For over two decades several projects have been carried out between conflicting sides in several regions around the world that have improved public health as a common denominator in the search for peace. Although these initiatives will not by themselves achieve peace, they have become significant points of contact between conflicting parties. They have benefited thousands of people and increased understanding between them, and showed that sustained cooperation can be achieved despite violent disputes and a hostile political atmosphere.

The recent talks between President Barack Obama and Israel’s Prime Minister Benjamin Netanyahu underscore the importance of promoting peace efforts at all levels between Israelis and Palestinians. For example, since its founding in 1988, the Association of Israeli-Palestinian Physicians for Human Rights brought together Israeli and Palestinian health professionals. Following the signing of the Oslo agreement in 1993, a new set of players –aside from NGOs and human rights groups- came into action between 1993 and 1997, focusing their activities on developing and providing health services to the Palestinian people.

In 1995, following an invitation of the late King Hussein of Jordan to officials at the Canada International Scientific Exchange Program (CISEPO), several actions were carried out to foster collaboration between Arab and Israeli doctors. The high incidence of hearing loss shared by Jordanians and Israelis was the basis of a project to provide auditory tests and improve hearing among infants.

Since then, there have been many scholarly exchanges between Canada, Israel and Jordan, many Israeli-Palestinian publications were created, and several scientific symposiums have been carried out. To date, more than 145,000 infants have been screened and treated for hearing loss and their hearing has considerably improved. In addition, the program has expanded to youth health promotion, maternal nutrition and management of infectious diseases.

In December of 2004, the first issue of the magazine bridges was launched under the auspices of the World Health Organization (WHO.) The magazine has contributions from both Israeli and Palestinian health experts, and is another example of the value of building bridges of understanding between Israelis and Palestinians.

Under the leadership of Dr. Mary-Claire King, who identified the first breast-cancer gene, scientists from Tel Aviv, Bethlehem and Seattle teamed up to find the cause of deafness, and have found several genes responsible for hearing loss. They were able to do that despite the obstacles posed by the shutting down of university facilities, blocked shipments and other inconveniences.

Those are just a few examples of what up to now is a very active collaboration between Palestinian and Israeli doctors and health workers. Despite their obvious value, these activities are not universally supported. In 2005, medical and health service providers and members of research and training institutions working in the Occupied Palestinian Territory strongly objected to what they consider is strong pressure to enter into Palestinian-Israeli cooperation in the health area.

According to them, a political agenda is the driving force in what they consider is a forced cooperation between Israelis and Palestinians. In addition, they don’t think that Israeli-Palestinian collaboration in the academic, scientific and professional spheres can truly contribute to reconciliation as long as justice for Palestinians has not been achieved.

Although there is some validity to their position peace will not be achieved overnight. It is only through some incremental steps that reconciliation between both peoples will take place. As former Prime Minister Yitzhak Rabin stated when awarding a UNESCO peace prize, “Peace will be built slowly, day by day, through modest deeds and countless spontaneous details. It will be built, step by step, by people.”

There is no better way to do it than through collaboration in the public health area on issues of common interest. The better health of thousands of women, men and children is a living testimony of the effectiveness of such approach. In a region plagued by lack of confidence and trust, health is the best antidote to war.

Dr. Cesar Chelala is an international public health consultant and a co-winner of an Overseas Press Club of America award.

My mom died on May 4th, 2009.

It was not unexpected, but we thought, we believed that she would last for another day or two... or three, maybe even a week. My mom was stubborn. She would hold on sometimes just to make you angry. And as we found out, even in her deepest pain, she would always try and be in control. She was tormented, struggling, and not at all content with the world. My mom had dementia. She did not die in peace.

I will not raise my children to kill another mother’s child.
CODEPINK Mother’s Day 2009

• Photograph by Kelly Van Pelt. Courtesy of CODEPINK. •

I needed peace.
I longed for it.

Mother's Day means an awful lot to me. Not in the traditional sense, where one brings flowers and candies and sits around the dining table, telling or sharing stories. No, Mother's Day is a day I observe, take in and do what I have done for many years: I promise myself to take the worst of any experience, the bluest of any sadness, and any and all conditional love, along with the kaleidoscope of instilled fear, and I make a promise - a vow - that as a woman, a grown woman, I will engrave those actions that caused such sadness and discomfort and fear, I will engrave them deep in my soul, and I will never do that to another person, male or female. Ever. We learn from the pain, the sorrow, the suffering, the tragic, and the thoughtless. We must, it is our opportunity, and it is our responsibility.

