Doctor and activist


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Author: Arthur Chesterfield-Evans

Veterans’ PTSD costs $241 million 3/1/21

Some time ago. I was driving through Western Sydney and saw a huge billboard for army recruitment.  An interesting and challenging job, training for a trade etc.  I then stopped in a supermarket and there was a much smaller ad for a charity that helped Veterans who were victims of Post-Traumatic Stress Disorder.  I wondered why they needed a charity when the Dept. of Veterans’ Affairs has a much larger budget per patient than anyone else.

I asked a clinical psychologist friend of mine about this.  The psychologist had a good practice and admitted that a lot of work came from ex-Veterans, commenting nervously that almost all the Veterans had PTSD, but that it was a closely guarded military secret.  I was not surprised.  I had read ‘Exit Wounds- One Australian’s War on Terror’ by John Cantwell, the ex-commander of the Australian forces in Afghanistan.  He had PTSD and took himself off the short-list to be the chief of Australian defence to go into a psychiatric hospital for treatment.  He wrote in 2013 that the war in Afghanistan could never be won and that every Australian life lost there was wasted.  Troops are still there, presumably until the Americans all leave.

In 2019 I went to a pub dinner with a group I knew vaguely at a hotel in Kings Cross.  I had arrived late from work and as I moved to the end of our table, a man sitting alone on the next table moved his pack so that I could get in. I nodded thanks.  My group said a brief ‘hullo’ and went on with a conversation about people I did not know, so I remained a little detached.  After a while the man on the next table stood up and asked me in a broad Scottish accent if I would mind looking after his pack while got another beer.  He was unshaven and looked very dejected, perhaps in his early forties in age but his clothes were new.  I moved his pack so that it was more directly in my line of sight, and noticed that it was a state of art pack, perhaps a military one.  When he returned I asked him what part of Scotland he was from.  (This is always a good opening line for Scots as they hate being asked what part of England).  He said that he was a stonemason, who had lived with his single mother until she had become unwell with memory loss and needed institutional care. He wanted to get a ‘powder ticket’ so that he could have his own quarry. He could not afford this training so he had joined the British Army. Seemingly he learned his explosives quite well and was posted to Afghanistan. He had had to do ‘a job’ involving explosives and was praised by his commander as he had apparently done it well from a military point of view.

He did not elaborate much at this point as he choked back his tears, but he felt utterly worthless and had asked for an immediate discharge from the army. He had an elder brother in Australia from whom he had been estranged since his parents separated when he was young and he had in arrived in Australia this very morning to find his brother at the most recent address he had.  He had no phone number or email.  The brother had left the address, so he had stopped for a drink. He had no friends, no country and was very, very depressed. 

As his tale unfolded, I was increasingly wondering what I could do, but in this case luck was with us both.  One of the others on the table I was in theory still having dinner with had started to listen to our conversation.  She was a counsellor in the Kings Cross area and joined in. She took over and found him accommodation, promising to get him some PTSD counselling when she finished a morning appointment the next day, and quite subtly got him to promise reciprocally not to commit suicide overnight. 

I followed this up with the counsellor and she was apparently successful.  He went with an Australian PTSD sufferer to a farm in the Central West where rehab is done for ex-Afghanistan veterans. Hopefully it was successful longer term.

But this story is largely luck, and success is not assured.  Here was the real face of the foreign policy stupidity in the Middle East, and prevention is far better than any hoped-for cure. 

The Vietnam war may have been ‘lost’  on the TV screens of America, but it is highly dubious that it could have been won anyway.  Iraq, Libya, Syria and Afghanistan do not look like having any chance of the West winning. But since the Falklands war, journalists are embedded with the Army and so are on one side that gives them protection and restricts their information, so there is no peace movement of any political note to stop the foolish machinations of Australia in fawning to please the US in wars.

I am not sure that Veterans have ‘unlimited access’ to mental health services- if they did, why would there be charities appealing for support?  My experience is that all funding bodies including Veterans Affairs try to deny the existence of a problem.   It seems the concern of the article is the cost of the rehab. The answer of course is to stop the war. 

The Buttery mentioned was the one of very few live-in addiction rehab programs that I could find when I was in Parliament.  It was near Bangalow on the North Coast and had endless trouble getting funding.  If it is now exclusively used by Veterans others will be missing out.

www.smh.com.au/politics/federal/bill-for-veterans-mental-health-care-reaches-241m-with-20-000-in-rehab-20201030-p56a9w.html

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China and the Taiwan Question. 1/1/21

As China increasingly decides to assert its status as a World Power, Australia has been given the message fairly clearly.

