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halat.pl dr Zbigniew Hałat, lekarz medycyny specjalista epidemiolog



dr Z Halat medical epidemiology consultant, noxologist

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Ebola Virus Disease by dr Z Halat, Medical Epidemiology Consultant
Ebola virus disease (EVD) aka Ebola hemorrhagic fever (EHF) [ICD-10 A98.4] 
by dr Z Halat, Medical Epidemiology Consultant



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Epidemiology:
the study
(surveillance, observation, hypothesis testing, analytic research, and experiments)
of the distribution
(analysis by time, place, and classes of persons affected)
and determinants
(physical, biological, social, cultural, and behavioral factors that influence health)
of health-related states or events
(diseases, causes of death, behaviour such as promiscuity, reactions to preventive regimens, and provisions and use of health services)
in specified populations
(identifiable characteristics such as precisely defined numbers)
and the application of this study to control health problems
(to promote, protect, and restore health)

John M. Last,
A Dictionary of Epidemiology
Noxology:
health hazards science, is a branch of epidemiology
and is the scientific study of harmful factors,
taking into account a number of
usually ignored aspects of the health hazards impact on human beings,
which include varied susceptibility of individuals
(families, communities, nations)
to a harmful factor acting alone
or together with others,
exhibiting a synergistic effects on health.
In noxology, the starting point of the diagnostic process is
the cause of health-related states or events
investigated on individual, family, community, national, or global level
(compare: Posita causa, ponitur effectus and Nihil fit sine causa).


dr Z Halat
DR HALAT COMMUNICATIONS halat.com

What about do epidemiologists care?
Who about do medical epidemiologists care?
Medical epidemiologists are medical doctors and care about human persons.

Human being = person = human person

Homo sapiens, earthling, higher animal, human, living person, living soul, mortal, person, soul

person definition Homo sapiens, earthling, higher animal, human, living person, living soul, mortal, person, soul
Visual Thesaurus Roget's 21st Century Thesaurus, Third Edition

Please note:
According to the Thesaurus's authors, a person denuded usually is not a person any longer;
this idea corresponds very well with forcible denunding practised by dehumanized dehumanizators
who want to dehumanize or, at least humiliate their victims.

What is a human person and who counts as a human person?
1. The human person is a living human body, and, conversely, a living human body is a human person.
2. The male body person is meant to be a gift to the female body person in the communion of persons we call marriage.
3. Human sexuality is itself integral to the human person; it is a good “of the person,”
and is meant to be expressed genitally only within marriage in the marital act, one “open” to the goods of communicating life and love.
In this understanding of the human person no distinction is made between a human being and a human person.
All human beings are persons.
Being a human being, therefore, has crucial moral significance inasmuch as a person surpasses in value the entire material universe and is never to be considered as a mere means or object of use but is rather the kind of entity to whom the only adequate response is love.
Being a human being, being a person, makes a tremendous difference.
William E. May
Michael J. McGivney Professor of Moral Theology
John Paul II Institute for Studies on Marriage and Family
at The Catholic University of America
Washington, D.C. 20017
What is a human person and who counts as a human person?:A crucial question for bioethics.
***
Peter Kreeft: Human Personhood Begins at Conception

We are all unique. Wszyscy jesteśmy wyjątkowi.
Marysia Sokolowska, age 17 lat. We are all unique. Wszyscy jestesmy wyjątkowi. All rights reserved halat.com
Marysia Sokolowska, age 17 lat.  We are all unique. Wszyscy jesteśmy wyjątkowi. All rights reserved halat.com
Kaplica Matki Bożej Różańcowej w Sobótce przy szlaku na szczyt Góry Ślęży - Chapel of Our Lady of the Rosary in Sobotka at the trail to top of Sleza Mt
 
 Persons have unique value

Roman Catholic personalism
A distinctively Christian personalism developed in the 20th century. Its main theorist was the Polish philosopher Karol Wojtyła (later Saint Pope John Paul II). A Christian basis for ethics is personalism. Here, the highest norm is that a person may not be used as a means to an end, but must always be loved. This is a first principle of Christian personalism: persons are not to be used, but to be respected and loved.
A Christian way of life must be based on the Great Commandments of love for God and neighbour. Every person (human and of the Trinity) must be loved, which means that we must always choose the true good of each person. But what is the true good of a human person? Human nature, uniquely among creatures, is to exercise rational self-determination, so the highest good towards human beings is to affirm and preserve their capacity for self-determination – that we must do so is the personalistic norm. One consequence of this is that we must never use another person merely as a means to an end.
 "This norm, in its negative aspect, states that the person is the kind of good which does not admit of use and cannot be treated as an object of use and as such the means to an end. In its positive form the personalistic norm confirms this: the person is a good towards which the only proper and adequate attitude is love. Karol Wojtyla:  Love and Responsibility, first published in 1960
"Norma ta jako zasada o treści negatywnej stwierdza, że osoba jest takim dobrem, z którym nie godzi się używanie, które nie może być traktowane jako przedmiot użycia i w tej formie jako środek do celu. W parze z tym idzie treść pozytywna normy personalistycznej: osoba jest takim dobrem, że właściwe i pełnowartościowe odniesienie do niej stanowi tylko miłość. I tę właśnie pozytywną treść normy personalistycznej eksponuje przykazanie miłości." Karol Wojtyla:  Miłość i Odpowiedzialność, opublikowana po raz pierwszy w 1960r.



In the 21st century after Christ, His message which is most important for genuine Christians and all other people is not yet known and understood.
Matthew 5:44-48
44. But I say, love your enemies! Pray for those who persecute you!
45. In that way, you will be acting as true children of your Father in heaven.
For he gives his sunlight to both the evil and the good, and he sends rain on the just and the unjust alike.

46. If you love only those who love you, what reward is there for that? Even corrupt tax collectors do that much.
47. If you are kind only to your friends, how are you different from anyone else? Even pagans do that.
48. But you are to be perfect, even as your Father in heaven is perfect.
Barnes' Notes on the Bible
Love your enemies - There are two kinds of love, involving the same general feeling, or springing from the same fountain of good-will to all mankind, but differing so far as to admit of separation in idea. The one is that feeling by which we approve of the conduct of another, commonly called the love of complacency; the other, that by which we wish well to the person of another, though we cannot approve his conduct. This is the love of benevolence, and this love we are to bear toward our enemies. It is impossible to love the conduct of a person who curses and reviles us, who injures our person or property, or who violates all the laws of God; but, though we may hate his conduct, and suffer keenly when we are affected by it, yet we may still wish well to the person; we may pity his madness and folly; we may speak kindly of him and to him; we may return good for evil; we may aid him in the time of trial; we may seek to do him good here and to promote his eternal welfare hereafter, Romans 12:17-20. This seems to be what is meant by loving our enemies; and this is a special law of Christianity, and the highest possible test of piety, and probably the most difficult of all duties to be performed.
Sermon on mount: New Living Translation (©2007)

VERITATIS SPLENDOR
ENCYCLICAL OF POPE JOHN POPE II
ON THE SPLENDOUR OF TRUTH
6 August 1993
3. The Church's Pastors, in communion with the Successor of Peter, are close to the faithful in this effort; they guide and accompany them by their authoritative teaching, finding ever new ways of speaking with love and mercy not only to believers but to all people of good will. The Second Vatican Council remains an extraordinary witness of this attitude on the part of the Church which, as an "expert in humanity", places herself at the service of every individual and of the whole world. The Church knows that the issue of morality is one which deeply touches every person; it involves all people, even those who do not know Christ and his Gospel or God himself. She knows that it is precisely on the path of the moral life that the way of salvation is open to all. The Second Vatican Council clearly recalled this when it stated that "those who without any fault do not know anything about Christ or his Church, yet who search for God with a sincere heart and under the influence of grace, try to put into effect the will of God as known to them through the dictate of conscience... can obtain eternal salvation". The Council added: "Nor does divine Providence deny the helps that are necessary for salvation to those who, through no fault of their own, have not yet attained to the express recognition of God, yet who strive, not without divine grace, to lead an upright life. For whatever goodness and truth is found in them is considered by the Church as a preparation for the Gospel and bestowed by him who enlightens everyone that they may in the end have life".
[Danish, Dutch, English, French, German, Italian, Latin,Polish, Portuguese, Spanish]