As a young woman, I was often huddled with a few of my girlfriends listening to Laura Nyro or Joni Mitchell, or Carol King. Oh my God, Tapestry. Every goddesses dream. I wanted to be Carol, and Joni and most definitely Laura. Come on, who didn't want to be them? These were my idols. They were passionate and vibrant and had a sense of mission and used their life and voice to be heard, to be heard loudly. They were bold, audacious, humanity at it's best, and each a mother.

• The peace quilt. Courtesy of CODEPINK. •

All these women – from all walks of life; shoulder to shoulder, knee to knee.

One of my fondest memories of my mom is when she and her friends would sit around and knit. It seemed that in those few hours they shared their woes, they solved their problems, they spilled a couple of secrets, they found great humor, and solace and comfort, and there, among those women -- a profound connection that could only be found in the bond between them. It seemed to me that women could accomplish anything once they put their minds (and knitting needles) to it.

A memory of my mom that I deeply longed for, but witnessed again this Mother’s Day in Washington, DC.

CODEPINK inspires, encourages and ignites a spark so that every woman can stand up and use their voice: No more War, Period. No more violence against women. Period. No more rape or ravaging or disrespect. Period. Period. Period. No more going deaf, dumb and blind at the sight of a woman trying to make her life just a hint better. No more settling. No more. No more pitting our strengths and gifts against each other. No more.

To stand shoulder to shoulder, to reconnect, to renew, to reestablish our passion and our place in the world, to not step back, to not step aside, but to step forward, to carry ourselves with the grace and dignity and determination to say NO to WAR, NO to Hate Crimes, NO to Injustice, NO to Intolerance, NO to Violence against … well, all life, NO to Insufficient Health Care. NO to taking away the basic rights that all people have the absolute right to have.

• The peace quilt. Courtesy of CODEPINK. •

I saw peace. I felt peace. It grabbed me.

And while watching all these glorious, magnificent women knitting and talking and singing and smiling and dancing and chanting:

I will not raise my children to kill another mother’s child.
I will not raise my children to kill another mother’s child.
I will not raise my children to kill another mother’s child.

I could once again imagine my own mother – with her girlfriends, sitting in a circle, knitting, -- when she was full of life, happy and determined and filled with great passion, and for that alone I am irrefutably grateful.

The women at CODEPINK are extraordinary, putting their profound mission and courage where their mouth is.

•

Amy Ferris is an author, screenwriter and editor. She is on the Women’s Media Center Advisory Board, the Executive Board of Directors at Peters Valley Arts, Education & Craft Center, and is a consultant/advisor to The Women's Education Center.

Amy's new book, a memoir: Marrying George Clooney - Confessions From A Midlife Crisis is coming out Fall 2009, Seal Press is publishing.

According to the Minneapolis Star Tribune, a judge has ordered 13-year old Daniel Hauser to undergo chemotherapy treatment for Hodgkin’s Lymphoma against both his and his parents’ expressed wishes. Diagnosed in January, Hauser initially began radiation and chemotherapy, but stopped in favor of alternative treatments – at which point the doctors filed a child-neglect petition. Noting that five doctors agreed on the necessary course of treatment, the judge ruled the boy to be in need of child protection, stating a “compelling state interest in the life and welfare of Daniel sufficient to override the fundamental constitutional rights of both the parents and Daniel to the free exercise of religion and the due process right of the parents to direct the upbringing of their child."

71% of readers on the Tribune site voted in favor of the ruling, and they have strong facts buttressing their opinion. According to MayoClinic.com, “advances in diagnosis, staging and treatment of Hodgkin's disease have helped to make this once uniformly fatal disease highly treatable with the potential for full recovery.” At first glance, then, the decision seems obvious and uncomplicated: a child has a potentially fatal yet easily curable illness, and his parents don’t want to treat him. Worse, they’ve brainwashed him into rejecting treatment and are leading him to his death. Clearly, the state should intervene.

