Can an Iranian System Really Help Mississippi?

Back to the question from my previous post: Can HealthConnect, an agency based on the primary health care system established in post-revolutionary Iran, really help Mississippi?

According to HealthConnect’s founder Dr. Aaron Shirely, HealthConnect serves two purposes in Mississippi: improve primary care for its rural residents and prove that Medcaid and health insurance will not eradicate all of the state’s health problems.

One of the major problems in Mississippi is the routine use of the emergency room for primary care. Patients who arrive in the ER and cannot afford treatment are still treated at taxpayer expense. While such practice is unfair to taxpayers, cutting of taxes appropriated toward this purpose will not prevent the arrival of unpaying patients to the ER. About 550,000 out of three million Mississippi residents lack health insurance. The state only has 176 doctors per 100,000, the lowest ratio in the country. Those numbers piggyback on Mississippi’s rank as “the country’s poorest and most racially divided state.”  That is where HealthConnect fits in. 

Mississippi is not the only state with a high percentage of its population lacking health insurance. This graph shows how it compares to nearby states and to the proportion of uninsured in the country as a whole. Note: these percentages reflect 2012 numbers. 

Photo credit: http://mepconline.com/blog/healthcare/building-toward-economic-mobility-in-mississippi-health-care/

This map shows the population density and the location/size of hospitals. Clearly there are fewer and smaller hospitals compared to the number and size in urban areas. No wonder such a large proportion of the population goes untreated simply because they do not have easy access to health care. 

Photo credit: http://archive.ahrq.gov/prep/nursinghomes/atlas/atlas_ms.gif

Unlike emergency C-sections, quadruple bypasses and ventilators, HealthConnect does not go after the final stage eruption of a health problem; it combats the part of the cause. While home-health agencies will dispatch nurses to conduct work in the patients’ homes, their care requires insurance and they often work for unregulated, lucrative for-profit agencies. Shirley’s approach, on the other hand, argues that the health care provider must be in it solely for the benefit of the patient. Without that sense of responsibility and loyally, the profit, rather than the best interests of the patient, is the foundation of treatment options.

Furthermore, the caregiver “must come from the patients world.” Black patients often do not trust white caregivers and will fabricate answers to pacify nurses or prevent them from asking more questions. As the daughter of a health care provider, one of the most important aspects of proper diagnosis and treatment is honesty with your doctor about symptoms, conditions and what you are experiencing. If a doctor does not know what is wrong, how can she or he effectively treat a patient?

Clearly, poverty in Mississippi is still very much a racial issue. As a result, it is imperative that an adequate proportion of Mississippi health care providers are African American who can actually see which health care problems stem from racism and mistrust on both sides. 

Photo credit: http://mepconline.com/blog/wp-content/uploads/2012/06/Child-Poverty-Rate-by-Race-Mississippi.jpg

Part of Shirley’s goal is to “get into homes and alter the course of future generations before obesity…or diabetes sets in.” He wants to make it so that the patients will trust their health care providers and in turn take measures to improve their health. To achieve this goal, Shirley opened health care houses in the schools. The location gave him access to both growing kids, to whom he can provide the most long-term benefit by teaching them good health practices early on, and their families. He also fills a much-needed gap, as many Mississippi public schools lack full-time nurses.

The workers of HealthConnect do not work 9-5. They are always trying to help, whether it take the form of allowing people who do not have electricity to stay a night in their home, making an unscheduled stop to check up on a patient and her new baby, or extending an appointment by an extra fifteen minutes to admire the patient’s family photos on the wall. In a way, they fulfill a particular void in many poor Mississippians’ lives: they act as family.

Many people shy away from making this kind of commitment. You sacrifice much of your time, energy and life to taking care of other people at a much higher cost than simply the financial expense. I am reminded of this every time I come home from college and my mom has to go do an emergency within five minutes of my arrival. But in the case of the poverty-stricken Mississippi Delta where all other attempts to improve health care have failed, such commitment is imperative. And I believe that it will work. Only proactive prevention of the most common killers of Mississippi residents, HIV/AIDS, diabetes, congestive heart failure, hypertension and asthma, will stop them from appearing in the ER when it is too late to treat them.