16. Finally, those who have not yet received the Gospel are related in various ways to the people of God. In the first place we must recall the people to whom the testament and the promises were given and from whom Christ was born according to the flesh. On account of their fathers this people remains most dear to God, for God does not repent of the gifts He makes nor of the calls He issues.  But the plan of salvation also includes those who acknowledge the Creator. In the first place amongst these there are the Mohammedans, who, professing to hold the faith of Abraham, along with us adore the one and merciful God, who on the last day will judge mankind. Nor is God far distant from those who in shadows and images seek the unknown God, for it is He who gives to all men life and breath and all things, and as Saviour wills that all men be saved.  Those also can attain to salvation who through no fault of their own do not know the Gospel of Christ or His Church, yet sincerely seek God and moved by grace strive by their deeds to do His will as it is known to them through the dictates of conscience. Nor does Divine Providence deny the helps necessary for salvation to those who, without blame on their part, have not yet arrived at an explicit knowledge of God and with His grace strive to live a good life. Whatever good or truth is found amongst them is looked upon by the Church as a preparation for the Gospel.  She knows that it is given by Him who enlightens all men so that they may finally have life. But often men, deceived by the Evil One, have become vain in their reasonings and have exchanged the truth of God for a lie, serving the creature rather than the Creator.  Or some there are who, living and dying in this world without God, are exposed to final despair. Wherefore to promote the glory of God and procure the salvation of all of these, and mindful of the command of the Lord, "Preach the Gospel to every creature",  the Church fosters the missions with care and attention.
[Byelorussian, Chinese, Czech, English, French, German, Hungarian, Italian, Latin, Portuguese, Spanish, Swahili]
Konstitusio ya kidogma juu ya Fumbo la Kanisa
Paulo Askofu Mtumishi wa watumishi wa Mungu pamoja na Mababa wa Mtaguso mkuu ataka haya yakumbukwe daima
16. Hatimaye wale ambao hawajapokea Injili huhusiana na taifa la Mungu kwa njia mbalimbali[32]. Kwanza kabisa taifa lile, lililopewa maagano na ahadi, ambalo katika hilo alitoka Kristo kwa jinsi ya mwili (taz. Rum 9:4-5). Hilo ndilo taifa lililo penzi kwa ajili ya Mababa zake, kwa habari ya kule kuchaguliwa, kwa sababu karama za Mungu hazina majuto, wala mwito wake (taz. Rum 11:28-29). Lakini mpango wa wokovu huwakumbatia pia wanaomtambua Muumba, na kati yao wa kwanza Waislamu: hao wakiri ya kuwa wanashika imani ya Ibrahimu, na pamoja nasi wanamwabudu Mungu mmoja, mwenye huruma, atakayewahukumu watu siku ya mwisho. Naye Mungu mwenyewe hayupo mbali na wengine wanaomtafuta katika vivuli na sanamu Mungu asiyejulikana, kwa maana ndiye anayewapa wote uzima na pumzi na vitu vyote (taz. Mdo 17:25-28), naye ndiye Mwokozi anayetaka watu wote waokolewe (taz. 1Tim 2:4). Kwa maana wanaweza kupata wokovu wa milele wale ambao, bila hatia, hawaifahamu Injili ya Kristo wala Kanisa lake, lakini hata hivyo wanamtafuta Mungu kwa moyo mnyofu, na kwa mvuto wa neema wanajitahidi kutimiza kwa matendo yao mapenzi ya Mungu wanayotambua kwa njia ya sauti ya dhamiri[33]. Maongozi ya Mungu hayakatai kuwapa misaada inayohitajika kwa ajili ya wokovu wale ambao, bila hatia yao, hawajaufikia ufahamu wazi wa Mungu, nao wanajitahidi, kwa neema ya Mungu, kuishi maisha manyofu. Kwa maana lolote lililo jema na la kweli lipatikanalo kati yao, lahesabiwa na Kanisa kuwa kama matayarisho ya Injili[34], na limetolewa na Yule amwangazaye kila mtu ili mwishowe apate uzima. Lakini mara nyingi wanadamu, wakidanganywa na Ibilisi, walipotea katika mawazo yao, wakaibadili kweli ya Mungu kuwa uongo, wakakiabudu kiumbe badala ya Muumba (taz. Rum 1:21 na 25). Au tena wakiishi na kufa pasipo Mungu hapa duniani, wanaelekea mwishoni kukata tamaa. Kwa hiyo Kanisa, likikumbuka amri ya Bwana: “Hubirini Injili kwa kila kiumbe” (Mk 16:15), husitawisha kwa uangalifu mkuu misioni, kwa ajili ya utukufu wa Mungu na wokovu wa watu hawa wote.( zaidi )

UBUNTU
(African Wisdom on How to Be a Human Being) PART2
November 2007
full text here

Ubuntu is a term derived from the word "muntu," meaning a person, a human being. According to ancient African traditional wisdom, each individual possesses positive, loving qualities. These qualities represent our natural internal state of being, and when we express them we are being genuine, an authentic human being. To be otherwise is to be out of harmony, and to be out of harmony brings unhappiness to ourselves, others, and our world. The values of Ubuntu manifest in good deeds, things like being sensitive to the needs of others, being compassionate, forgiving, caring and generous.
As these values are the basic foundation of each individual, they can guide us in how our life should be lived. They allow us to measure our actions in day-to-day life against our ideals. Do we practice Ubuntu and as a result live in harmony with ourselves and others, or are we living busy lives, deluded, self-centered, interested in only our own welfare, unable to practice love and compassion because we have lost our way? Ubuntu forces us to look at our actions to see if they match our values, for Ubuntu is measured in actions not good intentions.
Ubuntu is the art of being a human being. It is the living of our humanness. It is the unfolding of our natural goodness. Each living human being has this opportunity to discover their basic goodness and to practice it. "Umuntu ngumuntu ngabantu." I am because you are. It is through you that I am a human being.
Let's examine some of the pillars of Ubuntu living:
1.Caring: Caring is embracing others. Their needs become your needs. Their joys and sorrows become your joys and sorrows. It is the practice of concern and oneness, which Jesus expressed as "Love thy neighbor as thyself." It is putting the problems, interests and circumstances of others at a higher level of attention. For as Ubuntu teaches, "we are human through our interaction with others. Without others we are not human." From this perspective we should welcome our interaction with others regardless of whether they are pleasant or not, for all interactions allow us to express our humanness.
2.Empathy: Empathy is the ability to successfully enter into the emotional situation of another, to listen and feel genuine sympathy because you hear and feel what others share with you. You listen with your mind but you also feel with your body, and this feeling allows you to "see" the situation from a deeper perspective. When we cultivate the practice of empathy it deepens us and gives us access to more humanness with which we can help others.
3.Sharing: In the Ubuntu culture it is normal to share generously with others. "Mahala" is the traditional African practice that teaches that it is proper to give to others without expecting anything in return. Not everything needs to be done for money or gain. You work to support your family and if you prosper you share with others. Even if you don't prosper you must share because there is always someone else worse off than you. By sharing you express your humanness and find joy within because you awaken your heart. Heartless people have no joy, though they might have riches. People with heart have joy because they have discovered their humanness. To discover your humanness is to discover something great, a treasure unlike any other. Each day of our life gives us opportunity to discover and practice our humanness.
4.Respect: Respect covers many things. Respect for elders, children and all members of your community, respect for your ancestors, traditions, the ancient teachings and practices. Respect for oneself, for if one does not respect oneself how can one respect another? Respect for your environment and all living creatures. Respect for the Ubuntu way of life as a way to happiness and self-awareness.
A human being from an Ubuntu perspective should be kind, generous, friendly, living in harmony with himself, the environment and others, and at one with the creator. "This is what Africa can teach the world," said Credo Mutwa, the respected Zulu Sangoma, "We have forgotten how to be human beings, and we must remember quickly if we are to save the world. Life is an instrument and we have lost the ability to play it. People live but they are not alive. We must use life and play it like an instrument and make beautiful music."

John Kehoe

DO NOT KILL
People in motion: characteristics considered now as: good, bad, do not know, misterious.
DO NOT KILL People in motion: characteristics considered now as: good, bad, do not know, misterious. Would you kill a child for bad colour of eyes? Who would you kill for what transient characteristic?
Would you kill a child for bad colour of eyes? Who would you kill for what transient characteristic?

RESPECT FOR HUMAN LIFE
Respect for health
Catechism of the Catholic Church



Although most natural instinct of self preservation is exceptionally contestated, the right to life is rarely granted of other people than ourselves and/or our loved ones. Naturally, we do realize that other people want life for themselves as much as we do. This is why dehumanization of victims makes killing other human beings an easy job;
A number of characteristics are being employed to substantiate killing of these human beings who have been dehumanized because their permanent or even transient properties like age, faith, nationality, gender, descent, colour of the skin, etc. Some rulers and spiritual leaders did and still do not resort to dehumanizing their victims, they just say who or what nation must be exterminated.

The Genghis Khan's Value Statement: "To kill people, take their property, see and enjoy the pain you have caused their families, and rape their women as a final gesture of power" contradicted universal human rights values to an extent never seen before the Mongol conquests. He was admired by his followers though: the Lenin's Russians attacking our World, first Poland, and two decades later the Hitler's Germans attacking our World, first Poland.

Ansprache Hitlers
vor den Oberbefehlshabern der Wehrmacht
auf dem Obersalzberg 22. August 1939

"Unsere Stärke ist unsere Schnelligkeit und unsere Brutalität. Dschingis Khan hat Millionen Frauen und Kinder in den Tod gejagt, bewußt und fröhlichen Herzens. Die Geschichte sieht in ihm nur den großen Staatengründer. Was die schwache westeuropäische Zivilisation über mich behauptet, ist gleichgültig. Ich habe den Befehl gegeben – und ich lasse jeden füsilieren, der auch nur ein Wort der Kritik äußert – daß das Kriegsziel nicht im Erreichen von bestimmten Linien, sondern in der physischen Vernichtung des Gegners besteht. So habe ich, einstweilen nur im Osten, meine Totenkopfverbände bereitgestellt mit dem Befehl, unbarmherzig und mitleidslos Mann, Weib und Kind polnischer Abstammung und Sprache in den Tod zu schicken. Nur so gewinnen wir den Lebensraum, den wir brauchen. Wer redet heute noch von der Vernichtung der Armenier?"

Hitler's speech
to the Wehrmacht Commanders-in-Chief,
at Obersalzberg, 22 August 1939.

Our strength is our quickness and our brutality. Genghis Khan had millions of women and children hunted down and killed, deliberately and with a gay heart. History sees in him only the great founder of States. What the weak Western European civilization alleges about me, does not matter. I have given the order - and will have everyone shot who utters but one word of criticism - that the aim of {translator: this} war does not consist in reaching certain {translator: geographical} lines, but in the enemies' physical elimination. Thus, for the time being only in the east, I put ready my Death's Head units, with the order to kill without pity or mercy all men, women, and children of the Polish race or language. Only thus will we gain the living space that we need. Who still talks nowadays of the extermination of the Armenians?


A notion of Ausrottung in German and extermination in English,

a well established goal of German policy against non-Germans:

"Haut doch die Polen, dass sie am Leben verzagen. Ich habe alles Mitgefuehl fuer ihre Lage, aber wir koennen, wenn wir bestehn wollen, nichts andres thun, als sie ausrotten; der Wolf kann nicht dafuer, dass er von Gott geschaffen ist, wie er ist, und man schiesst ihn doch dafuer todt, wenn man kann."
"Let's beat the Poles until they despair of life. I have all pity for their situation, but we can do nothing else, if we want to subsist, than to exterminate them; the wolf cannot help having been made by God, and yet one shoots him dead for it when one can."
Otto von Bismarck, a letter of 26 March 1861 to his sister Malwine, written from St Petersburg, Russia, where Bismarck was Prussian Ambassador. Source: "Gesammelte Werke", XIV/I page 568, quoted in Hans Rothfels, "Bismarck, der Osten und das Reich", page 75.

