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Comment: Solution? Talk to those you are trying to "help" (Score 5, Insightful) 203

by adam (#37454344) Attached to: MIT's $1,000 House Challenge Yields Results
The New York Times rad an op-ed a few months ago on a similar project (Harvard's $300 house) that says basically everything I'd want to say here. It's worth reading, but I'll quote the most relevant portion(s):

The writers created a competition, asking students, architects and businesses to compete to design the best prototype for a $300 house (their original sketch was of a one-room prefabricated shed, equipped with solar panels, water filters and a tablet computer). The winner will be announced this month. But one expert has been left out of the competition, even though her input would have saved much time and effort for those involved in conceiving the house: the person who is supposed to live in it [in Mumbai] We recently showed around a group of Dartmouth students involved in the project who are hoping to get a better grasp of their market. They had imagined a ready-made constituency of slum-dwellers eager to buy a cheap house that would necessarily be better than the shacks they’d built themselves. But the students found that the reality here is far more complex than their business plan suggested. To start with, space is scarce. There is almost no room for new construction or ready-made houses. Most residents are renters, paying $20 to $100 a month for small apartments. Those who own houses have far more equity in them than $300 — a typical home is worth at least $3,000. Many families have owned their houses for two or three generations, upgrading them as their incomes increase. With additions, these homes become what we call “tool houses,” acting as workshops, manufacturing units, warehouses and shops. They facilitate trade and production, and allow homeowners to improve their living standards over time. None of this would be possible with a $300 house, which would have to be as standardized as possible to keep costs low. No number of add-ons would be able to match the flexibility of need-based construction. In addition, construction is an important industry in neighborhoods like Dharavi. Much of the economy consists of hardware shops, carpenters, plumbers, concrete makers, masons, even real-estate agents. Importing pre-fabricated homes would put many people out of business, undercutting the very population the $300 house is intended to help. Worst of all, companies involved in producing the house may end up supporting the clearance and demolition of well-established neighborhoods to make room for it. The resulting resettlement colonies, which are multiplying at the edges of cities like Delhi and Bangalore, may at first glance look like ideal markets for the new houses, but the dislocation destroys businesses and communities.

A recent (PBS-affilliated POV) film, Good Fortune , expands further on the damage that can be done via good intentions when it comes to rehousing folks.

Many economists, journalists, physicians, and so forth have written extensively about the aid industry, and the White/Educated/Western/Elite-knows-best mentality. I certainly am no exception — I moved to Ghana with notions of making solar lights in my spare time, so that persons without grid-access could see at night, only to come to understand that this was a product that most people in the place I was living would have little interest in. It didn't matter that I'd spent months figuring out how to cram solar panels and LEDs into wire-bale jars, media blast them with garnet to diffuse the light better, and so on ... it wasn't something they would have wanted. I helped vaccinate kids, which was something they wanted, and everyone won.

For some more literature on this sort of thing, I'd recommend William Easterly's The White Man's Burden , or Linda Polman's various works. Also, Joan Baxter's Dust From Our Eyes was also pretty good.

So is there anything wrong with these projects at Harvard or MIT? I don't think there has to be. But it seems like in the MIT project the same criticism — that those behind the project never even bothered to ask those who would 'benefit' from it — is true. The first couple paragraphs of the first link from TFS make that clear:

[in India] "When I saw some shelters by the side of the road, the idea for the $1000 house jumped into my head." Ciochetti explained that soon after, he had met with his friend Yung Ho Chang, Professor of Architecture and Head of MIT's Department of Architecture. Ciochetti had asked if the idea were viable, and Chang enthusiastically embraced it. Chang proposed that his students explore the project as a studio intensive, and that he and Ciochetti teach the studio together. Thus was the 1K House Project born.

I have posted on slashdot previously about Paul Farmer and his NGO, Partners in Health, so I am wary of sounding like a cheerleader, but he is especially relevant here because he is head of Social Medicine at Harvard. He is also an anthropologist. So he understands that you need to consider others' needs, desires, and worldview, rather than telling them what you think is best for their situation.

And speaking of anthropology, I think maybe the biggest American downfall — at least when it comes to health, which is where I am more acquainted — is the belief that we can engineer ourselves out of every problem. I'm not saying the world's poor shouldn't get $300 houses, or tuberculosis medicine, indeed they should. But the underlying problem is the social and economic structures that would breed tuberculosis, that would mean someone can afford no more than a $300 house.

Ghana is not nearly as bad off as many other sub-Saharan African countries, and yet still there is much poverty. People living in the region (their equiv. of a state/county) where I used to reside are finding themselves pushed out of their houses as rents rise from $25-40/month to $100 or more per month due to an influx of oil contractors (now that Ghana has offshore oil pumping as of 2011). The problem is not $100 rents, or even $1000 rents; the problem is that some can afford such rents, and some cannot. In short, the problem is inequality. I am not so naïve as to expect the world will be perfectly fair, but surely we can strive for some basic assurances for all humans — adequate food, water, medical care, social productivity, and basic economic security.

