"It Didn't Go So"

"It didn't go so," she said under her breath. —Erna Brodber, Myal, p.84.

My first letter to a congressperson - 24 Dec 2014 10:36

//Tags: //

In North Carolina, the NAACP just won a campaign to get the FBI to do a full investigation of a suspected lynching-by-hanging in a small town east of here, the Charlotte Police Department is buying body cameras, the unarmed young black football player Jonathan Ferrell who was shot and killed by a Charlotte police officer last fall hasn't been demonized, and Randall Kerrick, the officer who killed Ferrell, was indicted by a grand jury and we might see him face trial.

Nonetheless, the Fraternal Order of Police has swung into high gear here as everywhere with blowback against protesters in the aftermath of the killing of the two officers in Brooklyn. The silence from protesters/organizers, here as everywhere, has been deafening. I've never written a letter to my congresspeople before, but in the absence of statements from organized groups of people (some of which I'm a member of), it's all I can think of to do.

Here's my draft:

North Carolina Fraternal Order of Police president Randy Hagler called in Tuesday's Charlotte Observer for laws and policies to protect police from citizens "who are attacking our officers at an alarming rate."

According to FBI crime statistics, out of almost one million federal, state, and municipal police, 27 died last year from injuries "incurred in the line of duty during felonious incidents." The rate of assaults and homicides on officers has steadily declined every year for over 20 years, and police work is currently less dangerous than landscaping, farming, bartending, or playing in the NFL.

On the other hand, officer-involved shooting deaths have increased by at least a third in recent years. Although police agencies do not submit the total number of people killed by their officers to the FBI, The city of Seattle found that one in five killings last year were committed by on-duty police. An estimate based on news reports suggests that police may have killed more than 710 people last year—-less than the number killed in domestic violence-related incidents and break-ins, but more than the number killed in gang-related incidents.

Black Americans have done much of the dying. The ACLU found that across the US, black people were more likely to be arrested and almost four times as likely as non-black people to experience the use of force during police encounters. Black people were less likely to be harboring contraband than whites, but were searched, arrested, and assaulted by police more often. Police are more likely to be killed by a white assailant, but black civilians are 21 times more likely than white civilians to be killed by an on-duty police officer.

There is little recourse for officer misconduct. I could not find North Carolina data, but according to Chicago Police Department data, between 2002 and 2004, Chicago residents filed 10,149 complaints of excessive force, illegal searches, racial abuse, and false arrests. Only 19 cases (0.18%) resulted in any meaningful penalty (a suspension of a week or more).

Across the country, police union representatives and Fraternal Order of Police executives are cynically using the tragic deaths of these two officers to threaten protesters who demand only the right to not be killed without due process. Hagler ridiculed politicians trying to "protect the community from our police officers" with what he called "frivolous laws." The only law protesters have called for is a law requiring police to wear body cameras, which may decrease police misconduct. I would prefer legislation compelling every police department in the US to report complete use-of-force statistics and disciplinary actions taken against police to the FBI.

Police forces would inspire confidence and trust by being accountable to the people and the nation in which they serve, rather than by trying to protect their own and smear their critics. Police forces around the country should use this moment of grief for their own to show compassion to the hundreds of families in this country who are missing someone this Christmas who was killed by a police officer this year. I encourage you to take the young protesters seriously and consider promoting legislation to improve police accountability and effectiveness. - Comments: 0

Ferguson health promotion training outline - 23 Dec 2014 04:36

Tags: first-aid how-to protest training

Download this outline as a 4-page PDF.

For medics in New York, Chicago, Oakland, and elsewhere who might have trouble keeping up with all the actions, one solution is to teach more than you run. Teach on streetcorners, teach after organizing meetings, teach before marches start or when they're kettled. Teach at jail support.

I'm teaching a 30 minute training after the next organizing meeting of a network of black lives matter movement groups here in Charlotte. Six to eight hour affinity group medic trainings are also super useful. For affinity group medics, teach first aid and encourage them to use SAMPLE as to learn their group members' health before they hit the street.

Here are objectives, agenda, materials, and details on the learning tasks from a 2.5-hour health and safety training Scott and Andrea and I taught in Ferguson in early November (before the non-indictment of Darren Wilson). Adapt it to your people! Feel free to ask any of us questions. My # is (504) 710-1604.


were unfortunately vague and not achievement-based or particularly evaluatable: "promote self-organization, self-determination, and self-support."


1. Intro activities 15 min
2. PEARL activity and debrief: 15 min
3. Best-dressed/best-prepared protester activity: 10 min
4. Violence, cops, and rights lecture/discussion 20 mins
5. Crowds, scene assessment, scene control activities/ discussion 10 min
6. Chem weapons lecture and eyeflush practice 30 min
7. Jail and court reminder 10 min
8. Social health lecture/ discussion; HALTS activity 15 min
9. Directing/diffusing acute stress lecture and check-out 15 min


  • "Strongly agree" sign for human barometer
  • Chart paper with PEARL, know your rights, HALTS, "have a buddy/ground/do something" as antidote to "isolation/dissociation/powerless feeling."
  • Local resources and national hotlines, particularly 24/7 peer support line: 513-931-9276. See Chicago resources and Ferguson resources.
  • Hand-outs on other stuff you might teach, like handcuff injury, jail support, or SAMPLE.


1. Intro

  • Go-round: "Name, are you from here or out of town, and one thing you wish you knew."
  • Human Barometer: "I got enough sleep last night," "People come to me to fix their problems" (what kind of problems?), "I have been pepper sprayed or tear-gassed" (people who haven't: do you have any questions for the people who have?).


(Physical vulnerabilities, Emotional vulnerabilities, Arrest/Assault risk, Role, Loose ends if arrested or in hospital)

  • Maybe do your last human barometer question on buddies, so you can see where people stand, opinion or experience-wise.
  • Tell'em why we dig buddies: (Two heads better than one, not going through anything alone, jail/court support, etc). Tell'em PEARL comes from Atlanta Copwatch (Why would Copwatchers want buddies?)
  • Demonstrate PEARL: Tell your buddy your real vulnerabilities: that makes it safe for everybody else to do it in a minute. Emphasize starting with Roles to see if y'all even want to do the same thing (march, make food, make puppets, do media, do jail support, etc).
  • Group members turn to neighbor and do PEARL.
  • Debrief. Some kind of question like: anybody find a good buddy? A bad buddy? Why? Would you use this with a friend? A stranger?
  • PEARL helps you know yourself and your buddy so you can have each others' back. It's like an advance directive: "here's what I'm like, what I want to do, what I need/like, what I don't want in my life, and how to talk to me." We learn this shit through coming back to these questions with a buddy again and again, before and after stressful, boring, and thrilling times.

