Archive for the 'children' Category

End Gun Violence

Wednesday, March 21st, 2018

“…I call on President Trump and the Republican controlled House and Senate and Executive Branch to work together, get some bills passed and stop taking money from the NRA because children are dying and so is the future of America as a result.”

David Hogg, survivor of the school shooting in Parkland, Florida last month

“To every politician who is taking donations from the NRA, shame on you.”

Emma Gonzalez, another survivor, who has more Twitter followers than the NRA

I morned the 17 people who were killed in the mass school shooting in Florida. Then I realized that I have a granddaughter who is in high school, and that her life might be in danger; this made me feel afraid and angry. Why should a 14 year old have to worry about getting shot at her school?

Every year there are more than 37,000 gun deaths in the USA, including about 22,000 suicides. 2017 was the worst so far, with 15,591 homicides. Incredibly, there were 732 children and 3234 teens who were injured or killed by guns. These are data from the Gun Violence Archives. You probably know already that the USA has many times the gun violence of any other developed country.

Why? Although mental illness is blamed frequently, it should noted that 98% of people pulling the trigger are men. Women also have mental illness, but they are much less responsible for shootings. Male aggression (!) and the easy availability of guns are contributing factors to most shootings.

Unfortunately, our government has not taken responsibility for the ease with which guns can be purchased. Indeed, in 1996 an amendment to the omnibus spending bill stated: ”…none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control….” This has effectively halted research into gun deaths.

How did this happen? Certainly the deaths of thousands of Americans is a public health crisis! The National Rifle Association wields immense power in Washington; it was they that effectively put a stop to gun injury research. The NRA has bought our senators and representatives. All told, the NRA has given Colorado Senator Cory Gardner $3,879,064, according to the New York Times. Gardner’s comment after the Las Vegas shooting was: “My family and I are praying for the families of those injured and killed….” He has not taken any substantive action to stop the shootings. The Washington Post wrote that Representative Scott Tipton has received $19,950 from the NRA.

Shootings are a terrible way to reduce our population! In my series of bad ways to decrease human numbers, this is one of the worst, since shooting victims are often young people. What can we do to reduce the slaughter? I offer several ideas.

Do you remember Gabby Giffords, the Arizona representative who was shot in the head while campaigning? Sign her pledge at: https://action.giffords.org/page/s/gabby_giffords_pledge. It says, in part, “…I will use every means available to make sure we have a different Congress, one that puts communities’ interests ahead of the gun lobby’s.”

Another idea is to require gun owners to purchase insurance, just as car owners do. Then if you, or a gun you own, shoots someone, the insurance would help with bills. The effect would be strong because insurance companies would pressure gun stores to keep guns out of the hands of the wrong people, and limit assault weapons.

Already PayPal, Square, Stripe and Apple Pay don’t allow their services to be used for the purchase of guns. Andrew Ross Sorkin suggests that all financial institutions—including banks and credit card companies—should stop doing business with retailers that sell assault weapons, high-capacity magazines and bump stocks. This would not be a cure, but it would be a step in the right direction for the sickness of shootings.

Nicholas Kristof has an excellent online essay “How to Reduce Shootings”. It is a clear statement of the problem, and includes 9 ways to approach a solution. One of them is to research “smart guns” which require a PIN or fingerprint before they can be fired.

I am pleased that teens such as David Hogg and Emma Gonzalez, both quoted above, are stepping up to be gun safety activists. Please join me on March 24th at a local March for Our Lives. Starting at 1PM we will meet at the Durango High School parking lot and march to Rotary Park.

© Richard Grossman MD, 2018

Caring for Mothers and Babies

Sunday, October 22nd, 2017

I’m retired now, but one of the parts of my profession that I liked the most was delivering a healthy baby, giving the baby to the mother and then watching the new mom hold and love the new life. I miss that, although I must say that I like to sleep all night without having to wake up for a delivery!

This picture is not recent, but I like it because the people are special to me. The new mom was born breech in the middle of a very foggy night in January; the baby was born exactly 18 years later–on the mother’s birthday! I am still in touch with mother and son, and both are doing well.

