los anjalis

(Below is cross-posted a post I wrote over at LAist.com)

Photo by tao_zhyn on Flickr

Today marks the 60th anniversary of the Universal Declaration of Human Rights (UHDR), adopted by the General Assembly of the United Nations. The 30 articles of this declaration were written after the Second World War and represent the first global expression of human rights worldwide. The UHDR is the most translated document in the world and has inspired many international treaties and laws.

Now is as good a time as ever to remind ourselves of the human rights issues prevailing abroad, in the US, and here in Los Angeles. Violence and human rights abuses exist around the world, currently in Zimbabwe, Mumbai, Gaza, Iraq and Afghanistan, among other regions. Millions go without clean water or enough food. And a global financial crisis is ever present.

It is easy to focus on human rights abroad, but here in Los Angeles we have our own slew of human rights violations, including a housing crisis, homelessness, ICE raids, police brutality, displacement of communities in the name of development, health care access problems, unprocessed rape kits, and an increasing disparity between the wealthy and the poor. At the same time, there is much reason for hope.

One shining local example of this is in South Los Angeles, the area formerly known as South Central LA, where a unique coalition of health care providers, promotoras, and dedicated community organizations recently teamed up to address “The Perfect Storm” – the combination of homelessness, the housing/credit crisis, public health, and law enforcement issues. The coalition, known as the Homelessness Prevention and Intervention Collaborative, conducted an exhaustive survey of homelessness in South Los Angeles. And in October, they announced the findings of a report — Taming the Perfect Storm — written by Dr Rishi Manchanda, Director of Social Medicine at St. Johns Well Child and Family Center and the coordinator of the collective. In addition to describing the problem, the report presents recommendations for human-rights based solutions to the crisis in South LA. The report is well worth reading and concludes with:

In the nation as a whole, persistent widespread homelessness and the health care crisis offer compelling evidence of a collective disregard for human rights. Few places exhibit the ill effects of this disregard like South Los Angeles. Conversely, no other community stands to benefit as much from a community-based human rights approach to health. With a firm understanding of the links between critical determinants of health like housing, public and community health resources, and law enforcement policy, we commit to build the political will and skills needed to tame this perfect storm of homelessness and poor health. In short, we commit to reclaim and redefine our community guided by the practical application of fundamental human rights principles. As an important stage of community dialogue on the right to health, housing, and security begins, we welcome all constructive comments and critiques of this report.

On a national level, our President-Elect Barack Obama has stated a commitment to shutting down Guantanamo, ending the wars in Iraq and Afghanistan, strengthening the United Nations, improving diplomatic relations with other countries, and paying attention to the global crises of poverty and HIV/AIDS worldwide. And on this 60th anniversary of the Universal Declaration of Human rights, the official website of the United Nations notes:

“Following this historic act the Assembly called upon all Member countries to publicize the text of the Declaration and ‘to cause it to be disseminated, displayed, read and expounded principally in schools and other educational institutions, without distinction based on the political status of countries or territories.’”

On that note, I encourage you to read the 30 articles of the declaration. Aloud. To friends, family, anybody who will listen. In declaratory fashion. Try it. It’s quite compelling and a quick read. (idea inspired by my friend Linda who suggested this to me and 4 other friends as we were building and dreaming, during a break at a conference in El Salvador last year).

(cross-posted at Cure This)

I just received an email from The Gesundheit! Institute in West Virgina (run by Patch Adams and friends) — they’ve put out a call for applicants to their 2008-2009 Health Care Justice Gathering in West Virginia. These folks are non-traditional thinkers and dreamers, in every sense. I love the questions they’ve included on the application to the gathering:

3. What is your dream practice of medicine?

4. What is your expression of love? What connects you to people?

5. What is community to you? What do you consider your community? Who is your community?

6. If Peter piped a pickled-pepper, what is the most likely medical condition that he has, and how would you treat it?

Gotta love it!