3. Best-dressed

  • One trainer reads the weather report for this afternoon/evening off their phone.
  • Imagine the Grand Jury announced their decision right now, and we're going directly from here to the spot and staying out late. We're going to vote for who here is best dressed with what they came in for whatever may happen.
  • Encourage group to nominate 3 people. Sit them in front of group/in middle of circle.
  • Nominators say why their candidate should win. Encourage group (and candidates) to add reasons for or against each candidate.
  • Ask candidates worst conditions they've protested in, and how long they could stay out in those conditions.
  • Ask group what we could bring or do to help them stay out longer.
  • Give out prizes to all three, or say that when we put our warmth together, we all win!

4&5. Violence, cops, rights; Crowds

  • Why are there cops? Courts and prisons? (List reasons; don't let list get too pro or anti. This is about getting us all outside our boxes.)
  • What do cops do? Why do people want to be cops?
  • Boil it down to that cops use fear and the THREAT of violence to maintain current power relations.
  • Real quick know your rights for when you're caught alone: "Am I being detained?" You only have to provide name, birthdate, and home address. Other than that: "I won't talk. I want a lawyer." (In Chicago we also talk about how to use the First Defense Legal number, 1-800-LAW-REP4)
  • In crowds, cops have their bosses, legal observers, and (sometimes) media watching them, so they are more disciplined and less lethal. But their power to contain or disperse is still entirely in their ability to scare people.
  • We want to understand their weapons, training, and strategies, so they lose their power to scare us. The difference between a scalp wound from falling down and a scalp wound from a police baton is nothing more than fear. The physical injury is the same.
  • Ask what injuries people in the group have gotten or seen from cops in crowds. We'll probably be mostly hearing about blunt force from batons, projectiles, barricades, or vehicles; falling down (palm abrasions, bruises) and twisted ankles from fleeing; and lacrymation from tear gas/pepper spray. "Anybody see someone's palm burned from picking up a tear gas canister and throwing it back?"
  • The point of the discussion is for people to teach each other where injuries come from so they can think about risk and how to avoid more risk than they want — and how minor the physical injuries from streetfighting usually are. You can answer a few questions. Emphasize that we'll cover chem weapons in a minute.
  • Show'em how you hang onto your buddy for a 360 degree view; how you make space in a crushed crowd and make a privacy circle for someone who fell down; how you start a chant of "WALK, WALK" (and why you don't yell "Don't RUN!"), how you walk with great intention.
  • Talk about rumor control, looking for exits, and as much as you feel comfortable about topics like the matrix of force and ranked kettles used to assess the risk preference of a crowd.

6. Eyeflush

  • Go outside in the cold with water bottles, LAW bottles, and ponchos.
  • Pepper spray and tear gas hurt; for most people the effects go away within 30 minutes in fresh air and no other treatment.
  • Danger: can't see, disoriented. Solution: escorting to safety or "Come toward my voice"
  • Danger: asthma/breathing difficulty. Solution: scan crowd for silent sufferers in tripod position, escort to safety, help with inhaler, prepare to go to hospital or home with them.
  • Danger: contacts trap chemicals against eyes; eyeflush can make contact slip into eye socket. Solution: Public education. Write "Contacts?" on bottom of eyeflush bottle so you never forget to ask. They take their own contacts out and dispose of them before eyeflush. They can't be clean. Prepare to help them get home or to a safe place they can meet friends later.
  • Dangers: Rubbing eyes, losing glasses, getting wet from eyeflush, not paying attention while eyeflushing. Solutions: hands on knees, they hold their glasses, use a poncho, have a buddy who watches the scene.
  • Show eyeflush technique. Emphasize gloves, how to get eye open, tilting head so water runs away from tearduct, force of stream. Answer questions.
  • They practice.
  • Explain LAW: aluminum hydroxide/magnesium hydroxide (Maalox or Mylanta) antacid (plain or flavored, no alcohol, simethicone ok), 50:50 with tap water. Eyeflush works by mechanical force, LAW and milk work by buffering action.
  • Bag outer clothes before entering enclosed areas (car, bus, house), 30 minute shower (watch you don't let it run from hair into eyes or junk), wash clothes with harsh detergent.

7. Jail and court

  • Wait for friends to get out (dress warm and bring stuff they like).
  • If arrested, friends should call Jail Support with your name and birthdate (make sure everybody has #).
  • Don't lose your paperwork.
  • Go to court with your friends.

8. Social health

  • Have a buddy, know yourself, know your buddy, ground yourself, have a plan.
  • Facilitate brief support group. Purpose: to acknowledge the stress of waiting; how some people can't sleep and isolate; how people are scared and some are even suicidal. How friends and family might not understand experiences. Get feelings out more than stories.
  • 12-step groups identified HALTS (Hungry, Angry, Lonely, Tired, taking self too Seriously) as concrete reasons for relapse. Psych peer-run groups identified prolonged lack of sleep as far and away most common cause of psychosis and suicidality.
  • We're taught to find out if someone in crisis has a plan and the means, and then take away their remaining options by calling 911 without their consent. That's fucked up. What we should be doing is HALTS for ourself and them: help them figure out how to eat if they're hungry, how to let go if they're angry or beating themself up, how to connect if they're lonely or get space if they're crowded, how to sleep if they're tired, and how to laugh at themself.
  • We can plan with them, hang out with them, put them in touch with a hotline, or help them get ready to the hospital, but it's their call. And it's your call when you need to back the fuck up and do you.
  • Check in with your buddy: HALTS?
  • Debrief: Learn about any unmet needs? Training's over in 15 mins so you can go do you.
  • Another way to do it: "What did you do to take care of yourself today. What do you need to do?"

