Adonis Diaries

Archive for October 29th, 2015

Clowns Without Borders witnessed a capsized boat at night: casualties

 Sabine Choucair posted this Oct. 29, 2015

Lesvos is where you can plan nothing ahead of time; even deciding to go to the toilet involved two shows because… why not?

And what else we’re here for!

At night, it was a different story. we heard of a boat that had capsized with 400 people on it. We ran there not in clown costumes.

I was translating, supporting wounded people, people who lost family members, women and kids.

Molly and Luz helping with distributing warm clothes to the lucky ones who made it and Clay playing music sometimes and supporting us some other times.

There was this man in his 40s, crying so much. I thought he had lost a family member like many others around.

We sat together and he recounted that the moment they started swimming he saw a baby in a life jacket drowning, he held him tight and swam and swam and swam… then looked to check on him to realize that he was only holding the life jacket.

The baby slipped away and with him this man’s soul got lost in the sea

Our first performances in lesvos …
We’ve done one camp and a harbor so far.
It is so beautiful to be able to draw smiles on bored, tired, anxious, worried faces.
Thank you @clownswithoutborders Luz Gaxiola Clay Mazing and Molly Rose for being an amazing team.

Sabine Choucair's photo.
Sabine Choucair's photo.
Sabine Choucair's photo.
Sabine Choucair's photo.
Sabine Choucair's photo.

Clown Me In Clowns Without Borders Molly Rose Luz Gaxiola Clay Mazing

Obama’s drone wars

Leaked military documents expose the inner workings

More than 90% of victims and casualties are civilians (Not the intended targets? How often this trend has to continue before we dismiss this claim?)

DRONES ARE A TOOL, not a policy. The policy is assassination.

While every president since Gerald Ford has upheld an executive order banning assassinations by U.S. personnel, Congress has avoided legislating the issue or even defining the word “assassination.”

This has allowed proponents of the drone wars to rebrand assassinations with more palatable characterizations, such as the term du jour, “targeted killings.” (exterminate with utmost prejudice?)

Andrew Bossone shared this link

“In one 5-month period of a US operation in Afghanistan, nearly 90% of people killed were not the intended targets” -@HinaShamsi

The whistleblower who leaked the drone papers believes the public is entitled to know how people are placed on kill lists and assassinated on orders from
theintercept.com

When the Obama administration has discussed drone strikes publicly, it has offered assurances that such operations are a more precise alternative to boots on the ground and are authorized only when an “imminent” threat is present and there is “near certainty” that the intended target will be eliminated.

Those terms, however, appear to have been bluntly redefined to bear almost no resemblance to their commonly understood meanings.

The first drone strike outside of a declared war zone was conducted more than 12 years ago, yet it was not until May 2013 that the White House released a set of standards and procedures for conducting such strikes.

Those guidelines offered little specificity, asserting that the U.S. would only conduct a lethal strike outside of an “area of active hostilities” if a target represents a “continuing, imminent threat to U.S. persons,” without providing any sense of the internal process used to determine whether a suspect should be killed without being indicted or tried.

The implicit message on drone strikes from the Obama administration has been one of trust, but don’t verify.

The Intercept has obtained a cache of secret slides that provides a window into the inner workings of the U.S. military’s kill/capture operations at a key time in the evolution of the drone wars — between 2011 and 2013.

The documents, which also outline the internal views of special operations forces on the shortcomings and flaws of the drone program, were provided by a source within the intelligence community who worked on the types of operations and programs described in the slides.

The Intercept granted the source’s request for anonymity because the materials are classified and because the U.S. government has engaged in aggressive prosecution of whistleblowers. The stories in this series will refer to the source as “the source.”

The source said he decided to provide these documents to The Intercept because he believes the public has a right to understand the process by which people are placed on kill lists and ultimately assassinated on orders from the highest echelons of the U.S. government.

“This outrageous explosion of watchlisting — of monitoring people and racking and stacking them on lists, assigning them numbers, assigning them ‘baseball cards,’ assigning them death sentences without notice, on a worldwide battlefield — it was, from the very first instance, wrong,” the source said.

“We’re allowing this to happen. And by ‘we,’ I mean every American citizen who has access to this information now, but continues to do nothing about it.”

The Pentagon, White House, and Special Operations Command all declined to comment. A Defense Department spokesperson said, “We don’t comment on the details of classified reports.”

The CIA and the U.S. military’s Joint Special Operations Command (JSOC) operate parallel drone-based assassination programs, and the secret documents should be viewed in the context of an intense internal turf war over which entity should have supremacy in those operations.

