Health care and non-compete agreements

Two years ago this week I got caught up in a legal dispute that briefly threatened my life. Obviously, I'm still alive, but a version of what happened to me could happen to anyone who consumes health care in America, so I figure people should know a little about it.

First, a little background on me: Because I have a sort of muscular dystrophy that weakens my diaphragm muscles, I've used a trach and ventilator to breathe for the past six years. Generally, lungs react to this artificial breathing set-up by making secretions that must be suctioned out of the lungs several times each day by a trained assistant using sterile gloves, a sterile catheter and a suction machine. I have 24-hour home care assistance for this and other help I need. But the most important thing my nurses do is to keep me breathing, put the circuit tubes between my trach and my vent back together if they fall apart, troubleshoot vent alarms and keep me from drowning in my own secretions. Life is better than you might think, but I have to have this care to keep breathing.

So. This dispute between the business partners of my vent-specializing home health care agency eventually led to my choosing the management of one set of partners over another, and that's when their legal dispute began to directly involve me. At that time my nurses all worked only with me within the agency. And I'm the only vent client my metro-area-based agency has had in my small town 60 miles outside of the Twin Cities. So my nurses followed the job and switched agencies with me in order to keep getting a paycheck. The agency I departed sued all my home care nurses for breach of a non-compete agreement (NCA). They also sought a temporary restraining order (TRO) to keep all my nurses from showing up at my house to work and, you know, keep me breathing.

Are you familiar with non-compete agreements? They are contracts between an employer and employee that restricts what the employee can do after they leave the employer for a different job. It's meant to protect an employer's business, client list, company secrets, etc. It requires the employer provide the employee "reasonable compensation" and typically restricts competing work within a geographical area for a set time.

It used to be that NCAs were mostly just for tech companies protecting research and development secrets, but increasingly these agreements are used by all kinds of businesses now, including for-profit health care businesses. What this means for ANY health care consumer is this: in the terms of an NCA all clients/patients are considered business assets. If your health care provider -- primary care physician, psychiatrist, obstetrician, oncologist, surgeon, dentist, etc. -- is suddenly barred from having you as a client because they change partnerships/clinics/employers and there's an NCA, you have no legal standing in a dispute between employer and employee. (Your provider could also suddenly lack access to your medical records, by the way -- one of many reasons you should always have copies of the most vital aspects of your medical history.) Need some sort of life-saving medical care and want the professional who knows your case? Your individual preference to stay with that medical professional likely will be no part of the legal discussion about financial harm to the employer and the livelihood of the employee.

An exception is if the legal discussion includes consideration of the "public welfare". For example, if the medical specialty of the employee in question is rare in your geographical area, an NCA may be disallowed or limited in scope to protect the public welfare. And some states disallow NCAs involving all physicians. But the "private welfare" of one individual client/patient is not "the public welfare" and your right as an individual to choose your health care provider may not be considered.

State policies vary wildly. All employment NCAs in California and North Dakota are disallowed. Florida very seriously favors employers over employees. Colorado, Delaware, Illinois and Kentucky disallow NCAs for all physicians, Tennessee and Texas protect some physicians, New Jersey disallows NCAs for psychologists, and Massachusetts disallows for physicians, nurses, psychologists and social workers.

I'm in Minnesota and my nurses being sued as third-party defendants for violation of their NCAs was considered by the court a viable part of a big messy case. I have a lot I could say about that messy case that complicated the lives of hard working people just trying to make a modest living by giving me knowledgeable and competent health care, but I'll try and stick to the topic of NCAs and health care here.

In my situation, I wrote an affidavit to the court about how my life would be endangered by the temporary restraining order (I needed both a lawyer and a notary public for that.) Then I showed up in court for the hearing when the TRO was being considered, even though -- and I find this both galling and very key to my whole point -- without me present, discussion of the TRO and my life-saving daily care would have gone on without me. Remember, as neither plaintiff or defendant in this case I had no legal right to participate. Although I'd like to believe the judge wouldn't have ruled on a TRO that interfered with life-saving medical care, I suspect it was my presence in the courtroom that day (with my vent huffing and puffing loudly) that got my former agency to immediately withdraw the request for the TRO. I do not know for sure if the judge ever read my affidavit.

After months and months, the full case settled and the question of the NCAs and their validity was never ruled on. There's a Minnesota Home Care Bill of Rights (MN statutes, section 144a.44.) that states that any client has "The right to choose freely among available providers and to change providers after services have begun, within limits of health insurance, medical assistance, or other health programs." The conflict between that statute and an NCA was likewise not adjudicated or even debated at the court dates I attended. In any case, those matters would have been addressed long after the TRO, if the TRO request hadn't been withdrawn.

Things might have turned out differently. I might not have had a nurse who showed me the complaint she was served. I might have been unable to read it and understand the immediate threat of the TRO. I might not have had access to a lawyer for the affidavit, or a ride to the courthouse to attend the day the TRO was brought before the judge. I might not have had such loyal, brave nurses who stuck with me through months of threats of financial penalties to each of them. I might not have had such an excellent home care agency to choose as I currently have and been stuck under the management of the agency that aimed these troubles at my nurses and me. But because consumers of health care are basically the collateral damage of NCAs, you don't hear many stories like mine.

In fact, Googling "non-compete and health care" offers mostly lawyers selling their expertise and almost nothing about the clients every enforced NCA against a health care provider must displace. There are a few cautionary tales besides mine, however.

In May 2010, Madeleine Baran of Minnesota Public Radio reported on the story of Nadine Parker and her two daughters. The eight- and ten-year-old girls had been seeing a mental health professional for about a year and were finally experiencing some progress with troubles including bedwetting and self-injury when an NCA came between them and the one counselor they had developed trust in. The only current remedy in Minnesota for these children's traumatic loss of support appears to be litigation.

[Mental health] advocates also said that the situation serves as a valuable lesson for mental health consumers. Many clients, they said, have no idea that their therapist, case manager or other provider would not be able to see them if the provider switched to a new agency.

"Realistically, the average client is not going to be thinking that far ahead," [Frederic] Reamer, [a national expert on social work ethics and one of the chief authors of the code of ethics for the National Association of Social Workers] said. "It's usually, 'I'm depressed. I need help. Can you help me?' [Not] 'Oh, by the way, do you work in a place that has a non-compete?'"

In the 2006 Kansas case Caring Hearts v. Hobley and Hardy, the appellate court upheld the original ruling in favor of the employer and against the defendant home care nurses. In reviewing the issue of "the public welfare" the appellate court stated (italics mine) that "there is no evidence that public welfare would be harmed by enforcement of the agreements. Hobley and Hardy did not present evidence at trial that the desires of any of their former patients would be thwarted if an injunction were issued and they were denied care that they specifically desired to receive from Hobley and Hardy. But even if there were such evidence, the issue is public welfare, not the private welfare of an individual patient."

Does the court imagine that the elderly clients do not care who provides their health care? The court doesn't consider it relevant.

