Governor Jindal Is Keynote Speaker at Opening of LSU North Baton Rouge Clinic
Baton Rouge (June 2, 2009) – Governor Bobby Jindal will be the keynote speaker at the opening and
ribbon-cutting ceremony for the new LSU Health System North Baton Rouge
Clinic, 5439 Airline Highway, Thursday, June 4, at 10:00 a.m.
The clinic will provide quality comprehensive adult
preventive care in a state-of-the-art facility, offering the best in primary
care, cancer services, and women’s health.
“LSU is continually evolving in its provision of health
care to ensure that residents receive the best possible medical services,”
said Dr. Fred Cerise, Vice President for Health Affairs and Medical
Education. “The North Baton Rouge
Clinic is another example of LSU bringing health care closer to the people we
serve.”
With 44,000 square feet and two floors, the clinic will be
the umbrella facility for specialty clinics that have been housed at the Earl K.
Long Medical
Center, such as OB/GYN,
cancer services, and primary care medicine.
The ready availability of health care providers in such an
excellent facility will encourage people to receive preventive health care
and disease treatment on schedule, preventing minor illness from becoming
major.
The Women’s Clinic and Primary Care Clinic will provide
comprehensive obstetrics and gynecological services.
The Primary Care Clinic and its Disease Management Program
will offer patient education to prevent the many complications that can arise
from chronic diseases.
“The LSU Disease Management Program is recognized
nationwide for its superior outcomes,” said Dr. Michael K. Butler, CEO of the
LSU Health Care Services Division.
“Much of that success is due to accomplishments the program has made
here in Baton Rouge. We will continue to provide nothing less
than quality health care.”
The North Baton Rouge Clinic has 30 exam rooms, a
community meeting room, a diagnostics laboratory, a pharmacy, and radiology
services.
Laboratory services will include standard and special
chemistry; urine, hematology, and bacteriology studies; and therapeutic drug
monitoring. Radiology services will
include PET/CT scanning, digital radiology studies, digital mammography, and
obstetric and general ultrasound services.
Cardiology services will include EKG, Echo, and
stress-testing capabilities.
Plans for the future include an urgent care clinic for
unexpected medical needs.
Easily accessible, this $18 million facility will
accommodate the region’s rapidly growing population and is another
opportunity for LSU to provide quality health care to North
Baton Rouge residents.
The LSU Health System - Health Care Services Division is
one of the largest public health care delivery systems in the country. It has over 35,000 inpatient admissions,
nearly 196,000 inpatient days, 515,500 outpatient clinic visits, 894,000
outpatient encounters, and nearly 244,000 emergency department visits. Each year nearly 500 residents and fellows
from the LSU and Tulane Schools of Medicine and Ochsner
Health System and 2,200 nurses and allied health students from many colleges
and universities are trained in LSU facilities.
LSU is the largest single provider of uncompensated
inpatient care in Louisiana. LSU HCSD hospitals have an economic impact
of over $1.4 billion in asset business activity, $568 million in personal
earnings, and generate over 12,000 jobs.
[BACK TO TOP]
By David Hammer
Staff writer
In three months, new leadership in FEMA has resolved more
than 1,500 disputes over federal aid to fix Hurricane Katrina damage to
public buildings, but, in a sign that the problems run deeper than any
official or administration, Louisiana
and FEMA still can't agree on how many arguments remain outstanding.
That was the picture of mixed results Monday as U.S. Rep. Anh "Joseph" Cao, R-New Orleans, called
federal, state and local leaders together at devastated Charity Hospital,
the subject of the biggest dispute.
Participants had to sign waivers stating they understood
the risks of entering what was once Louisiana's
largest public hospital, and Cao was hoping his colleagues from Washington would be
swayed to the state's position that the building is a total loss.
Debris was still strewn in the tattered offices. Emergency
lights were hung in a few select hallways, and with no air conditioning, the
gathered officials and media felt a little of what it was like in the days
after Katrina flooded the Art Deco structure.
But the visit to Charity may not do anything to change
FEMA's position on the matter. In denying Louisiana State University's claims
that the hospital was more than 50 percent damaged by Katrina and thus is due
$492 million, FEMA has offered only $150 million, insisting that much of the
deterioration is due to LSU's negligence after the storm.
Officials on all sides expressed hope Monday that a new
mediation process, which was promised by Homeland Security Secretary Janet
Napolitano, will get under way to resolve the Charity issue.
Cao and other elected officials treaded lightly on the
issue of whether LSU should renovate the building or put the public
assistance money toward a proposed joint LSU-Veterans Affairs hospital
complex farther up Tulane Avenue, but Louisiana Recovery Authority Director
Paul Rainwater left no doubt about the state's position.
"Let's be clear: We are not going to put a hospital
back in this building," he said after several officials said they
weren't taking a side in the debate over the building's future use.
Community leaders and others have opposed LSU's plans to
tear down much of a residential neighborhood to build a new complex when they
feel the old Charity building can be refurbished.
However, Cao said Monday's meeting wasn't so much about
Charity, but about cutting through the red tape that has hindered the flow of
federal money to more than 1,000 state and local agencies that applied for
public assistance rebuilding dollars since Katrina.
The meeting was run by Rep. John Mica of Florida, the ranking Republican on the
House Transportation and Infrastructure Committee. Even with Republicans Cao,
Rep. Steve Scalise of Jefferson
and representatives of Gov. Bobby Jindal's
administration setting the tone, they expressed hope about stronger
cooperation with new federal officials put in place by President Barack
Obama.
At Jackson Barracks, where disputes over public assistance
projects still abound, National Guard adjutant Maj. Gen. Hunt Downer said
FEMA has approved $38 million in projects in the past three months, more than
doubling the total it sent to the flooded state military base in the previous
three years.
FEMA has approved more than $7.4 billion for state and
local agencies so far.
Advertisement
Still, state and local officials say something must be
done to make the process work no matter who is running the show.
Although FEMA says it has only 736 cases outstanding,
Rainwater says 2,800 disputes actually remain, dealing with some $2 billion
in aid.
"It's nice to have everyone working together, but we
need an understanding on these numbers," said Mica, who called on the
Homeland Security inspector general to figure out how many disputes there
are.
Rainwater said FEMA is counting only the written disputes
that have reached Washington
after they have already gone through months of back-and-forth by officials on
the ground. Rainwater suggested FEMA should do what he did with Louisiana's Road Home
program: Throw out the broken dispute process and put every contested issue
-- from fights over one piece of equipment in a damaged building to the $342
million discrepancy over Charity -- into a single, formal appeal process.
The overriding message from the locals -- including
Downer, New Orleans City Council members Arnie Fielkow, Jackie Clarkson, Cynthia Hedge-Morrell and Stacy
Head and Jefferson Parish Council Chairman Tom Capella
-- was that FEMA's arcane rules are the single largest obstacle to the
recovery of the area.