9. Check-out

  • Standing steady despite scary scenes, cop tactics, shitty weather, feeling isolated, and neglecting needs are what this training is about.
  • Acute stress response: adrenaline preps you to fight or flee. When we freeze or feel like we have to wait, it gets toxic: Isolation, dissociation, and feeling powerless.
  • Solution, not that hard. Have a buddy (fuck isolation), ground yourself in your emotions and what's really happening around you (fuck dissociation), and do something (you are *not* powerless). What you do: that's between you and your buddy.
  • Human barometer: "Someone in my family understands me and why I'm out here." "I'm ready for the grand jury decision to come back." "I'm ready for another month of waiting."
  • Check-out: low-point/high point.
  • Thank you all!!!!


PEARL was invented by earthworm of Atlanta Copwatch in 2012 or 2013. The "best-dressed protester" exercise was invented with Greg Rothman for a training we taught in 2014 in Maryland. The facilitated discussion about police was invented by Scott Mechanic of Chicago Action Medical for a training we taught in Chicago in 2014. The wording of the brief know your rights training is from We Charge Genocide (Who I think got it from First Defense Legal). Thanks to Black Cross Health Collective for LAW, Ann-Marie in Chicago for the "S" in "HALTS," Sugar Solidarity from Chicago Action Medical for "What have you done to take care of yourself today?" Ace Allen for acute stress response, and Trenton for Low Point/High Point. - Comments: 0

Expelling the boogeyman part 1 - 10 Oct 2014 21:08

Tags: blame violence

We must … be careful not to idealize community or to assume that turning away from the state will automatically replace punishment and separation with restoration and reconciliation [Bibliography item opa11 not found.].

Expelling Lily

I was the medical officer at an environmental justice training camp in the central Appalachians over a decade ago. Aware that camps full of young people are high-risk environments for sexual confusion and assault, I did 5-minute talks each morning and night about communication skills, recognizing discomfort, the role of alcohol, and coming to me or another advocate for help. Despite resistance from some campers, the organizers established an alcohol-free sleeping area and an alcohol-free fire circle.

After my first talk, one of the campers told me two campers told him "Lily" (a young woman camper) was in an "accountability process." They were passing word around the camp. I invited the concerned campers and Lily to tell me what happened, and the facts were not in dispute.

A year prior, Lily was "called out" by two women she sexually assaulted at drunken campouts. She didn't use threats or physical force, but both women had lasting feelings that something wasn't right. After the women realized their experiences were similar, they initiated the accountability process. Lily resisted seeing her harm at first, then agreed to seek sobriety, get counseling at her own expense, not hide or minimize what she did, and not go to any event attended by the women she hurt. This camp was her first political event since the beginning of the accountability process a year prior. She was sober, and no one at the camp had been harmed by her.

We made a mistake, then, because the three campers who knew about the accountability process wanted expulsion and I thought it was unfair. We decided to let the camp decide, but didn't give the camp all the information about what was happening.

That night at the evening fire, the situation was described matter-of-factly, but de-gendered. Here's what we told them: Someone in camp sexually assaulted two people while drunk over a year ago; abided by all conditions of the accountability process, and was in the camp and sober. Three people wo were not sexually assaulted by the person want the person to leave. What should we do?

The response quickly degenerated into men summoning the boogeyman. They imagined the unnamed Lily to be male,1 hiding behind bushes in the dark with a knife, waiting to ravish young, defenseless girls.

The men dominated the conversation, and concluded: We're here for the environment and don't want to be sidetracked by feminist bullcrap. Drop him off by the side of the road, make sure he's gone, and let him find his way home. They decided the boogeyman didn't need a beat-down if he left in the next ten minutes, but that they should post guards in the camp to beat him with baseball bats if he came back. They wanted someone to go with their boogeyman to make sure he was really gone.

At that point, Lily stood up and said, "Okay, I'll go home. The last year was really lonely and hard. I hoped to be able to get involved in this work again, but I guess it's not time yet." The group froze, and then a few of the most vocal men very quickly decided that she could stay. She was not, after all, the imaginary boogeyman, or even male.

She left anyway. It was 11pm. I made sure medical was covered while I was gone. I rode with her to a highway overpass and sat with her til she caught a ride in the morning. She felt herself a victim of injustice and was afraid she would never be allowed to return to environmental justice work no matter what she did. We talked about her responsibility to remember the hurt she caused because it was too easy for her to drink and cause harm when she felt like a victim.

The scope of the problem

Sexual assault has long been known to be common where youth with high ideals share mass-sleeping arrangements, where adrenaline and alcohol mix and new relationships are negotiated [Bibliography item casnd not found.].

  • At least 1 in 4 college women has survived rape or attempted rape. 300,000 college women report surviving rape every year.
  • At least 80% of all sexual assaults are committed by an acquaintance.
  • 48.8% of college women who were victims of attacks that met the definition of rape did not consider what happened to them rape.
  • 74% of perpetrators and 55% of rape victims had been drinking alcohol prior to the assault.
  • In a survey of high school students, 56% of girls and 76% of boys believed forced sex was acceptable under some circumstances.
  • About 1 in 10 college men admit to acts meeting the legal definition of either rape or attempted rape.

Expelling Lily did not solve any of these problems; it only hid them. Nonetheless, time and again, we expel Lily. Why?

Denial, minimization, and blame

Let me start by taking expulsion as a good option. If we wanted to purge our 300-person environmental justice camp of everyone who had raped or attempted rape, we would have to hunt down and send home 30 people. We can turn to Lisak & Miller's paper "Repeat Rape and Multiple Offending Among Undetected Rapists" [Bibliography item lis02 not found.] for characteristics we can use to detect the 19 men in camp who were statistically likely to each commit an average of 5.8 unreported rapes:

  • They use alcohol deliberately to render victims more vulnerable.
  • They easily feel slighted by women, and carry grudges against them.
  • They view women as sexual objects to be conquered and coerced. They view sexual relations as "conquests," and all women as potential "targets" of conquests.
  • They also commit and valorize non-sexual interpersonal violence.
  • They are adept at identifying "likely" victims and testing their boundaries. They use sophisticated strategies to groom their victims for assault and to isolate them physically.

The five men who led the clamor for Lily's expulsion, then changed their minds upon discovering that she was female had previously forcefully argued that sober spaces at the camp were unnecessary. They were part of a hypermasculine subculture that drank heavily, bragged of sexual conquests, played white knight, and felt that discussions of sexual assault were a diversion from the real work of aggressive activism.

If the word "rape" is not used but rather the behaviors legally constituting rape or attempted rape are described, perpetrators will self-identify [Bibliography item whi06 not found.]. If expulsion were a solution, the inquisition could begin. I betcha I can predict five of the 30 campers who would be purged.

