text:
CFP: 18th- and 19th-C. British Women Writers (9/30/05; BWWC, 3/23/06-3/26/06)
The 14th Annual
Eighteenth- and Nineteenth-Century British Women Writers Conference
March 23-26, 2006
The University of Florida
Call for Papers
This year's theme, "(Re)Collecting British Women Writers," encourages
interdisciplinary approaches to writers of the period, with a special
interest in issues related to archival scholarship and memory and how
those issues manifest themselves in collections, exhibitions, and canons.
We are very pleased to announce that our keynote speakers will be Talia
Schaffer (CUNY-Queens College), Carolyn Steedman (University of
Warwick), and Lynne Vallone (Texas A&M University).
We encourage proposals focusing on but not limited to:
Collections and Archives:
- Politics of display and archiving
- Textual and physical collections
- Intersections of written and visual arts
- Collecting in the (pseudo)sciences
- Exhibiting the empire
- The family: children's culture
- Collections and archives in the classroom
(Re)envisioning the Canon:
- Recovering women's writing
- Intersections between canonical and non-canonical writers
- Intersections between male and female writers
- De-marginalizing and de-centering groups, texts, crafts
- Theatrical adaptations of canonical and non-canonical texts
- Women's access to words: female literacies and publishing
- Children's literature in the eighteenth- and nineteenth-centuries
- Transatlantic links in children's culture
Influence and Textual Memory:
- Colony and the empire
- Nation, nationality, and the body
- Life writing: journals and letters
- Travel narratives
- Gendered intertexualities
- Subjectivity, agency, and authorship
- Family as a microcosm or metaphor
- The politics of historical representation
Please submit 1-2 page abstracts for individual presentations and panel
proposals (including the name of a moderator) by September 30, 2005.
Please do not include any identifying information in your abstract.
Proposals may be submitted via an online form at
http://www.english.ufl.edu/bwwc/cfp_submission.shtml after July 1, 2005.
Proposals may also be sent via regular mail (include a cover sheet with
your name, mailing address, email address, phone number, and
institutional affiliation) to:
British Women Writers Conference
University of Florida
Department of English
P.O. Box 117310
Gainesville, Florida 32611-7310
For more information about the conference, please visit our website at
From the Literary Calls for Papers Mailing List
Full Information at
or write Jennifer Higginbotham: higginbj_at_english.upenn.edu
Received on Tue Jun 14 2005 - 15:51:58 EDT


text:
Howard Sadwin is 65 years old and lives in Sarasota, Florida. Life has not been the same since a metal-on-metal hip implant in 2007. In fact, during his 10-month hospital stay, Howard's doctor leaned over and whispered to him that Howard was dying. But Sadwin survived and today is fighting mad about the artificial hip and its metal components that were approved for use in this country by the Food and Drug Administration (FDA).
"My intentions are to tell my story, and for others to listen to my thoughts on improving a system that is in dire need of help," he tells MDND.
"I was 61 and the pain I was getting in my hip and lower back was beyond tolerance," says Sadwin, now age 65.
An x-ray showed he needed his right hip replaced. The left hip had been replaced 16 years earlier in 1991 and so when it was time for the right hip his expectation was that it would be the same successful procedure which he chose to have done by a reputable orthopaedic surgeon at Sarasota Memorial Hospital.
Howard says today, "I don't have any doubts to his sincerity, honesty and integrity. It wasn't human error or doctor error."
So in 2007, Howard Sadwin was implanted with the metal-on-metal (MOM) Smith and Nephew, Birmingham Hip Resurfacing System (BHR), an artificial hip replacement system which was approved for sale in the U.S. the year earlier. The BHR hip is globally marketed in 23 countries for younger, active Baby Boomers who want to stay active, according to its website (here):
"This successful, bone conserving total hip system is well documented through independent clinical and laboratory studies. Additional clinical evidence supporting our BIRMINGHAM HIP Resurfacing System is published in multiple registries. This bone conserving procedure, combined with the virtual elimination of dislocation and excellent survivorship make the BIRMINGHAM HIP Resurfacing ideal for the active informed patient."
"Within 10 to 11 months I began limping and my back pain increased. The pain was getting worse and low grade fevers appeared along with rashes and blurry vision. I visited my orthopedic surgeon several times, the doctor who put it in, and he x-rayed the hip and saw no signs of a problem. My family doctor checked me almost weekly and recommended I see a back doctor, eye doctor, cardio doctor, dermatologist, but things got progressively worse. At one point I thought it was just me so I began taking anti-depression medication," says Sadwin.
"At this point I had an active life. I fished, hunted, and competed my dozen Labrador retrievers in field trials. I have four grandchildren, ages 4 to 8, 3 girls and 1 boy, and they are a big part of my life. I have a loving wife of 23 years, I went to the gym 3 times a week, had a real estate career of 31 years. I am involved with Little League. My grandson is like my son. I would pick him up at school in my truck, and the last time we were together we went riding ATVs and he was getting into racing."
Howard says by 2010 he was living with the constant pain but tried to maintain an active life. But in the beginning of January, while getting out of bed, he dislocated his hip which landed him in an ambulance to hospital.
"The hip was put back in place and I returned home after a few days in the hospital. I saw my orthopedic surgeon, more x-rays and he said everything looked okay, just cut back my activities, and I did.
"Within one week of being at home I got up from sitting in a chair at home, and the hip dislocated for the second time, another ambulance trip, same routine."
A second opinion from another surgeon confirmed the diagnosis – if the hip dislocated again it would have to be removed.
"The new surgeon suspected there was a buildup of fluids around the hip and ordered an MRI for me to have done the following day. Two hours later I got up from my office chair and out the hip came.
"The BHR was removed and the surgeon told my wife he had never seen such a mess. All the tissue and muscle surrounding my hip area was gone, there was nothing to support a hip. It had deteriorated."
After being hospitalized and sent home to recuperate, Howard spiked a fever of 105° F and he says there was a liquid-like substance coming from his body. For more than nine months, Howard would remain in the hospital undergoing 12 operations performed by four different surgeons.
"The operations were not just simple clean-ups. They had to cut off part of my femur twice. They had to go through abdomen to get muscle to cover the wound that was gaping open, about the size of a fist and a half. The muscle was used to help the wound heal from the outside as it was not healing from the inside. I never saw it but my wife had to leave the room.
"One surgeon came into see how I was doing, which was not so good. He leaned over close to my ear and told me I was dying, that he thought he could keep me alive, but the rest was up to me. I was dying with so much dope and medication going in me. I was listless. I was getting six different antibiotics a couple of times a day. After several months, the wound began to close. The bottom right side of my body looks like a crater, covered with enough railroad tracks to make you think you were in Grand Central Station.
"Going through something like this can't totally be understood unless one has lived the experience, I don't wish to happen to you, my grandchildren, my friends, or anyone."
Howard attributes his survival to, "God, great doctors and nurses, my loving wife, family, and friends. My Labrador retriever service dog came to the hospital regularly. My now 8-year-old grandson, the apple of my life and my beautiful granddaughters, my spirituality, and my will to survive kept me alive."
On February 28, 2012, the BBC and British Medical Journal (BBC/BMJ) issued a joint investigation into patient complications from metal-on-metal hip implants. Researchers have known for at least a decade that metal debris was excreted in the blood of some patients and that hundreds of thousands worldwide may be at risk for the complications which can include toxic levels of cobalt and chromium ions that can seep into tissues and organs and destroy muscle and bone, leaving some patients with a long-term disability.
The BBC/BMJ (here) looked at hips made by the largest companies including J&J of New Brunswick, New Jersey; Warsaw, Indiana-based Zimmer Holdings Inc.; and Smith & Nephew Plc of London.
On its website, Smith & Nephew admits metal ions can be released from wear and/or corrosion once the metal hip is implanted in the body. Some individuals have developed an immune response to the particulate or metal ion/protein complexes, though the company calls the reaction "extremely rare." And an inflammatory response known as "pseudotumors" has been reported in some patients along with fluid or soft tissue mass, largely thought the result of a higher rate of wear.
In May 2006, the FDA finally approved the BHR for sale in the U.S. after it had been rejected two years earlier. The principal investigator for Smith & Nephew who developed the device, then sold it to the company for $119 million with an additional $59 million in incentives, something a competitive company called a violation of the FDA's own rules on conflict-of-interest.
The head of a competing company, Wright Medical Technology, of Arlington, TN challenged the FDA's approval the second time around. In a Citizen's Petition, dated October 29, 2005, Jeffrey G. Roberts, Senior VP Chief Technology Officer, said the approval was rife with conflicts and the BHR should never have been approved. (See the Petition here).
Because the new technology of "resurfacing" was dissimilar to anything on the market, the FDA required premarket approval (PMA) requiring clinical data to prove the artificial hip was safe and effective.
This puts the BHR in a class by itself in that most hip replacements or implants get on the market after a relatively fast-tracked FDA approval process, called 510(k), after exchanging paperwork and naming a similar device that is a "predicate" already being sold. Having a PMA approved medical device means the medical device makers enjoy immunity if their device has undergone a PMA, because the device is FDA approved.