FEMA officials didn't endorse that view, but they didn't
put up much resistance to it, and they were ready to acknowledge that they
weren't the best partners in the past.
"I think we're not the FEMA we were a year ago or two
years ago," said James Walke, FEMA's director
of public assistance.
http://www.nola.com/news/t-p/neworleans/index.ssf?/base/news-10/1243920109315860.xml&coll=1&thispage=2
[BACK TO TOP]
Jindal:
LSU needs more details
By Bill Barrow
Capital Bureau
The Times-Picayune
Gov. Bobby Jindal says he
remains a supporter of a medical complex in Mid-City but wants a more
detailed business plan.
Listen in:
http://blog.nola.com/politics/2009/06/Jindal%206-1-09_02_01.mp3
BATON ROUGE -- Louisiana State University System officials
must craft a more detailed business plan for the state medical complex
proposed to replace Charity Hospital in New
Orleans, Gov. Bobby Jindal
said Monday.
"They will tell you they have a business plan," Jindal said of the university system that runs the
state's public hospital system. "My point is that they need more
details."
The governor said he remains a supporter of the proposed
424-bed academic medical complex in lower Mid-City. His comments come in the
context of a legislative session that includes debates over the hospital's
governance and a bill that could slow the state's acquisition of land for the
facility.
A House committee last week endorsed House Bill 780 by
Rep. Rick Nowlin, R-Natchitoches,
that would block the state from buying or taking property until the
Legislature's Joint Budget Committee approves a financing plan.
"I do think we need to move forward," Jindal said. But he said Nowlin
raises a legitimate concern about cobbling together the footprint with many
lingering questions surrounding the project.
The Legislature's joint budget panel already has approved
two plans for the hospital, including the latest version released in mid-2008
with Jindal's backing. That proposal calls for a
$1.2 billion facility with $492 million coming from federal reimbursement for
Hurricane Katrina damage to Charity; $300 million coming from the state's
capital outlay budget; and the rest coming from bonds to be repaid with the
hospital's future operating revenue.
Only the state's contribution is confirmed. The state
facilities office remains in a dispute over the Federal Emergency Management
Agency's offer of $150 million for Charity damage. The planned independent
governing board that would sell the bonds has not yet been created, and that
body could not go to the private bond market until the FEMA piece of the
construction budget is in place.
The operating model also assumes that about a third of the
patients, many of them projected to come from LSU doctors, would have
insurance coverage. That's a considerably higher portion of paying patients
than have ever used Charity or University
Hospital.
Some LSU critics, including state Treasurer John Kennedy,
have complained that the business plan is not detailed enough, particularly
given the possibility that Congress and President Barack Obama could overhaul
how federal health care money is distributed.
"It would be to LSU's benefit" to expand its
plan, Jindal said, arguing that it eventually will
be required anyway to attract bond investors.
Dr. Fred Cerise, LSU's vice president for health affairs,
said last week that Congress is most likely to expand health coverage. Cerise
said LSU's underlying assumption is that the paying patient base in the
region will increase.
Separately, lawmakers are considering how to structure a
governing board of a new hospital. House Bill 830 from Speaker Jim Tucker,
R-Algiers, began as a proposal to strip LSU of much of its control of New Orleans' public hospitals,
with a board that includes no representatives from any of the universities
that have a stake in the hospital's training programs. But the bill has been
amended and remains the subject of wrangling.
Jindal repeated that he believes
all the participating schools should have representation and that the
governing board should have the authority to sell bonds independent of the
state.
http://www.nola.com/news/index.ssf/2009/06/jindal_lsu_needs_more_detailed.html
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Jindal
calls for more detailed hospital business plan
Gov. Bobby Jindal said LSU needs
a more detailed financial plan for its proposed new public hospital and
teaching facility in New Orleans, which would
replace Charity
Hospital.
Jindal said Monday "there
is a legitimate frustration" that LSU hasn't presented enough details in
its business plan for the hospital. The current plan would be too vague to
attract investors on the bond market to help cover the costs of building the
hospital, he said.
"They will tell you they've got a business
plan," Jindal said of LSU. "My point is
they need more details."
The governor said he continues to support construction of
the new $1.2 billion hospital, to replace the public hospital flooded and
damaged by Hurricane Katrina four years ago.
Jindal's comments come as lawmakers
debate bills that would change governance of the hospital (House Bill 830)
and that would require legislative approval of a financing proposal for the
hospital before the state could buy or expropriate land for it (House Bill
780).
"I think there is a legitimate frustration that there
needs to be a very detailed business plan that shows where the revenues would
come from, how this would be operated, how this new hospital will be
self-sufficient, how this will serve both as a safety net as well as doing
first-class research and teaching," Jindal
said.
The Legislature's joint budget committee already has twice
approved plans for the hospital.
Those plans describe a hospital that would be financed
with $492 million in federal money, $300 million from the state and the rest
from borrowing that would be repaid with hospital income.
But federal officials haven't agreed to give the state
$492 million for the Charity
Hospital damage, and
critics question LSU's assertion that it would generate enough money from
paid patients to repay the borrowing.
Jindal announced Monday that he
supports a budget maneuver that would use money from the state's "rainy
day" fund for higher education and replenish the fund with dollars from
a planned tax amnesty program.
The House used $50 million in expected proceeds from the
amnesty program to offset some of the cuts Jindal
proposed for public colleges in next year's budget proposal. But college
leaders said they can't budget for the tax amnesty money because it was unclear
how or when they would receive it.
The use of the rainy day fund money could help alleviate
the timing concerns of the tax amnesty money.
The amnesty money would be generated under a bill (House
Bill 720) that advanced Monday to the full Senate for debate. The measure,
already approved by the House, would give delinquent taxpayers a two-month
amnesty period to settle their tax bills, under a plan that the Jindal administration estimates could raise over $150
million.
In other legislative action:
The
House narrowly voted to shelve a proposal that would let the state
health department privatize the operations of a state-run nursing home in New Orleans called the John J. Hainkel
Jr. Home and Rehabilitation
Center. Opponents
argued the bill (House Bill 783) could cost the state more money and
shouldn't waive public bid laws. Supporters of the bill, pushed by Health and
Hospitals Secretary Alan Levine, said the state shouldn't be in the business
of running a nursing home. The bill was stalled with a 51-46 vote, but can be
revived.
The Senate will take up a bill by House Speaker Jim Tucker
that would create a commission to study the governance, facilities and
funding of Louisiana
public colleges. The commission would consider ways to trim costs and
streamline operations. It would include members from state government and
groups with expertise in higher education and would have to report to the
Legislature next year. The House voted 96-1 for Tucker's bill (House Bill
794) on Monday.
