During the presidency of Bush, his administration's agenda of "compassionate conservatism" with its emphasis on market-based, rather than government-sponsered, approaches to health care services and income support, has been rejected by Democrats innumerable times. This philosophical conflict has resulted in stalemates on many health care issues, and the administration's proposed 2009 budget, which calls for reductions of 200.9$ billion in Medicare and Medicaid spending over the next 5 years, only deepens the political divide. Bush has remained resolute, though, in fulfilling one early campaign pledge that most Democrats enthusiastically embrace: doubling the number of community health centers (CHCs) over a 5 year period so that millions more people who lack insurance or have limited access to private medical care can be treated as publicaly funded facilities. Bush's commitmement persuaded more Republicans to support CHCs, and the result has been a politically effective bipartisanship on this front.
The CHC initiative was launched by Lyndon B. Johnson duirng the administration's War on Poverty and got its inspiration from a South African movement that had offstarted the creation of facilities where poor workers could receive both public healht services and medical care. The primary goals were combining these disparate models and removing financial barriers to access. These goals, along with an emphasis on empowering the community to participate in decision making for CHCs by requiring that the majority of their board members be patients, were build into the centers' operating principles.
Reflecting this "power to the people" philosophy, the funding mechanism for CHCs consists of federal grants that bypass state governments and flow directly to these nonprofit, community-based organiztions. CHCs now number 1200 nationally and operate in some 6000 urban and rural sites in every state and territory and served an estimated 16.3 million people this year. 40% of the patients are uninsured and 35% are covered through Medicaid, with the remainder on Medicare or private insurance. Patients who are uninsured pay according to a sliding scale based on their ability to pay [like Esperanza in North Philly].
2/3 of CHC patients are memebers of racial or ethnic minority groups and many lack proficiency in English. More than 2/3 live on incomes at or below the federal poverty level and more than 92% have incomes below 200% of this threshold. Because their population is relatively young and disproportianly made up of young women and children, there is a high demand for primary care services.
Still, the mix of private and public activities that make up the health care system presents the centers with major challenges. As more people have lost their employer-sponsored or Medicaid coverage and become uninsured, greater demands have been placed on CHCs. Other challenges include recruiting and retaining physicians, nurses, and allied professionals who can provide primary care; securing specialty referrals for uninsured and Medicaid patients; and functioning in the face of budget cutbacks in Medicaid and SCHIP.
The number of doctors providing charity care has dropped significantly over the past decade, increasing the burden on CHCs and ERs. Meanwhile, it is difficult to attract physicians to staff positions at CHCs because hospital medical groups can offer them higher salaries. It is difficult to find specialists willig to treat uninsured patients who have no source of payment.
CHC,s which participate in policy activities largely through the National Association of Community Health Centers (NACHC), are striving to attract more physicians through natoinal, state, and local levels. CHCs meet the definition of a 'medical home' as developed by primary care medical organizations, but we will not be able to reach expansionary goals if we cannot attract a greater number of clinicians to these centers and more federal support from Washington. Despite good intentions on both sides, it remains uncertain whether Congress or the new administration will see the continued expansion of CHCs as a vital step toward reforming the health care system. Clearly, I think it's a vital step.
Monday, April 28, 2008
Wednesday, April 23, 2008
healthcare, community, poverty, and policy
I just spent the last three hours listening to and talking with my new hero. Dr. Robert K. Ross, the president of the CA Endowment, whose goal is to expand access to affordable, quality health care for underserved individuals and communities, and to promote fundamental imporvements in the health status of all. I was so jittery and excited and at one point almost started crying because he seriously outlined exactly what I want to do with my life and gave me tons of crazy cool new ideas, and it is so strange and yet wonderful to be affirmed in those ideas by someone much older, well-known, and generally brilliant. Here is my response to some of what he said:
Health revolution #1: The late 70s/early 80s made communicable and infectious diseases the most importand health care issue. If you want to hear about the history of AIDS watch the movie "And the Band Played On."
Health revolution #2: In 1985/86 crack cocaine became the new street drug of choice. It went from 100$ per hit to 5$. It is highly addictive, causes pain to go away, releases people from depression, and only lasts about an hour. The effects of cocaine are so much greater in a community oriented framework. Since the advent of cheap crack cocaine, life expectancy in inner cities has decreased. In 1990 in Philadelphia, the average life expectancy was 48. In 1980 it was 60. The statistics are similar for Southern California. Women get addicted and how do they get their money? Prostitution. Men get addicted and how do they get their money? Stealing and dangerous street trade. The prostitution breeds STDs and unwanted pregnancy. Cocaine induces muscle contractions, so babies are born too early. Stealing and street violence produces gangs. All of the above produces unsafe streets and home environments, and there is an entire generation of young people who grew up in houses and neighborhoods where these effects were very present. What is society doing for these youths now? What is society doing for the 1980s coke addicts now? One might ask, can we really extrapolate all of these effects from one cause: cocaine? Mostly yes, but fully no. But we shouldn't be ignoring the fact that the answer really is 'mostly yes.' LA and San Diego were hit the first and the hardest with cocaine trafficking, but it clearly has become a national problem. Economics is key here. The fact that cocaine became more abundent and cheaper effected the drug market in huge ways, which in turn effected every other systemic structure of society these cocaine addicts came into contact with, from neighborhood housing, to education, to healthcare. 1 in 3 men of minority status is destined to be a part of the criminal justice system at some point in his life as of 1990. Clearly, no part of society is left untouched by these statistics...who, after all, is paying for the incarceration of these men?
The second healthcare revolution comes to a close in the early 21st century with chronic, rather than communicable, diseases being the most talked about issue. This is largely because health care organiztions and individuals gave up on trying to deal with the problems of drug dealer and prostitutes and changed their focus to the poor. The shift in healthcare brought a focus on the chronic problems of the poor: diabetes, obesity, malnutrition, hypertension, bad eyesite, some STDs, and even cancers [not an issue of the poor as much, but definitely chronic].
Heathcare revolution #3: The closer look at chronic conditions has caused healthcare organiztions and individuals to look more closely at the healthcare system at large. Chronic conditions, after all, don't go away and require long term care, so the issue becomes a systemic one rather than a 'fix-it-once' solution. If you look up the word system in the dictionary, in no way does it describe what we have in terms of healthcare. People are starting to realize that the US spends more on health care than any other country in the world, and by no means has the best health. This third revolution is focused, therefore, around bringing health. That should be a 'duh' isn't that what heathcare is for. But if you look throughout the history of healthcare in America, it really isn't. Healthcare has been structured around reaction to problems rather than action and prevention. Reactionary care is absolutely important, but it will always be incomplete. Preventative healthcare economics is predicted to be the new and revolutionary field in the 21st century.
Take a guess: how much of your life expectancy right now is determined by the quality of healthcare you receive? Between 10 and 25% depending upon your healthcare plan. That is ridiculous!! So, what else is determining your life expectancy? Race, class, social status, gender, genes, and the way these things affect the social structures you interact with. [this is all from a legit study nationally recognized].
So when I say that the new healthcare revolution is focused on health, I really mean that it is focused on extending life expectancy. This will require tackling these other seeminly non-health related issues.
How to act: it is all about neighborhoods and community. And really, it's not just because that's what I'm passioante about. This is what all studies in the last 4 years have shown. Healthcare workers who are fed up with trying to work within the confines of the system are opting out and creating neighborhood and community organiztions [some of which have grown state-wide and nationally!]. There's a guy in Harlem who picked 20 square blocks to dedicate himself to. He has fully reformed the way the kids in that neighborhood get healthcare, education, and housing/supervision at home. On his wall he has a map of his 20 blocks of Harlem, and another map of the US with pins in the different cities where these once-street kids are now going to college. This stuff works! [and it's making me cry to think about it working :)].
