Wednesday, September 30, 2009

Blaming the victim

Minority groups are particularly vulnerable because they are subject to discrimination, unequal access to resources, and lack of opportunity. Instead of actually helping these groups, many efforts seem to be just paying lip service to their problems. Only a relatively few organizations, individuals, and sometimes the government are truly dedicated to helping vulnerable populations. And as long as the majority group continues to hold prejudices, they will remain vulnerable. This is illustrated by the Roma population in Italy.

Often it is too easy to blame the victim. The very same attributes that are the consequences of vulnerability are misidentified as the causes (e.g. unemployment, poor health, HIV infection, lack of adequate housing). In the US, we feel that if these vulnerable people could just pull themselves up by their bootstraps then voila, problem solved. However, this view depends solely only on human agency and neglects the structural barriers confining these groups in their present positions. Vulnerable populations don't just exist, they are socially constructed and their problems must be socially ameliorated.

Tuesday, September 29, 2009

everyone is deserving!

“Are such vulnerable populations deserving of help or non-deserving?” I never thought that was even a question of debate. Who is not deserving of help? Vulnerable populations are still human beings and as human beings, we should all help each other. Yes, racism is prevalent, but I never understood what drove people to discriminate against each other, for example having a picnic while watching two gypsies die on the shore. Is that a new form of entertainment? They should do something! I was speechless when I continued reading along the article. How can someone find pleasure in one’s death?

I guess most of our prejudice comes from stereotypes. Gypsies are portrayed as witches who cast evil spells on those they hate on television. We know that they are not evil and just normal people trying to protect and raise their family. Italian government reinforces this stereotype by confining the Roma “animals” into camps where they are forced to work in black markets or beg for money. The government itself is turning its citizens against them. Both Christina and Violetta are both Italian born, so why the hate?

I was confused which side the Italian government was supporting, help or not helping the Roma camps. It seemed like they were trying, but not trying hard enough. Who initiated the discrimination against gypsies? Who agreed that they were “non-deserving” of help? Most of the Roma health issues are due to Italian government and its poor infrastructure. It seemed like the government was fragmented itself. One possible resolution for Roma equality and rights is to fix the Italian government. This also applies to other situations- to fix something, you must start at the root of the problems. In this case, the government must protect the Roma population from discrimination and provide health care. Instead, they promote the discrimination of gypsies among the blood-born-Italians. They live in Italy, thus Italians too! I found this quote very intriguing, “You cannot have one law for the Roma and one law for everyone else.” Everyone should be deserving of help. They should have people work with them, not against them.

I personally do not understand the role of gypsies and how they are perceived in the society they live in. I'm unsure of how I regard the topic of who is deserving and who is non-deserving of help. I believe that as humans, no doubt everyone has the basic human right to life, and as residents of that country they must be provided with the basics to live. When it comes to receiving help and giving public help, there are levels in which some people should be given priority due to physical ability (ex. handicap), health status (ex. chronic disease), living conditions, and other similar measurements. I don't have much of an opinion on the topic but as a future health care provider I believe everyone is entitled to and deserving of some form of help. With limited resources one can only receive so much and must work with that.

A question of social ethics.

The question of whether any particular group within society should be excluded from the social network is a contentious one. Distinctions are often drawn along ethnic or religious lines, notwithstanding the issue of social class or income. However, some things tend to be uniform, and those excluded are usually poor, socially mal-adjusted, and often badly educated. The Roma population of Italy, and indeed most of Europe, would fall within these parameters. When any given society looks to tackle social ills, it is almost inevitable that the majority of the population will search for easily identifiable causes, and when it comes to crime, violence, and a lack of commitment to the “social contract”, then the poor, the disenfranchised, and the isolated are an obvious choice. As with all predetermined conclusions, it is never hard to find a reason to hate someone if you are just willing to look hard enough. Even in societies that are ethnically uniform, and lack the easy finger pointing available with fresh immigrant populations, the same need to identify the “bad element” exists. This sub-culture is always the same, whether they are called “white trash”, degenerates, the criminal element, or any other of the labels applied to the lowest echelons of society. A lack of opportunity, combined with a lack of education and the squalid living conditions associated with poverty, results in a disproportionate amount of violence, crime, and ill health. This in turn is then taken to be “proof” of the undesirable nature of the population in question.