Three-hundred dollar housing is a stopgap, much as some vaccinations are a stop gap. I am strongly in favor of vaccinating kids in poor countries against measles because it might kill one in ten that it infects, and that is truly tragic. I am, however, even more in favor of lifting these kids out of poverty, so that if they aren't vaccinated their mortality rate will be more like the one-in-two-thousand that the United States enjoys. It's just that solving the problems of poverty and inequality is a much bigger task. And we cannot even begin to approach this task until we attempt to understand, to find solidarity, with those we claim to want to help.

Comment: Plumpynut (Score 3, Interesting) 98

by adam (#36058994) Attached to: Students Invent Revolutionary Solar Sterilizer
The peanutbutter-like product nzac is referencing is most commonly known as Plumpynut. It's used the world over, and I can attest it really does make a huge and immediate difference in the near-term outcome for malnourished children (the root cause of malnutrition — poverty — is often not addressed). September of last year the NYT ran an article on Partners In Health and their Nourimamba version of the PB product. For readers who want to know more about what you alluded to, I thought I'd chime in with some links and such. Plumpynut is patented in several countries, but not Haiti. Partners In Health uses local farmers to grow peanuts and employs local personnel to manufacture Nourimamba.

Partners in Health harvests peanuts from a 30-acre farm or buys them from a cooperative of 200 smallholders. It’s planning to build a larger factory, but for now the nuts are taken to the main hospital in Cange, where women sort them in straw baskets, roast them over an outside gas burner, run them through a hand grinder and mix all the ingredients into a paste that is poured into reusable plastic canisters.

PIH has a slideshow of manufacturing Nourimamba on smugmug, here. The Times article does address some of the interesting (and sad) legal wrangling behind a simple peanut mix that has the power to save millions of lives. Also, for an interesting take on how famines can be "manufactured" by unscrupulous governments or warlords seeking to skim or redirect aid, see Linda Polman's work. Here's an excerpt from a Guardian article,

All too frequently, according to Polman, the result is not what it says in the charity brochures. She cites a damning catalogue of examples from Biafra to Darfur, and including the Ethiopian famine, in which humanitarian aid has helped prolong wars, or rewarded the perpetrators of ethnic cleansing and genocide rather than the victims. Perhaps the most striking case in the book deals with the aftermath of the genocide in Rwanda in which the Hutu killers fled en masse across the border to what was then Zaire (now the Democratic Republic of Congo). There, in Goma, huge refugee camps were assembled and served by an enormous array of international agencies, while back in Rwanda, where Tutsi corpses filled rivers and lakes, aid was not so focused. The world was looking for refugees, the symbol of human catastrophe, and the refugees were Hutus. This meant the militias that had committed the atrocities received food, shelter and support, courtesy of international appeals, while their surviving victims were left destitute. Worse still, Polman believes the aid enabled the Hutu extremists to continue their attempt to exterminate the Tutsis from the security of the UNHCR camps in Goma. "Without humanitarian aid," she writes, "the Hutus' war would almost certainly have ground to a halt fairly quickly."

Comment: This is bullshit, and you know it. (Score 5, Informative) 832

by adam (#35115096) Attached to: Bill Gates Says Anti-Vaccine Effort Kills Children

Show us figures on what percentage of children in outbreaks of measles, for example, have been 'vaccinated'. Strangely enough, we never get to see those figures.

Let's look at your CDC link, since it has the exact info you want. In that case, all of the persons who developed measles had been vaccinated. So you win a point. Or do you? About fifteen percent of children vaccinated against measles won't develop immunity with the first jab, which is why a second is recommended. (Also, just for reference, the vaccine is most effective after 12 months of age, and not effective at all before six months.) So it's possible, maybe even likely that these students hadn't had their second jab (which would make 85% of the students immune, and 15% vulnerable — "The highest attack rate was 12% (9/74) for the 11th grade students (p 0.02)"). Furthermore, as I am sure you know, your immune system's memory (B-cells) 'forgets' threats over time, which is what creates the need for booster shots. The CDC indirectly notes this, "The attack rate was four times greater for students vaccinated 10 or more years before the outbreak than for students vaccinated more recently (p 0.05)". Lastly, the measles vaccine is very temperamental in its cold storage, with an acceptable range of 8 degrees, and any variance outside this range reduces its efficacy.

You lap up whatever the shills in the media tell you, then lambast anybody intelligent enough to question it...

