More on St. Luke's hospital closure

The sad looking woman in the photo above was staffing a table at 24th Street and Mission on last Friday, offering health information from California Pacific Medical Center (CPMC)/Sutter Health. Her health outreach materials were all in Spanish. A questionnaire sought opinions on what services were most important to passersby -- and offered, among other options, information about St. Lukes Hospital.

But only two weeks ago CPMC announced that it was shutting down the money losing St. Luke's facility in the Mission. Opponents of the closure quickly discovered unearthed evidence that the impact of CPMC's plan would be to dump most of their Black, Brown and charity care patients. CPMC wants to build yet another North of Market Street hospital on Cathedral Hill, while leaving the South of Market area entirely to the care of the over-crowded, under-funded county hospital.

Was CPMC perhaps stung by disclosure of the racial and class impact of its plans? This young woman didn't know -- she had not been told that St. Lukes Hospital, which she was for all practical purposes promoting, was about to be closed. Her job was to invite Mission residents to a health fair -- a health fair to take place miles across town in the well-off Marina district.

She was very nice -- and I thought she was being misused.

***On Sunday, a St. Luke's emergency room doctor, Marc A. Snyder, wrote the Chronicle, about CPMC's planned closure:

As an emergency physician who has practiced at St. Luke's Hospital for 25 years, I have concerns about some of the comments made about the plans for ambulatory care at St. Luke's. ...

The notion that 85 percent of our emergency department's patients could be handled by an urgent care center is ludicrous. Our department does have an urgent care area, staffed by a physician assistant 12 hours a day, but 80 percent of our patients are triaged to the acute side.

We have only seven rooms, but three have two patients each, separated by a curtain. Despite these 10 beds, we still frequently have two or three additional sick patients on gurneys in the hallway, a dangerous situation of overcrowding linked most commonly to ambulance diversion from San Francisco General Hospital (18 percent of the time). ...

The plan to close St. Luke's in 2009 will leave San Francisco with one overcrowded hospital South of Market. I don't think that this is a smart plan for the future of acute health care in the City.

St. Luke's is receiving the overflow from the country hospital emergency room. Where would those people go if St. Luke's is closed?

The San Francisco Health Commission will be holding a hearing about CPMC's plan to close St. Luke's on November 13, 3 PM, 101 Grove St., Room 300. The Saving St. Luke's Blog will have updates.

Dia de los Muertos, San Francisco

SFMike was right. Killed off by too much of a good thing in the Castro, the spirit of Halloween was all over in the Mission District last night at the Dia de los Muertos (Day of the Dead) procession.

Unusually warm late fall weather (no fog!) on a Friday night drew an enormous, friendly crowd to this Aztec-themed parade.


I'd forgotten how pleasant it was to be part of a happy crowd at night. People had worked on expressing themselves in semi-traditional costumes.




There were wonderful sights and sounds -- and it could seem a little scary.


Face painting was available.


And many in white-face were having a great time ...


... as were the many undead taking to the streets.


The police were friendly, but seemed a little confused by the crowds. I hope this annual procession has not outgrown the capacity of the neighborhood to accommodate the visitors. I overheard a couple of blonde women working their way through the crowds on 24th Street commenting: "I wouldn't want this in my neighborhood." We're not there yet, not even close.

One of the many hole-in-the-wall Mexican eateries on the street advertised "Special menu for Dia de los Muertos" -- chile rellenos $10.00. The dead are a boon to this community.

I left pretty early and later heard sirens; hope nothing too bad was going on.

This morning the SF Chronicle reports that some Castro merchants are having second thoughts about what they lose by closing down Halloween in the gay Mecca.

"I'm not shutting down the neighborhood again," [Supervisor Bevan] Dufty said Friday, acknowledging that the city's request cost some owners tens of thousands of dollars in revenue.

Hey Dufty -- unless this celebration gets super huge, we''re happy to have the party over here in the 'hood!

Who lives ... who dies

The Feast of All Souls celebrated at church last night and the Mission District celebration of the Day of the Dead that I'll attend tonight both remind me to reflect on those who have died. I keep coming back to an awareness that we -- contemporary people in the rich parts of the world -- live with an expectation about who lives that would seem extremely foreign (and happy) to most of humans during in history. That is, when a child is born, we assume the baby will live.

Not so until very recent human history. An interesting survey of the history of infant (under 1 year) and child (under 5 years) mortality reports:

In 1661, John Graunt examined English bills of mortality and concluded that "one third of all that were ever quick, die under five years old."

... Before 1850, infant deaths were commonly accepted as a part of everyday life, a reflection of the natural order in which the strong outlived the weak. In the latter half of the century, however, families began to value children as more than an economic resource, and infant deaths no longer seemed acceptable. Reformers believed that all children deserved to be protected from the ravages of poverty and unsanitary living conditions.
... Far from being a natural state of affairs, the high urban death rate reflected a society's moral standing.

According to the same article, as late as 1911, the United States had an infant mortality rate of 135 infant deaths per 1000 live births. Only three countries today, Angola, Afghanistan, and Mozambique, exceed that rate of infant deaths.

Kul C. Gautam of UNICEF puts contemporary child mortality rates [pdf] in perspective:

The association between poverty and child mortality has long been recognized. Indeed U5MR [under age 5 mortality rate] is often an excellent proxy indicator for the measurement of poverty. Over 90 percent of the world’s child deaths occur in 60 countries – all of which are low income or least developed countries, or the poorest areas of middle-income countries. ... These same countries also account for the vast majority of maternal deaths, malnutrition and lack of safe drinking water and sanitation.

