Adonis Diaries

Archive for August 8th, 2014

Yiddish song in the Warsaw ghettos: Any similarity with Gaza?

Everything is burning and crumbling. And you stand there looking on?

Yiddish speaking Jews sang this in the Warsaw ghettos

Yiddish speaking Jews sang this in the Warsaw ghettos

Glen Greenwald. Tonnie Choueiri shared

Glen Greenwald. Thanks Tonnie Choueiri

Did the “war on terrorism” fail or we got it all wrong?… After 13 years of this war, there used to be only one Qaeda, now there is Nousra, Da3esh, Abdullah Azzam… There was only Oussama Ben Laden and few helpers, now there is Abu Hurayra, Abu Oubayda and Abu Leila and thousands of jihadists in Iraq, Syria, Lebanon, Yemen, Libya, Egypt and in at least 3 continents… Saudi Arabia used to be the main accused of sponsoring them, now there is at least 10 Arab and Western countries accused of funding them… Jihadists used to be mainly Arabs, now they are multinational including French, British and American… They used to bomb a building or a train station with minimum resources and kill few dozens, now they control cities and countries with the most sophisticated weaponry and kill thousands daily… I am afraid we got it wrong, the war was not “on” terrorism but “with” terrorism…

How it’s like to work as nurse in a Gaza under the bombs?

My Mother, Dina Khoury-Nasser, just e-mailed us from Al Shifa Hospital in Gaza. 01:55 am 5th August 2014

She has been there for four days now. She went with a team of medics from the Augusta Victoria Hospital in Occupied Jerusalem in response to the appeal sent out by Gaza Hospitals, who were unable to cope with the extent of carnage brought about by Israeli Terrorism.

Today was day 4 in Gaza.

The first two days were like limbo. We felt we were in Gaza but not yet feeling what was happening around.

We live in the hospital compound: eat in the compound, work in the compound, sleep in the compound. We see the injured, hear the ambulances, see the bodies and people strewn around everywhere – still it does not sink in.

Yesterday evening things started to get real when I saw a child sleeping with his father in the open air on a piece of cardboard. He was there in the morning, there in the evening, and again this morning and this evening. I wonder where is his mother, where is his family?

The stories one hears about entire families being annihilated, completely erased from the national registers of citizenship makes your hair stand on end! But still, it does not sink in. Perhaps because I am in the operation room and used to seeing people injured.

Then reality hits when the shelling in Jabalia starts. At ten in the evening we receive a lady in her sixties. She is full of dust, full of earth and full of holes throughout her body. Head lacerated, thighs lacerated, leg crushed. I think of where she could have been sitting, what were her thoughts when the shell hit…

I thought of mom, I thought of all the older women I know.

A quick summary of the last 3 weeks.

When the bombing started this morning, it was children.

Our first patient was a little boy around 6 years old. He had massive lacerations to his groin, abdomen, face and head. He had burns all over his body as well. We were able to manage him in the theatre. I wait to see how he is doing.

Then comes Haneen. She is an 8 year old; my colleague from the emergency room, Dr. Haytham informed me that a child is coming up with her hand hanging on her side. I went up to Haneen who was waiting calmly in the holding bay. Her eyes were closed. She had a bandage across her head; her eyes were closed because of the swelling from the oedema and the burns to her face. I approached her and held her, and greeted her, and informed her of my name.

I held Haneen little hand on the injured side. I told her that I will be with her – she held my fingers. She informed me that her hand hurts. I told her that it was injured and that we will try and fix it. She then asked me about her father and two sisters. I told her that her father was waiting for her. I could not tell her that her sister had died. I still could not tell her that later that evening, her other sister was brought in dead from under the rubble…they were both less than four years old.

I saw Haneen in the ICU later. She was awake and extubated. I greeted her and told her that I was Dina. One eye was now open. She asked me if I had a daughter, I said yes. She asked me what is her name. I said Haya. She said that is a pretty name.

It was a tough day that ended with hopeful news.