The fallacy in this kind of scapegoating is easily apparent once you step back from looking to apportion blame, and start to try and tackle social problems at their root. As with all issues related to the idea of a common social contract, affording protection and responsibility to all includes the need to provide services to the folks living below the poverty line. The issues of healthcare should be viewed in the same light as that of education. How can a society flourish unless it continuously bolsters the young, encouraging them to develop and mature? Education is the foundation of citizenship, and the only hope for the continued evolution and life of the whole. Similarly, a healthy population is a pre-requisite for survival. No politician would think to deny a ghetto child from obtaining a basic education, and yet many feel it is okay to allow that same child to be stunted and warped through inadequate healthcare. The madness of this position is cruelly apparent to all, surely?

Ultimately, the need to have a strong social contract that includes all of society is an absolutely undeniable aspect of any modern democratic state. With that in mind, the initial question becomes less of a debate about the exclusion of any one section of society, and evolves into a national dialog on exactly how much society is willing to invest in its future.

No La Dolce Vita for Roma Gypsies.

It is truly shocking to see an image of two Roma gypsies lying dead on the beach while other people enjoying their picnic in just a few feet away and not even caring or surprising at all. This just demonstrates of severe inequalities and racial discrimination toward gypsies (minorities) in Italy. Most importantly, gypsies seemed to encounter social inequalities from virtually all aspects including from the basic living conditions (shelter and clothes), health care, education to criminal justice.

As most of blogger mentioned, they definitely deserve help from others. Why? Because they are the most vulnerable population who wandered around and settled at Italy for better life. They are not criminals, beggars or terrorists; they are very fragile population who simply ask for equal access as any other citizens in Italy do. They ultimately became the victims of social prejudice and hatred and perceived as just outcast, instead we should all respect their lives and basic human rights. Moreover, most of them have poor health and no access to the health care; therefore they indeed are in great need of help in terms of food and water sanitation, proper shelters and education. Without someone’s help and support, the next generation of gypsies will continue to go through same phases of intolerable hatred and racial discrimination as previous gypsies.

This just made me think the most vulnerable population in America; they can be homeless, disables, immigrants from different countries, or elderly/ young children. Whoever the vulnerable populations are, instead of rejecting them, we first need to embrace them as any other human beings, and then eventually they would blend in the society. I understand that this easier to said than done; however, we must to mainly focus on most vulnerable populations when we establish health care interventions and policies.

Vulnerable population in Ghana

There was 13 years of civil war in Liberia from 1990 to 2003; the country suffered an enormous amount of death and disability. It killed more than 200,000 people and about 500,000 people were forced to leave their homes and became internally displaced refugees who had to flee to other countries. The UN High Commission for Refugees (UNHCR) who is in charge of protecting the rights of refugees reported 42, 000 Liberians lived in Bujumbura Refugee Camp in neighboring Ghana, including 18,000 children and over 4,000 of these children were born in the camp. Their human rights were violated and they had to live their entire lives as refugees. Some of the refugees arrived in boats, canoes, helicopters and a few on cars. I remember watching the news with constant casualties and young children holding guns on the news in Liberia. One of my Liberian friend mentioned that another way to survive was to join the rebels and fight for that particular group, in that sense they could be able to arm and protect themselves. As he mentioned, it was just another way to survive. Perch my Liberian friend suffered cuts and a gunshot in his arm. Even though he is married to a Ghanaian woman, with two beautiful children, he still suffers some sort of mental health problem. It is possible that, his initial plan wasn’t to work as a car mechanic and settle in Ghana but due to the situation he found himself changing his career, just to make the best out of his stay in Ghana. The vulnerable population such as the Liberian refugee suffered mentally and psychologically from the war in their country. To enable the Liberian refugees who settled in the Bujumbura Refugee Camp in Ghana, they created the Liberian Dance Troupe project which used theatre and dance help them remember and maintain Liberian culture, to teach the youth within the camp about HIV/AIDS, teen pregnancy and drug abuse. Adult leaders were able to train over 100 children and youth in theatre, the arts, oral and written literature, dance and music. Youth who receive cultural training carried out weekly cultural training seminars in primary schools located in the camp which have provided support to over 1000 children. This project has also enhanced the literacy skills of young members of the Liberian dancing troops and supports their psychosocial rehabilitation. All these activities were used to raise awareness about important health and social issues. The youth were encouraged to participate in this project to build their self-confidence, acquire d dignity and develop renewed sense of identity and to continue with their way of life in Ghana.