Morrison foolishly, and perhaps encouraged by Trump in his pre-election hubris, criticised China’s management of the Coronavirus.  If China was looking for a middle-sized power to humiliate using its Trade power, Australia had stepped conveniently stepped into the role. This is still playing out. If China squeezes hard, we are likely to have a recession and Morrison will lose the election.  If not, probably not.

China is asserting its dominance over the South China Sea by building bases on the Spratly Islands, and the US and Australia are sailing through them to show that they still can, but this does not prove that the balance of power is not shifting quite dramatically China’s way.

China has asserted that it is not a democracy and that the Communist party will be dominant for the foreseeable future.  It did not tolerate independence in Tibet, nor with the Uighurs, and most recently with Hong Kong, moving to crush local democracy, lest anyone else in China get ideas.  The democracy activists in Hong Kong who tried to escape to Taiwan by speedboat were caught, tried and imprisoned (ABC News 30/12/20).

Taiwan, which had an indigenous population as Formosa, became Taiwan, when Chiang Kai-shek, the pro-US, Nationalist loser of the Chinese Revolution fled there with 2 million Chinese in 1949.  Their safety at that time was guaranteed by the US Navy and their economy benefitted mightily from the Korean War (1950-53), where they industrialised to manufacture goods for the US war effort.  The US has effectively guaranteed their separateness from China.  China has never accepted that Taiwan is a separate country, regarding it as a renegade province that will eventually return to China by negotiation.  Taiwan agreed that there was One China, as it intended to overthrow the Communists and re-establish their Nationalist government.  This has become increasingly unlikely and is now at the point of absurdity, but political parties that are pro-reunification with the mainland have been doing quite badly in Taiwanese democratic elections.  The Taiwanese population enjoy both democracy and relatively high incomes.  They are naturally concerned with events in Hong Kong, as they are the next domino. 

If China wanted a military victory and to assert its new Great Power status moving across a short strait into its own backyard would seem the logical step, and it is doubtful that the US would have the capacity to prevent this, even if it had the will.

Frankly, Australia has to accept the reality that China has arrived at great power status.  We cannot get involved in a war over Taiwan.  We should take a more neutral position between the US and China, and think in terms of more intelligent trade bargaining and not selling out our assets to foreign powers of any colour.

http://www.informationclearinghouse.info/56111.htm

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The International Criminal Court has Declined to Prosecute Britain for War Crimes in Iraq. 1/1/21

Some have said that the ICC is where the big countries prosecute small dictators. The ICC has, in a 184 page document declined to prosecute British soldiers for war crimes in Iraq. They have also declined to say that the 2nd Iraq war was illegal. To do this they have quoted British rationale about the need to find Weapons of Mass Destruction, WMDs and ignored that fact that the weapons inspectors said that they have not found any, the Iraqis were cooperating better and that they wanted more time.

They use British names for Iraqi places, refer to the Iraqis as ‘insurgents’ in their own country and took refuge in the fact that the ICC does not have to investigate war crimes if the country that committed them is itself investigating. They then look at how the British investigations have gone, which is actually nowhere.

The author of this piece says he was a great fan of the ICC, but now concludes that it has no credibility. It is not a short piece, but this can be excused as it summarises the 184 pages of the ICC’s decision not to prosecute.

It is sad, but unsurprising that there is no credible enforcement of international law at an individual level, or in statements as to the actions of countries.

http://www.informationclearinghouse.info/56113.htm

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Privatisation of Research will Kill Millions due to Vaccine Non-Availability 30/12/20

The COVID vaccines were an international race.   Many countries and companies competed.  The Uni of Queensland one fell over because it made the AIDS test a false positive.  There are now 5 principal ones in the media; Pfizer from Germany, Astra-Zeneca/Oxford from the UK, Moderna from the USA, Sputnik 5 from Russia, and Sinovac from China.  Over here we ignore the two from Russia and China, for some reason.  Do we not trust them, are we just racist, or do we want to support Big Pharma in ‘The West’?

I recently met with some medical sceptics, who said that there is no public proof that the vaccine works, i.e. published papers.  I said that it was in the media that there had been a 43,000 person trial with not very many side effects. They conceded that this was correct, but pointed out that you could inject water  into 43,000 people with few side effects, and that it was a question of how many of the 43,000 had been exposed to the virus, compared to a group of 43,000 in the same environment who had not been vaccinated.  And you could not ask a volunteer who had just had the vaccine to cuddle up to a COVID case- that would be foolhardy.  Their key point was that all the data was still in the drug companies’ hands and not publicly available.  Presumably the regulatory authorities have it, and hopefully they are still being rigorous under the pressure.  We have to assume the vaccines work as we need to open up the world economy.