Along with ignoring, denying, and minimizing, blaming people who have been assaulted is a well-established way that assailants and abusers defend themselves, and that bystanders protect them [Bibliography item hes11 not found.]. Could shifting blame onto known assailants or abusers serve a similar function? How do groups decide who they defend and who they expel?

:casnd : New York State Coalition Against Sexual Assault (n.d.), College Campuses and Sexual Assault; One in Four USA (n.d.), Sexual Assault Statistics.
Jacob Z Hess, Nicole E Allen, and Nathan R Todd (Jul 2011), Interpreting Community Accountability: Citizen Views of Responding to Domestic Violence (or Not). Qualitative Report 16(4):1096-1123.
David Lisak and Paul Miller (2002), Repeat Rape and Multiple Offending among Undetected Rapists. Violence and Victims, 17 (1), 73-84.
Julia C Opara (2011), Afterword: After the Juggernaut Crashes. Social Justice: A Journal of Crime, Conflict, & World Order 37(4):44-57.
JW White, KM Kadlec, and S Sechrist. (2006). Adolescent Sexual Aggression within Heterosexual Relationships. In HE Barbaree (Ed.) and Marshall, W. L. (Ed.). The Juvenile Sex Offender (2nd ed., pp. 128-147). New York: Guilford Press.

[[/bibliography]] - Comments: 0

Bombs and advisors in Iraq and Syria - 01 Oct 2014 18:56

Tags: war

There are powerful roles that practitioners, educators, and other workers in public health can play in preventing war itself, as well as mitigating the public health consequences of war.

— APHA position paper (2009): The Role of Public Health Practitioners, Academics, and Advocates in Relation to Armed Conflict and War [Bibliography item aph09 not found.]

The US news portrays Sunni militants flying the Islamic State flag as brutal, unstoppable, and threatening to civilians in the the US. Anti-ISIL airstrikes began again in northern Iraq almost two months ago, and the US has been arming and training anti-Sunni militias for an indeterminate amount of time. Most of ISIL's killing was done this year, and amounts to as many as 9,000 dead, including two Americans beheaded to protest US airstrikes. In this blog post, I hope to challenge the idea that more US military intervention in Iraq will serve the interests of any civilians anywhere.

Health impact

ISIL's body count is big and their brutality is terrifying, but it would be wrong to consider them the most violent actor in their region. It would take sixteen years like 2014 for them to rack up the Assad regime's death toll in Syria's 3-year war, and a century to match US kills exceeding a million after thirteen years of preventative war in Iraq, Afghanistan, and elsewhere in the Islamic world [Bibliography item apb14 not found.;Bibliography item wii14 not found.]. Saudi Arabia consistently funds and sends fighters to al-Qaeda, the Taliban, ISIL, and almost every group targeted by the US global war on terror, but is regarded as an ally by the US [Bibliography item bre13 not found.].

This summer, Sunni leaders plead for a non-military negotiated solution to ISIL's brutal insurgency and the resurgence of Shia militias [Bibliography item mui14 not found.]. US- and Iran-backed Shia militias undermined the political process in recent years by massacring unarmed Sunni Iraqi protesters [Bibliography item zun14 not found.]. Sunni adherents were ethnically cleansed from Baghdad [Bibliography item izand not found.]. Hundreds of Sunni civilians were rounded up by Shia forces and continue to be held on vague charges [Bibliography item fah14 not found.;Bibliography item mui14 not found.]. The US ignored the call for negotiated political solutions, instead seeking to "degrade and destroy" ISIL via aerial bombing, and continuing to advise and arm anti-Sunni militias.

The World Health Organization recently found that "civilian war deaths constitute 85% to 90% of casualties caused by war, with about 10 civilians dying for every combatant killed in battle." War hurts children's health, leads to displacement and migration, and diminishes agricultural productivity. Child and maternal mortality, vaccination rates, birth outcomes, and water quality and sanitation are worse in conflict zones. War contributed to preventing eradication of polio, facilitated the spread of HIV/ AIDS, and decreases availability of health professionals. [Bibliography item wii14 not found.]. Airstrikes and increased militarism degrade and destroy everyone except militants.

Air strike trauma stories

In the 1960s, US Strategic Air Command began covert aerial bombing in Cambodia against Viet Cong and People's Army of Vietnam bases and sanctuaries. The US Seventh Air Force inherited the campaign in 1970. They expanded and refocused the bombing on the growing local insurgency, the Khmer Rouge. By 1973 the US Air Force had dropped 2,756,941 pounds of bombs,1 directly killing more than 750,000 Cambodians.

The US bombing campaign "significantly increas[ed] the recruiting capacity of the Khmer Rouge, whom over the course of the bombing campaign transformed from a small agrarian revolutionary group to a large anti-imperial army capable of taking over the country" [Bibliography item kie96 not found.]. The US lost the proxy war and withdrew from the increasingly dire civil war it had provoked. In the four years following 1975, the Khmer Rouge government systematically killed almost a quarter of the Cambodian population in the worst genocide since the holocaust.

Aerial bombardment nourished civilian support for Taliban and al-Qaeda anti-US insurgencies. Speaking in March 2010, the US Chairman of the joint chiefs of staff said that "civilian deaths caused by American troops and American bombs have outraged the local population and made the case for the insurgency" [Bibliography item sha10 not found.]. Before air strikes against ISIL began this summer, the US had launched more than 94,000 air strikes since 2001 — mostly on Afghanistan and Iraq, but also on Libya, Pakistan, Yemen and Somalia.

Former Khmer Rouge official, Chhit Do, described the propaganda power of US bombing:

Every time after there had been bombing, [we] would take the people to see the craters, to see how big and deep the craters were, to see how the earth had been gouged out and scorched… The ordinary people… sometimes literally shit in their pants when the big bombs and shells came… Their minds just froze up and they would wander around mute for three or four days. Terrified and half-crazy, the people were ready to believe what they were told… That was what made it so easy for the Khmer Rouge to win the people over… It was because of their dissatisfaction with the bombing that they kept on cooperating with the Khmer Rouge, joining up with the Khmer Rouge, sending their children off to go with them… sometimes the bombs fell and hit little children, and their fathers would be all for the Khmer Rouge [Bibliography item kie96 not found.].