Two sets of slides focus on the military’s high-value targeting campaign in Somalia and Yemen as it existed between 2011 and 2013, specifically the operations of a secretive unit, Task Force 48-4.

Additional documents on high-value kill/capture operations in Afghanistan buttress previous accounts of how the Obama administration masks the true number of civilians killed in drone strikes by categorizing unidentified people killed in a strike as enemies, even if they were not the intended targets.

The slides also paint a picture of a campaign in Afghanistan aimed not only at eliminating al Qaeda and Taliban operatives, but also at taking out members of other local armed groups.

One top-secret document shows how the terror “watchlist” appears in the terminals of personnel conducting drone operations, linking unique codes associated with cellphone SIM cards and handsets to specific individuals in order to geolocate them.

The costs to intelligence gathering when suspected terrorists are killed rather than captured are outlined in the slides pertaining to Yemen and Somalia, which are part of a 2013 study conducted by a Pentagon entity, the Intelligence, Surveillance, and Reconnaissance Task Force.

The ISR study lamented the limitations of the drone program, arguing for more advanced drones and other surveillance aircraft and the expanded use of naval vessels to extend the reach of surveillance operations necessary for targeted strikes.

It also contemplated the establishment of new “politically challenging” airfields and recommended capturing and interrogating more suspected terrorists rather than killing them in drone strikes.

The ISR Task Force at the time was under the control of Michael Vickers, the undersecretary of defense for intelligence. Vickers, a fierce proponent of drone strikes and a legendary paramilitary figure, had long pushed for a significant increase in the military’s use of special operations forces. The ISR Task Force is viewed by key lawmakers as an advocate for more surveillance platforms like drones.

The ISR study also reveals new details about the case of a British citizen, Bilal el-Berjawi, who was stripped of his citizenship before being killed in a U.S. drone strike in 2012.

British and American intelligence had Berjawi under surveillance for several years as he traveled back and forth between the U.K. and East Africa, yet did not capture him. Instead, the U.S. hunted him down and killed him in Somalia.

Taken together, the secret documents lead to the conclusion that Washington’s 14-year high-value targeting campaign suffers from an overreliance on signals intelligence, an apparently incalculable civilian toll, and — due to a preference for assassination rather than capture — an inability to extract potentially valuable intelligence from terror suspects.

They also highlight the futility of the war in Afghanistan by showing how the U.S. has poured vast resources into killing local insurgents, in the process exacerbating the very threat the U.S. is seeking to confront.

These secret slides help provide historical context to Washington’s ongoing wars, and are especially relevant today as the U.S. military intensifies its drone strikes and covert actions against ISIS in Syria and Iraq. Those campaigns, like the ones detailed in these documents, are unconventional wars that employ special operations forces at the tip of the spear.

The “find, fix, finish” doctrine that has fueled America’s post-9/11 borderless war is being refined and institutionalized. Whether through the use of drones, night raids, or new platforms yet to be unleashed, these documents lay bare the normalization of assassination as a central component of U.S. counterterrorism policy.

“The military is easily capable of adapting to change, but they don’t like to stop anything they feel is making their lives easier, or is to their benefit.

And this certainly is, in their eyes, a very quick, clean way of doing things. It’s a very slick, efficient way to conduct the war, without having to have the massive ground invasion mistakes of Iraq and Afghanistan,” the source said.

“But at this point, they have become so addicted to this machine (drone), to this way of doing business, that it seems like it’s going to become harder and harder to pull them away from it the longer they’re allowed to continue operating in this way.”

While many of the documents provided to The Intercept contain explicit internal recommendations for improving unconventional U.S. warfare, the source said that what’s implicit is even more significant.

The mentality reflected in the documents on the assassination programs is: “This process can work. We can work out the kinks. We can excuse the mistakes. And eventually we will get it down to the point where we don’t have to continuously come back … and explain why a bunch of innocent people got killed.”

The architects of what amounts to a global assassination campaign do not appear concerned with either its enduring impact or its moral implications. “All you have to do is take a look at the world and what it’s become, and the ineptitude of our Congress, the power grab of the executive branch over the past decade,” the source said.

“It’s never considered: Is what we’re doing going to ensure the safety of our moral integrity? Of not just our moral integrity, but the lives and humanity of the people that are going to have to live with this the most?”

Do childhood trauma affects health across a lifetime?

In the mid-’90s, the CDC and Kaiser Permanente discovered an exposure that dramatically increased the risk for 7out of 10 of the leading causes of death in the United States.

In high doses (of  childhood trauma ), it affects brain development, the immune system, hormonal systems, and even the way our DNA is read and transcribed.

Folks who are exposed in very high doses have triple the lifetime risk of heart disease and lung cancer and a 20-year difference in life expectancy.

