Sunday, October 17, 2010

World Food Prize Laureate Summit, 10-11-10 Ames Iowa.

The first of several joint presentations by the two World Food Prize Laureates that occures on Monday night of World food Prize week each year.  It is at The Memorial Union Sun Room  at Iowa State University in Ames Iowa.  There is a two hour reception with posters of student research projects on hunger around the world.  They are judged and the winners are announced after the Laureates talk.  Here are the two lectures by the laureates and the question perriod.  The first question is by me.

Saturday, October 16, 2010

Iowa Democratic Party Annual Jefferson/Jackson Dinner 10-16-10

The event started momentously with fire alarm that was triggered by steam from a dishwasher.

After we finally got back in and everyone seated they went through introducing all the State wide candidates, all the leaders of legislature,  all the congressional candidates and finally the top of ticket and the guests.  Tom Vilsack and Gov Rendell introduced.
The girls safety squad led the Pledge of Allegiance and the Des Moines Gay Men's Choir sang the Anthem.  Benediction given. 

Sue Devorsky: we are cleaning up the mess the Republican made and they stood in our way on everything we tried to do. 

Cong Bruce Braley
Congressman Bruce Braley:  In 2006 we gave them hope in 2008 we gave them change and in 2010 we are going to give them Hell. We are at our best when we are fighting for people.  We passed first bill Obama signed giving women equal pay.

Dave Loebsack
Dave Loebsack.  We are not going to go into reverse.  We are not going to let them take it back.  He is very proud of what he did for military in Iraq and Afgan.  He cannot believe Supreme court let corp. pump unlimited money into campaign.  Lets go forward not backwards.

Cong Leonard Boswell
Cong Leonard Boswell  I'm not going to kick this can down the road.  We took a lot of risks and we are not going back.  We are going to close the doughnut hole. 

Roxanne Conlin

Senate Candidate Roxanne Conlin:  WE need to retire Grassley he needs a rest.  Today deficit 1.3 trillion same as when we took over.  Our sacred promise to our veterans.  Return to our lead position in the world in Education.  The corporations haven't even tried to give me money.  WE need to stand up,,,, ad a long list.  Our tax dollars should buy American.  I represented a raped teenager and a teen that was forced to have sex by her father for three years.  Grassley would force them to have a baby if they became pregnant.  I am proudly pro-choice.  No No No to secret contributions.

Sen. Tom Harkin
Sen Tom Harkin.  I can;t wait to have Conlin with me.  I enjoy having my three cong caucus with me in Washington.  THEY (THE Republicans) ARE NOT HIDING THE PLATFORM.  you CAN READ IT JUST HOLD YOUR NOSE.  Steve King is demanding Republicans to sign blood oath to shut down govt in Washington if they cannot repeal Health Care.  They say vote out the Dem's because they have not gotten us out of Bush;s debt and recession fast enough.  When emotions are high intelligence is low.  Of course he talked about he greatest accomplishment.  The Americans with Disabilities Act.  After 29 years I see a change.  people with disabilities taking a part in life with their families. 

Lt Gov Patty Judge
Lt Gov Patty Judge.  I have not seen Kim Reynolds.  I was ready to go and Branstead jumped out in front of her and didn't let her do it.  I love Chet but no-one tells me when to talk or not talk.  I told her I would come to her to debate.  i couldn't find her anywhere.  You keep showing up when we ask.  We know you will keep showing up for the next 17 days.  1st state in Nation to pass all 10 recommendations of DOD since 9/11.  They are still fighting for us and we will fight for them. 

Gov Chet Culver.
Chet Culver:  His 14th event this week.  We one last time and we will win this time.  Iowa third best run state in American.  When Branstead was Gov he had rank of third worse run state in Country.  Branstead will cut Government by 15% but will not offer where.  The budget will not necessarily be smaller.  Another broken promise.  He promised 300,000 new jobs his last term.  He was 240,000 jobs short during Clinton's job boom.  The first bill he signed was raising taxes and then did it 53 times more despite saying he would not raise taxes/.  His 15% cut would be a 500M dollar cut in education.  Public safety would be cut 67 million.  This boils down to everything you learned in third grade math.  Addition subtraction and division.  I want more research, more health care.  He would take away health care and decrease hawkey level of eligibility.   He wants to fight Roe v Way.  He wants to put ban back in place for embryonic stem cell research. 

Gov.Ed Rendell

Gov Ed Rendell: Tom Harkin will go down in History as one of the greatest Senators ever.  He thinks Tom running for re-election.  Chet Culver has done a good job and deserves to be re-elected.  One of the worst ideas is cutting pre-K in Iowa.  Every dollar we spend on Pre-K we save 6-7 dollars.  Dumb and Dumber.  Therte is good Government spending and bad Government spending.  They tried to stop our most successful programs time after time salling them socialism and they were wrong then and are wrong now.  We have to follow ourPresident.  The republican party are increasingly being influenced by people who are absolutely nuts.

Maria Muldaur Farm Concert for Francis Thicke (D) SCTY AG Candidate.

Maria Muldaur
Maria Muldaur performed today for Francis Thicke campaign for Iowa Secretary of AG at the Des Moinesw Social Club.

I inteviewed him before the concert (see at bottom of this blog).  He performed with Maria and here are two short clips of that performance.

I inteviewed him before the concert and will be posting the inteview later today or tomorrow.  He basicly is concerned about the loss of the small farmer and the over importance of large corparate farms.  While he is not against tillage farming he is for trying to get greater part of the year with ground coverage.  Going from at most 4 months coverage to as he called it perenial coverage(though that doesn't  quite make sense) I think he means 8-12 months coverage.  Overall I found him very knowledgable about farming and agriculture.  I is very progressive but main stream from what I learned at the World Food Prize Conference this past week
I was told by his campaign manager that they have polling just finnished yesterdaythat has them within 3 points.  Which considering that the governors race has a ten point margin that is very good, if it can be trusted.  Unfortunately there were only 20 people at the event. 

This took place immediately before the Jeferson Jackson Dinner which is Iowa Democrats annual large fund raiser. This yearKeynote Speaker Gov. Ed Rendell.

Friday, October 15, 2010

WorConversation: More food, better food ld Food Prize:

Conversation: More food, better food – improving and preserving quality

Philip Nelson – Professor, Purdue University
Great Advances in Ag production but much more needs to be done in the food chain.  How do we improve micro nutrients.  Cambodia had bumper crop of rice but lost 1/2 because there was no way to get it to market. 

Florence Chenoweth – Minister of Agriculture, Liberia
She is trying to rebuild the Ag sector in the face a a region with severe conflict.  When she was 17 she heard about hunger that showed her her future .  She had career day at school and a man came and talked about hunger in the world.  She had to fight to go to national Univ.  She brought lawsuit forcing Gov't to let her be 1st girl in Univ.  She went through Univ as only girl.  25 years of conflict destroyed the research and institutional aspects that fought hunger.  El Salvador and Liberia where two countries that have gotten to 100% of food in schools localy produced.  25 years of anything that walked was eaten and any plant product nothing saved for seed.  We are now rebuilding.  We are not aproaching hunger holisticly, we do not discuss nutrition.  Emphasis is more on suplements rather then getting it from the food.

Howarth Bouis – Director, HarvestPlus
Cereal production doubled in Green revolution while nutritious plant mater fell.  Price of fish and non-staple plant food doubled.  making harder to get nutrition.  80% of income goes to rice only 20% go to nutritious.  This is purely an economic issue.  As food prices in Nutritious food increase the % that go to this type decreases. 