The real reason I'm replying is that I want to address this comment above. I don't just lap up whatever I'm handed. Do you? When was the last time you were doing epidemiological field work? I just came back from northern Nigeria, where I was observing UNICEF and government health teams vaccinate kids, and independently surveilling measles outbreaks occurring now. Before that I was in Ghana, also working with government health teams to observe the vaccination of children, but I wasn't able to see any outbreaks. Why not? Because Ghana doesn't have outbreaks, because they maintain herd immunity amongst their under-five population. The region (like a state) I was living in for this period has a prevalence of higher than 90% for MMR vaccination, and Ghana hasn't had a measles death since 2003. In Nigeria the prevalence for vaccination in Kaduna State is around 13% for coverage of recommended vaccines, and it gets as low as 0% if you go to Jigawa State. So I'm not just lapping up whatever the "media" tells me (in fact the media is woefully silent on these sorts of matters, because most Westerners care more about Tiger Woods' indiscretions than dying kids in Nigeria), I've been in the thick of it and I've seen kids dying from measles. When was the last time (if ever?) you actually looked into this besides just lapping up what a few outcast theorists have told you to believe?

the real reason for the great reductions in some of the diseases they 'vaccinated' against - huge improvements in SANITATION.

Look, this is just bullshit, too. I've lived in Ghana, where there is sporadic running water (that you cannot drink without boiling) and no electricity and people defecate in the bush. And I've lived in Nigeria where the exact same is true. Yet in Ghana measles isn't a problem, and in Nigeria it is. This is just my anecdote, but if you look at where kids are dying from measles (or whatever disease) and you control for sanitation, you'll see that it isn't a factor. Polio (hep A, tyhpoid, cholera, etc) are spread by feces, so handwashing helps immensly there, and standing water breeds malaria (well, Anopheles mosquitoes that carry it), but there's about the extent of your sanitation argument. Once we get away from diarrheaol diseases and look at measles, sanitation isn't a factor at all (compared to rates of vaccination).

Comment: Wakefield's not even a doctor anymore... (Score 5, Informative) 832

by adam (#35114776) Attached to: Bill Gates Says Anti-Vaccine Effort Kills Children
I'm sorry to hear your child has autism — I can only imagine the difficulty of coping with something so generalized and poorly understood by modern science. You are also right: extraordinary claims require extraordinary proof; Wakefield has none. He's been stripped of his license. His paper has been retracted. And now it's come out that it was more than lacking in proof, it was a "deliberate fraud," to quote to editor of the BMJ (Dr. Godlee).

Of the 12 children in his study, children who supposedly developed entercolitis and then regressive autism after the MMR vaccination, only one of the 12 had regressive autism. Three didn't have autism at all. Five had developmental problems noted in their records before their MMR vaccine. The development of problems wasn't nearly as sudden as claimed (often months elapsed). Nine of the children's bowel tests were reported as "non-specific colitis" despite testing normal. Many of the children were recruited from lawyers who were hoping to sue the vaccine makers (can we say 'confirmation bias'?).

Most of these latter revelations have just come to light. I can only imagine how hard it must be to be in your position, to want to find an answer for causation. Especially if your child did have entercolitis and then regressive autism. But you should be aware that there isn't a shred of evidence to support this claim. Not a shred.

Also, Dr. Gupta is bordering on irresponsibility (imo) when he says to Gates, "There has been a lot of news about is there a connection with autism, for example. What do you make of all that? Dr. [Andrew] Wakefield wrote a paper about this [in The Lancet in 1998] saying he thought there was a connection." He may be a journalist, but he is a doctor first, and he could have formed his question in a way that more clearly stated what he surely knows to be facts (that Wakefield isn't licensed anymore, that the paper has been retracted and proven to be fraudulent). It's this sort of undue politeness in dancing around the truth that leave doubts in the minds of parents like yourself.

I've seen children dying of measles (in Kaduna State, northern Nigeria), and it's a terrible thing to have to see. In the case of Nigeria, it's a rumor about infertility drugs concealed in vaccines that led to a lot of resistance-to-consent amongst certain communities, and there too the damage of such a provably fraudulent statement has been a long time in undoing. I know it's tempting, maybe even easier to just believe whatever some conspiracy theorist says, but it's important to trust in the thousands of scientists who are advancing the science of saving lives, rather than the few psuedo-scientists who are trying to advance their own notoriety and financial positions.

Comment: USB Drive, SAN/NAS, LTO ... (Score 5, Informative) 680

by adam (#34945072) Attached to: How Do You Store Your Personal Photos?
In your case, since it sounds like you don't create that much data, you'd probably be fine picking up a couple of portable USB drives (2.5" drive, powered over USB = tiny). For consumer use, the Samsung Goflex 1TB (the 2.5" version) is around $100, widely available, and works great in my experience. Buy two. Use one as your master repository, one as a backup of that, and keep the second in a water-proof container (hint: try rubbermaid containers, they're waterproof and cost about $4), locked in an inexpensive fire safe, safety deposit box, or at a nearby friend's or relative's house. If you aren't needing to store more than 64GB of material then you could substitute "thumb drive" or "CF/SD card and reader" for portable USB drive ... solid state media will be 'safer' for long-term storage but obviously afford less space-per-dollar.