Obesity is one of the many faces of poverty in the United States. Left unaddressed, it condemns the child to an early death before he or she even becomes a teenager. As the cause of other conditions, Type II diabetes and high blood pressure for example, it proves to be more expensive to treat later than to prevent with a healthy diet and exercise now. Basic exercise (walking, running, push ups, crunches, etc) is free. Emergency room care is not. 

Photo credit: http://www.nourishinteractive.com/system/assets/general/images/nutrition-facts/childhood-obesity-rates-US-2011.gif 

I was appalled to read that some Mississippians have to shop for food at a gas station because a fully stocked grocery store is thirty miles away. That should not be the case in the twenty-first century United States. Insurance or Medicaid will not change that. But agencies like HealthConnect, who promote the well being of the patient and go after things like availability of healthy food and accessibility of medication, can.

Source: http://www.nytimes.com/2012/07/29/magazine/what-can-mississippis-health-care-system-learn-from-iran.html?pagewanted=1&_r=4&hp

Should I Approve My Tax Dollars to do That: Learn from Iran

In 2001, my mom described her health care philosophy to the Boston Globe: "Medical care is ideally broad enough to envelop not only the technical part of treating an illness, but caring for the whole animal - and the family around it.”

(https://secure.pqarchiver.com/boston-sub/access/70460160.html?FMT=FT&FMTS=ABS:FT&type=current&date=Apr+1%2C+2001&author=Naomi+R.+Kooker%2C+)

Though my mom’s expertise pertains primarily to animals, Dr. Aaron Shirley shares a similar sentiment about human patients. In 2010, Shirley founded HealthConnect, a rural Mississippi medical provider that provides a “holistic, intensely personal approach” to patient care. His inspiration for HealthConnect stems from “an unlikely place:” Iran.

In the 1980s, the Islamic Republic of Iran implemented a new primary health care system to combat the unsettling differences in health care quality and availability of rural and urban areas. As a result of this disparity, urban populations that had better access to better health care tended to out-health their rural counterparts.

The system was based on a single, multitiered structure. The first level, “health houses,” were constructed to accommodate the primary health care of approximately 1,500 people all of whom lived within an hour’s walk or less.  The 1000-square-foot houses themselves consist of exam rooms, sleeping quarters, and staff, who men and women trained in basic, preventative care. Services included family planning, prenatal care, nutritional advice, and immunizations.

The next tier was the rural center followed by the district hospital. This way, those who become very sick or require surgery, had access to a better-equipped hospital. It was also relatively inexpensive to implement. (http://www.nytimes.com/2012/07/29/magazine/what-can-mississippis-health-care-system-learn-from-iran.html?pagewanted=1&_r=4&hp).

Here you can see the flow of the hierarchical Iranian system and comparison of that flow between rural and urban centers. By the third tier, the urban and rural areas share the same hospitals. 

Photo credit: http://www.emeraldinsight.com/content_images/fig/0730190502001.png 

I see two crucial and extremely effective features of Iran’s system. The first is that by establishing good primary care, a more serious condition can be caught early before it lands the patient in the (expensive) emergency room or worse, dead. Obviously not all conditions are preventative. But many that face people living in poverty, such as diabetes, malnutrition, water contamination, malaria and other mosquito-transmitted diseases, and to an extent HIV, can be addressed before they reach a point of no return.

The second is that the health care workers are not foreigners imported in their fancy white lab coats and fancy stethoscopes; they are natives. They grew up in the villages they serve. They can relate to their patients on a personal level because they already share common ground, helping to forge an imperative sense of trust between health care provider and recipient. Such familiarity allows them to truly understand the problems their patients face and know certain realities of a solution. Some treatments we consider to be relatively elementary are impossible to prescribe in rural areas. Anything needing to be stored in the fridge, for example, is off the table for isolated areas without electricity.

In explaining how he made the leap from Iran to the United States, Dr. Shirley told the New York Times, “The Iranian model eliminated the geographic disparities, so why couldn’t this same approach be used for racial and geographic disparities in the United States?”