More info on the gathering:

The Healthcare Justice Gathering is an activism-oriented meeting of students, physicians, medical professionals, clowns, and community-builders, whose programming is organized and created by its participants. Initially started in 2005 by the Direct Action Interest Group at AMSA, the HJG is going on its fourth year and has expanded to include a workshop-based gathering at Patch Adams’ Gesundheit! Institute in Hillsboro, WV scheduled for Dec 31th 2008- Jan 3rd 2009.

Past conferences have included workshops on: Building Novel Model Health Clinics, Coalitions, Liberation Medicine, Body Language and Greetings, Medical School Curriculum, Laughter Yoga, Diversity and Racism, Permaculture and Land Sustainability, Media Tools for Activism, and the Economics of National Healthcare. Patch Adams, Susan Parenti, John Glick, Lanny Smith, John Stang, Andru Ziwasimon, and many other physician-activists have participated and presented, and we are looking to have a similarly brilliant line-up this year.

Doc Andru Ziwasimon is user aziwa on Cure This and an innovative leader in health and justice in New Mexico. And Lanny Smith, founder of Doctors for Global Health and tireless activist doc.

Pretty cool.

Last week I was a resident. This week, a fellow.

Ack! Suddently, I’m supposed to be smarter, more beautiful, more intense, and lots more fun. All that in wonderwoman style, with such a quick transition from Family Medicine resident to Family Medicine Fellow? Bollocks!

What in the world is a “fellow”? As always I first consult the handy dandy Wikipedia:

A fellow in the broadest sense is someone who is an equal or a comrade. Historically, the term fellow was also used to describe a man, particularly by those in the upper social classes. Nowadays, it is most often used in an academic context: a fellow is often part of an elite group of learned people who work together as peers in the pursuit of knowledge or practice.

Ah yes, elite. One would think that’s a bad thing after all the “elitism” thrown around about the Obama campaign. Anyway, I just completed an intense 3 year long residency training in Family Medicine (in early August i’ll take my Family Medicine boards exam, which means that after passing, I’ll be properly boarded in this field and if I want, I’ll be able to set up my own little humane, innovative clinic for low-income folks).

I made the decision to pursue a 1-year Fellowship in Faculty Development at my program in Los Angeles, with a focus on Homeless Health Care (and Resident Education). It’s a win-win situation for me. It’s not that I don’t know what i’m going to do and thus am stalling with a fellowship. No-ho-HO. I gave up a wonderful move to Albuquerque to do totally rad work there, I passed on a better salary and possibly more flexibility in my work in Los Angeles, to do this fellowship. It’s all part of a larger strategy for the 10 year clinic/neighborhoodchange/community-building/healing plan :>

I’ll post some of my goals for the year in another post (after I’m done narrowing them down — you have NO idea how long that list is right now!). But for now, this fellowship will afford me opportunities to continue to develop as a competent (and hopefully excellent – in the future) physician, opportunities to teach residents (and therefore really solidify my knowledge as well as develop my teaching skills), and opportunities to also work with homeless populations in Los Angeles and pursue some really rad projects with amazing folks in LA.

So it’s off I go, first thing tomorrow, to serve as a “preceptor” in the clinic in the AM (which means family medicine residents will present a story, if you will, of the patient that they’re seeing in clinic, and i’ll give feedback and suggestions and ask questions about what they plan to do for management of that patients’ conditions, before they go back in to finish seeing the patient and explain their thought processes to the patient to come up with a solution that both of them find acceptable). I’m excited and nervous, and stoked to develop skills to nurture, teach, and challenge doctors in training!

(I’ve also made the decision to try to blog more spontaneously here at Los Anjalis and on the community health justice blog Cure This, which turned one years old this past week!) Hope to share more of what inspires me, more on music, and more on strategy for community change, on a more regular basis.

Back to blogging, after almost a month. What an adventure the past month has been. Intense! (just the way I like it). During a two week vacation in October, I participated in an inspiring and totally radical Doctors for Global Health gathering in El Salvador (with a few of my close friends from LA and SF) — I liveblogged once from there, and hope to share some more experiences and photos from that inspiring trip.