Dyno Keatinge – Director-General, the World Vegetable Center
We don't have not elephants in the room but tyrannosaurus Rex.  Hunger and malnutrition.  1/5 of all diabetic are Indian, 1/10 of China is diabetic.  Type II diabetes is a dietary induced disease.  If we challenge malnutrition we have to get people to change their diets.  Need to consume more Vegis less grain.  It's not good enough to feed the world in 2015 if we are not nourishing it.  Not all Vegetables created equal.  No attention has been addressed by research on his nutirient leafy green Vegis.

Joseph Taets – Vice President, ADM Grain Group
Invest in Ag
We tranfere info to farmers small and lg

promoting Sustainable Ag
We have mult program. Doing it right in Brazil  more food better food in sustainable way.  Also partnering with industry]=try expert on eliminating post harvest loss

Leveraging our expertise.
In Haiti.  We had 800 tons of rice and we made that rice immediately available to Haiti.

Derek Yach – Senior Vice President, Global Health, PepsiCo
We cannot look at hunger without looking at the health and nutrition aspects.  The focus of pepsico will not just be on high end markets but will focus on small markets and smallholders and how do you improve the quality of the food supply.  How can we embed the knowledge we have into the developing markets. 

Jacqueline Morete, Farmer in Haiti.
I asked question on irradiation of food.  The rep from ADM and Pepsico could offer no work by their companies about this.  The Moderator reinforced that consumer is afraid they would glow in the dark(which is not true) and almost no-one is doing any work on this.
Pepsico will cut sugar in it's products by 25% and within two years remove all coloric drinks from schools.

World Food prize: Hon Rajiv Shah Head USAID: Hunger Fighters

Rajiv Shah
Hunger Fighters: Rajiv Shah

The Administrator of the USAID program.

Norman Borloug Commemorative research initiative.
   First effort to work on wheat rust UG 99. 80% of wheat in USA susceptible to this.  Generating rust resistant varieties. Convert CGAIR into several Mega programs.  Time to crisis to a few days. Work on the first 1000 days.  Move away from monetized assistance to extension aid.  Create markets for smallholder feed the world program.  $20M directly improve income of smallholders.  1/3 of Tanzanians below poverty, 1/3 of children show bodily stunting.  Joining with Gov't of Tanzania to three central regions where they have highest potential for growth.  Rather then have diluted country wide program.  we are focusing on small area that we can have success.  we are building roads, Japan building reservoirs and World Bank developing rice strains for region.  Our policy will lift 2M women out of poverty.

Feed the Future Private Investment Sector:  Facilitate small business in regions of need to work with those in need.

This is not just happening in Tanzania.  In Bangladesh, Ethiopia they have program to invest in sub region and small number of value change.  These programs will lift 1.6M children out of poverty.  This is in only four of the first twenty countries and in only sub regions.  Imagine when we can learn and replicate this we could have a foundation for a new sustainable Green revolution. 

Thursday, October 14, 2010

Kofi A. Annan,Ending Hunger in Africa. AGRA

Ending hunger in Africa:Change is now within our Grasp says Kofi A. Annan former UN Sect-Gen and current CEO Alliance for Green Revolution in Africa (AGRA):

Kofi Annan
" Africa is only continent which does not grow enough food to feed itself"

"Never before has there been such a collective drive for change"

The millennium goal of reducing hunger by 2015 will obviously not be met.  The goal is not to to eliminate hunger but to make it a sustainable system.

Our goal is to make smallholder farms Profitable sustainable and .

All African Govt to put 10% of their budget into agriculture and drive a 6% growth per year in production.

Central role of women farmers is finally becoming front and center.  However, rarely do they have title for land and they have problems with getting their product to market.  Less then 3% of all bank lending in Africa is ag related.

At last conference a large number of Bankers were present and this makes me optimistic about Africa's ability to turn the corner.  If we miss this current opportunity I don't know when we will get another chance.

Without a stable peaceful Africa our ambitions will not succeed.

World Food Prize: Overcoming Major Constraints Facing Smallholders

Uma Lele, World Bank, Chaired session 1
How do we bring all the expertise of the panelists together so each is not in a silo.

Rolf Derpsch: soil expert.
We hear very little about problem of degrading soil.  We need to focus on soil.  We cannot produce crops if soils are eroding away. Degradation and sometimes irreversible destruction of soil have reached frightening level of degrading ability to grow food.  >10 M Hectares are destroyed. Plowing degrades soil, Soil erosion, desertification. Intensive tillage leads to erosion and is largest cause of soil degradation. 
First :Stop soil degradation
Second:Build soil with calcium and nitrogen.
Conservation agriculture no tillage
Permanent soil coverage
No Tillage
Crop rotation
With no-till farming Brazil double crop production.

Dr. Joseph DeVries: Dir. African Seed System
Very optimistic because of increased supply of improved seed.  Seed is maybe the most deliverable.  Improved seed is the basis of the who;e green revolution. Lack of improved variety and problem getting seed to farmers if you have that improved variety.  We are starting to see improved seed. 150varieties recently released.  Micro delivery by bicycle seed dealers.  Micro packs. With better seeds can double yield from 800 KG /HA to almost two tons with both fertilizer and better seed. 

Dr Nuhu Hatibu: CEO Kilimo Trust. 
Africa had green revolution in the 50's before the other green rev. of the 60's.  There was markets, irrigation.  The markets are the key to making sure the farmers are sustainable.  Without markets that give fair prices the farmers cannot suceed.  Don't do good by us but do business with us.

The world has changed drastically in the last forty years but our conversation on food has not changed.  We are trying to reach 30K farmers to teach them to be independent farmers.  Multiple projects. Get information on crops and pest by cell phone to farmers in India.  No till demands the application of modern fertilization products and challenge organic farming.

Stephanie Hanson Dir One Acre Fund
Constraint of finance.  30K farmers in Kenya and Uganda.  Large banks do not want to do small farmers also micro finances are mostly urban.  They provide micro-finance plus.  They lend seed and fertilizer instead of cash.  they have 150 market points in Kenya and 200 in Uganda.  Within walking distance.  The farmers receive it in credit and repay it as they sell their crops.  Need to teach them how to plant and timing and how to use fertilizer.  Repayment rate of 98%.  They are doubling farm income.  $1.4M is 65% of there budget. 

Sarah Munalula, smallfarmer in Zambia
42, four children 1990 she stopped school (soshe went to school till 22) She had to farm because of economic pressure.  They could not plant variety. 2007 they got pioneer seed and she planted variety. Six Hectares owned but she only planted one hectare.  With Pioneer seed she has increased from 18X55 KG to 180X55KG of maze and now is very successful. She is now chairperson of womens cooperative.  The new seed from pioneer is the crucial change.

Nourishing The Planet: World Watch

Danielle Nierenberg: State of the world pre-release. Visited 200projects across Africa tosee what is working in Africa.  Full report released inearly Jan 2011. 