"Ich bitte Sie, das, was ich Ihnen in diesem Kreise sage, wirklich nur zu hören und nie darüber zu sprechen. Es trat an uns die Frage heran: Wie ist es mit den Frauen und Kindern? – Ich habe mich entschlossen, auch hier eine ganz klare Lösung zu finden. Ich hielt mich nämlich nicht für berechtigt, die Männer auszurotten – sprich also, umzubringen oder umbringen zu lassen – und die Rächer in Gestalt der Kinder für unsere Söhne und Enkel groß werden zu lassen. Es mußte der schwere Entschluß gefaßt werden, dieses Volk von der Erde verschwinden zu lassen."
"I ask you that what I tell you in this circle you will really only hear and never talk about it. The question came up to us: What do to with the women and children? – I decided to find a very clear solution also in this respect. This because I didn’t consider myself entitled to exterminate the men – that is, to kill them or to have them killed – and to let the children grow up as avengers against our sons and grandsons. The difficult decision had to be taken to make this people disappear from the earth."
Heinrich Himmler's statement at his Poznan, Poland, speech on 6 October 1943.Source: Märthesheimer/Frenzel, Im Kreuzfeuer: Der Fernsehfilm Holocaust. Eine Nation ist betroffen, Fischer Taschenbuch Verlag GmbH Frankfurt am Main 1979, pages 112 to 114. Reference of quote: Heinrich Himmler, Geheimreden 1933 bis 1945, edited by Bradley F. Smith and Agnes F. Peterson, Berlin 1974, pages 169
more

RELIGION IN THE EUROPEAN UNION

THE MOST RECENT AND ONLY TRUTHFUL ESTIMATES BY EUROBAROMETER 2012
EUROPEAN UNION POPULATION AGED 15 YEARS AND OVER (406.834.359):
72% CHRISTIANS (+ 3%); 23% NON BELIEVERS/AGNOSTICS/ATHEISTS (+ 1%);
2% MUSLIMS (+ 1%); 1% OTHER (SPONTANEOUS); 2% DON'T KNOW (- 2%)

3 of 4 nationals in the EU consider themselves to be Christians. Members of the European Parliament (MEPs) are elected and well paid for representing their voters.

What do MEPs do to represent you?
 3 of 4 nationals in the EU consider themselves to be Christians. Members of the European Parliament (MEPs) are elected and well paid for representing their voters. What do MEPs do to represent you? Global Movement for the Restoration of Human Rights in the European Union. Down with the dictatorship of the anti-Christian minority in the EU!
Global Movement for the Restoration of Human Rights in the European Union. Down with the dictatorship of the anti-Christian minority in the EU!




In the Oxford house of sir Richard Doll
(from right to left: prof. R Doll with his wife, dr Z Halat, prof. R Peto)
In the Oxford house of sir Richard Doll. Sir Richard Doll (1912 – 2005) was the foremost epidemiologist of the 20th century, turning the subject into a rigorous science.
Sir Richard Doll (1912 – 2005) was the foremost epidemiologist of the 20th century, turning the subject into a rigorous science.
Sir Richard Doll was a pioneer in research linking smoking to health problems. With Ernst Wynder, Bradford Hill and Evarts Graham, he was credited with being the first to prove that smoking caused lung cancer and increased the risk of heart disease.
Sir Richard Peto FRS is Professor of Medical Statistics and Epidemiology at the University of Oxford. His career has included important collaborations with Richard Doll beginning at the Medical Research Council Statistical Research Unit in London.




halat.com

DR HALAT COMMUNICATIONS

WAGE AND PRICE LEVELS WORLDWIDE
enlarge

Wage levels in 73 cities around the world, Price levels including rent in 73 cities around the world, New York = 100%

price levels including rent disproportionately high or
price levels including rent disproportionately low
in relation to wage levels
after taxes and payroll deductions

average wage level, average price level


Wage levels
in 73 cities around the world,

New York = 100%

Calculation is based on the wage,
social insurance contribution
and working hours data for
14 occupations worldwide
to arrive at a net wage level
after taxes and payroll deductions.


Price levels including rent
in 73 cities around the world,

New York = 100%

The cost of a weighted shopping basket of goods
geared to western European consumer habits,
containing 122 goods and services


Source of numerical data and methodology info:
Prices and Earnings August 2011
Wealth Management Research,
Zurich, Switzerland

Global Head Wealth Management Research:
Dr. Andreas Höfert


City
Wage net Price incl. rent
Amsterdam 74.2 68.4
Athens 48.0 60.1
Auckland 64.3 73.0
Bangkok 17.9 50.5
Barcelona 65.1 71.1
Beijing 16.3 46.2
Berlin 77.8 64.6
Bogotá 24.7 49.2
Bratislava 25.1 49.9
Brussels 82.1 74.5
Bucharest 18.5 43.4
Budapest 20.4 54.5
Buenos Aires 19.1 38.5
Cairo 12.6 35.6
Caracas 19.0 60.0
Chicago 79.3 72.3
Copenhagen 100.4 89.4
Delhi 11.4 36.6
Doha 30.0 59.2
Dubai 57.3 82.7
Dublin 97.3 78.8
Frankfurt 82.5 76.3
Geneva 133.8 106.5
Helsinki 89.5 81.5
Hong Kong 44.3 76.5
Istanbul 28.9 71.0
Jakarta 10.5 53.8
Johannesburg 40.5 55.0
Kiev 13.7 44.3
Kuala Lumpur 21.0 36.5
Lima 19.5 40.0
Lisbon 52.0 62.4
Ljubljana 37.7 51.9
London 84.7 82.5
Los Angeles 92.3 72.7
Luxembourg 107.8 77.1
Lyon 75.7 67.2
Madrid 66.6 68.7
Manama 34.2 48.7
Manila 8.7 33.1
Mexico City 12.0 44.3
Miami 82.7 69.2
Milan 63.6 68.9
Montreal 88.5 77.6
Moscow 42.2 69.4
Mumbai 8.4 32.5
Munich 83.2 75.0
Nairobi 9.2 38.5
New York 100.0 100.0
Nicosia 74.7 62.1
Oslo 104.8 108.9
Paris 75.1 82.8
Prague 31.4 51.9
Riga 21.6 46.1
Rio de Janeiro 36.3 68.4
Rome 49.8 74.4
Santiago de Chile 21.0 45.7
São Paulo 45.2 74.5
Seoul 45.2 68.4
Shanghai 19.2 53.1
Singapore 41.7 88.3
Sofia 15.0 44.1
Stockholm 97.2 88.5
Sydney 117.9 89.1
Taipei 44.9 57.3
Tallinn 31.0 45.9
Tel Aviv 53.6 66.5
Tokyo 90.6 94.2
Toronto 88.4 82.1
Vienna 79.9 75.2
Vilnius 21.0 44.8
Warsaw 27.8 54.5
Zurich 149.1 105.5

Two years later: 2013 collapse.
No jobs. No money. No funny, honey.
Worried about the western economic crisis?
Terrified of being poor? Scared of being homeless?  Afraid of dying of starvation?
Finally, you have realized what does it mean to be less privileged.
Why do you think this is happening to the West and to you personally?
Because there is no more nation to invade and loot?
Or, as the British queen was informed by Sujit Kapadia (Bank of England},
"financial crises were like earthquakes and flu pandemics and, because they are rare events, they are difficult to predict"
 
Πλούταρχος: Ἠθικά, Συμποσιακά, Πότερον ἡ ἄρνις πρότερον ἢ τὸ ᾠὸν ἐγένετο.
Plutarchus: Quaestiones convivales, Ovumne prius exstiterit an gallina?
Plutarch: Table Talk, Which came first, the chicken or the egg?"
Plutarque: Oeuvres morales, Lequel de la poule ou de l'œuf a été formé le premier ?

The chicken or the egg causality dilemma
 "which came first, the chicken or the egg?"
or
 "Which came first, ineptness that can't come without unchasteness, or unchasteness that can't come without ineptness?"




Global ranking of countries by years of life expected at birth

1980 and 2010,
increase, decrease over 30 years,
health adjusted 2007

enlarge

Global ranking of countries by years of life expected at birth 1980 and 2010, increase, decrease over 30 years, health adjusted 2007
Health of human society is not merely the absence of disease and good physical,mental and social health of individuals making up the society, but also the natural harmonious development of population and such environmental conditions that favour the health of the population.
prof. Jan Karol Kostrzewski
Source of numerical data: Human Development Report 201, Sustainability and Equity: A Better Future for All, United Nations Development Programme (UNDP)



Global ranking of countries by population growth from 2011 to 2030 Dying off nations highlighted
Source of numerical data: Human Development Report 201, Sustainability and Equity: A Better Future for All, United Nations Development Programme (UNDP)



GLOBAL RANKING OF COUNTRIES BY POPULATION GROWTH FROM 2011 TO 2030 [MILLIONS] dying off nations highlighted

>
The 2014 Feast of Saint Philomena Virgin and Martyr,  Gniechowice, Wroclaw Region, Silesia, Poland
The 2014 Feast of Saint Philomena Virgin and Martyr, Gniechowice, Wroclaw Region, Silesia, Poland Parafie rzymskokatolickie sa zaglebiem osób zyjacych w czystosci i ich zdrowych rodzin, w zwiazku z tym nalezy zdecydowanie wspierac i chronic wspólnoty religijne. Roman Catholic parishes are reservoirs of chaste persons and their healthy families, therefore religious communities must be strongly supported and protected. dr Zbigniew Halat, Medical Epidemiology Consultant
Parafie rzymskokatolickie są zagłębiem osób żyjacych w czystości i ich zdrowych rodzin, w związku z tym należy zdecydowanie wspierać i chronić wspólnoty religijne.
 Roman Catholic parishes are reservoirs of chaste persons and their healthy families, therefore religious communities must be strongly supported and protected.
dr Zbigniew Halat, Medical Epidemiology Consultant




Virgins until Marriage - Civil Society Organization of the African Union and the European Union

Mission Statement

The mission of the Virgins until Marriage - Civil Society Organization of the African Union and the European Union (acronym: VM) is to promote a universal value of virginity until marriage with the "VIRGINITY MATTERS!" slogan supported by an effective reward system action for virginity protection and by protest against abuse, torture and humiliation of virgins. Virginity as the source of world’s harmony preserves morals, saves lives, decreases morbidity, boosts self-esteem, enhances careers, opposes slavery, counteracts crime, strengthens families, empowers communities, spares funds and therefore should be protected by all means available and not to a lesser extent than those pitiful and deadly ideas that violate human rights of the young ones of both genders and rob them of their unrenewable assets for profiteering or sheer pervert amusement. Virginophobia, i. e. the irrational fear of, aversion to, or discrimination against virginity or virgins should be condemned and penalized, as well as the damage due to robbery of virginity fully compensated.