[BACK TO TOP]
Dennis Woltering / Eyewitness
News
Photo by Joe Hischer
Participants jammed the sweltering lobby of old
Charity Hospital in New Orleans on Monday, June 1, 2009 to take part in a
Congressional Field Hearing into why FEMA continues to delay payment of
damage claims as a result of Hurricane Katrina, including money to replace
the 80-year-old former hospital.
Watch Video: http://www.wwltv.com/topstories/stories/wwl060109cbcharitydamages.3cc88aba.html
NEW ORLEANS – A
congressional field hearing inside Charity
Hospital turned into
less of a tour than expected of the shuttered complex, and more of a call for
FEMA to resolve disputes over claims from Hurricane Katrina.
Video: Watch the Story
The ranking member of the U.S. House committee that
oversees FEMA, Rep. John Mica of Florida,
took a look at some treatment areas on the first floor of Charity Hospital
along with Louisiana
congressmen Steve Scalise and Joseph Cao. He then
convened a field hearing.
“Our focus is really to see, to assess the damages, to
look at what we can do in order to bring money down here,” said Congressman
Cao.
The hearing brought together state, federal and local
officials.
New Orleans councilwoman
Stacy Head argued Louisiana deserves the
full $492 million replacement cost for Charity Hospital,
not the $150 million that FEMA is offering.
“The estimates have been wrong, and they need to be
fixed,” Head said. “And we need to get the proper amount to rebuild Charity Hospital
or for the repaid of Charity
Hospital.”
“We believe under the Stafford Act that we are due a
replacement cost,” said Paul Rainwater, the executive director of the
Louisiana Recovery Authority. But he stressed the money will not be spent on
remaking Charity
Hospital.
“Let’s just make it clear, we are not going to put a
hospital back in this building,” he said.
The officials raised a series of other recovery issues.
They repeatedly complained that what they described as illogical rules of the
Stafford Act dealing with recovery funding have too often delayed recovery.
Major General Hunt downer of Louisiana's National Guard called for a
“catastrophic escape clause” in the Stafford Act. He said it would be an
escape clause “where an administrator comes in and says this warrants some
sort of an exception.”
He said the National Guard is much further ahead on
military-funded replacement claims at Jackson Barracks than on FEMA claims.
Cao asked a federal administrator who oversees FEMA, “Why
the constant blockage? Why the
constant obstacles that different (state and local) agencies have to face?”
James Walker, the acting assistant administrator for
disaster assistance, said, “I think our guys and ladies are doing what their
responsibilities are. And that is only to reimburse what is eligible.”
In the case of Charity
Hospital, the question
comes down to the amount of damage. If it's more than 50 percent damaged, the
state gets full replacement cost. But FEMA says it is less than 50 percent.
“Obviously this structure sustained a large amount of
damage,” Cao said after the hearing.
But does it look like more than 50 percent damage?
“Well based on what I have seen so far on the first
floor,” Cao said, “I believe the first floor was more than 50 percent
damaged.
Mica of Florida
sidestepped the question of how much damage Charity sustained. He said the
three congressmen just want to get the dispute resolved so Louisiana can move forward.
[BACK TO TOP]
by David Hammer, The Times-Picayune
TED
JACKSON / The Times-Picayune
Left to right: Congressmen Steve Scalese,
John Mica, Ranking Rep. member, Committee on Transportation and
Infrastructure and Joseph Cao hold a roundtable on Hurricane Recovery in the
lobby of the hurricane damaged Charity
Hospital, with no air
conditioning, and bare bulb lights, Monday, June 1, 2009.
In three months, new leadership in FEMA has resolved more
than 1,500 disputes over federal aid to fix Hurricane Katrina damage to
public buildings, but, in a sign that the problems run deeper than any
official or administration, Louisiana
and FEMA still can't agree on how many arguments remain outstanding.
That was the picture of mixed results Monday as U.S. Rep. Anh "Joseph" Cao, R-New Orleans, called
federal, state and local leaders together at devastated Charity Hospital,
the subject of the biggest dispute.
Participants had to sign waivers stating they understood
the risks of entering what was once Louisiana's
largest public hospital, and Cao was hoping his colleagues from Washington would be
swayed to the state's position that the building is a total loss.
Debris was still strewn in the tattered offices. Emergency
lights were hung in a few select hallways, and with no air conditioning, the
gathered officials and media felt a little of what it was like in the days
after Katrina flooded the Art Deco structure.
But the visit to Charity may not do anything to change
FEMA's position on the matter. In denying Louisiana State University's claims
that the hospital was more than 50 percent damaged by Katrina and thus is due
$492 million, FEMA has offered only $150 million, insisting that much of the
deterioration is due to LSU's negligence after the storm.
Officials on all sides expressed hope Monday that a new
mediation process, which was promised by Homeland Security Secretary Janet
Napolitano, will get under way to resolve the Charity issue.
Cao and other elected officials treaded lightly on the
issue of whether LSU should renovate the building or put the public
assistance money toward a proposed joint LSU-Veterans Affairs hospital
complex farther up Tulane Avenue, but Louisiana Recovery Authority Director
Paul Rainwater left no doubt about the state's position.
"Let's be clear: We are not going to put a hospital
back in this building, " he said after several officials said they
weren't taking a side in the debate over the building's future use.
Community leaders and others have opposed LSU's plans to
tear down much of a residential neighborhood to build a new complex when they
feel the old Charity building can be refurbished.
However, Cao said Monday's meeting wasn't so much about
Charity, but about cutting through the red tape that has hindered the flow of
federal money to more than 1,000 state and local agencies that applied for
public assistance rebuilding dollars since Katrina.
The meeting was run by Rep. John Mica of Florida, the ranking Republican on the
House Transportation and Infrastructure Committee. Even with Republicans Cao,
Rep. Steve Scalise of Jefferson
and representatives of Gov. Bobby Jindal's
administration setting the tone, they expressed hope about stronger
cooperation with new federal officials put in place by President Barack
Obama.
At Jackson Barracks, where disputes over public assistance
projects still abound, National Guard adjutant Maj. Gen. Hunt Downer said
FEMA has approved $38 million in projects in the past three months, more than
doubling the total it sent to the flooded state military base in the previous
three years.
Photo by Joe Hischer
Maj. Gen. Hunt Downer,
Louisiana National Guard, makes a point on differences between FEMA
reimbursement and military disaster rebuilding during a Congressional Field
Hearing at Charity Hospital in New
Orleans. At
right, Dr. Fred Cerise, LSU System Vice President for Health Affairs and
Medical Education.
FEMA has approved more than $7.4 billion for state and
local agencies so far.
Still, state and local officials say something must be
done to make the process work no matter who is running the show.
