama Senate Health Committee voted to criminalize transgender medicaltreatment for minors. With an 11-2 vote, the committee approved Senate Bill 10 (SB-10), a bill that will “outlaw puberty blocking medications and gender-affirming care for minors.” On March 3, the Alabama Senate passed this legislation, and it is currently awaiting Governor Kay Ivey’s approval. SB-10 empowers the legal system to prosecute clinicians and pharmacists with felony charges if they prescribe medication or provide treatment to aid in the transitional processes of minors. Bill sponsor Senator Shay Shellnutt (R-AL) claims that “minors are too young to be making this decision.” The Senator has also admitted that he’s never interacted with a trans teen before submitting the bill. Opponents of the SB-10 refute Shellnutt’s claim by acknowledging this decision is between the medical care provider, the patient, and the patient guardians. As such, SB-10 infringes on the private rights of parents to care for their children with necessary and proper interventions. Shellnut has mentioned that hormonal treatment and other transgender interventions cause long term issues and that a child is not mature enough to be making such a permanent decision. Shellnut’s claims are false; the effects of hormonal drugs that are puberty blockers are reversible. Also, when evaluating long term effects of gender reassignment surgeries, doctors prefer to wait until the patient is at least 18 years old before they perform the surgery.
Healthcare providers are only one pillar of the support system for patients wishing to transition. So, when healthcare providers are unable to provide care to these young individuals, it can harm their mental and physical wellbeing and contribute to gender dysphoria. Adolescent and young adult years are incredibly formative. It’s in these years that young people thrive and when they are in need of a lot of support and care. When their support systems and adequate healthcare is taken away “adolescents can feel alone, stigmatized, and undervalued”. Rejection, discrimination, and stigma during these formative years can put young adults at a higher risk of mental health disorders such as depression and anxiety. The aforementioned mental health disorders can lead to the usage of addictive substances like drugs and/or alcohol, and suicidal ideation. These factors contribute to significant health disparities within the LBGTQ+ community. It’s vital the care they receive is given without stigma and affirms the patient’s sexuality and gender identity, but this care cannot be given with government intervention that holds traces of transphobia.
Source: www.britishherald.com
Gender is a very dynamic concept, and there is no binary. It is up to the individual to choose their identity. Gender reassignment treatments and procedures are one way to reaffirm and respect an individual’s choice. LGBTQ+ youth deserve to know that they are respected and that they deserve quality healthcare and treatment. Healthcare providers should not be prevented from fulfilling their responsibilities. They should be able to provide quality care and treatment for their patients. If they can’t, they should be able to refer the patient to a doctor who can provide adequate healthcare. This is not the first time SB-10 has been passed to the full Alabama Senate. It was passed all the way up to the Governor in 2020 to be signed into action and is only back on the table due to COVID-19 complications. Advocacy is an important aspect of healthcare, and providers should be willing to advocate the most for marginalized communities. It is important to lift barriers to care for these groups, instead of continuing to make healthcare inaccessible.
A separate companion bill (HB-391) is currently in the Alabama House. This bill would restrict transgender students from participating in school athletics with the gender they identify with. Lawmakers that support the bill claim that it protects fairness for female and “keeps them from having to compete against transgender athletes who were born male.” The biggest difference to make right now is to call Alabama Senate representatives and tell them the harms these bills will cause to LGBTQ+ youth and to the healthcare providers that try to help them.
Since the middle of November, COVID-19 cases have hit record-highs for the pandemic across the world. Countries around the world are pushing to get healthcare workers and the general population vaccinated to ease the burden of increased cases on health systems, economies, and citizens. The logistics of obtaining and delivering the vaccine have proved a slow, arduous task in many countries across the world.
