August in Africa- Blog I

I will be spending the next several days in Africa, visiting Ethiopia, Mali and Cote d’Ivoire. My primary purpose of the trip is to look, first hand, at the way our HIV/AIDS money is being spent. I will also be giving some diplomacy speeches and meeting with officials of the government and civil society in each country. I am joined on the trip by Dr. Julie Gerberding, Director of the Centers for Disease Control and Prevention, and Admiral Tim Ziemer, who heads the President’s Malaria Initiative.

Our travel plan included a stop overnight in the Azores. These are nine small islands populated by about 250,000 people and located about 900 miles off the coast of Portugal. It is a charming place. During our approach to land at Lajes Field, a base operated jointly by the United States and Portugal, you could see miles of stone hedges separating fields. The hedges are built as a practical means of subdividing the land, and are also a way to use the rocks gathered from the fields, making the fields easier to cultivate. Hedge-building must be an art-form passed from generation to generation. The hedges are remarkably sturdy, yet built without mortar.

The visit to the Azores turned out to be an unexpected bonus to the trip. It is always gratifying to see the U.S. military at work. Colonel Jack Briggs is the Wing commander and senior U.S. officer. There are about 1,000 U.S. personnel and the same number from Portugal who operate the facility.

The base has four primary purposes: facilitating equipment that is being shipped to and from the United States and various theaters (the base is a giant gas station for planes), maintaining the global communications gear necessary to communicate while in the region, training and readiness of troops, and finally enhancing the relationship with Portugal.

We were hosted for dinner by Colonel Briggs’ team and the two most senior Portuguese officers on the base. The dinner illustrated the unique nature of the working relationship between our two nations on the base. In the small world category, the Vice Commander on the U.S. side, Colonel Paul Suarez, was the brother of a former colleague of mine at the Environmental Protection Agency.

After dinner, we drove to a town just a few miles away and walked through a festival that reminded me a lot of a county fair in the United States, except everybody spoke Portuguese. Aside from the somewhat isolated nature of the Azores, it seemed like a peaceful and graceful place to live.

Comments

Re: Physician Conscience Blog 2

I wanted to say that I loved this Blog. I thought this was VERY smart. Yes we protect free speech, etc but not conscience?

I just wanted to say that it was such a smart answer and I loved the response - how it was worded, etc.

Very smart and well written response. People have had the opportunity to follow their conscience in past and this is directly part of our freedoms.

I especially liked how you worded about the pro-life and abortion issue. Abortion is legal and is not effecting that.

I really cannot add to what Mike Leavitt said as I just thought it was really well written, worded and thought out. Just wanted to comment how much I loved his response!!!

Posted by: Dawn Simon | August 14, 2008 at 06:48 PM

If as you say, it currently violates 3 federal laws to compel a physician to do something that is against their conscience, then there is no need for additional protection. Your argument doesn't make one bit of sense. Physicians in this country are for the most part highly trained, ethical, and critically thinking people who decide each and every day how they will practice medicine, and they are not clamoring for more "conscience protection". There are many better ways in which you could help physicians if that is your intent.

Posted by: Becky Lieberman | August 18, 2008 at 04:30 PM

Lets do a better job of providing birth control so we don't even have to have the discussion about abortion.

Posted by: BEcky Monson | August 19, 2008 at 06:32 PM

When I was a young girl I remember one of my older sister's friend having a botched abortion and dying. witholding contraceptives to women who need and use them is archaic and barbaric. If this were a man's issue you can bet there would be plenty to go around. Why are we giving doctors so much power? This is a disgrace and I respectfully demand that they be required to give women the means to protect themselves.

Posted by: Judi Bennett | August 19, 2008 at 07:04 PM

Are we living on the Planet of the Apes? My family, devoutly religious, farm-dwelling Protestants used--and preached--contraceptives for generations. In a world where human procreation is forcing many, many animals into extinction as a consequence of our sheer numbers (and our arrogance!), contraception is a sane choice; and the right to it should be protected as a basic right--just as it has been for the generations that have gone before us.

Posted by: Sharon Gillespie | August 19, 2008 at 07:18 PM

Please do not limit access to birth control, especially for the poor. You have no right to impose your religious beliefs on those who cannot afford to have more children. You will cause more unwanted children, more starvation, more crime, more senselessness and poverty. Tend your own family and life. Let others make their own decisions and choose their own beliefs.
Hitler thought he was right, too. You don't want to be remembered as a destroyer.

Posted by: Nancy Lester | August 19, 2008 at 07:27 PM

Doctors have a duty to their patients regardless of whether or not they personally agree with the patients' decisions. It's time for the ultra conservatives to shut up and back off from things that are not their personal business.

