Trump creating U.S. hegemony

Hegemony is a word I have resisted using to describe U.S. geopolitics for sometime. It is described in Dictionary as:

Leadership or dominance especially by one state or social group over others.

It is a word that has been used by more left-wing commentators than myself to describe U.S. geopolitics – Noam Chomsky, Gore Vidal and others – when trying to explain the degree to which the United States seeks to impose itself on other nations. United States Presidents ranging from Jimmy Carter to the incumbent Donald Trump, have been accused of trying to impose this on the world, however true it may – or may not – have been in the context of their accusations.

When Mr Trump was elected President, he issued an Executive Order that withdrew the United States from the Trans Pacific Partnership Agreement. Many nationalist/populist commentators rushed to applaud him as an example of the nationalism that they wished their country would espouse. I wonder if they would have still congratulated him if they knew that barely a year later he would be making statements about potentially rejoining.

No one in New Zealand should be celebrating Mr Trump’s latest announcement, that New Zealand and nations like it should be made to made to adopt the American model of health care.

First off, what model? All I see is a mish mash of failing and failed health care programmes that might have been well intended when they were first released, but which have proven to be disastrous failures. All I see is a horrendously expensive, completely disjointed system dominated by inept corporations who only see dollars.

Second, why on Earth would New Zealand want to do away with Pharmac? This is the drug agency that negotiates on New Zealand’s behalf for affordable medicine at prices closer to what New Zealanders can afford than those that are being offered in the United States.

Third, who is Mr Trump to tell over sovereign nations what they can and cannot do with their health systems? Mr Trump is practicing as I always feared he would, economic hegemony, which he is prepared to back up using the pulpit of the bully boy – the big boy who goes around and smashes little kids lunches; who starts fights with vulnerable people if they do not let him have his way.

I live in New Zealand because I am committed to helping make New Zealand the best nation it can be. I am also living here with my severe hypertension for which doctors have pretty much given up on trying to find a solution, because New Zealand is lucky enough to have – for all the concerns aired about its funding priorities – a Government agency like Pharmac to keep costs affordable.

Depending on where one gets them from, my medication would cost hundreds of dollars per annum in the United States, just for one medicine. I am on five. A brief break down is below (source: Drugs):

  • Nifedipine – I have two a day; a years supply would cost about U.S.$500
  • Furosemide – 1 1/2 daily; a years supply would cost about U.S.$40
  • Metoprolol – 1 per day: a years supply would cost about U.S.$700
  • Felodipine – 2 per day: a years supply would cost about U.S.$750
  • Cilazapril – not found

If we took the cost of these medications and added it together, I am looking at effectively U.S.$2,000. If we add the nearly 29 years that I have been on some of this medication, we would be looking at a grand total of U.S.$58,000 (N.Z.$83,238 based on current exchange rate). It says nothing about the locoid and other creams I have used for my eczema or my inhalers for my asthma.

I believe everyone has the right to affordable healthcare. Why should New Zealanders and other nationalities suffer because of one persons desire for U.S. economic hegemony?

Jonathan Coleman’s dubious record as Minister of Health

Former Minister of Health, Jonathan Coleman abruptly resigned from Parliament last week. His departure from Parliament, whilst opening up a by-election in the Northcote electorate that he served, also brings to an end the Parliament and Ministerial chapter of a Health Minister, who many will remember as mediocre, aloof and out of touch with what was really happening in his Ministry and the D.H.B.’s under him.

But it might not be the systemic underfunding of health to the tune of billions of dollars that he is remembered for. Nor might it be the mental health crisis that exploded across New Zealand from a range of causes – loss of jobs and subsequent ability to support family; survivors of earthquakes in Canterbury and Christchurch struggling with every day chores as a result of suffering mental and/or physical harm in these events.

But it might be that Mr Coleman is remembered for the case of Nigel Murray who was Waikato District Health Board chief, and who was found seriously wanting for his misuse of public money. During his tenure Mr Murray racked up $218,000 in expenses including $78,000 in unauthorized expenditure.

More likely though, it will be the case of Middlemore Hospital in Auckland. This is a hospital where the damage caused by under investment in the health system exacted a substantial financial price in the tens of millions of dollars.