By establishing HealthConnect in rural Mississippi, the state with some of the worst health statistics in the country, Dr. Shirley is putting his money where his mouth is.
(http://www.nytimes.com/2012/07/29/magazine/what-can-mississippis-health-care-system-learn-from-iran.html?pagewanted=1&_r=4&hp).
Photo credit: http://faithandhealthdotorg.files.wordpress.com/2012/07/screen-shot-2012-07-31-at-8-43-53-am.png

The question now is, can HealthConnect actually help Mississippi?

I Approve My Tax Dollars to do That: Re-Vamp Health Care

The Obama Administration has pointed to and praised the Affordable Health Care Act as the way to fix our nation's broken health care system. But what if the solution actually involves the opposite? What if the disintegration of structured hierarchical medicine and insurance will increase the availabilty and quality of health care? 

I'm referring to the re-establishment of the house call practice.

Most Americans have never interacted with a family doctor who comes to their home and oversees their primary health care. Here there are no cold exam tables, no waiting rooms, and no stark white lab coats. I would not be familiar with such a concept either had I not grown up tagging along with my mom on appointments as she juggled her black doctor's bag in one hand and a rambunctious 2-week-old me in the other. 

With the back of her Toyota 4-runner loaded up with vaccines, records and other supplies, she drives from appointment to appointment rather than insisting her clients come to her. She has approximately 200 patients. Her paperwork office is in our house. She adjusts her prices based on a client's income so that the patient still receives adequate care. She knows every client by name and face. My mom leaves her cell phone number on the answering machine so that if one of her patients has an emergency, the client can easily get ahold of her. When we go on vacation, she always leaves that number as well. Though it is frustrating to get interrupted on holidays or vacations, she argues she took an oath; and she intends to uphold it. 

Some of her freedom stems from the fact she's a veterinarian as opposed to a doctor. But during my last visit home, an elderly client called, saying she had fallen and her hip hurt. My mom takes care of her cats. Despite having had knee replacement surgery a five weeks earlier, she and I drove over to this client's house to evaluate and comfort her. We ended up calling 911 and waiting with her until the ambulance arrived. Once home again, she attempted to contact the woman's family in Arizona. She even made arrangement for the care of the woman's cats. Talking to her about it later, I asked why she went over instead of just calling 911 from our house. She said, "You really get to know someone when you see them in the context of their real life. You can't do that in an office." 

An example of how house call vets interact with both their clients and their patients. Note the oven in the background. Both dog and vet are sitting on the floor. Neither look stressed or upset. 

Photo credit: http://www.yourathomevet.com/html/aboutus.html 

My mom understands where her clients are coming from and how they feel toward their animals. She can relate to them as a parent. She knows them on such a more personal level because of how she conducts her practice. Since her patients are less stressed without the hassle of transport to a clinic, her practice benefits the animals too. While there is a travel fee, her services are affordable. Whenever a problem arises that she cannot accommodate, she refers her clients to local hospitals. In a 2001 interview with the Boston Globe, she said, "I'm a primary-care doctor. I do the things I can do well; when it's something that's better taken care of at a hospital, I refer people." (ttp://pqasb.pqarchiver.com/boston-sub/access/70460160.html?FMT=FT&FMTS=ABS:FT&type=current&date=Apr+1%2C+2001&author=Naomi+R.+Kooker%2C+)

One client told me, "It's so comforting to know that when I have a problem, I don't have to wait for a call back or speak with a grouchy receptionist. I can speak directly with my dog's veterinarian. If he has a problem that requires more than she can do, she tells me and I take him into a clinic. But then when I know it's time, she'll be there to put him down in my own home. What pet owner doesn't want that?" 

Many of our problems in human medicine would benefit from implementing house call or house-call like practices. The key characteristic is being able to engage with your patients on a personal enough level that you can help them develop the best health care plan. Patients have to trust you, and feel like you understand them. Without that trust, the doctor-patient relationship is doomed and ultimately the patient suffers. 

In my next blog post, I will discuss a experimental system taking hold in the United States is trying to improve care in rural areas by integrating a house call approach with more advanced care. Who ever thought Mississippi would have something to learn from Iran? 

Follow Up: Elephant Poaching and the Ivory Trade

“It is difficult to know exactly how many people have died.”

This weekend the New York Times posted another article about elephant poaching and the ivory trade. While not an extension of the article described in my blog post from September 12^th, it does further investigate the consequences of such a lucrative “sport.” The author of the Op-Ed column, Louisa Lombard, examines the loss of human life in addition to that of the majestic elephant.