A better option, but beyond what you wanted is a SAN/NAS. Drobo makes some decent products, and I currently have a DroboFS at my home, loaded with 2TB drives. This gives me a little over 7TB of RAID storage to backup all my footage, images, documents, and so forth. It's network addressable, so any of the several machines in my house (both Mac and Windows) can access it. The total cost (Drobo + drives) was around $1100 or $1200 iirc. The downside to the FS is that its max transfer speed is around 20MB/sec, but they do offer other models with transfer speeds that are better suited to live editing — I only use the FS for backup, I have 4TB [in the machine I am posting from now] dedicated to live editing. The Drobo is nice, imo, because it's a consumer-oriented appliance (with RAID built in) that can take any SATA drive, will allow you to mix and match drive capacities on the fly, and they offer 'Time Machine' style automated backups (along with other apps) if you want that sort of thing. Beyond the Drobo, I also do separate backups to portable drives and keep them offsite (as I mentioned above), just as an extra level of paranoia in case my house burns down. If you are really paranoid or into safety, LTO would be a better way to go for this.

Actually, given how little data you (the original poster) might need to backup, an old LTO machine bought on craigslist (LTO 1 will do 100GB, 2 does 200GB) might be the solution. The tapes are relatively cheap, and the format is both open and reverse-compatible for a few generations (so when your LTO 1 craigslist machine dies you can buy an LTO 2 or 3 machine from the same venue and still access your content (and then migrate it forward to LTO 2 or 3)).

Comment: Microsoft? Not SBRI? (Score 5, Insightful) 176

by adam (#34892892) Attached to: Microsoft Seeks Do-Let-The-Bed-Bugs-Bite Patent
Organizations like SBRI are doing really interesting work on genetically attenuated malaria vaccines, and the research isn't as scary as TFS makes it out to be (e.g. comparing it to Jurassic Park). (Here's a detailed slideshow if you want to know the specifics.) The "runaway breeding" the article alludes to is ridiculous — we already have "runaway breeding" of anopheles mosquitoes, and as a result malaria kills a million or more persons per year, mostly in poor countries. The main issue with malaria vaccines is not "runaway breeding," but that eventually mutations may render the vaccine ineffective.

My main question here is: why is Microsoft filing for these patents? They have been involved in biomedics, afaik, only on the software and infomatics side. Bill Gates, through his foundation, is generously giving grants to many organizations doing promising research. I didn't realize that Microsoft was directly involved in the research side of things. Did they buy assignment rights to this research (and potential patent)? Develop it themselves? That, I think, is the bigger story for me — not that this patent has been filed for, but that it's MSFT that is the assignee.

Comment: Cross process != bleach bypass. (Score 1) 359

by adam (#33009024) Attached to: Last Roll of Kodachrome Processed
Thanks for your post — posts like this are why I try to make time to read /. when I have a free moment.

I want to point out that the statement you made at the end of your post is not technically correct (afaik). Three Kings and Blackhawk Down both did a bleach bypass develop, which is not technically a cross process but rather involves either skipping the bleach part of the process, or shortening it by more than half (thereby leaving some silver halide on the film). There is also a similar silver retention process called ENR, designed at Technicolor for Vittorio Storaro, and yields similar results (the blacks are "blacker" etc) with more predictability. Saving Private Ryan was processed by ENR.

I am a digital filmmaker, so anything I have written above may possibly be technically incorrect, but I'm 90% confident I got it right. I do shoot a fair amount of Velvia in my rangefinder/SLRs, however, and absolutely love color reversal film. I am headed to Africa (to shoot a documentary) in a few months, and am pondering my access to E6 labs while I am there (read: probably not likely) and considering whether I should switch over to a negative film (fuji pro 160C I have had good results with), or stick with Velvia 50/100 and attempt to get a lab there to C41 process all of it for me. I could wait until my return to the states to develop it, but my hope is to develop and print my snaps while there and then mail the prints to friends and family as surprise one-of-a-kind postcards.

Comment: Public Performance (Score 4, Interesting) 973

by adam (#32795678) Attached to: A Composer's-Eye View of the Copyright Wars
Actually, what you describe falls under the category of "public performance." To quote ASCAP (one of the two major music rights management orgs),

"Rental or purchase of sheet music or the purchase of a record does not authorize its public performance."