I flew back to LA just in time to fly out to New York City in order to hang with the ‘rents in NJ and DJ the 10th anniversary of MUTINY, an event that a few other DJs and I put on every month for 6 years. It was HISTORIC to say the least. Again, hope to reflect on that a bit here.

Flew back to LA and started a super intense adrenaline-rush of a 2 week stint working in the hospital with very sick patients. It was a truly rewarding experience, and I spent 16+ hour days in the hospital, taking care of patients, thinking out my clinical management of their diseases, talking to their families, and discussing plans with the subspecialty consult services in our hospital. Outside of the hospital I saw MIA in concert with a few friends, it was an out of control 2 hour visual and aural onslaught! Saw Suzanne Vega in concert the next week, she was amazing too. And now, I’ve completed a week on my new rotation as Resident Clinic Director, where I’m managing the flow of patients in our family medicine clinic as a 3rd year resident in family medicine. I’m also triaging the walk-in/urgent care patients and doing some administrative work too. It’s a fascinating learning experience, and very valuable for me since I’m jonesin’ to start my own clinic someday.

Lastly, this thanksgiving weekend has been filled so far with goooood movies (Syriana, City of God), goooood homecooked vegetarian food, goooood quality time with the bro, and some nice LA exploring (first time at the Eagle on wednesday night, and heading to dinner and maybe some dancing tonight in silverlake or west hollywood). I’m excited about my new resolve to spend some more time in Los Angeles instead of flying around the country and the world, and about figuring out what’s next for me after residency finishes in June. Always an adventure, always an adventure :>

and now, back to near-daily updates here. It’s been a month, and it’s time to get back in the game. I’m reading TOO much and experiencing TOO much that I’m itching to share with others…

The following is applicable to almost any urban neighborhood in the US. But it’s about Newark, New Jersey, after the recent shootings there. [I lived in Newark, NJ for 5 years before moving out to Los Angeles, and blog about Newark often on this site]. There’s been a lot written about the city especially after the shootings, but this piece by Bob Braun is a rare commentary that I believe really addresses the issues.

Newark. It’s a city neglected by the state for as long as I’ve worked there, and that comes close to 50 years.

Since I’ve started working, we’ve built highways around Newark to avoid seeing it and its people. We allow its property taxes to become confiscatory and then complain about the city’s shabbiness.

We allow its schools to become useless warehouses of children until the state takes over–and then the state fails to find a solution, so now talks of giving up. School failure is not simply a “report card” with eye-blurring, meaningless statistics–it’s hopelessness and self-destructive behavior among young.

What grotesque, grim poetry that the latest murders happened in a schoolyard to kids who believed in education.

We smugly congratulate ourselves on small anecdotal measures of success–more black faces on television, Barack Obama–but don’t think much of the folks left behind in even deeper pits of poverty and despair.

Think you got it bad? Try growing up in Newark poor and black, male and young. Tokenism is still the opiate of the white masses, and it’s a dangerous drug.

We tolerate racial isolation that is worse now than when it was politically fashionable to talk about integrating society–and that is no longer fashionable. Face it folks, New Jersey is a state of black and brown cities and white suburbs.

We think an arts center and a stadium and a Starbucks or two represent a Renaissance, when what is really needed are jobs, health care, and housing.

That’s right. I’ve argued extensively with friends in New Jersey that building another stadium (like they do in SO many cities — oh hai, there’s one being built in downtown LA too, as part of urban renewal) or building market-rate (aka expensive) new condos near the newark metro station is NOT the “renaissance” we need.

And oh, how nice would it be to start a medical clinic there, with a legal clinic, microfinancing center, and temporary housing, and classes, and promotora health outreach! (maybe part of the 10 year plan, we’ll see). Ok enough dreaming, back to the last two lines of the piece:

Huffing and puffing and lots of talk now about how this particular set of murders–so cold-blooded, happening to good kids–will change things.

