Health Care as Political Weapon

Version 2Access to affordable, quality, basic health care is a basic human right. Basic, as in fundamental and essential. In a civil society, in a democracy, health care should not be used as a political weapon—as it is being used by the current U.S. government administration. Using health care as a political weapon is sick. That it is being used as a weapon by powerful, affluent (mostly men) with the best health care and most comprehensive health insurance in the country—against those of our society who have the least power and resources, is despicable.

Repealing the ACA, which all health policy experts agree has had far-reaching positive effects on our health care system and on millions of people’s access to care, is senseless and mean-spirited.

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For a brilliant critique of the current heartless rhetoric of the leaders of the ACA dismantling, please read Nicholas Kristof’s NYT op-ed piece, “And Jesus Said Unto Paul of Ryan…” (3-16-17).

Ally is a Verb

IMG_1807.jpg“I’m tired of ally being used as just a noun—we need to remember that ally is a verb.” This was one of the more powerful statements made this past week by Roxane Gay, author of Bad Feminist, at her Seattle Arts and Lectures talk at Town Hall Seattle. To me, this is an important reminder to speak up and act up to address and redress the despicable hate speech and violence currently bubbling up from the sewers and cesspools of our country—and directed toward anyone who is not white/straight/male/American citizen/so-called conservative Christian.

We are living in dangerous times. Documented hate crimes are occurring daily, hourly, across our country and so much so that hate crime watch groups like the Southern Poverty Law Center and the ACLU are working hard to keep up with all of them. The Southern Poverty Law Center has an interactive Hate Map where you can look up the location of a currently active hate group (of the over 1,600)  in the U.S. that they are currently tracking. Having been born and raised in rural Virginia near the former capital of the Confederacy, Richmond—and on the South’s first racially-integrated children’s summer camp—and, oh yes, being a classmate of  (and receiving death threats from) the Grand Dragon of the Loyal White Knights of the KKK—I am not at all surprised to see the number of KKK and White Supremacist groups currently alive (and unwell and festering) in my home state of Virginia. I am, however, dismayed and discouraged to see that in my adopted state of Washington we currently have six white nationalist/skinhead/neo-Nazi groups, as well as three anti-islamic groups. Although I am not surprised even by that, given the fact that starting on Trump’s inauguration day last month, flyers (including razor blades affixed to the backs of them) from white supremacist groups, began appearing on the walls of classrooms—and even the hospital—of the University of Washington in Seattle where I teach.

Despicable. Cowardly. Violent and hate-filled vitriol that has absolutely no place in our society. This is not free speech; this is hate speech. There are no Constitutional or moral or religious or anything else protections for such actions, such words.

Roxane Gay ended her talk with this statement: “I have to believe there is grace beyond the disgrace.” Ally is a verb. Act now and weigh in on the side of grace.

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An additional and new resource for reporting of hate and bias crimes is Propublica’s site Documenting Hate. Use it.

Love and Sex in the Time of Misogyny

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“Woman in Love” stainless steel, 1983, Bob Haozous at the Heard Museum, Phoenix, Arizona. Photo credit: Josephine Ensign/2016

Prostitution is commercial sexual exploitation and no, I’m not throwing women under the bus by stating this, and yes, I am a feminist. Prostitution is not a victimless crime. Prostitution is a public health issue. Prostitution is a significant part of continued and even accelerated violence against women and children. Amnesty International‘s prostitution policy, which was enacted on May 26, 2016, frames prostitution as sex work, pimps as legitimate sex business operators, and johns as deserving customers. Did Amnesty International sell its human rights soul to the highly lucrative and heavily male-dominated sex industry?

Consider this: “The commercial sex industry is sustained through violence and exploitation. Prostituted people live with the daily threat of violence. Traffickers and pimps are not the only abusers—buyers cause tremendous harm through the repeated sexual use of women and children and other physical and psychological violence. Sex buying exploits vulnerable people and hurts our communities.” (source citations at Ending Exploitation.)  The vast majority of women and children who are prostituted come from poor and marginalized communities and have histories of childhood sexual abuse. The typical age of entry into prostitution is 12-15 years of age and upwards of 90% of all prostituted women and children want to leave “the life.” And in countries that legalize/decriminalize/regulate prostitution, the demand increases as does the number of women and children (typically, again, from impoverished and marginalized communities) trafficked into prostitution.

