Thursday, February 4, 2010

“Review: Philip Hoare's `The Whale' traces cultural history of giant ... - Washington Examiner” plus 2 more

“Review: Philip Hoare's `The Whale' traces cultural history of giant ... - Washington Examiner” plus 2 more

Review: Philip Hoare's `The Whale' traces cultural history of giant ... - Washington Examiner

Posted: 04 Feb 2010 05:17 PM PST

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"The Whale: In Search of the Giants of the Sea" (HarperCollins, 453 pages, $27.99), by Philip Hoare: A subject as big as the whale demands a book as broad as "The Whale: In Search of the Giants of the Sea." Part memoir, part nature writing and part literary criticism, the book takes readers around the world for an exhaustive look at the mysterious mammal.

Author Philip Hoare begins his book tracing the steps of Herman Melville's Ishmael, visiting the famous 19th-century whaling ports Nantucket and New Bedford, Massachusetts, before tracing the cultural significance of the whale from Jonah to "Free Willy."

Hoare is an unabashed lover of the order Cetacea. "They are animals before the Fall, innocent of sin," he writes. But he manages never to stray too far into sentimentality, opting instead to explain in graphic detail the various ways man has hunted whales throughout history.

A book this big does have its dull moments. Readers who do not love science may find themselves glossing over sentences like, "With its baroque, glossy body encrusted with callosities, its paddle-shaped flipper and its bizarre, yawning mouth filled with baleen, Eubalaena glacialis is both grotesque and wondrous, the stuff of ancient engravings."

Hoare is at his best when he inserts himself into his quest to know everything about whales, including his description of snorkeling 30 feet away from a sperm whale in the Azores.

At times entertaining and always educational, "The Whale" is an all-encompassing look at how an animal most people never see has impacted our history and inspired our imagination.

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China again says it opposes any meeting between President Obama and ... - Newser

Posted: 03 Feb 2010 01:19 AM PST

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It was the second successive day that China has spoken out against the meeting, and comes after Beijing said ties had been harmed by a U.S. announcement last week that it would sell arms to Taiwan.

"China resolutely opposes the visit by the Dalai Lama to the United States, and resolutely opposes the U.S. leader having contact with the Dalai Lama in any name or any form," Foreign Ministry spokesman Ma Zhaoxu said Wednesday.

The United States has already brushed aside previous warnings from China, and White House spokesman Bill Burton said Tuesday the meeting was still planned, although no date has been set.

"The president told ... China's leaders during his trip last year that he would meet with the Dalai Lama, and he intends to do so. The Dalai Lama is an internationally respected religious and cultural leader, and the president will meet with him in that capacity," Burton said.

According to Chhime R. Chhoekyapa, the Dalai Lama's secretary, the Dalai Lama will be in Washington on Feb 17-18. He then will head for California and Florida before returning to India on Feb. 26. He would not give any other details.

Bilateral relations have already been strained by the U.S. announcement Friday that it planned to sell $6.4 billion worth of arms to Taiwan.

Beijing quickly suspended military exchanges with Washington and announced an unprecedented threat of sanctions against the U.S. companies involved in the sale.

China is very sensitive to any meetings that the India-based Dalai Lama, the 1989 Nobel Peace Prize laureate, has with government leaders, calling them interference in its internal affairs.

On Tuesday, the official in charge of the office that deals with recent talks with the Dalai Lama's representatives warned there would be repercussions if Obama met the Dalai Lama.

Ma, responding to Burton's comments, said the United States should not allow its territory to be used by "Tibetan separatist forces."

"We urge the U.S. side to fully recognize the extreme sensitivity of the Tibet issue, and prudently and properly handle relevant issues so as to avoid causing further damage to China-US relations," Ma said in a statement posted on the ministry's Web site.

China maintains that Tibet has been part of its territory for centuries, but many Tibetans say the region was functionally independent for much of its history.

Beijing demonizes the Dalai Lama and says he seeks to destroy China's sovereignty by pushing independence for Tibet. The Dalai Lama has maintained for decades he wants some form of autonomy that would allow Tibetans to freely practice their culture, language and religion under China's rule, not independence.

Tibetan areas have been tense in recent years, with the minority community complaining about restrictions on Buddhism, government propaganda campaigns against their revered Dalai Lama, and an influx of Chinese migrants that leave Tibetans feeling marginalized. Those feelings boiled over in deadly anti-Chinese riots in 2008 that shocked Beijing's leaders.

___

Associated Press writer Muneeza Naqvi contributed to this report from New Delhi.

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Clinic Works to Include Ex-Inmates in Health Care’s Embrace - New York Times

Posted: 04 Feb 2010 08:38 PM PST

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The inadequacy of prison health care in California was one reason for the federal court decisions that will reduce the prison population by 40,000 inmates, starting this year. As the former prisoners, and their illnesses, move back into communities, they will struggle to overcome a new set of obstacles and find a way to better care.

"What happens in the prison system isn't isolated in the prison system," said Dr. John Stobo, senior vice president for health sciences and services for the University of California system. "It spills over into the free world."

And it is not clear that the county health systems in places like the Bay Area — where more than 15,000 parolees already return every year— are ready.

Because of intravenous drug use, unprotected sex and tattooing with unsterile needles, rates of H.I.V. infection are nine times higher in prison populations than in the public, according to a 2009 report from the RAND Corporation. The rates of hepatitis C were found to be at least 10 times higher, and probably much more.

