Sunday, December 29, 2013

South Sudan lurching toward genocidal conflict

The "White Army" is reportedly marching on the town of Bor in South Sudan. The Nuer tribe-based militia was dubbed for the white ash fighters rub on their skin to ward off insects. /Image via guardianlv.com

The world's youngest nation is on the brink of a fraternal bloodbath.

With widespread reports that the "White Army," an ethnic militia drawn from former Vice President Riek Machar's Nuer tribe, is on the march, time is running out to stop a genocidal civil war.

Anti-government forces appear determined to gain control of Bor, a strategic town in the oil-rich central region of South Sudan. Government troops loyal to President Salva Kiir, an ethnic Dinka, and rebels aligned with Machar have been fighting over Bor for nearly two weeks.

Reports that the youth-heavy, poorly disciplined White Army is bearing down on Bor are ominous.

The Nuer militia, armed with weapons ranging from automatic rifles to machetes and long knives, has been linked to a 1991 massacre in Bor that claimed about 2,000 lives. Most of the dead were members of the Dinka tribe.

Kiir claims Machar was among the leaders of an attempted coup on Dec. 15. It is far from clear who is controlling the militias and armed groups that have been fighting in South Sudan since the alleged coup attempt. But it is clear the country is spinning out of control.

Refugees crowd a U.N. compound in South Sudan in December 2013. /U.N. image

Monday, December 23, 2013

Phil Robertson fault lines sign of fractured union


Phil Robertson's suspension and the frenzied reaction that has followed is a taste of a great American schism in the making.

Set aside Robertson's suspension, the Duck Dynasty patriarch and A&E have deep pockets and their attorneys can clean up their mess. More concerning is the partisan screaming across the country's political divide.

For a country that prides itself on being "United We Stand" and "Boston Strong," the gap between the left and right of the American political spectrum could be as wide as it has ever been:
  • 50-50 elections over the past four presidential voting cycles
  • A deeply divided and gridlocked Congress
  • Radicalization on the left (Occupy Wall Street, etc.) and the right (Tea Party, etc.)
  • Stubborn divisions on several issues, including abortion, guns, immigration and sexuality
  • With income inequality and campaign spending at record highs, less than 2 or 3 percent of the population has both economic dominance and powerful political influence

The first casualty in war is truth

Americans should know the price of civil war. We have fought many wars but none was more bloody than the battle to preserve the union and abolish slavery.

Before we go down that road again, American history provides guidance to guard against disaster and disinformation:
  • President Lincoln: "America will never be destroyed from the outside. If we falter and lose our freedoms, it will be because we destroyed ourselves."
  • Second sentence of the Declaration of Independence: "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness."
  • Articles 1, 2 and 3 of the Constitution, establishing separation of power between the Congress, the president and the judiciary, respectively. (Firewall against dictatorship.)
  • The Bill of Rights, Amendment 1: "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people to peaceably assemble and to petition the Government for a redress of grievances."
  • The Bill of Rights, Amendment 2: A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed. (Basis for gun ownership and gun regulation.)
  • The Bill of Rights, Amendment 4: The right of the people to be secure in their persons, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized. (Basis of due process.)

Tuesday, December 17, 2013

Massachusetts health care outlook for 2014

The health care marketplace has been consolidating in Massachusetts for decades, with few standalone community hospitals remaining and a handful of players vying for dominant roles in Greater Boston.

In a rush of intense hour-long phone interviews, I recently produced four stories for MD News that included the 2014 prognostications of top executives at Greater Boston health care organizations. With the notable exception of a hospice and serious-illness care CEO who is grappling with falling Medicare reimbursement rates, the outlook these business leaders have for the year ahead is bright. All of them are keenly aware of the rapid and far-reaching change sweeping through U.S. health care.