Brian Hal   :  Hunger persists.  A policy of agricultural abandomment exist in Africa.  Africas food output hasbeen focused on raw commodities not on added value. 
First :Make better useof water,there is much greater potential that is not being tapped.  As little as 5%gets to crops.  Increase mulching, tilling.  can increase yeild 20-135%  Return on investment was so fast that 5 years later farmers will still use it and spread to surrounding farms
second:Make sure all the post harvest loses are minimized. This can be simple and very effective. Better storage, quickly get rid of spoiled produce, better drying.Community storage very effective.
Third: plan for more farmers incities.  By 2020 35-40M African will relie on urban agriculture.  There are many models for urban farms.
Fourth: Pay for programs for farmers to store carbon in the soil.i.e. keep farm planted more of the year  plant trees.  75 project in 22 countries that are working on this. Great GreenWall initiative and the Billion tree initiative.

Dr Dyno Keatinge: Humanity doesn't live by caloriesalone.  We need diverse diet.  Grains are just calories. and are 50% of food eaten.  We have 2B people who are malnourished.  Very few nuts and berries in diet.  This is major cause of epidemic of type two diabetes.  The Green Revolution is doing disservicebecause we have cast into stone that we put our effort predominately into grains.  Malnutrition is principle thing we need to address.  Not only to feed the planet but nourish it as well.  Rateof return in rice/wheat there is very small rate of return since there are so many people in it.  In nuts berries and other side crops the rate of return on $ can be very hi 3-400 %.  Broader crops are more likely to help break out of poverty and also address nutritional/vitamin deficiencies.  Don't give up what we are doing but expand to other typed of crops.

Hans Herren:Agriculture at the cross roads.  We need a paradineshift in agriculture.  In particular we need to look a changes from on that produces green house gases to one storing carbon.  We need a Brown Revolution in Agriculture.  Biggest return on research comes from one program.  this was using natural means with zero cost to farmer that preserves the crop better.  This is the most easily implement low hanging fruit.  If we want to move over into sustainable ag,we need todo these simple steps.  Indirect investments.  Infra structure, markets,

Wednesday, October 13, 2010

Analysis: Socialism is Dead in Farming. #foodprize #globalag

Borlaug World Food Prize Day 1 and Keynote

"Poor farmers are not a problem to be solved. They are the solution." -Bill Gates

The data shows(from almost everyone who spoke) that small holder farmers do as well if not better then large farms or collective farms.  The risk with collectives is that the small farmer is ultimately forced out by automation and efficiency of scale leading to an underclass with no hope of getting out of poverty.Examples from all regions were given of going in both directions and how forming collective was disastrous and helping or developing small holders improved both the yield and the level of food security and economics of the small farmers.  The critical thing is not to give someone a fish but teach him to fish.  This includes several aspects
  1. Access to markets (Howard Buffet's $13M donation)  Roads, develop markets.
  2. Ensure the farmer gets most of the market value and it is not lost to middlemen or to the known 1/3 loss of produce between production and consumption.
  3. have to  ensure that there is no land grabbing.  This is biggest risk to future development.
  4. R&D the best research to help produce the maximum yield.  Increased yield is better for environment.  It leads to less water need, It allows diversity of crops.
  5. Fertilizer subsidies are good as long as they are not robbing from other aspects that will make the farmer self sufficient rather then dependant upon government subsidies.
  6. Education.  You have to efficiently teach the small stake holder farmers to grow properly. Extension services critical. 
  7. Make the farmer the stakeholder in a small farm(even as small as a tenth of a hectare)
  8. Get production up to 3 tons per hectare.
  9. Stable government, in multiple examples going from stable govt to unstable led to drastic drop in production and the reverse going from unstable to stable led to amazing increases in production.
  10. need commodity markets to avoid price volatility

Five step(of Dr. Vo-Tong Xuanon how to do this in developing area
  1. Field survey
  2. Verify tech to be adopted
  3. Design water management system
  4. investment projects  essential infrastructure
  5. production of rice

Ambassador Quinn does welcome:


Howard Buffet:

Pradhu Pingali:

Conversation: Smallholder successes around the world

Pedro Sanchez – Director of Tropical Agriculture, the Earth Institute at Columbia University
     When you go from 1 ton per hectare to 3 tons you cut water loss and help climate.  Growth stunting of kids reversed. 

Shenggen Fan – Director-General, International Food Policy Research Institute   Grew up on small farm. He was child labor(LOL) policy is very important. Investment in rural roads.  Decentralize collectives to small holders.

Ruth Oniang'o – Editor, African Journal of Food, Agriculture, Nutrition, and Development

Ajay Vashee – President, International Federation of Agricultural Producers

Vo Tong Xuan – President, An Giang University Viet Nam second largest rice exporter in the world all on the backs of small stake holders but could not have been done without scientific help. Closed university for 2 months and 2000 students were trained how to make good seedling and how to grow rice.  they went out and trained every farmer how to do this on 1/10 of hectare. With this experience he feels that they could do this in Africa.

3:00 pm
Conversation: Smallholders as entrepreneurs and innovators

Louise Fresco – Professor, University of Amsterdam
She talked about the importance of teaching that there are markets and there is a chance to be an entrepreneur. It does not come natural and there is resistance but once they see it they quickly do well.

Marco Ferroni – Executive Director, Syngenta Foundation
He works on extension and linking farmers to markets.  For farmers to become entropenaurs need

  1. knowledge
  2. Technology

Eleni Gabre-Madhin – Director, Ethiopian Commodity Exchange
increased tonnage 1.5 to 2.5 per hectare however overwhelming market concern.  50% price volatility year to year.  highest in world.  2002 prices collapsed because of good harvest.  crop prices collapsed so much the farmers couldn't afford fertilizer so next crop fell to point that Ethiopia had to import massive amounts of food.  Contract failure also significant problem.  this now gets fair price for farmers and also the farmers know what they have to do produce higher grade of coffee. Farmers aggressively try to improve the grade of their crop to get paid higher.  This is free enterprise and not handout.

Rajesh Kumar:  had 2 acre farm in small village.  Did small kiosk to sell sweet corn both fresh, steamed and roated.  Now they have 200 kiosks and also sell kernals.  now has 200 Hectares.  They have 350 contract farmers that get the produce sold at a fixed price.  The kiosks are managed by college students who can study while they man the kiosks. 

Kamal El Kheshen – Vice President, African Development Bank
Largest development financial institution in africa $ 100B  They got completely out of HIV-aids since there are so many other NGO's involved.  But they are getting into HIV vaccine since there are not many investing in this.Doing irrigation scemes in large way.Tripple F crisis Food-Fuel-Financial.  Small Holder 80% of work done by women.  Micro crdit. Market development.

Shivaji Pandey – Director, Plant Production Division, UN Food & Agriculture Organization
Invest in local community so they can take care of themselves.  Walk the talk, don't just criticise.  
I will be posting videos and photos as they get processed so check back.

Gap Report:Is there enough to feed world: #FoodPrize

World Pop will hit 9.4 billion by 2050.

WE need to double global agri output in 40 years. we are now growing at 1.4% per year and will be short by 30% we need to increase to 1.&% to reach these goals.  Population growth is heavily front loaded.  By the time we get to 2050 pop growth will plateua.  Any investment take time to pay off.

Keith Fugile: Rising Global Agri Prod,:
in last 4 years we have only grown productivity by 0.8 percent.  way below what we need to be.  We can get more output will increased acrage or increased yeild. TFP growth: increase productivity at all levels.
TFP total factorproductivity.  this is mostly due to new technology.this is 1.8%per year .  no other eresources have increasedin USA.  China and brizil have 3% per year.  SSA have <1% TFP growth.  Countries need both research and extension/edu capacity to maintain high TFP. 