And yet, doctors today are not trained in routine screening or treatment. Now, the exposure I’m talking about is not a pesticide or a packaging chemical. It’s childhood trauma.

Patsy Z and TEDxSKE shared a link.
Childhood trauma isn’t something you just get over as you grow up.
ted.com|By Nadine Burke Harris

01:05 Okay. What kind of trauma am I talking about here? I’m not talking about failing a test or losing a basketball game. I am talking about threats that are so severe or pervasive that they literally get under our skin and change our physiology: things like abuse or neglect, or growing up with a parent who struggles with mental illness or substance dependence.  (Attention Deficit Hyperactivity Disorder)

For a long time, I viewed these things in the way I was trained to view them, either as a social problem — refer to social services — or as a mental health problem — refer to mental health services.

And then something happened to make me rethink my entire approach.

When I finished my residency, I wanted to go someplace where I felt really needed, someplace where I could make a difference. So I came to work for California Pacific Medical Center, one of the best private hospitals in Northern California, and together, we opened a clinic in Bayview-Hunters Point, one of the poorest, most underserved neighborhoods in San Francisco.

Prior to that point, there had been only one pediatrician in all of Bayview to serve more than 10,000 children, so we hung a shingle, and we were able to provide top-quality care regardless of ability to pay. It was so cool.

We targeted the typical health disparities: access to care, immunization rates, asthma hospitalization rates, and we hit all of our numbers. We felt very proud of ourselves.

But then I started noticing a disturbing trend. A lot of kids were being referred to me for ADHD, or Attention Deficit Hyperactivity Disorder, but when I actually did a thorough history and physical, what I found was that for most of my patients, I couldn’t make a diagnosis of ADHD.

Most of the kids I was seeing had experienced such severe trauma that it felt like something else was going on. Somehow I was missing something important.

Before I did my residency, I did a master’s degree in public health, and one of the things that they teach you in public health school is that if you’re a doctor and you see 100 kids that all drink from the same well, and 98 of them develop diarrhea, you can go ahead and write that prescription for dose after dose after dose of antibiotics, or you can walk over and say, “What the hell is in this well?”

So I began reading everything that I could get my hands on about how exposure to adversity affects the developing brains and bodies of children.

And then one day, my colleague walked into my office, and he said, “Dr. Burke, have you seen this?” In his hand was a copy of a research study called the Adverse Childhood Experiences Study.

That day changed my clinical practice and ultimately my career.

 The Adverse Childhood Experiences Study is something that everybody needs to know about. It was done by Dr. Vince Felitti at Kaiser and Dr. Bob Anda at the CDC, and together, they asked 17,500 adults about their history of exposure to what they called “adverse childhood experiences,” or ACEs.

Those include physical, emotional, or sexual abuse; physical or emotional neglect; parental mental illness, substance dependence, incarceration; parental separation or divorce; or domestic violence.

For every yes, you would get a point on your ACE score. And then what they did was they correlated these ACE scores against health outcomes. What they found was striking.

Two things:

Number one, ACEs are incredibly common. 67%of the population had at least one ACE, and 12.6 percent, one in eight, had four or more ACEs.

The second thing that they found was that there was a dose-response relationship between ACEs and health outcomes: the higher your ACE score, the worse your health outcomes.

For a person with an ACE score of four or more, their relative risk of chronic obstructive pulmonary disease was two and a half times that of someone with an ACE score of zero.

For hepatitis, it was also two and a half times. For depression, it was four and a half times.

For suicide tendency, it was 12 times.

A person with an ACE score of 7 or more had triple the lifetime risk of lung cancer and three and a half times the risk of ischemic heart disease, the number one killer in the United States of America.

This makes sense.

Some people looked at this data and they said, “Come on. You have a rough childhood, you’re more likely to drink and smoke and do all these things that are going to ruin your health. This isn’t science. This is just bad behavior.”

It turns out this is exactly where the science comes in.

We now understand better than we ever have before how exposure to early adversity affects the developing brains and bodies of children.

1. It affects areas like the nucleus accumbens, the pleasure and reward center of the brain that is implicated in substance dependence.

2. It inhibits the prefrontal cortex, which is necessary for impulse control and executive function, a critical area for learning.

3. And on MRI scans, we see measurable differences in the amygdala, the brain’s fear response center.

So there are real neurologic reasons why folks exposed to high doses of adversity are more likely to engage in high-risk behavior, and that’s important to know.

But it turns out that even if you don’t engage in any high-risk behavior, you’re still more likely to develop heart disease or cancer. The reason for this has to do with the hypothalamic–pituitary–adrenal axis, the brain’s and body’s stress response system that governs our fight-or-flight response.