Not saying I agree with that, but there are a lot of intricacies to public performance. See also: NFL threatening suit against bars that have Superbowl[tm] parties and show the game to their clientele. They also tend to sue (or threaten to) people who use the word "Superbowl," which is why all the radio stations promote their "BIG GAME PARTY!" in January, and not any sort of party having to do with bowls that may be super. But that is trademark law and outside the scope of what we're talking about here.

The point is whether he has the right to control what is done with his work. Whether people can make copies of it. Generally, I think the answer is yes. However, I think the real question is: do we want to live in a society where money is what motivates art? The true genius filmmakers, composers, they aren't doing it for the money, and if they are, well, I'll be disenchanted with their work when I find that out. Make art for art's sake. Artists and doctors, two professions that should be about sharing with your fellow humans, about the common good, not about profit. (*imho, of course — and my money is where my mouth is, I'm a filmmaker and people openly pirate my films. Huge pieces of them are on YouTube. I'm okay with it.)

Comment: Mod Troll. (Score 5, Informative) 584

by adam (#32637902) Attached to: What US Health Care Needs

Cuba has a dog and pony show.

...and you know this how, exactly?

I already warned you in my original post not to trot this shit out, because I'm not some idiot who happens to have seen a Michael Moore film and now thinks Cuba is a utopia. Instead I'll choose to believe the guy who runs Harvard Medical School's Social Medicine program (see: end of my original post), Jim Kim MD (former Prof of Medicine and Chair of Global Health for Harvard Medical School, now president of Dartmouth), and the World Health Organization, amongst many other credible sources.

Because I am busy and you make no effort to substantiate your claims, I'm just going to paste a chunk from Tracy Kidder's (Pulitzer Prize winner) biography of Dr Farmer, where Farmer talks to Kidder about dispelling myths about Cuba (and then after that some of Farmer's own writings)...

"For me to admire Cuban medicine is a given," Farmer said. It was a poor country, and made that way at least in part by the United States' long embargo, yet when the Soviet Union had dissolved and Cuba had lost both its patron and most of its foreign trade, the regime had listened to the warnings of its epidemiologists and had actually increased expenditures on public health. By American standards Cuban doctors lacked equipment, and even by Cuban standards they were poorly paid, but they were generally well-trained, and Cuba had more of them per capita than any other country in the world-more than twice as many as the United States. Everyone, it appeared, had access to their services, and to procedures like open heart surgery. Indeed, according to a study by WHO, Cuba had the world's most equitably distributed medicine. Moreover, Cuba seemed to have mostly abandoned its campaign to change the world by exporting troops. Now they were sending doctors instead, to dozens of poor countries. About five hundred Cuban doctors worked gratis in Haiti now-not very effectively, because they lacked equipment, but even as a gesture it meant a lot to Farmer.

One time he got in an argument about Cuba with some friends of his, fellow Harvard professors, who said that the Scandinavian countries offered the best examples of how to provide both excellent public health and political freedom. Farmer said they were talking about managing wealth. He was talking about managing poverty. Haiti was a bad example of how to do that. Cuba was a good one.

He had studied the world's ideologies. The Marxist analysis, which liberation theology borrowed, seemed to him undeniably accurate. How could anyone say that no war among socioeconomic classes existed, or that suffering wasn't a "social creation," especially now, when humanity had developed a grand array of tools to alleviate suffering. And he was more interested in denouncing the faults of the capitalist world than in cataloging the failures of socialism. "We should all be criticizing the excesses of the powerful, if we can demonstrate so readily that these excesses hurt the poor and vulnerable." But years ago he'd concluded that Marxism wouldn't answer the questions posed by the suffering he encountered in Haiti. And he had quarrels with the Marxists he'd read: "What I don't like about Marxist literature is what I don't like about academic pursuits-and isn't that what Marxism is, now? In general, the arrogance, the petty infighting, the dishonesty, the desire for self-promotion, the orthodoxy. I can't stand the orthodoxy, and I'll bet that's one reason that science did not flourish in the former Soviet Union."

He distrusted all ideologies, including his own, at least a little. "It's an ology, after all," he had written to me about liberation theology. "And all ologies fail us at some point. At a point, I suspect, not very far from where the Haitian poor live out their dangerous lives." 'Where might it fail? He told me, "If one pushes this ology to its logical conclusion, then God is to be found in the struggle against injustice. But if the odds are so preposterously stacked against the poor-machetes versus Uzis, donkeys versus tanks, stones versus missiles, or even typhoid versus cancer-then is it responsible, is it wise, to push the poor to claim what is theirs by right? 'What happens when the destitute in Guatemala, El Salvador, Haiti, wherever, are moved by a rereading of the Gospels to stand up for what is theirs, to reclaim what was theirs and was taken away, to ask only that they enjoy decent poverty rather than the misery we see here every day in Haiti? We know the answer to that question, because we are digging up their bodies in Guatemala."