Questions must therefore be asked about what Jonathan Coleman knew about the condition of Middlemore Hospital? Mr Coleman denies knowing about the state of the hospital, which had – among other problems – toxic mould which had sufficiently developed that it was capable of rotting walls and contaminate the air, a sewerage leak and an urgent cladding issue that has resulted in $27.5 million, including $11.5 million being announced yesterday, being approved for recladding.

A cynic might suggest that Mr Coleman’s abrupt departure from Parliament indicates knowledge of failings in the Ministry of Health and a failure of his Ministry to react appropriately to them.

In the case of the wood in the walls, testing showed that 90% of walls were decaying to some extent. It further showed that some walls had up to 98% saturation. With such heavy saturation, I am not surprised that the bug outbreaks that have occurred at Middlemore Hospital over the last several years, did, for the moisture content in the physical environment that the bugs developed would have been more than sufficient.

I find it interesting though, that Mr Coleman has resigned from Parliament to take up the top job in a private health company. His departure from Parliament last Thursday follows a host of other National Party M.P.’s including Steven Joyce, Bill English out the door since National’s surprise loss to Labour in the 2017 General Election.


Nurses fed up: Strike looming

So, it is come to this. After negotiations and various pay rise offers have failed, industrial action in the nursing sector is about to rock the country.

Due to the (often misinformed) perception of the public, that by going on strike, nurses are somehow endangering patients, I believe nurses have been reluctant to carry out significant strike action.

This perception I believe has no credibility. The very vast majority of nurses would never think of knowingly putting their patients or somebody elses patients in jeopardy. They work in conditions that are hugely demanding on them physically and mentally. They are groped, spat on, verbally abused or otherwise mistreated by patients sometimes for the most minor thing, or simply because they were not quick enough responding to a call for assistance. They can work hours that mean they finish mentally and physically exhausted but somehow have to recover in time to do another shift maybe only several hours later: circumstances in which mistakes become inevitable.

A nurse to me is a blood and flesh angel of mercy. I would be dead if it was not for a nurse on 15 September 1989 (my mother) when I collapsed in the hallway at home with severe hypertension.

Nurses have a number of vital roles that District Health Boards, the Ministry of Health and anyone lucky enough to have avoided hospital might not always realize. A nurse is often the eyes and ears of a hospital when dealing with patients, because in the course of everyday nursing, conversations they have with patients will tell them a lot about how they are as well as giving them opportunities to sight visual changes.

Yes, a nurse might be required to dispense medication, do things like record blood pressure, make sure any dietary restrictions in pre-operation circumstances are being adhered to. But they also have to keep a detailed and quite lengthy paper record that that is time consuming, demanding and can have significant consequences if improperly kept.

I am honestly not sure how nurses manage to cope. Based on the descriptions given in newspaper and online news articles, nurses get shocking treatment for the service they are expected to deliver. And there is probably nothing that can prepare them for the mental demands placed on them – medical school is about learning the roles of nurses, the procedures that they need to perform and so forth, not about surviving a demanding day.

So, if these nurses strike – and in some respects, I hope they do – it might be the wake up call the Government, the District Health Boards and the public need. The current situation cannot be allowed to continue and that there are potentially major consequences if it does.

Would you rather a nurse is worked to breaking point and administers morphine when it was not needed because s/he was too mentally broken to realize the wrong medicine was being administered? Or would you rather the nurse, having gone on strike and – hopefully been noticed – is working in an environment where s/he no longer feels broken at the end of the shift?

Water safety in New Zealand not so water tight

When I was at primary school we had what was known as swim week. It would occur in February in the first or second week of school, just after we had returned from summer holidays. The aim of swim week was an all out drive where the whole school learnt to swim, about water safety and some basic first aid such as mouth-to-mouth resuscitation.

Sometime after I left it seems to have stopped. Or maybe I just did not notice, as once I left Cobham Intermediate swimming lessons were not so much of a priority for my family.

Whatever the case, it is certainly something that should be happening in New Zealand schools near the start of each year. We are a nation surrounded by water. We are a nation with lovely beaches, great rivers and lakes to swim in (fresh water quality is a separate issue). And swim in them we do. And ignore the official warnings, and natural warning signs we do too.