Gautam points out that the UN Millennium Development Goals, not only by directly working for children's health, but also by empowering women and improving sanitation, amount to a map for reducing deaths among children. ***Last summer I visited a cemetery where many of my ancestors are buried. What struck me, that I had not properly noticed before, was how many of the headstones marked the graves of children who never grew to adulthood. The grieving parents erected quite elaborate monuments. Here are some of them:






The parents of the Bemis infant twins above not only listed them on the large family monument, but also set up their own little stones, below.






Arthur and Charlotte were my mother's siblings, born and died before she was born.


My Aunt Steva's child never even received a name.


Even in the middle of the last century. ...And today...

America may be the world’s superpower, but its survival rate for newborn babies ranks near the bottom among modern nations, better only than Latvia.

Among 33 industrialized nations, the United States is tied with Hungary, Malta, Poland and Slovakia with a death rate of nearly 5 per 1,000 babies, according to a new report. Latvia’s rate is 6 per 1,000. ...

The U.S. ranking is driven partly by racial and income health care disparities.

Associated Press
May 9, 2006

Pain

A friend of mine is suffering terrible pain in a hospital nearby today. In fact the hospital is inflicting this pain on her, though the medical personnel certainly bear her no ill will. You see, she's one of a class of people that the U.S. healthcare "system" routinely fails.

Oddly enough, her problem is not a simple matter of lack of access. She gets to doctors and into hospitals when she needs to -- but what happens then sometimes only makes her suffering worse.

Ten years ago, she was in a terrible auto accident; in addition to being thrown head first through a windshield, she broke multiple bones. After months in hospitals, she emerged with greatly reduced mobility and chronic pain. Other ailments followed in a downward spiral. And the pain never went away.

Naturally she lost all ability to earn a living and found herself on federal and state disability. She is very good at being poor, at finding what services exist, at cutting through bureaucracies, at making friends who will help and at demanding that she get whatever she can from medical providers. She works very hard at being poor.

She currently has an infection that won't heal. She tried calling her primary care doctor. She couldn't get a response. She got herself to an outpatient clinic. The prescription offered didn't work. Finally, after weeks, she dragged herself to a university medical center's emergency room. The ER took her in, recognized the severity of her infection and admitted her.

But, although she has a case record with this medical facility that is literally 2 feet high when printed out, the doctors are treating the infection but not the pain. They refuse to believe that she might, habitually, under her personal doctor's orders, take such high doses of pain medicine that any of the rest of us would drop dead if we ingested it. But she does. And she needs it. That medicine is what keeps her on a moderately even keel.

Today my friend is suffering, needlessly, in one of the best medical facilities in San Francisco. The doctors -- all new to her case of course -- will not allow her to have her normal dosage of pain medicine. She says this "cure" is worse than the infection that sent her to the hospital in the first place.

Apparently this kind of doctor and hospital inflicted pain is not uncommon. Jane Brody, the fitness and health editor of the New York Times had a similar problem after knee surgery. She suffered horrible on-going pain -- and her doctors hadn't a clue what to do for her. Some tidbits from her story (my emphasis):

Pain management is not generally taught as a part of medical education, not even to residents in orthopedic surgery. As a result, most doctors are clueless or unnecessarily cautious about treating pain, especially chronic pain like that caused by incurable neurological or muscular disorders. ...

... I complained about the severity of my pain, which had me crying for several hours a day [yes -- sounds like my friend] ...

When, at seven weeks after surgery, I spoke to Dr. [Jennifer P.] Schneider, a Tucson-based specialist in pain management and addiction medicine, she chastised me for not being more insistent about getting adequate pain relief. The trouble is, when you're experiencing intense pain, it's hard to be proactive about anything.

I know now from speaking with several doctors who routinely treat chronic pain patients that my story is hardly unique. Millions of people suffer needlessly year after year because their doctors do not know how to treat pain properly and don't refer patients to doctors who do know.

Many doctors are afraid to prescribe narcotic drugs like oxycodone, fearing they will create addiction problems. But that in fact rarely happens to chronic pain patients who don't have a history of addiction....

Furthermore, undertreatment of pain can actually cause a chronic problem when the nervous system changes in response to continuing pain signals. Nerves can become permanently hypersensitive to painful and nonpainful stimuli, like touch or vibration. With chronically undertreated pain, the painful area can also spread well beyond the original injured site...[yes-- that is my friend; the barest touch hurts her.]

"The way to prevent this undesirable outcome is to avoid repeated pain signals," Dr. Schneider said. ...

Surgeons may know a great deal about cutting, repairing and sewing up, but they are not experts on pain control, though I think they should be. I know of an orthopedic surgeon in New Jersey who won't see his knee replacement patients for two months after surgery because he doesn't want to see them when they're suffering. ...

First and foremost, patients need to be proactive and insist on the help they need. If patients are not able to do this for themselves, an advocate should do it for them.

Second, every person with prolonged or chronic pain should become educated about the huge range of medications, therapies and complementary remedies available to treat pain.

Good advice and I sure hope I can take it if I need it. But what good is that advice to a poor, severely disabled woman caught in the impersonal wringer of a medical center that neither respects nor believes her?

