3:34:00 AM
By Prof James Petras
Washington escalates its military interventions abroad, launching
simultaneous air and ground attacks in Syria, Iraq and Afghanistan;
multiplying drone attacks in Pakistan, Yemen and Somalia; training,
arming and financing proxy mercenaries in Jordan, the Gulf States and
Iraq; and dispatching National Guard battalions to West Africa,
ostensibly to combat the Ebola epidemic, though they lack the most
elementary public health capabilities. All in all the US spent $3.5 trillion for military invasions over 6 years.
At the same time, the US domestic public health services have
deteriorated. At the state and local level, like Dallas, Texas and at
the national level, officials and major institutions demonstrate an
inability to effectively detect and manage cases of Ebola infections
among the general population in a timely manner. An infected Liberian
immigrant was not diagnosed correctly when he presented to a major
Dallas hospital emergency room.
Instead he received irrelevant and
unnecessary ‘imaging studies’ and was sent home with oral antibiotics.
This confirmed the widespread belief that Emergency Room physicians and
nurses are under pressure from their administration to order costly CT
scans and MRI’s on patients as a way to make money for the hospital and
to cover-up their incompetence at basic patient history and physical
examination. Despite the patient’s informing hospital workers of his
recent arrival from Liberia, an Ebola outbreak hot-spot, personnel did
not put on basic protective gowns, gloves, hoods and masks and they
allowed the febrile, vomiting, desperately sick man to contaminate large
areas of the emergency department, waiting room and MRI suite.
Quarantine was not even considered. . . .
The director of the Dallas hospital covered up for his organization’s
incompetence by a series of victim blaming – the patient, the computer
system, the nurses… National health guidelines may have been inadequate
at the time, but Ebola was clearly on the national radar and the CDC
had provided basic guidelines and measures. All hospitals have
infectious control committees, disaster preparedness committees and
receive state and national alerts.
As the crisis and public panic deepened, President Obama engaged in
vigorous political fund-raising. Meanwhile, Vice President Biden was
preoccupied by his 40+ year-old son’s expulsion from the Navy Reserve
for cocaine use. The Defense Secretary was busy picking targets to bomb
in Syria and Iraq…
The Cabinet met over ‘National Security’ issues like ISIS, expanding
military interventions around the world, while US medical personnel,
international travelers and their family members, as well as average
American citizens felt more threatened by the apparent breakdown of the
public health system, both at the local and national levels, in the face
of a deadly viral infection.
The inadequacy, indeed breakdown, of the US public health system as
it confronts the first cases of Ebola in the US and the simultaneous
escalation of military intervention in Syria and Iraq typifies, in
microcosm, the demise of the US republic accompanying the rise of the US
military empire.
The Dallas hospital, which had at first turned a desperately sick
Liberian immigrant away, was run as a for-profit enterprise, directed by
business managers eager for high returns and dismissive of basic health
procedures and even more of the advice of competent, experienced
health workers: They had made their biggest investments in high
technology and multi-million dollar equipment, irrelevant to the
diagnosis and treatment of tropical and infectious diseases.
The
pressure to use the most expensive technology inappropriately and recoup
the corporate investment, resulted in a deadly delay in diagnosis and
contaminated at least a dozen health care workers. The corporate
hospital director eventually apologized for their ‘mistakes’. But the
fault goes far beyond “bad decisions”: The procedures and protocols are
built into the ‘for profit’ model emphasizing the need show a healthy
‘return’ on multi-million dollar advanced technological investments.
There is a stark contrast between the high tech advances in imaging and
surgery in a modern American hospital and the regressive, socially
backward ignorance of the socio-medico context in which critically ill,
infectious patients are embedded. It is as if such patients are not
supposed to enter the techno-medical world where only the most highly
remunerative procedures and protocols are available for those… who can
pay.
At the deeper level, the entire national public health system is
increasingly dependent on the formulation of rules and flows of
information, corrupted and distorted by ‘market demands’ and political
priorities heavily weighted toward expanding the police state at home
and militarism abroad. These political priorities in turn, are
influenced by the massive shift in resources to support the permanent
war policies of the Obama regime and the US Congress.