So, how to avoid losing your oncologist halfway through your chemo treatments? How to keep the social worker your mentally troubled child is getting support from? How to hang on to the primary care physician who has seen you through the birth of all your children? There aren't any great answers unless you live in a state that has a statute disallowing NCAs.

But here's my list of things you can do to protect yourself as much as possible:

Ask your health care provider if they are bound by a non-compete agreement.
Ask if they have any plans to leave the business where they are currently employed.
If possible, choose a provider not bound by any NCA.
Repeat this process if and when you add any new health care provider to your life.
Repeat this process if and when your health care needs become more extensive or dire and continuity of care becomes more vital to your health.
Talk to your elected officials about protecting patient continuity of care by limiting or disallowing NCAs for medical professionals in your state.



Other stuff to know about NCAs:

The American Medical Association believes "restrictive covenants" to be unethical:

Covenants-not-to-compete restrict competition, disrupt continuity of care, and potentially deprive the public of medical services. The Council on Ethical and Judicial Affairs discourages any agreement which restricts the right of a physician to practice medicine for a specified period of time or in a specified area upon termination of an employment, partnership, or corporate agreement. Restrictive covenants are unethical if they are excessive in geographic scope or duration in the circumstances presented, or if they fail to make reasonable accommodation of patients’ choice of physician. (AMA Code of Medical Ethics, Opinion 9.02)

A physician in internal medicine in rural Idaho where doctors are scarce writes about taking a two-year sabbatical as the only reasonable way she can find to escape an NCA.

An academic paper on how NCAs affect the labor market for physicians. (If the math scares you, skip to page 27 for the research conclusions.) Spoiler: States most supportive of NCAs have fewer docs per capita.

In 2005, the Tennessee Supreme Court ruled that NCAs for physicians were against public policy and unenforceable. In response, the state legislature has repeatedly tinkered with statutes mostly having the effect of overruling that court decision and allowing NCAs for most physicians.

One researcher finds that NCAs often derail careers.

For a good primer on NCAs read the paper "The Law and Policy of Non-Compete Clauses in the United States and Their Implications" by University of Illinois professors Jay P. Kesan and Carol M. Hayes.

Lame Duck

Image description: A color cartoon drawing of a white duck with George Bush's head and one hand, but a duck bill for a mouth. He's holding the red hotline phone and there's a cast on one duck foot. The cast has the seal of the president on it.

Like most people I know, it's been a refreshing change these past couple weeks to see how mostly toothless Bush appears after so many years of his callous destructiveness. But I tire of hearing the term "lame duck." It is ableist, of course, yet so ubiquitous most people don't think about it.

A "lame duck" is, literally, one that cannot keep up with the flock, and the primary definition provided by Merriam-Webster is "one that is weak or that falls behind in ability or achievement."

According to The Phrase Finder, the earliest recorded use of the term as a metaphor dates to 1761 and investors in the London Stock Exchange who couldn't pay their debts. Along with "bull market" and "bear market," "lame duck" was part of 18th-century stock trading lingo. How that came to be may or may not have something to do with the British game cricket:

In Horace Walpole's Letters to Sir Horace Mann, 1761, we have:

"Do you know what a Bull, and a Bear, and a Lame Duck are?"

In 1771, David Garrick, in Prologue to Foote's Maid of Bath wrote:

"Change-Alley bankrupts waddle out lame ducks!"

In 1772, the Edinburgh Advertiser included:

"Yesterday being the settling day for India stock, the bulls had a balance to pay to the bears to the amount of 23 per cent. Only one lame duck waddled out of the alley, and that for no greater a sum than 20,000."

We are still familiar with the terms 'bull market' and 'bear market', referring to rising and falling markets respectively, but 'lame duck' in the specifically stock trading context is now little used.

Why should someone who has no assets be called a 'duck'? Could it be related to the cricketing term, 'out for a duck' - used when a batman is out without scoring any runs? It seems not. That term is much later and refers to the zero on the scoreboard being similar to a duck's egg. First used in 1867, in G. H. Selkirk's Guide to Cricket Grounds:

"If he makes one run he has 'broken his duck's egg'."

The term made its way to American politics, with the first reference here in 1863 and the first presidential reference about Calvin Coolidge in 1926. Back then, out-going politicians had about 60 days longer to wreak havoc before newly elected representatives took office. The 20th Amendment to the U.S. Constitution, also sometimes referred to as the Lame Duck Amendment, shortened that time to it's current length, with new Congressional members taking office on January 3 and the president on January 20 following November elections.

"Lame duck" is particularly ableist since its current use refers not only to the decreased political power of elected officials who are slated to be replaced but also to the lack of accountability those politicians face. The daily "Quackitude" report on The Rachel Maddow Show on MSNBC, for example, covers both instances where Bush seems to be conceding his position to Obama already and the executive orders that reveal a gross misuse of power by bypassing legislative approval of things like uranium mining along the Colorado River.

I love Maddow and her show, but here's the relevant part of the November 7 show transcript that puts it all together under "Lame Duck Watch":
MADDOW:

We elected a new president this week, but there are still 10 scary weeks left of the Bush administration when anything can happen and most likely will.

And so we are back with another installment of our public service series, the RACHEL MADDOW SHOW "Lame Duck Watch" because somebody has to do it.

On the agenda at 1600 Pennsylvania Avenue, in the last couple days, nearly nobody watched. Scrapping Mid-East peace. Now, there's an idea. About a year ago, the Bush administration invited officials for nearly 50 countries to Annapolis, Maryland for a meeting with Israelis and Palestinians to try to forge peace before the end of the Bush era.

It widely considered the president's attempt to save a sliver of his otherwise, rather soily international legacy. At the time, those talks were deemed a success by Secretary of State Condoleezza Rice. And the administration vowed to keep working on this until Bush left office. They said they would get a deal before the end of the year.

Well, yesterday, the administration announced, forget it. They called off plans for any further talks before the end of the year. Legacy shmegacy. We've got an environment to wreck while we still have a chance.

They didn't say that thing about the environment, but yes. President Bush's Interior Department is busy relaxing environmental protection rules on mining for uranium within three miles of the Grand Canyon, you know, where the Colorado River runs, the one that provides drinking water for Phoenix, Vegas and L.A.

"Mommy, I didn't ask for lemonade. It's not lemonade, Sweetie. It's the seepage off those radioactive tailings. How much better would it be if January 20th were like tomorrow?

Daily, Maddow links impotent power with irresponsible use of what power Bush has left. So does everyone else. So being a "lame duck" is not just about being ineffective (which is ableist enough by itself), it's also about being an asshole.

Slumgullion #48

Just a few good links. That's all you need, right?

Bush cuts outpatient Medicaid services -- You heard about this parting gift from our Commander 'n' Thief? The Wonk Room at Think Progress has the details:

After arguing that legislation to cut over-payments to private insurers would “harm beneficiaries by taking private health plan options away from them,” President Bush, on Friday, “narrowed the scope of services that can be provided to poor people under Medicaid’s outpatient hospital benefit.”