Anyone who has watched Piha Rescue when it was on television (to this day I have no idea why it was cancelled, for it did a huge public service by helping to keep the focus on water safety at beaches), will have seen how quickly someone can get into danger. Anyone who has read a newspaper in the last few weeks will have noticed cases of drownings and near drownings. Some of these were simply avoidable, if people had been following lifeguard instructions and stayed within the flags; not gone into flat areas of water between waves where rips have formed.

Tragically in the last couple of years a new dimension to water safety in New Zealand has emerged. In 2017 there were two incidents in fresh water environments where the danger was well advertised by signage, lighting and sirens. They happened below the Aratiatia Dam on the Waikato River. Anyone familiar with this dam will know that every few hours during daylight the spillway control gates open to let water down a rugged rocky channel to form spectacular rapids. Prior to the gates opening a siren sounds three times, warning lights on the dam flash. There are also permanent signs warning about the danger. The water volume per second goes from 0m³ to 90m³ in just a few minutes. Tragically it has not stopped several lives being lost over the years and several more nearly being lost. With numerous other hydroelectric power stations around New Zealand, some with submerged intakes and other structures that take or discharge water, perhaps this needs to be a part of water safety campaigns in New Zealand too.

It is not just dams though. A tragic case occurred in Canterbury several years ago. Afghan refugees going for a swim in the Waimakariri River had observed others going into the river and decided to go in themselves. Unfortunately, not being from a country where water safety would have been a priority, none knew how to swim and at least one drowned.

98 people died from drowning in 2012, 90 in 2014 and 113 in 2015. This year in 2018, there has already been one death.

The New Zealand social emergency created by National

As we move further into the first term of the new Government, it is starting to become clear that there is a significant crisis in New Zealand society. The issues fuelling this crisis are numerous and varied, and none started on the watch of the recently ousted National-led Government. But in nine years in office these symptoms advanced far enough that combined they now pose an immediate and direct threat to New Zealand society.

National has in effect created a social emergency. The failure to address despite repeated warnings that there were problem emerging with housing, health, social welfare and justice have combined to create conditions where the so called market has left behind sections of New Zealand society whose deprivation is feeding social decay.

The conditions created consist of a combination of contributing factors. They include but are not limited to:

  • Drug addled neighbourhoods with police struggling to contain the epidemic of methamphetamine, synthetic cannabis and other harmful substances
  • Absentee parents/caregivers and a break down of parental/caregiver responsibility
  • Rampant truancy and young people leaving school with no qualifications, and no jobs or training to go to
  • School children living in inadequate housing, constantly having to move and living in conditions that are not compliant with basic human rights or housing law
  • Housing rents eating up money for food, clothes, medical expense – children go to school hungry and/or distracted

The problems start in the home or at school, but often end in a police cell. The following is a brief synopsis of how a person might go downhill. I am not suggesting that all people in such circumstances will experience this – indeed there are many fantastic parents who care very much, who go without themselves and try to be a positive influence in their child’s life, but in socio-economically deprived neighbourhoods, this is a real issue.

In the first instance at home or school, they have no food and often start the day on an empty stomach, are irritable or distracted. A failure to be settled in one spot for any length of time will mean the child has trouble settling in at school, distracted by problems at home. Over time this may fuel other problems, because the student will start getting into trouble, picking fights, associating with the wrong crowd. At home the parent/caregiver might be working long hours to make sure there is enough money to pay rent and will not be at home at critical times such as when they have homework or need underage supervision, so the children start misbehaving. At school the teachers realize that the person or people in question have a discipline problem. Homework is not being done, and the student is disruptive, argumentative. It begins to escalate with children missing school and truancy officers picking them up. At this point, the child is at an intersection in their life. At this stage the choice is stark. The child unless there is substantial intervention by the parent, the school and potentially social social workers will either leave or wind up being expelled from school with poor prospects for the future.

It never needed to be like this. And the long term cost to society, the economy and the people who know the child are substantial. If s/he devolves into drugs, then a life of crime and prison awaits. If s/he tries to turn themselves around their past – especially if a criminal history is involved – may catch up with them and hinder their future development.

This is why there is a significant and dangerous poverty issue in New Zealand. It has the potential to fuel illegal substances, crime, violence and gangs, none of which are welcome or wanted. All of which are horrendously destructive and all of which we need to shut down.