Sunni civilian leadership in Iraq organized against and fought ISIL before the US bombing began. Recent US-sponsored shelling and airstrikes killed civilians and refugees, brought a rival al Qaeda-affiliated militia together with ISIL, and drove recruitment of more than 6,000 new fighters [Bibliography item chu14 not found.;Bibliography item haa14 not found.]. Bombing trauma stories are likely to make more civilians cynical of political solutions and willing to bear arms with extremists to settle grievances.

Military advisors

The US demobilized the Iraqi army that served under Saddam Hussein, and organized, advised, and equipped an inexperienced sectarian Shia army. Many of the experienced officer corps of the previous Iraqi army, prohibited from serving in the new regime, participated in the anti-US insurgency in Iraq and the anti-Assad insurgency in Syria, and now form the officer corps of ISIL.

ISIL conducts mobile offensives — mostly from the back of pick-up trucks — on flat ground. Their stock of weapons and ammunition originated almost entirely from US military aid. The US directly supplied arms to the anti-Assad forces of which ISIL is one faction. Much of the heavy weaponry was captured from the the well-equipped2 Shia Iraqi military that the US put in place of Saddam Hussein's formidable armed forces [Bibliography item car14 not found.]. The Iraqi army is formidible in Shia-controlled areas, but halfheartedly abandoned tanks and heavy weaponry when sent to fight in Sunni areas.

Even as US bombs fall, all sides of the conflicts in Syria and Iraq are fought with US weapons and munitions. In 2011 the United States ranked first in worldwide conventional weapons sales, accounting for 78% of global weapons sales [Bibliography item wii14 not found.]. Through foreign military aid programs, the US provides the money to buy most of the weapons it sells.3 Before ISIL, the US provided training, funds, and arms to mujaheddin (who became the Taliban) against the Soviet Union, and Somali irregulars (who became al-Shabab) against Ethiopia. The US provided arms and advice to Saddam's Ba'athists even as they used poison gas against civilians in Iran, and — before the rise of Islamic fundamentalism — sponsored coups by dictators like the Shah in Iran [Bibliography item asp02 not found.;Bibliography item sid07 not found.]. In a world with a sole military superpower, it isn't surprising when that superpower arms and trains all the groups it eventually fights.

Militarism and trauma narratives

Militarism is the deliberate extension of military objectives and rationale into shaping the culture, politics, and economics of civilian life so that war and the preparation for war is normalized, and the development and maintenance of strong military institutions is prioritized … It glorifies warriors, gives strong allegiance to the military as the ultimate guarantor of freedom and safety, and reveres military morals and ethics as being above criticism … Studies show that militarism is … negatively related to respect for civil liberties, tolerance of dissent, democratic principles, sympathy and welfare toward the troubled and poor, and foreign aid for poorer nations [Bibliography item wii14 not found.].

Once produced and distributed, most modern weapons have a long service life. An AK-47 can fire 60-70,000 rounds before the barrel starts to erode and accuracy suffers. That's easily enough for 20—30 years of continuous duty in a hot war. There are AK rifles in use in Africa with the rifling in the barrels worn almost completely away leaving a near-smooth bore, and the rifles are still shooting. Almost half of US taxpayer dollars go into military spending, which directly or by proxy keeps the weapons coming off the assembly line and the bullets from running out [Bibliography item wii14 not found.].

As durable as weapons are, the other products of military advisor relationships are even more long-lasting. Militarism, once built up in a society, can last for decades, and trauma stories persist for generations and become woven into cultural and historic identity.

Societies emerging from brutal wars include tens of thousands, if not hundreds of thousands of … victims and perpetrators, shackled by their own pain and fear and unable to participate fully in life or in postwar reconstruction … The great majority of people are guilty of acts of omission and comission, acquiescence and witnessing, silence and suppression … People are never sure of the mindset of those to whom they are talking [and] never sure what they need to conceal….

Yet, in this silence, stories are constructed and relayed … These stories provide meaning and explanatory frameworks in a postwar context in which people no longer trust in what they used to believe … These stories travel across generations. They sustain the trauma narrative by providing encapsulated messages as to why one group must always be percieved as cruel, dominating, racist, or evil and the other group must always stay on guard [Bibliography item sid07 not found.].

So what?

This is part one of a two-part blog post. The second part discusses promoting health in Iraq, Syria, and the rest of the Levant.

Associated Press in Baghdad (18 Jul 2014). Iraqi Civilian Death Toll Passes 5,500 in Wake of ISIS Offensive. The Guardian.
APHA position paper (2009). The Role of Public Health Practitioners, Academics, and Advocates in Relation to Armed Conflict and War.
Robert Asprey (2002). War In The Shadows: The Guerrilla in History. Morrow & Co.
Gary Brecher (19 Dec 2013). The War Nerd: Saudis, Syria, and "Blowback". Pando Daily.
Conflict Armaments Research (Sep 2014). Dispatch from the Field: Islamic State Weapons in Iraq and Syria: Analysis of Weapons and Ammunition Captured from Islamic State Forces in Iraq and Syria.
Martin Chulov (28 Sep 2014). ISIS Reconciles with al-Qaida Group as Syria Air Strikes Continue. The Guardian.
Kareem Fahim, Azam Ahmed, and Kirk Semple (11 Sep 2014). Sunnis in Iraq Often See Their Government as the Bigger Threat. New York Times A9 (New York edition).
Haaretz (19 Sep 2014). Islamic State Recruitment Soaring in Wake of US Bombing. Haaretz.
Michael Izady (n.d.). Ethnic Cleansing in Baghdad (map series). Colombia University School of International and Public Affairs Gulf/2000 Project.
Ben Kiernan (1996). The Pol Pot Regime: Race, Power, and Genocide in Cambodia Under the Khmer Rouge. Yale University Press.
Jim Muir (29 Aug 2014). Iraq Crisis: Sunni Rebels "Ready to Turn on Islamic State". BBC News.
Thom Shanker (4 Mar 2010). Joint Chiefs Chairman Readjusts Principles on Use of Force. New York Times A16 (New York edition).
Barry Levy & Victor Sidel (2007). War and Public Health, 2nd ed. Oxford University Press.
William H. Wiist et al. (Jun 2014). The Role of Public Health in the Prevention of War: Rationale and Competencies. American Journal of Public Health 104(6):e34-e47
Stephen Zunes (25 Jan 2014). The US Role in Iraq's Upsurge in Violence. National Catholic Reporter.