From the link given, I 'm surprises and horrified by the picture with the two dead people and the two people sitting by the beach enjoying the breeze. How can they just sit there and not call for help or do something? It’s interesting to see how these dead bodies are covered with towels and to see how normal it is for the others around. Is it because they are used to such a problem or what?

 

Monday, September 28, 2009

The Power of Fear

First of all, what human being is non-deserving? Just because someone is born privileged in a higher social class doesn’t make them any more deserving then those who were not. So I guess I’ve already answered the question, but I’ll go on…

Second of all, racism is EVERYWHERE. I thought I knew where there were sever social problems from my experiences in Latin America volunteering, studying, working and living and seeing slum conditions. However, now my ignorant self realizes, it is EVERYWHERE. What is it about human nature that convinces certain groups to believe they’re superior to others? I must do it too, I mean, I’m human, but I’d like to think I judge at a minimum.

I was just talking with my brother over the weekend about the power of fear. We believe this is the main reason why so much hate and violence exists. The fact that gay marriage didn’t pass and people are dying because of the faulty health care system goes to show that fear of change and other different groups allows inhumanity. I use to wonder growing up, how could the Germans allow the massacre of millions of Jews? Now, I understand – it also traces back to fear. Why are the poor not provided health care? Fear that the wealthy won’t receive quality care? Fear of a unified health care system among so many different groups? The list goes on…

one in a million

The most striking fact about this photo essay is that it is only a glimpse of one of the many human atrocities around the globe.

Yes, vulnerable populations are deserving of help.

But, who are they? Where are they?



“Where ignorance is bliss, ‘tis folly to be wise.” – Thomas Gray





Who, then, are the non-deserving?

Vicious Cycle?

I was not surprised after viewing those pictures and reading about the Roma gypsies. There are many similar "vulnerable" populations all over the world, in every country. Here in America, they are just like homeless people. The people standing on the side of streets, begging for money, etc. However, I agree with another blog posted in that it is not my decision to decide who is deserving or not. I mean, yes, everyone should be entitled to air to breathe, water to drink, food to eat-and some might say-access to good health? But, either these people are born into this type of vulnerability and its not their fault, because this is all they know OR they choose to live life this way-for some strange reason. I think we should offer certain things like shelter or opportunities to learn something, possibly a microloan in certain situations-for instance, a lost job, etc...then that might make a change in the world. If not, this will just continue in this vicious cycle and nothing will change or grow. Also, I agree with some readings in that its a community effort actually-because everyone lives/works around the same areas and everyone influences people around each other. Therefore if an effort is made to help one particular area, instead of one person or family, it might be more effectful.

Discrimination since the beginning of time

Discrimination has hurt populations since the beginning on time. America was founded by a group of individuals seeking relief from religious discrimination. To me there is no such thing as deserving or not deserving. If a population is vulnerable it simply means they need even more help.

It is a sick circle that traps these vulnerable populations. They are frequently poor, and lack access to food, healthcare, and other necessities for a healthy life, but because they appear different then their neighbors people think less of them. Sometimes even to the point where people say they deserve where they are and how they are treated. That is the saddest statement I can think of. No one deserves to suffer the way the Romas do, or the homeless in America do.

This video should make everyone open their eyes. There is discrimination everywhere, and even if we don't know about it that certainly does not mean it isn't there. Photographs of people continuing their beach holiday as two young Roma girls lie dead under blankets on the sand is heartbreaking. Equally as heartbreaking though is the discrimination we haven't yet heard about or had to witness picture evidence as documentation. Everyone is worthy of help when they need it, be it a homeless person who needs help finding shelter, a Roma needing healthcare, or a small child who has lost their way. They all have something in common. They are vulnerable.