Rationale

VM offers normal people (the helpless youth, worried parents and frustrated spouses among others) and their leaders a crucial solution for three menaces threatening both continents that the Mediterranean Sea touches. These are: demographic collapse, human rights violation, and disaster profiteering.

The epidemiological evidence is clear. AIDS decimating Sub-Saharan Africa and chlamydiasis destroying fertility in Europe result from promiscuous voluntary activeness of one fifth of adults. Themselves victims of human rights violation ‘the walking sources of epidemics’ proliferate their traumas and attack more and more young people of both genders. They are encouraged and easily excused by a news and entertainment industry hostile to universal values and supportive to mass disaster profiteers: pornography and prostitution business organizers, prophylaxis and treatment suppliers, and social structure disintegration instigators, agents of influence among them.

Those who lose their virginity early are more likely to have multiple sexual partners, fuel epidemics and social pathologies.
Those who fight virginity with mockery, ridicule, and scorn are responsible for all the revealed and hidden harm they do.

A common sense type preventive measure to physical and moral abuses of individuals that add to mass disasters caused by promiscuity is raising the “herd immunity”, as it is called in epidemiological jargon, by promotion of a universal value of virginity until marriage. The VM mission priorities are endorsed by lessons learnt from African (i. e. South Africa, Uganda, Sierra Leone) and European (OURSELVES FOR OURSELVES Youth Peer Education Movement in Poland), experiences, as well as the SILVER RING THING program, which encourages young adults to remain as a virgin until marriage, until recently funded by the US federal government. Yes, we can! In Africa and Europe now.

Virginity until marriage is the source of world's harmony, all rights reserved halat.com
Virginity until marriage is the source of world's harmony, all rights reserved halat.com
Miss Love of Wroclaw, Poland, World Virginity until Marriage Capital
Miss Love of Wroclaw, Poland, World Virginity until Marriage Capital, all rights reserved halat.com
Miss Love of Wroclaw, Poland, World Virginity until Marriage Capital, all rights reserved halat.com

The Wroclaw virgins are us!

Wroclaw, Poland, along with  San Sebastián (Donostia in Basque), Spain, will be the European Capital of Culture in 2016.
Wrocław wraz z San Sebastian (Donostia po baskijsku), Hiszpania, będzie Europejską Stolicą Kultury 2016
Love Wroclaw's culture. Wroclaw, Poland, along with San Sebastián (Donostia in Basque), Spain, will be the European Capital of Culture in 2016. Wrocław wraz z San Sebastian (Donostia po baskijsku), Hiszpania, będzie Europejską Stolicą Kultury 2016 San Sebastián será Capital Europea de la Cultura en 2016 junto con Breslavia, Polonia 2016an Donostia hiria Polonia Wrocław hiriburuarekin bateria Europako Kultura Hiriburu izango dira.
San Sebastián será Capital Europea de la Cultura en 2016 junto con Breslavia, Polonia
2016an Donostia hiria Polonia Wroclaw hiriburuarekin bateria Europako Kultura Hiriburu izango dira.


MEET THE COMING DISEASE
VENIENTI OCCURRITE MORBO



Prevention is better than cure: Persius, His Holiness Pope Alexander III, Father Desiderius Erasmus van Rotterdam

Prevention is better than cure: Persius, His Holiness Pope Alexander III, Father Desiderius Erasmus van Rotterdam
When bloated dropsies every limb invade,

In vain to hellebore you fly for aid:
Meet, with preventive skill, the young disease,
And Craterus will boast no golden fees.

Helleborum frustra, cum iam cutis aegra tumebit,
Poscentis videas : venienti occurite morbo!
Et quid opus Cratero magnos promittere montis?


A physician in repute made nearly as much money by his practice, in Rome, as is now made by the most popular of the profession, with us: he noticed several whose fees amounted to five or six thousand a year. Craterus, like all the physicians in fashionable practice, was a Greek, he is mantioned by Cicero [Craterus fuit medicus celeberrimus aetate Ciceronii et Augusti], Horace... There were practitioners at Rome, in the poet's age, whose credit and whose fees were equal to those of Craterus, and whose name would therefore have furnished as apt an example... Aulus Persius Flaccus, 34 – 62 AD, Source of citation, translation and commentary: “The satires of Aulus Persius Flaccus", William Gifford, 1821


It is better to rush beforehand towards an evil about to occur,
than to seek help after the damage has been done

Melius est superventuro malo ante tempus occurrere,
quam remedium post causam quaerere vulneratam


His Holiness Pope Alexander III, 1159 - 1181 AD, The encyclical letter Cor nostrum, 16 January 1181
Fresco in the Palazzo Pubblico in Siena: Frederick Barbarossa submits to the authority of Pope Alexander III by Spinello Aretino

Prevention is better than cure
Voorkomen is beter dan genezen.


Father Desiderius Erasmus van Rotterdam
Porträt des Erasmus von Rotterdam am Schreibpult, Hans Holbein der Jüngere, 1523, Musée du Louvre




GLOBAL AIDSNEWS

The Newsletter of the World Health Organization Global Programme on AIDS ,
Year 1992 No 3, pp.15-16

An Interview with Zbigniew Halat

Dr Zbigniew Halat, an outspoken epidemiologist of 42, grew up and studied in the city of Wroclaw, close to Poland's border with Germany. Involved in the local organization of Solidarity in 1980-81, he left Poland after the declaration of martial law to study venereal and skin diseases in Kenya. From 1982 to 1984 he organized a free clinic to treat sexually transmitted diseases - STDs) in Nyeri, capital of Kenya's Central Province, where he saw patients with what he now believes were early symptoms of AIDS. After martial law was lifted in 1984, he returned to Poland to work in the public health system on allergies, skin disease and immunization. In the autumn of 1987 he launched one of Eastern Europe's first AIDS hotline counselling services, and since April 1991 he has been responsible for environmental health, disease prevention and control and the national health programme in Poland as a Deputy Minister of Health and Social Welfare. Despite considerable opposition, Dr Halat advocates (* see here revised position) condoms - not just abstinence - to prevent AIDS, and he is training an army of midwifery and nursing students to spread the message of safe sex to boys, girls and fellow teenagers of both sexes, partly through the use of educational materials from GPA. (WHO also assisted Poland in setting up its short-term plan on AIDS in 1990, and it is helping to prepare a conference to reach a national consensus on AIDS.) Dr Halat spoke to Global AIDSnews while on a recent visit to Geneva.

Dr Halat, how prevalent are AIDS and HIV infection in your country?

Officially there are said to be 2200 people infected with HIV, and 100 cases of AIDS. In both cases, about 70 per cent of them are attributed to drug abuse. I think all these figures are wrong. This is partly because male and female sex workers, and men who have sex with men, tend to get help in private clinics which have no procedures of notification. And there is a lot of misconduct in such places - people taking blood samples, for example, throwing it away and telling people they are uninfected. We need to strengthen our medical system and open it as much as possible to all groups in society. The true incidence of HIV and AIDS in Poland will bc seen only when we can fund a proper study and can organize a top-quality unit. We do not have what is needed to make proper diagnoses. We don't have the equipment to conduct a bronchoscopy, for example, to look for PCP. (Editor's note: Pneumocistis carinii pneumonia, a common AIDS related illness.) In my opinion, most transmission of HIV in Poland is through heterosexual sex.

If so, Poland would differ in this from other European countries. How do you believe this has come about?

It goes back to the 1970s, when the then communist government first allowed Polish citizens to travel to the West freely. Differences in the economic levels of neighbouring countries lead to prostitution and infection. And cheap sex brings with it an enormous danger of HIV. Living in Poland is like living in the Caribbean and being close to the USA. When Poles got the freedom to travel in the 1970s - I was earning $ 10 a month at the time - many of my fellow citizens went to Germany and sold sex to get money. Now, many people come here for sex. They pay girls and boys for unprotected sex. Young boys of 10 or 12 hang around outside buses from Germany offering sex for very little money. Unfortunately, there are men and women who find sex boring unless it is unsafe. And there are parts of western Poland where many young people go to Berlin to be prostitutes. Male prostitution is quite common, but not as common as female prostitution. Also, the spread of bloodborne diseases in our country is very dynamic.

One in 1600 Polish women between the ages of 20 and 29 get the hepatitis B virus (HBV) in hospital or outpatient clinics during their pregnancies. So HBV in Poland is more common in women than men, whereas in most countries, the reverse is the case.

Poland is heavily Roman Catholic. Does this pose problems for you in spreading the message of safe sex?

Religious problems are a real obstacle, a real interfering fact. According to Catholicism, a man should not deposit his semen anywhere other than in his wife's vagina, so sexual fondling and masturbation to ejaculation are out of the question. But we need to adjust our advice sensibly to reality. Promiscuity exists in Poland as it does in other countries, and you have to admit that sexuality is an issue for young people and cannot be seen only as a sin.

So have you run into problems with the Catholic Church?

If you say plainly that something endangers people, and if you repeat it enough times, thc Church has no objection. I say, let a priest be a priest, let a doctor be a doctor. But priests are not the only people who pose problems. In 1991, one of my fellow deputy health ministers said that condoms were only for deviants. He was fired by the prime minister of the time, Mr Bielecki, who was a liberal. And an education minister said recently that there was no need for AIDS education. I said his comment was "very exotic".

What is the position on AIDS education?

The older generation does not want to talk to another generation about sex. There are some things which most mums and dads find it impossible to say. Doctors are not good at AIDS education because they tend to medicalize the issue and use words of Greek and Latin origin. And teachers get red faces about condoms. In any case, in this time of transition from communism, when there has been a swing to the authoritarian right, it is not possible to incorporate AIDS education into the official curriculum. In my opinion the best way is to use peer educators.

Who will these peer educators be?

We have an army of young women - 13 000 secondary nursing students, 3000 of them doing midwifery - who could be health educators. We started a peer training programme in 1988 in Wroclaw with the headmaster of the local midwifery school. The midwife peer educators, who are usually 19 or 20 years old, go into local schools and talk to the pupils from the ages of 11 up, usually separating the sexes until they are 15. The system is now very well-known in the area. Other schools are asking for it, and parents too. We find that young women can talk about sex much more easily than young men with their peers, male and female. The educators tell the group that it is natural for young people to have sexual urges, to masturbate, and to fantasize. This gets them all relaxed. And then the educators come in with the message: "But when it comes to intercourse, use a condom and/or a virucide". And they tell the girls it is important to know someone for more than one day, and that they should check whether the boyfriend can fulfil his role not just as a sex partner, but as someone they can talk to and enjoy other leisure activities with. One aim is to delay first intercourse. I follow the idea of abstinence as an ideal, but at the same time realize that it can be too demanding.