That anti-consumer decision was made by the U.S. Supreme Court in a case known as Riegel v. Medtronic (here) and it has yet to be successfully overturned. The bottom line remains, anyone who is harmed by an FDA-approved medical device has no recourse in the courts.
In the United Kingdom, MOM hip replacement patients have been tracked post operatively since May 2010 and Australia's 2008 National Joint Replacement Registry found less than one-third of one percent of BHR implants were removed due to a metal reaction.
But in the U.S., there is no post-operative follow-up of patients. With approximately 500,000 U.S. patients with all-metal hips, there is no data on the complication rate. To correct that, the FDA in May of last year, wrote to 20 manufacturers to require post-market studies including blood samples to test for metal, and to determine the number of failures.
Andrew Burns, a spokesman for S & N, would not release figures on the number of implants or the complication rates of its product in the U.S. citing proprietary company information.
The London-based company stresses assurances of safety and in a February news release (here)
reported among 400 patients who had received the BHR, 99 percent had a successful or very positive outcome after a decade. The company sites its metallurgy and design as a reason for its success.
The BMJ report says the average failure rate at seven years is 11.8 percent for resurfacing metal hips and 13.6 percent for metal-on-metal total hip replacement, although the failure rates vary depending on the company. Compare that to the 3.3 percent to 4.9 percent failure rate of artificial hips made out of other materials.
Because the resurfacing process was new, as a condition of its May 9, 2006 FDA approval (here), the agency required Smith & Nephew to monitor patients, take blood sample sand determine the rate of complications and removals. The company tells MDND that the findings are not publicly available.
Howard Sadwin wonders what has happened to the data.
"What did the FDA do with it? In my opinion, the FDA has not been under control since conception with strict laws, rules, and implementation of fines to these device companies when they do wrong. This is the only business on earth, the medical device world, that doesn't seem to have to follow any rules unless it is okay with them."
Today Sadwin is in a wheelchair. While his plastic 16 year-old-hip has given him no problem, the S & N metal-on-metal hip was replaced on October 10, 2011 with a Regenerex® RingLoc®+ Modular Acetabular System - Biomet, constructed with titanium.
The tissues and muscle in his hip are what he calls 'gone' and he walks with a shoe that is two inches higher on the right side because of the atrophy of the leg muscles. He does water therapy and lifts weights twice a week. Sadwin can walk with a walker for about 15 minutes, and can also walk with a special leg brace. Otherwise he uses the wheelchair.
He says he's been told his quadriceps will probably not function, despite his trips to the gym.
"I work at it as hard as if I was a 30 year old guy training for sports, I don't stop till I'm ready to leave. Whatever it is, I have to deal with it. I have to accept the reality, I don't dwell on it, if I did, I'd be in a mass depression. The list goes on and on and on. Who the hell knows why some people react more than others."
"I've reeducated myself after talking to the second surgeon and asked 'Did this device do this to me,' and he said 'Yes.' There are scavenger ions in your body and when that device was put in, the scavenger ions created this mess, they fed off the metal-on-metal, that's what he believes.
"My opinion is what they are telling me, I have no clue in medical jargon. It makes sense to me, all I know is I'm in a wheelchair. "
"The medical device world provides a second chance at having a better quality of life, and has saved lives. However, it's time to face reality - metal-on-metal was not the material that would prove to be my best friend. I want to do whatever I can to see this never happens again.
"Ask your surgeons about whether the hip they are putting in you will still be in in six months or six years. Ask to see the data. There is none. That data will eventually come from me, you and every other person who is going to have or had a resurfacing procedure or complete hip replacement---in other words I consider myself a test rat."
"My 8-year-old grandson usually would stay over 1 or 2 nights a week. Last week, he said to me, could he go home and not spend the night, I had expected this, my heart sunk. I picked my head up, looked into those big blue eyes and asked him was this because we couldn't do to the things we use to do, he responded 'yes'. I said he could do whatever he wished. I understood.
"The biggest drawback when dealing with BHR clients is the lack of numbers when comparing to DePuy, ASR hips by Johnson & Johnson etc. This is a drawback in the U.S. and probably the UK. However, the fact remains there are people suffering due to this device. I am trying to reach out to these people so they seek out proper medical attention, if needed, and try to explain that they are not alone, and they need to come forward. Little by little people are coming forward."
Sadwin reaches out as a patient advocate through the growing blog, "Earl's View" started by Earl Stevens of New Zealand and now Australia who suffered debilitating complications after his Birmingham Spectron total hip-joint replacement. Other patients have come forward on "Earl's View" with their tales of complications following hip replacements.
"The most important thing we can do is work collectively, support each other when one is in need of a shoulder and speak your piece. If the system or the device that is responsible for doing this to me or to you is ever going to be changed, we must prevail. #
Learn More
Earl's View- Forum on Hip Replacement- his story
How safe are metal-on-metal hip implants?
BBC- Metal hip patients need lifelong checks
Metal-on-metal implants: FDA's role and activities
Birmingham Hip Resurfacing System (BHR)
BBC- Metal hip patients need lifelong checks
Patient POV on metal hips/ combine with BBC and BMJ
Newcastle University, UK on Improving Metal Hip Designs
Smith & Nephew BHR
Riegel v. Medtronic decision, February 20, 2008
Citizen's Petition by Wright Medical Technology
Blog, Medical Device Cases Dismissed under Riegel

subset: commoncrawl


text:
President Obama—a punching bag in the first presidential debate—became a sledge hammer in his second showdown Tuesday night against Republican Mitt Romney.
In what might prove to be the decisive 90 minutes of the presidential campaign, both flashed moments of seething anger during the town hall-style forum in New York. Their raised voices and intimidating glares conveyed a sense of mutual disdain for the other. The dislike went well beyond their differences on tax, energy, immigration, and the recent al Qaeda-affiliated attack that killed the U.S. ambassador to Libya.
The former Massachusetts governor has been climbing in the polls after successfully positioning himself as a champion of the middle class during their first Oct. 3 debate. Obama swung hard to stop that assent, labeling Romney—who co-founded the private equity firm Bain Capital—as a conservative extremist who will coddle the wealthy.
"Gov. Romney doesn't have a five point plan, he has a one point plan—and that plan is to make sure that folks at the top play by a different set of rules," Obama said. "That's been his philosophy in the private sector. That's been his philosophy as governor. That's been his philosophy as a presidential candidate—you can make a lot of money and pay lower tax rates than somebody who makes a lot less. You can ship jobs overseas and get tax breaks for it. You can invest in a company, bankrupt it, layoff the workers, strip away their pensions, and still make money."
A CNN poll of registered voters who watched the debate indicates the gambit might have worked. Forty-six percent chose Obamaas the victor, with 39 percent for Romney.
Republican pollster John Zogby gave the win to the Democratic incumbent. "Obama was on fire," he said, while Romney "lacked details and simply got caught in representing some ideas that were very different from the Mitt Romney who debated 19 times with his GOP opponents."
Romney rehashed his long-time argument that Obama had "crushed" the middle class by failing to lead the economy all the way out of recession—with unemployment at a historically high 7.8 percent despite government spending that produced four straight years of deficits in excess of $1 trillion.
In one particularly heated exchange, he dismissed Obama's professed support of fossil fuels. "The proof of whether the strategy is working is the price you pay at the pump," said Romney, knowing that gasoline prices on Long Island, New York had nearly doubled from $1.80 a gallon over the past four years.
Drilling on federal lands is down 14 percent between 2010 and 2011, Romney continued. Obama disputed the claim that he was hostile to oil and natural gas—and records kept by the U.S. Energy Information Administration indicate that overall production has increased since 2008.
"I don't think anyone truly believes that you're a person who's going to be pushing for oil, gas and coal," Romney responded.
Honesty and candor were frequently at the heart of their disputes. Romney would press the moderator, CNN's Candy Crowley, for additional time to address statements he deemed inaccurate, while Obama repeated variations on the refrain, "What Gov. Romney said just isn't true."
When the GOP candidate hit back, he often opened himself up to an uppercut. Trying to shake-off criticism about his offshore accounts and investments in companies that outsourced to China, Romney noted that Obama also had foreign holdings.
"Mr. President, have you looked at your pension?" he asked.
"I don't look at my pension, it's not as big as yours so it doesn't take as long," Obama said, as the 80-person crowd of voters who were reportedly undecided began to chuckle.
Romney similarly tried to score points on the deadly security breach of the consulate in Benghazi, Libya that killed U.S. ambassador J. Christopher Stevens and three others. Obama accepted responsibility for their deaths, reiterating that the day after the tragedy he stood in the Rose Garden and said he did call it an act of terror. Here's exactly what he said: "No acts of terror will ever shake the resolve of this great nation."
The former Massachusetts governor leapt at the bait, saying that he wanted to get on the record that Obama had described the incident as an act of terrorism, and not connected it to a spontaneous demonstration as mistakenly claimed at first by intelligence reports.
"Is that what you're saying?" Romney said.
"Please proceed, governor," Obama responded, drawing him into a trap.
"I want to make sure we get that for the record, because it took the president 14 days before he called the attack in Benghazi an act of terror," Romney said.
"Get the transcript," Obama said.
"He did in fact, sir," Crowley chimed in.