The parade of presidents, founders and CEOs was a perfect introspective and prospective finish to a year of producing freelance stories for the Greater Boston edition of MD News. Here are some observations from the CEO series that will publish in early 2014 and the dozen other projects I produced for MD News this past year:

  • The Greater Boston health care marketplace is a bubbling cauldron of innovation that is ahead of the reform curve. Romneycare is a mirror image of Obamacare, giving the health care establishment in Massachusetts about a five-year head start on the rest of the country.
  • A major driver of consolidation in Massachusetts health care has been gaining efficiency to provide convenient services to patients while containing costs. The consolidated players are able to provide a wide spectrum of "integrated care" including urgent care, primary care, specialty care, surgical procedures, chronic disease management and rehabilitation services. A couple of recurring buzzwords among CEOs and health care providers are "seamless care" and "good hand-offs."
  • The Greater Boston health care marketplace is fortunate to have a deep pool of intellectual talent. With several academic medical centers and dozens of other world-class medical facilities, the state is fortunate to have a relatively large number of highly trained health care providers. The region also has excellent medical administration leadership. The men and women running Greater Boston's health care organizations appear well-equipped to tackle the changing landscape ahead.
  • In Massachusetts, health care reform is working. The marketplace is competitive, which is fueling innovation. Nearly all children and about 90 percent of the adult population have health insurance. With increased insurance rolls, access to care is as challenging as ever, but the increase in patients has created opportunities such as the explosive growth in primary care practices and urgent care facilities.
  • On a compassionate note, the growth in patients coupled with a heightened emphasis on wellness programs has created opportunities to improve the health level of the entire state.
  • Providing access to high-quality health care at an affordable cost is a challenge that can be met in a state such as Massachusetts, which has an enviable talent pool and medical infrastructure. Making health care reform work in every state in America is going to be a daunting challenge.

Wednesday, December 4, 2013

Newtown: Open letter to those touched by shooting

Two-year-old Addison Strychalsky of Newtown, Conn., pets Libby, a Lutheran Church Charities comfort dog, days after the mass shooting at Sandy Hook Elementary School. /AP photo by David Goldman

I grew up in Connecticut. My heart will forever grieve for the shattered families of Newtown.

On top of a torment that will never go away, you face a terrible choice: silence or martyrdom.

Avoiding the spotlight is surely the safest way to guard your families against the pain associated with the loss of your children. In terms of human suffering, you have endured enough. You have no obligation to risk more.

As today's release of the local police 911 tapes has shown, if the Sandy Hook Elementary shootings become the icon of unbearable gun violence, then a reliving of the event will be part of the bargain. Your story could be a catalyst for change, creating something positive out of a hideously negative event. But the story would be told again and again.

Some of you want silence. Others want some gain to come out of a horrendous loss.

So much was taken out of your control. And more shocks will surely come: the Connecticut State Police tapes, the five-year anniversary, the 10-year anniversary, the stray revelations.

It would not be easy, but there is a conscious step you could take. Your 20 families share an unwanted bond. You can bear that bond in clans of silence or martyrdom. Or you can come together and choose a shared path.

As the situation stands now, periodic media frenzies are inevitable.

You are public figures who wish nothing more than a return to the private lives you had before Dec. 14, 2012. It is a terrible burden no one should have to bear.

Monday, December 2, 2013

Newtown: Meaningless death of 20 young children?

Snow blankets teddy bears last December in Newtown, Conn., at a sidewalk memorial to the first-graders and educators shot to death at Sandy Hook Elementary School. /AP photo

Nothing.

The first anniversary of the mass shooting that claimed the lives of 20 first-graders and six educators at Sandy Hook Elementary School will soon pass. Nothing has been done to stop the spread of military-style assault firearms. Nothing has been done to stop criminals and those suffering from severe mental illness from gaining access to these weapons.

A century ago, it took the death of 146 people in New York's Triangle Shirtwaist Factory inferno to curb sweat shops in America. Most of the dead were young women.

When it comes to entrenched U.S. political forces such as the gun industry, it apparently can require the wholesale slaughter of innocents to dislodge them.