Minorities and discrimination around the world

This seems to be a problem everywhere in the world. If one would step back just a little bit and think about this, it's obvious that we humans still have a lot of issues with race and of course, religion. In the 21st century, some of the most financially and culturally advanced nations (such as Italy) can't stand people with a culture or background other than themselves. I understand that health and health care access might be the most indicator of a quality of life. But when discrimination dominates a society, it comes in a big package of all social and economic issues. As one of the major points I learned during the public health program, health and health care should be approached in unique ways specific to each society and culture. As we learned, we have a lot of issues to argue about if we wanted to increase the quality of life, for example, for the minorities in Rome. Or may be we can combine all the issue and just work on discrimination.
On the same subject, I was watching Bill Maher show the other day, and he was saying that a lot of politicians are reporting concerns about the new health care bill. Their concern is to make sure that the new bill would not provide health care for the illegal immigrants. Because no working person would want to pay for a sick person who does not have legal documentation. Another guest brought up a good question when he said, "so what are we going to do with a bleeding Mexican worker in front of the emergency room"?

Are they deserving? Do they live and breathe?

Unfortunately, this seems to be a common problem worldwide. Populations, such as the Roma gypsies, seem to fall through the cracks of our developed societies and become these "vulnerable populations". As another student mentioned in their blog, we are health professionals and we are not to decide who is deserving or not. We are supposed to respect all human life regardless of anything else. However, as a human being I do not see how anyone could deny that these people need help. They are trapped in a perpetual cycle of poverty and near homelessness. They need proper housing, jobs, and health care. Without help they will never be able to get out of that lifestyle. The discrimination they face leads them to live in unsanitary housing and environments and often perform illegal activities to live.

This topic brings to mind the idea of migrant farm workers in the United States as a vulnerable population. These people work long grueling days earning billions of dollars for the farming industry in one of the richest nations of the world (the US) yet they live in barely Third World conditions. Many are making barely enough to live and definitely do not have extra for food, clothing, or healthcare.
http://www.ncfh.org/docs/fs-Facts%20about%20Farmworkers.pdf

The Roma of America

After reading about the Roma gypsies, I started thinking about how cruel and inhumane the Italians were to a group that were essentially also human beings. Although I think most of us are appalled by the extreme cases of police burning down Roma camps and people holding picnics around dead bodies, some of this also exists too close to home. Being new to the west coast and Los Angeles area, I constantly notice the overwhelming amount of homeless in the area. How many of us Americans are able to ignore those begging on the side of the street or homeless man or woman possibly in need of help? You hear stories of the homeless population subjected to violence and lacking protection. They are too often turned away from public places, forbidden to loiter in most areas, and expelled from hospitals for their inability to pay. Are the homeless of America really that different than the Roma of Italy? In general, people may feel that it is easier to ignore the plights of others than to regard them as human beings with life, feelings, and rights.

A voice for the voiceless

After viewing the Roma photo essay I was intrigued and began researching current news articles about the Roma situation. What I discovered was similar to what I viewed in the slums of India, in the shanty-towns of Peru, and the poor back streets of Ecuador and the rural seaside coast. When poor and vulnerable populations are discriminated because of their race, religion, culture, or traditions the whole surrounding population suffers because of it. This seems to be a cycle of evil. When those in a society who have power, resources, and money yet deny access of these to their fellow man, those discriminated against not only become ill and transmit disease but they decrease the quality of life for all living in the area, and they often resort to crime therefore continuing the cycle of evil. These rising levels of crime are fuel to the fire of discrimination and the cycle only spirals deeper into hatred.

The more articles and news reports I read, the deeper the animosity and hatred toward the Roma people seemed to be rooted. Much of it stems from Gypsy gang violence and theft taking place in more and more western European cities but also due to the extreme differences in culture and lifestyle. Traditional Roma people believe in marrying their children young (promised in marriage by age 12 where they send their daughters to live in the homes of their ‘future husband’ until she has reached maturity for marriage), large families with many children, and children foregoing education to work with their parents. Their discrimination denies them access to jobs, education, adequate and safe housing, citizen rights, and healthcare. In my opinion the cycle will only continue if Roma are denied these opportunities and for as long as racial discrimination continues.