However, Israel has reported success in rapidly vaccinating health care workers and the general population. At the end of December and early January, Israel reported that it had administered vaccines to around 17% of the population. According to the Jerusalem Post, Israel has secured enough vaccines to have all Israeli citizens vaccinated by March 16th of this year. Israeli Prime Minister Netanyahu has declared, “We will be the first country to emerge from the coronavirus. We will vaccinate all relevant populations and anyone who wants to can be vaccinated.” He went on to say that Israel will be a “model-nation” for how to exit the coronavirus.
Source: Amir Appel, Flickr
A significant portion of Israel’s borders is made up of 5 million Palestinians who live in the West Bank, Gaza Strip, and East Jerusalem. Israelis within the defined borders of the state number at 8 million, making Palestineans comprise 39% of the population. Israel occupies the West Bank, meaning most of the territory is under the control of the Israeli government. Gaza Strip has been blockaded, and the Israeli government controls all resources entering and exiting the area. However, Israel has no plans to vaccinate any Palestinians even though they are inoculating residents living in Jewish settlements in occupied territory. They sight the Oslo Peace Accords from the 1990s, saying that Palestine is responsible for their own healthcare. So far, the only Palestinians that have received any vaccines are those living in East Jerusalem, since they have Israeli residency and access to Israeli healthcare.
Source: archer10 (Dennis), Creative Commons
Within Israeli territory, Palestinians have carried the higher burden of COVID-19 cases and deaths per capita. Of the people who get COVID-19 in Palestine, 1.1% will die from the disease. In Israel, this number is 0.7% due to better access to higher quality healthcare. Israel has begun to give vaccines to medics, nurses, and doctors working in the 6 Palestinian hospitals, but they were not available until the past few weeks. Vaccines are still unavailable to Palestinians with high-risk health conditions and those over 65, even though all Israelis over 40 are now eligible.
Source: Joint Base San Antonio Public Affairs, Flickr
The human rights body of the United Nations has released a statement saying that it is Israel’s responsibility as an occupying power to provide equitable access to Covid-19 vaccines for Palestinians in Gaza and the West Bank. There has been a huge inequality in vaccine distribution between Israel and Palestine, and the people of Palestine need vaccinations like those in the occupying power of Palestine.
UPDATE (March 29, 2021): According to BBC News, in early March, Israel decided to start offering the vaccine to the some 130,000 Palestinians living in occupied East Jerusalem or coming to work in Israel or in Israeli settlements in the West Bank. In other parts of the West Bank and in Gaza, the situation continues to be very bleak – infections are rising, new restrictions are being imposed, and vaccination efforts have been much slower to start. The Palestinian authorities have begun administering vaccines supplied under the international Covax vaccine-sharing scheme, which is intended to help poorer countries access supplies, and the UAE has donated 20,000 doses of the Russian-made vaccine to residents of Gaza. There is some argument over who is responsible for vaccinating Palestinians, with Israel pointing to the specification in the Oslo Accords stating that “Powers and responsibilities in the sphere of Health in the West bank and Gaza Strip will be transferred to the Palestinian side, including the health insurance system.” On the other hand, the United Nations issued a statement saying that according to the Fourth Geneva Convention, Israel (the occupying power) is “responsible for providing equitable access to Covid-19 vaccines for Palestinians in Gaza and the West Bank.” In any case, now that the vaccine is in greater supply, Israel has begun including Palestinians with work permits in the vaccine rollout.
Stop the XL Pipeline. Source: tarsandaction, Creative Commons.
On his first day in office, President Joe Biden signed an executive order canceling the Keystone XL Pipeline Project. The pipeline, which had severe environmental and human rights implications, has been on a long road towards failure. This pipeline was proposed in 2008 and has been referred to as either the Keystone XL pipeline or KXL. In 2015, the Obama administration vetoed the pipeline due to its potential threats to the climate, drinking water, public health, and ecosystems of the local communities. In 2017, the Trump administration reversed Obama’s veto, signing an executive order to advance the Keystone pipeline as well as a similar crude oil project, the Dakota Access Pipeline despite the many valid arguments made against the two pipelines. President Trump also issued a cross-border permit to the pipeline developer, a permit that had been long sought after for the developers. Since the approval, the Trump administration has been sued twice by environmental organizations and lost each time.