The spoils of an ivory seizure in Kenya. The 1,550-plus pounds of ivory, valued at an approximately $750,000 US dollars, was guessed to have come from 50 adult male elephants. DNA testing can be used to determine from where the elephants had originated. 

Photo credit: http://www.awf.org/blog/huge-ivory-seizure-two-men-arrested/ 

One of the most sobering figures in her article is the lack thereof. As the first line of this post implies, no one knows exactly how many people have lost their lives by getting involved on either side of the war for ivory. Some groups keep track of how many guards are lost. No one even attempts to record the number of poachers killed.

What can be done to effectively stop the slaughter of both human and elephant life in the name of ivory? Lombard acknowledges that “human management” of the crisis (ie wildlife conservation) is relatively futile. She instead claims that, “curbing the demand for ivory is, in the end, the only way to curb both elephant and people life.” Yet I do not understand how such reduction in demand is possible. The countries with the highest demand for ivory cherish it for its religious connotations, not its construction properties or beauty.

Intricately carved ivory religious figurines. The notion that ivory honors God is evident in Buddhism and Catholicism.

Photo credit: http://newswatch.nationalgeographic.com/2009/06/19/illegal_ivory_trade_in_thailand/

Asking the Chinese to relinquish their love of ivory equates to asking Americans to omit “one nation under God” from the Pledge of Allegiance: it’s simply not going to happen.

I wholeheartedly support freedom of religion (though I myself am unreligious). But in a situation like this, where religion is tied up in other global conflicts, I feel hypocritical. Pretend such ivory demand existed in the United States. I believe I would advocate for regulations restricting the import and sale of ivory, whether it be used for religious purposes, piano keys, trinkets, etc in order to protect the elephants. But if ivory is believed by some religions to honor God, then are restrictions on its import and sale a violation of the First Amendment? Is asking a person to reconsider what he or she uses to honor God imposing upon his or her religious freedom? To me, it feels like it does.

In that case, how do we attempt to balance the two?  One solution I thought of was using elephant meat to feed starving villages. At least in that respect, the death of an elephant serves a bigger purpose than fueling the ivory trade. Yet that solution fails to protect elephants as a species and inevitably would create a whole assortment of other problems.  No answer will be the perfect solution. Sadly, more humans and elephants will have to die until that solution emerges.

I Never Approved My Tax Dollars to do That: Steal Food

I have a problem when my tax dollars end up supporting the military expenditures of corrupt governments. I have an even bigger problem when those funds appropriated toward supplying the impoverished with sufficient food are instead used to fatten up already stocky politicians. And of course used to pad their pockets.

India is experiencing the “biggest food heist” in its history. One in five adults are malnourished, as are half of children under the age of five. According to Bloomberg News, over $14.5 billion dollars in food has disappeared within the past 10 years – money intended to feed some of the approximately 900 million Indians who consume less than the daily “government-recommended” minimum. 

This map compares overall population hunger levels across the globe in 2011. Although the brackets are fairly wide (India sits in the 20-34% range), it does illustrate that even economically sound countries (CHINA) have high percentages of higher among their population. As expected, Africa has the highest levels of hunger of any continent. 

photo credit: http://filipspagnoli.files.wordpress.com/2008/10/word-hunger-map.png?w=600&h=420

Despite a food and storage budget upwards of $13 billion, the vast stockpiles of grain are not distributed to the needy. CBI leading officer Javeed Ahmad described the lucrative scam to Bloomberg Business Week:  

“…Often using dummy firms, local officials paid the national government the subsidized prices for the food—as little as one-tenth of the market rate—then sold it to private companies at market prices and pocketed the difference. Poor Indians seeking rations at their local Fair Price Shop would find a locked door, Ahmad says, or be told to “buzz off” and return the following month. By 2007, this was standard practice in at least 30 of Uttar Pradesh’s 71 districts…”(http://www.businessweek.com/articles/2012-09-06/indias-poor-starve-as-politicians-steal-their-food)

In 2010, the United States allocated $41 million dollars worth of foreign grants and credits to India. (http://www.census.gov/compendia/statab/cats/foreign_commerce_aid/foreign_aid.html).