Although FEMA says it has only 736 cases outstanding,
Rainwater says 2,800 disputes actually remain, dealing with some $2 billion
in aid.
"It's nice to have everyone working together, but we
need an understanding on these numbers, " said
Mica, who called on the Homeland Security inspector general to figure out how
many disputes there are.
Rainwater said FEMA is counting only the written disputes
that have reached Washington
after they have already gone through months of back-and-forth by officials on
the ground. Rainwater suggested FEMA should do what he did with Louisiana's Road Home
program: Throw out the broken dispute process and put every contested issue
-- from fights over one piece of equipment in a damaged building to the $342
million discrepancy over Charity -- into a single, formal appeal process.
The overriding message from the locals -- including
Downer, New Orleans City Council members Arnie Fielkow, Jackie Clarkson, Cynthia Hedge-Morrell and Stacy
Head and Jefferson Parish Council Chairman Tom Capella
-- was that FEMA's arcane rules are the single largest obstacle to the
recovery of the area.
FEMA officials didn't endorse that view, but they didn't
put up much resistance to it, and they were ready to acknowledge that they
weren't the best partners in the past.
"I think we're not the FEMA we were a year ago or two
years ago, " said James Walke,
FEMA's director of public assistance.
http://www.nola.com/news/index.ssf/2009/06/from_disputed_charity_congress.html
[BACK TO TOP]
by Bill Barrow, The Times-Picayune
BATON ROUGE -- U.S. Sen. Mary Landrieu said she expects
Homeland Security Secretary Janet Napolitano to announce within two weeks a
new, final arbitration process for lingering disputes over federal payments
for public buildings damaged in Hurricanes Katrina and Rita.
Hundreds of projects across the Gulf
Coast are affected, but the largest
price tag -- and perhaps the most intense dispute -- comes from Charity Hospital. The Federal Emergency
Management Agency remains opposed to the state's request for $492 million
that accounts for more than 40 percent of the construction budget for a
replacement medical complex.
Landrieu, who sponsored the arbitration amendment in the
federal economic stimulus bill in part because of the Charity case, did not
divulge all the details of the new group. But she said it would comprise
experts who are independent of the Federal Emergency Management Agency, which
remains an arm of Napolitano's department.
The senator's amendment, worded generally, requires that
the Obama administration establish an "arbitration panel" to hear
Public Assistance disputes from Hurricane Katrina or Rita for projects with a
price tag of at least $500,000.
The law states: "The arbitration panel shall have
sufficient authority regarding the award or denial of disputed public
assistance applications for covered hurricane damage under section 403, 406,
or 407 of the Robert T. Stafford Disaster Relief and Emergency Assistance
Act." No other details are included, giving discretion to the
administration.
FEMA's Public Assistance Program compensates local and
state governments, along with non-profit entities, for expenses and damages
related to federally declared disasters.
The senator said it is her understanding that arbitrators
would have immediate jurisdiction over any Katrina or Rita disputes,
regardless of where a particular project may be in the existing appeals
process.
FEMA's regional
office in Texas
recently rejected the state's appeal of the agency's $150 million offer for
Charity. Under existing procedures, the next step would be hearings in front
of FEMA officials in Washington, D.C. Louisiana
officials have throughout the Charity dispute criticized the Stafford Act appeals process as unfair because it
amounts to an agency reviewing its own decisions.
Landrieu declined
to offer a time frame for when the Charity question could be settled.
In the mean time,
she said she has no immediate plans to ask Congress for money to finance the
hospital. Settling the Public Assistance amount, she said, will allow the
state to finalize its construction budget. At that point, Landrieu said she
would consider the federal appropriations process as an option should the state
need additional money.
http://www.nola.com/politics/index.ssf/2009/06/landrieu_says_hurricane_relief.html
[BACK TO TOP]
The LSU Shreveport Department of Kinesiology and Health
Science received an $18,000 grant from the Louisiana Campaign for Tobacco-Free
Living, an Affiliated Program of the Louisiana Public Health Institute.
The grant will be used to train eight Community Health
majors to become Peer Health Educators. The program will allow eight to ten
additional Students Health Advisors to design anti-smoking modules and
present them to various student groups. The students will conduct marketing
and advertisement activities, exhibit at the annual health fair, contribute
articles to the University student newspaper “Almagest” and identify
individuals interested in smoking cessation programs. Finally, six of the
program participants will be selected to be a part of the Freedom from
Smoking Facilitator Training program.
Dr. Timothy Winter, chair of the Department of Kinesiology
and Health Science, is the recipient of this grant.
[BACK TO TOP]
The Associated Press
(AP) — BATON ROUGE, La. - Gov. Bobby Jindal
said LSU needs a more detailed financial plan for its proposed new public
hospital and teaching facility in New Orleans, which would replace Charity
Hospital.
Jindal said Monday "there
is a legitimate frustration" that LSU hasn't presented enough details in
its business plan for the hospital. The current plan would be too vague to
attract investors on the bond market to help cover the costs of building the
hospital, he said.
"They will tell you they've got a business
plan," Jindal said of LSU. "My point is
they need more details."
The governor said he continues to support construction of
the new $1.2 billion hospital, to replace the public hospital flooded and
damaged by Hurricane Katrina four years ago.
Jindal's comments come as
lawmakers debate bills that would change governance of the hospital (House
Bill 830) and that would require legislative approval of a financing proposal
for the hospital before the state could buy or expropriate land for it (House
Bill 780).
"I think there is a legitimate frustration that there
needs to be a very detailed business plan that shows where the revenues would
come from, how this would be operated, how this new hospital will be
self-sufficient, how this will serve both as a safety net as well as doing
first-class research and teaching," Jindal
said.
The Legislature's joint budget committee already has twice
approved plans for the hospital.
Those plans describe a hospital that would be financed
with $492 million in federal money, $300 million from the state and the rest
from borrowing that would be repaid with hospital income.
But federal officials haven't agreed to give the state
$492 million for the Charity
Hospital damage, and
critics question LSU's assertion that it would generate enough money from
paid patients to repay the borrowing.
Jindal announced Monday that he
supports a budget maneuver that would use money from the state's "rainy
day" fund for higher education and replenish the fund with dollars from
a planned tax amnesty program.
The House used $50 million in expected proceeds from the
amnesty program to offset some of the cuts Jindal
proposed for public colleges in next year's budget proposal. But college
leaders said they can't budget for the tax amnesty money because it was
unclear how or when they would receive it.
The use of the rainy day fund money could help alleviate the
timing concerns of the tax amnesty money.