[[/bibliography]] - Comments: 0

Finding and using community resources - 30 Sep 2014 06:11

Tags: how-to resource

When someone is having a hard time, friends or family sometimes say, "You need help" or "You need professional help." But all people actually have the same basic needs — enough to eat, a safe and restful place to sleep, supportive community, meaningful work, dignity, and persona growth. "Help" isn't a need, but a way to decide and get what you need!

Deciding who to call

When you decide to reach out to community resources, you have to decide who to call. Ask yourself these questions:

  • Are you calling for yourself? Are you calling for someone else? Is someone else making the call for you? The person who wants support should make her own decisions, even if she doesn't make the call herself.
  • What do you want? Often people think of an institution or program before they think of their wants or needs. For instance, if you are thinking of going to an emergency room, what do you actually want? Would a free clinic, a mental health crisis line, or a friend be better or worse options?
  • What obstacles might you encounter? It is important to plan for obstacles, understand how programs work, and learn how to get what you actually want. For instance, some programs only accept people who can prove they are homeless. Other programs only accept people who can prove they have a legal address. Are you prepared to prove homelessness or residency?

Make a list of who you want to call and any questions you have. It can also help to write down what you want, and how you think each call might help you get it.

Tips for health promoters

Call all numbers on your referral list except 911 before you have to use them. Tell the operators that you don't need their services right now, then ask about what services they provide and how to access each service. Visit places you might send people so you can give good directions.

Some helplines and advocate lines require you to leave a name and number and be called back within ten minutes. Calling all the numbers on your list helps you learn how each service operates.

If you're building a resource list

Be sure to include resources from these categories:

  • Financial assistance and free care
  • Mental health services
  • Substance abuse services
  • Sexual assault and domestic violence advocate services
  • Disability rights and resources
  • Services for undocumented immigrants
  • Sexual health promotion and pregnancy options
  • Non-emergency basic needs - Comments: 0

Street medic stories - 24 Sep 2014 01:03

Tags: history protest

Excerpt from the introduction of my new book North American Street Medic History 1999—2004, due out this week from Katuah Medics Collective.

“I think we told too many stories. Although some of them helped to illustrate points in a way that straight lecture could not, some others were unnecessary… A couple of comments in the evaluations are in this same vein, although one person also listed 'Doc's anecdotes' as their favorite portion of the training.” — from critique of 2004 medic training by the co-trainer, Soph.[Bibliography item soph04 not found.]

Despite silences in our public history, medics are not known for our silence. We speak up in trainings and evaluations. We give testimony to hold public officials accountable. We produce widely-read hand-outs and public health messages. We question, critique, and debrief, and can't resist weaving yarns of the things we've witnessed. Medics tell stories.

Our best stories add intimacy to big events in history. Hundreds walked on the Selma to Montgomery marches which led to the passage of the 1965 Voting Rights Act. Only medics tell the story of caring for the feet of 600 people walking 60 miles in their Sunday best shoes — feet that ached, blistered, and were rubbed raw but kept walking. Stories in this book restore the physicality of sweat and bruises to civil unrest in our time.

Our most useful stories tell how things were done. All the protests in this book predate universal adoption of cell phones. You'd better believe we told stories about fundraising thousands to rent UHF radios and trunk repeaters, confusion over radio protocols (what the heck is a 10-9?), and cops jamming our signals. In this book you'll find stories about practical things like organizing a field clinic, caring for injuries from impact munitions, and reconciling after conflict.

Our worst stories are contemptuous stories we tell about being better than someone else. We sometimes let contempt for each other breed from the results of bad decisions or differences in protocols. There's credible evidence that at least one of our schisms was deliberately created by the FBI. That's not who I work for, so this book won't rehash medic drama. It will share some of our process of getting past it.

This book documents the social process of street medics emerging as an independent subculture, distinct from the campaigns we support. In the process, we learned from EMTs to be contemptuous of some of the protesters we turn out to support. This book encourages medics to foster closer ties with other protest organizations and healthcare professionals by showing how we are them, and they take risks for us.

I hope this book invites you into greater intimacy with people in moments of social unrest and equips you with greater preparedness for social upheaval. All medic methods of self-organization and protocols became convention because someone did something different in the past, it worked, and it entered our stories. These are some of the stories that built our flexibility, curiosity, and toolbox of practical skills. This book widens the audience.


[[/bibliography]] - Comments: 0

Packing your first aid kit - 08 Sep 2014 00:28

Tags: first-aid how-to

New medics usually don't pack their kits well. You might identify medical supplies with social status and hoard unnecessary or rarely useful supplies, or supplies you don't know how to use. If you have a chaotic bag, you forget basics or lose them in your bag.


The only essential basic supplies are those you use to protect yourself (from weather, bodily fluids, etc.). If you have exam gloves, proper clothing for the weather, a change of socks for yourself in a ziploc bag, and a bottle full of your personal drinking water, you can improvise or quickly source much of the rest.

  • Ask businesses for trash bags. Rip or cut arm and head holes in them. Hand out homemade ponchos.
  • Grab free packets of honey from a Starbucks and use them for wound ointment.
  • Ask a bar or restaurant for lemon or lime wedges for cold-fighting vitamin C.
  • Ask a pizzeria for cayenne pepper flakes for keeping toes toasty.


These supplies are difficult to improvise when you need them, so keep them handy.

  • 15 pairs of nitrile or vinyl gloves that fit you (they come in s, m, l, and xl), packed in ziploc bags (2-3 pairs per bag). Keep a couple pairs in a ziploc in your pocket in case you lose your pack.
  • 30 nonsterile 2x2 gauze squares packed in ziploc bags.
  • 5 sterile 2x2 gauze squares packed in a ziploc bag (one of these plus tape equals a band-aid).
  • 5 sterile 4x4 gauze squares packed in a ziploc bag (one of these these plus wound ointment and roller gauze equals a dressing change).
  • 5 gauze bandage rolls.
  • 2 ACE-type compression wraps
  • 1 roll of 1 inch medical tape (micropore, transpore, or silk tape).
  • Some duct tape (less than 1 roll, wrapped around your pen or something)
  • 1 unit of wound ointment or wound salve (like ching wan hung burn ointment, honey, or a salve recommended by your local herbalist).
  • 1 liter of water in a sports-top bottle you don't drink from (for washing wounds, hands, etc.).
  • 1 small bottle of liquid soap packed in a ziploc bag in case it leaks, or individually-packed castile soap towelettes (for washing wounds and hands).
  • 1 bag of cough drops, slippery elm lozenges, or slippery elm bark.
  • Trauma shears.
  • A change of socks.
  • Lightweight high energy food (like energy bars, nuts, or dried fruit).
  • Pen and paper.
  • A handbook (like Buck Tilton's Backcountry First Aid and Extended Care, or bookmark one of the first aid guides on this page in your phone).