What about the argument: this is too small-scale? That is a valid argument [though let's not discout the fact that the small-scale efforts are working!]. Here is where the policy makers and economists come in. So far, the benefits of small scale community health care have yet to be scaled up to fit a larger national context. There are two options: Find a way to unite and scale up the several small community focused healthcare groups, or encourage lots more of them to form in as many communities as possible. I would argue that both need to happen at the same time and that they will strengthen each other. How do we create a national healthcare structure that has all of the intimacies of neighborhood healthcare? Our problem isn't that we don't know what a good healthcare structure looks like. We do know. The last 10 years have given us success story after success story of non profits, independent hospitals, and clinics which have drastically influence the health of a community. We have the structure, now we need to find a way to fit it to a larger model.
Behold, I will bring to it health and healing, and I will heal them and reveal to them abundance of prosperity and security...And this city shall be to me a name of joy, a priase and a glory before all the nations of the earth who shall hear of all the good that I do for them. -Jer 33:6,9
Health revolution #1: The late 70s/early 80s made communicable and infectious diseases the most importand health care issue. If you want to hear about the history of AIDS watch the movie "And the Band Played On."
Health revolution #2: In 1985/86 crack cocaine became the new street drug of choice. It went from 100$ per hit to 5$. It is highly addictive, causes pain to go away, releases people from depression, and only lasts about an hour. The effects of cocaine are so much greater in a community oriented framework. Since the advent of cheap crack cocaine, life expectancy in inner cities has decreased. In 1990 in Philadelphia, the average life expectancy was 48. In 1980 it was 60. The statistics are similar for Southern California. Women get addicted and how do they get their money? Prostitution. Men get addicted and how do they get their money? Stealing and dangerous street trade. The prostitution breeds STDs and unwanted pregnancy. Cocaine induces muscle contractions, so babies are born too early. Stealing and street violence produces gangs. All of the above produces unsafe streets and home environments, and there is an entire generation of young people who grew up in houses and neighborhoods where these effects were very present. What is society doing for these youths now? What is society doing for the 1980s coke addicts now? One might ask, can we really extrapolate all of these effects from one cause: cocaine? Mostly yes, but fully no. But we shouldn't be ignoring the fact that the answer really is 'mostly yes.' LA and San Diego were hit the first and the hardest with cocaine trafficking, but it clearly has become a national problem. Economics is key here. The fact that cocaine became more abundent and cheaper effected the drug market in huge ways, which in turn effected every other systemic structure of society these cocaine addicts came into contact with, from neighborhood housing, to education, to healthcare. 1 in 3 men of minority status is destined to be a part of the criminal justice system at some point in his life as of 1990. Clearly, no part of society is left untouched by these statistics...who, after all, is paying for the incarceration of these men?
The second healthcare revolution comes to a close in the early 21st century with chronic, rather than communicable, diseases being the most talked about issue. This is largely because health care organiztions and individuals gave up on trying to deal with the problems of drug dealer and prostitutes and changed their focus to the poor. The shift in healthcare brought a focus on the chronic problems of the poor: diabetes, obesity, malnutrition, hypertension, bad eyesite, some STDs, and even cancers [not an issue of the poor as much, but definitely chronic].
Heathcare revolution #3: The closer look at chronic conditions has caused healthcare organiztions and individuals to look more closely at the healthcare system at large. Chronic conditions, after all, don't go away and require long term care, so the issue becomes a systemic one rather than a 'fix-it-once' solution. If you look up the word system in the dictionary, in no way does it describe what we have in terms of healthcare. People are starting to realize that the US spends more on health care than any other country in the world, and by no means has the best health. This third revolution is focused, therefore, around bringing health. That should be a 'duh' isn't that what heathcare is for. But if you look throughout the history of healthcare in America, it really isn't. Healthcare has been structured around reaction to problems rather than action and prevention. Reactionary care is absolutely important, but it will always be incomplete. Preventative healthcare economics is predicted to be the new and revolutionary field in the 21st century.
Take a guess: how much of your life expectancy right now is determined by the quality of healthcare you receive? Between 10 and 25% depending upon your healthcare plan. That is ridiculous!! So, what else is determining your life expectancy? Race, class, social status, gender, genes, and the way these things affect the social structures you interact with. [this is all from a legit study nationally recognized].
So when I say that the new healthcare revolution is focused on health, I really mean that it is focused on extending life expectancy. This will require tackling these other seeminly non-health related issues.
How to act: it is all about neighborhoods and community. And really, it's not just because that's what I'm passioante about. This is what all studies in the last 4 years have shown. Healthcare workers who are fed up with trying to work within the confines of the system are opting out and creating neighborhood and community organiztions [some of which have grown state-wide and nationally!]. There's a guy in Harlem who picked 20 square blocks to dedicate himself to. He has fully reformed the way the kids in that neighborhood get healthcare, education, and housing/supervision at home. On his wall he has a map of his 20 blocks of Harlem, and another map of the US with pins in the different cities where these once-street kids are now going to college. This stuff works! [and it's making me cry to think about it working :)].
What about the argument: this is too small-scale? That is a valid argument [though let's not discout the fact that the small-scale efforts are working!]. Here is where the policy makers and economists come in. So far, the benefits of small scale community health care have yet to be scaled up to fit a larger national context. There are two options: Find a way to unite and scale up the several small community focused healthcare groups, or encourage lots more of them to form in as many communities as possible. I would argue that both need to happen at the same time and that they will strengthen each other. How do we create a national healthcare structure that has all of the intimacies of neighborhood healthcare? Our problem isn't that we don't know what a good healthcare structure looks like. We do know. The last 10 years have given us success story after success story of non profits, independent hospitals, and clinics which have drastically influence the health of a community. We have the structure, now we need to find a way to fit it to a larger model.
Behold, I will bring to it health and healing, and I will heal them and reveal to them abundance of prosperity and security...And this city shall be to me a name of joy, a priase and a glory before all the nations of the earth who shall hear of all the good that I do for them. -Jer 33:6,9
Saturday, April 12, 2008
Fling, Flung, Flang...Fun?
I got a fortune cookie once that said: "you need more fun in your life." Yeah. I know. What kind of fortune is that? I thought a lot about fun this weekend. One of my med school interview questions was: "what do you do for fun?" After a little internal chuckle, I replied: "Run, be active outside, read, play piano, talk with friends, hang out with my residents.." The guy gave me a look like "are you serious, wow, you have no life." I don't know...those seem like legit fun things to me.
It's hard to be an RA in the quad during fling and not switch into "high judgment" mode. After writing up dozens of people, coordinating medical transports, calling for barf clean-ups, and watching your relatively normal and responsible residents go totally nuts, and still having it be a part of my job to "punish" these kids, it's hard to remain judgement-free. Here I am being all good and clean and responsible and what do I get for it? hallways of barf. Not exactly the easiest moment to remmeber I've got my own internal hallways of barf...I just have the priviledge of being able to keep them relatively hidden. In that sense, there is an element of freedom, or at least honesty, in outward debachaury.
But back to the theme of fun. The lines between work and fun are not as defined for me as they are for some. There isn't much that I do that I would say is wholly devoid of fun [except pchem]. But on the flip side, I also don't do much that is wholly devoid of some kind of work. [hmm, this probably requires a definition for what exactly 'work' is] For example, I am having a great time writing my final research paper on Faulkner's representations of American cycles of poverty. That's a more nerdy example of what I mean by blending work and fun. But it does make me question: do I know how to have fun? really? Do I shirk away from fully non-work and all-fun situations because maybe I don't know how to interact in them? Do I not know how to let loose and have fun? What do these fun flingers have that I don't, in that respect? Where should the balance rest between interacting with the world around me, and drawing back to do my own thing? Is the "doing my own thing" a result of judgement/pride and even resentment that other people are having fun, and even though it's not the kind of fun I want to have, they're still having fun and I'm not? or am I really content with just having my kind of fun be a little different?
