Mother Theresa's Care For The Dying

 

NEWS WASHINGTON PERSPECTIVE

Health reform

no

longer

a

ting waste in the system. Add in, too, the inherent political weakness of Clinton, elected with 43% of the vote and barely workable majorities in Congress. Even with

hot issue

Innumerable taking the political autopsies those handicaps, the Clinton Health collapse of health-care reform withi tend to agree on the factors that Security Act seemed to be off to a indifference. Congressmen returning doomed the best shot yet at providpromising start at its launching last from the summer recess almost uniing this country with universal health autumn. But, distracted by other formly report scant interest in the care. Perhaps of primary importance, governmental issues and his personal most of the public and health-care issue. The Clintons have shied away woes, the President then devoted from the subject in recent weeks, thus industry are content with things as only intermittent attention to health a are, strains know dead feel The lobbies for the major care. that and they they though they signalling horse when they see one. And now anxieties. The Clinton camp broadeconomic interests in the health cast many true there is serious talk that in the homeand heartrending .’. industry produced a cacophony of stretch to adjournment for the Nov 8 reports about the uninsured 15% of fearsome warnings of danger to elections, Congress may avoid even the population and the many others if their self-serving prefermodest health-related measures. who are inadequately covered. But patients : ences were not enshrined in healthmost Americans are safely insured for Going home for pre-election bondreform law. ing with their constituents, legislators health care and not receptive to taxaLacking a majority coalition on tion for the benefit of the downtrodexpected to encounter strong sentiwhat to do, Congress is inclined to den. Arguments that health care for ments, on one side or the other, condo little, if anything, about health cerning Washington’s number-one the uninsured is really financed by reform in the remaining weeks of the domestic topic for most of the past higher prices for those who are covsession. The soothing argument of ered did not seem to register with the ’. year. But by general account the outthe moment says avoid haste, wait till spoken members of the electorate are public. Cost shifting, as it is known, ; next year, and then proceed carefully concerned with crime, welfare does not visibly affect the wellin dealing with the difficulties of reform, immigration, jobs-not with insured. ; health care for all. But health-care reform. that insure attaining everyone knows that is a specious among their Many corporations Typical Democworkers came out the legislators, a midwestern against a govthat the next Conernment-decreed employer mandate . argument, given ratic Congressman who strongly Supwill almost gress surely be less ported the Clinton health plan told for insurance, arguing that it would inclined to reform. The most imporme that he had gone home prepared . they tant factor seems to be that the voters cramp their options if later to do a lot of explaining about the had to cut costs. Doubt and conare not fired up about health-care fizzled effort. He found little interest ’. tention swirled around the White reform. In fact, they seem bored by it. in the subject. ; House’s claims that, over the long There are signs that major segrun, universal coverage could be additional cost by cut- Daniel S Greenberg ments of the public are weary of the achieved at debate and perhaps not so dissatisfied and d CALCUTTA PERSPECTIVE with the present economics an organisation of the health-care System, despite its well-publicised failMother Theresa’s care for the dying ings. The leading exemplar of reform as a winning political issue is DemocOn Sept 8 the Calcutta Telegraph work (my wife and I fed some of the ratic Senator Harris Wofford of ’. reported that an unidentified ma and scoured the metal man n residents Pennsylvania, who won an upset aged about 65 had been found dead plates and drinking vessels with wood election two years ago in a victory : near the Kalighat Temple. The ash). There are two large rooms, for credited to his belabouring of the remarkable thing is that this incident men and women, each with three Bush administration for neglect of was newsworthy. A walk through that rows of concrete benches with green health care. Wofford faces the voters squalid part of the city will show you plastic mattresses. In a central lobby two sisters of Mother Theresa’s disease and degradation on a grand again in November because he is fillthe of the late scale. The fact that people seldom order, the Missionaries of Charity, remaining portion ing Senator John Heinz’s term. This .’. die on the street is largely thanks to were coordinating the efforts of five time, however, health-care seems to the work of Mother Theresa and her volunteers (young people from Belhave lost its political lustre, and Wofmission. The citizens have been sengium, Germany, and Japan). Along ford is in a difficult campaign. Some sitised by her work over the past with two novices from the order, they retrospectives on his surprise election 40 years; and, where formerly they ‘°. were distributing rice, vegetables, now question whether his tended to avert their eyes, now they . and water to about 90 men and champiof health-care reform was oning really are likely to call an ambulance. And, women. the decisive factor. Whatever the case, if the hospitals refuse admission, I was surprised to see many of the reform of the health system is closely Mother Theresa’s Home for the v inmates eating heartily and doing

The country

seems to

be

on

no

:

associated with

a

President low in the

Dying will provide.

popularity ratings. Many Democratic candidates are keeping a safe distance

hostel close

from Clinton.:

are

The

home is

a

former

; well. These days, it

pilgrim’s

seems,

more

two-thirds leave the home

on

than their

the

temple. Visitors feet. Their common feature is not welcome, especially if willing to that they were originally perceived to to

807

 

dying but that they had failed to gain admission elsewhere. What sort of medical care do they get? It is hapbe

hazard. There

are

:

:

doctors who call in

:

usually the sisters and volunteers (some of whom have medical knowledge) make decisions as best they can. I saw a young

j

who had been admitted in poor shape with high fever, and the drugs

 

from time

to

time but

Mother

have looked

ethos

Theresa

of

at a

! !

not

blood film?

Mother

home.

the

prefers providence to planare designed to pre-

her rules

ning ;

any drift towards

vent

materialism;

Preventing spread of BSE

were

to assess

the worldwide extent

of BSE and the risks it poses to trade, and to reach a consensus on the connection between BSE and

Creutzfeldt-Jakob

dis-

ease.

