8.15.2009

We're not much better.

I heard a horrible story when I was in Yemen last week. A couple visited a typical Yemeni hospital, filled with bacteria cultures and lack of basic hygiene. They told how, if you have an emergency and need surgery immediately, such as an artery spilling blood out, the hospital won't even treat you, until your family pays up, in cash, ahead of time. Then, as they're doing the surgery, the family waits next to the table, for very time you need something, like anesthesia, the family must run off to the hospital pharmacy to purchase it.

The callousness towards the human condition turns my stomach. How can people be treated that way? How can we see a fellow human suffering, and not respond? How can we not heal, especially if we are doctors, regardless of the cost to ourselves or the hospital?

And yet, I can see what they might argue. There are limited resources, in this, the poorest of the Arab countries. If they were to treat everyone without demanding payment first, they would quickly run out of the resources. And if they did not demand the payment up front, in this culture, most families would never pay, for things can be put off, and most families are frankly far too poor to pay.

No, I find none of these arguments convincing either. But I was then struck, as I listened to the story from this couple, how similar our situation in America is, and how similar my own situation is.

No, we wouldn't allow someone to bleed to death on the operating table for non-payment- not here in America. But we would allow, and do allow, someone to go without if they refuse to sign a statement to pay. If it is not immediately life-threatening, and the person is in great pain, we require them to sign a statement saying they will pay before we treat them. I experienced this myself when I had kidney stones, and I lay writhing on the floor in pain while they insisted I sign a document. Trust me, to get rid of that pain, you'll sign anything.

And if the emergency is immediate, we will work to heal the person- and then bill them for tens or hundreds of thousands of dollars (depending on how severe the treatment and how long the hospital stay). Many like myself know this, so we don't go into the doctor, for we don't want to go deeper into debt. We can't afford insurance, and we can't afford costly hospital bills, so we weigh out how much pain we can tolerate before absolutely going in.

And this is where it gets worse. Because we wait, it does get worse. And our country is like the Yemen in this respect too: we refuse to treat the uninsured for preventive care, unless they pay up in full. Yet I am not insured, and I can not pay up, and so I do not go in for treatment. And when you don't work on preventive care, not only does the cost for the nation increase, but the danger increases that one's illness will be irreversible.

And so these were my thoughts when I listened to the couple describe their horrible experience in the Yemeni hospital. I've been to the doctor a couple times, and gotten tests, in the last six months. This resulted in bills of about $900. Thankfully the hospital reduced it out of compassion to half, and my church assisted in covering a quarter, the last doctor's visit. But unfortunately, my pains still continue, and the doctor didn't discover how to fix them, or what completely is wrong. I suspect things might be very wrong, but can't afford to go to the doctor yet again. I can't afford more tests. I can't afford surgery to alleviate the pain. And things might get worse, or already be too far gone to fix.

Are we all that different from Yemen? We allow the poor to suffer and die because they can't afford preventive care, insurance, or costly hospitalizations and surgery. While I was in Yemen, evidently a huge national argument, more a riot, blew up in the States over universal health care. And I am convinced, from what I read in various comments online, that I have a number of conservative friends who would rather that I die, then for them to give up their resistance to universal health care, or give an inch to what they perceive as creeping socialism. Oh, I'm sure that each of them would be happy to pay my medical bills, could they afford them. But that's not possible for any one individual, unless they were fabulously wealthy. It's only something an insurance company or a central government could afford.

It's time to look at ourselves honestly, and to no longer perceive ourselves in some colonialist way as better than the teeming masses. Yemen and 2/3rds World countries like it is just more honest in their rejection of care for the ill. We can either decide that we are better than this, and change our ways radically, and begin caring for all of our ill, no matter their poverty and ability to pay and the cost it might have in higher taxes; or we can forgo for all time the claim that we are somehow better than other countries in our righteousness and compassion and care for the least of these. We can not have it both ways.

7.15.2009

Why we need a wise Latina.

The most the Republicans have been able to say against Supreme Court nominee Sonia Sotomayor is a phrase she used in a few speeches over a decade ago, in which she stated that a wise Latina woman might have more to offer in terms of justice that a white man. As a white man, I think she's got it just about right.

The Republicans have responded that she is using "reverse racism", and this indicates she can't be fair and impartial on the bench. Let us move beyond the part that, while anyone can have prejudice, racism can only be expressed by the group in power. I'm interested in looking at what the Gospel says.