I find it somewhat problematic that at the mention of Spring Fling, my initial reaction is...ok, whose house can I go hang out at to get away from it. I can name tons of reasons for why I would more readily flee from Fling than from other situations of brokenness [and yeah, i think i can say Fling has got some brokennes to it when I find couples having sex in the public trash room...]. But at their cores, what makes one broken situation different from another? Why is it so much easier for me to love the homeless guy who refuses to accept food from me but will take my money to, theoretically, buy alcohol with? than to love drunk penn kids at fling? I mean, I do have some answers to that questions, but are they legit answers? Not really. These kids are my neighbors in the most literal sense of the word, and yet this weekend I would rather think of some obscure poverty-ridden country than about some of the more tangible problems that exist on campus. And that left me somewhat in a state of apathy this fling. I saw tons of stuff I could have written up, but didn't. I just didn't feel like putting the effort in to argue with another group of drunk people to get their Penncards and write them up and internally know that nothing was actually going to happen to them. So in that respect I'm kind of diappointed in myself that I wasn't consistent with the rules. Consistency is important when it comes to inforcing protocol. I guess it's just hard for me to see students who really do have opportunities that others will never have, simply by being here or by having grown up in the family/culture environment that they did, and then not using it. But then, I guess on the tiniest scale, that's what God feels. He gives us life and we still find ways of breaking it up. And at the end of the day, that's really why I'm not allowed any judgement on the residents I write up. Without mercy and grace, God would have written me up so many times the 'house dean' definitely would have kicked me out of the 'quad.'
It's hard to be an RA in the quad during fling and not switch into "high judgment" mode. After writing up dozens of people, coordinating medical transports, calling for barf clean-ups, and watching your relatively normal and responsible residents go totally nuts, and still having it be a part of my job to "punish" these kids, it's hard to remain judgement-free. Here I am being all good and clean and responsible and what do I get for it? hallways of barf. Not exactly the easiest moment to remmeber I've got my own internal hallways of barf...I just have the priviledge of being able to keep them relatively hidden. In that sense, there is an element of freedom, or at least honesty, in outward debachaury.
But back to the theme of fun. The lines between work and fun are not as defined for me as they are for some. There isn't much that I do that I would say is wholly devoid of fun [except pchem]. But on the flip side, I also don't do much that is wholly devoid of some kind of work. [hmm, this probably requires a definition for what exactly 'work' is] For example, I am having a great time writing my final research paper on Faulkner's representations of American cycles of poverty. That's a more nerdy example of what I mean by blending work and fun. But it does make me question: do I know how to have fun? really? Do I shirk away from fully non-work and all-fun situations because maybe I don't know how to interact in them? Do I not know how to let loose and have fun? What do these fun flingers have that I don't, in that respect? Where should the balance rest between interacting with the world around me, and drawing back to do my own thing? Is the "doing my own thing" a result of judgement/pride and even resentment that other people are having fun, and even though it's not the kind of fun I want to have, they're still having fun and I'm not? or am I really content with just having my kind of fun be a little different?
I find it somewhat problematic that at the mention of Spring Fling, my initial reaction is...ok, whose house can I go hang out at to get away from it. I can name tons of reasons for why I would more readily flee from Fling than from other situations of brokenness [and yeah, i think i can say Fling has got some brokennes to it when I find couples having sex in the public trash room...]. But at their cores, what makes one broken situation different from another? Why is it so much easier for me to love the homeless guy who refuses to accept food from me but will take my money to, theoretically, buy alcohol with? than to love drunk penn kids at fling? I mean, I do have some answers to that questions, but are they legit answers? Not really. These kids are my neighbors in the most literal sense of the word, and yet this weekend I would rather think of some obscure poverty-ridden country than about some of the more tangible problems that exist on campus. And that left me somewhat in a state of apathy this fling. I saw tons of stuff I could have written up, but didn't. I just didn't feel like putting the effort in to argue with another group of drunk people to get their Penncards and write them up and internally know that nothing was actually going to happen to them. So in that respect I'm kind of diappointed in myself that I wasn't consistent with the rules. Consistency is important when it comes to inforcing protocol. I guess it's just hard for me to see students who really do have opportunities that others will never have, simply by being here or by having grown up in the family/culture environment that they did, and then not using it. But then, I guess on the tiniest scale, that's what God feels. He gives us life and we still find ways of breaking it up. And at the end of the day, that's really why I'm not allowed any judgement on the residents I write up. Without mercy and grace, God would have written me up so many times the 'house dean' definitely would have kicked me out of the 'quad.'
Wednesday, April 9, 2008
pchem = antishalom
sample test question [ok, obvioulsy this is not an actual question...but they sound like this when you're reading them during your hour of testing]
1) a) i) Prove mathematically the meaning of life and the existence of the universe using concepts from quantum mechanics, thermodynamics, and statistical mechanics. Complement your answer with a diagram, and label and explain the various significant points within it.
1) a) ii) Explain how the above proof physically relates to the color of the sky and the average atmospheric pressure on Neptune.
1) b) i) Using a SINGLE mathematical statement, state how a liter of high-speed fermions in South Dakota will influence the average daily rainfall in Argentina.
1) b) ii) BRIEFLY explain the above equation in your own words. Feel free to complement your answer with equations. And diagrams. With labels. And equations to explain those labels which themselves are complemented by diagrams. Feel free to continue your answer into another blue book.
Suggested time: 3 minutes
1) a) i) Prove mathematically the meaning of life and the existence of the universe using concepts from quantum mechanics, thermodynamics, and statistical mechanics. Complement your answer with a diagram, and label and explain the various significant points within it.
1) a) ii) Explain how the above proof physically relates to the color of the sky and the average atmospheric pressure on Neptune.
1) b) i) Using a SINGLE mathematical statement, state how a liter of high-speed fermions in South Dakota will influence the average daily rainfall in Argentina.
1) b) ii) BRIEFLY explain the above equation in your own words. Feel free to complement your answer with equations. And diagrams. With labels. And equations to explain those labels which themselves are complemented by diagrams. Feel free to continue your answer into another blue book.
Suggested time: 3 minutes
Monday, March 24, 2008
little sis' revelation on maturity
an email from her:
neeeawwwwwwwwwww how cute....my little girl is alll...........big! i guess i'm the real little one though
i think the smarter you get, the more potential you have to be extremely immature. it's like climbing the stairs of immaturity. you start at the bottom and ur like, a baby. then you get smarter and take a step, and you also get a cookie and eat it, signifying smartness (now in the stomach). an so on and so forth. but if the right thing comes along to push you over, you fall down. you don't lose your cookies (aka your smarts) because you ate them....but you're back down on the immaturity. and the higher the stairs you go....the more potential to fall.....muahahaha physics. keep your cookies. but fall down the stairs every now and then (i'll make sure that happens)
love,
me
neeeawwwwwwwwwww how cute....my little girl is alll...........big! i guess i'm the real little one though
i think the smarter you get, the more potential you have to be extremely immature. it's like climbing the stairs of immaturity. you start at the bottom and ur like, a baby. then you get smarter and take a step, and you also get a cookie and eat it, signifying smartness (now in the stomach). an so on and so forth. but if the right thing comes along to push you over, you fall down. you don't lose your cookies (aka your smarts) because you ate them....but you're back down on the immaturity. and the higher the stairs you go....the more potential to fall.....muahahaha physics. keep your cookies. but fall down the stairs every now and then (i'll make sure that happens)
love,
me
Sunday, March 16, 2008
The Art of War
No, I'm not actually talking about or reading the famous book, "The Art of War," but the title is still appropriate. The last week in Germany was good for many reasons. Some questions that arose during the trip, which included a good amount of WWI/II/Cold War sights: How are we to remember the victims of a war who were on the "bad guy" side? For how many generations should a nation actively remember/repent/ask forgiveness for wrongs done in the past? Is it necessary and proper to remember/repent/ask forgiveness for wrongs done by your culture/nation in which you yourself played no active role? If these steps are not taken, will the conflict always live on, however well masked it may be? What would international politics look like if world leaders acted as Daniel did when he asked forgiveness not only for his own wrongs but for those of his whole nation? And finally, what role should art play in remembering the past? They are not new questions, but newly surfaced.