Our government promised a fortune to these companies before they even had a product to sell, and all the bluster about having an equal world in terms of vaccine access does not seem to have dollars attached.   At present there is not enough vaccine to go around, but it still matters where you start.  Logically, vaccinating Australians where there is very little infection would likely save fewer lives than vaccinating people where the virus is rampant.

I have told the story before about Jonas Salk, who developed the polio vaccine with public funds and did not patent it so that the maximum amount of vaccine could be distributed to rid the world of polio.  This was in sharp contrast to Glaxo, the drug company, which found that an old unpatented drug worked against AIDS, patented it and then insisted that the price of it be at least $US2 a day, although an Indian company said that they could produce it for 7 cents.  The result was several million extra AIDS cases in Africa.

Sadly the Human Papilloma Virus (HPV) vaccine, Gardasil was a similar story.  HPV was found to be the cause of cervical cancer.  The vaccine was developed at Uni of Queensland by Prof Ian Frazer, and then marketed by CSL and Merck.  Its roll out was considerably delayed by its cost, despite the fact that the Uni of Qld declined to insist on royalties from sales in developing countries.  It is still $73 a shot in Australia (2 needed, 3 recommended), though our government makes it free to Australian schoolchildren.

This article says that the Coronavirus vaccines will worsen inequalities.  This is true, because not only will poorer countries not be able to afford the vaccine, they will also have more people die and have higher health costs as they will have to treat the cases. It will also have a bigger impact on their economies.  The fine rhetoric about sharing world knowledge will certainly be tested.  It might be noted that the Chinese released the draft genome of the Coronavirus to the world in January 2020 (Sciencemag.org) in the interest of stopping the outbreak, which was a credit to China and gives credence to their vaccine.  On the other hand, I seem to recall that Pfizer declined to be involved in information sharing, but have been unable to find the reference for this.

Pfizer did not get public funding but their development partner, BioNTech, did.   The question is how much profit will there be in all this, and how much will the price stop poorer countries getting the vaccine.

The fact that governments no longer fund the research directly and go into ‘private-public partnerships’ gives rise to the feeling that governments put in the funds but the private partners both determine the priorities in research with a bias towards research that can make a profit and then make that profit.  The governments then either largely fund the profit, or leave their populations unable to benefit from the research that they as taxpayers funded.

I have two relevant articles on this, one below, and one coming shortly.

www.internationalhealthpolicies.org/featured-article/why-does-pfizer-deny-the-public-investment-in-its-covid-19-vaccine/

https://amp.theage.com.au/business/the-economy/a-pitiful-response-global-economic-inequality-a-side-effect-of-vaccines-development-20201226-p56q99.html

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The Evolution of Lying Proceeds Apace: New Daily 19/12/20.

When Trump was elected people asked me what he would be like. I said something like, ‘in any situation think what a dodgy real estate agent would do in that situation and you have my best prediction’.

Trump’s idea of truth was that it what is in your interest and what you can convince someone to believe. If you look at the real estate model of truth this is a ‘goer’. You convince someone that a property is worth a certain amount, even if its not. It the person believes you and pays the price, that becomes the value. and what you said becomes the truth.

Sadly, the paradigm does not work at all with science, and not even reliably in politics. But it takes some time for this to become evident, so the disinformation strategy still mostly works.

Morrrison invites journalists to a ‘briefing’ before he releases news. So if the coverage of the last issue was not to the government’s liking- no invitation this time. Journalists are in the unenviable position of getting a story and having to cover it s a certain way, or being scooped- the only one on the block without the story, bleating later. The technique is now called ‘media management’.

Here is Dennis Atkins with more on how it is done.

https://thenewdaily.com.au/news/politics/australian-politics/2020/12/19/scott-morrison-political-liars/

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Energy Storage is a large problem- the German Experience 13/12/20

Energy storage is a worse problem in Germany because they have longer cold periods with less sun than Australia. It seems that pumped hydro storage is our best option, but this article is correct that it requires a lot of energy alternatives for when the wind does not blow and the sun does not shine.


Demand management is also important, which means shifting things like off peak hot water to when the sun shines, but also paying people to switch off. If there is only a peak demand for a few hours a year, it is cheaper to pay people to turn off than to have a power source that is only used a few hours a year.

But articles about the problems in the German grid have been around for a long time and lessons need to be learned.

Those of us who want to move to renewable energy need to be aware of the problems and to address them, or we just look like naive ideologues.