They do have a point. And yet, there are many important subtleties and layers to this dilemma, in particular compelling issues of individual liberty. As such this ruling sets a chilling precedent for personal rights.

First, the ruling appears based on the assumption that life and death decisions cannot be left to the parents if they choose a course not preferred by the state. I would strongly disagree with the judge – it is exactly in such matters that the ‘due process right of the parent to direct the upbringing of their child’ must be upheld. Parents are the legal, moral and spiritual guardians of their children, and they have a fundamental right to raise their children within their particular world view – be it unconventional or unpopular. If such constitutional rights can be negated in a medical case of life and death, are they not made irrelevant? After all, constitutional rights are there to protect us in precisely these types of instances; by comparison we hardly need them in the monotony of every day life.

Parents make many unhealthy and unwise decisions for their children. Critically, we should ask, “What is the definition of abuse?” Rape is abuse, starvation is abuse, and physical beatings are abuse…but after that, it is murky. Will it become ‘abuse’ to raise a child in poverty? To remove an infant from life support? To attempt to deliver a baby with a midwife instead of with drugs? To refuse a blood transfusion? What of selective reduction in a multiple pregnancy? Whether to put tubes in a child’s ears or use chiropractic instead? Will parents be forced to steer their children through a course of heroic medicine instead of palliative care in diseases such as leukemia? What about children with weight –related diabetes – should their parents be arrested for the clear and present danger in which they have put their obese children? If high schoolers experiment sexually as they have done for generations, should parents now be prosecuted? What if they can’t or won’t pay for college tuition – that would affectively cut their child off from a meaningful economic future, which is a type of death. Once a thoughtful person starts down this road, the list of parental quandaries abounds.

So the first issue is one of parental rights and the dignity of the family. There is a pervasive crisis of confidence in our society which assumes that all families are dysfunctional, abusive and neglectful – and that the state must intervene to correct decisions of which it disapproves.

The second is an over-simplification of medical diagnoses and treatments. Having had two family members with the same cancer, I can relate to the difficult decision the parents are forced to make. Based on our outlook on life and a lack of spiritual barriers to treatment, in both instances we chose the invasive method – surgeries to remove the tumors, plus chemotherapy in one and radiation in the other. At least in the latter case, the doctors gave the patient two options: he could operate and then proceed with radiation, or he could simply monitor it, meaning regular tests but no treatment unless it became worse. In the previous case, chemotherapy was required – this was twenty years previous and radiation was not being offered.

I was personally relieved that my husband, the second case, chose the radiation. I didn’t want to have that threat of a disease lurking over our heads, always looming as something unresolved. And yet, before he could begin, we had to sign forms stating our understanding that side effects – in addition to extreme fatigue and nausea- were a substantial risk ‘compared to the average population’ of developing stomach and other soft-tissue and organ cancers. Cancers that are next to impossible to treat. Cancers that could kill him, all because he chose the invasive treatment method for the cancer he currently had instead of taking a “wait and see” approach. It seems simple at first, but it is quite the opposite when the pen is in your hand.

The first case of testicular cancer was my father. With two children at home and one on the way, my dad chose the chemotherapy for the same reason my husband later chose radiation. But it took its toll, nonetheless. Besides losing his hair, he risked liver damage because the doses at the time were substantially higher. The side effects that came later were even worse, with many current and frustrating health problems connected to that course of treatment twenty-some years ago: low testosterone, peripheral neuropathy, and chemo-brain, that pervasive forgetfulness experienced by many survivors.

We will never know with certainty if it was the treatment that saved my husband and father’s life. After all the expense and the pain, we tell ourselves that we did the right thing. But I wonder: had they had this disease today, as a child (and it is a disease that strikes boys in high school), would they have been given the same option to “wait and see”? Or, we they have been forced into aggressive treatment for “their own sake?”

The third issue is one of individual physical integrity and the right to choose not to live. As alienating as this idea may sound, it is a fact of life that none of us are going to live forever. Many cancer patients wrestle with this reality, as it hits them squarely in the face. It should be a fundamental right to choose one’s own path in dealing with a debilitating illness or how to live out one’s last days, if that be the case. Medicine should be holistic and concerned with the health of the entire person, not merely a missile defense system designed to hone in on one of the body’s trouble spots.