Berlin is a city full of the histories of different wars. Wars though, I believe, are never fully history- they live on into the lives of future generations, the way cities are constructed, the demgraphics of cities and countries, and the art that is produced decades and centuries later. War changes people, places, and things. War changed me when I was called "nazi girl" in 6th grade, and this week, when I was reminded of my Oma's time spent in a Russian concentration camp. Where there is war, there is art. I've become pretty sure of that. War brings battle songs, propaganda drawings, victorious murals and scuptures of battle heros, carefully designed memorials, new clothing styles, and new literary genres. It transcends all types of art and no theme is left untouched, from religion to fashion to sports.
It was not until recently that Berlin [and Germany in general] began to think more intently about how to remember the Holocaust in art and education. The Berlin Holocaust memorial was constructed only this year, and the Jewish museum remembering WWII is also new to the last decade. In addition to two other main sights, the Topographies of Terror and Checkpoint Charlie, these are the main Holocuast sites of rememberance. Both of them are considered modern art and the artists intentionally left their message open to interpretation. It would take too long to describe the memorial and museum in this post [maybe the next], but the theme of using modern art that is intentionally open to interpretation to remember/memorialize the Holocaust is pretty provocative, I think.
I don't know tons about the theory and and philosophy of modern art. Wikipedia says: Modern art refers to the new approach to art which placed emphasis on representing emotions, themes, and various abstractions. Artists experimented with new ways of seeing, with fresh ideas about the nature of materials and functions of art, often moving further toward abstraction. More generally, I've always though of modern art, particularly in the late 20th and 21st centuries, to be focused on the the viewers interpretation and experience. WWII is different than other wars in that it's hard to argue about who the "bad guys" were. In some wars its hard to tell...one side started something, another responded, and it was back and forth until someone won. But wars that have more clear "good guy/bad guy" sides are, ironically, harder to memorialize, I think, because no matter what, for the rest of history you are remembering one side as bad. So I find it interesting that Germany has chosen pretty abstract art forms to commemorate the Holocaust. It's not true for all the museums/monuments there, but for many. What reponsibility do artists have to remember the past through their work when the past is pretty clear cut on who the "bad guy" was. Is it responsible to use abstract art forms to memorialize something that maybe shouldn't be left open to interpretation? Is there a danger that the viewer won't the the right message? or won't get a powerful enough message to accurately reflect the Holocaust? Is using art that is highly inteprative [as opposed to strictly factual pictures/stories...etc] a way of avoiding a more blunt picture of the past...a picture that is still really really hard for Germany to face? Is that why the Holocaust is more frequently depicted in modern art in Germany as opposed to other cities/countires that have Holocaust museums? Or will this art give a greater and more intense response?
I think in many ways that this abstract art is more for the current German people than it is for the past or to remember those who were victims. You can't force someone to feel a certain way about an event, especially if they weren't even alive during that time. But you can create ways of helping them to think about it and arive at some personal emotional response through the process. Do we run the risk though of never arriving at an emotional response if the art is "too abstract?" Why is it important for later generations to have a resopnse? I'm not totally sure, but I'm pretty sure it's important. War changes everything.
a snipit from my Great Depression Lit seminar:
"This friend of mine, Karl, is a writer. He is always hungry. You cannot stuff yourself on a dollar a week. It is not his fault he is always hungry. It is that nobody buys the stuff he writes. He writes of starving babies, and men who tramp the streets in search of work. People do not like such things. For in Karl's stories you can hear the starved cries of babies. You can see the hungry look in men's eyes. Karl will always be hungry. He will always describe things so that you can see them when you read...Werner is an artist. He paints pictures of people he sees in the park. People will not buy them though. I think it is because of the hungry look. I think if Werner would take the hungry look out of the eyes of the people in his pictures, he could buy more hamburgers and take the hungry look out of his own eyes. Karl and Werner say this would be sacrilege to art."
-Waiting for Nothing, Thomas Kromer
Berlin is a city full of the histories of different wars. Wars though, I believe, are never fully history- they live on into the lives of future generations, the way cities are constructed, the demgraphics of cities and countries, and the art that is produced decades and centuries later. War changes people, places, and things. War changed me when I was called "nazi girl" in 6th grade, and this week, when I was reminded of my Oma's time spent in a Russian concentration camp. Where there is war, there is art. I've become pretty sure of that. War brings battle songs, propaganda drawings, victorious murals and scuptures of battle heros, carefully designed memorials, new clothing styles, and new literary genres. It transcends all types of art and no theme is left untouched, from religion to fashion to sports.
It was not until recently that Berlin [and Germany in general] began to think more intently about how to remember the Holocaust in art and education. The Berlin Holocaust memorial was constructed only this year, and the Jewish museum remembering WWII is also new to the last decade. In addition to two other main sights, the Topographies of Terror and Checkpoint Charlie, these are the main Holocuast sites of rememberance. Both of them are considered modern art and the artists intentionally left their message open to interpretation. It would take too long to describe the memorial and museum in this post [maybe the next], but the theme of using modern art that is intentionally open to interpretation to remember/memorialize the Holocaust is pretty provocative, I think.
I don't know tons about the theory and and philosophy of modern art. Wikipedia says: Modern art refers to the new approach to art which placed emphasis on representing emotions, themes, and various abstractions. Artists experimented with new ways of seeing, with fresh ideas about the nature of materials and functions of art, often moving further toward abstraction. More generally, I've always though of modern art, particularly in the late 20th and 21st centuries, to be focused on the the viewers interpretation and experience. WWII is different than other wars in that it's hard to argue about who the "bad guys" were. In some wars its hard to tell...one side started something, another responded, and it was back and forth until someone won. But wars that have more clear "good guy/bad guy" sides are, ironically, harder to memorialize, I think, because no matter what, for the rest of history you are remembering one side as bad. So I find it interesting that Germany has chosen pretty abstract art forms to commemorate the Holocaust. It's not true for all the museums/monuments there, but for many. What reponsibility do artists have to remember the past through their work when the past is pretty clear cut on who the "bad guy" was. Is it responsible to use abstract art forms to memorialize something that maybe shouldn't be left open to interpretation? Is there a danger that the viewer won't the the right message? or won't get a powerful enough message to accurately reflect the Holocaust? Is using art that is highly inteprative [as opposed to strictly factual pictures/stories...etc] a way of avoiding a more blunt picture of the past...a picture that is still really really hard for Germany to face? Is that why the Holocaust is more frequently depicted in modern art in Germany as opposed to other cities/countires that have Holocaust museums? Or will this art give a greater and more intense response?