In which the Netherlands endangers reproductive freedom -- Sylvia at Problem Chylde writes about a proposed bill that wants any woman deemed unfit to parent to be forced to take contraception for two years or any children she bears will be taken away from her at birth. I followed one link backward from Sylvia to a column for the Toronto Star to a blog post at Disaboom -- isn't it nice to know someone at a major daily reads a crip site?

Where neurodiversity meets feminist theory -- Lindsay at Autist's Corner has a three part series where she assesses an article by Kristin Bumiller titled "Quirky Citizens: Autism, Gender and Reimagining Disability" in the summer issue of the women's-studies journal Signs. Interesting writing from a blogger I hadn't found until now.

On the language

I want to go back to that acceptance speech Obama gave Tuesday night and how it began:

If there is anyone out there who still doubts that America is a place where all things are possible; who still wonders if the dream of our founders is alive in our time; who still questions the power of our democracy, tonight is your answer.

It's the answer told by lines that stretched around schools and churches in numbers this nation has never seen; by people who waited three hours and four hours, many for the very first time in their lives, because they believed that this time must be different; that their voice could be that difference.

It's the answer spoken by young and old, rich and poor, Democrat and Republican, black, white, Latino, Asian, Native American, gay, straight, disabled and not disabled – Americans who sent a message to the world that we have never been a collection of Red States and Blue States: we are, and always will be, the United States of America.

It's the answer that led those who have been told for so long by so many to be cynical, and fearful, and doubtful of what we can achieve to put their hands on the arc of history and bend it once more toward the hope of a better day.

It's been a long time coming, but tonight, because of what we did on this day, in this election, at this defining moment, change has come to America.

I especially like that he phrased our inclusion as "disabled and not disabled" instead of "disabled and able-bodied" or some other variation ("special needs and average needs" "handicapable and... what?"). My preference for "nondisabled" over "able-bodied" is based on semantically addressing several problems with the (inevitably-problematic) dichotomy:

"Disabled" and "able-bodied" are not opposites, both because disabled people are not "unable" and because some disabilities are developmental or psychological more than physical, which "able-bodied" implies. And for that matter, "disabled and able-bodied" is a lop-sided comparison when you understand the difference between impairments (actual conditions of an individual or body) and disability (the social phenomena). Also, the double prefix of "nondisabled" (or "not disabled") inclusively centers disabled people in a way that "disabled and able" cannot.

It's interesting that Obama mentioned "not disabled" people in the same way he mentioned "straight" people, as a complement to "disabled" and "gay," the historically marginalized groups. Putting "gay and straight" together in rhetoric is pretty common, but "disabled and nondisabled" really isn't that common -- we usually stand alone with lack of disability so presumed as the norm that it needn't be juxtaposed at all. That phrasing and inclusion in the list of marginalized groups felt really good in and of itself, even separate from where it leads in an Obama administration.

So often we never come up.

I was looking for this

I Googled "Obama wheelchair" earlier tonight in hopes of perusing pictures of Obama meeting disabled Americans on the campaign trail, but I couldn't find one. Just a cartoon of McCain in a wheelchair driving himself off of a cliff -- apt but ableist. (Yes, I know a wheelchair is not representative of all people with disabilities, but it's the quickest way to find a visual and it does represent my physical impairments.)

A similar search for "McCain wheelchair" shows that same cartoon repeatedly, McCain feeling up a seated guy's face (presumably faith-healing a military vet) and pushing his wife Cindy's chair after she had a minor stroke back in 2004. There are also McCain-less photos of disabled people getting arrested outside his Washington, D.C. office earlier this year when they tried to impress upon him the need to support our freedoms with the Community Choice Act.

So Google didn't much help me feel very represented.

And then I wander over to The 19th Floor and Mark has a photo of himself and then-Senator Obama from 2005. Image description from Mark's post, but go check out the photo, if you can:

a February 2005 photo of me and then-Senator Obama taken in the tunnels under the Capitol building in Washington, DC. Obama is standing to my left in a charcoal suit, leaning forward slightly and smiling at the camera. I'm wearing a leather jacket over a shirt and tie, my facial expression entirely too serious.

Excellent. Now I can back slowly away from the computer and go to bed.

Imagining the future

If you're like me, you spent a bit of time each of the past two mornings trying it all out: President-Elect Obama.

President Barack Obama.

A black president. A smart, thoughtful, gracious man in the White House.

Nope, I have no idea what that might feel like -- even the smart, thoughtful, gracious part has been too long to recall clearly. But I'm practicing imagining it, and it feels good.

The beginning to his acceptance speech has helped me imagine:

If there is anyone out there who still doubts that America is a place where all things are possible; who still wonders if the dream of our founders is alive in our time; who still questions the power of our democracy, tonight is your answer.

It's the answer told by lines that stretched around schools and churches in numbers this nation has never seen; by people who waited three hours and four hours, many for the very first time in their lives, because they believed that this time must be different; that their voice could be that difference.

It's the answer spoken by young and old, rich and poor, Democrat and Republican, black, white, Latino, Asian, Native American, gay, straight, disabled and not disabled – Americans who sent a message to the world that we have never been a collection of Red States and Blue States: we are, and always will be, the United States of America.

It's the answer that led those who have been told for so long by so many to be cynical, and fearful, and doubtful of what we can achieve to put their hands on the arc of history and bend it once more toward the hope of a better day.

It's been a long time coming, but tonight, because of what we did on this day, in this election, at this defining moment, change has come to America.

And I have been trying to reconcile that with the gay marriage bans in California, Arizona and Florida, because I also cannot fully imagine how these rejections of the basic rights of some beloved friends hurts them. Our failure is wrapped up in our success in a pretty intimate way, I'm afraid.

And then there's the passage of Washington State's Assisted Suicide Initiative (called Initiative 1000), which I'll admit I was aware of but not keenly attuned to like I certainly should have been. Most people I know won't see the connection here: Assisted suicide is about personal freedom, right?

It would be about personal freedom if we had a health care system that supported alternatives, like Medicare that paid more than $162/day for all medical expenses (including drugs -- painkillers) of people in hospice. Initiative 1000 was not an issue that arose from the grass roots in Washington, as Stephen Drake points out. It was funded by wealthy outsiders, which does raise the question of what that money is all about, doesn't it?

The future I'm imagining certainly includes hope. But that's not nearly enough.

Voting: On the importance of process

A reminder of why the nation continues to wrestle with the technology of voting machines. From seattlepi.com:

Like other vote-by-mail counties, King County will leave a few open to allow disabled people to continue voting with a new generation of machines. And in future years, they'll be left open for 20 days before elections -- not for nostalgia, but to allow some such as 55-year-old Gary Pearson -- who has used a wheelchair since he was 19 -- to vote with dignity.