Every person should have a right to the dignity of their own person and their own body. It is not an indication of insanity to reject a course of treatment as simply being beyond the bounds of what one individual can- or is willing- to bear. People who wish to live a spiritual life of a different color should be allowed to do so; families who do not feel the same way about the material world should not be forced to act against their own beliefs in order to execute the state’s beliefs in order to prolong the corporeal existence.

This ruling is particularly troubling as we consider geriatric medicine, where patients are repeatedly overruled with the argument that “they don’t really know what they are saying” or “they don’t really mean that” or “they don’t really know what they want.”

It is a dangerous road that we all travel as a society when doctors claim to speak for the “true” interests of a patient – one who is attempting to speak for himself but is opposed to the doctors. A doctor who overrules a patient’s expressed wishes clearly does not have the patient’s best interest at heart. In such cases, the court should defend the patient’s right to self-actualization, not the doctor’s desire to see his scientific outcome bear fruit.

This case is fascinating and terrifying because it presents a story formed from the overlapping spheres of the ordinary citizen’s life: family, parenting, health, religion, and individual rights. Especially in the US legal system, where cases set a precedent for future rulings, we as citizens must question whether this decision is in all of our best interest. While it is a victory for the young patient’s battle over cancer, it is clearly a loss for his personal dignity and liberty. A pyrrhic victory, indeed.

Posts written mainly to vent one's emotions rarely enjoy warm reception from other people, so self-help books advise to send such posts directly to the Recycle Bin. But this deprives the post of desired effect; so I prefer to publish such texts, and come what may.

I have just read a third - yes, third - post here at the WIP site bashing the torture used by US at Guantanamo. I do not intend to cite the three authors, for I strongly suspect it could be almost anybody. Yes, torture is a bad thing, but I admit that the concern whether Khalid Sheikh Mohammed & Co. have been tortured isn't anywhere among my top 70,000 priorities. My God, I wish to have some people's problems!

If it were a human rights site, then well, it should defend the rights of anybody who nominally belongs to the human species. But why at WIP? The torture victims in question share an ideology including, among other things, a cart blanche for married men to beat their wives, criminalization of female sexuality, depriving divorced mothers of parental rights and blaming rape on victims. So I find proponents of this ideology the finest collection of misogynists currently alive on Earth. Why don't we women leave their advocacy to someone else?

Here, I expect readers to challenge me to state my attitude to torture without any ifs, buts ans waffle talk. In reply, I would ask them to do the same first. Dear opponents, are you really against torture from purely moral and principle viewpoint? Or do you care only when suspected Islamists are tortured by people working for the US government?

Since Bulgaria became EU member in early 2007, it has become impossible to attract outside attention to violations of human and civil rights in this country. In January, two pretrial detainees died at the hands of police within a week, and nobody gave a damn. Apparently people think that EU membership magically guarantees human rights, so torture in an EU member country, even when lethal, should be considered nonexistant for any practical purpose.

Well, forget Bulgaria. How much do you care about torture in other countries such as China, Cuba, Egypt, Iran, Libya, Russia, Tunisia or Zimbabwe, to name just a few? Here my opponents, if they are honest, should say that they are mainly interested in torture done by Americans. Well, be as you like. What about the Judge Rotenberg Center, "a school for special needs students that operates in Canton, Massachusetts... charging $220,000 a year for each student... (which) administers 2-second electric skin shocks to residents using a Graduated Electronic Decelerator (GED), which was invented to administer the skin-shocks by remote control through electrodes worn against the skin" (quote from Wikipedia)? Where is the public outcry demanding this hellhole to be closed? Or perhaps disabled children aren't human enough and torturing them is OK?

One of the reason to reject inhumane treatment is that, if violation of human rights is once allowed for somebody we find exceptionally disgusting, it could then relatively easily be extended to other people. However, defending the human rights of bad people doesn't always have the effect of raising the general standard. The reason is that media time and public attention are limited resources. Allocating them to a specific problem means removing them for other problems. Now, all media and public attention that could be devoted to the torture subject is occupied by the Guantanamo detainees. Respectively, all other victims remain in the dark for indefinite time. So, Pres. Obama, please pardon all people tortured at Guantanamo, release them and give them fine compensations. Hopefully then somebody could find a minute to think of the Judge Rotenberg Center.