Bill Lesher:Concluding remarks.
Water will be one of the main battles.:
Watch his closing remarks.

I will be updating this over next two days as I proccess video.  Check back. 

Five areas of e
international trade
private investment
streamline international development
Science development

1st quest:  Is it not inadequate to only focas on TFP:

I will be updating this with video  and questions.  So check back over next twodays.

Borlaug CAST Communication Award

Wed. October 13th, 2010

Jay Vroom President of Croplife America Foundation: 
Dr John Bonner, Exec VP CAST- Council for Agriculture Science and Technology.  Dr Borlaug was for the last three years of his life was a communicator first and foremost.  He received an award from Cast in 1973.  He told cast they had to expand their borders beyond Iowa and the USA.  He commanded that CAST needs to not just research and develop but needs to communicate their work.  Dr. Borlaug was critical in increasing support for CAST.  He wrote the 1st paper published on CAST and 26 years later his last paper was published through CAST.

Dr. Pedro Sanchez presented the award to Dr. Akin Adesina.  He is an agronomist with chlorophyll. At Purdue he is the VP of AGRA- Alliance for Green Revolution in Africa.  He developed idea of small crop shops run by families.  He came up with idea for micro lending in Africa.

Dr, Akin Adesina:  I am honored to win this first renamed award after my hero Dr. Borlaug.  Sci and tech critical to improve agriculture. His father told him  'If god even enables you to influence the world make sure it is in agriculture.' Africans are not benefiting enough from the science and technology available.  Support for Ag has plummeted.  the Gains of the Green Revolution have eroded.  World Food Crisis was a wake-up call.  The world needs to double efforts for food production.  We must lead the power of Sci and Tech to the most powerful force that of communication.  Agriculture has been managed as development program but it is not a development program it is a business.  You can not eat potential.  Need to improve access.  Increase Agri dealers across Africa, He took plan to African Union and he organized a summit to accomplish this.  The African Fertilizer Summit occured.  Dr. Borlaug strong armed the attendees to implement the plan. Wehave long pursued policies of abandoment of the farmers of Africa. We have to subsidize the farmers.  It is cheaper then importing food. Plans to take African agriculture from development to a real Business.  Need to improve acessto markets so farmers can make profit or this will never work.  We must put in mechanisms to ensure adaptability to envirnmental change.  There is no such thing as half freedom we will march to freedom when our stomachs are full, our kids are fed and our farmers are self supporting.  Then we can say Free at last, free at last.

Tuesday, October 12, 2010

Iowa Hunger Summit, #Worldfoodprize Des Moines Iowa 10-12-10

9:00 AM  “Livestock’s Role in Reducing Food Insecurity”

Organized by Elanco and Heifer International
The Elanco Speaker, Kevin Watkins, presented data that in 1990's we were getting ahead of hunger in the world and the number of those hungry was going down at a good rate.  Then in this last decade the number of those in hunger has risen to some of the highest levels seen.  He talked about how improving hunger improved almost all aspects of their live.  Improved performance in school, better health on several metrics, improved economic situation.  He showed how one glass of milk and 2 ounces of protein a day was all that was needed to supplement diets and see measurable improvements.
The Heifer International speaker, an organization which gets livestock into the hands of poor and hungry, do complex engineering of their lives.  They teach them how to manage the environment and their livestock.  They are taught how to use the animal waste for fuel and fertilizing, how to use hoses to irrigate their fields, how to have safe fireplaces and burn fuel safely(one of the largest sources of death and disease in the third world).  They have developed models of how to work in these communities and get the most bang for the buck.
You cannot just give them food.  You have to ensure that what you do is sustainable.  They require 'Pass-On' were they person getting the livestock shares the result.  i.e. community that received ducks the fertile eggs are shared so more and more in the community can support themselves and self perpetuate.
10:00 a.m.

"Starving for Knowledge: Nutrition, Brain Development, & Education"
Mary Minter Hanson, Global Health Consortium: introduced panel.  Dr Shah, not on panel, organized the GHC to work on health issues .  It is a consortium of all the colleges and Univ.  in Iowa.
Dr Robert Zore, Millennium Dev Goal.  $ of seven are health related. Underrate/stunting/wasting is simply precursor to child mortality.Uganda: 17% underweight, 38%stunting, 128/1000 child mortality 

Two Students will present their work on brain development.

Heme is critical for Brain development.  Need to make sure you get enough iron.  If not your brain does not get enough oxygen.  Iron is the #1 deficiency in the world.  Vit C is critical for brain development.  Need to get it continuously not in spirits.  Countries with high vit C production have some of the highest deficiency since it is exported.
Vit D.  New appreciation of importance. Controls 900 genes in the Brain. Motor development, socialization.

Dr Jenifer Hall on impact of Iowan food on other countries.
Lindsey Willstra  Grad Student,

Organized by the Heartland Global Health Consortium

11:00 a.m.
“Local and Regional Food Systems:
Countering Food Insecurity in Iowa”
Organized by ISU Extension and the Leopold Center for Sustainable Agriculture
Food Insecurity, access to food on a regular basis. 11% of Iowa do not have enough food.  Leads to poor health, physical limitations, more chronic illness, stomach and headaches, more hospitalizations, anxiety and depression, psychosocial dysfunction. 
Rich Pirog: Leopold Center
Supply of food.  How do we build a local food system.  Leopold Center State funded on tax on nitrogen fertilizer.  Leopold center charged by legislature to develop sustainable local food plan.  12 key issues to developing a Local food economy:
  1. financing
  2. incentives to farm
  3. Access to land
  4. Insurance
  5. Education-tech
  6. Regulations and policy
  7. workforce
  8. Aggregation/distribution
  9. Marketing Network
  10. Consumer Ed
  11. Data Collection
  12. Resources to pay for programs
Regional food systems working group.  Umbrella network of stake holders to develop sustainable local food programs.

Angie Tagtow, Iowa access &health working Group. Emerging group just launched 3/10 six meetings so far. 32 partners,

Brenda Ranum,Iowa food and fitness initiative
Link health with food. Work in 6 counties in NE Iowa only 100,000 people. Ensue school district policies support healthy living. Local food procurement policies, Farm to school program. Goal two: Ensure local healthy food is available, mini-grants and micro-loans, food safety Certificate process , regional food directory. food sales by farmers increased 1.2 million $'s.

Bahia Barry,  Southwest Iowa food and farm initiative.
Least populated counties and also most elderly area in Iowa.  Mission: build a sustainable regional food system that link production, processing, distribution and consumption. Successes,connecting farmers to farmers markets, awareness building, Farm to School, Link Urban rural projects, Moving forward: issues- infrastructure, transportation, aging populating.  Encourage increased participation in human food based agriculture.  Increase fresh food in emergency food supply.

12:00 p.m.

The World Food Prize presents the “Hunger Luncheon,” featuring meals used by Iowa-based organizations in food assistance and hunger-relief efforts.
Keynote Address by Tony Hall, director of the Alliance to End Hunger and three-time Nobel Peace Prize nominee

Ambassador Quinn welcomed everyone and told about in this fourth year there is a record attendance.
FDL Financial and Iowa Farm Bureau pledges to sponsor this Hunger Summit for the next five years.  $150,000 donation toward the Hall of Laureates.