It has been a privilege to be with people at the special time of birth. I am concerned, however, that the babies that I have helped birth will know a world that is very different from the world I have enjoyed. My goal is to do my best to help them and all people to be happy and healthy–the same goal as I had for the 40+ years that I practiced medicine.

Richard

Keep Children Healthy

Saturday, September 23rd, 2017

I am writing this column in Northern Ghana, where 1 in 16 children dies before 5 years of age. Although that number is high when compared to developed countries, there has been amazing progress since 1960 when one in 5 died.

The under-five mortality rate is a valuable statistic because it gives an overall idea about the state of health and healthcare in a country. It reflects the social, economic and environmental conditions in which children live. It is defined as the number of children who die before their 5th birthday per 1000 live births, and is also called the child mortality rate.

The UN set 8 Millennium Development Goals, one of which was to: “Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate.” In Ghana during that period the rate went from 127 to 62 deaths per 1000 births. This halving reflects global progress; worldwide child mortality dropped from 90 to 45 in this period. Although we didn’t hit the goal, cutting the death rate in half is still an amazing accomplishment. Sadly, worldwide almost 6 million young children still die each year.

There is hope, however. Ghana recently trained several thousand Community Health Workers (CHWs). These “barefoot doctors” live close to the people they serve and treat illnesses as well as advocating prevention.

I traveled with a midwifery training-team to a village clinic. This part of the country has more than its share of maternal and infant deaths. Two midwives from the Baptist Medical Centre did an excellent job of teaching the clinic’s staff, which included 2 midwives and 3 midwifery students. Two rooms away another student midwife performed a delivery so quietly that I was amazed when a nurse brought out the healthy baby who was just minutes old.

While in the health center I saw a bottle of high-potency vitamin A capsules and was reminded of a remarkable study performed in this region. The overall death rate of children was lowered by 20% if they were given vitamin A supplementation. It appears the vitamin helps children fight infections such as measles and diarrhea, even where vitamin A deficiency is not prevalent.

If we are concerned about overpopulation, why should the death of children trouble us? Of course there are humanitarian reasons to keep children alive and healthy—they are our future! Demographers have found that people choose to have large families where there is a high child mortality rate.

It may appear paradoxical that preventing deaths will help eventually to slow population growth, but it is true. One of the best-known demographers of Africa, John Caldwell, cited three requirements before people will choose to have smaller families: educating girls and women, making effective contraception available and reducing the under-five mortality. He said that people only consider having a small family when child mortality is less than 130 per 1000. I could understand that number better when I converted it to a percentage—13%. That means that one in seven children dies—the thought is distressing!

In addition to training midwives, Ghana has instituted other ways to have healthier children. As I walk to the hospital I pass a nutrition center where small children are fed healthy, local food. Young kids with kwashiorkor (protein deficiency) and marasmus (severe malnutrition) are referred from the hospital, from outlying clinics and by CHWs. They spend 2 weeks or longer there being fed; many are still breast feeding. Every child is accompanied by a parent who is taught many ways to promote health, including nutrition and good hygiene.

Three days ago a young pregnant woman came to the hospital complaining of headache. Her blood pressure was elevated and the doctor noticed that she kept bumping into things, as though she couldn’t see well. Her mother gave the history that the patient had had an episode of shaking—a seizure. The doctor diagnosed eclampsia, the worst form of Pregnancy Induced Hypertension (PIH), with cortical blindness—a type of stroke. It was necessary to induce labor to save the mother’s life and hopefully her vision will improve. Unfortunately the very premature baby didn’t survive.

I am in Ghana studying PIH because it is more common here than in the USA. PIH can endanger the mother’s health and life, and has no treatment other than delivery of the baby. It is one of the most common causes of loss of life for babies and mothers, yet is poorly understood. Perhaps my study will shed light on this cause of obstetrical tragedies.

© Richard Grossman MD, 2017

Creative Commons Attribution 3.0 United States
This work is licensed under a Creative Commons Attribution 3.0 United States.