How do you plan to mobilize the whole army of nursing and midwife students?

We have set up a programme called Sami Sobie - "Ourselves for Ourselves". It is headed by Dorothy Czyrek and Ivonne Mackiewicz, who were in the first group of peer educators. We hope to make a short-cut to a new generation of Poles using self made educational materials based on WHO and Red Cross models. Fifteen girls from Warsaw and Wroclaw went to Bristol in June to learn of British experiences, and with WHO support we organized summer camps for 60 midwifery students and 60 nursing students in August to train them as trainers to go into the schools. They will go into the schools and show how to use condoms by putting them on their fingers, and so on. (I do that whenever I go on television.) The girls will also talk about general health promotion, including what tobacco can do to you, not just about AIDS and sex. The Polish population is dying from smoking and drinking and lack of physical exercise.

What about condom supply in Poland?

For many years, there was a factory in Poland which produced condoms with holes and measured their elasticity with rulers. Now we have founded a new Polish-German joint venture with quality technology looked after by German specialists. We make all kinds of condoms, even flavoured ones, for oral, vaginal and anal sex. And they cost the equivalent of 18 US cents for three.

If your plans for peer education come to fruition, the younger generation will be well educated on AIDS issues. What about the generation of people who came before them?

People are shy of picking up leaflets. It is easier for them to pick up a phone. That is why I think hotlines are very important. I first set up a counselling service for pre- and post-HIV diagnosis in the autumn of 1987. We were the first in central and eastern Europe to have dialled automatic information on AIDS. There are now about 10 or 11 hotlines in Poland. Recorded messages directed at housewives, drug users or other groups supply other numbers to phone if the callers feel they are in danger. They then reach an operator from their own social group whom they can talk to. Usually people say they are ringing on behalf of a friend, but gradually we gain their confidence and they come to visit a doctor, who is usually attached to an STD clinic. In my country, a typical problem might involve a young married mother who suddenly fears she might be infected after having a single sexual encounter with someone who has been abroad - her first love, perhaps, unexpectedly met in the street. She wants to have another child, she doesn't want to infect her husband, so she feels she needs condoms, or support. She worries, she gets psychosomatic symptoms. ... For such cases, I think it is inhuman not to create an anonymous counselling unit. The same goes for homosexuals: why not invite them to a place with a gay doctor for pre- and post-test counselling? I think we will soon set up that kind of facility.
GLOBAL AIDSNEWS The Newsletter of the World Health Organization Global Programme on AIDS , Year 1992 No 3, pp. 15-16 An Interview with Zbigniew Halat


WHO REGIONAL OFFICE FOR EUROPE
GLOBAL PROGRAMME ON AIDS
COPENHAGEN, DENMARK
AIDS HOTLINES FOR COUNTRIES
OF CENTRAL AND EASTERN EUROPE 1992
Report on a WHO Workshop
Warsaw, 13-16 December 1991
This activity was organized by the WHO Regional Office for Europe to promote work aimed at achieving the following target in the health for all strategy.
OPENING SPEECHES
Zbigniew Halat, M.D., Deputy Minister, Ministry of Health and Social Welfare, Poland
Hans Moerkerk, M.D., Special Adviser on International Health Affairs, Ministry of Welfare, Health and Cultural Affairs, The Netherlands
Monique Middelhoff, Ministry of Welfare, Health and Cultural Affairs, The Netherlands
Richard Rector, WHO Temporary Adviser

Opening statement, by Zbigniew Halat, M.D.

It gives me great pleasure and it is an honour for me to welcome you to Poland, to Warsaw and to this workshop on AIDS hotlines for countries of central and eastern Europe* The workshop is convened in collaboration with the World Health Organization» the Ministry of Welfare, Health and Cultural Affairs of The Netherlands and the Ministry of Health and Social Welfare of Poland, and organized by the Dutch National Committee on AIDS Control.

I understand that this is the second such meeting in Europe, and the third in the World, organized with financial support from the Dutch Government. I wish to express my gratitude to the Government of The Netherlands for their commitment in this respect. I also want to put on record my ppreciation of the fact that so many participants from the countries in Eastern and Central Europe have been able to come together here, in spite of all the practical difficulties we know most of you experience at present. Some sixty individuals from countries in central and eastern Europe have gathered here today including facilitators and temporary advisers from seven Western European countries.

The tremendous interest to participate in the workshop is an indication of the correct decision of the Global Programme on AIDS in the WHO Regional Office of Europe to give priority to the planning and development of AIDS hotlines in countries in central and eastern Europe.

This is a field where a tremendous amount of experience has accumulated recently in countries in western and northern Europe over a relatively short period of time. There is need to share knowledge of the success and the failures that has been gained, so that we in the countries of central and eastern Europe may profit by the experiences in western and northern Europe, and adapt your knowledge to our own realities.
<>It is often said that, at present, the only vaccine we have against transmission of HIV infection is information and education. However, the AIDS pandemic has underscored what we have known for a long time; that not every form of information influences people, increases knowledge, changes attitude, or makes a difference in changing behaviour. The AIDS pandemic has taught the world that there are great differences between old-fashioned health propaganda and the modern social marketing that is part of health promotion. It has illustrated the importance of target groups having confidence and trust in the source of the information. It has underlined that representatives of target groups should have a say in how their peers should be approached. It has shown the total superiority of one-to-one transfer of information in a counselling setting, and targeted campaigns should not be discounted as important consciousness-raising elements of a total information, education and health promotion strategy in HIV/AIDS prevention and control- However, before we start attempting to transmit information to achieve behaviour change, we must learn how to communicate effectively in a counselling situation.

Counselling in any setting demands listening skills and empathy. Helpline counselling by telephone requires special skills. These skills do not come naturally to most of us; they need to be learned.

When a person has overcome his or her reluctance to call an anonymous telephone number and to start to talk to a stranger about sensitive issues like HIV/AIDS, sex and drug use, they do not usually want to be met by a person spewing out series of epidemiological statistics or masses of biomedical facts. What they want to meet at the other end of the telephone line is a sensitive, empathie person with active listening skills; a person with ability to guide the caller to decisions that are right for her or him.
< style="font-weight: bold;">Various ways have been chosen in various countries and different settings to meet the needs and demands of the hotline callers or "customers". In some cases great stress has been put on the counsellors with professional training in health or social sciences or services. In other cases the stress is on volunteers with non-professional backgrounds; simultaneously stressing the need for the helpline to enable the non-health (or social service) professional to be really a professional counsellor rather than a counsellor with a professional background» and achieving this through intensive and extensive training» and on-the-job supervision.

Participants at this workshop will have the possibility to discuss the pros and cons of various solutions to a number of challenges and problems that have accumulated over the years of running AIDS helplines and other specialist telephone hotlines in western and northern Europe.
< style="font-weight: bold;">In this, let us remind each other, however, that the solution we choose for our own ventures must build on acknowledgement of the cultural and traditional sensitivities that are peculiar to each group targeted* Such sensitivities exist and need to be recognized. Breaking down social, legal, cultural, religious and traditional barriers may be needed concerning sexuality, sexual orientation and sexual practices, as well as concerning illicit use of alcoholj drugs and other substances. But in breaking down these barriers we must be willing to acknowledge that they exist and respect them for what they are, and on the other hand not be over afraid of breaking taboos. The very fact that there exists in the countries of Europe such variety of social» legal» cultural» religious and traditional attitudes is in itself one of the things that make Europe an exciting continent, and with increase in personal liberty in so many -more countries» even more so at present than a few years ago. However, in.relation to the AIDS epidemic the very expressions of freedom paradoxically..put the population at risk calling for a firm public health and social policy response with concerted action of voluntary activities and statutory actions and duties.

There is an impressive array of participants and of advisers at this workshop. I am convinced that together you will be able to find answers on how to respond to this paradox of personal freedom and health-endangering behaviour. You will not give us the ultimate answer, but you cannot fail to give us important guidance. I wish you every success in your deliberations.



"the quixotic and controversial deputy minister of health, government sanitary inspector, and chief environmental health officer, Zbigniew Halat MD is engaged in a personal crusade to shake the health service out of the spiritual atrophy induced by 45 years of communism. Hard working, self reliant, aggressive, and abrasively masculine, this man of Promethean energies put me in mind of a nineteenth century northern mill owner"
Karin Chopin: British Medical Journal, Volume 304, 30 MAY 1992, pp 1429 - 1432

Letter from Poland #1: Karin Chopin, Letters from Poland, Too many advisers, not enough aid, British Medical Journal, 30 May,  the pdf file loading slowly
Letter from Poland #2: Karin Chopin, Letters from Poland, Pollution most foul, British Medical Journal, 6 June, - the pdf file loading slowly
Letter from Poland #3: Karin Chopin, Letters from Poland, Post-totalitarian medicine, British Medical Journal,  13 June - the pdf file loading slowly

British Medical Journal, 30 May, 6 June, and 13 June 1992

Letters from Poland

"This is the first of three articles examining health issues in Poland
By Karin Chopin, medical student, Bristol University
22 Montague Hill, Kingdown, Bristol BS2 8ND

British Medical Journal
Volume 304, 30 MAY 1992
pp 1429 - 1432

Too many advisers, not enough aid
by Karin Chopin
"The minister says you will be able to explain more easily to the English when you have seen something of our country. He would welcome the opportunity, moreover, to see for once his country - through a foreigner's eyes. Would madam be interested in accompanying our itinerant minister on his travels while she is here?" Word had obviously reached the Polish deputy minister of health that someone writing for the BMJ was in town. I had arrived in Poland in the autumn of last year to see how the new regime was addressing the country's poor health record. Having just spent a fairly fruitless week being ushered politely from office to office, listening to a lot of rhetoric about the proposed Polish health reforms, I was most definitely interested in travels with this minister.

