Although by cable news standards the war in Afghanistan may be ancient history, the battle to restore basic services to that ravaged land continues. That's what had HHS Secretary Tommy Thompson in Kabul last week, where he helped to open the partially reconstructed Rabia Balkhi Women's Hospital.
It was the secretary's second trip to Afghanistan. He first visited the ruined hospital last October. After years of civil war and neglect the facility had broken windows, few medical supplies and no working plumbing.
Besides helping to refurbish and improve the facility, HHS and the U.S. Defense Department aided in training the hospital's staff in modern medical practices.
"Six months ago, we made a promise to the people of Afghanistan to help rebuild their nation's public health infrastructure," Thompson said at the opening, with a portrait of Afghan President Hamid Karzai looming behind him. "Today is a new day in Afghanistan, where we now have a new hospital for women to receive top-notch healthcare and a new training program that will provide the best of medical instruction to Afghanistan's healthcare providers."
Forty percent of deaths among women of childbearing age in Afghanistan are caused by preventable complications related to childbirth. Additionally, an estimated one in four children dies before reaching his or her fifth birthday, HHS said.
The Bush administration has pledged $5 million for the project in fiscal 2004, $3 million of which will go toward completing the rebuilding of the hospital and training of staff. Another $2 million is earmarked toward establishing four satellite clinics to provide maternal and child healthcare to rural areas in the rest of the country. Each clinic would provide direct healthcare to patients as well as training to healthcare workers at all levels, including physicians, nurses, community health workers, midwives and others.
The SARS epidemic hasn't become as big a problem in the U.S. as elsewhere, but it already has claimed a few business casualties. One of those was a meeting of the Society of Teachers of Family Medicine, which was set to meet in Toronto this week until the Leawood, Kan.-based group canceled.
The cancellation followed the addition of Toronto to the Centers for Disease Control and Prevention's list of areas with documented or suspected community transmissions of the virus, severe acute respiratory syndrome.
The CDC is recommending that U.S. travelers to Toronto avoid settings where SARS is most likely to be transmitted-such as healthcare facilities caring for SARS patients-and monitor their health while visiting and for at least 10 days after leaving Toronto. "If fever or respiratory symptoms (for example, cough or shortness of breath) develop, a visit to a healthcare provider is strongly recommended," an official CDC statement read. "If a meeting attendee developed any of those symptoms, it is not clear if they would be allowed to leave the country without voluntary isolation," Betsy Garrett, the organization's president, wrote in an e-mail to conference registrants, most of whom work in a variety of clinical settings with vulnerable populations. "Implications for any of us who were to develop respiratory symptoms and a fever within 10 days of return would be significant." The meeting has been rescheduled to Sept. 20-24 in the CDC's hometown of Atlanta.
Stop 'em, fine 'em, take care of 'em
Texas' cash-strapped trauma centers soon could get some financial relief from some of their most frequent patients-bad drivers.
The state Legislature is considering a bill that aims to raise up to $310 million a year by requiring habitually bad drivers to pay additional fines for motor violations, including speeding and drunken driving. The money would go into Texas' existing tertiary-care fund, which helps subsidize the state's 189 trauma centers largely through unclaimed lottery proceeds.
"There is an inextricable link between dangerous driving behavior and the over-filled capacities of our trauma facilities," says Texas State Rep. Dianne White Delisi, a Republican who authored the bill. "For too long, the responsible citizens of Texas have been picking up the tab for this behavior, both through increased taxes and decreased services. House Bill 3203 shifts the responsibility to where it belongs."
The bill would create a point system for motor violations and require drivers with six or more points to pay $100 or more annually for up to three years. Drivers would receive one point for failing to wear a seatbelt, two points for a moving violation that doesn't cause an accident and three points for causing an accident. Drivers convicted of more serious offenses-drunken driving, refusal to consent to a sobriety test, or driving with a suspended or expired license-would be charged $250 to $1,500 annually for as long as three years.
Texas leads the nation in both the number of fatalities from car accidents and the number of deaths caused by drunken driving, Delisi says. Car accidents account for 54% of Texas' emergency room costs, and the bulk of those accidents are caused by a small percentage of habitually bad drivers, she says.