I think in many ways that this abstract art is more for the current German people than it is for the past or to remember those who were victims. You can't force someone to feel a certain way about an event, especially if they weren't even alive during that time. But you can create ways of helping them to think about it and arive at some personal emotional response through the process. Do we run the risk though of never arriving at an emotional response if the art is "too abstract?" Why is it important for later generations to have a resopnse? I'm not totally sure, but I'm pretty sure it's important. War changes everything.
a snipit from my Great Depression Lit seminar:
"This friend of mine, Karl, is a writer. He is always hungry. You cannot stuff yourself on a dollar a week. It is not his fault he is always hungry. It is that nobody buys the stuff he writes. He writes of starving babies, and men who tramp the streets in search of work. People do not like such things. For in Karl's stories you can hear the starved cries of babies. You can see the hungry look in men's eyes. Karl will always be hungry. He will always describe things so that you can see them when you read...Werner is an artist. He paints pictures of people he sees in the park. People will not buy them though. I think it is because of the hungry look. I think if Werner would take the hungry look out of the eyes of the people in his pictures, he could buy more hamburgers and take the hungry look out of his own eyes. Karl and Werner say this would be sacrilege to art."
-Waiting for Nothing, Thomas Kromer
Friday, February 22, 2008
community
Real Sex: The Naked Truth about Chastity: Lauren F. Winner
For most of human history, people of many different cultures have agreed that societies must order certain forms of exchange in order to survive. Communities have ordered language, establishing grammars nad vocabularies that shape how people comunicate with one another; they have ordered the exchange of money, property, and labor; and they have ordered the practice of sex. As essayist, poet, and novelist Wendell Berry has put it, "sex, like any other necessary, precarious, and volatile power that is commonly held, is everybody's business." In the last half-century, however, that assumption has been routed, replaced by the axioms of individualism and autonomy. Indeed, today the idea that sex "is everybody's business" sounds alternately shocking and silly...
...But in the Christian universe, the individual is not the vital unit of ethical meaning. For Christians, the most basic images, metaphors, and signs are corporate, and the basic unit of ethical meaning is the Body, the comunity. Israel experiences covenantal fidelity as a people, and the People of God is a collective- not merely an aggregate of individual persons, each doing his or her own thing, but a body. In the Bible, God elects the People of Israel as a body. He sustains them as a body. And, finally, He redeems them as a body. This talk about community is not metaphorizing. The community has a role i making ethics. Paul makes this clear when he instructs the Galatians to hold one another accountable for sin: "Brothers, if someone is caught in a sin, you who are spiritual should restore him gently. But watch yourself, or you also may be tempted. Carry each other's burdens, and in this way you will fulfil the law of Christ."
That passage in Galatians, if we construe it uncharitably, can lead us to envision a community that functions primarily as a police force: Christinas' responsibilities to one another begin and end with peering into other Christians' bedroom windows and sounding the alarm if something illicit is going on.
While one task of any community is to enforce its own codes when they are being violated, perhaps the prior task of the community is to make sense of the ethical codes that are being enforced. Here the community is not so much a cop as storyteller, telling and retelling the foundational stories of the community itself, sustaining the stories that make sense of the community's norms. This storytelling is part of hte working out of God's grace in the church. we, teh church, retell our own story- we do this every time we read scripture, every time we celebrate the Lord's Supper, and every time we minister to one another. And that reteling is part of what enables us to live into the story. It is the community that ensures that ethics is not about the dispensing of cut-and-dried answers to moral questions, but that ethics is the story with meaning and power.
For most of human history, people of many different cultures have agreed that societies must order certain forms of exchange in order to survive. Communities have ordered language, establishing grammars nad vocabularies that shape how people comunicate with one another; they have ordered the exchange of money, property, and labor; and they have ordered the practice of sex. As essayist, poet, and novelist Wendell Berry has put it, "sex, like any other necessary, precarious, and volatile power that is commonly held, is everybody's business." In the last half-century, however, that assumption has been routed, replaced by the axioms of individualism and autonomy. Indeed, today the idea that sex "is everybody's business" sounds alternately shocking and silly...
...But in the Christian universe, the individual is not the vital unit of ethical meaning. For Christians, the most basic images, metaphors, and signs are corporate, and the basic unit of ethical meaning is the Body, the comunity. Israel experiences covenantal fidelity as a people, and the People of God is a collective- not merely an aggregate of individual persons, each doing his or her own thing, but a body. In the Bible, God elects the People of Israel as a body. He sustains them as a body. And, finally, He redeems them as a body. This talk about community is not metaphorizing. The community has a role i making ethics. Paul makes this clear when he instructs the Galatians to hold one another accountable for sin: "Brothers, if someone is caught in a sin, you who are spiritual should restore him gently. But watch yourself, or you also may be tempted. Carry each other's burdens, and in this way you will fulfil the law of Christ."
That passage in Galatians, if we construe it uncharitably, can lead us to envision a community that functions primarily as a police force: Christinas' responsibilities to one another begin and end with peering into other Christians' bedroom windows and sounding the alarm if something illicit is going on.
While one task of any community is to enforce its own codes when they are being violated, perhaps the prior task of the community is to make sense of the ethical codes that are being enforced. Here the community is not so much a cop as storyteller, telling and retelling the foundational stories of the community itself, sustaining the stories that make sense of the community's norms. This storytelling is part of hte working out of God's grace in the church. we, teh church, retell our own story- we do this every time we read scripture, every time we celebrate the Lord's Supper, and every time we minister to one another. And that reteling is part of what enables us to live into the story. It is the community that ensures that ethics is not about the dispensing of cut-and-dried answers to moral questions, but that ethics is the story with meaning and power.
Friday, February 8, 2008
personal statement
It seems like so long ago that I started writing this for my med school primary app. Almost exactly a year ago. So much changes in a year. In the last year I have very much come to know God as the Father who loves to give good gifts to His children. And they really are gifts...unearned and good. Receiving from God, I've come to see, is most complete when we can offer back to Him what He gives us and allow Him to continue to shape it.
In the spring of my freshman year at Penn I asked a few friends if they wanted to join me for an organized street clean-up of West Philly. This is the kind of invitation that many feel guilty turning down, but rationalize by saying: "the trash will just reappear the next day," or " you can't do everything to try to fix the world." Both statements are true. Half a day of picking up trash has no lasting effect, and I struggled that week with the feeling that serving others is an overwhelming task- that there are too many people and places in the world that need help.
The next summer I worked at Esperanza, a Spanish-speaking medical clinic in North Philadelphia that serves the poverty-level families of the neighborhood. My days were filled with accompanying doctors in examining rooms to translate, writing and administering quality of well-being surveys to patients, and compiling these responses for the purpose of future grant proposals.
The patients at Esperanza frequently struggle with diabetes, hypertension, malnutrition, skin diseases, depression, and a wide range of STDs. I sat with physicians and observed the process of developing treatment plans for patients, often diagnosed with multiple conditions. I then accompanied the doctor during his time with the patient, translating prescriptions and medical documents into Spanish, explaining, and often re-explaining, the purpose of each drug or nutritional suggestion. Many of the patients could not read or write well enough to complete the needed paperwork without my assistance.
One afternoon I spoke with a woman who had recently emigrated to Philadelphia from Puerto Rico. She had diabetes, but could not find a successful treatment plan. When her lab results came in, I listened as the doctors problem-solved for a better combination and dosage of drugs. What intrigued me about this process was that it required a personal knowledge of the woman's medical history as well as a powerful and intricate scientific knowledge of the biochemistry unique to the drugs prescribed. Even slight changes to dosages affect the patients in individual ways. This problem-solving process required patience and a clear and systematic thought process, as the medications she had previously been prescribed should have been effective. I learned that persistence and patience were key in the medical field, and I called the woman once more to double-check the medication that had previously been prescribed to her. Through our dialogue I learned that she could not read the instructions on the pill bottles and thus had not been correctly administering the medication. I asked the woman to come in so that we could give her a more formal explanation of diabetes, the treatment plan, and the remainder of her lab work, which showed that she was also infected with an STD. When she returned to the clinic the following day, I reviewed each medication and dosage she would be receiving and helped the doctor relay vital information about diabetes to her. I saw that as a physician I would need to know the biochemical consequences of these medications, how they would affect other physical ailments or drugs, what nutritional and environmental factors could be helpful or harmful to treatment plans, and most of all, how to communicate these facts to patients in a way that is clear and compassionate. It took a lot of patience and determination to ask the right questions in order to get accurate medical and personal histories; but it often took even more patience to respond, knowing that I had to put aside complicated scientific explanations and instead deliver accurate information in ways that showed each person dignity and compassion.
