Just Like Home Made

Regarding this New York Times story about a baby who died during a home birth attended by a midwife — a few observations …

The fact is that most of the time you don’t need a doctor to have a baby. For that matter, you don’t need a midwife, either. The fact of the matter is that most of the time you could have your baby alone on the floor of a gas station restroom, and you and the baby will be OK. I’m not recommending that; I’m just sayin’. High maternal mortality rates of the past were mostly caused by postpartum infection, known as “childbed fever,” which these days can be treated with antibiotics.

My understanding is that most of the time good prenatal care is more important to a good outcome than what happens during the delivery. There are all manner of studies that show a correlation between how early a woman begins prenatal care and her chances of delivering a healthy, full-term baby. But most of the time hospital deliveries are medical overkill, and if you have to ask how much they cost, you can’t afford them.

The big argument in favor of going to hospitals is that the sorts of things that can go wrong often go wrong very suddenly and catastrophically, and the mother’s or baby’s life can hang on how quickly physicians with high-tech medical gizmos can address the problem. And you have to go to hospitals if you want the mostly effective and mostly safe anesthesias they have these days.

The argument against midwives with no medical training is that they might not recognize a serious problem as it develops and know when to call in the experts. Remember, even a midwife with no idea what she’s doing will be successful most of the time, because most of the time babies will be born just fine if nature takes its course. An untrained midwife with a few good deliveries under her belt might not realize how much she doesn’t know. I can’t tell from the article if the midwife in question did anything wrong, however.

Over the years, every now and then, somebody proposes that trained registered nurse-midwives work under the supervision of physicians. If the physician doesn’t believe the delivery will present complications the midwives can attend the births at home if the mother wishes to give birth at home. And they would be able to recognize potential problems and would know when to move the show to the hospital or call 911 for emergency assistance. This seems like the best of all worlds to me. I suspect the biggest reason this plan never seems to be implemented is medical liability.

Full disclosure — I had both of my babies in hospitals, with no regrets, mostly because I didn’t have to be concerned about cleaning up. Childbirth is messy.

Identifying Evil

Sometimes the worst evil is done by good people who do not know that they are not good. — Reinhold Niebuhr

Via Avedon — David Gerrold has written a post reflecting on the nature of evil. One of his points is that the way evil is usually portrayed on television and in the movies is phony.

People like to pretend — they like to pretend to be vampires and monsters and princesses and Vulcans and whatnots.

And that’s what most Hollywood evocations of evil are — people pretending, because they have no sense of the reality. That’s what was wrong with this particular recreation of the Manson Family; they played it like a bunch of teenagers giddily enjoying their own awfulness. …

… in this show, evil wasn’t portrayed as evil, but as a bunch of Hollywood actors pretending to be evil, chewing the scenery, baring their teeth, flashing their eyes, and practicing their wicked laughs — bwahahahaha. It was pretense.

Real evil looks very different from Hollywood evil.

Hannah Arendt, in her book about the trial of Adolf Eichman, the architect of the Holocaust, Eichmann in Jerusalem: A Report on the Banality of Evil writes of how she sat there day after day, trying to understand how a mild-looking human being could have authored such monstrousness. Ultimately, she coined the phrase “the banality of evil” to describe the essential thoughtlessness — ie. without thought, without feeling, without compassion — that results in evil deeds. The monsters of the Holocaust weren’t monsters, they were acting without regard, without conscious awareness, without empathy, without connection to the larger spiritual realm of humanity.

For a long time I’ve noticed that when racists are portrayed in films they are nearly always depicted as people who are scowling (or smirking) and disagreeable all the time; think Rod Steiger in The Heat of the Night. Yet in my experience — I grew up in an all-white redneck zone — racists can seem to be lovely people in any other context; they can be soft-spoken, considerate, and reasonableness itself except on the matter of race. It’s as if some part of their conscience were missing. It can be hard to grasp that nice Mr. Smith who voluntarily cuts the grass on the church lawn, or sweet Mrs. Johnson who bakes pies for the old folks’ home, would be capable of evil. Yet history tells us that a whole lot of “ordinary” people have taken part in evil acts in the past.

Gerrold writes, “I think evil occurs as a complex cocktail of forces.” I suspect most people are capable of evil if they get caught up in these forces. This is not an excuse for evil, but a warning to take care to recognize those forces and avoid them. People fall into evil because they don’t recognize evil as evil. They mistake it for justice, or righteousness, or even God’s Will.

“Evil does not see itself as evil,” writes Gerrold. “Those who commit evil acts do not see those acts as evil or even malicious. They see themselves as justified.” This is exactly right.

Osama bin Laden and his 9/11 flunkies believed their terrorist attack was righteous and justified, as did Tim McVeigh when he blew up the federal building. Even the all-time great evildoers like Hitler and Stalin and Mao no doubt rationalized their actions as serving a greater good.

A couple of years ago I argued that most of us think of evil as an intrinsic quality that some people have and others don’t, or at least have very little of. If you see evil that way, the next step is to assume that “evil” people are so dangerous and corrupted that “good” people are justified in whatever they do to get rid of them. Thus, “evil” and “good” people are different not because of what they do, but because of who they are. But when you start thinking that way, you’re opening the door to evil and inviting it in.