Torture: our peculiar peccadillo?

Pools used for water torture preserved in the museum of the Guardia Nacional in Leon, Nicaragua. The Nicaraguan dictatorship that used these facilities was overthrown by a populist revolution in 1979. The U.S. spent the next ten years working to overthrow that revolution.

As we contemplate the confirmation process for an Attorney General nominee who cannot bring himself to repudiate U.S. use of torture, it is worth taking a step back and attending to how the world sees torture and the United States' place in the international effort to encourage respect for human rights.

We can't pretend the U.S. doesn't have history of practicing torture. As Tom Engelhardt has pointed out

It wasn't, of course, that the U.S. had never imprisoned anyone abroad and certainly not that the U.S. had never used torture abroad. Water-boarding, for instance, was first employed by U.S. soldiers in the Philippine Insurrection at the dawn of the previous century; torture was widely used and taught by CIA and other American operatives in Vietnam in the 1960s and 1970s, as well as in Latin America in the 1970s and 1980s, and elsewhere. But American presidents didn't then see the bragging rights in such acts...

...the top officials of the Bush administration believed torture to be the royal road to their ultimate dream of unconstrained power...

The United Nations has an official whose job is to wander the world, visiting prisons and detention centers and issuing reports when mistreatment is alleged. He carries the unwieldy title of "Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment." The incumbent rapporteur, Manfred Nowak, is an Austrian human rights lawyer. As he explained to Der Spiegel, being the U.N.'s man on the torture beat is a pretty ghastly job.

in the Nigerian city of Lagos, where the United Nations special rapporteur on torture and his team carried out a surprise inspection of a police station that had given itself the rather lofty title of a detention center. "I've never seen anything like it," Nowak says. "Between 100 and 120 severely tortured people crowded closely together. Three women among them, and children too -- the oldest aged 14. Men with untreated gunshot wounds and limbs that were literally rotting -- a common torture method in Nigeria."

No one was expecting him when he showed up at the police headquarters in Amman on the last day of his visit to Jordan. He ordered a secret cell to be opened. Behind the door lay a prisoner "in a terrible condition." He had been suspended above the ground by his wrists, which had been tied behind his back -- a classic torture method dating back to the Middle Ages. "He could no longer stand, walk or anything," Nowak says. "In these types of cases, emotional distance is impossible. You're fully involved." ...

But, as a European, he is most distressed by the behavior of the countries he identifies with:

Torture is still "considered a peccadillo," he says, adding that this is now the case "even in developed countries." ...

Ever since former US Secretary of Defense Donald Rumsfeld authorized the use of so-called "enhanced interrogation" techniques in Abu Ghraib, "the United States has lost its moral leadership and authority," Nowak believes. "Today, when the Bush administration criticizes other countries for their human rights abuses, no one takes them seriously anymore."

But Europe has not succeeded in taking the place of the United States as the "driving force when it comes to human rights," the lawyer says. On the contrary, he believes the European Union is "seriously tarnished." European governments' cooperation with the CIA in the war on terror and their denial of secret detainee renditions and prison camps has weakened the EU, according to Nowak.

On occasion, Nowak has been even more pointed in his criticism of the United State's adoption of torture. This week he released his findings that torture is routine and widespread in Sri Lanka -- and emphasized how U.S. practices lend support to torture regimes.

The United States's willingness to resort to harsh interrogation techniques in its so-called war on terror undermined human rights and the international ban on torture, a United Nations spokesman says. ...

"I am very concerned about the undermining of the absolute prohibition of torture by interrogation methods themselves in Abu Grahib, in Guantanamo Bay and others, but also by rendition and the whole CIA secret places of detention. All that is really undermining the international rule of law in general and human rights but also the prohibition of torture," said Mr Nowak.

"(Other countries) say why are you criticising us if the US, the most democratic country with the oldest history of human rights, if they are torturing you should first go there. It has a negative effect because the US is a very powerful and important country and many other countries take the US as a model."

Sydney [Australia] Morning Herald
October 30, 2007

I'm afraid the answer to the question Nowak can't answer is that U.S. adoption of torture signals that it should no longer claim to be "democratic country."

We can hold all the elections we want, but if the people can't reign in the torturers -- if the people will not or can not lay down a moral and legal line that defines torture as intrinsically unconscionable, criminal -- our "democratic" model is definitively useless and dead.

A time of crime

The Gallup opinion research outfit reports a paradox:


Fully 71 percent of us think crime is rising nationally and slightly over half are sure that it rising locally.


Meanwhile the Department of Justice reports that violent crime has been declining for ten years.

What's up? Gallup opines

Americans' pessimism about crime may reflect an overly negative interpretation on their part of the fact that the decline in crime has tapered off. It could possibly reflect a real increase in media attention to crime on the local and national news. Or it could reflect Americans' broader dissatisfaction with the way things are going in the country, a sentiment that extends from ratings of President Bush and Congress to the economy, as well as to their satisfaction with the direction of the country more generally.

I don't think Gallup is doing anything more grounded than indulging in speculation in those suggestions, so I'll offer a few of my own.

• When CSI and imitators have been the preponderant content of evening entertainment for several years, is it surprising that folks believe there must be criminals under their beds?

• When local TV news has reduced its content to traffic accidents, fires and murders, perhaps it is to be expected that people think violence is rising.

• When the mere presence of an immigrant low wage work force is considered a crime by many people, does the growing visibility and ubiquity of immigrants lead to a belief in rising crime?