And consider this innovative Seattle-based program on men’s accountability (and misogyny and perpetuation of the patriarchy): The Buyer Beware partnership to end commercial sexual exploitation, coordinated by the King County Prosecuting Attorney’s Office and the Organization for Prostitution Survivors (OPS).  The Buyer Beware model emphasizes prosecuting (and educating) sex buyers and connecting prostituted women and children to services. The goal of the program is to reduce demand for commercial sex, thereby decreasing harm to prostituted persons, reducing self-destructive (toxic masculinity) behaviors of buyers, and curbing sex trafficking in our region. This is a highly enlightened approach and one that our health system—including public health—should support. For instance, standard screening questions on sexual health for health care providers to use with patients can include ones pertinent to sexual exploitation and the buying of sex, along with appropriate referrals for assistance.

In the Seattle area we have YouthCare’s Bridge Program for prostituted teens, the OPS programs for adult women seeking to exit commercial sex exploitation, and the OPS men’s accountability program “Stopping Sexual Exploitation: A Program for Men.” There is a recent and fascinating GQ article “Can we ‘cure’ the men who pay for sex?” about this program by Brooke Jarvis (February 2, 2017). In the article, Jarvis avoids straying into the current political climate as it relates to the fueling of toxic masculinity and violence against women, but she does write this tagline: “Inside a two-month program that aims to end prostitution—and help dismantle the patriarchy—by rehabilitating the men who perpetuate it.” It should be abundantly clear that this is a lofty—and essential—goal for all of us to be working towards.

(No) Home for the Holidays

bed13b6f-4b6b-4041-8baf-3581fe5f737aThe holidays are festive, fun, frantic, frolicsome, fleeting—frankly fickle affairs. The sheer number of holiday-themed, family-times-gone-wrong Hollywood movies attests to this fact. And then there is the endless loop of the still popular Christmas song, “I’ll Be Home for Christmas,” first sung by Bing Crosby in 1943 as WWII raged on. Supposedly, major record company executives at first refused to record the song, due to its final line, “I’ll be home for Christmas, if only in my dreams.” They felt it was a downer of an ending. But, of course, it tapped into the reality for many people—not just soldiers—who couldn’t go home and were left with only nostalgic dreams of snow and mistletoe.

It continues to tap into the reality for many people. Not just for people displaced from their homelands by wars, such as the current one in Syria. (For an excellent in-depth article on this for a Syrian refugee family in Canada, see the NYT article “Wonder and Worry, As a Syrian Child Transforms” by Catrin Einhorn and Jodi Kantor, 12-17-16. This makes me love my neighbor country to the north.) And not just for people who never had a safe, warm, protective home to begin with. Dr. Nancy Goldov of the Washington State Psychological Association talks about this, pointing out that some people “find the pressure to be merry and happy difficult,” and that a particular trigger this year is the “highly fraught political situation that’s polarized some families.” (see the Seattle Times article, “Alone for the holiday—and loving it” by Christine Clarridge, 12-16-16.)

Home, not just for the holidays but anytime, is also just a dream for so many of our community members who are home-less. I know this at a personal level, yet yesterday it took on a new level of poignancy. Working in sub-freezing, snow-flurry weather, we helped move in residents of Tent City 3 to a corner of the University of Washington (UW), Seattle campus. Community volunteers helped Tent City residents sort tarps and tents and cans of food. Others moved wood pallets into a line and hammered  plywood on top to serve as partially dry and unfrozen “ground” for the tents that residents will sleep in for the next three months. Tent City 3 is part of the organization Seattle Housing and Resource Effort (SHARE), which is self-governed, democratic, grassroots, and led by homeless and formerly homeless people.

I am proud of the dedicated work of many of our UW students, faculty, and staff who have advocated for UW to host Tent City 3. I am proud of our public university for living up to its stated institutional values, including:

  • “World Citizens We are compassionate and committed to the active pursuit of global engagement and connectedness. We assume leadership roles to make the world a better place through education and research. We embrace our role to foster engaged and responsible citizenship as part of the learning experience of our students, faculty and staff.
  • Being Public As a public university we are deeply committed to serving all our citizens.”

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Home Is…

p1020046What is the meaning of home to you? What is the one essential ingredient of home? These are questions I pose to people in my workshops and talks on homelessness. I’ve adapted “The Meaning of Home” values clarification exercise that I learned from the (sadly, now defunct) Bay Area Homelessness Program, which was a dynamic collaborative of Bay Area universities and homeless-serving agencies. As they put it, the goal of this exercise is “to help participants understand the connection between home and humanity. It builds empathy for homeless people, shows the range of reasons why a person can become homeless, and shows the interconnectedness of human needs.” (Source: my copy of the exercise directions, dated September 1998).