The proliferation and escalation of military interventions dominates
the Obama Administration’s real agenda. According to Assistant
Secretary of State for Eastern European Affairs, Victoria Nuland, six
billion dollars of public money was spent on subverting the elected
government of the Ukraine – $6 billion shifted from US domestic sectors,
like health care and real disaster preparedness.
Meanwhile hundreds of
hospitals have been closed in most major US cities and rural clinics
abandoned for lack of personnel. The entire health care system, in its
current ‘for profit’ corporate form is devoid of competent, effective
leadership. On the other hand, the US military is seen as the solution
to the world’s (and increasingly domestic) problems, while the social
roots of conflict and disaster are ignored with contempt.
The militarization of the minds of our political leaders has led to
the most grotesque decisions: In the face of the Ebola epidemic in West
Africa, the Obama regime has sent 2000 National Guard combatants to
Africa. These are soldiers who lack the most elementary knowledge,
skill, capability and training to deal with the complexities of a major
public health crisis in a devastated, war torn part of the world.
One
must recall how Washington pressured the United Nations to send
‘Peace-keepers’ to Haiti after the earthquake – UN soldiers from Nepal,
who brought not peace but an epidemic of cholera killing additional tens
of thousands of Haitian civilians. The immediate question regarding US
National Guard troops in West Africa is not whether they can build
rural clinics or maintain camps of quarantined Africans, the real
concern is whether these heavily armed ‘health aides’ can avoid being
infected and bringing Ebola home. This concern has now led the Pentagon
to impose mandatory quarantine on its own soldiers returning from West
Africa – a knee-jerk reaction motivated more by fear-mongering than
science.
In contrast, Cuba has sent hundreds of highly skilled health workers,
who form teams with proven track records in confronting public health
crises in the tropics and elsewhere. Cuban teams include skilled
epidemiologists who develop effective local programs, based on
real-time, on-the-ground fact-finding and assessment of available
resources.
The enormous differences between the Cuban and US responses
to the Ebola crisis reflects the profound contrast in their social and
health systems: Cuba has a free national health system and strong
public health and civil defense structures using rigorous procedures and
effective guidelines to set up clinics and camps appropriate to the
objective conditions. They emphasize the social context of disease and
are not invested in expensive high tech medical equipment and tests
irrelevant to the challenges at hand. Their budget is not skewed toward
promoting imperial wars: for the Cubans health and welfare is an
integral political priority.
In contrast ‘health care’ in the US has become big business while
military metaphysics dominate the minds and policies of the political
and business elite. The deterioration of basic health care delivery in
general and the public health sector in particular is not only a
consequence of a failure of political leadership, it also reflects the
recurring and deepening economic crises.
Under the ‘War on Terrorism’
fear-mongering over bio-weapons, namely threatened Anthrax attacks, tens
of billions of public money was diverted from public health at the
national and state level and the corrupted, crippled system has never
recovered.
The economic crisis, gripping the US, the European Union (EU) and
beyond, is clearly manifested in the stagnation of the US economy. The
private corporate elite, who form the ruling class, are unable to
sustain growth without massive US Treasury subsidies ($4.5 trillion
dollars, according to the Financial Times (10/14/14).
The US has experienced extreme volatility in its stock market, together
with the impoverishment of its working class and diminution of its
middle class.
Heightened social inequalities are everywhere, especially
in access to decent, effective health care. In the EU, Germany’s
economy is plunging from zero to negative growth, while France, Italy
and Holland are in deep recession. Greece, Spain and Portugal are in a
prolonged depression, burdened by unpayable debts and unable to escape
the downward social and economic spiral because of austerity programs
imposed by Brussels.
Washington’s war policies, the concentration of state resources on
financing military invasions and subsidizing the grossly inflated
financial sector, account for the fatal deterioration of health and
welfare services in the US. Growing majorities feel the pain, and many
more are alienated from the Presidential and Congressional elite – as
well as from their own corrupt, incompetent local elected officials.
To safeguard the power of the military-financial elite, the political
rulers have resorted to a series of “Horror Shows” – orchestrating vast
propaganda spectacles designed to strike fear and loathing of ‘external
enemies’ among the American public, in order to secure their submission
and obedience to police state policies.