How does it work? Well, imagine you’re walking in the forest and you see a bear. Immediately, your hypothalamus sends a signal to your pituitary, which sends a signal to your adrenal gland that says, “Release stress hormones! Adrenaline! Cortisol!” And so your heart starts to pound, your pupils dilate, your airways open up, and you are ready to either fight that bear or run from the bear.

And that is wonderful if you’re in a forest and there’s a bear. (Laughter) But the problem is what happens when the bear comes home every night, and this system is activated over and over and over again, and it goes from being adaptive, or life-saving, to maladaptive, or health-damaging?

Children are especially sensitive to this repeated stress activation, because their brains and bodies are just developing. High doses of adversity not only affect brain structure and function, they affect the developing immune system, developing hormonal systems, and even the way our DNA is read and transcribed.

For me, this information threw my old training out the window, because when we understand the mechanism of a disease, when we know not only which pathways are disrupted, but how, then as doctors, it is our job to use this science for prevention and treatment. That’s what we do.

So in San Francisco, we created the Center for Youth Wellness to prevent, screen and heal the impacts of ACEs and toxic stress.

We started simply with routine screening of every one of our kids at their regular physical, because I know that :

1. if my patient has an ACE score of 4, she’s two and a half times as likely to develop hepatitis or COPD, she’s four and half times as likely to become depressed, and she’s 12 times as likely to attempt to take her own life as my patient with zero ACEs.

2. I know that when she’s in my exam room.

For our patients who do screen positive, we have a multidisciplinary treatment team that works to reduce the dose of adversity and treat symptoms using best practices, including home visits, care coordination, mental health care, nutrition, holistic interventions, and yes, medication when necessary.

But we also educate parents about the impacts of ACEs and toxic stress the same way you would for covering electrical outlets, or lead poisoning, and we tailor the care of our asthmatics and our diabetics in a way that recognizes that they may need more aggressive treatment, given the changes to their hormonal and immune systems.

So the other thing that happens when you understand this science is that you want to shout it from the rooftops, because this isn’t just an issue for kids in Bayview.

I figured the minute that everybody else heard about this, it would be routine screening, multi-disciplinary treatment teams, and it would be a race to the most effective clinical treatment protocols.

Yeah. That did not happen. And that was a huge learning for me.

What I had thought of as simply best clinical practice I now understand to be a movement.

In the words of Dr. Robert Block, the former President of the American Academy of Pediatrics, Adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today.”

And for a lot of people, that’s a terrifying prospect. The scope and scale of the problem seems so large that it feels overwhelming to think about how we might approach it.

But for me, that’s actually where the hopes lies, because when we have the right framework, when we recognize this to be a public health crisis, then we can begin to use the right tool kit to come up with solutions.

From tobacco to lead poisoning to HIV/AIDS, the United States actually has quite a strong track record with addressing public health problems, but replicating those successes with ACEs and toxic stress is going to take determination and commitment, and when I look at what our nation’s response has been so far, I wonder, why haven’t we taken this more seriously?

13:14 You know, at first I thought that we marginalized the issue because it doesn’t apply to us. That’s an issue for those kids in those neighborhoods. Which is weird, because the data doesn’t bear that out.

The original ACEs study was done in a population that was 70 percent Caucasian, 70 percent college-educated.

But then, the more I talked to folks, I’m beginning to think that maybe I had it completely backwards. If I were to ask how many people in this room grew up with a family member who suffered from mental illness, I bet a few hands would go up.

And then if I were to ask how many folks had a parent who maybe drank too much, or who really believed that if you spare the rod, you spoil the child, I bet a few more hands would go up.

Even in this room, this is an issue that touches many of us, and I am beginning to believe that we marginalize the issue because it does apply to us. Maybe it’s easier to see in other zip codes because we don’t want to look at it. We’d rather be sick.

 Fortunately, scientific advances and, frankly, economic realities make that option less viable every day. The science is clear: Early adversity dramatically affects health across a lifetime.

Today, we are beginning to understand how to interrupt the progression from early adversity to disease and early death, and 30 years from now, the child who has a high ACE score and whose behavioral symptoms go unrecognized, whose asthma management is not connected, and who goes on to develop high blood pressure and early heart disease or cancer will be just as anomalous as a six-month mortality from HIV/AIDS.

People will look at that situation and say, “What the heck happened there?” This is treatable. This is beatable. The single most important thing that we need today is the courage to look this problem in the face and say, this is real and this is all of us. I believe that we are the movement.


adonis49

adonis49

adonis49

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