Compared to other expenditures I have investigated, the $41 million is actually a lower figure than I had anticipated. Therefore I’m finding it difficult to view India with an “all-or-nothing” approach I had taken with regards to other abused aid, such the poaching of elephants in Africa. I do however think the United States should threaten to withhold funds and put increased pressure on the Indian government to combat the corruption. If United States rejects any proposed involvement in going after the corruption, which may be a good thing in itself, then an international governing body must finally speak up for India’s people. It is grossly disgusting that a government would withhold so much of a basic necessity from its people. It does not even try to disguise it either. The stockpiles just sit, tantalizing and mocking the hungry: salt in an open wound.

India's rapidly growing urban population is only going to exacerbate the already existing food shortages. Unless something is done to implicate and stop the Indian government, the country will face an even larger problem in failing to feed its population. 

photo credit: http://www.marketoracle.co.uk/Article32764.html

I never approved my tax dollars to do that. 

I Need My Tax Dollars to do That: Support My Family Too

Imagine you’re 80. Your partner of 50+ years just died. You both paid your taxes throughout adulthood so you should be able to live off of your spouse’s social security, right? Wrong.

For the 131,729 same-sex couples who identified their partner as their “husband” or “wife” in the 2010 Census Report (http://www.foxnews.com/us/2011/09/28/census-reports-more-than-130000-same-sex-couples-say-theyre-married/), they will not receive their spouse’s social security because the Federal Government does not recognize them as married. As the proud daughter of a same-sex couple, I find it outrageous that my moms pay their appropriate taxes toward social security (approximately 14% of their income), have a Massachusetts marriage license and yet when the time comes, one will be denied the other’s social security.

This is how the Social Security Administration handles it:

“Under Federal law an individual whose claim for benefits is based on a State recognized same-sex marriage or having the same status as spouse for State inheritance purposes cannot meet the statutory gender-based definition of husband or wife of the worker, including one who is divorced. Therefore, for all benefit purposes, the Social Security Administration does not recognize such individual as the spouse of the worker.” (http://www.socialsecurity.gov/OP_Home/handbook/handbook.03/handbook-0306.html)

photo credit: http://krystlem.tumblr.com/post/3729304852

The equal rights symbol. I have seen it on cars, laptops, binders and water bottles as a demonstration of equal rights for all families. 

The Tenth Amendment states, “The powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people” (http://www.law.cornell.edu/constitution/tenth_amendment). Marriage, or more specifically marriage legislation, falls under state jurisdiction, not Federal. Massachusetts is currently the only state that grants full marriage rights to same-sex couples. Furthermore, my moms’ marriage license is not recognized in any other state (http://www.amsa.org/AMSA/Homepage/About/Committees/GenderandSexuality/StatebyStateLGBTLegislation.aspx#MA). 

The failure of a state to acknowledge the marriage license of another state simply because of the sex of the couple when driver’s licenses are readily accepted is ridiculous. But the fact that the Federal Government completely disregards the Tenth Amendment in this case is ludicrous.  The Federal Government has no right to redefine a state’s definition of marriage. It needs to recognize Massachusetts’ definition of marriage so that the same-sex couples like my parents who work hard and pay their taxes get the same financial protection heterosexual couples receive. What the Fed is doing is not just unconstitutional: it is flat-out discrimination. 

Should I Approve My Tax Dollars to do That: Import Health Care

While most career fields in the United States experienced job loss during the recession, the health care sector added 1.2 million jobs, a lone “bright spot in the economy”. Yet an NY Times Op-Ed Column alerted me to a disheartening reality. To fill the demand for new health care professionals, we are not educating and employing our own. Instead, we are importing them.

The demand for more health care workers arose in part from changes imposed by Obama’s Affordable Health Care Act and the aging of the Baby Boomers.  However, American medical schools have not responded with an increased output of M.D.s. They still reject hundreds of thousands of qualified applicants while we fill the need for doctors by importing foreigners who now comprise twelve percent of the health work force. In 2011-2012, 43,919 students applied to US medical schools. While that number does not differentiate between domestic and international students,  only 19,230 students actually matriculated (https://www.aamc.org/download/153708/data/charts1982to2012.pdf). The author of the Times article, Kate Tulenko, argues that in doing so, we are also taking doctors away from the areas that really need them. Countries where twenty percent of children die before their first birthday should not be losing health care workers to the United States. Leave those doctors to do a job that for many is a matter of life and death and start increasing the production of our own.