"Would you say that a little louder, Candy," Obama said, once again drawing laughter.
Crowley then acknowledged that it took two weeks for the administration to disavow the demonstration over the anti-Islamic video that at first was said to have prompted the attack.
Among the frequent disruptions, Obama did something he failed to do during their previous match-up in Denver. He challenged Romney head-on. He knocked the governor's commitment during the GOP primary to the "self-deportation" of illegal immigrants, a clear policy loser with Latino voters. And he took the Republican to task for not spelling out the "sketchy deal" of which programs he would slash to find the $5 trillion needed over the next decade to cover the cost of his planned 20 percent reduction in income taxes. Romney responded that the president has not delivered on immigration reform, nor upheld his pledge to halve the deficit.
After the question, "What do you believe is the biggest misperception that the American people have about you as a man and a candidate?" Without a strong economic track record to hype, he theorized, Obama had chosen instead to attack him personally.
"In the nature of a campaign, it seems that some campaigns are focused on attacking a person rather than prescribing their own future and the things they'd like to do," Romney said. "In the course of that, I think the president's campaign has tried to characterize me as someone who is very different than who I am."
Then, as if expecting Obama to end by lobbing a cannon shot about his "47 percent" comment, Romney tried to preempt the impact: "I care about 100 percent of the American people. I want 100 percent of the American people to have a bright and prosperous future. I care about our kids. I understand what it takes to make a bright and prosperous for America again."
Obama didn't hesitate to remind the millions of people watching of the former governor's surreptitiously videotaped comment to donors in May that "47 percent" of Americans don't pay income taxes and believe they are victims who are dependent on the government.
"I believe Gov. Romney is a good man, who loves his family and cares about his faith," Obama said. "But I also believe that when he said behind closed doors that 47 percent of the country considered themselves victims who refuse personal responsibility, think about who he was talking about: Folks on Social Security, veterans who sacrificed for this country, students who are out there trying to hopefully advance their own dreams but also this country's dreams . . . people who are working hard every day, paying payroll taxes, gas taxes but don't make enough income. And I want to fight for them. . . . Because if they succeed, I believe the country succeeds."


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text: The CD7506 is a precision 4.5GHz RG6 coax for HD/SDI, standard SDI or high resolution video applications. Clark's CD series coax features specifications that meet or exceed SMPTE 259M, 292M and 424M standards for high-definition digital video interconnect applications. Also built for easy termination, the CD series has an easy-to-strip outer jacket and dielectric that streamline connector termination. Rated type CMR C (UL) US and FT-4, the CD7506 can be installed in a variety of permanent installation locations and environments.


text:
First Look: HARBINGER WARS 2 #1 – Matt Kindt & Tomás Giorello Charge into Valiant's Earth-Shattering Comics Event on May 30th!
As revealed today at Comicbook.com, Valiant is proud to present your first look within the pages of HARBINGER WARS 2 #1 (of 4), the FIRST ISSUE of the summer's most anticipated comics crossover event! On May 30th, New York Times best-selling writer Matt Kindt (DIVINITY, Mind MGMT) and breathtaking artist Tomás Giorello (NINJA-K) – the best-selling team behind X-O MANOWAR – push the Valiant Universe to its breaking point and beyond with a world-shaking opening volley to begin the senses-shattering clash of 2018!
For the rare and immensely powerful subset of humanity known as psiots, their unique abilities have come with an enormous cost. Once, their existence was known only to a select few. Now, the revelation that thousands of these latent telekinetic "harbingers" secretly live among us…with the potential to become active at any moment…has led the American government to a dramatic tipping point…
Armed with new extra-governmental authority, the deep-black military contractor known as Omen has been authorized to identify, evaluate, and, if need be, eliminate all super-normal threats to the homeland. H.A.R.D. Corps units have been deployed into cities and towns across the United States to enforce their orders.
In the East, one of the most powerful minds on Earth, Peter Stanchek, is leading his band of Renegades across the country, activating any potential psiots willing to join them, and building an insurrection force of ultra-powerful and unwieldy new abilities that will soon bring war to Omen's doorstep…and the unstoppable force known as X-O Manowar raging back to Earth…
In the West, Livewire – the telekinetic technopath with the ability to bend machines and computers to her will – will be forced to choose between her former allies…or her newfound team of Secret Weapons. As the situation escalates beyond human control, the United States will be plunged into darkness from coast to coast, launching Bloodshot and Ninjak into a dangerous mission to neutralize their one-time teammate – and setting the stage for the most shocking, most violent, and most consequential clash of powers ever witnessed in the history of the Valiant Universe!
This summer, Valiant's biggest and most ambitious event yet takes hold…and, on May 30th, all of America will witness the raw, unrepentant power of the Valiant Universe unleashed in HARBINGER WARS 2 #1 (of 4) – featuring covers by J.G. Jones (Final Crisis), Mico Suayan (BLOODSHOT REBORN), Juan José Ryp (BRITANNIA), Felipe Massafera (Planet of the Apes/Green Lantern), and Lewis LaRosa (BLOODSHOT SALVATION)!
But first: JUMP ON BOARD with HARBINGER WARS 2: PRELUDE #1 – a STANDALONE INTRODUCTION TO THE VALIANT UNIVERSE's most powerful forces from all-star creators Eric Heisserer, Raúl Allén, and Patricia Martín, the master storytellers that brought you SECRET WEAPONS, on May 2nd!
The Harbinger Renegades have been scattered across America…battered by the brutal MASSACRE that decimated their ranks.
Now, behind them, Livewire – leader of the Harbinger Foundation's most unusual group of Secret Weapons – is about to incite the coast-to-coast clash that brings them all together in an inescapable collision of power.
Pushed to the brink by the government she once served, Toyo Harada's former star pupil is about to make an irreversible decision…and deactivate America's power supply in a last-ditch bid to save the extraordinary individuals called "psiots" from extinction. As a nation goes dark, the paths of our world's most powerful heroes will soon converge…and the stage will be set for the most cataclysmic confrontation in the history of the Valiant Universe!
On May 2nd, the creative team behind the best-selling SECRET WEAPONS will soon reshape the landscape of the Valiant Universe and plunge its heroes to new depths with a powerful standalone prologue, only in HARBINGER WARS 2: PRELUDE #1 – featuring covers by Raúl Allén (BLOODSHOT REBORN), Michael Cho (Batwoman), Cary Nord (X-O MANOWAR), and Felipe Massafera (Flashpoint: Abin Sur)!
For more information, visit Valiant on Facebook, Twitter, Tumblr, Instagram, and ValiantEntertainment.com.
For Valiant merchandise and more, visit ValiantStore.com.
Written by ERIC HEISSERER
Art by RAÚL ALLÉN with PATRICIA MARTÍN
Cover A by RAÚL ALLÉN
Cover B by MICHAEL CHO
Variant Cover by CARY NORD
HW2 Icon Variant by FELIPE MASSAFERA
$3.99 | 32 pgs. | T+ | On Sale MAY 2nd (FOC – 4/9/18)
HARBINGER WARS 2 #1 (of 4)
Written by MATT KINDT
Art by TOMÁS GIORELLO
Cover A by J.G. JONES
Cover B by MICO SUAYAN
Interlocking Variant by JUAN JOSÉ RYP
HW2 Icon Variant by FELIPE MASSAFERA
Brushed Metal Variant by LEWIS LAROSA
Blank Cover Also Available
$3.99 | 32 pgs. | T+ | On Sale MAY 30th (FOC – 5/7/18)


text:
Summer camp: Sunset for an American tradition?
| GREELEY, Pa.
Nearly 300 boys will make their way through the Poconos to Camp Shohola this summer to be welcomed by the coolness of the lake, the earthiness of the woods, and the zany good humor of the college-age counselors.
Here, a settlement of cabins encircles a flagpole, where the days begin and end. Here, surrounded by shade and serenaded by streams, there are stables and playing fields, boats and docks enough to launch every relay and stage every drama. The well-worn, hearth-centered dining hall is layered with artifacts from campers past, the flags and photos so thick from the 66 summers the camp has operated that new hanging space always needs to be added.
Most campers who come to the all-boys Shohola have been here before, says Duncan Barger, whose family has owned Shohola since 1943. And over the weeks, they'll tell, perhaps, of the night campers escaped their cabin through a trapdoor they'd made in the floor, or the time the GaGa pit disappeared as they slept, replaced – as if by aliens – with a miniature woodshop-made version. The new guys will hear about the time somebody's bed found its way out to the floating dock and the bolder among them will begin to envision their own addition to the camp mischief.
Sure, there are other places where young people can learn the stout virtues of confidence, teamwork, and resilience; of independence and friendship; of love of nature. But few disguise the lessons quite the way summer camp does – as pure fun.
Yet spending the summer at camp is a fast disappearing tradition. It's being elbowed out by the viral pace of childhood, where the school year starts earlier and earlier, where high school sports – and their very specific skill sets – now dangle the promise of a free ride to college. Where the opportunities for travel are unprecedented. Where many kids need to make visitation time for a noncustodial parent. And then there are the alternatives: Video design camp. Chess camp. Robotics camp. Zoo camp. Engineering camp. Dancing with Disney camp. Pampered camper camp.