The plane up above, called zanana (drone) keeps buzzing all around. My colleagues from Augusta Victoria Hospital in Jerusalem arrived today with supplies. I felt proud to greet them. The Hospital had done an excellent job sending supplies and individual packs to each of us. They were greeted and their support appreciated. Being there is all that matters.

On a personal level, I feel responsible for a big group now. It is very nice to have Dr. Haytham here; he is a wonderful professional colleague. My other colleagues are in Nasser Hospital in Rafah (South of Gaza), treating the injured and witnessing the toll of martyrs. One other colleague is at Al Aqsa Hospital working in surgery.

The smell of blood and death is around the young and the old.

Each day we are greeted with the car coming to take the martyrs.

Our room is close to the mortuary. You look at the faces of people here – they are all stunned. A nurse on duty looks deeply sad – her son comes with her to work.

My friend Bassam from Gaza came to visit me and brought me a lot of goodies to eat. I distributed them among our team and colleagues. I was worried when I looked into his eyes and saw how red they were. The strain on his face was apparent. His son had a close call, and his nephew has ben injured. They are children. They were playing in the street and had just stepped into the house….

The nursing director had to take a deep breath as he recalled all the children that he had seen. We will need time to heal she said, the pain will take time. The stories are overwhelming and the loss has not yet stopped.

Gaza. Day 5

Below is the second e-mail from my mother, Dina Khoury-Nasser sent yesterday evening (10:17 pm 5th of August 2014) almost 20 hours after her first.

We woke up today to the sound of thundering, followed by the sound of an F16 fighter jet.

I jumped out of bed hoping the ceasefire hopes we went to bed with were not shattered. I looked at my watch and saw it was 7:30 in the morning. I realized that this must be the usual cycle (as people say) before the ceasefire was in effect at eight. I was relieved, I felt the buzzing sound outside sounded different.

My colleague, Dr. Dina, with whom I share a name and a room, laughed. She thought the buzz had never stopped, so how could it be different? In fact it was outside. The small selling stalls on the floor selling flip flops, underwear, t-shirts, shorts…

The mats and cardboards were gone from the balcony, yet the makeshift tents were there.

People were arguing, discussing going home or waiting. To go check their homes, or to wait. Like every morning on the walk to the hospital passing the morgue we encounter death, today another martyr in another ambulance.

We walked past a young man crying and pulling at his hair and a woman in the car in tears.

I reach the operating room as I do each morning and there was a happy atmosphere. No casualties today, nothing to do this morning. I did not even feel like holding my chlorine based wipe and going around with it. I decided to visit Haneen.

Dr. Haytham, my colleague and I went in. How are you? We asked. Ok she said, her head tilted to the side.

What happened to my sister? I do not know, I said, but I will ask. What happened to my father? We saw him in the emergency room, he is ok, perhaps he is in the hospital or he has been sent home, I answered. What home? I bit my tongue. There is no more home.

I said perhaps to someone’s home from the family. But I promised we will ask. Finally she asked about her mother. I had no idea…Tell me what happened to them. I promised again I would ask. She asked me once more about my daughter. How is she? She is well, I said.

Again, she asked about her sisters.

I went to the operating room and asked to find out. The nurses helped find a relative who came a few hours later. He had tears in his eyes. Haneen’s mother had passed away, her two sisters, her uncle and her cousin from another uncle. That was the baby that had come in that morning with her…

This afternoon, my colleagues from Gaza insisted on taking us around. The damage, the destruction, the awe, the smell of rot. It was Jenin revisited a million times over!

I have still not made it to the Shejaieye proper, there it is total annihilation…

We are not the heroes. It is the Gaza people that are the heroes as they survive and live on through all this pain.

See More

 Ebola outbreak in West Africa harvest over 1,000 lives: Epidemiologist Perspective

The current case in point is Ebola viral disease that is spreading wildly in Liberia, Sierra Leon, Guinea, Nigeria and a few cases in Saudi Arabia

There has been much ranting and raving about closing our borders to people with Ebola infection (as if that were possible), even some misinformed speculation that the virus has been intentionally released.