Want to bet?

Bob Braun takes us to task. Check out the full article (ok i posted most of it because it was THAT good) and add your reaction to it on the same link (to counter the racist comments that currently exist there). Thank you, thank you so much, Mr. Braun, for the clarity.

Also, Ameer Washington wrote a nice post on The Daily Newarker about the same, here’s a piece:

The New Jersey Devils, a hot latte, and a dance troupe will not ease the suffering of Newark’s poor minority population. Those Saturday night events and sports are simply entertainment to sidetrack the fact that no one really cares. As long as it looks like someone is doing something to make progress, then that’s all that counts. Baltimore has the Orioles and the Ravens; Detroit has the Tigers, Red Wings, Lions, and Pistons, yet these two cities like Newark are still among the most dangerous in the country. Renaissance is French for “rebirth” and is defined as the revival of learning and culture. What has Newark learned over the past forty years since the 67 riots? Where is the rich culture that was once Newark? Where is the Newark that Council President Mildred Crump spoke about on My 9 News’ show “Real Talk”?

Right on. Interestingly, many of the comments on Ameer’s post and on bob Braun’s post are outwardly racist. To the tune of, that’s ok, the residents will be pushed out of the city as others from Hoboken and NYC move in, it’s really prime real estate. Or, the same old same old — personal responsibility argument. THIS is why the right to the city movement and national alliance is so pressing in our country.

-anjali

tonight i drove home from work around 9pm, just when the fireworks in Los Angeles were starting up. Silly me, thinking there would only be a few spots in the city that would be hosting major fireworks. On the drive up 110 and the 405, on a simple 20 minute drive, I passed about 12 different sets of bigtime fireworks. It was a beautiful sight (with some lovely sounds too) but also a bit distracting to the drivers. I had to be extra careful with driving, as it seemed most drivers were attempting to place one eye on fireworks — in front, to the side, behind the head — while keeping the other eye on the road.

i got to thinking about events in los angeles that facilitate the actual physical gathering of people. there are quite a number, but this day’s events seemed so wonderful, and i saw families with babies and elderly folks walking home from the local fireworks in my town, and tons of folks riding their bikes back, after talking and ooh-ing and aah-ing with people they knew and others they just met that day, sitting on the blankets or the open grass next to them. and earlier in the day, i saw a wonderfully diverse group of people bbq’ing in the park near our house — latinos and whites and blacks and kids and old folks alike. can’t help feeling like this is one of the few times where people freely celebrate together — people who wouldn’t otherwise be invited to similar events in other settings.

i hung out with some friends after getting home from work. we had our own post-fireworks gatheration. and we discussed some logistics behind the “medical clinic / legal clinic / microfinancing / temporary housing / community space / organic farm” idea i’ve had for a while. they’d just seen the movie SICKO and were ready to support an innovative model of delivering just and humane health care. it was rad talking to friends who aren’t in medicine about this idea. got some good business tips and sustainability coaching for the idea. i feel like i’ve got friends in high places, ones who are willing and ready to help make this thing work. sweet :>

From
“Erasing Tattoos, Out of Regret or for a New Canvas” (NYTimes, June 17, 2007)

On the horizon is a development that could change the very nature of tattooing: a type of ink encapsulated in beads and designed to break up after one treatment with a special laser.

The technology for the ink, called Freedom-2, was developed by scientists from Massachusetts General Hospital, and Brown and Duke Universities. It is to go on sale this fall.

“We think the fence-sitters who always wanted a tattoo but have been afraid of the permanence will jump in and get tattoos,” said Martin Schmieg, the chief executive of Freedom-2. “But as your life changes from young to middle-aged to older, from single to married to divorced, you get tattoo regret, so we think the tattoo removal market will increase as well.”

There are no hard statistics on tattoo removal, but Catherine A. Kniker, a senior vice president for Candela, a laser manufacturer, calculated that Americans may have 100,000 laser tattoo removal treatments this year.