The amnesty money would be generated under a bill (House
Bill 720) that advanced Monday to the full Senate for debate. The measure,
already approved by the House, would give delinquent taxpayers a two-month amnesty
period to settle their tax bills, under a plan that the Jindal
administration estimates could raise over $150 million.
http://www.nola.com/newsflash/index.ssf?/base/national-21/12438972695610.xml&storylist=louisiana
[BACK TO TOP]
La. health chief opposes physician advisory
panel
By MARSHA SHULER
Advocate Capitol News Bureau
Louisiana’s
health chief is opposing legislation that would create an all-physician
advisory group to help state officials make decisions on how best to use
state health-care dollars.
The legislation, House Bill 717, would provide clinical
and medical advice on Medicaid policies affecting patient care. Medicaid is
the government’s health insurance program for the poor and covers about
one-fourth of Louisiana’s
4 million people.
The legislation is being pushed by the Louisiana Chapter
of the American
Academy of
Pediatricians.
It is scheduled for House floor debate today.
State Department of Health and Hospitals Secretary Alan
Levine said he instead favors reactivating a Medicaid medical advisory
council. The council, which has not met since 2004, is required under federal
law. “I’m not sure what problem they are trying to fix,” Levine said.
Dr. Stephen Spedale, a Baton Rouge
neonatologist and an advocate for HB717, said there is a need for the special
expertise that physicians can provide as decisions are made affecting patient
care.
“Is this good medicine or not good medicine? Is this
something we stand by? Should we be paying for this kind of care?” asked Spedale.
“It lets the Legislature know what a group of independent
physicians think. Right now they don’t have that kind of independent voice.”
Levine said physicians can already comment when Medicaid
rules and regulations are proposed.
Under HB717, sponsored by Rep. Hunter Greene, R-Baton
Rouge, Levine said a group of eight physicians would be reviewing more than
200 Medicaid rules that are proposed every year.
In addition, the advisory panel would require health
agency staff support and that would cost money, Levine said.
Spedale said many of those rules
do not deal with medical policies. He said the review is manageable and the
panel won’t require staffing. Other states have similar physician councils
that have worked well, he said.
http://www.2theadvocate.com/news/46681177.html.
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By Jan Moller
Capital bureau
BATON ROUGE -- Dr. Don Donaldson is a West
Bank pediatric dentist who has spent years lobbying the
Legislature to increase the reimbursement rates for children's dental
services.
Dr. Greg Folse is a Lafayette dentist who
made most of his living treating patients in nursing homes until the rates
for treating children went up last year and he began providing services in
schools.
Now Donaldson and Folse are at
the center of one of the most heavily lobbied bills of the session: House
Bill 687 by Rep. Kevin Pearson, R-Slidell, which seeks to outlaw most
school-based dental services and is scheduled for debate today on the House
floor.
The bill could affect how hundreds of thousands of poor Louisiana children get their dental care, and has
attracted attention from as far away as Washington, where the Federal Trade
Commission calls it anti-competitive.
Although most of the debate has centered on the safety and
propriety of practicing dentistry in a school setting, meeting transcripts
and interviews with the key participants show the central role that money has
played in bringing this turf war to the Legislature's attention.
Dentists gave more than $325,000 to lawmakers last year
through two political action committees, according to a transcript of a
presentation Donaldson gave to the Louisiana Dental Association earlier this
year that was provided to The Times-Picayune by opponents of the bill.
Donaldson said the money helped give the association "a pretty good
reputation" at the Legislature, according to the transcript.
Both Donaldson, who supports the bill, and Folse, who is fighting it, said their only motivation is
to make sure poor children have access to care. "One of my passions has
always been to try and treat these kids who were without care," said
Donaldson, who owns five pediatric dental clinics on the West
Bank and in St. Tammany Parish.
"To me, my whole life has been spent treating
vulnerable patient populations," Folse said.
"I'm called to do this. I don't care about money."
Until recently, however, the Medicaid rates were not
enough to cover overhead costs, Donaldson said, and only about one-third of Louisiana's dentists
would see Medicaid patients as part of their practice. As a result, only 37
percent of poor children who qualified for free dental care had ever seen a
dentist, while the rest -- more than 400,000 -- went without care.
Starting about a decade ago, the LDA, with Donaldson
serving as the head of its Medicaid task force, began pushing the Legislature
for rate increases. The group made slow but steady progress, culminating with
last year's session, when lawmakers agreed to a 15 percent to 20 percent rate
hike.
The number of dentists willing to see Medicaid patients
began to rise, doubling to nearly 1,200, according to Donaldson.
It also drew the attention of Folse,
who has won flattering national publicity for his work treating nursing home
patients in rural Acadiana. By November he had
started a school-based practice, where dentists in Shreveport,
Baton Rouge and New Orleans would visit schools with high
percentage of Medicaid children to provide checkups, fill cavities and
perform other routine services.
A Maryland
company, Reach Out America, was contracted to handle administrative tasks
such as billing, making appointments and making sure that parents filled out
the required consent forms. Folse estimates that
his practice has provided services to 5,000 children who otherwise would not
have seen a dentist.
The Dental Association quickly noticed, and by January a
petition was circulating to ban the school-based clinics in favor of a
"dental home."
"In two to three years, most kids will be seen in the
schools, and dental practices that see kids will be in trouble," the
petition said. "Every practitioner's income and livelihood will be
threatened."
Donaldson said the rate increases were the first step in a
multipronged plan to increase access among poor children through an outreach
program in schools that would encourage parents to bring their children for
treatment in private dental offices.
As it comes to the House floor for the third time, the
fate of the bill remains uncertain. It fell two votes shy of passing the
House May 19, and was abruptly pulled from consideration last week. House
Speaker Jim Tucker, R-Algiers, a co-sponsor, said amendments will be offered
to the bill that will direct the Louisiana Board of Dentistry to draw up new
regulations governing mobile clinics.
"It allows it to go forward, but it allows it to go
forward under much more protective regulations," Tucker said.
http://www.nola.com/news/t-p/neworleans/index.ssf?/base/news-10/1243920093315860.xml&coll=1
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By JAMES MINTON
Advocate Baker - Zachary bureau
CLINTON
— Officials of a rural health-care organization signed documents Monday to
obtain tax-credit financing for a new clinic that will be more than five
times larger than its facility.
Primary Care Providers for a Healthy Feliciana operates
RKM Primary Care in Clinton,
five school-based clinics in East Feliciana Parish and a health clinic in
Port Allen.
Located between the old and new lanes of La. 10 on the
west side of Clinton,
the clinic operates in a 3,700-square-foot building, a smaller portable
building for dental patients and a portable administrative building.
The new $4.9 million building will total 19,968 square
feet and will be behind the clinic, architect Roy Hendrick
said.
As a federally qualified health center, RKM offers primary
care in the under-served rural area for all patients, including those without
health insurance.
The initials are those of Dr. Richard K. Munson, who
donated a building for the clinic’s first location.
Chief Executive Officer Ginger Hunt said her group is the
first federally qualified health center in Louisiana to use federal New Market Tax
Credit funding for a capital project.