:

The group concluded that BSE continues to affect largely the UK (133 766cows

dead since 1986), although the number of suspected cases has fallen by 32% over the

past year. Veterinary advice

to

stop

giving

animal-derived foodstuff to cows since 1988 has been estimated to have saved the lives of 50 000 animals

to

to

be spent

on

little are

some

competent luxury. Finally, the at managing pain? On sisters short

visit

I

could

not

after

at

commu-

their annual conferences. In Munich

the German

a

the

judge

v

Society for Gynaecology and

Obstetrics and in Darmstadt the German

don’t Society

home,

and

for

Psychiatry, Psychotherapy, Neurology publicly accepted responwith the horrors

for

sibility mitted

by

dealing their medical

com-

colleagues in the

past. The

president of the gynaecologists’ power of their spiritual approach, but Prof Hermann Hepp from I was disturbed to learn that the organisation,

formulary includes no strong analgesics. Along with the neglect of diagnosis, the lack of good analgesia marks Mother Theresa’s approach as clearly separate from the hospice .

Munich, offered his apology

who

were

sterilised

or

to

forced

the

to

women

have abor-

tions. He admitted that after World War

gynaecologists had failed by not talking about the physical and psychological harm done to women and by not giving them movement. I know which I prefer. ; special help. It is impossible to go on talking about ethics if the past is not faced, Hepp said. A recent poll has shown that about twoRobin Fox thirds of the directors of university gynaethink that the Nazi past derived foodstuffs imported from the UK. cological hospitals was never properly discussed. However, The number of is

date. Four other

countries have

atively

98

however, compar- ’, in Switzerland, 92 in

small:

:

Ireland, 10 in Portugal, and 8 in France.

that progress of research into prion-transmitted diseases is Another conclusion

slow

despite

was

funding of a the by European

annual

ECUs per year Prof D C Gajdusek,

meeting, hoped

that

Union.

the solution to partial

who a

million

the difficulties would be

chaired

through the

study

of chimeric mice with human genes. group also requested that until more are

The

data all

available "infected countries take

II

there are few ideas this problem or how

on

to

victims. About 300000 were

sterilised,

how

help

to

deal with

the

men

remaining

and

women

of whom 5000 died

as a

consequence of the surgery. 75 000 handicapped people were killed by doctors, and at

least 100 000 lost their lives in medical

experiments. Of all the professions, doctors had the greatest involvement with the Nazi party, 45% being members. When the war ended, victims did not

receive

compensation, and many Nazi

doctors

were

able to continue with their

possible precautions to avoid any spread careers. This unfairness was also true for of BSE, however remote the probability of psychiatrists and their patients. At their it occurring to human beings ... Even annual conference, psychiatrists likewise though prions are likely to be dangerous . discussed the responsibility that their disonly when ingested in large amounts, all cipline holds for the Nazi crimes. But the organs of infected

tain

prions

must

that might condestroyed, and no

cows

be

suspect material used in the manufacture of pharmaceuticals". :

reported cases import of infected cows or through feeding cows infected animal- Jean-Yves Nau European

For decades the German medical

cases,

on bovine spongiform Experts encephalopathy (BSE) called for compul: sory reporting of BSE and worldwide surveillance of the disorder when they were brought together at a meeting in Paris earlier this month by the International Office of Epizootics and WHO. The main

aims

Theresa’s

how

sub-

Investigations, I was told, are seldom permissible. How about simple algorithms that might help the sisters and volunteers distinguish the curable ; from the incurable? Again no. Such systematic approaches are alien to the

quently rubbed out, to allow re-use of the paper.) If you give money to

doctor

a

Apologies for Nazi crimes

cleanliness, the tending of wounds nity abstained from discussing crimes and sores, and loving kindness. (One committed by Nazi doctors. But two medical societies have now broken the requirement is that all prescriptions silence by making the issue a major topic be written in and subse-

tetracycline and   expect it

had been

Later, malaria paracetamol. visiting and diagnosed probable stituted chloroquine. Could someone

sisters

pencil,

:

man

prescribed

must remain on equal with the poor. So the most important features of the regimen are

the

terms

injustice persists today; there

of the Holocaust who be rehabilitated.

are

are

still

survivors

waiting

to

the

German health

on

Annette Tuffs

introduction will lead

plastic

to

"doctor shop-

ping".

:

The

made

tendency tor patients to consult specialists without first seeing their general practitioner, but says that the trend is not new. However, a tact. it admits that tnere is a

by allegations, some of their societies, have been By January, 1995, members of the strongly . in health-insurance federal denied the health system The e recent survey by the Central Institute for ministry. Th obligatory by Germany (which covers about 95% of ministry argues that the card will lead to Health Care and the Scientific Institute of the population) will carry yet another less abuse, since it could be lent to only Local Health Insurers has concluded plastic card in their pockets. It will replace one person at a time, during which the otherwise-ie, that the card has encourwould have no access to the vouchers that the health-insurance aged patients to go direct to specialists. rightful and will contain the medical There vouchers has been whereas the care, could companies issue, accompanying increase be basic personal and membership data widely distributed. In either case in health-care costs so far. Whether the doctors

and

owner

no

.

more

.

to

be read by a practice’s computer. The card has been tried out in a few states, such

as

Bavaria and Hessia, and

a

contro-

versy has arisen over claims that the cards are open to abuse and that their general

808

the identity of the carrier is checked by the doctor.

usually not :

ministry also insists that fears of shopping when the card replaces vouchers are based on myth than on

quality of medical care has been affected remains to be seen.

The

doctor

more

Annette Tuffs