Re: [Marxism] One Hundred Hours with Fidel

["Sayan Bhattacharyya" <ok.president+marxmail@xxxxxxxxx>]

On 1/20/07, Walter  Lippmann <walterlx@xxxxxxxxxxxxx> wrote:

> Listen, nobody can ensure that revolutionary changes are going to
> occur in Latin America now. But neither can anybody ensure that they
> could not happen at any time in one or more countries. If you
> objectively analyze the economic and social situation in certain
> countries, you cannot be in the slightest doubt that it is a matter
> of an explosive situation. The rate of infant mortality is, for
> example, 65 per 1,000 live births in several of those countries; ours
> is less than 6.5; 10 times more children die in Latin American
> countries, on average, than in Cuba.

In Turnabout, Infant Deaths Climb in South

Copyright 2007 The New York Times Company
By ERIK ECKHOLM
April 22, 2007

<http://www.nytimes.com/2007/04/22/health/22infant.html?hp>

HOLLANDALE, Miss. — For decades, Mississippi and neighboring states
with large black populations and expanses of enduring poverty made
steady progress in reducing infant death. But, in what health experts
call an ominous portent, progress has stalled and in recent years the
death rate has risen in Mississippi and several other states.

The setbacks have raised questions about the impact of cuts in welfare
and Medicaid and of poor access to doctors [...]

"I don't think the rise is a fluke, and it's a disturbing trend, not
only in Mississippi but throughout the Southeast," said Dr. Christina
Glick, a neonatologist in Jackson, Miss., and past president of the
National Perinatal Association.

To the shock of Mississippi officials, who in 2004 had seen the infant
mortality rate — defined as deaths by the age of 1 year per thousand
live births — fall to 9.7, the rate jumped sharply in 2005, to 11.4.
The national average in 2003, the last year for which data have been
compiled, was 6.9. Smaller rises also occurred in 2005 in Alabama,
North Carolina and Tennessee. Louisiana and South Carolina saw rises
in 2004 and have not yet reported on 2005.

[...]

Most striking, here and throughout the country, is the large racial
disparity. In Mississippi, infant deaths among blacks rose to 17 per
thousand births in 2005 from 14.2 per thousand in 2004, while those
among whites rose to 6.6 per thousand from 6.1. (The national average
in 2003 was 5.7 for whites and 14.0 for blacks.)

The overall jump in Mississippi meant that 65 more babies died in 2005
than in the previous year, for a total of 481.

The toll is visible in Hollandale, a tired town in the impoverished
Delta region of northwest Mississippi.

Jamekia Brown, 22 and two months pregnant with her third child, lives
next to the black people's cemetery in the part of town called No
Name, where multiple generations crowd into cheap clapboard houses and
trailers.

So it took only a minute to walk to the graves of Ms. Brown's first
two children, marked with temporary metal signs because she cannot
afford tombstones.

Her son, who was born with deformities in 2002, died in her arms a few
months later, after surgery. Her daughter was stillborn the next year.
Nearby is another green marker, for a son of Ms. Brown's cousin who
died at four months, apparently of pneumonia.

The main causes of infant death in poor Southern regions included
premature and low-weight births; Sudden Infant Death Syndrome, which
is linked to parental smoking and unsafe sleeping positions as well as
unknown causes; congenital defects; and, among poor black teenage
mothers in particular, deaths from accidents and disease.

Dr. William Langston, an obstetrician at the Mississippi Department of
Health, said in a telephone interview that officials could not yet
explain the sudden increase and were investigating. Dr. Langston said
the state was working to extend prenatal care and was experimenting
with new outreach programs. But, he added, "programs take money, and
Mississippi is the poorest state in the nation."

Doctors who treat poor women say they are not surprised by the reversal.

"I think the rise is real, and it's going to get worse," said Dr.
Bouldin Marley, an obstetrician at a private clinic in Clarksdale
since 1979. [...]

Another major problem, Dr. Marley said, is that some women arrive in
labor having had little or no prenatal care. "I don't think there's a
lack of providers or facilities," he said. "Some women just don't have
the get up and go."

But social workers say that the motivation of poor women is not so
simply described, and it can be affected by cuts in social programs
and a dearth of transportation as well as low self esteem.

"If you didn't have a car and had to go 60 miles to see a doctor,
would you go very often?" said Ramona Beardain, director of Delta
Health Partners. The group runs a federally financed program, Healthy
Start, that sends social workers and nurses to counsel pregnant
teenagers and new mothers in seven counties of the Delta. "If they're
in school they miss the day; if they're working they don't get paid,"
Ms. Beardain said.

Poverty has climbed in Mississippi in recent years, and things are
tougher in other ways for poor women, with cuts in cash welfare and
changes in the medical safety net.

In 2004, Gov. Haley Barbour came to office promising not to raise
taxes and to cut Medicaid. Face-to-face meetings were required for
annual re-enrollment in Medicaid and CHIP, the children's health
insurance program; locations and hours for enrollment changed, and
documentation requirements became more stringent.

As a result, the number of non-elderly people, mainly children,
covered by the Medicaid and CHIP programs declined by 54,000 in the
2005 and 2006 fiscal years. According to the Mississippi Health
Advocacy Program in Jackson, some eligible pregnant women were
deterred by the new procedures from enrolling.

One former Medicaid official, Maria Morris, who resigned last year as
head of an office that informed the public about eligibility, said
that under the Barbour administration, her program was severely
curtailed.

"The philosophy was to reduce the rolls and our activities were
contrary to that policy," she said.

Mississippi's Medicaid director, Dr. Robert L. Robinson, said in a
written response that suggesting any correlation between the decline
in Medicaid enrollment and infant mortality was "pure conjecture."

[...]

Oleta Fitzgerald, southern regional director for the Children's
Defense Fund, said: "When you see drops in the welfare rolls, when you
see drops in Medicaid and children's insurance, you see a recipe for
disaster. Somebody's not eating, somebody's not going to the doctor
and unborn children suffer."

Visits with pregnant women and mothers in several Delta towns suggest
that many poverty-related factors — including public policies,
personal behaviors and health conditions — may contribute to infant
deaths.

Krystal Allen, a cousin of Jamekia Brown's, was 17 when she had her
first baby. When he was 4 months old, she said, he developed breathing
problems. Ms. Allen took the child to an emergency room, where he was
put on a vaporizer and given an antibiotic and a prescription and they
were sent home, where they slept for a few hours.

"When I woke up I thought he was sleeping, and I was getting ready for
church," Ms. Allen said. "But he was dead."

Now 21, a mother of two with a third on the way, Ms. Allen lives in a
sparsely furnished house in Hollandale with her unemployed boyfriend
and his mother. Her children live with her parents.

Ms. Allen greeted visitors with breakfast in hand: a bottle of
Mountain Dew and a bag of chips.

Janice Johnson, a social worker with Delta Health Partners, urged her
to eat more healthily. "I'm going to change my diet one day," Ms.
Allen replied.

She had been to a doctor for one visit but had to sign up for Medicaid
to get continued care. That required a 36-mile trip to an office in
Greenville.

"Can't you go this Friday?" Ms. Johnson asked.

"Well, if my mom is going to Greenville," Ms. Allen replied, "and if
she has gas in the car."  [...]

In the past 10 years, the infant mortality rate for blacks in most of
the Delta has averaged about 14 per thousand in some counties and more
than 20 per thousand in others. [...]

Copyright 2007 The New York Times Company

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