Jesus' mission statement was that he had come to bring good news to the poor and freedom for the oppressed. Some of why he was killed was certainly because of this mission. Everywhere he went, he looked for those who were outcast from society, as Luke especially convincingly shows us. He was there for the blind, the lepers, the women, the tax-collectors, and the Samaritans. His Gospel is decidedly not good news for those in power. It was good news for those who were not in power, who were being held down by the Man, whoever that might be. At that time and place, it was the ruling Jewish authorities and the Romans. Jesus didn't look for men and women of power in his society, but consistently searched for those without, so that their power would so obviously come from God. He came for the sick, not the healthy; for the blind, not the sighted. And by this he was clear- we are all in need of the Doctor, but only if we recognize where and how we are sick, blind, and oppressed; only if we give up our power. The Gospel was never for those in power, and can never be. Jesus came to bring Jubilee, an Upside-down Kingdom, a complete change to the way life is done, where those who were oppressed don't become the oppressor, but rather grab hold of justice and teach the oppressor how to love.

Now we return to Justice Sotomayor's comment on the wise Latina. It goes without saying that we need diversity in all aspects of life, and certainly a few more people of colour in the highest court in the land. But multiculturalism and affirmative action were always of value not simply because of this. They were and are of value because of the unique contribution that other cultures can bring. And as a Christian I am mandated to go further. Those who come from groups who have not been in power, who have historically experienced the brunt of racism and oppression, are precisely those we can learn the most from. They are those that Christ came for. They are the foundations of leadership in the coming Kingdom.

We need those dispensing justice to be intimately familiar with the miscarriage of justice. We need them to be acting in the person of Christ, to be his ambassadors, looking out for those who are oppressed and bringing in justice. And so, yes, a Latina justice- a woman of colour- can offer something unique, and is better in this position that a white man. She is better able, on average, to represent who Christ is.

But only on average. There are plenty of Latinas who would make poorer justices than plenty of white men. And that's why we need a wise Latina- someone who knows how to dispense justice with that gentle rain from Heaven, the quality of mercy not strained.

5.14.2009

On Nudity and Culture

There has been a big brouhaha of late over Obama's course decision about no releasing hundreds of new photographs of the atrocities committed by the US military at Abu Ghraib. During the campaign, Obama stated unequivocally that they should be released. Now he's not releasing them because he doesn't want US servicemen to be attacked because of what's on the photos. Many are suggesting that the photos aren't being released because they would show the extent of the atrocities- that it wasn't just a few bad apples, but in fact a covert policy of the US military to demean and torture. And if that's true, higher heads would roll. But there's a completely different reason why these photos shouldn't be released.

They shouldn't be released because of the reason that the original photos should never have been released. Yes, the photos should be investigated, and every individual who was responsible for these actions should be fully prosecuted. But the photos should be viewed only by those who need to seem them directly- defense and prosecuting attorneys, and judges and juries.

It was quite clear that the perpetrators of Abu Ghraib knew what they were doing. They were making use of Arab cultural norms and fears to intimidate and demean their prisoners. They used Arab dislike of homosexuality to put Arab men in compromising positions. But more to the point, they used the Arab conventions against nudity to attack their prisoners.

This isn't only true in Arab culture. It's a widely held Middle Eastern belief, found even with Noah at the time that the Genesis stories were being told and written. Nudity is inappropriate- to a far greater degree than we find in Western culture. In early hadith in Islam, one is told that even a husband and wife should never be completely naked in front of each other. (It is unknown, naturally, how much these particularly hadith are followed. But even today, there are imams calling for this to be followed.) In the wider Arab and Middle Eastern culture, the shame of nudity never transfers to the person viewing, but rather to the person viewed; to the one who is naked. That person is exposed in front of others, in a culture where what others view is paramount above all else. These are shame cultures, not guilt cultures.

Thus, when the perpetrators of Abu Ghraib took pictures of nude Arab men, they were knowingly attempting to shame them. When we allowed those pictures to be reproduced in newspapers and the American nightly news, ostensibly in order to reveal America's crimes to the world, we were unknowingly assisting the perpetrators of Abu Ghraib in their crimes. We were increasing the shame of the Arab victims a thousand fold, beyond the wildest dreams of the evildoers of Abu Ghraib.

Now we hear that there are more pictures, hundreds more. This can only mean more shame, for more people. Haven't they suffered enough at our hands? Is there any reason to assist the perpetrators of Abu Ghraib? Prosecute them, certainly. But let us end the suffering of our victims. Don't publish these photos.