It is in my opinion that all people are created equal and therefore all are deserving of help. Therefore I believe I have the responsibility and opportunity to share what I have been given with others who have less. I want to help the poor, the orphans and the widows and as a public health leader I want to eliminate the racial discrimination and improve the living conditions of people like the Roma. May our voices be heard on behalf of the voiceless.

Sunday, September 27, 2009

They ARE deserving

This absolutely breaks my heart. I had the opportunity to both study in Italy and volunteer in Bosnia, so this really brought me to tears. After my experiences in both countries, I completely 100% believe that it is our responsibility and duty, and in fact should be our honor and genuine desire to help people who are part of vulnerable populations. After what I saw and heard in both countries, I firmly agree that people do not choose this type of life-but it is the kind of life experiences they have had that bring them to where they are. They should not be blamed or targeted, but should be regarded as people who are unique and could teach us all so much if we just listen. Therefore, I do believe that vulnerable populations ARE deserving of help.

When I went to Italy I noticed many children who looked so frail my first week there. I wondered why there were so many and why they were on the streets. My first weekend there, as I exited the metro, I felt a very strong tug against my shoulder. As I turned around I realized it was a group of 5 children running away from me. They tried to take my camera from me- but were unsuccessful because the strap was around my neck. After this experience I became interested in finding out how these children got on the streets, and why many of my friends in the program had wallets or other items taken within the first week by these children. I asked around and found out that there was so much hostility and prejudice against these children and their families. They were labeled as "gypsies" and I could just tell by the way many talked about them that something was all together wrong. I found out that many came from Russia or the Balkans in search of a better life, especially during the war in Bosnia during the 1990s. I did not really know much about Bosnia or the war but I would find out soon.
When I went to Bosnia to teach college students English, my new friends told me stories of what it was like to have lived in a country ravished by war for years. I saw visual depictions of the destruction that took the lives of many and forced many families to flee for their safety. Remnants of the national library right in the center of the capital, bullet holes on every face of the buildings people pass by every day, "red roses" on the ground which depicted where bombs struck the ground and took a life- war had never seemed so real to me. My friends told me that because of their ethnicity or religion their families had to run and leave everything behind-in their case they fled to the city of Zenica, which is where I lived that summer. Zenica was a refuge for them-camps were built to keep them safe from harm and the city was fortunately spared from physical destruction, but the emotional toll is something very present. However, not all families fled to Zenica, some fled to other neighboring countries, such as Italy. Everything seemed to make sense now-the children I saw in Italy were taken there by their families to find safety-to find a place where they would not be oppressed and threatened simply because they were a certain ethnicity or believed something different. Yet, they were not received in Italy with open arms.

I could go on for pages about what I saw and heard. My Bosnian friends were some of the nicest, most hospitable, gentle-spirited, determined, hard-working people I have ever met. I imagine myself and my family in the situation they were and still are in-and I ask myself if I would be that strong. I ask myself if my family and I had to flee for safety to another country, how would we be received. Would we be denied the common courtesy, respect, love, and compassion that everyone is entitled to? Would we be isolated and alienated, blamed and targeted?
I completely understand that "helping vulnerable populations" is easier said than done. I know that there are language and cultural barriers. I know that it would require a lot of resources and also a lot of emotional healing, forgiveness, and cohesive efforts on the parts of various people groups. I know it would be difficult, but I think it is necessary.

Totally shocking!

The photographs have a huge impact on me, the two Roma girls bodies lay on the beach where seems people picnicked just beside them. How could people there just let the tragedy happen in front of them? How could the family deal with the accident? And how could the vulnerable populations become the public enemies?