"The biggest area of growth is the day camp area," says Bette Bussel, executive director of the American Camp Association, New England. The association's website recently suggested that day camp growth has doubled in the past 20 years.
The result of all this competition, say camp directors, is that there's less of a market for traditional overnight summer camp. "Private camp sessions used to be seven or eight weeks long," says Carol Sudduth, director of Wyonegonic Camps in Denmark, Maine. "Now they tend to have two sessions of 3-1/2 to four weeks. At not-for-profit camps, where there were maybe two-week sessions, they're down to one week."
Beading a bracelet for a cabin mate simply doesn't make the cut on many family priority lists. But maybe it should, say experts.
"The opportunity for kids to experience these wonderful communities is an old idea now being replaced by specialty camps and the just-for-fun camps," says Tufts University child development expert W. George Scarlett. "So many [of the new] camps are just an extension of our exaggerated focus on achievement,"
The to-the-woods model of American overnight camp is attributed to William Gunn, headmaster of the Gunnery School in Washington, Conn. He and his wife took the school's students on an outdoor character-building trip in 1861 that included hiking, fishing, boating, and sleeping in tents. Today's advocates consider this same model the ideal antidote to the too-fast, too-stressed, too-wired world of clinics and skill-building – a world many say is threatening childhood. They see camp as an incubator of personal resources that prove far more useful than a 50-point bump on someone's SAT score.
"Real" camp, its advocates say, may at some time involve the perfection of a plié or a jump shot, but that's not the point. The point is the change in a child who hunkers down for a week's worth of rainy nights outdoors, followed by singing for the entire dining hall despite paralyzing stage fright, all the while making his bed unreminded and growing to appreciate bugs, if not bug juice.
"You get kids in a rustic setting, away from being mothered, and also away from modern devices ... so they're connected to the natural world and thrown back for the first time on their own instincts," Professor Scarlett explains. "You're also looking out for your cabin buddy. Everywhere you look, camp stresses caring – not a phony kind of care, but a very deep caring for the group. It takes time to develop that sense of community."
Day camps are an easy fit for families already in a child-care mode, says Thayer Raines, professor of recreation and outdoor studies at Green Mountain College in Poultney, Vt. But he suggests that parents should take a broader view of their children's education. Consider the Greeks, advises Professor Raines: "The Greeks had it all – sound body, sound mind. You eat right, you sleep right, you laugh a lot, you spend a lot of time out of doors." The idea, he says, is that the camper emerges "a Renaissance person" with broad understanding and experience, comfortable with nature. "There's art, there's drama, there's creativity," he says, all removed from the achievement-centered, peer-critiquing setting of school, all coming together to give young people "a reason to live."
The American Camp Association (ACA) estimates that approximately 10 million children attend camp annually and that there are 12,000 traditional camps in this country – 7,000 of them overnight and the rest day camps. Though the recession has affected enrollment at some camps, the association says that 70 percent of members anticipate enrollments this year to be equal to or better than last year's. But last year, says Ms. Sudduth, "I was hearing camps report enrollment off 15 percent. This year, I'm hearing camps are even with last year."
Recession dips in enrollment notwithstanding, interest in specialized camping has been up across the board. The ACA's 2007 survey found that about 20 percent of camps focus on a single activity, while 71 percent specialize in one activity or more. Three- quarters of camps added new programs that year. "The biggest increase is in science programming," says Peg Smith, CEO of the ACA.
A movement toward shorter sessions lets wary newcomers put a toe in the water of summer camp, and allows directors to fill bunks. Steve Hallowell, a former corporate executive, used the trend to his advantage when, in 2007, he bought Camp Netop in Casco, Maine – the camp of his own childhood. He began to offer sessions of 10 days, 2-1/2 weeks, and 3-1/2 weeks.
"After my first year, I found that you can really have a great experience in a short amount of time," he says. Today 80 percent of his campers stay 3-1/2 weeks, while 20 percent stay the summer.
In New England, the tradition of staying the summer has always been strong, says Ms. Bussel. Her region has the most ACA-member camps. Most camps are privately owned, but virtually every religious denomination, and many nonprofit agencies, offer a version. There are even camps for children of atheists.
• • •
The American-grown notion of camp has expanded internationally, as well as across the United States, and a great number of counselors here come from abroad, reinforcing another camp staple: It's good to learn about people different from yourself.
Fees run $1,000 a week and more at private camps, while the nonprofits may cost as little as half that. The ACA says the weekly average is $325 to $780. The bigger number may buy perks such as better transportation or laundry service and a formal portrait of cabin mates, but facilities are often comparable at nonprofit camps, experts say. There are innumerable agency programs and resources for kids in need, for those who are ill, and for children of deployed members of the military. At private camps, alumni often underwrite scholarship programs.
Parents who went to camp themselves understand that being away from Mom and Dad is part of the growth process. For children who are new to camp and leery, precamp programs help with the separation. But don't worry too much, says Tufts' Scarlett: "The first time you get a home run, you're suddenly not so homesick."
In the end, the apron strings may be tighter on Mom and Dad than on Junior – not that a "yippee!" hasn't been heard once or twice from cars headed home on drop-off day.
Phoning-home policies vary from camp to camp. At the 102-year-old Camp Oneka in Tafton, Pa., director Barbara Dohner generally keeps to the no-phone-calls policy of yore. Shohola's Mr. Barger is more lenient, unless frequent calls from home seem to be making homesickness worse.
Cellphones are a different animal, as are other devices that allow Internet access.
"There are no camps that I know of that allow cellphones for campers," says Bussel. Imagine the e-havoc that could descend upon a camp with the latest tricked-out smart phones and the Internet access and photo transmissions they afford. Food is also contraband in many camps, what with food allergies, wild things, and the ability of someone with a mean streak to lord it over an entire cabin with a bucket of caramel corn.
E-mail policies vary: Some places allow e-mail exchanges with parents, but many still insist on the "real letter on real paper," as Ms. Dohner of Camp Oneka puts it.
Perhaps the most telling innovation is the posting of campers' photos online.
"Parents demand to see photos of their children within 48 hours after their having arrived, and every day after that," says Barger, calling the new practice "a tiny bit neurotic." Parents have been known to spot their momentarily unhappy-appearing children online, and call their camps, upset. Barger takes the practice in stride: "They enjoy it. And we get a lot of good photos."
Tradition and innovation continue their push and pull in camps everywhere. At some places, the requisite all-camp "Color Wars" is now "Color Day," a concession to the peace movement sensibility. At some places, the customary "Apache Relays" are now simply the "Relays" or the "Olympics." Midnight raids and pranks have disappeared in some camps, the victims of a litigious age of risk management.
Now, there may be "official" or staged pranks: Instead of sneaking out under a counselor's nose, a counselor may sneak a cabin out for an ice-cream raid on the kitchen after lights out. In places where hiding someone's shoes is still allowed, it's generally because that camp has an established culture of respect that can absorb the prank without it being seen as bullying; having your stuff missing may actually be a badge of honor. As for the "Ghost of the One-armed Hunter" stalking those who would venture out at night, well, the spooky spirits tend to be friendly ones these days, lest a terrified child stay home next summer.
• • •
Spiritual growth is common – if perhaps unspoken – at camp, rooted, as the experience is, in the outdoors and often in native American lore. Summer nights spent tending a campfire, listening to the lessons enveloped in camp culture, singing, is "like a retreat from the modern world," says Scarlett. "That doesn't mean it isn't about baseball and knives and canoes. That's all part of the mix. But the experience of connectedness to the community and the natural world give a deeper meaning to life."
Middle- and high-schoolers are especially primed for a lasting leap of growth on the spiritual front, he says. "In adolescence, especially, you are ready to define yourself in terms of something larger than yourself."
At secular camps, the overtly religious is not on the calendar, but the big-time values are often reinforced at a weekly service or campfire, where ideas like friendship or forgiveness or respect get addressed. The spiritual side gets more attention at church-run camps. Here, the smaller group functions as part of a larger faith community and values may be articulated in more theological terms.
In the Northeast, especially, Jewish identity-building has long been linked to its summer camps. Though they vary in the extent of religious programming, they typically mark, with special music or worship, Shabbat as being different from other days of the week. An arrow reading "Israel" may share the signpost with markers pointing to the dining hall and the lake. Religious education may take place.
Interest in Jewish camps has been on the wane in recent years, and concern about perpetuating Jewish identity has risen. The 150-camp Foundation for Jewish Camp, armed with an anonymous grant, decided several years back to draw in first-time campers by discounting their camp fees. This year, 7,000 of the foundation members' 70,000 campers will get up to a $1,500 break as long as they stay at least three weeks, says Jeremy Fingerman, CEO of the nonprofit advocacy organization. A second program specifically for the western US is under way, again with the aim of fostering the Jewish leadership that donors believe comes out of the Jewish camping experience. But Mr. Fingerman, himself a camp alumnus, says that for all its serious intent, the prevailing culture of camp remains primarily one of fun. Suffice to say that random undergarments will find their way up foundation camp flagpoles this summer.
[Editor's note: The original version misstated the amount of the grant and how much aid campers get.]