After explaining diabetes and the procedure for measuring blood sugar, the doctors and I told her about her STD, Chlamydia. She was clearly upset, vexed by the issue of how she had contracted it. It was difficult and heart-breaking to then explain that if she had been faithful, it was likely that her husband had not been. It was in conversations like these that I marveled at how different genres of medicine fit together. My time spent in research at the Scripps Institute and in science classes at Penn made the process of prescribing medication and explaining the intricacies of the human body to patients in a clinic extremely meaningful.
Further experiences at Esperanza and in my current job with the UCSD clinic have shown me that many patients share similar, heart-rending circumstances. No matter how hard the doctors, nurses, and I work, we find the same stories walking through our doors every day. My time in city clinics has taught me to persist in choosing action, relationship, and communication through the moments I am tempted to settle with simply feeling overwhelmed by the condition of community healthcare. In these clinics I find myself re-living that morning when I cleaned the streets of Philadelphia, and I think back to that summer day at Esperanza when I chose to give 'esperanza,' or 'hope,' to one of my first patients. It was then that I learned that hope, emerging from persistent scientific research melded with sincere human compassion, is not only something worth giving, but what I most desire to bring to patients in tangible and lasting ways.
In the spring of my freshman year at Penn I asked a few friends if they wanted to join me for an organized street clean-up of West Philly. This is the kind of invitation that many feel guilty turning down, but rationalize by saying: "the trash will just reappear the next day," or " you can't do everything to try to fix the world." Both statements are true. Half a day of picking up trash has no lasting effect, and I struggled that week with the feeling that serving others is an overwhelming task- that there are too many people and places in the world that need help.
The next summer I worked at Esperanza, a Spanish-speaking medical clinic in North Philadelphia that serves the poverty-level families of the neighborhood. My days were filled with accompanying doctors in examining rooms to translate, writing and administering quality of well-being surveys to patients, and compiling these responses for the purpose of future grant proposals.
The patients at Esperanza frequently struggle with diabetes, hypertension, malnutrition, skin diseases, depression, and a wide range of STDs. I sat with physicians and observed the process of developing treatment plans for patients, often diagnosed with multiple conditions. I then accompanied the doctor during his time with the patient, translating prescriptions and medical documents into Spanish, explaining, and often re-explaining, the purpose of each drug or nutritional suggestion. Many of the patients could not read or write well enough to complete the needed paperwork without my assistance.
One afternoon I spoke with a woman who had recently emigrated to Philadelphia from Puerto Rico. She had diabetes, but could not find a successful treatment plan. When her lab results came in, I listened as the doctors problem-solved for a better combination and dosage of drugs. What intrigued me about this process was that it required a personal knowledge of the woman's medical history as well as a powerful and intricate scientific knowledge of the biochemistry unique to the drugs prescribed. Even slight changes to dosages affect the patients in individual ways. This problem-solving process required patience and a clear and systematic thought process, as the medications she had previously been prescribed should have been effective. I learned that persistence and patience were key in the medical field, and I called the woman once more to double-check the medication that had previously been prescribed to her. Through our dialogue I learned that she could not read the instructions on the pill bottles and thus had not been correctly administering the medication. I asked the woman to come in so that we could give her a more formal explanation of diabetes, the treatment plan, and the remainder of her lab work, which showed that she was also infected with an STD. When she returned to the clinic the following day, I reviewed each medication and dosage she would be receiving and helped the doctor relay vital information about diabetes to her. I saw that as a physician I would need to know the biochemical consequences of these medications, how they would affect other physical ailments or drugs, what nutritional and environmental factors could be helpful or harmful to treatment plans, and most of all, how to communicate these facts to patients in a way that is clear and compassionate. It took a lot of patience and determination to ask the right questions in order to get accurate medical and personal histories; but it often took even more patience to respond, knowing that I had to put aside complicated scientific explanations and instead deliver accurate information in ways that showed each person dignity and compassion.
After explaining diabetes and the procedure for measuring blood sugar, the doctors and I told her about her STD, Chlamydia. She was clearly upset, vexed by the issue of how she had contracted it. It was difficult and heart-breaking to then explain that if she had been faithful, it was likely that her husband had not been. It was in conversations like these that I marveled at how different genres of medicine fit together. My time spent in research at the Scripps Institute and in science classes at Penn made the process of prescribing medication and explaining the intricacies of the human body to patients in a clinic extremely meaningful.
Further experiences at Esperanza and in my current job with the UCSD clinic have shown me that many patients share similar, heart-rending circumstances. No matter how hard the doctors, nurses, and I work, we find the same stories walking through our doors every day. My time in city clinics has taught me to persist in choosing action, relationship, and communication through the moments I am tempted to settle with simply feeling overwhelmed by the condition of community healthcare. In these clinics I find myself re-living that morning when I cleaned the streets of Philadelphia, and I think back to that summer day at Esperanza when I chose to give 'esperanza,' or 'hope,' to one of my first patients. It was then that I learned that hope, emerging from persistent scientific research melded with sincere human compassion, is not only something worth giving, but what I most desire to bring to patients in tangible and lasting ways.
Friday, February 1, 2008
Life as a Wheel
I said I would expand on my theory stated in "The Great Depression" post that life was like a wheel with six spokes. Here's what I wrote before:
"Let's think life as a wheel with six spokes. The six spokes would be: economics, health, learning, environment [and what it provides for you...often a living], social/sociopolitical, and spiritual. Each of those spokes deserves it's own paragraph [that'll come in the next post]. I believe God cares about each of these spokes. This model would work...except the spiritual spoke is a part of all of the others."
The hub in the middle represents abject, unrelenting, bone-grinding poverty. These people have absolutely nothing. The outer rim of the wheel representes wholeness, adequacy, "enough." Notice I didn't say "wealth" or "riches" or even "abundance". Simply the condition of having one's actual needs met.
Spoke one is economics. If you don't have much money, your options are limited. In Haiti, the poorest nation in the Western Hemisphere, the average peasant family ears 140$ USD/year by trying to grow coffee or cotton. They would like a better life for their six, seven, or eight children...to send just one of them to school would cost 50$/year. So they take a deep breath, choose one child, and send him off to learn, tightening down the screws on life's other necessities even further. In daily life a lack of money translates into a lack of options, which is perhaps a more accurate definition of poverty. The world's poor look at a situation and cannot say, "Well, I could pursue choice A, B, or C. Which one makes the most sense? Which wuld turn out best for me and my family?" No, under the circumstances, there is only choice A. That is the reality of poverty.
The next spoke of the wheel is health. A big part of health maintenance of course is getting adequate nutrition. Some people think the earth can't keep up with the food needs of its population. That is not true. In fact, the UN Food and Agriculture Organization delcared at a World Food Summit in Rome that the planet could produce enough food for every one of us to have a daily diet of 2720 calories. So why is a third of our world battling obesity and spending large sums to burn off excess calories, while the other two-thirds yearn to get more of them? Poor health is a major component of poverty and not disconnected from the first spoke, economics.