On Tuesday, Pearson will wheel himself down the block from his house in Wedgwood to use the polling place at Decatur Elementary School. Partially paralyzed, he'll push a touch screen with his wrist to cast his vote. He will not need somebody to push pins through ballots or color in bubbles on a ballot.

And he'll vote like most of us -- privately.

Although results are the focal point of elections, for some such as Pearson, the actual voting process means a lot.

The process means more than the actual vote or election outcome, in my opinion. Anyway:

The old machines -- in which voters punched a card with a pin -- were too high up to see the candidates' names. He couldn't punch the cards, anyway, with his hands hobbled. The same was true when new machines required filling in bubbles.

For others, voting-booth curtains close for privacy while voting. He'd have to ask his young sons to do it for him. Or he'd ask a poll worker.

Some use an elbow to push the screen, or a pin held in their mouths, Pearson said. Absentee ballots were a possibility, but difficult....

The new machines also allow blind people to vote with more independence. Blind voters can wear headsets and respond to a voice reading choices using a keypad. King County does not have absentee ballots in Braille, and because many blind people do not read Braille, the machines are a better option.

"I hear excited utterances (about the machines) all the time because they can vote privately for the first time," David Lord, president of Disability Rights of Washington, said.

I written previously on the importance of having a polling place with election officials to go to, as opposed to relying solely on mail-in ballots here and here.

Finally!

Image description: Button courtesy of Nezua. It's round, reflective, 3D-ish and looks like a real lapel button. It's blue with a few stripes of red and white at the bottom. It reads "I VOTED," with the "v" as a bold red check mark over a landscape and a blue-toned Obama campaign logo. The word "CHANGE" arches subtly along the top, blue on blue.

It's done! And it took me just a half-hour from start to finish here in my little town. Everyone votes at the same place, with the rec center gymnasium divided into the three local precincts.

The weather is stunningly beautiful today, and that made the crowded parking lot less stressful. If I'd driven and parked myself it would have maybe taken a half hour to find a place to roll out my van's ramp, but I went with family who did the parking for me. There is disabled access parking but it was all taken. The entrance is all level with no steps anywhere, and the three sets of double doors were all propped open. The disabled access door had a sign on it saying that anyone needing assistance with voting could ask an election official for it.

There were two people standing outside the building who were poll watchers, I think, since I didn't see an "election official" badge on either of them. I didn't know them but chances are good they were Republican poll watchers as there have often been some in the past despite this rural area being a conservative stronghold.

I got to the poll at about 9:30 am. Just inside the gym is the first line, for those registering today as they vote. Once I got around these newbs and found my precinct table to sign in (no line there), I had to wait in another line for a couple minutes to get my ballot. A guy next to me said loudly to his friend that I shouldn't have to wait in line and someone should be there to "take care of that." He wasn't listening when I replied that there was no reason I couldn't wait in line like everyone else -- I didn't need to rest: already sitting. I didn't need special help to hand in my slip and get my ballot. It was a quick line anyway.

Then the line to vote was perhaps 15 minutes long, and that was simply a line to use a booth or table stall. People who had black ink pens and didn't mind filling out their ballots while standing finished before they came to the front of the line. People everywhere chatted, but mostly not about politics. I heard a conversation between a couple people pondering how to vote for the school bond. I heard someone laughingly say this was a lot of lines to stand in just to get a sticker. The mood was busy and spirited.

An election official told me they'd been running about 200 people through per hour since 7 am. He also said there were no electronic machines to use. They'd had some the last time I went to vote, but according to this guy, all machines in Minnesota were taken away. So it was a low tech procedure all the way, with just the machine that accepts and approves your ballot at the end being the one automated moment.

No one offered me special assistance, but I didn't need any and came with my own nurse anyway. If I'd needed help there were plenty of poll workers there who would have provided it.

My precinct had about ten standing voting stalls and 16 seated table stalls and the line moved smoothly with another line that also moved well to give your ballot up to the machine. The other two precincts have their own similar set-ups on the other side of the gymnasium. And then there's the happy guy at the end handing out "I Voted Today" stickers.

I voted: for Barack Obama, for Al Franken (the least unappealing candidate for U.S. Senate -- I hope he's more inspiring in office), for Rep. Collin Peterson, against a local state incumbent named Ron Shumanski who exists principally to say no to all good ideas for the community (he'll surely be re-elected in this very conservative district), yes on the Minnesota amendment for conservation and the arts (I was torn on this one), and yes on a couple of badly needed school bonds that will surely fail as they always do. And I voted on some of the local stuff: school board, county commissioner, an unbelievable number of judges on the ballot, mostly running unopposed.

I was done by 10 am (a half hour total) and went out to breakfast with my parents. Coffee, one egg over-easy and hash browns. I'm working with a brand new nurse this afternoon so it feels especially good to have my part in the election done.

Is it too early to be really excited about this?

Whoooooo.

"I had a choice, and I chose life. Does that make me pro-choice or pro-life"?

Tierney Temple Fairchild writes in the Washington Post about her ten-year-old daughter and what it means to her to "choose life":

I had a choice, and I chose life. Does that make me pro-choice or pro-life? Our political parties tell us we can't have it both ways. If I am pro-choice, then I must be for abortion. If I am pro-life, I may be lauded for a heroic choice when in fact none existed.

She continues:

In this economy, I must reflect on the circumstances that allowed us to make ordinary what some view as heroic. We were fortunate to have a health-care plan that covered Naia's medical bills. We were fortunate to have enough money to cover three weekly therapies carrying co-pays of $10 each. We were fortunate to have the educational backgrounds necessary to read research and advocate inclusive education for Naia. We were fortunate to have the lessons of discrimination and perseverance from another choice some also label heroic, interracial marriage.

Now, I look at my budding 10-year-old, and I see her beauty, poise and humor, not her disability. What I have learned is that we are not exceptionally burdened. Naia has some novel developmental and social challenges. Nevertheless, we and others are often struck by how typical she is, integrating with peers, reading on grade level and riding horses. All choices may not have the same result, but it is crucial that we all have the opportunity to make our own decisions.

If it's our choices that define us, choices that allow us to face down fears and lead us to our greatest achievements, what might come from taking those choices away?

Fairchild references Sarah Palin and her infant son Trig, but doesn't specifically mention this fact: Palin doesn't believe in allowing women this choice and neither does John McCain and the Republican party.

Oh happy day, tomorrow!

Vote if you haven't already.

h/t Patricia E. Bauer

Ohio study finds many polling places with access problems

Ohio is a swing state, you know.

From the Columbus Dispatch in Ohio:

Dozens of Franklin County polling sites failed to meet accessibility standards for voters who need wheelchairs or walkers or have other disabilities, according to a study that Ohio State University students undertook this summer. . . .

The study, conducted from June through September, says that only 10 percent of the sites reviewed met all 63 items the Ohio secretary of state's office uses to determine whether polling sites meet the Americans with Disabilities Act and state standards.