How many people will have to die in a school or some other public place before constitutional limits on military-style firearms are established? Will the death of 20 first-graders be meaningless or the beginning of the kind of changes that have saved countless worker lives since the Triangle Fire?

On March 25, 1911, A New York City police officer stands guard over Triangle Shirtwaist Factory fire victims as he watches the sweatshop blaze rage more than 100 feet above. /Image via thehistoryblog.com

Monday, November 25, 2013

Bullwork Top 10: Best films of the last Boomers

Films I wish my daughters' generation would see


No. 1 Little Big Man. How the West was really won.

No. 2 In the Heat of the Night. Sidney Poitier bitch slaps a racist plantation owner.

No. 3 To Kill a Mockingbird. Gregory Peck was the main man of dignity in Baby Boomer cinema.

No. 4 One Flew Over the Cuckoo's Nest. Why Jack Nicholson is more than an icky old guy at the Lakers games.

No 5 The Deer Hunter. Coming home is the hard part.

No. 6 Dog Day Afternoon. Al Pacino loses his cool.

No. 7 Sleeper. Woody Allen imagines a future dystopia.

No. 8. The Birds. Alfred Hitchcock get his creepy on.
No. 9. Zulu. Michael Caine makes his big screen debut; need I say more.

No. 10. Dr. Strangelove or: How I Learned to Stop Worrying and Love the Bomb. Peter Sellers plays several roles in this Cold War classic.

Newtown: State's attorney releases shooting report


Excerpts of Connecticut State's Attorney report, Nov. 25, 2013

"On the morning of December 14, 2012, the shooter (Adam Lanza), age 20, heavily armed, went to Sandy Hook Elementary School (SHES) in Newtown, where he shot his way into the locked school building with a Bushmaster Model XM15-E2S rifle. He then shot and killed the principal and school psychologist as they were in the north hallway of the school responding to the noise of the shooter coming into the school. The shooter also shot and injured two other staff members who were also in the hallway.

"The shooter then went into the main office, apparently did not see the staff who were hiding there, and returned to the hallway. After leaving the main office, the shooter then went down the same hallway in which he had just killed two people and entered first grade classrooms 8 and 10, the order in which is unknown. While in those rooms he killed the two adults in each room, fifteen children in classroom 8 and five in classroom 10. All of the killings were done with the Bushmaster rifle.

"He then took his own life with a single shot from a Glock 20, 10 mm pistol in classroom 10.

"Prior to going to the school, the shooter used a .22 caliber Savage Mark II rifle to shoot and kill his mother in her bed at the home where they lived at 36 Yogananda Street in Newtown. ..."

"It was fewer than five minutes from the first 911 call, and one minute after the arrival of the first officer, that the shooter killed himself. It was fewer than six minutes from the time the first police officer arrived on SHES property to the time the first police officer entered the school building. In fewer than 11 minutes twenty first-grade pupils and six adults had lost their lives. ..."

"All of the firearms were legally purchased by the shooter’s mother. Additionally, ammunition of the types found had been purchased by the mother in the past, and there is no evidence that the ammunition was purchased by anyone else, including the shooter.

"At the date of this writing, there is no evidence to suggest that anyone other than the shooter was aware of or involved in the planning and execution of the crimes that were committed on December 14, 2012, at Sandy Hook Elementary School and 36 Yogananda Street. ..."

"The evidence clearly shows that the shooter planned his actions, including the taking of his own life, but there is no clear indication why he did so, or why he targeted Sandy Hook Elementary School.

"It is known that the shooter had significant mental health issues that affected his ability to live a normal life and to interact with others, even those to whom he should have been close. As an adult he did not recognize or help himself deal with those issues. What contribution this made to the shootings, if any, is unknown as those mental health professionals who saw him did not see anything that would have predicted his future behavior. He had a familiarity with and access to firearms and ammunition and an obsession with mass murders, in particular the April 1999 shootings at Columbine High School in Colorado. Investigators however, have not discovered any evidence that the shooter voiced or gave any indication to others that he intended to commit such a crime himself."