For me, the first sights of communist Cuba were a great relief after Haiti. Paved roads and old American cars, instead of litters on the gwo wout Ia. Cuba had food rationing and allotments of coffee adulterated with ground peas, but no starvation, no enforced malnutrition.



And now some of Farmer's own writing on Cuba. I have chosen a quick general passage on Cuba from his book Pathologies of Power, which also quotes another noted Harvard historian. This book references Cuba in detail in too many places to list. It recounts Farmers experiences of actually visiting many times the palatial estates where Cuban HIV patients receive free medical care (and in fairness I should note recounts how the initial policy was mandatory HIV testing and mandatory treatment there, and how this policy was relaxed after the initial panic of the AIDS epidemic faded — Farmer can occasionally say things about Cuba that are critical too). Don't take my word for it. You can find it on books.google.com. Search "cuba" within it and read a few different pages. Then search his other books. Repeat. Then try to find a way to prove he's somehow not one of the world's foremost authorities on Global Health (good luck here).

Perhaps the Elián Gonzalez story will help to expose some of the hypocrisy surround both our policies toward Cuba and our attitudes and policies regarding Haitians. The idea that the Gonzalez child would have his rights violated by returning to Cuba with his father is laughable, especially if one regards social and economic right as important to child welfare. Harvard historian John Coatsworth put it trenchantly:

"In Cuba, Elián will have his father and the rest of his immediate family, a decent standard of living, free public education through university, cradle to grave medical care, and a relatively crime-free environment. His life expectancy will be about what he could expect in Miami (73 years). His chances of getting into college will be a bit lower. The likelihood of being assaulted, robbed, or murdered substantially less.

In short, Elián's chances in Fidel Castro's Cuba appear to be infinitely better than in most of the developing world. Better than in most places-like Haiti, for example-to which U.S. authorities routinely deport undocumented immigrants and their children. In Haiti, one out of eight children dies before the age of and nearly half have no school to go to. Malnutrition and violence are endemic and male life expectancy at birth is 51 years."


So we have you, with no substantiation, and well, lots of noteworthy experts, at least three of whom (plus the WHO) I've invoked above. Unless you reply and have stellar examples of the "dog and pony show," consider yourself branded a troll, or at best to be uninformed.

Comment: Let's ask the AMA (Score 5, Informative) 584

by adam (#32637798) Attached to: What US Health Care Needs
Don't listen to me, just listen to the AMA instead; they're happy to admit their mistake (although they won't overtly admit the motivation behind it). Basically in the 1980s they wrongly predicted in 10-20yrs we'd have a surplus of hundreds of thousands of doctors and the market would crash (yeah, wouldn't that be horrible, to have too many doctors? I mean, horrible if you want to drive a Lexus and you're a doctor, I suppose...). Of course they got it wrong ("accidentally," I am sure) and overshot in the other direction and now we have a huge shortage. "Whoops." Unfortunate byproduct: ridiculous salaries (mostly for specialists). Not so unfortunate if you're a dermatologist, though.

Some quotes from the AMA themselves:

"Not a single allopathic medical school opened its doors during the 1980s and 1990s ... The surge in new medical schools is taking place as the Assn. of American Medical Colleges predicts a shortage of at least 125,000 physicians by 2025 ... But some experts on work-force issues say new schools are not enough. They say that without more federal funding for residency slots or changes in the doctor payment system, the schools are unlikely to avert an overall work-force shortage or address the undersupply of primary care physicians and general surgeons ... 1 in 3 active physicians is 55 or older."

I think we can agree that it's unreasonable to have 99.999% of the applicants on one side of the line or the other, but beyond that? What about taking only the best 10%, or only the best 90%, would one of those be OK with you?

How about 98% rejection rate? From the AMA article above: "Many private medical schools have 5,000 or more applicants for a class of 100 students."

Again, I hope it comes across, I know something about this issue. I said "ostensibly qualified" and "more than half" in my OP because I didn't want to get into a big debate about the exact percentage of people who apply and are grossly underqualified and rejected versus the legit applicants who are rejected, but basically the former is not happening, since you need to take the MCATs (not easy) and complete the equivalent of a degree in Molecular Biology simply to even apply to med-school (and currently to be competitive you need hundreds of hours of volunteer work, professional medical experience such as EMT work, and even then it is often a crapshoot, I know many qualified applicants who have been rejected more than one year in a row).

Comment: also: more doctors, less pay, more compassion. (Score 5, Informative) 584

by adam (#32637582) Attached to: What US Health Care Needs

If I want to give my patients the best care possible ... This will take science. It will take art. It will take innovation. It will take ambition.