Graduate occupational-therapy students at Ohio State, working with the Ohio Legal Rights Service, randomly selected 217 of 533 polling sites in the county to study.

They found that 22 percent did not have a fully accessible entrance, only 25 percent have an adequate number of accessible parking spaces, and 49 percent have no parking space for a wheelchair van.

Is your poll site accessible?

Here are some tips from the article's sidebar, with a few additions from me:

Voting-day tips:

• Call your polling place and ask about parking or which entrance is the most accessible. You can get that number by looking up your state or county elections office -- many have websites and toll-free numbers.

• Consider avoiding peak voting times, especially if you have difficulty standing for a long time. Midmorning is usually a slower period.

• Consider taking a friend to assist you.

• Consider bringing a lightweight portable stool or lawn chair if standing is tiring or painful. Also consider bringing a bottle of water and snack to help you wait in line comfortably.

• Consider bringing a sample ballot you've already filled out, or a list of your chosen candidates and positions on initiatives to help you fill out your official ballot more quickly.

For Ohio voters, especially those in Franklin County:

• Consider voting at Veterans Memorial, 300 W. Broad St. It is fully accessible to the disabled, although parking is a distance from the polling site.

• Franklin County voters who need assistance once they get to a polling place (transportation not available) can call 614-466-7264 or 1-800-282-9181. A team of occupational-therapy students from Ohio State University will arrive to help them.

• Call the same numbers to file a complaint about lack of access to a polling place.

Palin's speech about kids with disabilities

Did Palin's speech last Friday in Pittsburgh meet my low expectations for details on actual concerns of people with disabilities?

Palin reiterated her convention announcement that, if elected, "families and caregivers of special-needs children all across this country" would have a "friend and advocate in the White House." That's sweet, and needed. She might have said she'd be a friend and advocate to actual disabled people too.

She did reference both the IDEA and IEPs, though she never mentioned the ADA -- the premier disability civil rights law that secures not just friendship and advocacy, but citizenship rights. She pledged to create a sort of voucher program that would allow federal funding for children with physical and developmental disabilities to be used at either public or private schools the parents choose.

The catch? There are several: Portable federal funding will only apply where state funds are deemed portable as well. And no private or parochial school will be required to accept or accommodate these students, which is already a serious problem with educational voucher programs.

She also declared that a McCain-Palin administration would fully fund the IDEA, seriously underfunded now for decades. That would be welcome, except she made clear that availability of this funding relies completely on cutting it from earmarks elsewhere. So, once your state passes education funding reforms designed to deregulate the public school system and her administration proposes a federal budget that moves earmark funding to IDEA and Congress approves it, then parents can look for a private school that will accommodate their disabled child, though those schools will not be required to make the effort.

Palin briefly mentioned the high "medical and other costs" concerning parents of disabled kids, but, predictably, didn't mention how a McCain-Palin administration refuses to support the Community Choice Act and would limit insurance opportunities for kids (and adults) with pre-existing conditions through their health care plan.

Palin also falsely claimed that an Obama administration would tax the special needs trusts parents set up to protect and support their disabled children into the future. That's not true, as independant estate planners (and the Obama campaign) have clarified. (h/t Patricia E. Bauer)

In contrast, as stated on a dedicated page at their website (something the McCain-Palin site lacks), the Obama-Biden administration has a four-point plan to support disabled people:

1) provide educational opportunities (fully funding the IDEA -- yes, before McCain took on Palin as a running mate Obama had pledged to do this),

2) end discrimination and promote equal opportunity (this means funding the offices already pledged with the task, like the EEOC, where there's an astounding backlog of disability discrimination complaints),

3) increase the employment rate (Obama mentions that insuring federal job opportunities for the disabled includes fully accessible information technology, while McCain claims he can't use a computer himself because of his disabilities), and

4) support independent, community living (including the Community Choice Act).

Read the detailed .pdf of the Obama-Biden commitment.
Read Palin's speech yourself at the McCain-Palin campaign site.

Vote early

Two years ago, I wrote something about how I thought absentee voting as a standard practice for disabled citizens, or as a plan for all citizens, was detrimental to the rights of disabled people. I believed that it would undermine the push for accessibility at all the schools, churches and other public polling places required by law to have disability access -- not just for the actual voting, but in building access:

One solution to this whole mess that seems to be gaining currency is voting by mail. Absentee voting is being expanded to "permanent" absentee voting and then to "no excuse" absentee balloting and voting by mail for all. Many claim it's a much better system and supposedly many disabled people would prefer to always vote by mail.

I think it's a bad idea. Oh, it might be smart in the short-term while the numerous problems with voting are minimized, but in the long-term it's maybe bad for democracy and certainly bad for the disabled. If the solution to problems of accessibility is to not require anyone to show up, then all the churches and rec centers and other polling sites that are not currently accessible will have less pressure to become so. And all the poll workers who will be trained on how to interact with disabled people to help them vote will never be trained. And all the disabled people who rarely get out of the house because of Medicare homebound laws* and lack of transportation, will have one less reason to interact with the world. All this equals less accessibility and freedom for the disabled in the long-run.

Additionally, I believe the assurance of maximizing privacy and actual casting of the votes disabled people choose themselves can only happen at polling sites.

I've changed my mind on this. I do still believe there's value to meeting with your community and voting on the same day, and to this activity requiring accessibility of those public meeting places. And I do believe that a disabled individual who physically needs help voting absolutely needs ready access to a system that is supposed to provide a neutral assistant to help, if necessary. That neutrality may not be available for many disabled voters asking someone in the privacy of their own home for help. Family or hired caregivers' politics can differ radically from that of the person needing assistance, so somehow the availability of that check on abuse needs to be maintained.

But read what my friend Skylanda has to say about the importance of voting early. Here's an excerpt:

I sat in on a meeting a few days ago for partisan volunteers who are aiming to work the precincts on election day. It was an interesting talk, from a strategy perspective. The on-the-ground democratic strategizers are predicting - assuming, preparing for - regular and systematic challenges to every voter with any iota of irregularity worth challenging in any precinct that has traditionally leaned blue. A misspelling of a long ethnic name, a discrepancy between "street" and "avenue" on your drivers license, a typo that transposes a couple of numbers in the address on your voter registration card. If you live in a heavily democratic zone, expect there to be any guff that can be cooked up over your right to vote. It may not happen, this may be a regional over-reaction to national scrapping between the big guns, but after Florida circa 2000? I'm not gonna call it conspiracy theory; the democratic brass aren't calling it that either.

In historically democratic precincts, it won't just be about throwing individuals off the rolls - that's small potatoes. The real goods are in a different goal: slowing down the lines at the polls until people by the handful or the dozen or the hundred get bored, cold, or compelled to go back to work/pick up their kids from daycare/return to the demands of their lives before they reach the front of the line to cast their vote in those blue-hued precincts. Even if your personal data line up like the moon in the seventh house, the time will be taken - if you are in those precincts - to inspect your credentials. Slowly. Carefully. Painstakingly. Just, ya know, to make sure you're legit. While someone in line behind you considers if they can really wait another five minutes before their kid's daycare closes, or their afternoon shift starts, or that chill in the November air turns out to be too much for their elderly lungs....