• • •
Like many of the traditional camps, Camp Shohola offers a little niche specialty, in this case a well-respected communications and technology center run by a college professor who has spent more than 50 summers at the camp.
But, says Barger, "nobody comes here just for one thing." He smiles ever so slightly at the notion of the excursions to places like ESPN Zone run by some competitor camps. Though camper interest drives Shohola, its many trips and overnights remain rooted in woods and water – rappelling, rafting, and such. Barger's concession to fads is more on the order of turning a couple of the lesser-used tennis courts into skate parks. That, plus he instituted two two-week June sessions back in 2003.
Whether he had shorter sessions "was the most common question I was ever asked," he says. Now, 20 to 30 percent of his boys stay two weeks, while 20 percent stay the full summer. And his regular season now runs seven weeks, not the traditional eight.
Experts say camp's benefits increase exponentially with time. "In my own interpretation, it's not double the value if you stay seven weeks [rather than four], it's triple the value," says Sudduth. Take conflict resolution, a high priority on every camp director's list of skills to be developed. Need to bunk with someone for a month or two? You learn to work things out. Leaving in a couple of days? Maybe waiting it out is easier, and the lesson is missed. Camp identity, too, is a strong motivator. For Dohner's Oneka girls, for example, nastiness is corrected simply by calling it "not Oneka-ble." But caring what Oneka-ble is takes time.
Loyalty, another biggie, is also not a calendar item to be scheduled in between the service week and the Italy trip. You've got to experience the culture first. And thus, there's your team "color." At Oneka you're a Red or a White. Once a Red, you'll always be a Red, and every other Red is your friend forever. If your mother was a Red, you'll be one, too, and so will your sister. Community is built, Dohner says, when you spend a summer "being cold and wet" – and Red – together.
Even the best communities need marketing, however, Barger explains, standing in the center of his rec hall, anticipating the season ahead. Here, the wall sconces are still trimmed with their 1940s tepee shades. A pile of boats waits to be moved down to the lake. Echoing the early enrollment experience of other camps, he says that things are "a tiny bit up" over last year. Last year, of course, was way off from the year before, though at Shohola, 2008 was so successful it had to add bunks. Parents now shop for camp online, Barger explains, making winter trips to camp fairs less productive for him. So this year, he brought in a private e-marketing consultant to help build his summer community.
Say what? Search engine optimization driving kids away from it all? Pay-per-click connecting them with the stars?
Yes, apparently.
"The phones have been ringing," says the camp director with a smile.


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...one of the most highly
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text:
Preliminary findings
on antenatal, perinatal and postnatal care of refugees in Greece
1 General Information
information in this report is based on a Survey on Maternity Practices conducted
on women living in refugee camps in Greece in the period of September/October 2016.
The interviews were collected by a group of volunteers acting on behalf of
Pleiades. The questionnaire, prepared by Pleiades and included in Appendix of
this document, was defined in context of the international law, excerpts of
which are included in section 3.
number of women who could be reached by the survey is fairly limited due to
circumstantial difficulties including, among others, the lack of female
translators (desirable if not critical, given the sensitivity of the matter),
the lack of professional translators (and resulting potential inaccuracies),
and finally the reluctance of women to entrust private information to
strangers, often as a result of experienced situations of shame and humiliation.
information is reported to the best understanding of the surveyors, given in
good faith, and collected from trusted sources.
2 Credits and References
report is the result of teamwork: Electra-Leda Koutra, Ifigeneia Intzipeoglou, Simona Bonardi, Omaira Gill,
Milena Zajovic Milka (Are You Syrious?), Dr.Dina
Kamba and other volunteers have contributed.
3 Interviews
At 3am my bleeding started. I didn't have emergency contact information. No one did. I had to wait until the camp manager came to the camp the next morning. At 10am the camp manager came to the camp, and my sister-in-law spoke to her. The camp manager said that the ambulance would not come to the camp because it was Saturday. She suggested that I go to the MDM clinic, which is 10 minutes walk from the camp. I was bleeding and she did not offer me a means of transportation at least to reach the clinic, which is 2 minutes away by car. I went to MDM. No gynecologist was there that day. A general doctor visited me and injected a serum. They returned me to the camp after my serum finished. They said "We have no ambulance to take you to the hospital and you should go back to the site where you live and be picked up from there." I was at the office from 2pm until 9pm when the manager left. I was in pain and I was screaming but she didn't care. I left the office and went up the stairs to my tent. My pain got worse. I went to the washroom and miscarried. Ambulance came at 7pm the next day.
[M.S., 35 years old, from Afghanistan, Elliniko airport terminal reception site]
I have such a bad pain in my head sometimes I feel like banging my head against the wall. But the doctors told me it's normal and it will pass.
[Y.S., 19 years old, from Afghanistan, Elliniko hockey stadium reception site]
[Z.R., 32 years old, from Afghanistan, Elliniko airport terminal reception site]
[A.S., 24 years old, from Afghanistan, Elliniko hockey stadium reception site]
After 12 hours of trying
to give birth naturally, they told me they will give me a C-section. While I
was still awake and bound on the bed they started cleaning the area of my
abdomen with alcohol. I was scared and I asked the anesthesiologist for
sedation saying in Arabic "Khadirini". The anesthesiologist started laughing and
telling me "no Khadirini". I panicked and started screaming from the pain and
the fear, so much that I tore the belts that kept my hands. Luckily, at that
moment, the doctors came in and started talking to me and relaxed me.
[S.O., 37 years
old, from Syria, Skaramagas reception site]
I live in a former
school class with other 4 families with small children. It is never quiet and I
cannot sleep well at night. The situation gets worse considering that I have to
sleep on the floor without a mat, which is painful for my pregnant body.
[N.A., 19 years old, from Syria, "Jasmin School" squat in Athens]
3.1 General Remarks
The information in
this report is based on a Survey on Refugees' Perinatal care in Greece which
took place in September - October 2016. The Survey, coordinated and conducted
by the NGO Hellenic Action for Human Rights -
"Pleiades", will continue and will lead to the publishing of a wider
The Hellenic Action for Human Rights - "Pleiades" is an action-oriented
NGO in the field of the protection of Human Rights, having legally publicized
its Statute in February 2009, subsequently registered with the National General
and National Special records of NGOs in Greece (reg.nr.09110ΑΕΕ12066021Ν-1032), and moreover certified as a structure offering
pro bono social care (legal, medical, social, psychological, educational and
cultural) by Ministerial Decision (ΦΕΚ 836/τ.Β'/19-3-2012). Its scope is international. The NGO has
cooperated with the Council of Europe and several UN's institutions, as well as
with a multitude of national and international NGOs.
Among its activities,
the NGO advocates for birthrights, having among others and in cooperation with
GHM succeeded in bringing Greece under UN Committee for the Elimination of Discrimination
and Violence Against Women's (CEDAW) 4-year monitoring for the high percentage
of CS in the general population. The monitoring ends in March 2017. The
report's preliminary findings confirm that the percentage of CS has not
decreased, as regards the perinatal treatment of refugees.
The first part of the
survey was conducted in the beginning of October. Twenty-nine women were
interviewed in total who live in refugee camps and squats in or around Athens.
From them, 23 are from Afghanistan, 5 from Syria and 1 from Iraq. 8 of them are
pregnant, 1 had a miscarriage, 20 gave birth and 1 of them lost her child after
birth. Their average age is 26 years old. For many of them, this is their first
child or have another one to three children.
most common issues reported are listed in the following table.
Issues reported
Inadequate accommodation
Lack of safety
Lack of sanitation
Lack of hygiene
Inadequate food
Insufficient medical support / services
Lack of female doctor personnel or uncertainty about availability
Lack of information or inability to access information (denied access
or lack of translator)
Delayed access to key information (delay of one month or more)
Inconsistent information received (assistance and support, access to
medical services including exams and child vaccinations)
Faced discrimination during gestation or birth
Lack of financial means to provide for themselves (food, medicines,
High-risk pregnancy
Potentially life-threatening complications (mother or child) resulting
from living conditions (including journey to reach Greece) or denied/insufficient
Miscarriage resulted from denied assistance
No legal assistance
age of women: 26 years old
3 Children per woman.
3.1 Pregnancy
All the women interviewed arrived in Greece while pregnant, starting from the spring of 2016 until 10 days ago. Even though they were recognized as such by the authorities upon arrival, they did not receive special care as provided by international, European and Greek law. Instead, they were placed in refugee camps where they faced circumstances entirely incompatible with the condition.
The main problem they report is the low quality of food. As many indicated even though they resided in different camps all around Greece, they could not eat it the food because it was not cooked, stale and dirty. When they found the money, they would always buy food from outside. Also, there was no special provision for extra quantities given their condition. Fresh fruit, vegetables, meat and fish were rarely provided. Thus, all of them report being malnourished during pregnancy, which led to anemia and low blood pressure. Less than half received supplements (vitamins and iron) and the ones who did had to pay for them.
The other big issue was an absence of regular prenatal health monitoring. In their majority, they only visited a doctor once or twice during their pregnancies and some of them did not visit one at all. The routine tests were ultrasounds, blood pressure check and blood check. The doctors always told them that they were fine without further details even if later in their pregnancies they faced serious risks. One woman reports that even though she knew from previous pregnancies that she needs strapping, the doctors told her that she would just need to avoid heavy lifting and refused to perform the operation.