The Nuremberg Principles, a set of guidelines established after World War II to try Nazi party members, were developed to determine what constitutes a war crime. The principles could also be applied today, when judging the conditions that led to the Iraq war and in the process to the deaths of hundreds of thousands of people, many of them children, and to the devastation of a country’s infrastructure.

In January of 2003, a group of U.S law professors warned President George W. Bush that he and senior officials of his government could be prosecuted for war crimes if military tactics violated international humanitarian law. The group, led by the New York-based Center for Constitutional Rights, sent similar warnings to British Prime Minister Tony Blair and to Canadian Prime Minister Jean Chretien.

Although Washington is not part of the International Criminal Court (ICC), U.S. officials could be prosecuted in other countries under the Geneva Convention, indicated Michael Ratner, president of the Center for Constitutional Rights. Ratner likened the situation to the attempted prosecution by a Spanish magistrate, Baltazar Garzón, of the Chilean military dictator Augusto Pinochet, who was held under house arrest in London.

Both former President George W. Bush and senior officials in his government could be tried for being responsible for torture and other war crimes under the Geneva Conventions. In addition, should Nuremberg principles be followed by an investigating tribunal, former President Bush and other senior officials in his administration could also be tried for violation of fundamental Nuremberg principles. In 2007, Luis Moreno-Ocampo, the ICC’s chief prosecutor, told The Sunday Telegraph that he could envisage a scenario in which both British Prime Minister Tony Blair and then President George W. Bush could face charges at The Hague.

Perhaps one of the most serious breaches of international law by the Bush administration is the doctrine of “preventive war.” In the case of the Iraq war, it was carried out without authorization from the U.N. Security Council in violation of the U.N. Charter, which forbids armed aggression and violations of the sovereignty of any state by any other state, except in immediate self-defense.

As stated in the U.S. Constitution, international treaties agreed to by the United States are part of the “supreme law of the land.” “Launching a war of aggression is a crime and no political or economic situation can justify it,” stated Justice Jackson, the Chief U.S. Nuremberg Tribunal Prosecutor. And Benjamin Ferencz, also a former chief prosecutor of the Nuremberg Trials declared, “a prime facie case can be made that the United States is guilty of the supreme crime against humanity, that being an illegal war of aggression against a sovereign nation.”

The conduct and the consequences of the Iraq war are part of the Crimes against Peace and War crimes stated in Nuremberg Principle VI which defines as crimes against peace, (i) Planning, preparation, initiation or waging of a war of aggression or a war in violation of international treaties, agreements or assurances; (ii) Participation in a common plan or conspiracy for the accomplishment of any of the acts mentioned under (i).

In the section on war crimes, Nuremberg Principle VI includes, “…murder or ill-treatment of prisoners of war or persons on the seas, killing of hostages, plunder of public or private property.” The criminal abuse of prisoners in U.S. military prisons in Iraq, Afghanistan and Guantánamo are clear evidence of ill-treatment and even murder of prisoners. According to the organization Human Rights First, at least 100 detainees have died while in the hands of U.S. officials in the global “war on terror,” eight of whom were tortured to death.

As for the plunder of public or private property, there is evidence that even before the war started, members of the Bush administration had already drawn plans to privatize and sell Iraqi property, particularly oil.

Although there are obvious hindrances to trying a former US president and his associates, such a trial is fully justified by legal precedents, in particular the Nuremberg Principles, as well as by the extent of human lives lost and the breach of international law it has produced.

Cesar Chelala, a co-winner of an Overseas Press Club of America award, writes extensively on human rights issues.

I am happy to report that Afghan Star was featured on Oprah yesterday!

And, Made in America: Crips and Bloods is premiering on PBS this evening.

According to the U.S. Census Bureau, by 2010 sub-Saharan Africa will have suffered 71 million deaths from AIDS. By comparison, the bubonic plague of the Middle Ages killed some 30 million people. These are staggering figures, particularly if one considers that deaths from AIDS are only one of the problems affecting African women and children.
Experts at the United Nations warn that most sub-Saharan countries will be unable to reach the Millennium health goals related for 2015, particularly those related to improved health for mothers and children.