Much Ado About a Fist Bump Study

h1

Ebola: A Nurse Epidemiologist Puts the Outbreak in Perspective

August 6, 2014 (Selected as one of best posts for the day)

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

We have a knack for taking any newly reported issue of legitimate concern entirely out of context, foregoing all common sense as we transform it into a danger of galactic proportions.

To me as a nurse epidemiologist, though, the central questions in this tragic outbreak are the same for Ebola as for any other disease:

  • How is the organism transmitted?
  • What is the risk of protected or unprotected exposure to the infected person?

Ebola is a blood-borne pathogen.

It’s spread in the same way as HIV, hepatitis B, or hepatitis C: when blood or other body fluids contaminate another person’s non-intact skin or mucous membranes.

None of these diseases is spread by casual contact.

And unlike HIV or hep B or C, Ebola is not a chronic condition; transmission occurs during acute infection, after the fever begins and the disease progresses. It is virtually impossible to contract the virus by walking past an infected person in the airport, or sharing a bus ride, or shopping in the same grocery store. (When you have high fever you don’t travel)

Preventing transmission.

Unlike for HIV or hep B or C infection, isolation precautions are implemented to prevent transmission of Ebola.

This is because bloody secretions, vomit, and diarrhea are typical symptoms as the disease progresses. Because of the resulting probability of exposure to the patient’s blood or bloody secretions/excretions, both contact and droplet precautions are used (i.e., gown, gloves, mask, and eye protection) in order to place a barrier between the infected person’s secretions and the caregivers.

Airborne transmission has not been documented—however, because of the potential for aero-solization of blood or bloody secretions/excretions, most experts recommend airborne isolation precautions as well (negative pressure room, N95 or greater respirators), if possible.

(Here’s a CDC table with recommendations regarding transmission precautions for Ebola in various clinical situations.)

Why the rapid spread in West Africa?

News reports of unchecked spread of the virus in West Africa have fueled global fears. However, a closer look at what’s happening makes it clear that two main groups of people have been at particular risk for Ebola infection:

  • close family members of those who are already infected
  • health care workers

There are risk factors unique to these groups in this region that have contributed to transmission.

It has been reported that many family members have continued to provide close personal care to their infected loved ones, without using any kind of protective gear. (Don’t attribute this to ignorance. If your two-year-old child were gravely ill, would you be likely to gown, glove, and mask? And even if you thought about doing so, do you have a large stash of these items at home?)

The repeated exposure of close family members to blood and body fluids inevitably leads in some cases to the contamination of mucous membranes or non-intact skin.

Postmortem care is traditionally done by families, and this also involves much intimate contact. Added to prolonged, unprotected exposure are health belief systems that can further increase risk.

Reportedly, family members in some of the outbreak regions deny the possibility of Ebola infection. They see their loved one’s illness as a curse, not a virus, and believe it can only be cured by a traditional healer.

For health care workers, risk is increased by the difficulties of maintaining full isolation precautions under these particular circumstances. Have you ever complained about suiting up for isolation because the gown, mask, and gloves make you too warm, even in an air-conditioned workplace? Imagine wearing all of this gear for a prolonged period of time in a high-temperature, high-humidity environment.

Western medical professionals who have worked under these conditions have noted how easy it is to unconsciously wipe their faces with their contaminated hands, as they try to keep the sweat streaming into their eyes from blurring their vision.

It’s not that personal protective equipment doesn’t work, but that difficult conditions and a high-pressure care situation can compromise the use of personal protective equipment (PPE), sometimes unnoticed.

Should we be worried in the U.S.?

In this age of global travel, it is inevitable that we will eventually see cases of Ebola in the U.S. Of course the prospect is sobering; though the virus is not spread casually, the mortality rate from Ebola infection is high. (As of August 1, there had been 1603 confirmed or suspected cases in this outbreak, with 887 deaths.)