Recently, there was the lurid media shock of the Muslim terrorists in
‘ISIS’ beheading two American captives. The public ‘horror’ was
manipulated to justify the large-scale US military re-entry in Iraq and
the air war against Syria – policies largely opposed by the war-weary US
citizenry.
Close on the heels of the ‘beheading’ atrocities, came the spectacle
of a fearsome African “Ebola” epidemic, spreading to the US and
threatening Americans with brutally painful deaths… This was used to
justify Obama’s sending of thousands of US National Guard to West Africa
to act as “health workers”.
The total collapse of the public health systems throughout Africa
follows decades of civil wars, fomented by US and EU military policies,
in order to plunder Africa’s economies and rich natural resources –
while marketing Western arms and mercenaries. Militarizing the problems
of Africa and creating millions of refugees has naturally led to
plagues – Ebola today, malariayesterday and other infectious diseases
and miseries tomorrow.
The immensely complex and catastrophic health crisis in West Africa
is the stark backdrop to years of western propaganda hailing the massive
growth of foreign investment in Africa’s extractive sectors – notably
energy and mining. The business press (Financial Times, Economist, Wall
Street Journal…) featured images of “Africa; the Sleeping Giant Awakes”,
describing of emergence of wealthy mineral enclaves powered by
large-scale foreign investments, creating vast private foreign and local
fortunes while ignoring the sea of massive poverty, broken public
health clinics, non-existent schools and devastating living conditions,
as well as the war-lord ravaged masses of refugees fleeing the fights
over mineral-rich lands. This created the ‘perfect storm’ for the
emergence and spread of epidemics – like Ebola.
In Africa, under IMF and Western corporate dictates, entire budgets
and foreign aid programs were channeled to finance infrastructure
(roads, transport, ports, etc.) for extractive imperialism – while
virtually nothing, in terms of public policy, was or is allocated to
basic public health and preventative medicine. The ‘focused’ programs
of the ‘Gates Foundation’ and others served to divert African health
workers and resources to the ‘NGO’s, rather than national, priorities
and encouraged the flight of African doctors and nurses to the West.
The recent cases of Ebola in the US highlight the deterioration of
national and local public health systems – the result of deregulation,
privatization and corporatization of the medicine. The ‘profit ethos’
permeates medical care in the US. Cutbacks in preventive medicine,
divorcing medical care from the social context of illness, as well as
the lack of accountability and transparency in the face of erroneous
diagnoses and inappropriate or incompetent care are consequences of the
larger failures in public policy. This also explains the emergence and
rampant spread of multi-drug resistant bacterial infections within the
hospitals and out in the communities. The preference for expensive,
profitable techno-medicine (marketed as ‘personalized’ health care) over
competent ‘hands on’, science-based medicine rooted in an understanding
of objective social conditions, has fueled the crisis and spread mass
confusion among the public.
When the government engages in long-term, large-scale wars abroad,
when the Treasury allocates trillions of public dollars to Wall Street
for the better part of a decade, when the government secures submission
(“consent”) via horror scenarios that replace public accountability with
fear and loathing, we, the US public pay a steep price in public health
under autocratic elite rule.
The recent ‘police-state’ response to an American nurse, Kaci Hickox,
highlights the corrupt arrogance of US politicians and opinion leaders,
long accustomed to control via fear-mongering and criminalizing
dissent. The fact that Nurse ‘Kaci’ arrived at ‘Liberty’ International
Airport in perfect health from her months of heroic work in West Africa
where she set up clinics and hospitals to help stem the Ebola crisis at
its sources, did not dissuade the thuggish governor of New Jersey from
confining her, like an animal, in a clear plastic cage in the parking
lot of a Newark hospital.
Her successful fight for freedom against this
arbitrary confinement exposed Governor Cristie and his side-kick, New
York Governor Cuomo, as ignorant bellowing thugs, intent on making her
‘an example’. Nurse Kaci Hickox’ victory of science and civil rights
over brutal scare-mongering may be temporary – as the tendency has long
been to militarize crises and erode citizen rights.
The American public is beginning to understand the relationship
between this policy of scaremongering, the bail-out of billionaires and
rampant militarism with the daily erosion of their standard of living,
health and security and civil rights. It will take more than a Nurse
‘Kaci’ to reverse the tide, but one tough competent nurse has set a
glorious example.