No one who has the ability and the wherewithal to vote before November 4th should be taking a space in line that day.

While many bloggers voting early have reported short waits, Mustang Bobby at Shakesville writes that the happy experience did take him four hours in Miami-Dade County.

Here's the link to find out about absentee and early voting in your state.

Remember to bring photo identification. And bring a sample ballot that you've already marked, if possible, to shorten the time you spend in the voting booth, whether you get there early or on November 4.

Most importantly for everyone -- be persistent and get it done. By this, I mean go early. If you need a ride, ask someone. Don't be afraid to get a fresh ballot if you make a mistake. Don't let anything discourage you, voting is your right. Just get there and be counted.

Palin to speak today on disability issues

I haven't really blogged yet about my opinion on veep candidate Sarah Palin and her claim that having an infant son with Down Syndrome gives people concerned with disability issues a "friend" in the White House. Frankly, I don't find her a credible enough candidate to get very wonky about: I find anyone who believes that the End Times will occur in their lifetime fundamentally unfit to be a steward for the future of my country.

But anyway.

Palin is expected to speak in Pittsburgh today, and according to a Palin advisor she will offer specific policy details of how a McCain-Palin administration will be of any use at all to people with disabilities. It will be interesting to see her pledge her advocacy while simultaneously opposing funding for services to assist disabled people.

Earlier this week in Denver, Palin spoke against a Colorado ballot initiative designed to address the wait list of over 12,000 developmentally disabled citizens needing services like home health care and job training. Although there is reportedly no organized opposition to the initiative, Palin made a point of expressing her lack of support for Colorado disabled waiting years and years for help.

What Palin won't be mentioning in her speech today: McCain's dismal health care plan and how its goal of deregulating health insurance will assuredly shut out many Americans with pre-existing conditions -- like, for example, Down Syndrome. Or McCain's refusal to support the Community Choice Act, a bill designed to break the nursing home monopoly on government-funded health care and allow people to receive care in their own homes.

But let's see if she can play the acronym game. Look for some sort of minimal competency on the ADA, IDEA, and IEPs. See if she can do better than the rote speech on "curing" autism. Listen for even one mention of aid for adults with disabilities, those pesky grownups that should be part of any genuine "commitment to protecting life." If she references her choice to not abort a child with developmental difficulties, wait in vain for her to say what her policy details do for institutionalized disabled girls or women who get pregnant by the rape of their caregivers. Those women (possibly institutionalized due to lack of funding alternatives) would be forced to carry the fetuses of their rape to term under McCain-Palin policies, of course.

Look also for some more baby-cuddling because that's substantive policy we can all appreciate.

h/t several times over to Patricia E. Bauer

McCain can't use a computer because he's disabled

About a month ago ABC news' correspondent Jake Tapper reported on John McCain's choice to not use computers. Barack Obama's campaign had just released an ad criticizing McCain for being out of touch in a number of ways, including his self-confessed computer "illiteracy."

Tapper explains for us, though:

Assuredly McCain isn't comfortable talking about this -- and the McCain campaign discouraged me from writing about this -- but the reason the aged Arizonan doesn't use a computer or send e-mail is because of his war wounds.

I realize some of the nastier liberals in the blogosphere will see this as McCain once again "playing the POW card," but it's simply a fact: typing on a regular keyboard for any sustained period of time bothers McCain physically.

He can type, he occasionally does type, but in general, the injuries he sustained as a POW -- ones that make it impossible for him to raise his arms high enough to comb his hair -- mean that small tasks make his shoulders ache, so he tries to avoid any repetitive exercise.

Again, it's not that he can't type, he just by habit, avoids when he can, repetitive exercise involving his arms. He does if he has to, as with handshaking or autographs.

Now, I have no doubt it's true that McCain's injuries affect him enough that typing causes chronic pain that the man would rather avoid. And I've also no doubt he has minions who can and should do many of the computer-related tasks of a busy U.S. Senator and presidential candidate.

But Tapper explicitly claims McCains lack of computer use is not a choice and is because of physical impairment:

It's certainly possible that the Obama campaign did not know this, since McCain makes it sound in interviews as if this is a matter of choice, not discomfort because of his war wounds.

So, McCain is not computer illiterate, though he did once say he was. (That's okay. I know a few septuagenarians on a steep computer learning curve.) And he can type, he knows how and can physically do so, Tapper says. It's just so uncomfortable that he chooses not-- no, wait. It's not a matter of choice. His discomfort means he cannot.

Except that is total crap.

Plenty of us on the intertubes manage to tap something out now and then without full use (or any use) of our fingers, hands or arms. There's voice recognition software and even free software that allows the somewhat tedious-but-effective typing with a mouse instead of a QWERTY board. I used the latter for a while last year and didn't even need to sell one of my many cars or houses to make it happen.

Here's my point: October is National Disability Employment Awareness Month. One of our presidential candidates has significant physical impairments that, according to Tapper, his own campaign claims are the reason he cannot readily use a computer. Of the 56 million Americans with disabilities, about 65% of disabled adults are unemployed.

Let me say that again. 65% of disabled Americans. Conservatively, that's 6 out of 10 disabled adults without a job. Compare that to the national rate of unemployment, currently freaking everyone out at a whopping 6.1%.

The rate of unemployed disabled Americans has remained virtually unchanged since WWII, so you might say that it's an issue needing knowledgeable and committed public officials addressing it. And McCain either does not know that physical disability is not an excuse for not using a computer, or he does not care if he is perpetuating the stereotype that disability makes a person incapable of a basic skill needed for employment in today's workforce.

Here's a one-minute YouTube video, with in-screen captioning and open audio description, on the topic:

Brief description of video: Karl Rove, McCain campaign advisor, states for a FOX News interview that McCain can't use a computer because of his war injuries. His voice and the audio description continue as a number of disabled people, with prosthetic limbs, amputated stumps, and mouth pointers type at computer keyboards. A final collage of these computer users includes an image of FDR in his wheelchair, then fades into a photo of Obama and chants of "Yes, we can!"

Cross-posted at Alas, A Blog

A handy guide to your presidential candidates and their senatorial records on disability

Provided by the Ohio Legal Rights Service. (Link leads to a chart showing the positions of both McCain and Obama on a wide variety of disability issues, both professed positions and voting records as of this September.)

An update for that chart: Tucked into the financial bailout bill that just became law is the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, listed in the above chart as the Paul Wellstone Mental Health and Addiction Equity Act that previously McCain had opposed and Obama had supported. As an add-on to the bailout bill, both candidates voted for it.

Heh.