Additionally, with the prison population aging, and a large segment lacking consistent care for most of their lives, advanced diabetes, hypertension, asthma and cancer are common.

Current public health care systems are not designed to accommodate the varied logistical and cultural needs of men and women who have been incarcerated. As a result, many former inmates simply do not seek care at all, said several doctors who work with former prisoners.

"Incarceration strips you of responsibility for yourself," said Clifton Martin, who spent 20 years in and out of prison on drug and theft convictions and now works at a drug counseling center. "You get three meals a day. Your laundry is done for you. Even your medication is brought to you."

The failure of former inmates to connect with medical services also has consequences for public health. Untreated infectious diseases like hepatitis C, latent tuberculosis and H.I.V. infection can be spread to family members or the public. Missing even a few days of H.I.V. medication can lead to drug resistance and increased viral loads, making the virus easier to transmit.

Some counties are looking to the Transitions Clinic in San Francisco as a possible model for ensuring that this group gets health care. The clinic is the first in the country specifically for parolees, combining aggressive outreach — like recruiting prisoners before their release — with a nonjudgmental approach.

"You get out, and you're angry," said Ronald Sanders, a community health worker at Transitions and a former inmate. "A lot of these other clinics don't know how to deal with ex-cons, how to talk to them, how to approach them."

When those who have recently been paroled have no access to primary care, they tend to end up in emergency rooms with advanced illnesses that are complicated and expensive to treat.

"You have uncontrolled hypertension leading to stroke, heart failure; uncontrolled diabetes, leading to leg ulcers, kidney failure, blindness, heart failure; untreated cancers," Dr. Stobo said. "Treatment is not happening early where it's more effective."

Mr. Martin said the blame could be placed on patients and the health care staff.

"I've seen a lot of conflict in the public heath care system," he said. "We carry a lot of resentment and trauma from the experience in prison, and sometimes that can be acted out. They've not been trained to be sensitive to that population."

With an eye toward saving money in the long run by preventing overuse of emergency rooms and providing comprehensive care that may reduce recidivism, several counties are learning from the Transitions Clinic.

"It's good to have a particular clinic that you know is culturally competent to the population," said Cynthia Belon, the director of the Contra Costa County homeless program.

On Thursday and Friday afternoons, Juanita Alvarado runs through the Transitions Clinic in Bayview, escorting patients to examination rooms, taking case-management calls on her cellphone and handing out candy to co-workers.

"What's up with you?" she calls to Sherice Scranton, a patient sitting across the waiting room. She hurries over and gives her a huge hug. They chitchat. Then Ms. Alvarado asks how Ms. Scranton is doing. How does she feel about her coming mammogram?

Ms. Alvarado and her colleague, Mr. Sanders, are the heart of the clinic. They were both trained as community health workers at City College of San Francisco. Both bring their own prison experiences to bear in anticipating patients' needs and helping them through the system.

"They trust me because they know I've been there, done that," Ms. Alvarado said. The clinic easily fills up to 144 patient slots a month. They are already at capacity and are trying to figure out a way to fit in another 36 visits.

The medical director, Dr. Shira Shavit, manages common post-prison chronic diseases, making referrals to specialists for advanced illnesses. Ms. Alvarado and Mr. Sanders also connect patients to mental health and substance-abuse counseling, housing and employment programs.

"In prison I was just a number," said Kenneth Mays Jr., who spent 10 years in and out of prison on drug and robbery convictions. "I was not a person, not a black man with high blood pressure. They have no ears for what's going on with you."

Mr. Mays calls the Transitions staff family.

He comes to the clinic once or twice a month for his hypertension and for support in avoiding cocaine. "I'm getting health care that's probably as good as President Obama's," he said.

Contra Costa County is considering opening a clinic similar to Transitions by the end of the year. Alameda County has a similar clinic called Healthy Oakland. Other Bay Area counties, at best, are just beginning to develop re-entry health programs.

Under a new state law, California slowly began reducing its prison population in January, with the full reduction plan expected to take effect after resolution of a Supreme Court appeal.

The impending increase of parolees — coupled with the normal parole cycle that releases about 120,000 inmates a year — only intensifies the problem of creating continuity between the care inmates receive in prison and after their release, Dr. Shavit said.

"It really should be coordinated care," she said. "Those walls make it extremely difficult for prisoners inside to communicate with the providers in the community."

For instance, hepatitis C takes 6 to 12 months to treat, and latent tuberculosis takes six to nine. Disrupting H.I.V. treatment carries serious risks.

And the frustrations that face all patients — long waits on hold, phone trees — are particularly hard for former inmates. Bay Area counties are hiring community health workers like Ms. Alvarado to coach parolees through such moments.

They try to identify prisoners with health care needs while they are still incarcerated, then meet them at parole meetings after they are released. They go with them to appointments and constantly check in by phone to make sure they are taking their medication.

This spring, City College will graduate its first group of community health workers with a special certificate in caring for the post-prison population.

"The concern for us is how they'd add additional burden to our already taxed delivery systems," Stephen Kaplan, director of alcohol and drug services for San Mateo County, said, referring to the parolees. "We don't want this to be a repeat of when psychiatric institutions were deinstitutionalized and the money didn't follow people out. The communities now bear the responsibility of that."

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