The Keystone XL pipeline was proposed by the energy infrastructure company TC Energy. It was proposed to be an extension of the existing Keystone Pipeline System, which has been in operation since 2010. The goal was to transport 830,000 barrels of crude, tar sand oil to refineries on the American Gulf Coast each day. Tar sands lie beneath the northern Alberta boreal forest. They contain a form of petroleum called bitumen, a relatively sludgy substance that can be turned into fuel. Because of the highly corrosive and acidic nature of the tar sands oil, there contains a higher likelihood that the pipeline will leak. A study set between the years 2007 and 2010 found that pipelines carrying tar sands oil spilled three times more per mile than pipelines carrying conventional crude oil. The southern portion of the pipeline, from Oklahoma to Texas, has already been completed. This portion of the pipeline is called the Gulf Coast Pipeline. The climate impact of a complete and fully operational Keystone XL would be drastic. It would increase mining by accelerating the production and transportation of crude oil. It has also been determined that tar sands oil emits 17 percent more carbon than other forms of crude oil. In 2017, the US State Department released a study which proved that carbon emissions could be between 5 and 20 percent higher than the original 17 percent estimation. This means an extra 178.3 million metric tons of greenhouse gas would be emitted annually, a similar impact to 38.5 million cars.
Keystone XL protestors. Source: Victoria Pickering, Creative Commons.
President Biden’s executive order was a landmark achievement and a sigh of relief for indigenous and environmental activists alike. Indigenous leaders are encouraging him to go even further and cancel more controversial fossil fuel projects, such as the Dakota Access pipeline. Several indigenous leaders, including Dallas Goldtooth of the Mdewakanton Dakota and Dine nations and Faith Spotted Eagle of the Ihanktonwan Dakota nation, have seen Biden’s executive order as a sign of the administration keeping its campaign promise to work against climate change and work with indigenous communities. Many indigenous populations have fought for over a decade to defend their water and land rights against fossil fuel companies. Goldtooth called Biden’s decision a “vindication” of the hard work and struggle many indigenous communities have put forth in protest of the pipeline. Pipelines like the Keystone XL and Dakota pipelines as well as other fossil fuel projects actively pollute native land and water resources as well as consistently contribute to global warming due to their high greenhouse gas emissions.
A similar crude oil project, the Dakota Access Pipeline has received media attention in previous years due to the police and state reactions to the protests over its creation. This pipeline transports 470,000 barrels of crude oil from North Dakota to Illinois, over 1,172 miles. The pipeline continually threatens the sanctity of indigenous sacred lands and the purity and safety of the local water supply. The Standing Rock Sioux tribe has been one of the most vocal groups in working to oppose the creation of the Dakota Access Pipeline. There did occur a series of protests for many months, in opposition of the creation of the pipeline. The protests were primarily peaceful, with camps and prayer circles set up on the land where construction was to take place. However, despite youth and elderly leaders being in the front during the inevitable standoffs with police, Mace, tasers, and rubber bullets were used against the protestors.
Indigenous Justice. Source: John Englart, Creative Commons.
The briefest look at American and Canadian history clearly shows that the pipeline situations are most certainly not the first instance of the government refusing to respect the lands, waters, and even peoples of indigenous groups. Until 2016, Canada officially objected to the United Nations Declaration on the Rights of Indigenous Peoples. Canada is considered one of the most water-rich countries in the world and yet many indigenous communities continue to be provided with inadequate access to safe drinking water which provides a large public health concern for these communities. The Canadian federal government refused to provide child and family services funding for indigenous children living on reserves, a purposeful discrimination tactic against indigenous communities. It has been determined that the pervasive violence against indigenous women amounts to genocide.