Ambassador Tony Hall was charged by GW Bush to Feed the world and end insecurity.  He has been to 130 nations in the world. 1984 was in Ethiopia during worst famine.  OUr elected officials have fallen way short of what the public wants.  During the next few eeks go ask the candidates about hunger issues. Mother Teresa: What I do is a drop in the Ocean not a bucket but without out it there would be one less drop.
  efforts to reduce hunger in Iowa
Last year in 2009.
$ 8,720,000
15,600,000 pounds of food
451,000 hours

This year 2010 in Iowa.
9,380,125 dollars
18,266,006 pounds
539,086 hours.

Side conference on agriculture and health and nutrition.  This was amazing.  It was like being a fly sitting on the wall.  Here were seventeen of the Worlds leading experts on Hunger(see links).  Almost everyone has a wiki page.  They were discussing how to organize a conference coming up.  It was amazing to see this level of negotiating and international discussion.  I learned a lot.
Prabhu Pingali from the Gates Foundation.
Rajul Panlya-lorch
Why despite economic growth in India the poverty levels have remained high.  We are trying to see how economic growth ensures less poverty and better health.
Conference in India.  This is the planning meeting.  for "Leveraging Agriculture for improving nutrition and health"
How do you nutritionalize agriculture.
The summary of the conference schedule was reviewed.
Sukhadeo Thorat:  Need to improve nutritional value not just quantity of food.
Barbara Underwood:  Nutritional impact.
Peter McPhearson: have to make sure that the three professions: Agriculture, Nutrition and Health all need to internalize the other two arms of the conference and not just give lip service to it.
Emmy Simmons: Are we actually do what the title says or not be about production alone but about all aspects of the food-eating - health train.
MERIDITH  Soule:Are we really getting into the nutritional and the consumer choice part.
DEREK yach:Health relation from this needs to be greater.  Also the issue of livestock. Sweden when they saw that CV was major cause of death they changed their entire food chain to take care of this.Need to deal with satiety and affordability.  Need to address subsidy issues.
Bibi Giyose:We need to discuss the systems to implement the changes.  without a good system this will not work.
daSilverta Pimleiro:We need to ensure the quality and that contaminated food is not produced/shipped/sold/consumed.After conference make sure those suggestions are implemented.
Prabhu Pingali : Obesity needs to be addressed also. Session on governance and excluded populations, we also need discussion on excluded regions.
Kabba Joiner:  We have to avoid a one size fits all solution.  The side session on communication tools. Health people cannot communicate. NCD's (non-communicative diseases)  What went wrong that increased NCD's.  We are all individually comfortable in our comfort zone and we do not like to move out of them.  We need to make sure people move out of their comfort zone.
Christian Henckes:Describe at beginning of conference what our view of the future How can it look like.  Then let conference figure out how to get there.
Lisa Dreler: How can you create the institutional structure that comes out of the suggestions.
Marie Ruel:Make sure nutrition and health are not just outcomes but are the driving force.  The first 1000 days. The target group for malnutrition health vs food born disease health is critical and a big gap.
Stuart Gillespie:How do we design and implement nutrition sensitive agricultural issues.  There are very few examples.  How do we make visible joint incentives.How do we find all the stakeholders that we don't know about now( suggest to him a moderated poster session.
Peter McPherson: How can we make the 3 disciplines see that they are overlapping?  That is the dominant theme I hear here.
Prabhu Pingali: The title is fine. Most of these populations are primarily agricultural and not nutritionists or health workers.  You don't want to lose their ability to be good farmers.
Derek: Get historians to present how these three fields were historically linked in Hippocrates, Maimonides.

Shenggen fan:  Summed up what everyone said and discussed the plans for the up coming conference.

Saturday, October 9, 2010

ACLU Iowa 75th Annual Meeting 10-9-2010

I covered the meeting for WHO Radio and for my Blog.

Workshop 1: Racial Justice

Dave Kuker: Very disproportionate number of people of color incarcerated. Most arrest though are misdemeanors. project implicit a site to test your prejudices. They have tests on multiple items including race.  People of color at all stages of criminal Justice system have worse outcome then kids of non-color.  A lot said and basically can be summarized as if your of color the system is against you no solutions or suggestions at all.

Keynote Speaker.  Robert Sheer, journalist and social, political commentator.

Covered Vietnam war, 6Day war, interviewed Fidel Castro (first American), interviewed all presidents from Nixon to Clinton.  The Great American Stickup is his book just out.  will be having his talk on video.

Robert Scheer
He recommended check out Paul Conrads writings. He talked about the topic of his last two books were abuse of political power and abuse of financial power. Freedoms and local control broke down with the alien and sedition laws. The founding fathers foresaw that if you tried to be an empire you would loss individual freedoms.  Washington talks about this in his Farewell address(full Text).  Instead of trying to figure out why 9-11 happened we just used it to increase the military budget.  When it comes to war and peace rational discussion of freedoms and specifically freedom of the press take a back seat.  You can not have a republic and an Empire at the same time.  An empire by definition is more totalitarian.
You go to war forget a free press.  He talked about how 9-11 report has disclaimer that they had no direct access to witnesses but had to submit questions through military.  So even presidential commission did not have free access to info.  How can we expect reporters to do better.  Pat Tillman and Jessica Lynch are examples of how military lies to press.  The military try to change the stories to aid public image of war and not the truth.
Our economic meltdown.  Ronald Reagan wanted to remove regulations but then savings and loan debacle hit and he pulled back.  Clinton ended federal obligation to poor people i.e welfare reform.  Then Rubin got rid of Glass-Steagal act.  The in 2000 the commodities future act. He asked to have it explained and was told it was too tricky to understand and was referred to lobbyist working for Wall Street. Formation of Citigroup was major blow to the protections in place from the 1930's.  He went through micro dissection of mortgage breakdown.  Nothing new but very good summary.Informed public making basic decisions about public policy.  He implied that we do not have an informed public but a deceived public.
Questions:  No ones going to touch Social Security.  There has been no more successful program in USA.
Person hood of corporations: Corrupting our political system.  Should FOX news be considered a political party and not a news media.  They are news said Scheer

Inteview with Robert Scheer

Workshop :Media:Are newspapers dead? The Future of in Depth Reporting. Rekha Basu, Kevin Cooney, Joyce Russell, Brian Steffen.
Brian Steffen-communication Prof Simpson  four of his 16 students did not know the name of the Governor.  They had an average score of three out of ten.  There were a couple of college students that only got Pres Obama right.
Joyce Russell Iowa Public Radio:New ways to get news since newspapers are cutting back.  ProPublica new type of free lance investigative news agency.Iowa center for news. web site. 

Rekha Basu

Rekha Basu:Newspapers are not dead but they are morphing.  The Des Moines Register is no longer calling itself a newspaper but a media outlet.  In India her mother reads 6 newspapers a day and is typical.  She also went into a journalism class and only a few of the students read newspaper on daily basis.  We cannot be everything to everyone.  WE can bring contextual information you can not leave to chance.
Kevin Cooney
Kevin Cooney:We are not as interested in medium but the message.  They will die but that doesn't talk about the message, i.e. in depth reporting.  That is decreasing because the media cannot pay for it. 
Robert Scheer:  Predictions of death are premature however the real question is will journalism survive and it will.  Readership is way up but profits are down.We are now subject to a ruthless honesty that our predicators did not.  Journalism should be driven by passion not that you are making a big living.  I wrote a column attacking proPublica.  James Leach (former US Rep.Iowa(R)) led fight to get rid of financial regs and is the Chairman of the Board of ProPublica.  We are not the Good Old Days but the future is much more promising.