Tattoos have been used for centuries to reflect changes in life status, whether passage into adulthood or induction into a group like the military or a gang. In recent years, tattoos have also become a fashion accessory, a trend fueled by basketball players, bands and celebrities.

A report by the Food and Drug Administration estimated that as many as 45 million Americans have tattoos. The report based the number on the finding by a Harris Interactive Poll in 2003 that 16 percent of all adults and 36 percent of people 25 to 29 had at least one tattoo. The poll also found that 17 percent of tattooed Americans regretted it.

Wow, 36 percent of folks in my age group have at least one tattoo. My friend Thilan just got a sweet one on his arm, done in Las Vegas. I’m working out some details for a design that may never come to fruition because the permanence of it all is ruining my creativity. But now with this removable ink… :>

Friends and I volunteer to do tattoo removals at a clinic set up at Homeboy Industries in East LA, for former gang members. It’s called Ya ‘Stuvo. And the Yag laser we use is dope. And big and scary.  So watch it. :>

From “Young Gangsters’ Special Weapon: Poetry“, LA Times, March 2007:

Use this time to tear up the old contracts, Henrikson told his young writers, who listened to him as if he were a guru. “People die never getting to know who they are,” he went on. He read them a Rumi poem, written in the 13th century, called “Ali, the Fighter,” in which Ali prepares to vanquish a foe who, in a last fit of anger, spits in his face. Ali pauses, sees a younger version of himself in his foe, and helps him up.

Of all the kids in the room, only Mario seemed old enough to be world-weary and wise. He’d already revisited his past — It’s not a life-style, It is a death-style — and wanted to move on. He called his poem “Better Days,” and read it as if he were ready to graduate.

Now I’m looking forward to

The better days

Where I don’t have to steal

For me to buy a meal

Or run around like a menace

Looking for an enemy to kill

“You’re a man now,” Henrikson told him when he was done. “You’re 18, and you’re an old soul.”

And that’s not unusual. “I see a difference in the kids who go through the program,” said Craig Levy, director of Camp Kilpatrick, which is next door to Miller. “It exposes them to things they don’t know well, like reading, writing and expressing themselves in public. They come out of it with a little less slang, and speaking more like young men.”

More of Henrikson and others’ work is detailed on their organization’s website, Street Poets, Inc. They do a lot of violence-prevention themed poetry, sessions with youth in juvenile centers, and performances in public, and they’re based in Los Angeles. There’s a beautiful poem written on the left side of the website, written by a 21 year old boy man.

This is somewhat similar to what two of the faculty members in our Department of Family Medicine (Dr. Puvvula and Dr Granados) do many sunday mornings — talk with kids in LA Juvenile Hall, support them, encourage creative outlets. And Father Greg Boyle created Homeboy Industries in 1992 to help transform the lives of ex-gang members through a variety of personal development and community building programs (that’s also where we — family medicine residents! — are trained to remove tattoos with a yag laser for ex-gang members who are making changes in their lives). All of this is so beautiful, and these methods are much more humane and long-lasting in their ability to make positive change than the negative ways of prison and negative reinforcement.

And thanks to Andy Hilbert for the tip, who blogs about education, the LA Unified School District, teachers, and other related issues.

(cross-posted at Harbor Family Medicine Blog)

As culture minister Gil has also sponsored an initiative called the Cultural Points program. Small government grants are issued to scores of community centers in poor neighborhoods of some of Brazil’s largest cities to install recording and video studios and teach residents how to use them.

The result has been an outpouring of video and music, much of it racially conscious and politically tinged rap or electronica. Since Brazilian commercial radio, which is said to be riddled with payola, will not play the new music, the creators instead broadcast their songs on community radio stations and distribute their CDs independently, at markets and fairs, rather than through existing record labels.

From “Gilberto Gil and the Politics of Music“, March 12, 2007.

Note to self: incorporate this into the 10 year neighborhood/clinic plan. :>