In the United States, there live over 5.2 million indigenous peoples and among them, 573 federally recognized tribes, numerous unrecognized nations, and many communities scattered across the North American continent, displaced by a long history of western oppression and forced assimilation. Between the years of 1778 and 1871 alone, the United States government has signed over 370 treaties with different indigenous nations, nearly all of which promised peace, defined land boundaries, and protection of land, water, and hunting rights. Based on the current status of indigenous peoples within the United States, it is evident that these treaties and those that followed were either never fulfilled or were manipulated to provide leverage for the United States government. President Biden’s executive order ending the construction of the Keystone XL is a very hopeful step forward, however it needs to serve as a pushing off point for the administration to continue furthering both environmental and indigenous rights.
The illicit pharmaceutical industry is bigger than one might think. In an age where coverage for prescription drugs may be limited and an opioid crisis is rampant, more and more people are turning to this illicit market. Because not everyone that purchases pharmaceutical drugs is aware they are doing so, this industry has been difficult for law enforcement to track. Thus, it has grown internationally and there are few places that are not affected by it.
The illicit pharmaceutical drug industry is a far reaching one. One reason for this is because counterfeit drugs can be made relatively cheap. A recent 60 Minutes segment illustrates how easy it is for companies to produce counterfeit pharmaceutical drugs; small rooms with relatively primitive equipment are used to make multiple drugs including blood pressure medicine, Viagra, painkillers, and seizure medication. One-way people are able to get these drugs is through illicit dealers posing as legitimate online pharmacies. So, even if an individual is not intentionally seeking out alternatives to legally prescribed medication, they may be tricked into it none the less. Other dealers have been much less reserved in how they market their products. As with the “Silk Road” site that operated on the dark web from 2011 to 2013, which included 4,000 dealers and around 100,000 buyers, it made no attempt to hide their illegality. This site acted as a huge distributor of numerous illicit substances including prescription drugs. While the “Silk Road” has been shut down for years, there are still many other sites on the dark web facilitating illicit pharmaceuticals. Additionally, when costumers buy illicit drugs online from sites posing as legal businesses, or even from sites like the “Silk Road,” they are often shipped to buyers through the postal service. This makes drugs difficult to stop, especially when they are shipped in small amounts. All in all, this makes it easy to deal in counterfeit drugs and allows the industry to spread across the globe.
But what are the negative implications? Is it only the pharmaceutical industry’s profit margins that suffer from this illicit industry? The answer is, sadly, no. There have been numerous negative consequences for public health that have resulted from it. Especially in the wake of the opioid pandemic–which hit the country largely due to doctors over prescribing highly addictive opioid painkillers–this industry has caused a large amount of irrevocable damage. As one source states, it is hard to know for sure how much the illicit drug industry has impacted people’s health. That said, it is predicted to have contributed significantly to the 42,249 deaths that resulted from opioid related causes in 2016 alone. Additionally, counterfeit pharmaceuticals are entering hospitals and pharmacies around the country. Even if the drug itself was manufactured licitly, counterfeit materials can make their way into the ingredients, or the ingredients may be safe but the wrong dose is recommended, thus making it counterfeit. These counterfeit ingredients can be anything from chalk to flour. While chalk and flour are fairly harmless, when those ingredients are used in life-saving medications, the results can be catastrophic. In one instance, counterfeit materials found their way into the blood thinner, Heparin, which resulted in the deaths of 80 people. While most pharmaceutical drugs that people receive are not counterfeit, the illicit pharmaceutical industry is continuing to grow and deceive people.
Source: Creative Commons
So, what can be done? As previously stated, most of these illicit pharmaceutical drugs are shipped through the mail and they have proven difficult to stop. Even so, there is still hope. There are new procedures being put in place including implementing new technology in international mail carrier facilities that allows those working there to scan packages and detect even minuscule amounts of opioids, and dark web sites are increasingly being monitored by government analysts. As of now, counterfeit drugs account for less than 1% of all pharmaceutical drugs sold in the United States. While counterfeit drugs are still a major problem in developing countries, it seems like likely that countries across the globe will eventually pick up similar measures to the U.S. and other countries that have reduced the problem significantly, so that this trade can be further snuffed out.