Posted by: Donna Naylor | August 19, 2008 at 07:45 PM

PROTECT A WOMEN'S RIGHT TO BIRTH CONTROL. MY DAUGHTER NEEDS THE PILL FOR MEDICAL REASONS.

Posted by: Robert Yunk | August 19, 2008 at 08:59 PM

As is often the case whose rights are paramount? How can everyone act according to his/her own conscience? We are talking about women's rights here and these rights should not be taken away. Doctors should be able to follow their conscience and not provide a service if it goes against their concience but be able to refer a patient to someone who could help.

There are times we may disagree with someone's ideas and/or rights but we should be able to guarantee the rights just the same. Why should personal ideologies rise above allowing someone else their rights?

Posted by: | August 19, 2008 at 09:05 PM

Senator Leavitt, Birth control is not abortion, in fact if women had access to birth control, I believe the need for an abortion would decrease. Are any of these people who oppose brith control offering to take a child born into poverty and a life of potential abuse, to take responsibililty for an unwanted pregnancy. I don't think so. When, as Govenor of Utah you stood in the Capital and encouraged people to adopt or become a foster parent, I would have had more respect for you if you had led by examnple, after all you could certainly afford more children. Govenor Huntsman by contrast, has been a shining example of utting his money and heart where his mouth is" Do not punish woman and families who can barely take care of one child in todays economy, by denying them birth control based on someone elses moral judgement. Thank You

Posted by: Kathleen S pearce | August 19, 2008 at 10:51 PM

Dear Secretary,
Please Protect Women On Birth Control And So We Want Women To Be Protected!
Thanks,
Elizabeth

Posted by: Elizabeth | August 19, 2008 at 11:59 PM

It is quite interesting to see the variety of twists in rhetoric that are coming forth as a result of the so-named 'conservative' view on family planning. As a woman and a health-care practitioner, I most assuredly have views regarding what aspects of sexual/reproductive behavior are ethical and which are not. It is quite clear to me, however, that a woman's right to choose birth control for her own well-being and for the integrity of her family life is not to be interrupted by someone else who has no entry into her personal environment. Be that of her home, or her relationship with husband/partner or God.
The notion that a physician or pharmacist can refuse to provide birth control methods to a woman is outrageous. Another marker of the increase, yet again, in rendering female members of society less powerful than those who have been able to acquire a larger share of influence or political power.
We know that many fertilized eggs do not come to the status of implantation or further development. To state that one will refuse birth control methods to a patient/client because it is a form of abortion is stuff and nonsense. Rendering both the health care practitioner and the woman less effective than each might be in a more sensible environment. One that we hope to achieve by insisting on an approach that has empirical worth while providing support for a satisfactory quality of life for women and families.
Thank you for your consideration in the direction of reason, respect and fairness.

Posted by: Kate Walsh RN | August 20, 2008 at 02:00 AM

Iam appalled by this goverment that thinks it is in the business of legislating morality. It is a Physicans responsiblity to provide medical care to their patients not subjecting them to their own personal beliefs. There are things in this life that we all have to do whether we like it or not. Women are entitled to all their choices concening their physical well being.You probably think that it is acceptable for insurance companies to pay for Viagra but not birth control! Shame on you.

Posted by: Lorraine Farrell | August 20, 2008 at 06:17 AM

I ask you, Secretary Leavitt, not to impose the new HHS reglation. Women need access to the medical care that fits the dictates of THEIR consciences. There are too many ways for powerful political and corporate forces to overwhelm individual doctors and medical clinics, making it difficult or frightening to help women determine the paths they want to choose for their lives and medical care. We in the U.S. need to back off from regulating so many aspects of individual choice and let people and their doctors make their own decisions without fear of attack or repecussions from forces outside their lives.

Posted by: Wendy Andersen | August 20, 2008 at 07:23 AM

I want my access to birth control protected. Period.

Posted by: Lisa Mulrane | August 20, 2008 at 08:45 AM

The method of Birth control is a womens right. Do any of you men in the Bush administration know the numbers of women mamed or killed due to illegal abortions prior to the legalization of the procedure. How many women were forced into these procedures by the every men that forced themselves on women. How many women lost their lives due being beaten by the men they had children with. There is no reason strong enough to turn back to these times. Women need birthcontrol to ensure their own safety. I beleive that birthcontrol choice is for women to decise with the guidance of her doctor, period!

Posted by: Donna Snyder | August 20, 2008 at 10:28 AM

In our country, we correctly treasure religious freedom. This requires, among other things, that one person's beliefs, such as the moment of conception, not be imposed on another person. If a person wishes to be employed to provide a service to others, his beliefs should remain private and not be imposed on others.