There’s no question that what took place in that prison was horrible, but the Arab world has to realize that the U.S. shouldn’t be judged on the actions of a…well, we shouldn’t be judged on our actions. It’s our principles that matter, our inspiring, abstract notions. Remember: just because torturing prisoners is something we did, doesn’t mean it’s something we would do. — Rob Corddry, The Daily Show

How many times have you heard a rightie say something like this

The difference between you and me is that, deep down inside, you cannot accept the fact that there are truly evil people in the world. The difference between the liberal and conservative viewpoints boils down to this: you think that, deep down inside, the Islamic nutjobs really only want to have a nice house and a yard, and raise their children in a loving and safe environment, just like all the people you know. Whereas I think that they are truly evil people, like the Nazis, that want more than anything else to destroy all that we hold dear. And they are more than willing to sacrifice their lives, their families, everything in their hatred of all that is good and beautiful.

What most righties don’t understand about evil is how seductive it is. The seduction begins with the notion that “his hatred of me is evil, but my hatred of him is justified.” The fellow who wrote that paragraph may not yet be completely besotted with evil, but he is sure as hell flirting with it.

I say evil is as evil does. It’s not who you are; it’s what you do, that is evil. Or not.

Again, I’m not saying that evil acts should be forgiven, or that people shouldn’t defend themselves from evil or seek to apprehend or even destroy dangerous people before they can harm others. I’m just saying that as we do these things, we must take care not to be seduced by evil ourselves. And that’s hard. It takes a lot of self-honesty and self-discipline.

And it takes recognizing evil as evil. Evil doesn’t wear a big E on its T shirt. Evil can seem to be virtuous. It flatters your ego. And it can feel really good.

See also: Jill at Feministe, “God and Abortion Rights.

Oh, Wait …

Dennis Byrne writes in the Chicago Tribune that accusations that news media has a “liberal bias” are valid:

Those of us who haven’t been in a war zone criticize the work of war correspondents at our own peril. Yet, for all the assertions that little or no good news is to be found in Iraq, it is simple to find some on the Internet from, for example, the U.S. Agency for International Development, which is helping rebuild Iraq. (Why is it called “rebuilding” Iraq, when it was a sorry state before the war? Shouldn’t we be talking about “building” Iraq?)

Billions of dollars of highway and other public works projects; new safety nets for the poor and vulnerable, entrepreneurial opportunities, a free press, leadership training–all requisites for successful self-government. For all the stories about power shortages, for example, how many explain that they are partly the result of exploding demand, a good sign of economic progress?

Oddly, some journalists give little credence to such official, attributable reports.

Yeah, if the government says it, it must be true, right?

Well, Dennis, today’s Washington Post carries the good news of Iraq reconstruction! Ellen Knickmeyer writes,

A reconstruction contract for the building of 142 primary health centers across Iraq is running out of money, after two years and roughly $200 million, with no more than 20 clinics now expected to be completed, the U.S. Army Corps of Engineers says.

Oh, wait …

The contract, awarded to U.S. construction giant Parsons Inc. in the flush, early days of reconstruction in Iraq, was expected to lay the foundation of a modern health care system for the country, putting quality medical care within reach of all Iraqis.

Parsons, according to the Corps, will walk away from more than 120 clinics that on average are two-thirds finished. Auditors say the project serves as a warning for other U.S. reconstruction efforts due to be completed this year.

Dennis is right that billions of dollars were allocated for “highway and other public works projects.” We know this is true because senior officials of the Coalition Provisional Authority had so much cash lying around they played football with stacks of $100 bills. Unfortunately the games got a bit rough; contractors managed to piss away about $20 billion in American taxpayer dollars while leaving project unfinished, and $23 billion in Iraqi money set aside for reconstruction seems to have mostly, um, disappeared.

According to Lisa Zagaroli of Scripps Howard News Service (March 13),

… shortfalls in infrastructure were detailed in a recent report by Stuart Bowen Jr., special inspector general for Iraq reconstruction.

Of 136 water sector projects, only 49 will be completed, and most of those involving sewerage, irrigation, drainage and dams have been canceled. Of 425 electricity projects, only 300 will be completed and only 2,200 megawatts of additional power will be delivered instead of the 3,400 megawatts that had been planned, Bowen told senators last month.

But this is looking at the glass half empty. Let’s focus on what actually has been accomplished. And here we can turn to no better authority than Secretary of State Condoleezza Rice, who has a genius for optimism. Sue Pleming reported for Reuters (February 17):

Congress has given more than $20 billion for projects aimed at improving Iraq’s dilapidated infrastructure and winning over Iraqis with better utility services, and Rice told lawmakers that conditions were better.

But in three key areas — access to drinking water, electricity and sewer service — Iraqis are worse off than before the U.S.-led invasion in March 2003, according to statistics released last week by the U.S. special inspector general for Iraq reconstruction. …

… Rice, who had told the committee more Iraqis had access to sewerage and water services than before, argued that what the United States had improved was “capacity” and the United States had made a difference.