Other concerns were lack of privacy, poor sanitary conditions and lack of gender sensitive policies. The presence of "single" male co-refugees appears to be a threatening factor, particularly during the night, obliging them to avoid circulation even to the toilets.
3.2 Women who gave birth
3.2.1 Babies'
The bad nutrition and
condition of the mothers affected the children and 6 out of the 20 newborn
remained hospitalized in the Intensive Care Unit for more than 10 days after
birth. They suffered inter alia from yellow fever, meningitis, lack of vitamin
D, neonatal sepsis and tuberculosis, all of which are almost unheard of for
Greek children. One of them died. All these diagnoses were not explained to the
mothers due to a lack of interpretation.
Many of the women
interviewed still did not know what was wrong with their babies at the time of
the interview and the interviewers had to translate it for them. For example,
the family of the baby that had meningitis found out about it and the fact that
they were prescribed a precautionary treatment themselves upon the time of the
Nevertheless, all the
babies are being breastfed which led to most of them gaining weight according
to the Worlds Health Organisation Health Standards.
Another noteworthy
finding is the lack of regular monitoring of the children's health and
vaccination progress. Many mothers were not aware of their babies' weight in
the time of the interview and 3 babies have not been checked by a doctor at all
after their exit from the hospital. Some mothers reported that even if there
are medical NGOs in the camps they live, they were always unavailable.
As far as
vaccinations are concerned, the parents were given vaccination cards in the
hospital but it was in Greek and there was no explanation for follow-ups. They
could only find the vaccines in NGOs, especially the clinic of Doctors of the
World in Omonoia.
3.2.2 Mothers'
The mothers totally
neglected their health after the birth of their children. None of them monitored
her health regularly.
Even though, they were
allowed to stay for at least 3-4 days in the hospital, if not more for medical
reasons, they were not explained how to take care of themselves during the
first 40 days postnatal. The ones that had a CS operation did not return to a
hospital for cutting the stitches out because their place of residence was far
from the hospitals. As a result, two of them report having open wounds even
after a month after their labor which they try to treat by changing their
bandages daily.
All the women answered
that they would like to received psychological and emotional support from an
expert since they feel angry, desperate and anxious. However, no psychologist
is available to them.
Their access to family
planning and contraception services is also limited.
3.2.3 Place and type of labor
Out of the 20 women, only one did reach the hospital on time for the labor because the ambulance was late. 12 (60%) of them had to have a Caesarian section because of emergency reasons or after trying to give birth for hours. We cannot assess the findings of the doctors because we do not have access to the medical files of the women. However, the women did not feel that they were being bullied into a C-section.
3.2.4 Informed Consent and Refusal
reported that they did not give informed consent during antenatal and
intrapartum care. There is no standardized printed information available about
options and interventions in pregnancy and childbirth, save for consent forms
given in hospital. Women who proceeded to CS (60%) report being asked to sign a
document in Greek language, right after the decision for CS was made by the
doctors. No woman has been given a copy of that document upon exit from the
hospital or at other stage.
In average, there were
4 or 5 doctors and nursing staff in the labor room and some of them were men
which was problematic for the women since in their countries gynecologists are
only women.
None of the women
interviewed by Pleiades (0%) was invited to question any form or decision being
made for her. One of them underwent a removal of the uterus after the
C-section, without ever being informed about the reason why. Intrapartum
interventions were perceived as necessary and not open to discussion. The
latter would be impossible in any case, because of lack of interpreter present.
Informed refusal and assessment of emotional/psychological coercion by a
specialist was out of the question.
In all cases (100%) a
labour companion was not allowed, even though all women asked for their
husbands to be present in the delivery room. A labour companion is a
contentious issue. Acceptance of such a request usually is the case in the
general population, in private maternity hospitals. Practices vary. The
criteria are not written and known.
3.2.5 Informed Consent and Refusal for
Common Birth Interventions
No pain medication was
given to women who did not have a CS. Among the women who were subjected to CS,
only 1 was given an epidural, while the others were subjected to total
anaesthesia. No medical history could be taken before proceeding to
anaesthesia, because of complete lack of translation All women who had
physiological birth report having asked for pain sedation (through hand
gestures), but they got the feeling, from the reaction of the medical staff,
that this was not an option in the case of physiological birth.
Augmentation of labour
(speeding labour up) – No woman reports being subjected to augmentation of
labour. This may be understood by the fact that an ambulance was called on site
(refugee camp) upon labour had already started. Women report finding it
extremely difficult to convince NGOs operating on camp to call an ambulance for
their transfer to the hospital. 100% report finding it extremely difficult to
return to the camp or squat, since they had no money and no relative social
support. Risks and information about any interventions was never given. No
information was given on possible psychosocial support and "medical directions"
upon exit from hospital. Lack of interpreters is directly linked to the lack of
informed consent. Women have no practical and effective remedy at hand to
achieve their information during labour.
3.2.6 Hospital
Normally the child was
given to the mother immediately for skin to skin contact and breast feeding and
stayed in the room with her, unless there were medical reasons for the
contrary. In case of problems with lactation, children were provided with
artificial milk. However, in one case a child was left with no food for the
three first days because the mother was not able to breastfeed it and the
doctors refused to give artificial milk.
Clothes were sometimes
given during hospital stay. Nappies were always given during hospital stay.
They were not
asked for money in the hospital. They did not receive their medical files.
of the women report a positive hospital stay, where they experienced a good
sense of safety and a kind treatment from the hospital staff Nevertheless, this
result must be further assessed by interdisciplinary and cross-cultural
3.3. Postnatal conditions
problems they face in their place of accommodation after birth remain the same
as above since the State once again did not take any action to provide them
with better living conditions. Additionally, they report a lack of provision
for milk and specialised food for their children that forces them once again to
buy it on their own
a pronounced absence of sanitary environment for them and their kids that puts
them in a great risk of infections and contagious diseases.
3.3 Living Conditions
Open fire to warm water for tea in Vasilika
camp. Camps do not offer any facility for self-preparation of food.
Taps at Vasilika camp
In rural areas and open buildings, snakes are
common. They are found indoor and outdoor.
Crowded tents inside
Elliniko airport terminal
Numerous families (including
Yazidis) live in camping tents in the area surrounding Elliniko airport
terminal. They have occasional, limited or no access to the camp's services.
Large UNHCR tents hosting
people at Elliniko baseball stadium. Tents are outdoor exposed to the sun all
day where temperatures may exceed 40 degrees Centigrade.
In Vasilika camp, tents are mounted inside
hangars. The problem of rats and cockroaches is common throughout all
reception sites. In rural areas and open buildings,
snakes are common.
Warming water in the sun for use to shower.
The solar panels in Vasilika camp in Northern Greece make the hot water too
hot for use and there are no controls to regulate the water temperature in
the showers. In Elliniko reception sites, hot water is not
Air ventilation system?
Elliniko airport terminal
hygienic conditions of bathrooms and occasional flooding
general, there are not enough toilets, showers and water taps in the camps,
on average 1 toilet for about 100 people, 1 shower for about 200 people.
camps, promiscuous use of toilets, showers, bathrooms is reported. Women feel
generally unsafe to use the facilities at night.
spaces divided by blankets and curtains at Elliniko.
3.4 Food
In most camps
three meals are distributed, however the quality is extremely poor. Food is
neither varied nor nutritious. Furthermore, cases of expired food and food
poisoning were reported over six months in camps throughout Greece.
Pregnant women
report being unable to consume the food distributed due to both quality and
nausea caused by bad smell.
It is constantly
reported that not enough baby food (including milk) is available or distributed.
Parents refer to the not-for-profit organization running the medical services
also for the provisioning of baby food. Special dietary needs (allergies and food intolerance) are fully neglected.
many camps/reception sites/shelters, food is reported of poor quality, not
nutritious, occasionally old / with mould
at Elliniko terminal
3.5 Access to Medical and Health Services
3.5.1 Children Vaccinations
During the months of July and August, it was
announced that vaccinations would be carried out in camps throughout Greece.
The following remained unclear: 1) how it could be ensured that all children
requiring vaccination be identified/reached (and the procedure for those not
reached or unable to attend); 2) the procedure for children missing medical
records; 3) the operation was once-off, therefore no sustainable, regular
process was put in place for children born after the appointed dates; 4) how
to apply for additional vaccinations.
4 Law Context
A. Convention for
the Protection of Human Rights and Dignity of the Human Being with regard to
the Application of Biology and Medicine (Convention on Human Rights and
32. The Convention for
the Protection of Human Rights and Dignity of the Human Being with regard to
the Application of Biology and Medicine was opened for signature on 4 April
1997 and entered into force on 1 December 1999. It has been ratified and
entered into force in respect of twenty-nine Council of Europe member States,
namely Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech
Republic, Denmark, Estonia, Finland, France, Georgia, Greece, Hungary, Iceland,
Latvia, Lithuania, Moldova, Montenegro, Norway, Portugal, Romania, San Marino,
Serbia, Slovakia, Slovenia, Spain, Switzerland, The former Yugolslav Republic
of Macedonia and Turkey.[1] The Russian Federation has not
ratified or signed the Convention. Its relevant provisions read as follows:
Article 5: General rule
"An intervention in the health field may only be carried out after
the person concerned has given free and informed consent to it. This person
shall beforehand be given appropriate information as to the purpose and nature
of the intervention as well as on its consequences and risks. The person
concerned may freely withdraw consent at any time."