Saturday, November 23, 2013

Mental health resources for NH and US veterans


FEATURED CONTENT: Military suicide and invisible wounds of war. 

Army Spec. Christopher Journeau died by suicide in June 2010. Post-traumatic stress disorder, isolation and alcohol abuse played major roles in his death. /Family photo


VETERANS CRISIS LINE

800-273-TALK (8255): Press 1 for veterans
Send text message: 838255

_____________________________________________________________

MILITARY-AFFILIATED RESOURCES IN N.H.


718 Smyth Road, Manchester, 624-4366
Mental Health Clinic: Karen Brown, ext. 2151; Loren Haberski, ext. 2150
TBI coordinator: Judy Kowalik, ext. 6455

215 North Main St., White River Junction, Vermont
802-295-9363 or 866-687-8387
Initial Mental Health Patient Intake, ext. 6132
Anne Martis, ext. 5632

VA Vet Centers

Berlin: 515 Main St., Gorham, 752-2571
Keene: 640 Marlboro St., Keene, 358-4950
Manchester: 1461 Hooksett Road, Hooksett, 668-7060
Sanford, Maine: 628 Main St., Springvale, 207-490-1513
Lowell, Mass.: 10 George St., Lowell, 978-453-1151
White River Junction, Vt.: 222 Holiday Drive, White River Junction, 802-295-2908
VA Combat Call Center (24 hours, manned by Vet Center counselors): 877-WARVETS or 877-927-8387
         

Chris Journeau's high school and Army buddy, MP Kevin Lapointe, served two tours in the Iraq War. At the urging of his wife, Donna, he is receiving treatment and recovering from PTSD and traumatic brain injury. /Don Himsel photo, The Nashua Telegraph


New Hampshire National Guard

1 Minuteman Way, Concord
  • Lisa Aldridge, transition adviser, 225-1309, lisa.a.aldridge.ctr@mail.mil
  • Susan Brown, director of psychological health, 227-1497
  • SFC Dale Garrow, suicide prevention program manager, 227-1450, dale.e.garrow.mil@mail.mil
  • Lt. Col. Richard Oberman, deputy state surgeon, 227-1457
  • Chaplain Steven Veinotte, 227-1560

Care Coordination Program New Hampshire

Intake coordinator, Jeanine Merrill: 888-989-9924

Portsmouth Naval Shipyard, Kittery, Maine, 207-438-6961


Before he received treatment Lapointe said he had "a never-ending amount of anger" linked to his PTSD and TBI. Now he is able to interact positively with his family. /Don Himsel photo, The Nashua Telegraph

_____________________________________________________________

STATE OF NEW HAMPSHIRE-AFFILIATED COMMUNITY MENTAL HEALTH CENTERS


Region I: Northern Human Services, Conway, 447-3347
Region II: West Central Behavioral Health, Lebanon, 448-0126
Region III: Genesis Behavioral Health, Laconia, 524-1100
Region IV: Riverbend Community Mental Health Center, Concord, 228-1551
Region V: Monadnock Family Services, Keene, 357-4400
Region VIII: Seacoast Mental Health Center, Portsmouth, 431-6703
Region IX: Community Partners, Dover, 749-4015
Region X: Center for Life Management, Derry, 434-1577

_____________________________________________________________
109 North State St., Concord, 225-8400 or 800-773-8400 

Wounded Warriors @45 North

Pittsburg, 566-8450 


Chris Journeau on patrol in Iraq. /Family photo

Thursday, November 21, 2013

JFK gravedigger: 'It's an honor just for me to do this'

On Nov. 25, 1963, first lady Jacqueline Kennedy, her children, Caroline and John F. Kennedy Jr., and other family members leave the Capitol during the state funeral of President Kennedy. /White House photo by Abbie Rowe