Posted by: Carleton Spotts | August 20, 2008 at 10:57 AM

Make are women of today and are future women of the world have a choice .

Posted by: Mary Mattio | August 20, 2008 at 12:49 PM

As a family therapist and custody mediator, I am alarmed at the wanton disregard the administration has shown for the realities of our population generally. But especially, the choice for young families without means are narrowing drasticly. This is particularly true of young moms whose parenting is too often undercut by the power and control behaviors of men they are with or have worked hard to leave. It is their children who are the living sacrifices and quickly become the next and growing crop of budding character disorders. As a systems therapist, I notice the parallel cultural attitudes that promote narcisstic posturing in place of mature substance in the young and uneducated that exactly reflect this loss of wisdom at the highest levels. Unless we are in fact committed to escalating predator/prey relationships in families, we must begin to standup for 'real' self-determination and pro-social individuation which is Realistic in acknowledging our mutual interdependence! If there was ever a time to promote and protect family planning, NOW is that time.

Posted by: Darcy Skarada, LMFT | August 20, 2008 at 01:22 PM

A doctor should provide services on behalf of the patient's interests. A doctor should not provide healthcare based solely on his or her interest. Patients should have a fundamental right to healthcare and should not be denied acess to it. Why is Viagra covered by insurance but not contraceptives in many insurance policies?

Posted by: Tim Wright | August 20, 2008 at 09:58 PM

Thank you for increasing awareness and support for federally funded health care providers' right of conscience, including the right to refuse involvement in abortions or sterilizations on moral grounds. Careful reading should demonstrate to the reader that they are not deprived of any services. The individual providers' rights are protected, however, as they should be and have been in the past. It should be noted that this highlighted awareness does not change existing laws.

Posted by: Karolyn Gladdys | August 24, 2008 at 04:32 PM

I submit this post in opposition to the HHS proposed rule to allow medical personnel to deny women birth control. This regulation marks a set back not only for women, but patients. It opens the door to allowing all people who work in health care settings to decide who gets care and who doesn't. Under the banner of "conscience" , it allows other people, and not just doctors and nurses, to intrude in other people's important life decisions. Ostensibly, this is about abortion, but it is easy to see that this regulation can impact the availability and access to birth control, stem cell research, palliative care, in vitro fertilization, and even liver transplants in the case of alcholics. Secretary Leavitt, these regulatons you propose undermine the goals of Healthy People 2010, particularly those on family planning. It's release on Women's Equality Day adds to the sting, as the ability of women to make their own decisions about when to have a family is key to their attaining equality. I respectfully ask you to live up to your responsibility as the nation's lead decisionmaker on health and withdraw this proposed rule.

Posted by: A.P. Camp | August 27, 2008 at 10:18 AM

Abortion kills a baby. Planned Parenthood is the nation's largest abortion provider. To say good things about them is like saying good things about "the final solution" of the last generation. Go to abortionfacts.com., sidebar "Abortionists Speak" to find out what this dirty business is really all about.

Posted by: | August 27, 2008 at 02:32 PM

At a time when our earth, and our very existence is threatened by over population, we should be honoring EVERY desire to curb our over burdened little planet. Birth Control and Abortion should be easy, and inexpensive.

Posted by: Diana K. Perkins | September 03, 2008 at 02:14 PM

As has been mentioned by many, a major component of the physician-patient relationship is the notion of trust. A patient will simply not allow themselves to be treated by a physician whom they do not trust to be doing what is in their best interest. Intimately tied to any relationship where trust is foundational is integrity. When a person in their conscience believes that something is wrong, yet they do it anyway, we say that such a person would not be acting with integrity. How is it then that we can possibly ask healthcare professionals, who are dealing with the lives of people, to act against their own conscience. We would be ultimately wanting them to undermine and disposing of their integrity. To anyone involved in this debate, do you prefer the person caring for you and your family's physical well-being, to possess or lack integrity?

Posted by: Rafik Hanna, M.D. | September 04, 2008 at 10:38 AM

Why is it always white men who put forth such ludicrous restrictions on women. Does it bother you that we are able to run our own lives, take care of ourselves and don't need a man to tell us what to do?
I think Katha Pollit had the best idea. Install a peter meter on men and tax them everytime they ejaculate. This would help pay for all of the men that do not contribute to the well being of the children they helped bring in to this world.
It is outrageous that someone like you is allowed to have anything to do with women's health. You were handpicked for this very reason. What you are doing is unethical and without integrity so it is funny that you talk about conscience.
If you think women won't hit the street again....you are also crazy!

Posted by: Gayla Winger | September 23, 2008 at 01:18 PM