...it will also take the AMA not artificially restricting the number of new doctors. More than half of ostensibly qualified applicants every year are turned away. In the 1800s there were 400+ medical schools in the united states. By the early twentieth century there were less than eighty. The fewer doctors we have, the more each doctor is paid. The AMA carefully guards doctor salaries. This practice can be seen over and over (and resistance to influx of doctors willing to work for cheap) in country after country (the film Salud covers this well).

Furthermore, we need to eliminate the debt load for student doctors. You can't expect doctors to work for lower salaries (as I propose above) when they are graduating with hundred of thousands in debt. Basically we need way more medical schools (or slots in existing schools) and we need to lower their cost in exchange for a willingness to work for less money. This has the benefit of more doctors and lower cost, as well as shifting the pool of applicants to those who want to be DOCTORS and not just those who want to make MONEY or play GOLF all the time (and so on).

Cuba is a perfect example of this. They have better or equivalent health outcomes to the United States, yet they spend a fraction (read: less than 1/20th) as much per person on healthcare. They achieve these same outcomes using finnicky x-ray machines from the 1980s and out of date textbooks. They do this by having the greatest doctor-to-patient ratio of any nation, and by focusing on preventative medicine. But that's evil socialism. Insert dramatic music here. At any given time more than a third of Cuban doctors are voluntarily serving abroad (often in Africa) doing global health work. More than a third. What percentage of American doctors voluntarily serve in Africa? And they have a 98% retention rate, so any claim that this service is to "escape Cuba" is pretty well dispelled. (and just to go on the offensive for a sec, since I don't generally reply to those who reply to me, unless they actually make good points, since as you know /. has a typical signal-to-noise comment ratio... for those who want to doubt my claims above, calling them propaganda, etc, they are backed up by reputable sources. Paul Farmer, for instance, has written extensively about Cuba [and also happens to be the UN Envoy to Haiti and runs Harvard's School of Social Medicine at their Medical School, so he tends to be considered a reputable source] and almost never has a bad thing to say about their healthcare attitudes or outcomes. The list goes on.)

Comment: To address your points. (Score 5, Informative) 688

by adam (#32563472) Attached to: $1 Trillion In Minerals Found In Afghanistan
[1] I don't ignore tax/royalty/dividends that may go to the local government in my original post. I partially address this (mine leases in Mali that are in the hundreds-of-thousands-of-dollars per year), but even if the mines are paying "fair" taxes (etc) to the governments, that implies very little about eradicating poverty in a country that is unstable undeveloped. See: Yemen vs Oman. When something like 90% of US foreign aid comes directly back to the United States (source: Baxter's book, which is full of cites, apologies I don't have it available), I am dubious that the taxes paid by natural resource extraction firms will be any more beneficial to the impoverished people of a region.

[2] Morila did get a $150M loan, yes (source: Joan Baxter). These types of loans usually call for community investment, that is the point of the World Bank (ostensibly anyway), to develop countries, not to make mine owners richer (although you can make a good argument for the inverse! See documentary: Life and Debt). As to whether they got this loan, I tend to trust Joan Baxter on this matter (she's a BBC correspondent, etc), although I don't have her book handy (I loaned it to a colleague).

[3] Claims of community reinvestment are now standard practice, sure. Note: you are citing mining companies press released. According to BP's web site they are "unaware of any reason" that would have caused their "share price movement." This just happens to be a timely example, but I think it's a good one, in that it's pretty obvious what caused their share price movement (I assume their argument would be that they are still quite profitable despite their current environmental catastrophe — while that may be true, this argument is spin, at best). I am extremely dubious of any claims made by mining interests as to what they are investing in communities. I'd rather believe neutral sources (like BBC reporters) who actually VISIT these areas and report on what they've seen. "Investing" $240,000 might mean they have a $200,000/yr consultant on payroll and he had $40,000 in expenses while "researching" how to help the community.

Quoting your press released, "in areas where there had been little economic activity other than subsistence farming..." Maybe those farmers were happy. Now there is "economic activity" there, but are the farmers more or less impoverished? I'll bet more. We are debating whether minerals in undeveloped countries bring people out of poverty, mind you, not whether mining companies pay taxes.

[4] Ghana is the most stable of western African countries, and thus the least applicable to Afghanistan. Nevertheless, I'm happy to talk about it. I'll be spending three months in Ghana this year doing infectious disease work, so I'm reasonably versed on its issues. As you stated, Ghana might be the best case example. Even so, a third of the country lives on less than a dollar a day, and although that percentage has come down a lot, and they may well meet their MDG for poverty by 2015, it's still not great. More than half the country lives on less than $2/day. 40 years ago South Korea and Ghana had the same per capita income (source: council on foreign relations). Still think mining has brought Ghanaians out of poverty? PPP GDP nowadays for Korea = $27000, Ghana = $1400. No contest as to who is still mired in poverty. I'll admit that I have a biased perspective, when I see children dying because their parents couldn't afford the twenty-six cent cost of a measles inoculation, three dollars for malaria treatment, or ten dollars for a bed net. And I have yet to witness mining or oil extraction doing much to help fix this. Sierra Leone, Nigeria, etc, the story is always the same ... as the "subsistence" farmers if their lives are better after the "economic activity" came to their region, and the answer is invariably: NO.