By Jimmy Breslin
Newsday
Washington (Nov. 26, 1963) -- Clifton Pollard was pretty sure he was going to be working on Sunday, so when he woke up at 9 a.m., in his three-room apartment on Corcoran Street, he put on khaki overalls before going into the kitchen for breakfast. His wife, Hettie, made bacon and eggs for him. Pollard was in the middle of eating them when he received the phone call he had been expecting. It was from Mazo Kawalchik, who is the foreman of the gravediggers at Arlington National Cemetery, which is where Pollard works for a living. "Polly, could you please be here by eleven o'clock this morning?" Kawalchik asked. "I guess you know what it's for." Pollard did. He hung up the phone, finished breakfast, and left his apartment so he could spend Sunday digging a grave for John Fitzgerald Kennedy.


When Pollard got to the row of yellow wooden garages where the cemetery equipment is stored, Kawalchik and John Metzler, the cemetery superintendent, were waiting for him. "Sorry to pull you out like this on a Sunday," Metzler said. "Oh, don't say that," Pollard said. "Why, it's an honor for me to be here." Pollard got behind the wheel of a machine called a reverse hoe. Gravedigging is not done with men and shovels at Arlington. The reverse hoe is a green machine with a yellow bucket that scoops the earth toward the operator, not away from it as a crane does. At the bottom of the hill in front of the Tomb of the Unknown Soldier, Pollard started the digging.

Leaves covered the grass. When the yellow teeth of the reverse hoe first bit into the ground, the leaves made a threshing sound which could be heard above the motor of the machine. When the bucket came up with its first scoop of dirt, Metzler, the cemetery superintendent, walked over and looked at it. "That's nice soil," Metzler said. "I'd like to save a little of it," Pollard said. "The machine made some tracks in the grass over here and I'd like to sort of fill them in and get some good grass growing there, I'd like to have everything, you know, nice."

James Winners, another gravedigger, nodded. He said he would fill a couple of carts with this extra-good soil and take it back to the garage and grow good turf on it. "He was a good man," Pollard said. "Yes, he was," Metzler said. "Now they're going to come and put him right here in this grave I'm making up," Pollard said. "You know, it's an honor just for me to do this."

Pollard is 42. He is a slim man with a mustache who was born in Pittsburgh and served as a private in the 352nd Engineers battalion in Burma in World War II. He is an equipment operator, grade 10, which means he gets $3.01 an hour. One of the last to serve John Fitzgerald Kennedy, who was the thirty-fifth President of this country, was a working man who earns $3.01 an hour and said it was an honor to dig the grave.

Yesterday morning, at 11:15, Jacqueline Kennedy started toward the grave. She came out from under the north portico of the White House and slowly followed the body of her husband, which was in a flag-covered coffin that was strapped with two black leather belts to a black caisson that had polished brass axles. She walked straight and her head was high. She walked down the bluestone and blacktop driveway and through shadows thrown by the branches of seven leafless oak trees. She walked slowly past the sailors who held up flags of the states of this country. She walked past silent people who strained to see her and then, seeing her, dropped their heads and put their hands over their eyes. She walked out the northwest gate and into the middle of Pennsylvania Avenue. She walked with tight steps and her head was high and she followed the body of her murdered husband through the streets of Washington.

Everybody watched her while she walked. She is the mother of two fatherless children and she was walking into the history of this country because she was showing everybody who felt old and helpless and without hope that she had this terrible strength that everybody needed so badly. Even though they had killed her husband and his blood ran onto her lap while he died, she could walk through the streets and to his grave and help us all while she walked.

There was mass, and then the procession to Arlington. When she came up to the grave at the cemetery, the casket already was in place. It was set between brass railings and it was ready to be lowered into the ground. This must be the worst time of all, when a woman sees the coffin with her husband inside and it is in place to be buried under the earth. Now she knows that it is forever. Now there is nothing. There is no casket to kiss or hold with your hands. Nothing material to cling to. But she walked up to the burial area and stood in front of a row of six green-covered chairs and she started to sit down, but then she got up quickly and stood straight because she was not going to sit down until the man directing the funeral told her what seat he wanted her to take.