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Cooperation on COVID Vaccines? 13/12/20

We hear a lot about 3 COVID vaccines; the Pfizer one being rolled out in the UK last week and in the US from tomorrow, the Oxford Astra-Zeneca one that is imminent, cheaper and has less problems with refrigeration, and the Moderna one, which is US based and does not yet seem to have a launch date.

There are two other vaccines in the news, the Russian Sputnik V one being rolled out there and in Eastern Europe, and the Chinese Sinopharm one that is going into Indonesia, India and elsewhere.  But it seems that no one is considering bringing these two into the Western world.  We might ask, ‘Why not?’

Is it racist?  Do we think their scientists are no good and would fake the results?   Are we simply in the thrall of Western pharmaceutical companies with captive regulators?  Perish the thought, would their vaccines be cheaper?  China has 1.3 billion people to protect and have goes to a lot of trouble to do so.  They had scientists working with the US until the fuss started.  They had a head start in the vaccine race.  If the vaccine did not work they would have wasted a lot of time and effort vaccinating their own country and would suffer a huge loss of face.  It seems unlikely that their vaccine does not work.  So again, why no evaluation here?  If Australia asked the Chinese to give us the data on their vaccine to evaluate it for licence here, it would be a nice peace gesture in the needless spat that was created when Morrison accused the Chinese of hiding the origins of the COVID epidemic.

It seems that some scientists in Britain and Russia have suggested cooperation between the Oxford and the Russian Sputnik V vaccine. This story is from RT- Russia Today. Will this actually happen?

www.rt.com/russia/509340-astrazeneca-sputnikv-vaccine-collaboration/

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COVID19 Vaccine Roll Out 11/12/20

People are asking me if they should get vaccinated. It shows how trust in our institutions has been eroded. A few years ago no one would have questioned it.

The side effects are far less than the death rates from COVID, particularly in older age groups or those with other health conditions. COVID also seems to have a considerable amount of long-term after-effects in a significant percentage of people; note the difference between the infection rate and the recovered rate in the statistics. (Of course some may have just been lost to follow-up).

Children seem to have few symptoms, but if they are not infected and grow older without immunity, it would be ironic if they are then badly affected later. Mumps is like that- relatively trivial in youth, but can cause pancreatitis, encephalitis and sterility later. Years ago in the pre-vaccination days, if a child had chicken pox or measles, the mothers would all bring their children to be deliberately infected at a ‘Pox Party’, though these are now discouraged. This sort of immunity may well be spreading and giving herd immunity in countries that have COVID now endemic, but it would be unwise to do it here as it would spread it to more vulnerable demographics.

Chicken pox can cause herpes zoster (shingles) in older folk, which is very painful, and now has a vaccine (Zostavax) that is very expensive but free after age 70.

This article is about the Oxford-Astrazeneca vaccine, which is not the Pfizer one that is currently being rolled out in the UK. It seems that the Oxford one is the first to publish the results of a Phase 3 trial, and though a lot of people have been vaccinated, not many people have been infected, which means that the numbers on which the conclusions are drawn are still not large. There is an embedded link in the article that gives a good summary of the trial procedures. It seems that the Oxford vaccine will have the advantages that it is easier to store, and transport and is cheaper. Presumably as this article is now published, its roll out is imminent also.

From an Australian perspective, there is now a huge rollout of the Pfizer vaccine in the UK, so we will know exactly how well it works by the time it gets here.

It is sad that the Qld Uni vaccine has been abandoned as it gives a false positive for the HIV/Aids Antibody test. Presumably it would have worked, and perhaps an alternative HIV/Aids test might have distinguished the two apart.

https://theconversation.com/the-oxford-astrazeneca-vaccine-is-the-first-to-publish-peer-reviewed-efficacy-results-heres-what-they-tell-us-and-what-they-dont-151755?utm_medium=email&utm_campaign=Latest%20from%20The%20Conversation%20for%20December%2011%202020%20-%201808017569&utm_content=Latest%20from%20The%20Conversation%20for%20December%2011%202020%20-%201808017569+CID_01f3cb2f6f072670ce3f7d184deeafcf&utm_source=campaign_monitor&utm_term=The%20OxfordAstraZeneca%20vaccine%20is%20the%20first%20to%20publish%20peer-reviewed%20efficacy%20results%20Heres%20what%20they%20tell%20us%20%20and%20what%20they%20dont

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US Health System and COVID-19 11/12/20

Here is an article about the US Health system and its response to COVID. Basically it seems that the US government is subsidising COVID treatments so that they are more lucrative than treatment of other diseases, so the private operators are filling their hospitals with COVID patients whether they need to be admitted or not, and non-COVID patients are excluded.