Workshop 3: LGBT: Marriage equality.  Mostly a report on the retention vote and were public opinion is on gay marraige issue.  The most interesting item is that on Tuesday Oct 19th at Simpson College West Desd Moines 1450 28th Street between 4:30 and 6 pm there will be the only discussion between both side with Van De Platts being there.  All must attend.

Performance by 'Thursday's Children' did musical based upon the Tinker case.  Here is one song from it.

The Garst Family Tribute.  over 50 years of the Garst family supporting the ACLU.

Jonathan Turley:  Shapiro Chair for public interest at George Washington Univ.Legal Expert for major news outlets.  Considered one of the top 100 attorneys in the country.
Fantastic victory in Iowa on civil liberties.  Stripping the court of these three judges is an assault upon all civil liberties.  Why we have independent judiciary.  The Independence of judges is important to protect us from people of ill Jefferson.  At issue is not the future of these judges but the future of all Iowans.
Many Judges want to be Judge Judy and engage in outrageous actions.  Discussed Supreme Court.  A deeply flawed institution. He has suggestions to fix it.   Increase court to 19 members.  does not have ability to reform itself.  No term limits and serve for life.  Madison is only framer that looks good.  He was trusted by both sides.  He would have been a member of ACLU he insisted on and wrote Bill of Rights.  Mandatory retirement at 70.  his pick of nine greatest Justices of all time:  We have a disfunctional political system. 

Jonathan Turley: Supreme Court Flawed, History and Fix Part 1

Jonathan Turley: Supreme Court Flawed, History and Fix Part  2

Jonathan Turley: Supreme Court Flawed, History and Fix Part  3

I will be covering the World Food Prize and the many associated conferences and lectures and will be reporting on them her.

Saturday, October 2, 2010

Future Party: A Rational Response To The Tea Party by Alan Koslow M.D.

by Alan Koslow M.D.

I am dismayed. I see a growing political movement that is based on looking to the past for answers. They believe the worlds is static and that solutions to current day problems can only be found in the political writings of our Founding Fathers. However, they like religious fundamentalists tend to pick those writings of these venerated Founding Fathers that support their views while ignoring those that refute it. The worst is that they do not see the need to change the game plan as the game changes. I felt this is a critical time to bring a rational perspective to the national political climate. It is the right time to birth a new political movement: The FUTURE PARTY.
The Future Party Manifesto
Where as: Public policy and politics have become irrational, and

Where as: Our Founding Fathers were products of the Enlightenment: and

Where as: The founding documents of the United States, including the Declaration of Independence and the Constitution, are based upon Enlightenment philosophy, and

Where as: The world is not static, and

Where as: Global Warming will make our future more uncertain, and

Where as: We are moving into the Future not the past, and
Where as: The rest of the world is moving into the Future at a faster rate then the USA, i.e. the world is flattening, and
Where as: The Scientific Method is well established as a way to understand our physical world, and
Where as: Rational, critical thinking is often lacking in our political process, and
Where as: Every human being have the right to Life, Liberty and the Pursuit of Happiness as defined in the Declaration of Independence, and
Where as: The majority does not the ability to deny a minority the same rights that majority enjoys, and
Where as: Our fore fathers came to the United States to escape religious intolerance and of all our freedoms the first one enumerated in the Bill of Rights is religious freedom and separation of church and state, and
Where as: The Constitution establishes that there shall be no religious test for office, and
Where as: Our politicians are for sale because of our campaign finance system, and
Where as: Our political system has deteriorated into One dollar One Vote instead of One Person One Vote, and
Where as: Corporation are not persons
We Pledge to: Restore sanity and rationality to public policy and politics, and
We Pledge that: The best scientific knowledge and predictions will be used to form public policy, and
We Pledge that: A Manhattan Project approach to solving Global Warming that does not cripple our economic system will be implemented, and
We Pledge to: Base all political solutions on Enlightenment principles and concepts, and
We Pledge to: Ensure all students are taught critical thinking skills in school starting in pre-K, and
We Pledge to: Ensure all students graduate High School with adequate science skills to understand our physical world and the scientific method that teaches us how that world functions, and
We Pledge to: Ensure all students be taught financial skills to thrive in our complex financial world, and
We Pledge to : Make Consumer Contracts and User agreements be required to have a plain word summary that would fit on a single page, and
We Pledge to: Eliminate the concept of person-hood for corporations, and
We Pledge to: Eliminate private financing of campaigns and have only public financing or small dollar individual contributions, and
We Pledge to: Ensure the freedom of religion, that our fore fathers felt so important is granted to all persons in the USA including the right to not have a religion, and
We Pledge to: Ensure the constitutional demand that NO religious test be used for public office be enforced, and
We pledge that: Theology will not be a basis for public policy and we will fight to uphold the first amendment, and
We Pledge that: College and professional school be affordable for all and not be a barrier to anyone, and
We pledge that: All persons in the United States will have health insurance, and
We Pledge to: Have a pathway to citizenship for all illegal aliens that have not committed a felony, and
We Pledge to: Have a rational visa system to allow enough seasonal workers to come into the country to fill the need not filled be legal residence, and
We Pledge to: Fight for human rights of all, regardless of how small or outcast a group they are in and regardless of age, race, country of national origin, religion (or lack of), sexual orientation, sex or philosophy.

This is a document in Flux. I have already made two major changes. As I get feedback and comments I may make more. i recommend if you are interested in this you re-check this on a weekly basis. I will also post major analysis and academic analysis as a separate blog on 'The Future Party' Blog.

Sunday, September 26, 2010

Fools Rush In: Saving Two Lives

I started another Blog, 'Snippets Of My Life', here is a sample.  If you like it go to this link and follow that Blog also.  Also please leave comments.

We were living in Vienna Va. and I was working at the American Red Cross Blood Research Laboratories at the NIH campus. The director of industrial design for the Am Red Cross was the regional director of the Industrial Design Group. They arranged a trip to the Amish area of Pennsylvania to tour the John Deer design facility. We had great tour of the design facilities and saw some of the first 3-D CAD systems in the world. We then all had dinner at a family style Amish restaurant. And we left to drive the two and a half hour drive back to DC at about 8 P.M.

We started driving on route 83 from Pennsylvania toward Baltimore. There was a detour and we had to leave the highway and go on a small two lane road that went through a very mountainous area near Hereford MD. Margie was driving and I was sleeping in the passenger seat. All of a sudden Margie stopped short thrusting me against the seat belt. I quickly awoke and looking out the windshield I saw in front of the car before us a tractor trailer laying on its side having rolled over between 120 and 150 degrees, about halfway between being on it's side and being on it's top. There was fuel spilling out of the tank onto the road. I rushed out of the car to the tractor and climbed up to the drivers window.