Part of my adaptation of “The Meaning of Home” exercise is to give participants strips of colored paper (the size of a large bookmark), crayons, colored markers and pencils, and I ask them to write or draw (or both) their most essential ingredient—or essence—of home. And, if participants agree, I add their responses to a growing public art project I’ve named The Blue Tarp Tapestry. This is part of my ongoing digital humanities transmedia project, Soul Stories: Voices from the Margins, funded, in part by the National Endowment for the Humanities, the University of Washington Simpson Center for the Humanities, Jack Straw Productions, and 4Culture. (A special thanks to all of these.)

I highlight some of the participant responses here and today because they are especially pertinent to the season, the climate of our country, and the sort of community that people in Seattle seem to desire: safe, diverse, compassionate. Their responses also highlight the fact that, unfortunately for too many people, home is not a safe and cozy place. The photo above is a weaving I made out of responses to “The Meaning of Home” exercise. The photos in the slideshow below are some of the responses from recent workshops.

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Endurance Test II

fullsizerenderSafety pins are not enough—not even the giant safety pins I managed to dig out of my possessions this past week. For anyone working on social justice issues, the world has just become a much less safe, less just, less sane place. Even less so for anyone who is not a white, so-called Christian, “able-bodied,” “straight,” born in America male. Again, the wearing of silly safety pins is simply not enough. And wallowing in grief and sadness and depression is not going to help. Righteous indignation leading to considered action is what is needed.

That, and the appropriate attention to self-care. Not the banal bath-taking-day-at-the-spa sort of self-care, but the authentic self-care of trauma stewardship as taught by the amazing Seattle-area social worker, Laura van Dernoot Lipsky. Her book and resource guide, Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others (San Francisco: Berrett-Koehler, 2009), is a permanent and oft-used part of my own resource library. I use it in my teaching. I dip back into its underlined, dog eared, sticky-noted treasure trove whenever I’m feeling the too-familiar crispy edges of professional burnout. Like now.

I highly recommend watching (and re-watching and sharing) her inspiring Tedex talk, “Beyond the Cliff,” from April 23, 2015. In it, she reminds us that in the midst of chaos, “one of the things in your ability is to bring your exquisite quality of presence to what you are doing, how you are being.” She reminds us of a whole host of inspiring people (including  Thich Nhat Hanh, Malala Yousafzai, Viktor Frankl, and Maya Angelou) and the fact that “when they could not change anything external, they were able to shift everything as a result of where they put their focus.” She ends her talk by encouraging us to take care of our own part of the web, and to focus on what makes us come truly alive and go do that.

And there is the recent Washington Post (November 12, 2016) article by Karen Attiah, “Self-care tips for those who are terrified of Trump’s presidency” in which she ends with a quote by Audre Lorde: “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”

On Hope

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Detail from mural “Sonoran Desert:Yaqui Home” by Mario Martinez

Today was absolutely the hardest day to teach out of all of my decades of teaching. I have a class of about 150 nursing students for a course on community/public health nursing. They are a very diverse group in terms of race, ethnicity, religion, country of origin, sexual orientation, gender, and even age. Today’s topics were cultural humility and the social determinants of health equity. How appropriate. One of my students also pointed out to me how helpful it was that I had also assigned a training module on disaster preparedness, which included PTSD prevention. She found the content helpful in terms of facing the outcome of our national presidential election. This made me remember the highly effective CDC Zombie Apocalypse disaster preparedness public education videos and materials. There is a zombie-like mindset within our healthcare system, within academic nursing, and within our society that I find highly disturbing. It would be so much easier to just yield to zombie ways.

I take diversity seriously in my teaching and strive to promote a class climate of respect for all differences, including different political views. But the profession of nursing as a whole, and especially of community/public health nursing, is built on the value of social justice and health equity. And higher education at a public university is based on inclusion and social justice. To now have a president-elect whose political platform included openly racist, xenophobic, homophobic, and beyond-misogynistic-into-sexual-assault-on-women values, takes us—takes me as a teacher—into an entirely new and uncharted territory.

Today in class I tried to acknowledge this in a transparent and respectful way—and to emphasize our responsibility to do our part to make the world, to make our country and our community a better and healthier place. We had terrific trainers from the NW Network of Bi, Trans, Lesbian, and Gay survivors of abuse who helped us address some of these issues directly. And a group of nursing students are continuing a Knitting for Change community group, an idea my UW Study Abroad in New Zealand students brought back with them last year. My co-teacher for that program was the community empowerment “Neighbor Power” expert Jim Diers. And then after class today I received notification of this recent mention I made in a Seattle-area community event of the New Zealand concept of community cafes as places to help strengthen our communities. “Experts offer ideas to help Seattle area’s homeless youth” by Neal Morton (Seattle Times, November 9, 2016).

I choose to hold on to all of these examples of the goodness and compassion in the world. I choose hope and a renewed energy to work for a socially just society.