However, given the infection-control resources and expertise of hospitals and health care providers, there is very little risk of the spread of Ebola in the U.S. The take-home points for health care workers are these:

  • This is a blood-borne pathogen. It is transmitted through contact of mucous membranes or non-intact skin with blood or body fluids.
  • Transmission is most likely to occur after fever develops and as the disease progresses.
  • If infection is suspected, ALWAYS inquire about the patient’s travel history. Ebola and other diseases don’t appear out of thin air. Look for a link to outbreak areas.
  • INSTITUTE ISOLATION PRECAUTIONS IMMEDIATELY. Policy in all health care organizations should specify that any clinical staff person can initiate isolation; if your policy limits isolation “orders” to physicians, change it.
  • Wear appropriate PPE.
  • Don and remove PPE as though someone’s life depends on it. Often, someone’s does. Unfortunately, we caregivers can be careless about suiting up because in most situations, we are not the people at risk.
  • But the patient down the hall to whom you’ve just carried MRSA (because of poor hand hygiene, messy glove technique, or a sloppily tied gown) can die from MRSA bacteremia or pneumonia.
  • With a disease like Ebola, or any emerging infectious disease that has not yet been fully defined (e.g., MERS), a “gatekeeper” should be stationed outside of the closed door of the patient’s room. The gatekeeper’s role: to ensure that only essential personnel enter the room, and to supervise the meticulous donning and doffing of protective gear.

For details on the pathogenesis, clinical presentation, epidemiology, and treatment of Ebola virus, see this still very relevant AJN article from several years back, free until the end of September.

London Palestine Action shut down Israeli arms drone factory near Birmingham

#StopElbit

Resist: Palestine exists. Respect Palestinians UN rights

Victory to the Palestinian struggle! Stop arming Israel

UK activists shut down Israeli arms factory

For nearly a month, Israel has bombarded Gaza from land, sea and air.

More than 1800 Palestinians have lost their lives and war crimes have been committed.

To our collective shame, the UK government has not only failed to take action to pressure Israel to stop its massacre, but has refused to take steps to end the material support it provides to Israel’s brutal regime of apartheid and colonialism.

When governments support crimes against humanity, grassroots movements must take direct action.

A group of activists from the London Palestine Action network have today (5/8/14) chained the doors shut of an Israeli weapons factory based near Birmingham in the UK and are now occupying the roof.

As part of the boycott, divestment and sanctions movement (BDS) and in response to calls for action from Palestinian movements, we are demanding the permanent closure of the factory and an end to all forms of military trade and cooperation with Israel.

The factory that we are occupying produces engines for drones and is owned by Elbit Systems, Israel’s largest military company and the world’s largest drones producer.

Drone engines manufactured at this factory have been exported to Israel in 2010, 2011 and 2012 and Elbit Systems drones are being used in Israel’s ongoing massacre. Any claims that components manufactured at this factory are not being used in Israel’s current attack on Gaza are not credible.

Drones are a key part of Israel’s military arsenal.

By allowing this factory to export drone components and other arms to Israel, the UK government is providing direct support and approval to Israel’s massacres.

The factory is also a key part of the Watchkeeper program under which Elbit Systems is leading the manufacture of a new generation of drones for the UK military.

The Watchkeeper drone is based on the Hermes 450, documented as being used to kill Palestinian civilians during the 2008-09 attack on Gaza. Elbit Systems markets its drones as ‘field tested’ – by which it means that their drones have been proven to be effective at killing Palestinians. The UK government is importing technology that has been developed during the course of Israeli massacres.

UK prime minister David Cameron and the UK government have Palestinian blood on their hands.

In order to end their deep complicity with Israel’s system of occupation, colonialism and apartheid against Palestinians, they must take steps to impose a full military embargo on Israel and close the Elbit Systems factory immediately.

It is more important than ever that the solidarity we build with the Palestinian struggle is effective and impactful. Israel does not act alone but is supported by governments and corporations across the world that have names and addresses.

It is time for the international solidarity movement to escalate its direct actions against those that support and profit from Israeli apartheid to take action that can lead to a genuine isolation of Israel.

Join the boycott, divestment and sanctions (BDS) movement!

Stop arming Israel!


adonis49

adonis49

adonis49

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