Pack your kit in a few quart-sized ziploc bags to shield it from leaks, weather, and contamination. Put the ziploc bags in a convenient location — a fanny pack, fishing vest, small backpack, or shoulder bag.

Additional items

The kit lists below should get you thinking about how important the basics are in all kinds of situations. If members of your group are trained to manage these situations, you may carry some of these supplies, stockpile them in a bin, toolbox, or locker at your housing site, or keep them in your car. If you carry them, pack them underneath the basics, so you can get your most important supplies easily.

Most medics pack only for the situations they see most often. If you find yourself in a situation unprepared, be safe, support the person's dignity, use community resources, and collect the supplies to be prepared the next time.

Cold weather care

These items are useful for cold-weather care.

  • Personal preparation, including a buddy, so you do not become a casualty.
  • Hats and dry socks packed in ziploc bags; emergency ponchos.
  • Water; especially hot water in thermoses with refill options and disposable cups. Instant hot chocolate, instant miso soup, instant hot cider, ginger tea with honey, or Jell-o (with sugar) for the hot water; something to stir with.
  • Candied ginger and other snacks.
  • Instant handwarmers or a microwavable rice bag handwarmer.
  • Talcum powder.
  • Cayenne powder or flakes.
  • Mylar emergency blankets and other insulating materials.

Do not dispense or administer any pharmaceuticals. If the person wants Burow's solution/Domeboro from the pharmacy for a foot soak, give her directions to the nearest pharmacy. When she returns, draw the water and let her mix the remedy into the foot soak basin.

Care of infected wounds

These items are useful to have on hand for dressing change and care of infected wounds.

  • Plenty of nitrile or vinyl gloves that fit you (packed in small ziploc bags for your carry kit).
  • Plenty of clean sterile or nonsterile gauze squares packed in small ziploc bags (2x2, 3x3, or 4x4 are good sizes).
  • Soap, water, and a basin or sink.
  • A way to heat water for a wound soak or compress (an insulated container to carry hot water from a nearby friendly business; a cookpot and stove, hotplate, can of sterno with rocks or bricks to elevate your pot, camp stove, etc. Don't forget a lighter or matches if you will need it and fire safety equipment like a fire extinguisher, wool blanket, or bucket of wet sand).
  • A big container of table salt (poured into a labeled ziploc bag) and (optional) a small container of bleach.
  • Cling wrap or a clean plastic bag.
  • Individual packets of honey, a tub of drawing salve, or a tube of ching wan hung ointment.
  • Sterile gauze squares (3x3 or 4x4), preferably Telfa non-stick dressings.
  • Roller gauze, silk tape, and a permanent marker (for labeling dressings).
  • Biohazard trash bags.
  • Antiseptic surface cleaner and paper towels or antiseptic surface wipes.

Acquiring supplies

The most expensive place to get supplies is at a pharmacy. Good local medical supply companies are much better, and you can put in a big order then pick it up. Internet ordering is also a good idea. Try boundtree.com, amazon.com, and eBay, or call manufacturers and ask for factory seconds or overstock as a donation. If you have a nonprofit sponsor it can be tax-deductible for the donor.

Consider keeping a supply dump somewhere for your group with an inventory person who keeps everything organized so medics can resupply on the fly, and replenishes the supply dump when anything gets low.

Another perspective

If you're browsing galls.com and very tempted by that $200 pre-packed kit, please read this blog post about first aid kits by my old friend Anne before you buy anything. The take-home message? One size never fits all, and training is way more important than ownership. - Comments: 0

Civil rights shouldn't expire at sundown - 25 Aug 2014 04:15

Tags: protest

Killing a black mother's son

In the middle of the day two weeks ago, on August 9, unarmed black 18-year-old Mike Brown jaywalked in his grandma's housing complex. Officer Darren Wilson got out of his car and shot Mike Brown six times, killing him. A hundred people saw Brown's body where it lay uncovered in the street for hours. Despite witnesses, physical evidence, and autopsy reports, Officer Wilson has not been arrested. You know this because of what happened next.

What happened next

The last two weeks have been terrifying, exhilarating, and exhausting. Squads of white police in military fatigues with assault rifles and 40 mm grenade launchers drew down on unarmed Americans. More than 160 arrests later, the only known killer is still free. Beyond the nightly taste of teargas, the militarization of Ferguson caused public school closures, which hurt working parents and kids who depend on school lunches. Buses were re-routed and roads were closed, so third-shift workers had to make do with smaller paychecks. Elderly people depended on neighbors to help with activities of daily living because police barricaded them in their neighborhoods.

Neighbors visibly mobilized to call for the indictment of Officer Wilson. At the same time, they cared for each others' concrete needs: informally, through new organizations like Operation Help or Hush, and through established institutions like the public library, Greater St. Mark Family Church, and the United Way. Supporters and detractors rallied across the country, converging on Ferguson in ways that helped and ways that harmed.

Checking the tide

Last week, organizers and residents directly asked my colleagues to help check the tide of well-meaning whites flooding Ferguson. If you are white and want to go, please think, first, about what you can do from your hometown. Consider these facts:

  • Your local or university police department is equipped with the same precision weapons and tactical gear you saw in Ferguson.
  • Last year, one in five killings in Seattle was at the hands of a police officer. Nationally, US police report that they kill an average of 400 people each year, while last year 45 police died of all causes while on duty.
  • In the last month, police killed at least Mike Brown in Ferguson, MO; Eric Garner on Staten Island, NY; Ezell Ford in Los Angeles, CA; Dante Parker in Victorville, California; and John Crawford in Beavercreek, Ohio. Many more unarmed black men were injured but not killed. Every 36 hours there's an extrajudicial killing of a black person in the United States. Chances are good there's a grieving family near you.
  • Fans raised almost half a million dollars for Officer Darren Wilson. Charles Murray, who identifies as Imperial Wizard of a South Carolina chapter of the KKK, is one of the few raising funds for Wilson who has not remained anonymous. Overt racist comments are commonplace on the crowdfunding platforms and facebook pages supporting Wilson.
  • If you have white family, friends, or colleagues, or if you work in law enforcement, you have heard people you know change the subject, try to justify the killing of an unarmed teenager, or tell you how bored they are by the whole thing.