Slumgullion #46

A random collection of links, starting with blog posts on Palin and disability:

Sarahlynn at Yeah, But Houdini Didn't have These Hips wraps up her assessment on the veep and presidential candidates' stances on disability with a look at Sarah Palin's actions on disability issues (as opposed to her convention declaration of a "friend ... in the White House"). See her posts on Obama, Biden and McCain. Also, her initial reactions to Palin's nomination as McCain's running mate.

In a "Memo to Governor Palin," Penny at Disability Studies, Temple U. responded to Palin's RNC speech, and she includes a link round-up of other disability bloggers on Palin's statement that her having an infant with Down Syndrome gives parents of special needs children "a friend and advocate in the White House."

More on Palin's RNC speech from early September at Shakesville: Shapeling and Shaker Sweet Machine write on "Disability, Parental Martyrdom, and Reproductive Choice."

At Feministing, drahill writes: "Undecided: Sarah Palin, Disability Rights, and Abortion."

In a guest commentary at Patricia Bauer's disability blog, Paul K. Longmore also responds to Palin's announcement by writing on What Kind of Advocacy Do Americans with Disabilities Really Need?"

By the way, since she took point on bringing publicity to the ableist humor in the summer comedy Tropic Thunder, Patricia E. Bauer's News & Commentary on Disability Issues has become a must-read for me. She's always thoroughly covered the latest news, but comments have become especially lively as well.

Back to Shakesville, where Melissa McEwan recently requested:

I just wanted to take a moment to ask that we all please refrain from using the term "McLame" in comments. It's ableist, and therefore violates the tenets of the safe space.

I know I set a terrible example, because I once used it myself, but it was pointed out to me that I was being an asshole, so I don't use it anymore, and I'm sorry that I did.

My comments on that:

YAY! Yay to working for ableist-free safe space. Seriously.

Also, though he'll never label himself so, McCain is a candidate with significant disabilities, so referring to him as "McLame" does matter. It's not just rhetorical play.

Slumgullion #45

Yeah, I'm still here. I got new eyeglasses this weekend, and while it may take a few days to adjust to the bifocals (!) I hope to be spending less time squinting and more time online again.

In the meantime, this is the news I'm catching up on today:

"What happens when chronically ill kids grow up?" -- A June article in the Houston Press explains the gap in health care for disabled children who come of age. It's an important topic I haven't seen covered in such depth before, but, hello... the "first large generation of chronically ill pediatric patients to reach ­adulthood"? I'll be 40 in October, and I'm really tired of hearing how all the seriously disabled children before now died before needing adult health care. We're here. We've been here. A number of us have even been blogging online for quite some time. It's just that we're mostly invisible to the mainstream media.

"Girls parents and agency face charges in starvation" -- Danieal Kelly of Philadelphia was 14. She died in 2006 and the charges have just now been filed. Mark at The 19th Floor writes about Danieal and the grand jury indictment (pdf file with one very graphic photo) of nine people for her needless suffering and death.

"Immigrants facing deportation by U.S. hospitals" -- From a NYT series on how the government and others "compel illegal immigrants to leave the United States." Here's an excerpt:

Eight years ago, Mr. Jiménez, 35, an illegal immigrant working as a gardener in Stuart, Fla., suffered devastating injuries in a car crash with a drunken Floridian. A community hospital saved his life, twice, and, after failing to find a rehabilitation center willing to accept an uninsured patient, kept him as a ward for years at a cost of $1.5 million.

What happened next set the stage for a continuing legal battle with nationwide repercussions: Mr. Jiménez was deported — not by the federal government but by the hospital, Martin Memorial. After winning a state court order that would later be declared invalid, Martin Memorial leased an air ambulance for $30,000 and “forcibly returned him to his home country,” as one hospital administrator described it. . . .

Mr. Jiménez’s benchmark case exposes a little-known but apparently widespread practice. Many American hospitals are taking it upon themselves to repatriate seriously injured or ill immigrants because they cannot find nursing homes willing to accept them without insurance. Medicaid does not cover long-term care for illegal immigrants, or for newly arrived legal immigrants, creating a quandary for hospitals, which are obligated by federal regulation to arrange post-hospital care for patients who need it.

American immigration authorities play no role in these private repatriations, carried out by ambulance, air ambulance and commercial plane. Most hospitals say that they do not conduct cross-border transfers until patients are medically stable and that they arrange to deliver them into a physician’s care in their homeland. But the hospitals are operating in a void, without governmental assistance or oversight, leaving ample room for legal and ethical transgressions on both sides of the border.

Indeed, some advocates for immigrants see these repatriations as a kind of international patient dumping, with ambulances taking patients in the wrong direction, away from first-world hospitals to less-adequate care, if any.

“Repatriation is pretty much a death sentence in some of these cases,” said Dr. Steven Larson, an expert on migrant health and an emergency room physician at the Hospital of the University of Pennsylvania. “I’ve seen patients bundled onto the plane and out of the country, and once that person is out of sight, he’s out of mind.”

"Taking the long way around" -- From Oceanside, California, an example of how higher gas prices and budget cuts that have led to more crowded public transit is pushing wheelchair users off the bus. We'll be hearing more stories like this, I suspect.

"Her new role is fighting old label" -- Ms. Wheelchair America is interviewed by the Houston Chronicle. Beauty contests for disabled women have been covered here before, but I do like the approach to her new job that the current Ms. Wheelchair America, Michelle Colvard, seems to be taking. She says:

They're two main ways that the media portray women who have disabilities. It's either kind of passive, needing help, victim, suffering. You hear a lot of those words, wheelchair-bound, these negative-word connotations. ... On the other hand, women with disabilities who have done pretty well for themselves are put up on a pedestal. I think sometimes that's a bad thing, too.

Culture, chaos theory and choice

So, in my BADD post the other day, I explicitly noted the evil of our U.S. foreign policy in Iraq -- our war that, among other things, disables Iraqi children, many of whom will live their lives in a society with such a damaged infrastructure that their basic needs will never (not for one day) be well met. I know that some people trying to understand disability culture and the idea of impairments as not inherently tragic will be further confused by this. (No, being disabled is not a tragedy, yes, being disabled by an occupying army is an outrage and tragedy.)

The current discussion in comments at Alas, A Blog, started by WheelchairDancer's wonderful post "On Making Argument: Disability and Language" (also with a separate comment trajectory at her personal blog) struggles with this, or with several readers' inability to mesh together the ideas that while being or becoming disabled is not a choice, it is experienced by many people as normal or even filled with various human joys.

The confusion persists, I think, because disability is seen as this separate thing that happens, not as part of the whole spectrum of possible valid and ordinary life experiences. Maybe the breadth of what disability includes causes part of the confusion: we are the person born with spina bifida and the old fart losing his hearing, we are the person born to quadriplegia in a car crash and the cancer survivor who lost a limb while winning the battle, we're the child born with Down Syndrome and the dyslexic movie star, we're the institutionalized schizophrenic and the woman taking anti-depressants to keep moving through her busy day.