• When local media outlets crusade for prosecution of nuisance offenses so as to lock homeless people up out of sight, is it any wonder that people feel surrounded by crime?

• When young people in poor neighborhoods really do have to fear encountering gun play on the way to school, it's no accident that they and their parents fear rising crime.

• When the U.S. government invades countries without legal justification, when the Republican party's entire campaign strategy is to hype fear of terrorists, is it any wonder that people think criminality is increasing?

We are living a lawless place and time -- and we know it. And we don't like it. Politics is, among other things, an argument about what a law respecting society would look like.

Hat tip to Chris Kromm at Facing South for pointing out this survey.

Barack Obama is not brave

Back in 1970's three visionary African American women, Gloria T. Hull, Patricia Bell Scott, and Barbara Smith, published a ground-breaking anthology titled: All the Women are White, All the Blacks are Men, But Some of Us Are Brave: Black Women's Studies. That title vividly illustrates how people who live inside multiple identities all of which are concurrently struggling for their rightful dignity and place can find themselves erased from all directions.

Seeking to endear himself to black evangelicals, Obama has enthusiasticly endorsed of the "inspirational talent" of an "ex-gay" African American gospel singer. Evidently his campaign didn't include any black, gay, Christians though such people certainly exist. If Obama and his people actually knew such individuals, if they had listened to such individuals, they'd have had a harder time adding up constituencies and trying to buy a sector by offering token representation. Human realities are too complex for such stereotyping -- and nothing pains and infuriates any of us more than having our lived identities thoughtlessly erased.

I have no doubt that Obama is not personally homophobic, whatever than means. But his campaign practices a mechanical adding and subtracting of identity constituencies that is certainly not any kind of "new, post-partisan politics." And in this instance, the politics of the campaign were homophobic, especially toward black, Christian LGBT people.

And on an old politics note (courtesy of Pam Spaulding), what were Obama's people thinking when they headlined a performer who hailed Bush at the 2004 Republican convention?

No, Obama is not brave. The recent South Carolina fiasco can more accurately be called "stupid."

Healthcare racism: Scrubbing Sutter white

On October 19, Sutter Health/California Pacific Medical Center (CPMC) announced it would shut down in-patient care at St. Luke's Hospital in the Mission district of San Francisco. At a city Supervisor's hearing last Thursday, the profitable hospital corporation was the object of withering criticism from doctors, community members and elected officials.

Supervisor Tom Ammiano delivered a [sharp] rebuke, accusing hospital officials of dispensing snake oil and failing to provide adequate charity care to the poor and uninsured.

The California Nurses Association, which represents nurses at St. Luke's, has unearthed statistics from the Office of Statewide Health
Planning and Development showing that the effect of closing St. Luke's would be, quite simply, getting CPMC out of the business of caring for Black and Brown people.

• 40 percent of in-patient hospital discharges at St. Luke's are Hispanic patients - compared to just 1 percent of CPMC discharges.

• 54 percent of emergency room visits at St. Luke's are Hispanic or African-American patients - compared to just 8 percent of ER visits at CPMC.

Not too surprisingly, the data CNA presents also show that, in comparison to CPMC's facilities in the north and west of the city, St. Luke's patients are far more likely to be on Medi-Cal than private insurance plans and far more likely to live in the Mission and adjoining Bayview districts.

Sutter/CPMC is trying to dump its money-losing poor Black and Brown patients. How much longer will we tolerate profiteering in "healthcare"?

Skeletons came out of closet ...

...at today's peace march in San Francisco. Immunity for the telecommunications companies was not popular with the antiwar crowd. Neither were spineless, Bush-enabling Democrats.

Friday cat blogging: Kittens against impending homelessness

My neighbors are being forced out of their home of the last twenty years. Theirs is a commonplace San Francisco situation. The building is old; the former owner was ancient (really, over 100); the tenants never asked for any upgrades or even repairs; and their rents, stabilized by inertia and legal limits on increases, gradually fell way below what the market would bear. When the landlady died, the heirs looked at this piece of San Francisco property and said to themselves "goldmine -- but only if we can get rid of the tenants." The tenants have some legal protections, but over the next year or so, through tortuous legal processes that may eventually lead to cash payments, they are going to be booted out.

So how did one of the tenants respond to the prospect of losing her home? She became a "foster parent" to homeless kittens. Her task is to spend six weeks loving and handling the offspring of feral cats for Animal Control so that the kittens become ready for adoption. How about these charmers?







Not the worst companions when faced with the loss of your home.

Volunteering: for pay and/or for community

Volunteers in Florida during the 2004 election.

This week the New York Times published a very interesting article, "For Love and a Little Money." Here's the author's conclusion in a nutshell; we are becoming a culture of:

paid volunteerism. The phrase may sound oxymoronic, but an ever-growing number of retirees and nonprofit executives say it is an apt description of the way modern retirees view nonprofit work. And while no one has gathered statistics on the tendency, experts say there is a good chance that the automatic link between doing good and working for nothing has been permanently severed.

A lot of reporter Claudia H. Deutsch's observations seem astute and worth sharing.

• "Even a small check is a symbol that what they are doing really makes a difference," said Ben Rosen, a management professor at the University of North Carolina's Kenan-Flagler Business School. Mr. Freedman thinks that is particularly true of women. "Volunteer work used to be considered women's work, so it is not surprising that career women reject the concept," he said.