[5] To address the last sentence of your post, "But, the assumption that mines are inherently destructive, and that mining companies are inherently evil, is wrong." I content this sentence shows you know very little about mining. I'll simply link this report about gold mining ("Dirty Metals: Mining Communities and the Environment details the massive pollution, huge open pits, devastating community health effects, worker dangers and, in many cases, human rights abuses that have become hallmarks of gold and metals mining in countries such as Peru, Indonesia, Ghana and in parts of the United States."). Or if you don't like my source you can simply google "gold" and mercury/cyanide/pollution/dirty/etc and see what pops up. And just to drop one figure from Baxter's book, a single gold ring can produce 20 tons of mine waste.

Your post was well-written and logical. Thank you for engaging in intelligent discourse (if you look at my prior posts you'll see I rarely reply to those who reply to me, because usually they don't take the time to read + comprehend my original posting). I'd be even happier if you decide to reply again and don't click the AC button. I have work to do now, so I'll see any future replies at a later time (and likely I won't have time to reply), but thanks for your thoughts ... conversations like these are why I read /.

Comment: Mineral deposits almost never reduce poverty. (Score 5, Informative) 688

by adam (#32562724) Attached to: $1 Trillion In Minerals Found In Afghanistan
If you think mineral deposits "wipe out poverty" you ought to travel to west Africa.

The vast majority (99%+) of Sierra Loeneans who spend their lives in poverty, toiling to find diamonds, have never seen a finished and cut diamond. Many never even find a single diamond. Sierra Leone ranks amongst the five least developed countries.

A single gold mine in Mali will produce $1.5BN (USD) and has made a 0.07% reinvestment ($100k) in schools from its World Bank loan. The words of one worker, “[w]e read on the Internet that AngloGold has pronounced that Morila is the most profitable gold mine in the world, and yet most workers here get no lodging or training, or even health care. In South Africa, AngloGold is paying for the anti-retrovirals for its staff that are HIV-positive, and here they take all our medical costs out of our salaries.” Mine companies often pay only hundreds of thousands of dollars per year in lease fees.

Rutile is 95% titanium dioxide and Sierra Leone’s deposits of rutile may account for as much as 30% of the world’s supply, and the U.S. government lists it as a “strategic metal” to be stockpiled by the U.S. defense department. Sierra Leone is pock-marked by destroyed farmland and displaced communities, all in the name of rutile and diamond minining.

Another poster made an allusion to the mid-east, but Africa I think is a much better example as oil actually has been good for the average person in some mid-east countries, but these are fairly stable and developed countries. To look at natural resource reserves in unstable and undeveloped countries, versus stable, one only has to look at Oman and Yemen (both oil-rich and neighbors, one has GDP per capita 10x of the other). West Africa is a much better comparison to Afghanistan than Kuwait or the UAE (so if you want to make the mid-east comparison, skip Dubai and look at Yemen).

For a good read (and my source for much of the info above) I would recommend Joan Baxter's Dust from our Eyes.

Comment: GM's eyes are bigger than its stomach ... (Score 5, Insightful) 206

by adam (#31605194) Attached to: GM Unveils Networked Electric Mini Cars
"...and can be operated autonomously or under manual control. In autonomous mode the EN-V is designed to use high-speed wireless connectivity and GPS navigation to automatically select the fastest route, based on real-time traffic conditions gleaned from the Web or some other networked source of traffic information."

Seriously? Toyota — the guys who ate your lunch in the marketplace — can't even make a software-gas-pedal work correctly and you're trying to float an EV that navigates autonomously? Good luck with that. You guys need to stick to trying to make what people want now, not what Shatner fanboys are hoping will exist in 20 years. There are so many technical problems here I don't even know where to start. GPS can't detect when little kids run into the road chasing a soccer ball. Trust me, just work on making the Volt not suck, and maybe try to do something like the Aptera, and you'll be just fine.

On a serious note, I don't get why companies introduce "concept" cars with shit they know can never exist in the near future, and with shit no one wants either. If the idea of a concept car is to "WOW" me with all the stuff you're working on making in the next 10 years, how about you start bragging about high density energy storage and biodiesel powerplants that run on algae-derived fuel. This is the stuff people want that isn't practical yet, but might be someday soon[ish]. No one gives a shit about Segway gyro (remember how well the Segway sold?*) and autonomous driving is best left for SciFi films.

*Dean Kamen is a complete badass, though, and despite his misunderstanding of the market, DEKA's other work is amazing.

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