The other thing that is interesting is that there has been a huge growth in administrators since the 1970s. It has to be understood why private health systems are so inefficient. They have to keep individual insurance databases to keep track of premiums and churn as people change funds. When someone is treated they have to account for every band aid, visit, procedure or investigation, bill the patient and pay the practitioner. They have to market their product, compete for staff, and then figure out ways to avoid paying if possible.

Universal systems have everyone eligible, so do not need to worry about who is getting treated. No need to market the system, maintain many different churning databases, compete for doctors, keep accounts for every details of every treatment and bill and pay for them individually.

In terms of better health care there is no problem of adapting to whatever disease needs the most attention as the staff are motivated to do the most effective treatments, and there is no distortion of priorities to maximise profits.

The US health system is the least effective in the developed world in terms of delivering health care. but it is the most effective at its primary object- turning sickness into money.

No one has looked too closely at why the Australian system has been able to respond. Basically our public health system is State-based hospitals, which are still largely public and have doctors who could be re-directed to testing and vaccination. They can also change to do COVID if needed, and treat disease on their merit.

The private hospitals did very well out of the government subsidies here because they were emptied ready for a COVID influx that never came and they just pocketed the cash without much publicity for this from either themselves or the Government.

Australia has continued on its previous course, which is to starve Medicare and help the private system move towards a US system by stealth, and the COVID pandemic has so far not brought this to light. What is left of the public system has done well, helped by the fact that we are an island nation, so had some warning and could act to quarantine ourselves. The government was happy to take advice from the medical professionals because it had made such a mess of not taking advice from the firefighting professionals. But Medicare is still being quietly destroyed and we are moving to a US system of private medicine.

The government saves money on Medicare doing this, even though the system is much less efficient and much less equitable. But the key reason is not the savings on Medicare, it is the money to the Party coffers from the Private Health Industry (PHI), which is now much stronger with the changes John Howard did to the Aged Care system in 1997, which made it effectively a for-profit system, and the NDIS also a for-profit system, subsidised by the taxpayer through the Medicare levee, which was ironically not being used for health. (The discussion of the Aged Care system was in one of my posts last week).

The key thing to understand in the destruction of Medicare is that the rebate to doctors which was set at 85% of the AMA fee, so as to replace private medicine, has risen at half the inflation rate for 35 years and is now 46% of the AMA rate. Doctors are paid half what they were, so specialists mostly will not use it, and GPs who still bulk bill just do shorter visits.

Here is the article on the US response to COVID. Their prevention is also hopeless, as with such a poor welfare system the people cannot afford to stop work, and the story that it was a hoax was also promoted by President Trump. The obsession with ‘individual rights’ sits uneasily with the idea of staying home for the common good, and makes disinformation campaigns easier. People wanted to believe it was a hoax, because they could not afford to stop work anyway.

http://www.informationclearinghouse.info/55999.htm

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Global Dimming- another climate problem 5/12/20

Global dimming is the reduction in the amount of sun energy hitting the surface of the Earth. Research shows that the amount of sun energy reaching the surface of the earth has fallen 9% in Antarctica, 10% in the USA, 16% in the UK, 22% in Israel and 30% in Russia since the 1950s.  Water evaporates correspondingly more slowly. The results are from long term studies and data, and two relatively rapid studies, the change in temperature differences during the day when planes were all grounded in the USA after 9/11 in 2001 and a study comparing sun energy received in the north and south of the Maldives.

It seem that the particles in the air allow smaller water particles to be suspended on them as clouds, and these reflect more heat and light back out into space, hence shielding the earth.  This affects evaporation of ocean water and may have caused the droughts and famines in North Africa.

There has been a real effort to lessen air pollution particularly in Europe which may have helped African monsoonal rainfall, but if the dimming lessens and more sunlight comes into the atmosphere, it will mean that the greenhouse effect will worsen.

Revised calculations show that global warming may be 10 degrees Celsius in a  century, because the melting of the Greenland ice sheet and the release of oceanic methane, which is 14x worse than carbon dioxide as a greenhouse gas will make the global warming phenomenon irreversible.

The answer is that we have to stop burning fossil fuels. We need electric cars, renewable energy, and to replace planes with trains as much as possible.  It a shame we have a Liberal Government!

This 49 minute video is from the BBC Horizon program.

www.youtube.com/watch?v=57D2ii5HKxA&list=PLe6EP38qqR0af4fPQGy1LzbR6-8gY8KgA&index=11&fbclid=IwAR2eKLs9Jx2jgksiFy4rkgTaS1jRG2ZgU3Pvs7cGB5Ot9CdyDGLmqtvkyVc&t=0s

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