14 October 2001
1,748 words

Medical Writers in NYC
recovering from WTC bombing;
UK medical journal coverage beats US

Why they hate us:
"Stopping cancer treatments will not topple a dictatorship"

NEW YORK -- For a week after the World Trade Center bombing, every writer I knew was depressed and unable to work. Now we're recovering.

None of the writers in my community is missing -- though some of them lost clients or sources (and friends) in the WTC.

Some Muslim writers were harassed. In Chicago, mobs with molotov cocktails attacked Muslim neighborhoods, overwhelming the police. Science and religion writer Ibrahim Abusharif, who subscribes to my list, peacefully confronted the mob by joining their demonstration with American flags, and overcame their hostility.

The British medical journals had excellent coverage, some of it by writers on this list. BMJ , Lancet, Lancet .

Their American counterparts did not inspire confidence in the new editors. JAMA ignored the WTC bombing [as of this writing]. The NEJM did worse than nothing -- in a timid, banal editorial ("September 11, 2001" ), they wrote, "We are physicians, not politicians... we must act on the core value of our profession: healing."

So they're saying we should leave politics to politicians, not to citizens.

For a doctor who does believe in politics, see the 1999 Nobel lecture of James Orbinski, of Medecins Sans Frontieres (Doctors Without Borders) .

Following is what doctors were saying in the British journals.

Courageous editors

The NEJM has had more courageous editors in more dangerous times. In 1962, after the Supreme Court suspended the First Amendment (Dennis v. U.S., 341 U.S. 494 (1951)) , editors were still in jail for challenging the government. Linus Pauling lost his US passport, and his freedom to travel, because of his non-violent political beliefs.

In 1962, VW Sidel et al challenged President Kennedy's claim that 97% could survive nuclear war with bomb shelters. Sidel et al concluded that medical efforts were futile, and the only effective intervention was prevention. ("The Medical Consequences of Thermonuclear War," N Engl J Med 31 May 1962;266:1126-1174).

There were doctors in 1962 who argued, "We are physicians, not politicians." Sidel et al argued that physicians, because of their special knowledge, and their special responsibility for patients, had a special responsibility to prevent the use of nuclear weapons, by political action, even working with the enemy -- Soviet doctors. Nobel prize

Medical journalists also have special knowledge and responsibility, and often the medical story leads into politics, and into painful facts.

After Sept. 11, American politicians called again for censorship, and many American journalists, notably William Safire of the New York Times , disgracefully agreed. British journalists, including BBC-trained Arab journalists at Al Jazeera, and the Emir of Qatar, in contrast defended press freedom and the need to hear all sides of the debate.

Why they hate us

Unlike the NEJM, British doctors and journalists addressed the root causes of the WTC bombing, in words that in the US are reviled as "pacifist," or unpatriotic bordering on treason.

The US "must ask itself why it is so disliked," wrote Douglas Holdstock, FRCP (Reacting to Terrorism, BMJ 328:822) One reason, said Holdstock, is the US refusal to approve multilateral treaties, including those designed to prevent terrorism: the international criminal court, the Convention Against Terrorism, the Convention on the Illicit Trade in Small Arms, and the verification protocol for the Biological Weapons Convention. The ultimate need is the eradication of the causes of terrorism, usually territorial. "US support for Israel is a principal cause of its unpopularity," said Holdstock. (This is confirmed in Arabic polls, wrote Gary Kamiya in Salon . While Osama bin Laden probably has no sincere concern for Palestinians, he is exploiting an issue strongly felt by Muslims around the world. The Israelis are violating international law, while the Mitchell report offers a practical, fair solution, which Israeli PM Sharon rejected, wrote Kamiya. The US must use its leverage of $3 billion a year foreign aid, and insist on ending the settlements, he said.)

Even educated, westernized Muslims who are sympathetic to the US consistently express irritation over American hypocrisy and double standards on human rights and terrorism, particularly in Israel and Iraq.

Iraq embargo

One charge made by bin Laden, which is confirmed by independent medical monitoring groups, is that US- and UK-imposed sanctions on Iraq have caused somewhere around 0.5 to 1 million deaths of children alone. ("Iraq sanctions lead to half a million child deaths," BMJ 9 Dec 1995;311:1523 , "Sanctions against Iraq 'double' child mortality, 16 Dec BMJ 2000;321:1490 ; Rep. John Conyers (D-MI) ; contrary views from Chris Suellentrop, "Are 1 Million Children Dying in Iraq?" Slate 9 Oct 01 , ; US Department of State , Michael Rubin, Washington Institute for Near East Policy; response from Voices in the Wilderness .)