General Recommendation No. 24 adopted by the Committee on the Elimination of
Discrimination against Women (CEDAW)
33. At its 20th session which took place in 1999 the
Committee on the Elimination of Discrimination against Women adopted the
following opinion and recommendations for action by the States parties to the
Convention on the Elimination of All Forms of Discrimination against Women
(ratified by all Council of Europe member States):
"20. Women have the right to be fully informed, by properly
trained personnel, of their options in agreeing to treatment or research,
including likely benefits and potential adverse effects of proposed procedures
and available alternatives.
22. States parties should also report on measures taken to ensure
access to quality health care services, for example, by making them acceptable
to women. Acceptable services are those which are delivered in a way that
ensures that a woman gives her fully informed consent, respects her dignity,
guarantees her confidentiality and is sensitive to her needs and perspectives.
States parties should not permit forms of coercion, ... that violate women's rights
to informed consent and dignity.
31. States parties should also, in particular:
(e) Require all health services to be consistent with the human
rights of women, including the rights to autonomy, privacy, confidentiality,
informed consent and choice."
Declaration on the Promotion of Patients' Rights in Europe
34. The Declaration was adopted within the framework of the
European Consultation on the Rights of Patients, held in Amsterdam on 28-30
March 1994 under the auspices of the World Health Organisation's Regional
Office for Europe (WHO/EURO). The Consultation came at the end of a long
preparatory process, during which WHO/EURO encouraged the emerging movement in
favor of patients' rights by, inter alia, carrying out studies and
surveys on the development of patients' rights throughout Europe. In its
relevant part the Declaration stated as follows:
"3.9 The informed consent of the patient is needed for
participation in clinical teaching."
D. Article 8 ECHR
"1. Everyone has the right to respect for his private and family
life, his home and his correspondence.
2. There shall be no interference by a public authority with the
exercise of this right except such as is in accordance with the law and is
necessary in a democratic society in the interests of national security, public
safety or the economic well-being of the country, for the prevention of
disorder or crime, for the protection of health or morals, or for the
protection of the rights and freedoms of others."
Lack of information and consent during the delivery, as is the
case with lack of interpretation, constitutes "an interference" with
women's Article 8 rights. This interference is not lawful, neither
necessary nor proportionate.
The European Court of Human Rights has reiterated that under its
Article 8 case-law, the concept of "private life" is a broad term not
susceptible to exhaustive definition. It covers, among other things,
information relating to one's personal identity, such as a person's name,
photograph, or physical and moral integrity (see, for example, Von
Hannover v. Germany (no. 2) [GC], nos. 40660/08 and 60641/08, §
95, 7 February 2012) and generally extends to the personal information which
individuals can legitimately expect to not be exposed to the public without
their consent (see Flinkkilä and Others v. Finland, no. 25576/04, §
75, 6 April 2010; Saaristo and Others v. Finland, no. 184/06, § 61,
12 October 2010; and Ageyevy v. Russia, no. 7075/10, §
193, 18 April 2013). It also incorporates the right to respect for both the
decisions to become and not to become a parent (see Evans v. the United
Kingdom [GC], no. 6339/05, §
71, ECHR 2007‑I) and, more specifically, the right of choosing the
circumstances of becoming a parent (see Ternovszky v. Hungary,
no. 67545/09, §
22, 14 December 2010).
40. Moreover, Article 8 encompasses the physical integrity of a
person, since a person's body is the most intimate aspect of private life, and
medical intervention, even if it is of minor importance, constitutes an
interference with this right (see Y.F. v. Turkey, no. 24209/94, § 33, ECHR 2003‑IX, V.C. v. Slovakia, no. 18968/07, §§ 138-142, ECHR 2011; Solomakhin v. Ukraine, no. 24429/03, §
33, 15 March 2012; and I.G. and Others v. Slovakia, no. 15966/04, §§
135 - 146, 13 November 2012).
Under the Court's case-law, the expression "in accordance with the
law" in Article 8 § 2 requires, among other things, that the measure in
question should have some basis in domestic law (see, for example, Aleksandra
Dmitriyeva v. Russia, no.9390/05, §§
104-07, 3 November 2011), but also refers to the quality of the law in
question, requiring that it should be accessible to the person concerned and
foreseeable as to its effects (see Rotaru v. Romania [GC],
no. 28341/95, §
52, ECHR 2000-V). In order for the law to meet the criterion of foreseeability,
it must set forth with sufficient precision the conditions in which a measure
may be applied, to enable the persons concerned – if need be, with appropriate
advice – to regulate their conduct. In the context of medical treatment, the
domestic law must provide some protection for the individual against arbitrary
interference with his or her rights under Article 8 (see, mutatis
mutandis, X v. Finland, no. 34806/04, §
The absence of any safeguards against arbitrary interference with
patients' rights in the relevant domestic law at the time constitute a serious
shortcoming (Konovalova v. Russia, §45, V.C., cited above, §§
A woman giving birth should have received prior notification about
any arrangement interfering with her private life and be able to foresee its
exact consequences (Konovalova v. Russia, §46) so as to be capable of making an
intelligible informed decision (Konovalova v. Russia, §§ 37, 46).
In order for the requirement of lawfulness of Article 8 § 2
of the Convention to be fulfilled, sufficient procedural safeguards should be
in place against arbitrary interference with women's Article 8 rights in the
domestic law and practice, like sufficiency of information provided to the
pregnant and birthing woman, in a language that she understands, consideration
of refugee women's vulnerable condition during the procedure, availability of
alternative arrangements in case the woman decides to refuse the proposed
medical arrangement.
In Greece, the
relevant matters are regulated by the Code of Medical Ethics (Law. 3418/2005),
which replaced the old Medical Ethics Regulation (NW 25.6 / 06.07.1955).
The obligation of the
doctor not to carry out medical procedures without the consent of the patient
also finds legal basis in the European Convention on Human Rights and
Biomedicine (Convention OF Oviedo, 1997) and supplementary in Article 47 of
Law. 2071/1992 for hospitalized patients.
The Code of Medical
Ethics (L. 3418/2005) reiterated the Oviedo Convention arrangements and worked
more closely with the issue of patient consent in its Article 12.
The patient, to which
a birthing woman is legally equated when reaching out to a hospital for
prenatal and perinatal care, has the right to decide, after receiving adequate
information from the doctor, whether to carry out any intervention on her body
or health. That right, deriving from the volitional autonomy and
self-determination to the body, is constitutionally protected under the free
development of the personality and the protection of human dignity (Article 5
paragraph 1 and Art. 2 paragraph 1 of the Greek Constitution).
Apart from its
constitutional foundation, the patient's consent plays an important role in
civil law.
After affirming that
the woman has the substantial and legal capacity to consent (i.e. she is not
unconscious, or a psychopath, or below 14 years old), the second condition for
the validity of the patient's consent to medical practice is her to properly be
informed first by the doctor.
In many jurisdictions,
the role of informing the patient by the doctor is a necessary element for
"valid consent". A complete and adequate information of the patient enables the
latter to freely form their will, having regard to all the parameters and
complications involved in the medical practice.
The Code of Medical
Ethics rightly states in its Article 12, Paragraph 2, that conditions of
validity of the patient's consent is firstly to provide the latter after a
full, clear and comprehensible information. In particular, such information, as
is clear from Article 11 para. 1 of that Law, includes the content and the
results of the proposed medical procedure, consequences and potential risks or
complications from execution, the alternatives, and the potential recovery
Information of the
birthing woman by the physician should be done discreetly, in a non
intimidating manner, non forcefully encouraging to consent to medical practice,
as health is a particularly sensitive issue, in which the doctor is a
dominating figure.
Apart from the above
two key conditions of valid consent, the Medical Ethics Code establishes
further prerequisites for valid, "illuminated" consent.
Consent may not be
conditional or under deadline, and must be be freely withdrawn at any time
–although this is not clearly regulated in the Law, it follows from the very
concept of consensus as a manifestation of self-determination of the patient
and the Oviedo Convention (art. 5 par. 3 and Art . 6 par 5), which is a legally
binding text, of hierarchical supremacy.
Furthermore, in
accordance with the provisions of RLS and in particular Article 12 para. 2c, we
conclude that if the consensus is the result of error, fraud or threat, then it
is invalid, without even having to be declared as null. This provision protects
the freedom of consent, under the prerequisite that the latter is the product
of free will rather than that of coercion or deception.
Under the same
provision, the agreement is also void if it is contrary to morality. Such a
situation arises when the act to which consensus is asked for, is also illegal
or immoral (eg consensus to prohibited killing of the baby), or where the
agreement relates to a principle punctuated by an unethical element, such as
providing financial "gifts" to stte-appointed doctors. It also holds the view
that that medical practice should aim to save an overriding property or benefit
expected to be greater than the harm caused by medical practice. Otherwise, the
medical practice and the respective consent is illegal.