The organization also will receive state tax credit
funding for the project, significantly lowering the cost of borrowing the
capital.
The federal tax credits are worth 39 percent of a private
investor’s stake in the project, taken over a seven-year period, and the
state tax break is worth 25 percent of an investment over three years, Hunt
said.
The Legislature also put $1.9 million in a capital outlay
appropriation, Hunt said.
New Orleans tax attorney
Robert W. Nuzum said the Clinton
project will pave the way for other health-care facilities in Louisiana to use New
Market Tax Credit financing, which is available to nonprofit groups.
Nuzum also said he hopes state
legislators will take note of the opportunities for tax-exempt entities that
they created through the state tax credit program.
The building used as a clinic will be converted to a
facility for mental-health care, while the dental clinic will be included in
the new building, Hunt said.
Hendrick said Blount General
Contractors was selected as the builder. The work is expected to take about
10 months.
The building will have 37 adult medical, pediatric and
dental exam rooms, two interior courtyards and an ambulance entrance.
http://www.2theadvocate.com/news/46681302.html.
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Opinion: Louisiana Gov. Jindal Is Freddie Kruger On
Louisiana
Higher Ed Budget
BayouBuzz
| 06.02.09
Dr. Albert Samuels
When Bobby Jindal ran for
Governor, he talked about how important higher education is in securing Louisiana’s future. He
cited his experience as former president of the University of Louisiana
System as one of his key qualifications for the
office of governor. Many in the higher education community were encouraged by
Candidate Jindal’s background, thinking that
someone who was “one of them” would occupy the Governor’s Mansion.
But that was then - before the national recession and the
meteoric descent in oil prices turned surpluses into deficits. The same governor, the Rhodes Scholar that
some had hoped would be a friend to higher education, proposed a Friday the
13th Freddy Kruger type of budget for higher education - to the tune of $219
million in cuts, a reduction of 15% in state funding.
Thus far, the legislature has not come up with enough cash
in order to substantially mitigate the proposed cuts. The latest proposal,
offered by Sen. Lydia Jackson (D-Shreveport) would delay the implementation
of a portion of the Stelly tax rollback enacted
last year (projected to raise $118 million) in order to soften the blow to
the universities.
The governor has threatened to veto this bill should it
reach his desk; he calls it a tax increase by another name. However, the
governor has yet to offer a serious proposal to offset the cuts facing higher
education this year. Unless something changes soon, Louisiana’s colleges and universities will
experience a catastrophic hatchet job that will have devastating, long-term
consequences on the state. These impacts will cripple not just our colleges,
but will have far-reaching implications for Louisiana’s economic development for
decades to come.
The governor justifies his proposals in part by decrying
his lack of “flexibility” due to the failure of the Louisiana Constitution to
include higher education and health care among its constitutionally protected
areas from budget cuts. He supports a constitutional amendment granting the
administration more flexibility to deal with budget crises (However, since the earliest an
amendment can be voted on by the people is October, it’s not clear how this
amendment helps us with the problem we have right now.)
However, he found $50 million to save a chicken plant in
Farmerville from going out of business and $85 million to keep the Saints in New Orleans. To be sure,
I have nothing against the chicken plant and I love the Saints. The point of
these examples is that the problem is not simply one of revenue - the problem
is one of priorities. And when it comes to higher education,
that has historically been a problem in Louisiana.
The truth is that Louisiana
has never given higher education - or education, for that matter - its proper
priority. Education, in the heady days of the oil-financed populism that is
the legacy of Louisiana
politics from Huey Long to Edwin Edwards, was always the state’s highest
priority - after everything else of course. By comparison, Texas,
another oil state, invested the proceeds of its oil revenues in higher
education (which explains, for example, why the University
of Texas at Austin is significantly more
well endowed than LSU).
However, in a state with such an abundance of natural
resources, it did not matter (or so it seemed) that its higher education
system was under financed or poorly organized. Not when people with an eighth
grade education could get middle-class level jobs in the oil patch making
more money than people with college degrees.
This way of life came crashing down to earth in the 1980’s
during the Oil Bust. As a result, higher education endured thirteen
consecutive years of budget cuts starting in the early 1980’s; indeed, in
some years, colleges experienced mid-year cuts, which are even more
debilitating. Many bright professors and researchers left the state, finding
greener pastures elsewhere. The state began to reap the consequences of its
failure to invest in education at all levels. Industries for decades have
more often cited inadequacies in Louisiana’s
education system than its supposed “unfriendly
business climate” or its reputation for political corruption as the principal
reason they choose not to invest in our state.
This point is significant because it explodes the key
fallacy in Jindal’s political and economic
philosophy thus far - the notion that Louisiana’s
history of poor ethics and its “unfriendly business taxes” constituted the
chief stumbling block to the state’s economic growth. It has taken the
state’s colleges and universities 20 years to recover from the budget crisis
of the 1980’s - only to be walloped again by the current proposals by the Jindal administration.
It is through the prism of the budget crises of the 1980’s
that the proposed cuts by Jindal must be viewed
because it disrobes one of the arguments used by those who support the cuts -
the idea that higher
education could simply return to its 2006 funding levels (before the Katrina
funding boom) and simply “cut the fat” that colleges put on during the boom
years. This argument ignores the fact
that Louisiana
went 25 years without fully funding its higher education formula.
The recent infusion of dollars into higher education represent
the first time in decades that Louisiana
funded its colleges and universities at the Southern average. While that was
a noteworthy accomplishment, it should not be the end-all we strive for. If,
for example, Les Miles were simply an “average” coach with an average win
total, it wouldn’t be long before the LSU faithful would be calling for his
head. A football program that has grown accustomed to competing for a
national championship would not long tolerate a coach who was simply
“average.” Similarly, Louisiana
should not settle for an “average” or a “below average” higher education
system.
Just recently, LSU was mentioned among U.S. News and World
Report’s top U.S. universities--it was ranked 130th , making it the first
public university in Louisiana ever to make the U.S. News and World Report
rankings. This is partly attributable to the university’s “Flagship agenda,”
its “Forever LSU” Campaign, higher academic standards, and other factors that
are starting to pay off.
Louisiana
needs a first-rate research university if it is to be a major player in the
global economy. The connection between economic development and research
universities is well known in economic development circles. The draconian
cuts proposed by the administration threatened to undo the progress that LSU
has made in recent years. They will send a powerful signal nationally that Louisiana is not a
good place to invest. And to the degree that LSU catches a cold, many of the
state’s other universities will have pneumonia. The cuts will have
devastating impacts at many of the smaller universities. They will require
massive layoffs, cause the cancellation of numerous academic programs (and
imperil the accreditation of other programs that are not outright
eliminated), and threaten the long-term viability of some universities.