The ceremonies began, with jet planes roaring overhead and leaves falling from the sky. On this hill behind the coffin, people prayed aloud. They were cameramen and writers and soldiers and Secret Service men and they were saying prayers out loud and choking. In front of the grave, Lyndon Johnson kept his head turned to his right. He is president and he had to remain composed. It was better that he did not look at the casket and grave of John Fitzgerald Kennedy too often. Then it was over and black limousines rushed under the cemetery trees and out onto the boulevard toward the White House. "What time is it?" a man standing on the hill was asked. He looked at his watch. "Twenty minutes past three," he said.

Clifton Pollard wasn't at the funeral. He was over behind the hill, digging graves for $3.01 an hour in another section of the cemetery. He didn't know who the graves were for. He was just digging them and then covering them with boards. "They'll be used," he said. "We just don't know when. I tried to go over to see the grave," he said. "But it was so crowded a soldier told me I couldn't get through. So I just stayed here and worked, sir. But I'll get over there later a little bit. Just sort of look around and see how it is, you know. Like I told you, it's an honor."

Friday, November 15, 2013

The media and suicide prevention: An open letter

Jo-Ann and Merrill Clark lost their son, Army Spec. Christopher Journeau, to suicide in 2010. /Rich Beauchesne photo, seacoastonline.com


Open letter:
The media and suicide prevention

When Jo-Ann Clark invited me into her Stratham home in September to share the story of her soldier son, her first words could have come from any mother who lost a child to suicide: "I don't want him forgotten."

I’ll never forget Army Spec. Chris Journeau. His story was a worst-case scenario for veterans who have returned from Iraq and Afghanistan with PTSD and TBI.

I’ll also never forget the level of cooperation achieved in the seven-week Portsmouth Herald effort to report on suicide among N.H. veterans. Members of the N.H. suicide prevention community inside and outside the military were active participants in the project. I was handed all of the information needed to write compelling, informative and valuable stories.

One of the top lessons of the Portsmouth Herald project is the need for the media to play a constructive role in suicide prevention. An informed and engaged media could significantly reduce stigma about mental illness and educate the public about suicide prevention.

Amber Alerts transformed the relationship between the media and public safety officials in missing children cases. A similar spirit of partnership between the media and suicide prevention officials would help address this gravely serious mental health challenge.

In the Portsmouth Herald’s military suicide project, the essential elements that fueled cooperation were time and trust. I had the time to speak with many people and learn the complexities involved in suicide. A shared commitment to helping prevent suicide made creation of partnerships based on trust easy to build.

Other lessons and recommendations
  • Journalists should be familiar with the media guidelines for reporting on suicide available at www.ReportingOnSuicide.org. The guidelines include a concise “factbox” on suicide prevention including warning signs that should be part of in-depth media reports on suicide.
  • The National Suicide Prevention Lifeline contact information (800-273-8255) should be included as a “tagline” at the end of most media reports on suicide. In many media outlets, this kind of information is routinely provided for good causes and as part of crime coverage.
  • Media reports should avoid glamorizing, normalizing or sensationalizing a suicide.
  • Suicides are the result of a complex set of circumstances. It takes time to unravel the individual strands that snare someone in suicide. Media reports should avoid portraying suicides as linked to a single cause or moment where someone “snapped.”
  • Maintaining periodic and constructive coverage of suicide should be part of prevention officials’ outreach and education efforts. Steps include developing media contacts who are experienced in reporting on suicide; providing timely notice of accomplishments, initiatives and new information linked to suicide prevention; and building partnerships with media outlets.

A complex set of circumstances drove Chris Journeau to take his life in June 2010, including PTSD, isolation, the Great Recession and alcohol abuse. /Rich Beauchesne photo, seacoastonline.com

VETERANS CRISIS HOTLINE
800-273-TALK (8255)
Press 1 for veterans