The quixotic and controversial deputy minister of health, government sanitary inspector, and chief environmental health officer, Zbigniew Halat MD is engaged in a personal crusade to shake the health service out of the spiritual atrophy induced by 45 years of communism. Hard working, self reliant, aggressive, and abrasively masculine, this man of Promethean energies put me in mind of a nineteenth century northern mill owner. While he attended a seemingly endless succession of meetings and conferences in horrendously smoke filled rooms all over the country I was at liberty to sit in and listen, or privileged to roam free throughout hospitals, talking to patients and staff, or honoured as a foreign guest in schools, academic institutions, and factories. Over the next three months I was shown such a picture of Poland that I felt I had been to the horizon and back. Miraculously, door after door opened before me. I was profoundly touched by the warm acceptance and generosity with which I was received everywhere I visited, deeply appreciated after the struggle of Poland' s paradoxical public boorishness. For all the traumas of their recent past, the Poles have retained their legendary hospitality, sense of humour, and capacity for enjoyment.

(...)
British Medical Journal
Volume 304, 6 JUNE 1992
pp 1495 - 1497

Pollution most foul

by Karin Chopin

In 1848 Rudolf Virchow published his Report on the Typhus Epidemic in what today is Upper Silesia. His report detailed the oppression of the Polish speaking inhabitants by the Prussian landowners and bureaucracy, which he saw as the source of their and illness. Subsequently, in poverty, starvation, l879, he noted that matters in Upper Silesia had hardly improved since his previous report. In June 1990 Professor Irena Norska-Borowka, head of the neonatal pathology clinic of the Sileslan Medical Academy, Zabrze, published an account of health in Upper Silesia. She wrote of "increasingly high rates of infant mortality and child morbidity in the Upper Silesian Mining Basin, a high percentage of mentally and physically handicapped children ... socioeconomic factors such as poverty, smoking, alcohol, and drug abuse, and previous abortions ... hard physical work, and stressful urban conditions." It comes as a shock to find things so little changed since Virchow's time.

As facts come to light after 45 years of communist obfuscation, Silesia is emerging as the most ecologically disturbed part of Europe with the poorest health record of any industrialised community in the developed world. It would seem that a century and a half of industrial so called "development" has apparently had little impact on the wretched life of that province - if anything, it has created a new source of ills. Last November I travelled to Upper Silesia to see for myself. It was not a part of the country my host, the itinerant Polish deputy mister of health, Dr Zbigniew Halat, visited too often if he could help it. "When Poland faces a tricky international football fixture," he had said to me when I told him I was going there for three weeks, "the odds are that it will be played in Katowice: if the surroundings do not incapacitate the opposition with depression, the oxygen free atmosphere usually takes a few yards off their pace."

The Polish side of the "black triangle" Upper Silesia is the industrial base of an otherwise agricultural country. It consists of an almost continuously built up conurbation of about a dozen towns. Two million inhabitants make this the most densely populated part of Poland (population 38 million). It lies along one side of the infamous "black triangle," where Polish, Czech, and eastern German heavy industry creates desolation that does not respect borders. The air is sulphurous here. The snow is acid snow. The lakes and rivers still look alive. Not so the forests: whole tracts of once glorious birch and pine stand naked, stripped of their foliage, or stunted, resembling the skeletal survivors of a nuclear storm. The region has attracted worldwide attention since the beginning of the glasnost era because of the horrendous pollution from its outdated factories. It has been officially classified as an environmental disaster area by the Polish Academy of Sciences and represents an impressive example of the environment's influence on health and the results of unregulated industrial development and official neglect.

For 40 years the acceptable level of pollution was that amount the foundries, steel mills, chemical plants, and coal mines, etc, needed to emit to meet production quotas. The principal source of this pollution is Poland's dirty brown coal, which yields benzo(a)pyrene, one of the deadliest of carcinogens. The district is dominated by mining: Upper Silesia boasts 98% of Poland's coal production; 23% of the country's electrical energy is produced here, 52% of its raw steel, and 100% of its zinc, lead, and silver. Levels of heavy metals in soil and river sludge are alarmingly high around metallurgical plants. Sulphur dioxide outputs per head from this part of Poland (along with neighbouring parts of eastern Germany and Czechoslovakia) are the world's highest (table). Because untreated industrial and communal sewage are released in surface waters there is no water of first class purity that is, no drinking water. One fifth of the food commercially grown here is polluted to the point of being unfit to eat. Rates of sick leave and industrial diseases are much higher than the national average. Accommodation is often situated alarmingly close to plants. There is a significant and rapidly worsening unemployment problem due, firstly to the collapse of the Russian market and, secondly, to the forced closure of some of the least economically viable plants or worst offenders in the pollution stakes. Cigarette smoking undoubtedly increases the health damage done by air pollution. In Poland in 1988, 72% of men and 57% of women in their early 30s smoked, compared with 33% of men and 30% of women in that age group in Britain (source: Katowice Sanitary Epidemiological Station, Upper Silesia).

A serious problem

The capital of Poland's black country is Katowice, and presiding over the sanitary epidemiological station there is the formidable Teodora Karczmarowa, who, once reassured that I had not come in pursuit of sensation, was most forthcoming, and, indeed, saw the BMJ's interest in the situation in Upper Silesia as evidence that other people are taking the yellow flags as seriously as she does. "Any research into, or exposure of, links between Soviet industrial tyranny and disease was deemed seditious under the communist regime and therefore banned," she explained. "Although studies so far show only correlations and do not establish causation, they do indicate a marked effect of environmental degradation on the health of the population. We can't wait for irrefutable proof that people are falling sick and dying as a result of the devastation of the environment. There is no time to wait until the economic battles in this country have been won." Two years ago the old regime would not even admit that there was a serious problem, and now there are laws controlling the disposal of waste and air pollution, while further emission levels are being drawn up and with them criteria for the environmental assessment of new projects.

Tired and angry

Democracy in eastern Europe has a hundred faces; this one was sad and silent. And somewhat sceptical about visiting foreigners, too. I had waited a long time to meet Professor Mieczyslaw Chorazy, head of the department of tumour biology at the Institute of Oncology in Gliwice, Upper Silesia. "Dr Livingstone, I presume?" he greeted me with a sardonic smile. "Another foreigner come to civilise the natives." I assured him I had come to do no such thing. The prophetic vision of a kingdom of justice on earth, which was called Marxism, brought not only intolerable bestiality, suffering, and practical failure to hundreds of millions of men and women, but, according to Professor Chorazy and his associates, also seems to have left its mark on the genetic code of the population of Upper Silesia. ''I have had the greatest difficulty in getting any of my material published until recently," he told me, and went on to elaborate the details of his research. Since 1984 he and his team have been analysing organic material from airborne pollutants collected on fibreglass filters in 27 locations throughout Upper Silesia. "Our evidence leads us to believe that people living in the area have very distinct signs of damaged genetic material. The epidemiology of the situation has not yet been published but significant correlations between clusters exist. We have unique human genetic material in our hands here, and we want to get other people interested - for example in DNA repair, individual susceptibility , how particular genes are affected, etc. We would like to organise a tissue bank from this material so that others can have access to our unique material in Silesia."

Professor Chorazy is a tired and angry man. In common with many of the other health professionals I met in Poland, he too complained that well meaning international organisations came over with good intentions but on different wavelengths from the Poles. "All they bring in their baggage is ideology. Just look out of the window and see for yourself where ideology has got us these past 45 years....What is the point in sending us 17 highly sophisticated pH meters (as his department had recently received) when (a) there are not enough people here trained in using them and (b) we don't need your sophisticated pH meters to tell us how filthy our rivers are anyway. OK, our methods of measurement may not be quite as exact as yours, but our rivers are pure poison anyway - if we're a couple of units out of this way or that, what difference will it make in the long run? I fully appreciate the importance of accurate baseline measurements, but we simply cannot in our circumstances, afford the luxury of establishing exactly how lethal our waters are. If the World Health Organisation or World Bank is going to spend money on us, let the money be spent doing something about our problems, not forever measuring them, for God's sake!"

"And where does it get us when they tell us that Poland comes second only to Russia on just about every European table of dangerous emissions? Should we close down all our factories and live unemployed, in the dark? Or redirect traffic out of our towns? What on to do? The existing road network in these towns does not even come close to supporting the local and transit traffic. Better spend that foreign aid on building a bypass for Gliwice, instead of pH meters for my laboratories. . . . And the number of visits I've had from Western ecological organisations! I keep on telling them that you cannot apply First World ecological philosophy to a Third World country such as Poland!" he expostulated.

Sepia coloured cities

Mr Tadeusz Frackiewicz, a retired mining engineer, and his wife, Lucyna, professor of sociology at the Silesian Academy of Economic Sciences, had kindly offered to spend a day showing he me how people live in Upper Silesia. Walking the streets of Silesian cities, one cannot help but notice that many of the people appear tired and prematurely aged, their health destroyed by the foul air they must breathe and a diet of greasy sausage and cigarettes. The women invariably look older than they really are. They are often poorly dressed and overweight. For me, they are the most beautiful in the world because I know what is behind the serious worried faces; behind a pale pink lipstick that doesn't exactly go with the colour of their eyes, or hair, or dress; behind the bad teeth, the smell of their sweat in a tram. Their beauty should not be compared with beauty that comes from the West. Their image, fashion, and make up should be judged by different criteria, with knowledge of the context, and, therefore, with appreciation; They deserve more respect than they get, simply because just being a woman - not to mention a beauty - is a constant battle against the way the whole system works.

We called in to see a family living in an apartment out of whose windows I stared across a busy dual carriageway straight into the open furnaces of Huta Kosciuszko ferro-alloy works. There was a satellite dish perched on their balcony. Indeed, a striking feature of the landscape in Upper Silesia is the number of satellite dishes around: "Junk food for the mind," Professor Frackiewicz said contemptuously. Driving around, here and there short stretches of road would drop a few feet, half a tenement block stood derelict due to subsidence, while people still lived in the half that had been spared. Like the English, the Poles love their gardens, and everywhere we saw allotments and backyards exploited to the maximum, with all manner of fowl pecking optimistically at any remaining patch of bare earth. But the vegetables apparently come up runty, the flowers looked sorry for themselves, and the much rows of lettuces are reported to absorb as much as 200 mg of lead/kg (source: Katowice Sanitary Epidemiological Station, Upper Silesia).

In the town of Chorzow, I stopped to take a photograph and an old woman leaned out of a window and eyed me suspiciously, but I managed eventually to coax a smile out of her, and she invited us into her two room house. Onions to be put by for the winter covered her kitchen floor. There was a large cow lying on bare earth in the room next door. She remarked on the absence of a wedding ring on my hand and we talked about the excess of batchelors in her small town, about the men drinking too much. She proffered a meal of boiled potatoes, pickles, and a most unappetising looking sliver of pork fat. Now and again her house shivered as a heavy truck passed on the road outside - probably yet another piece of Soviet military machinery going back home eastwards, further wrecking the terrible Polish roads. "Good riddance!" (a polite translation) she shouted out of the window each time one passed.