I climbed up the twelve feet to the window on the drivers side and looked in. I could see the driver trapped by the steering wheel and climbed through the window. He groaned "my brother". All I could see was a massive amount of chains in the back seat of the cab. I quickly realized that his brother was under all those chains. I quickly started to dig out the brother from under out. He had been sleeping in the back seat. Fortunately, I was able to get his head exposed. Neither of them were conscious at this time. It took almost 17 minutes for the local volunteer fire department to arrive. During that time I was keeping the neck stable on the brother in the back seat (I suspected a severe neck injury from having hundreds of pounds of chains fall on him (they were in the compartment under the matress he was sleeping on). Also he was unrestrained and likely to have injured his neck. While I was doing this the driver, his brother vomited. When the Hereford volunteer fire Dept arrived I refused to leave until someone with at least comparable training to myself arrived. I had worked seven years with the FAST team of western NY, was an EMT, had three years of surgical residency behind me. I explained I was already in the best position to render aid and the best skilled at the scene. They explained it was a highly dangerous situation because of the hundreds of gallons of fuel that had spilled. I told them you take care of the fuel and hand me two cervical collars and IV catheters and bags. I started an I.V on each. BTW there was not enough room for anyone else to come into the cab. I was doing this all upside down.I placed an cervical collar on each of the men. Several times I had to clear their months from vomit. I was given the Menaris France Award For Valiant Service in Emergency Medicine at their annual dinner in January 1984.

The Go team from Baltimore Shock Trauma Center was just recently organized and had not flown a mission yet. This rescue was their maiden rescue. The unique aspect of the team was that they had a surgeon, anesthesiologist, trauma nurses and carried O-negative blood for field transfusion. They could set up a full field surgical unit. They arrived about 45 minutes after the fire department and I allowed them to take over from me. I slowly backed out of the cab and was helped down by several of the firemen. It took them nearly 2 hours to get the men extracted. They had to get a crane to lift the cab. They first got a twenty ton crane and it was not enough finally they got a 45 ton crane and were able to get the men out of the tractor cab. We were finally ablee to get on our way about 2:30 in the morning. I took thee next day off from work and slept in. I was given the Citizen Award by the Baltimore County Fire Department. The two men both survived after weeks in critical care and months of rehab.

This Blog Snippets of my life, is going to be a daily blog for at least one year. I will tell stories about me that I hope you find interesting. If you like them please do two things: click to become a follower; and post on your Facebook page or twitter them. I hope to have 10,000 followers by years end. Some stories will be very personal. I will try to remember the correct names of those involved, however, I have a terrible memory for names and some names will be completely fictitious. The stories however are completely truthful as far as I can remember. Hope you enjoy. Some of these blogs may seem mundane. However, they

Sunday, September 12, 2010

I RESIGN: Candidacy in Iowa House District 60

I am(or was) the Democratic candidate for the Iowa House District 60, composed of most of the Polk County portion of West Des Moines. I am running against Peter Cownie the incumbent, who I ran against and lost to two years ago when it was an open seat. Two years ago he out spent me 17 to one. His father is Jim Cownie, one of the founders of the cable network in Iowa and after selling it in 1991 one of the richest men in Iowa. Peter Cownie has distinguished himself in the House with a lack luster first term. Looking at his website he can not even site a single accomplishment or single bill he introduced, other then his committee assignments. He has not a single new plan since he ran two years ago.

We have developed not a meritocracy but an affirmative action system for those of privilege. the system we have of private funding of campaigns through raising campaign contributions has led to corporatization of the United States Congress and our State Houses. We have representatives and senators at all levels costing the Government much more money because they spend based upon their contributors interest rather then the fiduciary interests of the public, their voters.

I feel we are long over due for a Clean Election Bill here in Iowa. There have been lots of court challenges of this because of potential unfairness to third part candidates. As described in Wikipedia:
Unlike traditional campaign finance laws that focus primarily on restricting spending and placing caps on campaign donations, Clean Elections laws provide a public grant to candidates who agree to limit their spending and private fundraising. Candidates participating in a Clean Elections system are required to meet certain qualification criteria, which usually includes collecting a number of signatures and small contributions (generally determined by statute and set at $5 in both Maine and Arizona) before the candidate can receive public support. In most Clean Elections programs, these qualifying contributions must be given by constituents. To receive the government campaign grant, "Clean Candidates" must forgo all other fundraising and accept no other private or personal funds. Candidates who choose not to participate are subject to limits on their fundraising, typically in the form of limits on the size of contributions they may accept and the sources of those contributions (such as limits on corporate or union contributions), and detailed reporting requirements.
I am as I describe myself a community activist who supports myself by being a Vascular Surgeon. I went to Haiti on two medical missions two weeks and two months after the devastating earthquake. I have developed a plan to allow every student attend college/university/professional/technical school and not pay a dime till they were working and then pay a fixed relatively small percentage of their salary for ten years. I developed a plan to pay for all health care in Iowa and not cost the taxpayers anything more. Several news sources credited me with keeping health care as a major issue in the last Presidential caucus cycle by attending and asking questions at 224 caucus events from all 18 candidates of both parties. I started my activism in High School and was one of ten to conceive of and run the first March of Dimes Walk (the first walk to raise money for charity) and developing the first program in the country for High school students to get academic credit for community service. Here in Iowa I have received National Volunteer of the year award from both the March of Dimes for my advocacy for the child health insurance HAWK-I and from the American Diabetes Association for conceiving of and getting passed the Farm-to-School bill and the seed that became the Healthy Child bill. The question and follow-up I asked Mr. Lightfoot in 1998 led to Vilsak being elected Governor (yes one person can make a difference). Seven months ago I completed a nine month diet losing 95 pounds and today is the seven month anniversary of completing it and I haven't gained a single pound back.

Speed your computer Ditch the bitchy virus software.

This is a draft the full version will be out later today.

Last week I was at Dragon-Con, the worlds largest Science Fiction convention. I happen to be the Volunteer director of the Blood drive and this year we were about 200 units short of the world record for a non-disaster blood drive (well there is always next year). I attended a session at the Electronic Freedom Foundation track ( the same track were I was a panel member discussing medical marijuana), on Why You Should NOT Use a Virus Scanner. My view of virus software was changed forever. I have already made the changes on both my office and home computer and plan to do this on all 7 computers at my medical practice, both desktops and all laptops at home.

First your need to understand that virus and worms need to have administrative permission to do what they do. If they are opened in a user that does not have administrative permission then they just sit there. You don't get infected.

Second you need to know that you can only get a virus if you allow it in. It is like a vampire that it cannot enter your house unless you give it permission(at least according to True Blood). So you have to be super careful not to open attachments you are absolutely sure about. Not to click on any part of a pop up. If anything is suspicious then restart your computer or use task manager to close it. Even if you get am e-mail from a close friend or loved one, unless you are expecting it do not open it.

Third thing to know is that virus/worm/hazard protection is the biggest hog of CPU and memory on your computer. Also you may have multiple competing programs running. i just finished doing this to my wife's computer and she had 7 different forms of protection. Also you will probably be infected before the virus software has your virus's information. Additionally virus software can get expensive. I spend over $450 dollars a year between all the computers at my medical practice and my family. Also it isn't unusual for the protection to lapse and a system not to be protected anyway. So why not ditch the BITCH.