• Greg O'Neill, director of the National Academy on an Aging Society, suggests yet another reason: paid workers are less likely to be assigned to licking stamps or ladling soup.

• "Savvy people have learned that they are used more intelligently when they are paid."

• Many retirees have learned, to their irritation, that what they give free is discounted as fluff. Ten years ago, Fabianne Wolff Gershon, now a retired public relations executive, did a pro bono marketing plan for a local botanical garden. It was never carried out. "I made a mental note: If they had paid for the report, they would have taken it seriously," Ms. Gershon said.

• There is, of course, a potential downside to the trend. Once payment becomes the norm, fewer people are likely to volunteer their services free — which could be a problem in a budget crisis. ...[And] "attaching payment to a job turns it into work."

Deutsch is writing, largely, about retired, economically comfortable, older "volunteers". These folks are no dummies.

Something similar goes on in "youth leadership development." To be sure about this, yesterday I checked with a friend whose nonprofit organizes young people to do political advocacy; he reports, yes, foundations, are willing and consider it customary to fund stipends for participants in youth programs. (My friend would want me to mention this practice is not universal; his group works with scores of young "leaders" who are unpaid.) So the "link between doing good and working for nothing" is under strain there too.

What does this trend mean for political campaigns? A great deal I think. Democracy depends on citizen participation, but media and professional campaign consultants treat campaigns as spectator sports. Not surprisingly, so do most citizens. In many circumstances, recruiting campaign volunteers can feel like pulling teeth. Once we get them, we need to make sure we treat them respectfully and enable them to feel their work was useful. And then the money issue comes in.

For some years now, I've been training community groups on how activate their memberships in political campaigns. Many of these groups are hesitant about electoral work, fearing that elections distract them from their own priorities and place them in an arena that's unfamiliar and corrupt. Most of these groups work with low-income people. For training, I've come up with an exercise in which trainees are asked to develop a skit illustrating their response to a situation I've actually seen in a campaign. I've got quite a few situations, but recently I've always included this one:

You've done your planning, you know your organizational goals for this election, members have been recruited and trained, and THEN you confront this situation:

You've been out talking with voters for a couple of weeks. Your members are learning to doorknock effectively about your election issues. Suddenly "Canvass/Victory in 2008" is offering $200 a day to your members to canvas for them. Not surprisingly, many of your members who need the money want to go get paid instead of working on your organization's canvass. What do you do?

To be honest, groups don't usually come up with very creative responses to this hypothetical situation. There aren't a lot.

And yet historically political activity that changes the national trajectory has come down to people acting out of some combination of passionate belief and personal necessity. Votes for women, racial equality under law, gay rights -- these things were not won by paid volunteers and campaign consultants. Not only won't the revolution be televised -- it won't pay most of its activists either. In our consumer society, we need to cultivate an understanding that the most vital social activities are those we do "for nothing," for preservation and extension of the hope for community.

Holy Land Foundation trial: Jury opts for acquittals, maybe

Juries fascinate me. I'm frequently -- yearly -- called for jury duty and remain certain I'll never be seated. But even my short exposure to a succession of jury examinations has convinced me that there is something about the experience that can, sometimes, bring out the best in us as citizens. I've told the story of one such episode here.

On Monday, a federal jury in Dallas reported out numerous acquittals and several failures to reach a verdict in the trial of the Holy Land Foundation and its executives on various charges of funding terrorism. The Texas-based Muslim foundation had been under federal investigation for many years -- some of the charges dated back to before the Palestinian Hamas movement that allegedly benefited from the charithad even been declared a terrorist organization. None of the charges suggested Holy Land's contributions paid for guns and bombs; they paid for clinics and schools, but that propped up "terrorism."

For a few moments in the courtroom, it seemed that the jurors had resoundingly rejected the government's theory of guilt -- and then some jurors protested that they hadn't voted as they indicated on the signed jury statement. The judge declared a mistrial and the feds say they'll try again.

So what came out of this bizarre trial and its aftermath? There are a lot of different points of view. I've compiled some here.

"I think it is a huge defeat for the government," said David Cole, a Georgetown University law professor specializing in 1st Amendment cases and terrorism prosecutions.

"They spent almost 15 years investigating this group, seized all their records and had extensive wiretapping and yet could not obtain a single conviction on charges of supporting a terrorist organization."

Los Angeles Times
October 23, 2007

Dennis Lormel, who created the FBI's Terrorist Financing Operations Section and is now a terrorism consultant, said the collapse of the trial is a blow, but far from a death knell for similar cases.

"Obviously, it's a disappointment," he said. "But this should have no effect on the overall war on terror or terrorism financing. Regardless of the guilt or innocence, that charity was used to provide Hamas with funding. The government already won in this case, in that this charity's assets were frozen and that kept them from sending more money. At trial, your standard is different, and they didn't prove it beyond a reasonable doubt."

... Counterterrorism expert Fred Burton, vice president for counterterrorism and corporate security at Austin-based Stratfor, a private intelligence firm, said it's best to view the prosecution as part of a disruption strategy. The verdict didn't come out as hoped, but "you have in essence tied this organization up in knots for a long time."

Dallas Morning News
October 23, 2007

The decision is "a stunning setback for the government, there's no other way of looking at it," said Matthew D. Orwig, a partner at Sonnenschein Nath & Rosenthal here who was, until recently, United States attorney for the Eastern District of Texas.