The pathos inspired by this highly industrialised region is also at part due to the ubiquitous erosion of its cities. Shabbiness and the colour of sepia are their common denominator. About 70 km common to the east of Katowice lies the beautiful renaissance city of Krakow, Poland's ancient capital. We spent the afternoon there. The very city itself appears as if covered with a sepia coloured film - as if it were fading away, crumbling at the edges, disappearing. I saw angels without wings, caryatids without breasts, horses with broken legs, and gargoyles without noses, their hideous features eaten away by the acid rain - a city slowly decaying. Professor Frackiewicz explained: "To say it's the poor quality paint under socialism is correct, but it is not enough. To say it's soft coal exploitation and air pollution, bad gasoline and bad cars, or lack of money - that again would be correct. But it is not the whole story. All the reasons (and probably many more) are not enough to explain the decrepitude. Our cities have been killed by decades of indifference, by the conviction that somebody else - the government, the party, those "above" is in charge of them. Not the people. How could it have been the people if they were not in charge of their own lives? Maybe now, after the political changes in eastern Europe, the people will have a chance to repossess their cities, reprivatise them, treat them as if they are not merely places they are sentenced to be in or which they only pass through.

A monolith does not come undone overnight, and I had not come to Silesia: expecting happiness and light, but as I neared the end of my stay I wondered how long it would take for that part of the world to shake off its melancholia. On the road back to Warsaw I even wondered how long it would take to me to shake off.

British Medical Journal
Volume 304, 13 JUNE 1992
pp 1557 - 1560

Post-totalitarian medicine

by Karin Chopin

There is no way of knowing what democracy will end up looking like in Poland but here are some glimpses of it now.

Ania, a 45 year old obstetrician I met on my travels with the itinerant Polish deputy - minister of health, Zbigniew Halat MD, invited me to her home to meet a group of people involved in various aspects of health care. Sitting round her kitchen table, they unfolded their lives for me.

Temptations of corruption

The young psychiatrist: "People have so much initiative in this country. This is our capital - but it must be exploited appropriately." The head of a public health laboratory. "Our records aren't that good, I'll admit, but who are the World Bank, the World Health Organisation, or the Americans to come preaching to us? Rather a life in a Gdansk housing estate than a life in the Bronx. . . . And as for Sweden, people there are so bored that they all want to commit suicide."

The matron in charge of a nursing home: "We experienced the second world war and ever since, like most of the people in eastern Europe, I think, we behave as if it never ended. Maybe this is why .I an1 never really surprised that even 45 years afterwards there is still a lack of medicines, bandages, syringes. . . ." ,

"If the new laws permitting private clinics are not encouraged, one can safely predict that our citizens will continue to resort to the time honoured Polish custom of illegal payoffs - bribing doctors and nurses," the ward sister said. The corruption of the medical services in Poland is an undeniable social fact - "It's so much easier to bribe women doctors than men doctors," a friend from Warsaw once admitted. "How much more natural to give presents to a lady."

"We don't want to be like this," a young doctor protested, "but it is the system that forces us to. We are state employees, but the state is bankrupt and tells us to go and earn privately. You start out with noble intentions but then you find yourself having to succumb to the temptations of corruption just to survive." (Doctors currently earn 72% of the average national wage.) The newly appointed Polish minister of health, Dr Marian Miskiewicz, acknowledges that doctors , accept bribes, especially in surgery, orthopaedics, and obstetrics, but he does not agree it is a common practice. A Polish sociologist elaborated: "The trouble is that the health care system, basically designed in the early '50s, remains a highly centralised and rigid structure. The more rigid the structure and functions of a given institution, the more likely is a split between formal and informal structures."

The hospital manager: "Do you know that ambulances are called out four times more frequently in Poland than in the developed countries of western Europe?" (The minister of health had recently publicly deplored the disgracefully wasteful deployment of ambulances in Poland.) "A woman has a temperature and cannot be bothered to go down to the clinic, so she calls an ambulance. And then we don't have enough petrol to send out for the chap who's having a heart attack." Here I could not help interjecting: "But people in the West think of you also as a developed country." "What do you mean, 'developed'?" one of the company retorted in the fashionably self deprecating manner of he postcommunist era. "We're lagging at least 20 years behind you. Don't you realise that in the past decades our principal slogan was building communism, our main priority defence . . . an issue such as personal health was about number 193 on our list of national priorities."

I mention the young man I had seen on the way there, crouched in the doorway, covered with only a blanket to protect him from the falling snow. "I have AIDS, please help me," said his sign. "It is only a miracle that there are not more beggars, what with more than half of the working population living at the edge of poverty," explained Father Rornan Indrzejczyk, pastor to the medical profession in Warsaw."

And then, in the midst of all this, our anti-choice nationalist government is threatening our right to abortion and telling us to multiply, to given birth to more Poles!" Ania, our host, was enraged by officials in the Ministry of Health, who refuse to disseminate any birth control information, and accused them, the Chamber of Physicians, and the gynaecology establishment of being "criminals" for allowing abortions to proliferate by opposing birth control programmes. "They should be serving time," she said, "for the harm they're doing to women's health. And apart from anything else, abortion is a costly method if used as a primary resource of contraception as it is in Poland." She is involved in a passionate crusade to lower the nation's appalling abortion rate. "Do you really want to know why so many of our doctors oppose birth control? In this country much shame is still attached to abortion, and our doctors oppose birth control because they make so much money out of private abortions (many women apparently choose this alternative to ensure proper anaesthaesia and anonymity). We've been brought up to look on abortion as a necessary evil, and on birth control devices as harmful and unreliable. . . . We are so backward that half our condoms break upon first use."

There were, inevitably, some negative comparisons with the West, which tended to centre on Westerners' "sad over-individualism." "Our sense of community is fast declining, but you're still far more solitary and lonely than we are. ... Over here if you fell sick in the street you'd immediately be taken into someone's house; over there, no one would know the difference if you died. And you put all your old people into homes for the elderly, which would be unthinkable to us, even if we had many such homes. Old age is celebrated in our country, rather than regretted." But someone else countered this: "Our family ties are sometimes too strong, and our living conditions kill all privacy - I could do with a little bit of loneliness sometimes, maybe even some of your Western alienation."

Health care reforms

"You are a fortunate young woman," Dr Andrzej Wojtczak, the distinguished professor of public health medicine at the Medical Postgraduate Centre in Warsaw, told me. "Foreigners usually only meet a very select bunch of English speaking people in our country. Do not be sparing in your criticism; you have seen so much. The trouble here is that knowing and accepting have become the same thing, and it takes an external voice to shake us. The politician cannot be pessimistic - even if a good dose of introspective gloom might be the only precursor to radical change. . . . We know the patient is sick, but sometimes you need to borrow the eyes of a friend to see yourself."

The avuncular Professor Wojtczak was an island of calm in the turbulent waters I had found myself tossed into in Poland. Every couple of weeks I would collapse into one of the comfortable chairs in his office, tea and cakes would immediately appear, and, with infinite patience and kindness the good professor who, as the principal author of the country's new national health policy, had far more important things to do, would help me get all that I had seen and heard into perspective. He attributed the current predicament of the Polish health service to years of excessive centralisation and bureaucracy; to the high priority put on developing the production of materials and consequent devaluing of health, and of non-manual workers including health workers; and to the informal health care system based on privilege that arose alongside the formal system. "Now add to that the present lack of discipline among civil servants, the arbitrary decision making that goes on at all levels, the country's outdated laws, the continuing corruption of many officials, and the fact that in the past many health statistics were either kept secret or were non-existent or unreliable, and perhaps you can begin to understand why you are finding reporting on our health service such a challenge."

Professor Wojtczak summarised for me the underlying trends of the Polish health care reforms now either in force or under discussion: decentralisation to a local level; increased cost consciousness; a diversification of health care funding sources; a shift of responsibility to the patient; and the re-education of about 40% of doctors to create general practitioners, and the introduction of the concepts of general practice and health promotion into medical education. "The latter will be our most difficult task," he explained, "for the concept of general practice is completely alien here. And since we have very few resources, the government has not got enough money for health promotion. What exists is totally uncoordinated, and anyway, the whole concept is bedevilled by the problem of lack of credibility of the source - politicians have been lying for so long that the general public distrusts them and is not receptive to health education messages. The transition to a more effective and efficient health service will be difficult without a restructuring of the whole socialist legacy," he admitted. "And it will take so long to change habits. For even though the socialist states have fallen apart, many of the old habits haven't. They are still with us, built in like a microchip. . . . Although Poland is currently leading the countries of central and eastern Europe in the field of health reform," he told me proudly, "the faltering progress it has made in this field stands both as an example and a warning for those emerging nations to our east about to undertake the same adventure."

Need for a change of heart

Sadly, the Polish people are not a healthy lot. Moreover, Poland is experiencing increasing problems meeting the health care needs of its population. The key problems are lack of money, inefficiency in the health service, profound demoralisation among health professionals, and a predominant reliance on public funds for the system's revenue. Since the 1970s the health of the Polish people has deteriorated and the increases in life expectancy achieved during the 1950s and 1960s have actually been reversed (figure). Mortality among men over 30 is now greater than 10 years ago, and 20% fewer men in Poland can expect to live to the age of 65 as compared with men of the same age in the Netherlands or Japan. Infant mortality is higher in Poland than in most European countries; although it declined from 111 deaths/1000 live births in 1950 to 15,9/1000 in 1989 (as compared with the Organisation for Economic Cooperation and Development range of 5,0-14.2), the rate of decline has slowed. The incidence of hepatitis B infection is 10 times greater than the European average. Poland's tuberculosis problem is still the most severe in Europe, and this disease remains the single most common cause of death of infectious aetiology in the country, although the number of deaths from tuberculosis has decreased drastically to 49/100 000 (as compared with 9/100 000 in the United States), The number of disabled people among the working population is increasing: this may be linked to the fact that about 20% of the workforce is exposed to a hazardous working environment. It is differences in lifestyle and harmful health practices such as unhealthy eating habits, smoking (Poland has Europe's highest growth rate in the incidence of lung cancer), excessive drinking, a sedentary way of life, and, to some extent, accidental injury and deaths that are held responsible for this remarkable divergence between eastern and western Europe (data from the Polish Ministry of Health). Although the programme of radical reform launched by the new Polish government to remedy the major ills of Polish society applies equally to the Polish health care system, the government has so far paid little attention to health problems, as it has been mainly concerned with improving the country's desperate economic situation and establishing a new political system. "We have already wasted two years arguing," Dr Miskiewicz admitted bitterly in a recent newspaper interview. In common with most people in the Ministry of Health, he is seized by the urgency to reorient Poland's health policy to address the radically altered epidemiological situation that has emerged in the past two decades. But he concedes that improvement in health care will be a prolonged process, as much a result of a change of heart as of a change of policy. "People have to understand that, although the system has changed for the better, they will get less for some time to come. ... There is no reaching out for simple answers provided by quick fix demagogues... The health care system needs large infusions of funds but money alone will not solve our problems."