Supporters of these cuts argue that Louisiana has more four-year colleges than
it can afford and this crisis creates an opportunity for a long-overdue
pairing down of universities. But too many colleges by whose definition?
There is no magic ratio for what the “optimal” number of universities should
be - the city of Boston has 18 four-year
colleges, more than the entire state of Louisiana!
Furthermore, only 27% of the state’s population is college
educated (the national average for a state is 39%), making Louisiana dead last in the proportion of
its population that is college-educated. Given our deficit of college
educated citizens, it is not clear how closing colleges and universities makes a whole lot of sense.
Some say Louisiana
should invest more in its community and technical colleges and reduce the
number of four-year schools. But that is a false choice. The argument often
used is that Louisiana’s
shortage of skilled laborers is what is preventing companies from locating
here; consequently, we need to build up our community colleges to create the
workforce necessary for those kinds of jobs. Then, we will be able to nab the
big firms, like the German steel plant that recently went to Alabama or the Nissan facility that located in Mississippi.
(Actually, Louisiana
lacks no shortage of good training programs - we already train welders and
carpenters and brick masons, who very often move to other states
where they make more money). The same thinking is behind this so-called
“alternative diploma” (ostensibly to solve the state’s high school dropout
problem) to provide opportunity for those kids not likely to earn a four-year
degree. This rationale overlooks the
fact that if Louisiana
decapitates its colleges and universities, that will hurt all workers, not
just those in the so-called “knowledge industries.“
Furthermore, it fails to consider that even the kids taking “shop” or “auto
repair,” or “business math” in a digital, automated economy, need to
understand computers and mathematics to deal with the high-tech equipment
currently utilized in these so-called “mechanical” fields.
Not only is it short-sighted to cut higher education as
deeply as is being proposed, but the manner in which the administration
proposes to do so is grossly unfair. Jindal wants
to use a so-called “performance-based” formula as the basis for determining
the state allocation for its public universities.
Institutions would be funded on the basis of their
graduation rates and the amount of federal research dollars they generate, as
opposed to their levels of enrollment.
On the surface, it appears to be a fair measuring stick. But the devil
is in the details. In actuality, the formula does not measure performance at
all. If for example, it treats institutions like Southern University, whose
entering freshman average 18 on the ACT on par with LSU, where students
frequently score 24 or above on the same measure. Colleges who primarily
admit the best-prepared students will always have an advantage over smaller
schools with more lenient admissions standards that enroll a higher
proportion of the less-prepared students. It is like comparing apples and
oranges.
For those institutions like Southern University, whose
mission has been to offer educational opportunity not just to the elite or
the best prepared, the formula penalizes Southern and institutions like it
simply for fulfilling their own missions. Jindal’s
so-called “performance based” formula is a thinly-veiled mechanism that
appears purposely designed to mortally wound “less favored” higher education
institutions within the state.
The legislature and the administration must come up with a
solution to this current crisis that minimizes the impacts to higher
education. Literally, the future of our state is at stake. Jindal cannot simply be “Dr. No” and stick to his
unrealistic, anti-tax, anti-solution stance to the problem. His posture is
particularly infuriating considering that his policies are partly to blame
for this crisis. It was the Stelly tax rollbacks
that he brags about (and which he seems unwilling to acknowledge were a mistake)
which have aggravated the budget crisis. While he opposes using “one-time
money” to solve the current problem, that did not stop him last year from
spending $500 million in one-time money on road projects. Lawmakers should
delay or roll back the tax cuts from last year, dip into the Rainy Day Fund,
apply the tax incentives that Jim Bernhardt wants to give back to the atate,
or some combination of the above in order to avoid catastrophic cuts to
higher education. If state leaders do not change course (and soon), they will
not only be cutting colleges; they will be cutting our own throats.
http://www.bayoubuzz.com/News/Louisiana/Politics/Louisiana_Gov._Jindal_Is_Freddie_Kruger_On_Louisiana_Higher_Ed_Budget__8930.asp
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FUN staff
AIDSLaw of Louisiana, which has
been serving the Baton Rouge metropolitan area
since 1995, is opening an office in Baton
Rouge.
The organization will hold a ribbon-cutting at 11 a.m.
today at the new office at 4560
North Blvd., Suite 118.
A reception will follow at 5:30 p.m., hosted by the Baton
Rouge Bar Association at 544
Main St.
AIDSLaw provides legal services
to those living with HIV-AIDS, providing protection from discrimination,
access to essential medical care and public benefits, and estate planning
services.
AIDSLaw of Louisiana has been
serving people affected by HIV/AIDS for 20 years.
http://www.2theadvocate.com/news/46680962.html
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Advocate business staff
Department of Health and Hospitals secretary Alan Levine
and Together Rx Access executive director Roba
Whitely will hold a news conference at 2 p.m. Tuesday at the state Capitol to
draw attention to efforts to help more uninsured residents gain access to
prescription medicines.
Around 640,000 Louisiana
residents lack health insurance. Together Rx Access offers a free card that
can help cardholders save 25 percent to 40 percent on more than 300
brand-name prescriptions, as well as lower prices on thousands of generic
drugs.
The program is supported by major pharmaceutical
companies.
For more information, go to TogetherRxAccess.com or call
(800) 250-2864.
http://www.2theadvocate.com/news/business/46637472.html
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An American scientist says he was misquoted in reports
claiming the swine flu virus originated in "either New Zealand or China".
"The statement was based on early phylogenetic
analysis of available sequences. It was misquoted," Professor Gus Kousoulas of the School
of Veterinary Sciences at Lousiana
University told the New
Zealand Science Media Centre.
"There is no basis currently to support a New Zealand
origin. While we still do not know the true origin, a US or Mexico origin is more
likely," he added.
Swine flu, or influenza A(H1N1),
hit the headlines when a group of New Zealand
high school students contracted the virus while on a trip to Mexico
in April.
The World Health Organisation
said that since then 53 countries had reported 15,510 cases of swine flu,
including 99 deaths.
The number of suspected flu cases in New Zealand is steady with all
nine confirmed cases now recovered.
However, Australia's
swine flu tally has passed 400 as Victoria
recorded a massive surge in cases, most of them children.
Most of the new cases in Victoria involved young people aged five
to 18, prompting a 12th Victorian school to be closed on Monday. Two schools
in Cairns
also will be closed this week after two 13-year-old girls tested positive for
the virus.
New
Zealand schools are also being warned they
might have to close if students test positive for swine flu.
The Ministry of Health is writing to all schools this
week, warning of possible closures of up to a week where flu cases are found.
Director of public health Mark Jacobs said confirmed swine
flu cases could lead to school closures.