Pitting one life experience against another is ludicrous and unfair, of course, but in those comparisons I just made, the first examples are routinely seen as tragic and the second ones are all sometimes -- for better or worse -- seen as either common and ordinary or as triumphs of luck, strength and will. Neither characterization sums up the individual life or experience with disability. With adequate and just support, any disabled individual might lead an utterly ordinary life where his impairments are only one aspect of who he is. Or it might be the very thing that completely defines him. It might inspire him to amazing heights or leave him paralyzed with bitterness. (Yeah, note the metaphor there. Discuss, again, if you like.) People are different like that.

Two people can have the same job, with one hating it miserably and the other blithely content. Neighbors living side-by-side for sixty years can lead incredibly different lives. All life, but maybe especially disability, is chaos theory in action. Any outcome might be true.

The thing that makes the war in Iraq and the children it disables an outrage and tragedy is the degree of human choice. Someone somewhere (or many someones) makes a decision, and it leads to this event causing pain to other people. To value freedom and the individual means to value and support choice wherever possible and to be against human actions that limit freedom and choice of others. I don't find that contradictory to also embracing the disability experience as one that is in many ways fulfilling for many of us, even though few of us got here by choice and some of us have been injured at the hands of others.

The Most Important Disability Policy

I had a hard time choosing one topic for this year's BADD. There's the presidential candidates' disability policies, McCain's refusal to even listen to the concerns of disabled Americans worried about institutionalization, funding cutbacks sure to threaten the mobility and health of disabled Americans (and all Americans) even more in the future.

A judge in Kentucky recently found a man named Ohmer Portwood guilty of breaking the pedestrian code for driving his wheelchair in the road, even though Portwood reportedly has nowhere else to be because of a lack of safe and accessible sidewalks. The judge declared that the city of Lancaster's failure to comply with the ADA was a separate issue.

Pharmaceutical companies lie for profit, children are given shock therapy, returning military vets are discharged without adequate health care.

And yet, the greatest example of disablism at work in the world today is this immoral war in Iraq that terrifies, maims, and kills while also destroying the existing social structure of supports that could help manage the everyday needs of Iraqi citizens. Maybe it sounds like a stretch to call civilian war casualties disablism in action, but what is disableist policy if not a policy that holds the lives, bodies and minds of others so cheaply?

What follows are 20 photos, mostly of Iraqi children.* Some are very hard to look at -- consider this a trigger warning. I've added my usual image descriptions for accessibility for all but they are limited to descriptions of what I see and lack specifics of time and place. Feel free to comment if you see something different in the images.











Image description: A young girl -- no more than three-years-old -- is in the foreground being carried by an adult. In the background, behind other people, are black trails of clouds from something burning. The girl is frightened and crying.












Image description: Under a sky blackened by sooty clouds, a tank follows a family that flees. A man and three children all hold hands as they move toward the camera. The background appears to be all desert. They carry nothing with them.











Image description: A close-up of a young girl facing the camera, her eyes brimming and wet with tears. In the background a military tank comes down the street.












Image description: A boy and girl, both perhaps age five, stand before a man in full military gear who runs a metal-detecting wand in front of the girl's chest. She stands with arms outstretched so the man can sweep her for explosives.













Image description: In the foreground, the torso of a man standing in full military gear and carrying a machine gun. In the background a child, perhaps four-years-old, sits, with both hands raised to cover her face.
















Image description: A young girl (maybe six?) sits cross-legged, arms wrapped to hug herself and cries, open-mouthed. A cinder block wall next to her is spattered with blood and just in front of her an adult lies in the grass, with only his feet and calves visible in the photo.
















Image description: A girl, maybe eight-years-old, sits cross-legged on a cushion, crying in anguish (and perhaps, pain) as she faces the camera. Her face and neck are spattered with blood, and the front of her pink shirt is wet with blood, as well.












Image description: A bearded man sits on a bed's bare mattress wearing only an undershirt and shorts. His feet are bare and dirty. He cradles a small child in his arms. The child appears to be unconscious and wears only an olive t-shirt and a white bandage over the top half of his head, with blood soaking through at the top.











Image description: A toddler lies on his back on a bed, his right arm covered in heavy white bandages and his shirt pulled up to reveal another bandage on his chest. He is crying.












Image description: A pretty girl (maybe eight?) lies on her side looking solemnly to the camera. The hand of her arm that lies along the pillow before her face is heavily bandaged.
















Image description: A girl, perhaps ten-years-old, lies stretched on a gurney. One hand is bandaged and the other holds a child's drawing. Her bare legs show serious, deep wounds, with about half of both her right knee and left ankle missing as if very large bites of flesh were taken from each.
















Image description: A child of three or four lies sleeping on her side, face nestled against the hip of an adult. Her left knee and foot are lightly bandaged, and the right leg is heavily bandaged from the top down to where it ends above the ankle.












Image description: A young boy lies, half-unconscious, with a bandage over his nose possibly holding a naso-gastric tube in place. His entire torso is covered in heavy bandages. In the background a woman sits keeping vigil.











Image description: A boy lays on a bare mattress, on his stomach but resting his upper body on his elbows. The white clothes he wears are all stained with blood, as are his hair, face and legs. He stares pensively off-camera.
















Image description: A man in Arab dress carries an unconscious girl past a jumble of bodies in the background. The girl's clothes are torn and a grotesque jumble of flesh and bone hangs where her right foot should be.
















Image description: A man carries a girl in a school uniform across a courtyard. She is crying and blood runs across her face, down her bare legs and across her sandals.











Image description: A close-up of a girl's face as she stares blankly toward the camera. While her eyes appear undamaged, the skin of her forehead, nose and cheeks is badly damaged, perhaps burned.
















Image description: Two women, one in a white medical coat and the other an older woman in Arab dress, stand over a toddler laying on a table crying. Heavy bandages cover the child's torso and crotch. The child's left leg is entirely missing.











Image description: A boy lies in a bed on his back. His heavily-bandaged left forearm is raised to rest across his forehead. His right arm ends a few inches below the elbow with the bare stump in the foreground. His torso is a mass of stitches and bandages, with a chest tube adhering to his right abdomen.












Image description: A boy lies in bed on a colorful blanket, conscious and trying hard not to cry as a hand wipes his cheek. A bandage is wrapped around his forehead. Both of his arms are almost completely missing, with the stumps in white bandages. His chest and abdomen are covered in what seems like a white paste, though the black burned skin is clearly visible beneath the salve.


*Given that these photos were mined from the internet, it's certainly possible they are not all of children in Iraq under the current occupation. But I found them on sites that presented them as such, and they are, if nothing else, all photos of children living under violent circumstances, many in the clear presence of military occupation that leads to their great injury and harm. My BADD post is late because I was trying to find mainstream media news sources for these photos that might include photo credit and caption info. That's proven difficult but I'll happily accept any info on any of these photos' origins that anyone might have.While these photos were at various sites, they were also grouped together at a site called Children of Iraq, where dozens of similar ones can be seen.