I think the vulnerable populations definitely deserve help, but it‘s hard to define what kind of help is exactly that the populations really needed? There could be all kinds of help, food, jobs, finance, health services, education, etc., and what’s the most important one? We do know that there are lots of people and organizations deliver all kinds of help and governments provide the public plans and social welfare just for the vulnerable populations, but what we don’t know is that “Is all these help really work? ” or “Is all these help truly improve and benefit the right populations? ” I think there are no certain answers to these questions; and exactly how do we define the vulnerable populations? My perception of vulnerable population probably would be like children, poor, disability, elderly, minority, etc., and all these populations have different kind of needs. Nowadays, people are still struggling to determine what’s the most needed for the vulnerable populations. I think the priority to take care of the vulnerable populations is to find the proper and precise needs for them.

Saturday, September 26, 2009

What about the value of humanity?

The image of the two dead Roma bodies basking in the sun while people continued their picnics at the beach was really shocking to me. It didn't seem to matter that these Roma girls were human beings, and the normalcy of the whole situation bothered me even more. Perhaps if these girls were material goods, they would be cared for more? Sadly, the answer is probably yes. Why are vulnerable populations like the gypsies constantly being discriminated against and excluded from many social and health services? Shouldn't the vulnerable population be paid the most attention to?

The vulnerable population is deserving of help, in fact, they need even more help in order to get them on their feet and functioning members of society. Without help, the gap between those that are less fortunate and those that are more fortunate will only continue to grow. Many people are born into difficult situations void of any choice, and to say that these people are not deserving of help (particularly children) is absurd. Vulnerable populations need the most help, and this help must come from the larger society sacrificing for the greater good of all human beings because we are all invested in each other's livelihoods. Something that affects one person affects all of us. Is that not the value of humanity?

Friday, September 25, 2009

It may be apples and oranges, but in the end they're all fruit

As health care professionals, I don't think it is our jurisdiction to determine whether someone deserves care of not. There's lots of these types of hypothetical situations that people like to pose to doctors, such as "If you had a patient who was bleeding to death and you were the only one who could save him, would you even though he's a murderer and would probably just go out and kill again if you save his life?" or whatever hoopla they can come up with. The answer, without question, is yes. It's not the doctor's job to determine what kind of person you are, or what you do. He (in an ideal setting...even though we are all subject to human biases, and that can't be avoided) is supposed to treat and care for everyone, regardless of race, class, occupation, politics, religion, what have you.

I like to think that in public health, we adopt the same attitude towards the people and the communities with which we work. It doesn't matter if it's a village of martians, if they need help and we can provide it, then we ought to do that sans prejudice.

The unfortunate reality, though, is that biases do exist. Sometimes we see certain populations as not as "hard working" as others, so we associate this with them not "deserving" the same services as those who "earned" it. Health care is for everyone. There can be better interventions and programs in place to educate and prevent people from unnecessarily straining the health care system (i.e. not taking care of themselves to begin with, waiting until an illness has reached severe stage, inappropriate overuse of ER, etc), but this goes for all populations, not just those who are vulnerable.

Thursday, September 24, 2009

Teach A Man To Fish

Every vulnerable population, whether they are “deserving” or “non-deserving”, are still human beings and thus have the right to have at least some form of assistance, short term or long term. We don’t know how or why they got in to their situation, we just know that they are there and need our help not our judgment. Alex Karev in Grey’s Anatomy best describes this, “ I’m no underdog, like this guy here. He’s fighting for his life, paying for someone else’s mistakes. It doesn’t make him an underdog. He just has to work harder to overcome the cards he was dealt.”

The hard part is how to help them. In this situation, it is better to help them on the individual level not the population level. In my group this week, the Abolish Poverty Movement, our basic plan was to create a self-sustaining work force by providing both training and microloans.

The first aspect is mandatory schooling, whether it’s high school or some form of vocational school. This will keep juveniles off the street and away from negative influences, such as drugs and gangs, and will save money for the state that can be reinvested into them. Secondly, this will create a higher skilled and disciplined workforce that can allow the vulnerable population to start pulling themselves up by the bootstraps.

The second aspect is microloans, where small amounts of money, anywhere from $50 to $500, is given to people with the hope they will spend the money starting businesses or investing. Consequently, jobs are created and the money will be repaid. Several of these programs have been started in smaller nations and have had success so far.

As with all solutions, the problem is finding funding to pay for all of these programs. If this hurdle can be cleared, this can become the first step to helping the vulnerable become less vulnerable.