"This is a message, a two-by-four in the middle of the forehead," said Mr. Orwig, who was appointed by President Bush and served on the United States attorney general's advisory subcommittee on terrorism and national security. "If this doesn't get their attention, they are just in complete denial," he said of Justice Department officials, who he said might not have recognized how difficult such cases are to prosecute.

New York Times
October 23, 2007

"This case shows that we have not done our homework," said Karen Greenberg, executive director of New York University's Center for Law and Security. "It's conveying an impression to the American people that we don't know how to do this." ...

Studies by the NYU center over the six years to September 2007 found that of 619 defendants in federal cases potentially involving terrorism, 196 were indicted on actual terrorism charges.

Greenberg said this relatively small share indicated prosecutors were either chasing the wrong suspects or using the wrong laws. ...

Of the 196 terrorism defendants, 62 have been convicted, according to NYU center figures. Only one case, the conviction last year of Pakistani immigrant Shahawar Martin Siraj for planning to bomb a New York subway station, involved the archetypal terrorism scenario of a suspected clandestine cell seeking to carry out an attack on U.S. soil, the center said.

Reuters
October 23, 2007

The government's case was a sweeping, if ultimately unpersuasive, indictment of a charity organization that had been under scrutiny for about 14 years. It was also a legal stretch from the start. The indictment essentially conceded that the money HLF donated was used to build hospitals and aid the poor, yet it accused the charity and its officers and fund-raisers of aiding a terrorist organization by helping it spread its ideology and recruit members. Translation: Even those who support good works are guilty of terrorism if the good works make the terrorists look good.

... the jury utterly rejected the essence of the government's theory of prosecution. A brief review of similar cases, however, suggests that the case is far from over. The government is unlikely to find in the verdict a reason to question its approach, or to hesitate to bring these sorts of cases in the future. The reality of federal criminal prosecution is that even when juries are deeply skeptical of government overreaching, in the end, the relentless might of the government almost always leaves those it prosecutes bankrupt and incarcerated....

David Feige
Slate

All praise to God, this trial is the biggest trial against a Muslim charity in the history of the US, and today I feel that there is hope people are still capable of thinking and utilizing their god gifted talents of analyzing the facts and not playing with the lives of innocent people who are just being wrongfully charged for helping orphans and widows.

Dr. Asma Salam
Texas Civil Rights Review

One Holy Land Foundation case juror told The Associated Press, "I thought they were not guilty across the board. Juror William Neal added that the case "was strung together with macaroni noodles. There was so little evidence." He said the government "really used fear" to try to sway the jury.

This was a classic case of guilt by association and a political vendetta against American citizens to carry out the agenda of a special interest group -- the Israel lobby.

Parvez Ahmed,
Tracy Press,
October 24, 2007

The United States of America, for all of its current and past ignominious trampling on the rights of the weak (whether or not we want to own up to that truth) still has a paradigm of value hidden in our collective memory (or at least in our deepest desires) to look to for guidance. It is a paradigm of equality and liberty that very few of us ever really experience, equality and liberty whose very names were penned by a man who owned slaves; equality and liberty in the name of which our ancestors drove indigenous peoples from their lands; equality and liberty in the name of which, in our lifetime, we insisted that our brothers and sisters of Japanese ancestry be herded up and sent off to desert camps; equality and liberty in the name of which many now hold Muslim Americans and Arab Americans in suspicion and hatred. But they are equality and liberty that are larger than our weakness, equality and liberty that are stronger than our prejudices, equality and liberty that will last longer than our selfishness, our fear, and our pride.

We are still growing into the equality and liberty that Mr. Jefferson said we hold to be self-evident (if they are so obvious, why are they so amorphous as to disappear when we need them most?). Mr. Jefferson wrote better than he knew or acted, and we read his words better than we understand or fulfill.

But once in awhile, in spite of ourselves, a glimpse of equality and liberty breaks through. It may be in the unsatisfactory verdict of "mistrial." It may appear at a moment when the "system" seems to have broken down. It may be, no, it almost certainly will be, in a situation over which we think control is lost.

Harold Knight
THE ENEMY SHALL NOT OUTWIT HIM
A blog that has followed the trial

I'm neither as encouraged as Mr. Knight nor as pessimistic as Mr. Feige at the trial's outcome. But I am reminded that "it's never over til it is over."

Meet the Iraqi insurgency

I don't like YouTube much. I can read faster than I can watch video and I prefer that. But this really is "must see TV."

It is a clip from the upcoming film "Meeting Resistance" made by Steve Connors and Molly Bingham.

War on his mind...

A 16 year-old peace activist in Alabama reminds us why we need to turn out -- again -- to the antiwar mobilizations on Saturday October 27.



Ava Lowery is raising cash for her full length documentary about the war in Iraq and the troops who have lived it. She can do this for the tiny sum of $10000 -- drop by and drop her some change if you can.

Defending rendition

Detail from a mural in Leon, Nicaragua that depicts treatment of prisoners under the U.S.-backed Somoza dictatorship which was overthrown in 1979. Yes, the U.S. has been in the business of supporting torture in some places for a long time.