The next spoke is called learning. Poverty is greatly aggravated by the absence of information and acquired skills. Without these, the big world swirls around you like a dust storm, bombarding you from all sides with surprises that you have no way to comprehend or process, let alone overcome. An example: One of the biggest killers in the world today is diarrhea. I didn't just say it was uncomfortable; i said it could take your life. How so? Because the message passed around villages is: obviously, too much water inside of you if it is all coming out. We need to stop drinking for a while and dry out. Then it'll be okay." And children go on dying of dehydration by the hundreds of thousands. The beautiful thing is, an educated child in the developing world becomes a multiplier of learning, creating a ripple effect.
The fourth spoke is called environment. This is no sideline issue. Ivoery Coast has cut down and exported so much timber that it competes in volume with Brazil, a country twenty times as large. Since 1975, Ivory Coast has suffered the highest deforestation rate in the world. The herds of elephants, lions, hippos, leopards, antelopes, and many other animals have ben decimated as a result, which has changed things for humans as well. Haiti too is in ecological disaster. The sun beats down on the bare, parched earth and radiates upward again. Rain clouds form over the land, are driven up by the head, and then pushed off toward the sea, there to drop their precous moisture where thirsty people cannot access it.
The fifth spoke is social/sociopolitical. Poverty is, among other things, a functio nof being powerles in the hall of governments and the social structures that administer our lives. If you are fairly sure your vote won't count and that whatever taxes you pay will only end up financing a war or maybe increasing the governor's personal fortune, it is very easy to get discouraged and become fatalistic. When jobs and infrastructure improvements go inevitably to the tribe or region of the party in power, while other sections of the population are ignored, resentment grows. Corruption bleeds the meager resources that average citizens can muster, making it harder and harder for them to get on their feet. Nothing saps teh peasant's initiative faster than a sense that the system is stacked against him.
The final spoke of the wheel is called spiritual. Religious bondage can suffocate the poor in excruciating ways. This is true for those who forgo the nutrients of a meal because they feel they must obey the witch doctor's directive to sacrifice it to ward off evil, or when neighbors decline to help one another because they feel it will interfere with their karma. The starving child in the street, they say, is working out some issue from a previou slifetime, and so that process must run its course.
Jesus asked one time, "what good will it be for a man if he gains the whole world yet forfeits his soul?" All the dollars adn euros and pesos and shillings and rupees in the world will not equal the peace that comes from knowing a God who loves you. He's not out to get you or destroy you. He is, in fact, on your side. In fact, far from being peripheral, the spiritual aspect is essential to the other five spokes of the wheel.
Does God get involved with econonics- absolutely- Proverbs 14:23- all hard world brings a profit, but mere talk leads only to poverty. Scripture is full of instruction about money and labor.
Does God care about health- absolutly.
Does God care about education- yes, his entire revelation to us comes in the form of a book, which he fully expects us to read and to help others read. Teaching is a gift of the spirit
Does God care about the environment- check out Psalm 8- it is his earth, after all, he made it in the first place. He put this planet together to serve the needs of his highest creation, human beings. When we interrupt or currupt the systems that should sustain us, he is not happy. He wants to see the created order restored to its highest and best uses.
Does God care about our sociopolitical world? Definitely. Poverty and injustice break the heart of God. He warns us in Proverbs 22:22-23: do not exploit the poor because they are poor and do not crush the needy in court, for the LORD will take up their case and will plunder those who plunder them.
If we are seroius about helping overcome poverty, about moving people from the dark hole in the center to the state of wholeness ath the perimeter, we must care about all areas of their lives. It is not enough to simply favor one spoke. It's what makes community so extremely and unswervingly important. No one can care about all of those spokes alone, and i don't think we're called to do that. We refelct the image of God individually when we care about the whole, but we reflect the image of God communally when we actively care for the whole.
"Let's think life as a wheel with six spokes. The six spokes would be: economics, health, learning, environment [and what it provides for you...often a living], social/sociopolitical, and spiritual. Each of those spokes deserves it's own paragraph [that'll come in the next post]. I believe God cares about each of these spokes. This model would work...except the spiritual spoke is a part of all of the others."
The hub in the middle represents abject, unrelenting, bone-grinding poverty. These people have absolutely nothing. The outer rim of the wheel representes wholeness, adequacy, "enough." Notice I didn't say "wealth" or "riches" or even "abundance". Simply the condition of having one's actual needs met.
Spoke one is economics. If you don't have much money, your options are limited. In Haiti, the poorest nation in the Western Hemisphere, the average peasant family ears 140$ USD/year by trying to grow coffee or cotton. They would like a better life for their six, seven, or eight children...to send just one of them to school would cost 50$/year. So they take a deep breath, choose one child, and send him off to learn, tightening down the screws on life's other necessities even further. In daily life a lack of money translates into a lack of options, which is perhaps a more accurate definition of poverty. The world's poor look at a situation and cannot say, "Well, I could pursue choice A, B, or C. Which one makes the most sense? Which wuld turn out best for me and my family?" No, under the circumstances, there is only choice A. That is the reality of poverty.
The next spoke of the wheel is health. A big part of health maintenance of course is getting adequate nutrition. Some people think the earth can't keep up with the food needs of its population. That is not true. In fact, the UN Food and Agriculture Organization delcared at a World Food Summit in Rome that the planet could produce enough food for every one of us to have a daily diet of 2720 calories. So why is a third of our world battling obesity and spending large sums to burn off excess calories, while the other two-thirds yearn to get more of them? Poor health is a major component of poverty and not disconnected from the first spoke, economics.
The next spoke is called learning. Poverty is greatly aggravated by the absence of information and acquired skills. Without these, the big world swirls around you like a dust storm, bombarding you from all sides with surprises that you have no way to comprehend or process, let alone overcome. An example: One of the biggest killers in the world today is diarrhea. I didn't just say it was uncomfortable; i said it could take your life. How so? Because the message passed around villages is: obviously, too much water inside of you if it is all coming out. We need to stop drinking for a while and dry out. Then it'll be okay." And children go on dying of dehydration by the hundreds of thousands. The beautiful thing is, an educated child in the developing world becomes a multiplier of learning, creating a ripple effect.
The fourth spoke is called environment. This is no sideline issue. Ivoery Coast has cut down and exported so much timber that it competes in volume with Brazil, a country twenty times as large. Since 1975, Ivory Coast has suffered the highest deforestation rate in the world. The herds of elephants, lions, hippos, leopards, antelopes, and many other animals have ben decimated as a result, which has changed things for humans as well. Haiti too is in ecological disaster. The sun beats down on the bare, parched earth and radiates upward again. Rain clouds form over the land, are driven up by the head, and then pushed off toward the sea, there to drop their precous moisture where thirsty people cannot access it.
The fifth spoke is social/sociopolitical. Poverty is, among other things, a functio nof being powerles in the hall of governments and the social structures that administer our lives. If you are fairly sure your vote won't count and that whatever taxes you pay will only end up financing a war or maybe increasing the governor's personal fortune, it is very easy to get discouraged and become fatalistic. When jobs and infrastructure improvements go inevitably to the tribe or region of the party in power, while other sections of the population are ignored, resentment grows. Corruption bleeds the meager resources that average citizens can muster, making it harder and harder for them to get on their feet. Nothing saps teh peasant's initiative faster than a sense that the system is stacked against him.
The final spoke of the wheel is called spiritual. Religious bondage can suffocate the poor in excruciating ways. This is true for those who forgo the nutrients of a meal because they feel they must obey the witch doctor's directive to sacrifice it to ward off evil, or when neighbors decline to help one another because they feel it will interfere with their karma. The starving child in the street, they say, is working out some issue from a previou slifetime, and so that process must run its course.
Jesus asked one time, "what good will it be for a man if he gains the whole world yet forfeits his soul?" All the dollars adn euros and pesos and shillings and rupees in the world will not equal the peace that comes from knowing a God who loves you. He's not out to get you or destroy you. He is, in fact, on your side. In fact, far from being peripheral, the spiritual aspect is essential to the other five spokes of the wheel.