In essence, there are many outlets to the illicit pharmaceutical industry. These range from seemingly legal sites on the internet, the dark web, and even pharmacies and hospitals. These outlets have knowingly, and sometimes unknowingly, helped distribute sometimes dangerous counterfeit drugs to citizens across the globe. This has resulted in the deaths of many people and also helped perpetuate the opioid epidemic. Thankfully, the U.S. has amped up regulation in recent years leading to very little illicit pharmaceuticals ending up in the homes of people across the nation. In the future, it seems hopeful that the regulations that have been implemented in countries like the U.S. will soon be commonly used in other countries as well in order to stop this industry for good.
The Memphis Sanitation Strike started the environmental justice movement in February of 1968 when sanitation workers in Memphis, TN organized a strike to protest unfair treatment and the effects on their health. The workers had been receiving less pay than their white coworkers, while also doing the more dangerous work. Before the beginning of the strike, two black men had been killed by the trash compactor during work. The movement eventually lead to a recognized union and higher pay. This was not the first instance of environmental racism. However, it was one of the first time that head way was made when it comes to equality and equity.
The most famous example of a fight for environmental justice, Love Canal, seems to have few people of color as part of the story as many of the vocal people involved were white women. After heavy rain fall in 1978, residents of Love Canal, NY, noticed that there was a bad smell in the air, children were returning home after playing outside with burns on their skin, and babies were being born with birth defects at a very high rate. They didn’t know that toxic chemicals had seeped from the chemical waste dump they had built their homes and school on.
However, there was a federal housing project in the area as well that housed mainly people of color, and their voices were overshadowed by people like Lois Gibbs. The movement to move people out of the hazardous area did not extend to moving the people living in the federally funded housing to a safer area even though they were affected by the hazardous waste just as significantly. Luckily, both groups were able to relocate and receive compensation for the health effects.
While the Memphis Sanitation Strike and Love Canal both happened over 40 years ago, the environmental injustice experienced during those times has not completely gone away. Today people of color and low-income individuals are still more likely to live and work in hazardous areas. Most Superfund sites, which are areas that have been deemed severely environmentally contaminated, are within one mile of federally funded housing. Even more disturbing, a disproportionate amount of these families are people of color.
The disproportionate placing of federally funded housing, and therefore low-income communities of color, into environmentally hazardous areas stems from systematic racism, or more specifically, a Not In My Backyard (NIMBY) mentality held by higher-income white communities. No one wants to live near a hazardous waste site, a factory that releases toxic fumes, or a stinky landfill. However, the people with the power to say no get their way while the people who are already more likely to have health risks are placed in dangerous situations.
A larger problem is that low-income communities and communities of color have been not listened to. In northern Birmingham, AL a recent study showed that a coke mill on a Superfund site has been releasing carcinogenic chemicals in the air for years. Many residents have severe respiratory problems, such as asthma, and now can’t survive without many medications. However, the EPA didn’t catch the extremely high levels of rarer toxins in the air because they don’t typically test for those. It took a study from a nongovernmental organization to expose the harm that the coke mill was doing to this community.
No one wants to live somewhere that is going to make themselves or their family sick, and they shouldn’t have to. While the United States has made progress towards environmental justice over the past 40 years, there is still a long way to go. Superfund sites were created in 1980, but most of the current public housing was created before then. New federally funded housing should not be put near hazardous areas like Superfund sites, and we should work on solutions to clean up Superfund sites near federally funded housing or moving that housing . By reducing the number of housing projects near hazardous waste and taking note when a whole community gets sick, we will begin to move towards racial and income equity when it comes to the environment we live and work in.
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