The film "Rendition" continues to get a rise out of defenders of the U.S. practice of yanking up suspects without legal process and sending them off to be tortured. David Benjamin, a former director for counterterrorism policy on the National Security Council staff now with the Brooking Institution, took a whack in the Washington Post at explaining how misguided defenders of decency and the rule of law are because we're distressed about renditions. Let's see what he has to say:

1. Rendition is something the Bush administration cooked up.

Nope. George W. Bush was still struggling to coax oil out of the ground when the United States "rendered to justice" its first suspect from abroad.

According to Benjamin, the first instance of the practice took place when Ronald Reagan ordered the abduction of a Lebanese who the U.S. had "convicted" without any known court proceedings of being a hijacker. Benjamin goes on to suggest that perhaps we should look at the Israeli capture of Adolf Eichmann in Argentina as the prototype for rendition. He neglects to mention that the Israelis then gave Eichmann, Hitler's technician of extermination of European Jews, a public trial that documented Eichmann's guilty complicity in massive crimes. Benjamin cannot be arguing that U.S. renditions lead to public legal proceedings.

But he does want us to know that Bill Clinton did it too. I believe him on this -- U.S. presidents will keep doing this until we the citizens, and the world, impose the rule of law on our far-flung spooks.

2. People who are "rendered" inevitably end up in a foreign slammer -- or worse.

Actually, that's not a foregone conclusion. ...By my count, most renditions since 1995 have involved moving individuals from one foreign country to another -- not grabbing someone in Washington and carting them off to North Africa, as happens to Witherspoon's onscreen husband. ...The CIA has acted as a go-between, arranging the transfers and providing transportation. Usually those being rendered are not brought to the United States because, while the U.S. government may have an abundance of intelligence showing their malfeasance, it doesn't have enough courtroom evidence.

No -- rendition is not about bringing someone to trial -- it is about the U.S. government, sometimes on its own and sometimes acting for friendly governments, acting as judge and jury, without evidence that would pass muster in a trial, to lock somebody up, usually outside their own country -- and frequently subjecting them to torture. Mr. Benjamin wonders whether the U.S. still asks the recipient countries "to have some kind of legal process against the suspect" -- not much of a standard.

3. Step one of a rendition involves kidnapping the suspect.

The individual may feel as though he's being kidnapped, but that's not usually what's going on. Most of the time, the person is detained by the authorities of the country he is in. They will then hand him off to the CIA, which will fly him to his destination.

So I guess he thinks rendition is not kidnapping because someone, somewhere, in some government has decided without any adversarial process that the subject ought to be grabbed up. Sounds like either kidnapping or criminal abduction to me.

4. Rendition is just a euphemism for outsourcing torture.

Well, not historically. The guidelines for Clinton-era renditions required that subjects could be sent only to countries where they were not likely to be tortured -- countries that gave assurances to that effect and whose compliance was monitored by the State Department and the intelligence community. It's impossible to be certain that those standards were upheld every time, but serious efforts were made to see that they were.

Yeah. And pigs can fly. Such guidelines may had given the officials responsible some plausible deniability in the unlikely event that someone tried to apply the rule of law to them, but the kind of countries that would cooperate with the U.S. in such lawless procedures are the same ones that routinely abuse those they incarcerate. And our spooks knew it and know it - and apparently like the knowledge that someone is doing their dirty work.

5. Pretty much anyone -- including U.S. citizens and green card holders -- can be rendered these days.

Not so. ... A "U.S. person" (citizen or legal resident) has constitutional protections against being removed from the country through rendition ...

Yeah, and Jose Padilla, a U.S. citizen had a right be brought before a court and charged with a crime if the government was going to hold him -- didn’t happen, did it? Instead, that U.S. citizen got three and a half years of solitary confinement in a military brig without charge or access to a lawyer and physical and psychological abuse that broke his mind and body. Yes, they finally tried him for phone conversations with a couple of guys who may have had ties to enemies of the U.S. and got a guilty verdict from a jury who had not been told what had been done to Padilla.

So much for U.S. citizens' legal protections.

Why are apparatchiks like Benjamin so solicitous of the government's "right to render" and and so little concerned with the rule of law that they argue with a movie? Do they perhaps fear that it is still possible to arouse the conscience of the U.S. people against our international lawlessness and its perpetrators? Do they enjoy being unfettered judges and juries for the unfortunate individuals "rendered"? Do they have a lingering fear they might be judged someday?

As Bob Dylan once sang: "To live outside the law, you must be honest...." That's hard stuff as Mr. Benjamin demonstrates in his flimsy defense of rendition. Better to have laws and procedures and obey them.

Yes on A; No on H

San Francisco is having a true snooze of an election. With no real contest for mayor or district attorney, this off year exercise has little to draw anyone to the polls.

But the ongoing fight about whose city this is and what kind of place it will be goes on as usual in the propositions. The folks who want San Francisco to be a slightly exotic shopping mall full of financial and commercial headquarters for suburban commuters are facing off against the usual coalition of working class residents, transit users, renters, unions and environmentalists. The turf this time is the contest over Prop. A, our latest attempt to improve the bus system, and Prop. H, a grab bag off developers' wish lists designed make the city more friendly to cars.

Don Fisher, who owns the Gap clothing retail chain stores and would like to own San Francisco, is paying for Prop. H propaganda. Fisher is the kind of guy who collects art, decides his collection should be preserved by a museum, but wouldn't dream of accepting a wing of an existing institution -- he's going to build his own palace to his taste out in the Presidio (nominally a national park.) A proper contemporary plutocrat, this guy. What does he care whether the buses run on time? Or at all.