The embargo prevents medical books and journals , radiotherapy sources, chemotherapy and analgesics from reaching Iraq, leaving cancer patients untreated.

Notwithstanding Saddam Hussein's brutality, sanctions have not accomplished their purpose, are killing innocent people, and should be stopped, doctors said in the BMJ. "Stopping cancer treatment will not topple a dictatorship," wrote Karol Sikora, chief, WHO Cancer Programme. (Further articles can be found by searching BMJ and Lancet for "Iraq".)

Self-indulgent pigs

"I am sick of hearing how we're such self-indulgent pigs, we brought this on ourselves," said one science writer. Well, hear it again. We are self-indulgent pigs, and we did set up bin Laden and the Taliban.

Some American journalists don't know that the forces which became the Taliban and Osama bin Laden's terrorist network were created, trained, equipped, and organized with billions of dollars from the CIA to fight the Soviets in Afghanistan. (Blowback, Mary Anne Weaver, Atlantic, May 1996, 277(5):24-36 ; Blasts from the past, Ken Silverstein, Salon, 22 Sep 2001 ; The CIA's Intervention in Afghanistan, Interview with Zbigniew Brzezinski, Le Nouvel Observateur, 15-21 January 1998 ; Reaping What We Sowed in Afghanistan, David Corn, TomPaine.com for followup questions with Brzezinski). They did to us what we taught them to do to others.

2 days after the WTC bombing, the US belatedly agreed to pay $582 million outstanding UN dues, of its $2.33 billion total. In June, the UN announced a Global Health Fund of $7-10 billion, but pledges have reached only $1.3 billion ( BMJ 323:186 ).

We could be saving tens of millions of lives worldwide for less than we spend on alternative medicine. We could save a woman's life for the cost of pizza. Women in east Africa have 1 in 12 chance of dying in childbirth; interventions could save lives for $3 per woman and $230 per death averted. ("Reducing maternal mortality in the developing world," BMJ 14 April 2001;322:917-920 .

IMF, World Bank

Even worse, say medical relief groups, US-backed World Bank and International Monetary Fund policies have actively harmed third-world health care with currency devaluation and privatization. In Tanzania and Kenya, IMF-imposed user fees have made health care unaffordable for poor rural women. ( BMJ 323:120-121 )

Countries that can't afford US drugs have patent laws that allow cheap generic manufacture, but pharmaceutical companies, through US trade representatives, have pressured those countries to stop exercising even their rights under international laws. ("Look at Brazil," Tina Rosenberg, New York Times Magazine ) Fortunately, pharmaceutical companies and US trade representative have been backing down. How can anyone defeat doctors who work unarmed in Chechnya and Lebanon to treat abandoned patients?

David Earnshaw, a senior SmithKline executive, "defected" to Oxfam ("Drug company lobbyist joins Oxfam's cheap drugs campaign," Roger Dobson BMJ 28 Apr 2001;322:1011 ). Earnshaw accused the industry of "crass stupidity" with their high-price, low-volume strategy that only gets "medicines to rich people," which is both immoral and bad business.

No panaceas

Yes, the killers who flew into the WTC were western-educated and financially comfortable, driven by ideology, not poverty, and would hate the US whatever we did. But their ideology grew in a world of poverty and early death, much of it caused by US policies. [New Scientist editorial] . It grew in a world in which the US government had announced it would have no responsibility for world poverty, it would further the interests of global corporations at the expense of lives and public health, and it would offer the free market as a panacea for all problems. We've overthrown democratically elected governments and supported military dictatorships and terrorists, including the Afghan "freedom fighters" who are now using our own terrorist training against us.

If we have no concern for their lives, why should they have concern for ours?

Americans have been living in a comfortable delusion. We have a president who doesn't know that Africa is a continent, who doesn't know what the Crusades were, who can't name a favorite book, and who has no idea why terrorists would bomb us. Americans think they are Lady Bountiful, bestowing charity to the grateful children of the world. The British keep saying, "You don't understand, there are serious problems." And they're right. It's our responsibilty to report the painful facts. If we don't, who will?

--Norman Bauman