“I think this may be an issue of whether we are talking about delivery or capacity. We have increased the capacity for clean water for several million Iraqis,” she said.

Yeah, I know I’ve used that one before, but it’s too good not to repeat.

Still, Dennis might say, we have liberated Iraq. They should be grateful to us for setting them free and making their lives better!

On March 18 Iraqi blogger Riverbend wrote,

I don’t think anyone imagined three years ago that things could be quite this bad today. The last few weeks have been ridden with tension. I’m so tired of it all- we’re all tired.

Three years and the electricity is worse than ever. The security situation has gone from bad to worse. The country feels like it’s on the brink of chaos once more- but a pre-planned, pre-fabricated chaos being led by religious militias and zealots.

School, college and work have been on again, off again affairs. It seems for every two days of work/school, there are five days of sitting at home waiting for the situation to improve. Right now college and school are on hold because the “arba3eeniya” or the “40th Day” is coming up- more black and green flags, mobs of men in black and latmiyas. We were told the children should try going back to school next Wednesday. I say “try” because prior to the much-awaited parliamentary meeting a couple of days ago, schools were out. After the Samarra mosque bombing, schools were out. The children have been at home this year more than they’ve been in school.

Oh, wait …

Actually, the Riverbend post I wanted to link to is this one, which freaked out even me. Riverbend was watching television —

I was reading the little scrolling news headlines on the bottom of the page. The usual — mortar fire on an area in Baghdad, an American soldier killed here, another one wounded there… 12 Iraqi corpses found in an area in Baghdad, etc. Suddenly, one of them caught my attention and I sat up straight on the sofa, wondering if I had read it correctly.

E. was sitting at the other end of the living room, taking apart a radio he later wouldn’t be able to put back together. I called him over with the words, “Come here and read this- I’m sure I misunderstood…” He stood in front of the television and watched the words about corpses and Americans and puppets scroll by and when the news item I was watching for appeared, I jumped up and pointed. E. and I read it in silence and E. looked as confused as I was feeling.

The line said:

وزارة الدفاع تدعو المواطنين الى عدم الانصياع لاوامر دوريات الجيش والشرطة الليلية اذا لم تكن برفقة قوات التحالف العاملة في تلك المنطقة

The translation:

“The Ministry of Defense requests that civilians do not comply with the orders of the army or police on nightly patrols unless they are accompanied by coalition forces working in that area.”

That’s how messed up the country is at this point.

This doesn’t sound good —

They’ve been finding corpses all over Baghdad for weeks now- and it’s always the same: holes drilled in the head, multiple shots or strangulation, like the victims were hung. Execution, militia style. Many of the people were taken from their homes by security forces- police or special army brigades… Some of them were rounded up from mosques.

Be sure to read the whole post; it’s gut-wrenching. How can Iraqis not hate us for bringing this about? And the perps are not always “militia” or “terrorists” or even “insurgents.” This is from A Star from Mosul, March 9:

Uncle S was dad’s only uncle from his mother’s side. … Yesterday, he was shot by Americans on his way back home, and he died. Like many others, he died, left us clueless about the reason, and saddened with this sudden loss. He was shot many times, only three reached him: One in his arm, one in his neck and one in his chest. But they said they’re sorry. They always are.

War supporters seem to think Iraqis should overlook these little episodes and love us anyway, because we’re carrying out whatever it is we’re carrying out for their own good. Yet there are righties who have never been personally wronged by a Middle Easterner, but who feel justified in hating Middle Easterners because, you know, they wear strange clothes and eat falafel. No good comes from that.

Today U.S. Secretary of State Condoleezza Rice and British Foreign Secretary Jack Straw are on a secret but well-publicized visit to Iraq (let’s hope they brought several cases of bottled water). This dauntless duo is demanding that Iraqis must disband the militias and dump the prime minister and get their government together right now because the “coalition” is losing patience with them.

John Ward Anderson reports for the Washington Post that

At least 50 people were killed Sunday in Iraq in a catalogue of violence that included a mortar attack, military firefights, roadside bombings and other explosions.

In addition, the U.S. military reported the deaths of six soldiers and airmen, including two who were killed when their helicopter apparently was shot down during a combat air patrol southwest of Baghdad on Saturday.

But it’s not fair to report on bad things happening in Iraq without discussing the good things, says Mr. Byrne:

News often is defined as something that didn’t happen before, or rarely happens. So, if indeed little good is happening in Iraq, every piece of (rare) good news ought to be reported with the same fervor as every act of violence–which we’re to believe is an increasingly common occurrence. And, logically, less deserving of reporting. Or does the absence of reporting “good news” in a country the size of Iraq actually mean that reporters can find absolutely nothing good?

If all this is confusing, it’s nothing compared to the confusion shared by the American public about what actually is happening in Iraq. The media’s credibility has become so strained that partisans on both sides have to admit in good conscience that they’re unsure of what’s real. Obviously, this isn’t good for a democracy.

I’d say that Jill Carroll’s release was good news, and it got a lot of attention, but apparently that’s not enough. And the truth is, some journalists in Iraq admit that the images projected on television do not accurately reflect the situation on the ground.

The situation on the ground, they say, is worse.