Solving Africans' health and development problems need more than statements of good intention, promises of aid (often empty) or movie stars' adoption of African children. Yet, many diseases affecting children and adults can be addressed with minimum resources if they are used strategically.

Childhood malnutrition is a critical issue. Almost 60 percent of deaths of children under 5 in developing countries are due to malnutrition and its effects — such as greater mortality from infectious diseases. Malnourished children are up to 12 times more likely to die from easily preventable infectious diseases (such as measles, malaria, diarrhea and pneumonia) than are well-nourished children.

It is estimated that African women are 10 to 100 times more likely to die during pregnancy and childbirth than women in industrialized countries. Most of these deaths and disabilities are caused by delays in recognizing complications, difficulties in reaching a medical facility and lack of adequate medical care. Skilled health workers are vital in addressing these challenges but their numbers are pitifully low.

Malaria, HIV/AIDS and tuberculosis continue to be major threats facing both children and adults. Recent experiences in Africa and Latin America show that malaria can be controlled without use of DDT, an important new approach to dealing with this disease. It can be done through rapid-case detection and drug treatment, as well as through prevention efforts at a community level emphasizing the use of insecticide-impregnated bed nets, sanitation measures to eliminate vector breeding sites and use of chemical substitutes for spraying houses.

Recent studies have shown that HIV treatment is "failing" in many African countries. The rates of failure vary depending on the program and the country under consideration. Treatment failure in many patients is due to their starting to take medication too late in the course of the infection. Other patients have problems in accessing the drugs, either because they are too poor or live too far away from the health center providing the medication.

Throughout Africa, the stigma associated with HIV/AIDS is one of the main barriers in dealing successfully with that infection, both in terms of prevention and treatment.
Education, public health campaigns and the active participation of members of the clergy have contributed in many areas to overcoming the stigma but much remains to be done and progress is slow.

HIV/AIDS has also had a significant though rarely discussed effect on the education sector. In sub-Saharan Africa, the HIV/AIDS pandemic is killing teachers at a rate faster than replacements can be trained. Another effect of the pandemic is teacher absenteeism, loss of educators, planners and management personnel. It is estimated that close to 30 percent of South Africa's teachers are HIV positive, a higher rate than among the general population.

According to statistics from Zambia's education ministry, every day one teacher dies from an AIDS-related disease. This is the equivalent of the closure of one school per week due to loss of teachers.

In Africa's rural areas, not only are health services and infrastructure inadequate but there also is a lack of properly trained medical personnel. To compound the problem, there is an exodus of trained personnel to higher paying jobs in industrialized countries.

It is estimated that there are more Malawian physicians in Manchester, England, than in Malawi a country of 12 million people with only 100 doctors and 2,000 nurses. Over 15 percent of Malawi's population is HIV-positive. Many of its health-care workers are infected with the disease or have died of AIDS.

According to the World Health Organization, 23,000 health-care workers leave Africa annually. Equally serious is the distribution of health-care workers within the countries themselves. They tend to remain in urban areas.

“In 25 years, Africa will be empty of brains,” warned in 2005 Dr. Lalla Ben Barka of the UN Economic Commission for Africa (ECA) reflecting his concern over Africa’s exodus of human capital. It is estimated that over 300,000 professionals reside outside Africa.

Solving the problem of poverty and the resulting malnutrition and disease it engenders requires three distinct steps: developing efficient and effective health-care systems; increasing access of the poor to adequate health care; and redirecting resources from acute care hospitals using high-tech equipment to investment in low-tech, but effective, community-based primary and preventive care.

Health problems in Africa cannot be considered in isolation — and are not only the responsibility of Africans themselves. Foreign technical and financial assistance is required. Aid must bypass corrupt governments and find ways to help people directly, for example through nongovernmental and U.N. organizations with a proven record of effectiveness. Aid can strengthen civil society and community-based organizations, which are the basis of a democratic society.

To bring hope to a continent ravaged by poverty and disease, effective and urgent action is required. It is available and it can be done.

Dr. Cesar Chelala, an international public health consultant, has conducted health-related missions in several African countries. He is a co winner of an Overseas Press Club of America award.