Schools would have to plan on how to notify parents and
identify how to continue lessons. It was only a matter of time before more
cases emerged in New
Zealand, he said.
http://www.3news.co.nz/News/HealthNews/Scientist-misquoted-on-swine-flu-origin/tabid/420/articleID/106729/cat/58/Default.aspx
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The New York Times | 06.01.09
By DENISE GRADY
Béatrice de Géa for The New
York Times
COMPLICATIONS A woman in Berega,
Tanzania, who sought care after a botched abortion. In Tanzania, where abortion is
illegal, the maternal death rate is high in part because of failed abortions.
BEREGA, Tanzania
— A handwritten ledger at the hospital tells a grim story. For the month of
January, 17 of the 31 minor surgical procedures here were done to repair the
results of “incomplete abortions.” A few may have been miscarriages, but most
were botched operations by untrained, clumsy hands.
Abortion is illegal in Tanzania (except to save the
mother’s life or health), so women and girls turn to amateurs, who may dose
them with herbs or other concoctions, pummel their bellies or insert objects
vaginally. Infections, bleeding and punctures of the uterus or bowel can
result, and can be fatal. Doctors treating women after these bungled attempts
sometimes have no choice but to remove the uterus.
Pregnancy and childbirth are among the greatest dangers
that women face in Africa, which has the
world’s highest rates of maternal mortality — at least 100
times those in developed countries. Abortion accounts for a
significant part of the death toll.
Maternal mortality is high in Tanzania: for every 100,000
births, 950 women die. In the United
States, the figure is 11, and it is even
lower in other developed countries. But Tanzania’s
record is neither the best nor the worst in Africa.
Many other countries have similar statistics; quite a few do better and a
handful do markedly worse.
Eighty percent of Tanzanians live in rural areas, and the hospital in Berega
— miles from paved roads and electric poles — is a typical rural hospital,
struggling to deal with the same problems faced by hospitals and clinics in
much of the country. Abortion is a constant worry.
Worldwide, there are 19 million unsafe abortions a year,
and they kill 70,000 women (accounting for 13 percent of maternal deaths),
mostly in poor countries like Tanzania
where abortion is illegal, according to the World Health Organization. More
than two million women a year suffer serious complications. According to Unicef, unsafe abortions cause 4 percent of deaths among
pregnant women in Africa, 6 percent in Asia and 12 percent in Latin America
and the Caribbean.
Reliable figures on abortion in Tanzania
are hard to come by, but the World Health Organization reports that its
region, Eastern Africa, has the world’s second-highest rate of unsafe
abortions (only South America is higher).
And Africa as a whole has the highest
proportion of teenagers — 25 percent — among women having unsafe abortions.
The 120-bed hospital in Berega
depends on solar panels and a generator, which is run for only a few hours a
day. Short on staff members, supplies and even water, the hospital puts a lot
of its scarce resources into cleaning up after failed abortions.
The medical director, Dr. Paschal Mdoe,
30, said many patients who had had the unsafe abortions were 16 to 20 years
old, and four months pregnant. He said there was a steady stream of cases,
much as he had seen in hospitals in other parts of the country.
“It’s the same everywhere,” he said.
On a Friday in January, 6 of 20 patients in the women’s
ward were recovering from attempted abortions. One, a 25-year-old
schoolteacher, lay in bed moaning and writhing. She had been treated at the
hospital a week earlier for an incomplete abortion and now was back, bleeding
and in severe pain. She was taken to the operating room once again and
anesthetized, and Emmanuel Makanza, who had treated
her the first time, discovered that he had failed to remove all the membranes
formed during the pregnancy. Once again, he scraped the inside of her womb
with a curet, a metal instrument. It was a
vigorous, bloody procedure. This time, he said, it was complete.
Mr. Makanza is an assistant
medical officer, not a fully trained physician. Assistant medical officers
have education similar to that of physician assistants in the United States,
but with additional training in surgery. They are Tanzania’s solution to a severe
shortage of doctors, and they perform many basic operations, like Caesareans
and appendectomies. The hospital in Berega has two.
Abortions in Berega come in
seasonal waves — March and April, August and September — in sync with
planting and harvests, when a lot of socializing goes on, Dr. Mdoe said. He said rumor had it that many abortions were
done by a man in Gairo, a town west of Berega. In some cases, he said, the abortionist only
started the procedure, knowing that doctors would have to finish the job.
Dr. Mdoe said he suspected that
some of the other illegal abortionists were hospital workers with delusions
of surgical skill.
“They just poke, poke, poke,” he said. “And then the woman
has to come here.” Sometimes the doctors find fragments of sticks left inside
the uterus, an invitation to sepsis.
In the past some hospitals threatened to withhold care
until a woman identified the abortionist (performing abortions can bring a
14-year prison term), but that practice was abandoned in favor of simply
providing postabortal treatment. Still, women do
not want to discuss what happened or even admit that they had anything other
than a miscarriage, because in theory they can be prosecuted for having
abortions. The law calls for seven years in prison for the woman. So doctors
generally do not ask questions.
“They are supposed to be arrested,” Dr. Mdoe said. “Our work as physicians is just to help and
make sure they get healed.”
He went on, “We as medical personnel think abortion should
be legal so a qualified person can do it and you can have safe abortion.”
There are no plans in Tanzania
to change the law.
The steady stream of cases reflects widespread ignorance
about contraception. Young people in the region do not seem to know much or
care much about birth control or safe sex, Dr. Mdoe
said.
In most countries the rates of abortion, whether legal or
illegal — and abortion-related deaths — tend to decrease when the use of
birth control increases. But only about a quarter of Tanzanians use
contraception. In South Africa,
the rate of contraception use is 60 percent, and in Kenya 39 percent. Both have lower
rates of maternal mortality than does Tanzania. South Africa also allows abortion
on request.
But in other African nations like Sierra Leone and Nigeria,
abortion is not available on request, and the figures on contraceptive use
are even lower than Tanzania’s
and maternal mortality is higher. Nonprofit groups are working with the
Tanzanian government to provide family planning, but the country is vast, and
the widely distributed rural populations makes many
people extremely hard to reach.
Geography is not the only obstacle. An assistant medical
officer, Telesphory Kaneno,
said: “Talking about sexuality and the sex organs is still a taboo in our
community. For a woman, if it is known that she is taking contraceptives, there
is a fear of being called promiscuous.”
In interviews, some young women from the area who had
given birth as teenagers said they had not used birth control because they
did not know about it or thought it was unsafe: they had heard that condoms
were unsanitary and that birth control pills and other hormonal
contraceptives could cause cancer.
Mr. Kaneno said the doctors were
trying to dispel those taboos and convince women that it was a good thing to
be able to choose whether and when to get pregnant.
“It is still a long way to go,” he said.
http://www.nytimes.com/2009/06/02/health/02abort.html?_r=1&ref=health
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