As someone pursuing a career in medicine, the ability to get into (and consequently pay for) school is a big concern. Though I plan to enter veterinary school, applicants across pre-health fields face the same dilemmas of completing mile-long lists of requirements, achieving impossibly high test scores and GPAs in order to be competitive and extraordinary volunteer work, extracurricular activities, internships or research so yours stands out among the myriad of applications. Such glitter, if you will, often requires two things: money and connections.

 Politics and financial status should be irrelevant when it comes to health care. Good health care entails a patient and his/her doctor devising preventative, maintenance and recovery plans that best suit the patients needs. Yet a paper application ignores that necessary quality. For example, it is pointless to prescribe insulin to a diabetic patient in rural Mississippi if she does not own a fridge to store it in. The doctor must figure out a more creative, unorthodox approach. She (the patient) frankly will not know or care if her doctor had a 4.0 GPA as an undergraduate or achieved a perfect score on the MCAT. She will just want to feel better.

I wholeheartedly support the exchange of techniques, theories, and developments across nation lines. But I have a real problem with the fact that the US has imported and is importing tens of thousands of health care workers while there are thousands more already here ready to take the Hippocratic oath. The Federal Government needs to apply more pressure on medical schools and state regulators to increase the number of teaching hospitals, increase class size and reduce the cost of a health profession education. Everyone has the right to adequate health care. But first, they need access to the people. Thus even before we facilitate the access, we need the people.

So in asking myself whether I approve my tax dollars to import health care, my answer is no. I want more of my tax dollars devoted to encouraging the education and output of American health care workers.

Think about it: what do you want from your doctor? 

I Approve My Tax Dollars to do That: Prevent Another Attack

It is no secret that the illegal drug trafficking persists between Latin America, the Caribbean, South America and the United States. From breast implants to teddy bears, smugglers have concocted creative guises to evade authorities and shuttle drugs across nation borders. Now a new even more covert courier has emerged: a fully submersible submarine.

Described as “the Super Bowl of counternarcotics” by Commander Mark J. Fedor of the Coast Guard in a recent NY Times article, these aquatic crafts have been increasingly detected in the Caribbean within the last year.  Semi-submersible submarines are not rookies in the narcotics game; it is their fully submersible cousins that are now startling and worrying authorities. Only required to surface at night to recharge their batteries off the onboard diesel engine, they can travel underwater and therefore virtually invisible from South America all the way to the United States.

In addition to the challenge posed by their imperceptibility, authorities also face the problem of the submarines’ increased carrying capacity compared to their predecessors. The more commonly employed high-powered fishing and leisure boats can transport approximately one ton of cocaine. The fully submergible vessels, meanwhile, can haul upwards of ten tons, which are then ferried to shore by small boats once in shallow enough water.

Of the potential drug shipments identified by the Joint Interagency Task Force South, the group at the helm of American counternarcotic efforts, only one-fourth is ever intercepted. Manpower, aircrafts, and ships simply cannot respond to every shipment. Increasing the number of shipments seized involves working with local South and Central American authorities to prosecute the drug trafficking networks.

But there’s another unique aspect of these fully submersible submarines weighing on the minds of American authorities: the potential use of these vessels by terrorists to transport attackers or weapons. Though such use of submersibles by militants has yet to be detected, no one though a bomb could be smuggled through airport security in someone’s shoes or in a Gatorade bottle (for fact citations, see NY Times article above). Obviously air travel is a much more popular method of travel by the typical citizen, as 48% of adults in the US having flown for business or leisure in 2009 (http://www.ustravel.org/news/press-kit/travel-facts-and-statistics). But it seems both naïve and careless not to protect our ports and coasts from an attack. The United States has been caught unprepared twice within the last 75 years. I personally do not want to see another terrorist attack in my lifetime.

The $15 billion Obama allocated toward combating the drug war in 2010?  (http://www.msnbc.msn.com/id/37134751/ns/us_news-security/t/us-drug-war-has-met-none-its-goals/#.UFSiNu0ZdSo). Yes, I approve of my tax dollars going toward that if it means combating these sneaky submarines.