Proponents of Prop. A held a nice little rally in front of the Gap's downtown store last week. Hope San Franciscans bother to vote.

Medical care for profit means NO care

Last spring, ads like the one above were all over bus shelters on the east side of San Francisco. Yesterday, California Pacific Medical Center/Sutter Health announced that the campaign was the sham that many have long feared. Sutter is pulling the plug on the cash draining business of caring for poor people at St. Luke's Hospital in the Mission.

St. Luke's Hospital in San Francisco's Mission District will no longer be an acute-care facility after 2009, but become an outpatient "hub," providing emergency care and services that don't require a hospital stay, according to a plan announced Friday by California Pacific Medical Center.

The city knows screwed when it hears it.

"This is not the right thing for the health of San Francisco," said Dr. Mitch Katz, head of the city's Public Health Department.

Katz argued that the plan leaves one acute-care facility - the public San Francisco General Hospital - in the South of Market region, while it concentrates eight hospitals in the northern, generally more affluent parts of the city. He also didn't think providing the St. Luke's neighborhood with emergency services - but not a hospital to back up that care - made sense.

"It isn't optimum care," Katz said. "If you had something serious, would you want to go to a hospital where, if it turned out you had something serious, they couldn't take care of you?"

As long as providing life and death services is treated by our society as a license to coin money, people without money will, literally, be treated as unworthy to live.

How long?

"Torture has come home..."

Franciscan Fr. Louis Vitale, pictured here peaking out from under a huge puppet figure bearing the Virgin of Guadalupe's veil of stars, won't be at his usual place at Bay Area peace and justice events for the next five months. Along with Jesuit Father Steve Kelly, Fr. Louis was sentenced Wednesday to prison time for a November 2006 protest at the Army's Fort Huachuca in Arizona. The base is the headquarters of military intelligence in the U.S. and the place where military and civilian interrogators are taught how to extract information from prisoners, according to the two men's lawyer, Bill Quigley.

Fr. Louie explained his civil disobedience to Fr. John Dear of the National Catholic Reporter:

"Our message is that torture has come home to us. We learned from Fort Benning that the U.S. manuals on torture come from Fort Huachuca. The Nazis tortured, Latin American death squads tortured, now we know that we torture people, too. But where does it come from? It comes from Fort Huachuca. That's the headquarters. It's one of the most sinister places on the planet.

"We can make a difference. It can be done. ... St. Francis got caught up in a bloody war, and realized that war is not what God created us for. So he came out of it committed to a new world without war. We have to learn from him. We need to address the world's needs with love and compassion, not with war and destruction."

Supporters of the two protesting priests pass on a message:

Fr. Kelly and Fr. Vitale ask that every woman and man of conscience do all that they can to protest the injustice of torture and to end U.S. policy that sanctions torture. They encourage people to participate in the protests at Ft. Benning, Georgia and Ft. Huachuca, Arizona on November 17 and 18, or consider having a protest in your community. For more information, visit School of the Americas Watch (protest at Ft. Benning) and Southwest Weekend of Witness (protest at Ft. Huachuca).

Boys at play in Baghdad

Laith, who works in Baghdad for McClatchy News Service and writes at the Iraq Today blog, enjoyed the Eid holiday celebrating the end of the Muslim month of Ramadan:

For the first time since four years, I have this quite nice feeling about the Eid. ... It was really nice to see so many big number of families moving going to the parks, giving their kids a chance to run in the yards, to play soccer and even to fight in a funny way with each other. ...

Its really nice to see the kids playing in the streets but we miss our old peaceful games like soccer or marbles. Instead, I saw the kids specially the boys play with the fake guns. ...

OMG, some of them look like real guns because they are made with the same size and same details accept for being made of plastic and they don’t kill innocents. When I saw these kids playing with the fake guns, I felt happy because they at least could have some fun but I felt so sorry because its not the type of fun I wished for them.

Several years ago, Nir Rosen made a similar observation about children's games in occupied Iraq in his book In the Belly of the Green Bird. Of course one could see similar children's games in just about any U.S. neighborhood. Do these games mean one thing in occupied Baghdad, another in U.S. inner cities, and something else altogether in a U.S. suburb? Probably.

Photo by Wissam Sami

Hope for progressives in rural areas

Click on the image above to view an awesome presentation of a necessary but needy campaign. You have a choice of Quicktime or Windows Media and you should go look -- this is simply the best houseparty video I've ever seen.

Take Back Red California (TBRC) is a serious, apparently grassroots-led, effort to build a Democratic base in the rural areas of the state. They've got a lot of work to do -- as in most of the country, local organization is either non-existent or lost its umph years ago. Meanwhile the right moved in to scare the natives. The difficulties of bringing out a progressive rural vote have been much studied nationally. The battle can be frustrating; as one speaker explains

We've always thought of ourselves as the underdogs, so our political strategy was to be really, really, really annoying.

But now activists have banded together to overcome the isolation of working in areas where being known as a Democrat can doom your business. They are talking with neighbors, walking precincts, and running for office themselves. They know they are in for the long haul.

We need a farm club. In San Joaquin, our politicians haven't done anything to bring people up for the supervisor's seats or the city council ...so now we are hurting for politicians to run for higher office.

If you haven't already, watch their video now.

And toss them some change via their Act Blue page.

H/t to California Progress Report for introducing me to TBRC.