The best place to challenge these trends is where you are. Here are some ideas:

You want me to focus on the looters, but I stay focused on the shooter.
—- Protest sign in Ferguson

What happened was a tragedy in a long line of tragedies. It will take political will and political power to change the story of the future. Wherever you are, there is something to do that must be done. You are creative. Do it. - Comments: 0

Notes and resources for Ferguson protests - 17 Aug 2014 06:58

Tags: protest resource

Health and safety information


First Aid guides:


Medical support people are encouraged to read and consider these ethical guidelines.

For clinicians:

Local resources

Phone numbers

  • Emergency Services: 911
  • Jail Support: gro.omgnizinagro|nioj#gro.omgnizinagro|nioj or (314) 862-2249
  • United Way (for food assistance, counseling services, etc): 2-1-1 or 1-800-427-4626
  • The Organization for Black Struggle (OBS): moc.oohay|evomehtno_sbo#moc.oohay|evomehtno_sbo or (314) 367-5959
  • Crisis Intervention and Suicide Prevention: 314-647-4357 or 1-800-273-8255
  • Alive Domestic Violence Hotline: (314) 993-2777
  • Homeless Hotline (St. Louis area): (314) 802-5440
  • St Louis AA (24/7): http://www.aastl.org/ (314) 647-3677
  • St Louis NA (24/7): http://stlna.org/ (314) 830-3232
  • Peer Support Warmline (24/7): (513) 931-9276
  • Veterans Peer Support Warmline (24/7): 1-877-927-8387
  • Sex Info Line (M-Th 5-11p, F 5-8p, Sa 4-7p): (415) 989-7374
  • National LGBT Hotline (M-F 3-11p, Sa 11a-4p): 1-888-843-4564
  • Backline Pregnancy Options talk line (M-Th 7p-12a, F-Su 12-5p): 1-888-493-0092

Hospitals and urgent care: Name, address, approximate time by car from Canfield Green Apts, phone number, hours.

  • St Louis University Hospital: 3635 Vista Ave, STL. 25 min. 314-577-8000.
  • Concentra Urgent Care: 463 Lynn Haven, Hazelwood. 13 Min. 314-731-0448. M-F 8-5
  • Concentra Urgent Care — North Broadway. 8340 N Broadway, STL. 15 min. 314-385-9563. M-F 8-5.
  • St Luke's Urgent Care: 8857 Ladue Rd, STL. 18 min. 314-576-8189. M-Su 8-8.

Services for people who often face discrimination

  • Casa de Salud serves new immigrants and refugees, including undocumented immigrants. 3200 Chouteau Avenue, STL. (314) 977-1250
  • Paraquad is the Independent Living center, offering services to people with disibilities including home care, transition from nursing homes, wheelchair and equipment, and Deaf interpretation. 5240 Oakland Avenue, STL. (314) 289-4200

Counseling appointments

  • Ferguson Community Center. 501 N Florissant Rd, Ferguson. (314) 521-5661. 10a-2p.
  • University of Missouri Counseling Center. (314) 516-5824.


Notes (from 17 August)

Thanks to Esther for putting these notes and resources together tonight for our fellow medics in Ferguson, MO.

Weather tonight: 77, down to 73 in early hours and morning. Rain possible all night.

Medics are staying 8.5 miles, or 16 minutes by car, from where the protests are happening and near where the shooting happened.

Scene assessment

Currently: the march has been going up and down Florrisant Ave at least since 7 pm local time, in the street but allowing cars to drive on it going the other way. There are many cars guarding the march from behind and driving with it up and down the street. People are poking their heads through sunroofs and sitting on the roofs and hoods of cars and in the beds of trucks as they drive.

There are spectators with signs line the march. Lots of cameras in the march and among the spectators. I haven't had a good view of the marchers but the spectators are old and young people; youngest is 4 or 5, oldest is in her 60s it seems.

According to twitter:
@BusquedaJess: Ferguson protestors to challenge midnight curfew with march to the city border.


Last night there were at least 1,000 protestors on the streets after midnight. Some protesters threw molotovs at police; police responded with tear gas. New Black Panthers and other volunteers tried to push those protesters back.

There was looting last night; some protesters formed human barriers and wielded guns to stop looting, and in the morning swept broken glass and tried to repair damage. Volunteers organized to protect stores from looters tonight but the curfew may put a stop to that. Protesters say looters are "outsiders"; "this is not us, did you see how peaceful we were earlier?"

Today: Gov. of MO declared state of emergency and curfew: Midnight to 5am.
Highway Patrol says officers will not enforce curfew with tear gas but will "talk to people" — however breaking curfew is theoretically grounds for arrest. Police are establishing a media staging area to allow press in and out of emergency zone.

There are pictures showing bystanders handing out water to marchers. Unsure if that is from today or not.

Rally due Sunday afternoon; schools due to open on Monday.


A pastor speaks: "Individuals are sick and tired of being sick and tired. I've been out here close to an hour, but I came out last sunday and prayed, for the community and for the family."

Young black women speak: "We came out here to support… from indianapolis, IN… we didn't know each other, we just met up on Facebook…. also to support Travon Martin and (someone else who was killed last month)… we're just tired. … They shot him because he was black. We were talking in the car about how they dehumanize black people… he was going to college, that doesn't matter, he was a life! I love that there are multiple races out here — that's the best part, that we're coming together." - Comments: 0

Shelter; solutions - 13 Jan 2014 03:30

Tags: shelter

Yesterday the plywood shelter in my side yard grew taller. Two fellow medics and a fellow southerner swung hammers and lifted panels with me. We set in the loft, lifted the gables and topper, and finished skinning the roof panel, which should be in place tomorrow after lunch.

With torn-up palms and a ladder on the roof of my car, two of us went to a screening and discussion of Shock Doctrine by Radical Public Health. It was a packed but intimate event, well-divided between public health professionals, students, and undocumented youth. Our discussion ultimately turned to creative solutions or victories we had seen of the public against private interests that sought to monetize something intrinsically valuable. - Comments: 0

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