I Never Approved My Tax Dollars to do That: Elephant Poaching

Elephant poaching is nothing new to the park rangers of Africa. But what is new is the increased organization, voracity and militarization of elephant poaching in the pursuit of precious ivory. Also new? The decisive role my tax dollars play.

According to a New York Times article from September 4, 2012, tens of thousands of elephants lose their lives each year to poachers who then hack away their tusks and leave the corpse to rot. Officials seized a record-breaking 38.8 tons of ivory in 2011, an amount accumulated at the expense of over 4000 elephants. Though poaching was a “job” previously thought to be reserved for the criminal type, the increasing demand of ivory from China has encouraged more participants to join the lucrative hunt. Ivory has peaked at $1000 per pound in some areas. At that price, and especially when compared to the minuscule salaries soldiers receive, one can understand the irresistible attraction of the ivory trade.

Efficient elephant hunting, however, requires proper weaponry. Proper weaponry costs money. Conveniently, the United States appears happy to help.

During 2011 fiscal year, the United States gave 456.1 million dollars to Uganda, 400.2 million to Sudan and 215.9 million to the Democratic Republic of Congo (http://www.fas.org/sgp/crs/row/RL33591.pdf). Soldiers from all three nations have been caught and reprimanded for elephant poaching (see the above NY Times article).  To Tanzania, another area of active elephant poaching, the United States gave 501.7 million (http://www.fas.org/sgp/crs/row/RL33591.pdf). In addition to funds, the United States also provides some armies, including the Ugandan military, the Congolese Army, and the South Sudan military, with training and assistance (see the above NY Times article).

I don’t dispute the need for foreign aid in many African countries. Poverty and disease are rampant and as a leading world power, we have a responsibility to aid weaker institutions and areas. Yet corruption is also a notorious problem. At the same time, ensuring that financial assistance reaches the rightful recipient is an impossible task, one that no amount of manpower, sanctions, or security could resolve.

My concern lies directly with the funding and training of the military groups that in turn use the US assistance to kill elephants and buy more weaponry from the sales of the ivory. In my opinion, stricter regulation and oversight should accompany further donation of funds. Conviction or acknowledgement of participation in the ivory trade should result in deductions or withholding of aid.

It’s simple: If abused, I want my tax dollars going somewhere else.  Preferably, I want them going away from the elephants. 

At The Trailhead

Two months out from the November presidential election, it seems as though all anyone can talk about is the campaign. Engaged in a transcontinental game of “he said, she said,” both Obama and Romney pledge reforms neither can realistically make while they simultaneously denounce their opponent and his party. Scanning the headlines on NYTimes.com yesterday, I saw election coverage, election coverage and what a surprise more election coverage. Thus I wanted to take this opportunity to remind Mr. Obama and Mr. Romney (as well as the American media) that there is more going on in September 2012 than who will next inhabit the White House. 

Exasperated, I clicked on the “World” tab and browsed the article titles, finally settling on one that fell under the “Most E-mailed” category. The five-page article, Elephants Dying in Epic Frenzy as Ivory Fuels Wars and Profits, revealed the disturbing escalation of violent elephant poaching as a result of increased demand for ivory in Asia. I’ll expand upon my thoughts about the article in the next post but in the meantime, check out the full article here. Most upsetting to me however wasn’t the loss of elephant life: it was the fact I’d indirectly facilitated it.  More specifically, it was my tax dollars designated to support underfunded ally African governments that enabled the deaths of hundreds and hundreds of elephants for their precious tusks.

That’s funny…I never approved my dollars to do that.

            This November, I will join the many previously ineligible voices in casting my first vote in a presidential election. With Election Day rapidly approaching, it is our responsibility to be educated voters.  As part of an assignment for my World Politics class at Mount Holyoke College, I’m making it my mission to investigate and track down my federal tax dollars on all seven continents. Where exactly do they go? Who benefits from them? Do people actually benefit from them? Are the recipients really deserving of aid? And most importantly, where do I want them to go?

 photo credit: http://www.jessehora.com/index.php?/ongoing/somethin-somethin-series/