Does God get involved with econonics- absolutely- Proverbs 14:23- all hard world brings a profit, but mere talk leads only to poverty. Scripture is full of instruction about money and labor.
Does God care about health- absolutly.
Does God care about education- yes, his entire revelation to us comes in the form of a book, which he fully expects us to read and to help others read. Teaching is a gift of the spirit
Does God care about the environment- check out Psalm 8- it is his earth, after all, he made it in the first place. He put this planet together to serve the needs of his highest creation, human beings. When we interrupt or currupt the systems that should sustain us, he is not happy. He wants to see the created order restored to its highest and best uses.
Does God care about our sociopolitical world? Definitely. Poverty and injustice break the heart of God. He warns us in Proverbs 22:22-23: do not exploit the poor because they are poor and do not crush the needy in court, for the LORD will take up their case and will plunder those who plunder them.
If we are seroius about helping overcome poverty, about moving people from the dark hole in the center to the state of wholeness ath the perimeter, we must care about all areas of their lives. It is not enough to simply favor one spoke. It's what makes community so extremely and unswervingly important. No one can care about all of those spokes alone, and i don't think we're called to do that. We refelct the image of God individually when we care about the whole, but we reflect the image of God communally when we actively care for the whole.
Wednesday, January 23, 2008
A Snipit from Last Year's Journal
At retreat last week, Shannon had us all spend one hour doing some sort of service. We had been talking a bit about the scene in which Jesus washes His disciples’ feet, and how had they ultimately refused for that to happen, they totally missed the point of what He was all about. Without them being able to receive that from Jesus, and receiving it both on a literal physical level and knowing what it felt like emotionally for that to happen, they wouldn’t have been able to follow the next command of continuing to wash one another’s feet. Practically speaking, it was pretty gross thing to do. But after being on the receiving end of it, they had a more real motivation to follow that command. Jesus didn’t give them this random command to go wash people’s feet, but first had his disciples receive it, so that they could go out authentically.
So following that, Shannon challenged us each to spend the next hour serving someone(s). Initially I think I was like…ummm, here? What can I possibly do in one room with 50 other Christians all trying to serve one another? So as a group we started, somewhat awkwardly, to think of ways to serve one another. Some people wrote cards, gave massages, taught others something, listened, prayed, cleaned, talked…etc. I think the list of things to do was surprisingly long, at least for me, after about 15 minutes of time doing that. But it created an interesting atmosphere, because after a while, we all realized that for the service to actually ‘work,’ people had to receive from those around them. And when there are about 50 people in a room, relatively limited in their potential acts of service due to time and place, pretty much everyone had to receive from someone else, in that hour, in addition to serving.
And it caught me off guard when my initial response to that receiving was ‘no, this is my time for serving, i’m not allowed to receive now.’ So then God was like, ‘well Stef, you missed the point too.’ It isn’t possible to serve in a room full of people not willing to receive. And it makes the service frustrating. And I feel like that might be how our relationship with God is a lot of the time. Like we’ll receive up to a certain point, and then feel like, ok, you’ve given me enough, I have to give back.
The setting for that hour was one that modeled I think how I would picture the phrase ‘heaven on earth’ lived out. The service was creative, thoughtful, communal, unifying, loving, and sometimes not how I think we typically picture ‘service.’ So what I mean by that….you know that feeling of joy you get when you give a friend a present or card or something that you’re really excited for them to open and see?
And I think I question often if that feeling belongs in acts of service…if it means I’m doing it for myself, to get those feelings. And sometimes I think that’s true for everyone- we’ve all got hidden motivations and impurities in our actions a lot of the time. But this hour was good to remind me that someone else receiving my service, and me allowing myself to be excited for them, or happy that they liked it, is often me allowing myself to receive their service to me of receiving. So…allowing them to serve me by receiving their joy that came about because I tried to serve them. I don’t know if that came out right. But let’s face it, we like to make people happy, and that isn’t a bad thing. And so following that, it is then necessary to receive from other people, to allow them to have that felling of joy so that ultimately, that receiving from others serves them. And yeah, like anything, that can and does get distorted. But in that hour, it felt right, and it was very cool to feel service and receiving come together, and see them coexist not only within the same hour, but sometimes in the same few minutes. And that’s what I think helped define friendship with God and with people for me.
And in the world of non-retreat-time, it is really easy to get overwhelmed by the needs of the people we see. Actually, it is really possible to get overwhelmed by the needs of 50 Christians in a room for an hour also. And that really clearly reminded me that that feeling of overwhelmingness (that a word?) can overpower the original reason for service- that it isn’t to meet the needs of everyone and lift them up, but to seek and follow through with ways of serving that lift up Jesus, imitate Him, and create a spirit of service that lasts when there is overwhelming need, when the service isn’t overtly fun, when it’s risky, when it’s hard, when it’s washing someone’s gross and dirty feet.
So following that, Shannon challenged us each to spend the next hour serving someone(s). Initially I think I was like…ummm, here? What can I possibly do in one room with 50 other Christians all trying to serve one another? So as a group we started, somewhat awkwardly, to think of ways to serve one another. Some people wrote cards, gave massages, taught others something, listened, prayed, cleaned, talked…etc. I think the list of things to do was surprisingly long, at least for me, after about 15 minutes of time doing that. But it created an interesting atmosphere, because after a while, we all realized that for the service to actually ‘work,’ people had to receive from those around them. And when there are about 50 people in a room, relatively limited in their potential acts of service due to time and place, pretty much everyone had to receive from someone else, in that hour, in addition to serving.
And it caught me off guard when my initial response to that receiving was ‘no, this is my time for serving, i’m not allowed to receive now.’ So then God was like, ‘well Stef, you missed the point too.’ It isn’t possible to serve in a room full of people not willing to receive. And it makes the service frustrating. And I feel like that might be how our relationship with God is a lot of the time. Like we’ll receive up to a certain point, and then feel like, ok, you’ve given me enough, I have to give back.
The setting for that hour was one that modeled I think how I would picture the phrase ‘heaven on earth’ lived out. The service was creative, thoughtful, communal, unifying, loving, and sometimes not how I think we typically picture ‘service.’ So what I mean by that….you know that feeling of joy you get when you give a friend a present or card or something that you’re really excited for them to open and see?
And I think I question often if that feeling belongs in acts of service…if it means I’m doing it for myself, to get those feelings. And sometimes I think that’s true for everyone- we’ve all got hidden motivations and impurities in our actions a lot of the time. But this hour was good to remind me that someone else receiving my service, and me allowing myself to be excited for them, or happy that they liked it, is often me allowing myself to receive their service to me of receiving. So…allowing them to serve me by receiving their joy that came about because I tried to serve them. I don’t know if that came out right. But let’s face it, we like to make people happy, and that isn’t a bad thing. And so following that, it is then necessary to receive from other people, to allow them to have that felling of joy so that ultimately, that receiving from others serves them. And yeah, like anything, that can and does get distorted. But in that hour, it felt right, and it was very cool to feel service and receiving come together, and see them coexist not only within the same hour, but sometimes in the same few minutes. And that’s what I think helped define friendship with God and with people for me.
And in the world of non-retreat-time, it is really easy to get overwhelmed by the needs of the people we see. Actually, it is really possible to get overwhelmed by the needs of 50 Christians in a room for an hour also. And that really clearly reminded me that that feeling of overwhelmingness (that a word?) can overpower the original reason for service- that it isn’t to meet the needs of everyone and lift them up, but to seek and follow through with ways of serving that lift up Jesus, imitate Him, and create a spirit of service that lasts when there is overwhelming need, when the service isn’t overtly fun, when it’s risky, when it’s hard, when it’s washing someone’s gross and dirty feet.
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