Here is what you do:
  • Update and run what ever virus software you have.
  • Do a Back-up of your system.
  • Using Add/Delete Program from Control panel remove every virus/ad-blocker/spam filter/protector you have on your computer.
  • For good measure while your at it remove all this programs you haven't used in two years.
  • I also removed all the Microsoft Office and Word-perfect software (ultimately replacing it with Open Office).
  • Using Google Chrome Pack I loaded Spyware Doctor and Google Chrome(safest browser to use to prevent malicious programing), you can also load other great free programs at same time.
  • In Control Panel I opened User Accounts and added user with limited access (no administrative capabilities). I called it by person using computers first name.
  • I then run Spyware Doctor after updating it and also Defrag and disk Cleanup. All of which can be found in the Control Panel.
  • I then open my computer Browser and in Documents and Settings, I copy the contents of the current user(with administrative abilities), into the folder of the new user with limited abilities. This gets all your e-mail and bookmarks and preferences to the new user. You obviously don't need to do this if you are setting up a new computer or don't have anything you care about if you were just getting a new computer.
  • I then turn off all the features of Spyware Doctor so it will not run at all. This is very easy, on status page click the two green on buttons so computer immunization says Disabled and Intelliguard protection is off (when you click it you get pulldown and ppick the never(not recommended) line. Then in settings unclick every box but let it download updates silently.
  • Now turn off computer and when you restart only open limited user. **Never leave administrative user running in back ground.*****
  • You are ready to go.
But, you must remember that you need to change some of you habits:
  • Never open attachment you are 100% sure about.
  • Never hit reply to e-mail you are not 100% sure about.
  • If you end up on a web page you didn't expect (i.e you got redirected), then close browser and re-open browser and resume your browsing.
  • If not sure of e-mail instead of hitting return or clicking on link go to email program or browser and send e-mail asking to clarify if it was ligit email, link or attachment.
  • If you do need to download something. down load it and then check it with a Web (cloud) based virus scanner, before opening or running it. It is actually less often then you think you will need to do this. I will post here a site to go to later today so it you see this before come back tomorrow.

Sunday, February 14, 2010

Haiti: Follow-up, My Medical Experience and Future Needs.

I felt I should summarize what I did from a medical point of view and some new principles I notices. Also I will talk about the future needs.

I was with a group of 13 physicians and nurses. The first day we split up and eight of us went to CDTI Hospital (one of only two hospitals in Port Au Prince{PAP} still standing) and joined the American team of about 25 already there. The other 5 went to an orphanage 20 minutes away. The hospital had severe damage to the patient room section so all the patients were kept in the courtyard in eight(8) tents set up by the French. The Americans were responsible for four(4) and the French the rest. The Americans were there from 7:30 till 8:30 each day, and we left 3 military medics there over night. The French were there 9AM to 4:30PM and left no one to take care of their patients at night. If one of their patients had a problem hopefully their family would get one of the medics and they could handle it, otherwise the patient died as happened. 3-400 patients came to be evaluated at the hospital each day. I was consulted on about a dozen each day.

The surgeries I performed or assisted in included:
  • Four reverse solius flaps (assisted 2 and performed 2)
  • two gastrocnemius flaps
  • Above elbow arm amputation
  • Ten (10) dressings under anesthesia (ketamine/versed sedation)
  • Eight (8) Drainage of abscess and/or debridement of wounds (bone.muscle and skin).
I saw the first patient I ever witnessed die of Tetanus. After that I gave every patient with an open wound a tetanus vaccine.

We had two patients who were anemic, one with HCT=17 and another with HCT=21. I wanted to transfer the patient with 17 to a facility when I found out we could not get blood to our facility to do the transfusion. I was told because of the limited resources we could not transfer the patients till their HCT=12 or HGB=4. This, by the way, is the point when 50% of patients will die. I was told to stop doing blood counts since we most likely couldn't do anything about it. This was one of the hardest things I have ever done in medicine (except maybe the next story).

I was the lead physician of a trauma patient that came in. He was a fifty something man who had been struck by a truck. The police brought him in a police car and dropped him on the curb and drove off without waiting or telling us anything. The man was in coma and had obvious abdominal trauma. In the states he would have been brought immediately to the operating room for an exploration. We had no anesthesia personnel, no labs, no x-ray. He had no blood pressure until we resuscitated him with three liters of fluids. We called the director of the hospital and asked her to arrange transport. She told us there was no transport and to put him in the courtyard on a stretcher and if he is alive in the AM we will then deal with it. I could not accept this. So I told the medics to pump fluid into him to keep his blood pressure over 100 and his urine output over 50 cc per hour. With hard work they kept him alive over night and had to give an additional 7 liters of fluids. He had a liver injury and a fractured pelvis. We transfered him to the French Hospital ship. We found out he had survived.

I wrote about baby Noah multiple times.

Privacy: There was none. Foleys were put in in an open co-ed tent with the other patients and their families looking on. Patients washed themselves out in the open.

There were many patients, I took care of 4 of them (amputating the arm of one and one other had the HCT=17), who had closed crush injuries of their arms. They came to the Hospital 7-14 days after the earthquake with a compartment syndrome. This is when from a crush injury the muscle swells to the point that the nerves and muscle in the limb dies. the skin and bone survive. If you see the patient within hours of the injury (usually less then 6) opening the arm and releasing the pressure can save function in the arm. Opening the arm at 7-14 days has no chance of saving function. It only exposes dead tissue to infection and gives a massive surface that will slowly loss blood (thus the low HCT). If they had not done fasciotomy(opening the arm) the patient would have ultimately needed an amputation but could have had a functional id forearm amputation instead of being condemned to an above elbow amputation.

The temperature was 85-94 degrees every day with 70-85% humidity. This is the definition of an incubator to culture bacteria. Except for the operating room there was no clean areas of patient care. As a matter of fact the patients were housed in an open field with every bacteria blowing around. Every open wound was contaminated, most with pseudomonus. The problem wasn't that we didn't have the antibiotics, we did. It was that with all those open fracture. Open fractures are being treated by putting on an ex-fixiture (ex-fix) to stabilize the bone. The problem is that the area of the fracture with the open skin wound has poor circulation so the antibiotics do not get there. To over come this I started using Daikin's solution. This is a 0ne percent clorax solution. I would drip it at 10 cc's per hour into the wound and the next day there would be no infection.

It was felt that a large number of early amputations may have been unneeded. Therefor before we left there was a policy in place that two American and one Haitian surgeons need to concur on all needs for amputation.

Every patient coming to the hospital was dehydrated and malnourished. I will talk about food and water in a separate post. It is just that from a medical point of view they started behind.

The obvious biggest need is food and water. From a medical perspective the care of the 200-300,000 open fractures is the major medical work that will be done over the next 3-6 weeks. This is phase two of these open fractures, phase one was applying the ex-fix and doing the early amputations. The third phase will be late amputations over the next two months. all of these 200-300,000 open fractures are at risk of this. This could double the number of amputations. Phase four is rehab. There will need to be multiple centers for rehab centers. There will need for 400-500,000 artificial limbs and the people to fit them and the people to do the rehab. I'm currently working to help start this effort. Also there are some inexpensive prostectics used in the third world. I am planning on contacting them.

Finally the rainy season will begin in one to two weeks. This means that almost every day there will be a one-two hour deluge delivering one to one and a half (1-1.5 inch) of rain. Almost every drainage ditch is filled with rubble. Even with them open many streets were turned into rivers in past rainy season. This year with almost no functional drainage ditches most streets will become rivers. With almost 1,000,000 homeless and living in tents on the streets, 200,000 buried inadequately in mass graves and 100-150,000 still under the rubble, a public health crisis on unimaginable proportion is on it's way. I cannot even imagine how to prepare for this or how when it happens it will be handled but I plan to return in the middle of the rainy season so I will be able to report on it.

cdti Hospital, Haiti, earthquake, disaster, Dr. Alan Koslow, french, patients, tetanus, solius flap, gastracnemeus flap, amputation, anesthesia, transfusion, trauma, fasciotomy, pseudomonus, daikin's, rainy season