Finally, Article 12
para. 2 of the Law points out that the consent must relate to the specific
medical procedure that is proposed to the patient at that time. It means that
consensus relates vaguely to any medical interventions which may possibly take
place in the future. To be strong, therefore, consent must completely cover the
medical practice and the specific content at the time of its execution. (Art.
12 para. 2d)
The patient's consent
before performing a medical procedure is a key issue of the law. The New Code
of Medical Ethics was able to enter detailed settings and fill regulatory gaps
in the past, mediating in a clear way, among other things, the issue of
consent. However, it does not miss defects in its formulation, which hinder its
implementation, and omissions, such as the failure to regulate the
consensus-making case when the patient is not conscious.
The provisions of this
Law are governed by the spirit of respect for human life, dignity and
integrity, and human rights in general. Moreover, it, at least
theoretically, seeks balance between paternalism, whereby the physician is
paramount in the relationship with the patient as a father to his child, and
autonomy under which the patient forms its decisions at will.
The medical act performed without the valid consent of the
patient constitutes "arbitrary medical practice" and violates the
principle of medical treatment contract, drawn up between the doctor and the
patient. It also runs counter to provision 57 of the Civil Code as an offense
to the personality in the manifestation of the person, self-definition and
autonomy, in relation to her physical integrity and health.
According to the first view, each medical act is a bodily
injury, whether carried out "lege artis" or having had successful
results. In particular, it constitutes "harm to the body or health"
within the meaning of art. 929 of the Greek Civil Code -any medical act,
performed without the informed consent of the patient, is unlawful. Therefore,
patient consent is the only reason that removes the illegality of injury
(medical intervention). The second view advocates that if a medical act, and
especially an operation, such as a Caesarian Section, has taken place without a
prior valid "illuminated" patient's consent, it constitutes an unlawful breach
of her personality, under the aspect of the individual's freedom to define
oneself, in relation to physical integrity and health.
Irrespective of the nature of the illegality, it is absolutely
common place that medical intervention without informed consent is unlawful.
This research reveals that all refugee birthing mothers, without
exception, who were subjected to CS, suffered a breach of their right not to be
subjected to unlawful medical interventions, and were performed without them
being priorly informed and without them providing valid consent. It is also a
finding of this research that the lack of interpretation in medical procedures
refers to a systemic pathology, based on lack of relevant policies. The
systemic nature of the problem and the multi-vulnerability of the subjects – carriers
of rights, currently obstruct women in analogous conditions from finding,
individually, redress and exit their victim status while giving birth.
5 Appendix – Pleiades Questionnaire
5.1 The interview
Where is the interview collected?
In which format? E.g. mother is interviewed
in person, or the questionnaire is filled in privately by the mother.
If in person, was a (female) interpreter
If by a facilitator/cultural
intermediator/other professional (please specify), was a female one used?
5.2 Mother's information
Name/Surname/Asylum Seeker Card No (and
Date of Birth/Age
Country of origin
Number of children (excluding the pregnancy
subject of this interview)
Family situation (mother's marital status,
father's domicile, if pursuing reunification how long since last time husband
and wife met, etc.)
10. Vulnerability:
11. Contact number (specify if Whatsapp/Viber available)
5.3 Pregnancy subject of this interview
A. Gestation is ongoing at the time of the interview
12. Describe the mother's health at the time of the interview
13. Are you aware of any health condition affecting you (mother) or the
child associated to high-risk pregnancy/birth?
14. Have you received any healthcare advice since learning about your
15. Have you received any medical assistance and/or services (diagnostics,
monitoring, check-ups) since learning about your pregnancy?
16. When was the health status of you or your child last assessed?
17. Describe your living conditions during pregnancy:
B. The interview is conducted after the birth date
Answer all questions of Section A.
Answer questions
Baby's information
18. Date of Birth
Baby's health
20. Weight of the baby at the time of birth
21. Weight of the baby at the time of the interview
22. Health of the baby at the time of birth
23. Health of the baby at the time of the interview
24. Was it a premature birth?
25. Were there any birth complications?
26. Were there any post-partum complications?
(Refer to following subsections for baby's
Mother's health after birth
28. Describe the mother's health at the time of birth
29. Were there any birth complications?
30. Were there any post-partum complications?
31. Have you received any post-partum healthcare support/medical assistance?
a. Baby's physical health monitoring
b. Mother's physical health monitoring
c. Mother's psychological health support
d. Mother's emotional support, e.g. under high stress and/or difficult
family circumstances
32. Do you have access to community support groups and additional
counselling services? E.g. contraception, family support, family planning.
33. Did you have access to breastfeeding education and/or practitioners for
professional guidance/advice?
Were you referred to any breastfeeding
support groups for the duration of the lactation period?
35. Did you feel safe during birth?
Did you or your child face any threats
before or after birth?
Living conditions after birth
37. Describe your living conditions after birth:
Go to section B1 if it was
"free birth" (mother's decision to give birth at home or elsewhere without the
assistance of a healthcare professional)
Go to section B2 if it was a
case of "born before arrival" (mother gave birth at home or elsewhere before
the planned arrival of a healthcare professional)
Go to section B3 if birth
happened at hospital's premises
B1. Free birth
38. Where did the birth occur?
39. Was it a safe environment?
40. Was it a clean environment?
41. Was a family member or friend with you during labor and/or at the time
of birth?
42. If no, was it your choice?
43. Which healthcare professionals were present at the time of birth?
44. Did you have access to clean baby clothes and nappies?
45. Did you have access to pain-relief measures during labor?
46. If yes, were you made aware of benefits and risks?
47. Did you undergo any procedure or treatment that seemed potentially
harmful to you or to your child?
48. Are you informed about the compulsory vaccination prophylaxis for your
49. Do you have a vaccination card?
50. Were you able to obtain information and instructions regarding the
compulsory vaccinations?
51. Did your baby face any medical condition before or after vaccination? If
so, describe what and when.
52. Did you or your baby face life-threatening complications before, during
or after birth?
53. Did you seek/receive prompt assistance?
54. Were you or your baby hospitalized after birth?
55. Were you asked to pay money at any stage?
B2. Born before arrival
Answer all questions of Section B1.
Answer questions
38-55 of section B1.
56. Summarize events that led to OOH (Out-Of-Hospital) birth. E.g. late
arrival of ambulance, hospital too far, etc.
B3. Birth at hospital
38. Was an interpreter available in all critical phases, including hospital
admission, labor, birth, post-partum procedures?
39. Was a family member or friend with you during labor and/or at the time
of birth?
a. If no, was it your choice?
40. Which healthcare professionals were present at the time of birth?
41. Were you allowed to be with your baby after birth?
a. If yes, how long after?
42. Were you allowed to be skin-to-skin with your baby after birth?
43. Was the baby with you the whole time? E.g. Baby bed in mother's hospital
room 24 hours.
44. Did you and your baby have to be separated for medical reasons? If yes, for
which reasons and for how long?
45. How long after birth were you allowed to breastfeed?
46. Was your baby given any artificial teats, pacifiers, food, drink without
your previous authorization? If yes, were you clearly communicated any medical
indication requiring that?
47. Did you have access to clean baby clothes and nappies?
48. Did the personnel conduct themselves in a professional manner? Were they
kind? Respectful of your privacy? Did you feel uncomfortable about specific
behaviours by the hospital personnel?
49. Were you explained at each stage what was about to happen?
50. Were you normally offered options?
51. Which birth procedure was carried out?
52. Were you offered options regarding the possible birth procedures?
53. Were you recommended a specific birth procedure?
54. If yes, were you explained the reasons?
55. Did you feel that you were being put under pressure or bullied into
choosing a specific birth procedure or treatment by any healthcare
56. Did you feel that you were being put under pressure or bullied into
choosing a specific birth procedure or treatment by any family member?
57. Were you allowed to ask questions?
58. Were you provided answers?
a. If not, were there specific reasons? E.g. unavailability of interpreter,
unavailability of information, lack of promised follow-up, etc.
59. Were you asked for authorization about the selected birth procedure?
60. Were you offered pain-relief measures during labor?
61. If pain-relief measures were provided, were you asked for authorization
before proceeding? Was the procedure explained to you? Were benefits and risks
explained to you or to your birth partner?
62. Did you undergo any procedure or treatment that seemed potentially
harmful to you or to your child?
a. If yes, did you raise your concerns?
b. If you raised your concerns, was the response adequate? Reassuring?
c. If no, why?
63. Were you illustrated the vaccination prophylaxis for your baby?
64. Were you provided a vaccination card?
65. Were you given information and instructions regarding the following
vaccination appointments?
66. Did you or your baby face life-threatening complications before, during
or after birth?
67. Did you receive prompt assistance?
68. Were you and/or your birth partner explained what was happening?
69. Did you or your baby undergo surgery?
70. Were you and/or your partner asked to provide written authorization?
a. If so, was that in a language that you understood?
71. Were you asked to pay money at any stage?
72. Were you granted access to your medical/maternity records?
73. Was your overall hospital experience positive in terms of assistance,
support, professionalism?
a. If no, did you make a complaint?
b. Were you offered the option to formalize your complaint?