The "Polish factor"

Indeed, the formidable problems facing Polish medicine are also those facing Polish society: the solution to the former cannot be achieved without that of the latter. Unfortunately, Solidarity tactics of political revolution remain the only tested method of achieving change. The Poles seem to be having great difficulty in making the necessary management changes to respond to the new opportunities. "At every level, people simply don't know how to take decisions and act upon them," a frustrated Ministry of Health official complained to me. "And if they do, they do so in an entirely disarrayed and arbitrary manner. The totalitarian system did not permit people to develop such skills; they were considered dangerous, because democratic."

Initiatives in the health field, as elsewhere, are stymied at each step by all kinds of bureaucratic, and what the Poles themselves refer to as "characteristically Polish," factors. The bureaucratic situation in the Ministry of Health is indeed so distressing that a visitor can only laugh at the outrageousness of it all; And, unfortunately, Stalinist ghosts still haunt the splendid nineteenth century palace in Warsaw's old town that houses the ministry. Those who helped run the health services into the ground still hold many powerful positions; The Chamber of Physicians (Poland's equivalent of the General Medical Council), for example, is still virtually controlled by members of the former nomenklatura, who may consider they have more to lose than to gain from further changes.

As regards the infamous "Polish factor," every visitor to Poland is, of necessity, referred to the history books for an explanation of the country's current distress. For Poland lies at the crossroads of Europe, and its spirit has been formed and deformed by the cataclysmic pressures of a millenium of continental madness. Centuries of oppression have therefore left the Poles with very little experience of government, negotiation, or leadership, and yet they have a tremendous ability to mobilise in times of crisis. Moreover, they are a highly individualistic people: every Pole has a different opinion on everything, and considers it imperative it be known. Inspiration and panache are held in high esteem; to be correct and dull is considered a horrid misfortune. They possess enormous vision and energy, but these energies often spill over in a disorganised, sometimes even disastrous way. Consequently, meetings, conferences, etc, often dissolve into chaos. As one visiting World Health Organisation consultant remarked to me: "The Poles must be restrained, they have too many ideas." Poland's history is, indeed, extraordinarily unhappy, and that unhappiness seems to permeate its modern day consciousness in a very tangible way. But they really cannot, as is their wont, put so much of what ails their health service down to the fact that Roosevelt sold them down the river at Yalta.

Strong emotions

One winter's day, the Polish deputy minister of health and I drove halfway across Poland to a meeting of chief sanitary inspectors from Poland's 49 provinces. We stopped for lunch in a village 100 miles south of Warsaw, and a hundred years away from 1991. The openings provided by the postcommunist order have turned the streets into a continuous market place, and life into a bit of a nightmare for these pioneers of public health, who are having to battle with the consequences of free enterprise bursting out all over. Unfortunately, Poland has become something of a dumping ground for substandard foreign food imports. Parliament is already overwhelmed and unable to keep up with legislation in this field, while regional public health departments hardly have the resources to keep up with vaccination programmes, let alone keep tabs on entrepreneurial Polish peasants turning out sausages in their back yards and then setting up shop by the road side. After a while the horror stories the sanitary inspectors were telling one another of what had been found inside some of these sausages, jars of pickled mushrooms, etc, and of milk from obviously leukaemic cows finding its way on to shop shelves, began to run together in my head. But their man from Czestochowa, home of Poland's Black Madonna, had a happy story: "Two million pilgrims we had, when the Pope came to visit last June, and not a single outbreak of diarrhoea...... And, what's more, I didn't even have to ban the sale of ice cream."

At cocktails that evening, I was assailed by the Lithuanian minister of health, a burly, genial epidemiologist: ''I am here because we in Lithuania are looking to Poland, our neighbour and ancient ally, for an example for our health service," he told me. "Tomorrow I return to Vilnius." He paused. "Would you do us the honour of coming to write about our health service too? There's plenty of room in my car." I declined regretfully; he was wonderful company at dinner.

The next day found us in Wroclaw, Lower Silesia's historic capital, where I was shown around the maternity wing of a local hospital. A curious feature of the Polish maternity system is that new mothers are forbidden to see their husbands or relatives at anytime during their hospital stay. Ministry of Health officials upheld this custom as an instance of Poland's strict or hygienic precautions in hospitals. Women have little or nothing to say about the conduct of their labour. The treatment is invariably rough, impersonal, crass, as in a production line. But my most vivid impressions of all concern the lack of warmth or personal attention in these maternity wards, in which I never saw a sign of women's practical ot emotional needs being taken into account: no personal effect such as a nightgown or slippers is permitted, no flower or card is allowed to taint Polish maternity wards' supposed "sterility." I seldom saw a smile or heard a happy voice in these institutions.

We continued out journey northwestwards to Zielona Gora, near Poland's border with Germany, where the minister opened Poland's first national conference on sex education (a suitable euphemism, which I now forget, was found for its official title). By coffee time, however, I was bored and sneaked out in search of our driver, who needed little persuasion to take me mushrooming (a favourite national pastime) in the beautiful forests surrounding the town. "Bison, lynx, and boar live here," the minister had told me as we had driven through. "And bears and storks and fish eagles," his driver had added. These two never missed an opportunity to draw their English guest's attention to the wealth of their nation. We filled the car boot with mushrooms and I returned to the conference hall trailing burr-like fragments, half a dozen yellow apples concealed in my ample handbag, just in time to witness the meeting erupt into impassioned chaos. That evening I ventured to ask the minister why Poles did not try to control their feelings in such situations. "What do you mean?" he retorted angrily, as if the idea had been proffered by a robot. "How can we do that? They are our feelings." Thus I learnt that true Slavs suffer their emotions as if they were forces of nature, winds and storms and volcanic eruptions. They cannot imagine tampering with them, for they are the most authentic part of them.

Sick but passionate

"So what is your diagnosis on the Polish health service after three months in our country, Dr Chopin?" the amiable journalist pressed me. "Third or Fourth World health care?" I wished fervently I had nor been so bold as to agree so the interview as her tape recorder whirred menacingly on the table between us. I managed to avoid committing myself by making a feeble joke about the English remaining an underdeveloped nation too - in passion. She liked that.

My tour of the Polish health service had been an extraordinary journey, both professionally and personally. I was profoundly depressed by the shocking vastness of the damage done by 45 years of communism to the health of the Polish people, and to their psyche. Equally, I was enormously inspired by the sense of basic values which survives, impressed by their extraordinary initiative, by their blissful lack of cynicism, so fashionable in the West. And although the Poles are living in an epoch rife with problems and perils, life there is certainly nor boring.

I would like to thank the many people all over Poland who were so helpful to me in researching these articles. I am indebted, in particular, to Professor Andrzej Wojtczak of the Medical Centre for Postgraduate Education, Warsaw; Dr Zbigniew Halat, deputy minister of health, and Mr Piotr Jaworski, his invaluable assistant; to the World Health Organisation team from Copenhagen - Dr Franz Staugaard, Dr Ilie Marcu, Dr Allan Juhl, and Ms Katinka de Vries; and, above all, to my friend Michael Slattery, who encouraged me to undertake this project and who died of an AIDS related illness while I was in Poland."



National Geographic
Volume 179, No. 6 JUNE 1991
pp. 36 - 63

East Europe's Dark Dawn
The Iron Curtain Rises to Reveal a Land Tarnished by Pollution.
by Jon Thompson, MD

While the world wasn't looking, Eastern Europe's regimes poisoned their environmet in the name of progress. Now new leaders must assess the damage and set priorities for reversing it.

In the fall of 1989 the communist governments in Eastern Europe began to crumble. As the Iron Curtain was torn apart, journalistst - nosing around in Poland, East Germany, Czechoslovakia, Hungary, Romania, and Bulgaria with a newfound freedom - were met by an outpouring of complaints about polluted air, contaminated water, and poisoned soil.

The headlines in the Western press - "Pollution Chokes East-Block Nations", "Environmental Catastrophe in Eastern Europe" - brought a crowd of questions to my mind: Why all the fuss right now? How bad is it? How did it happen? Is it affecting people's health, and how are the new governments responding?

(...)

Now that the Eastern block has opened up, the most outdated, inefficient, and uneconomical factories - often the worst polluters - will simply disappear, and thousands will find themselves out of work. With massive unemployment and backward industry, it will be almost impossible for any governments to make the environment a top priority.
Because pollution was used by political activists as a stick to beat the ruling communists and because money and jobs are far more important to the man in the street, the pollution issue will likely fade from the headlines. The sewage and sulphur dioxide, however, will still be there. To achieve the standards we take for granted, huge sums of money will have to be spent. But whose money? How will Eastern Europe's struggling economies pay for the necessary improvements, let alone the clean technologies we are now beginning to expect?

Enormous tasks lie ahead. To tackle them, East and West must join together. But will Eastern Europe's new rulers find the environment as important now as they did when they were in the opposition?


National Geographic
Volume 179, No. 6 JUNE 1991
pp. 44-45

Pollution's long shadow

From the Baltic to the Black Sea, half a century of runaway industrialization has left a smear of destruction through the heart of Eastern Europe. Under orders from Moscow, factories appeared where only farms and markets had stood. The historic university of Krakow was "given" the huge Nowa Huta steelworks simply because the Stalinist regime mistrusted the city's intellectual elite. Now the city lies within "the dirty triangle" formed by Poland, Czechoslovakia, and eastern Germany - a region of dense population where pollution controls are often nonexistent". Eastern Europe's network of rivers has become a convenient method of disposal - especially the Danube, recipient of eight nations' waste.





National Geographic
Volume 179, No. 6 JUNE 1991
pp. 44-45

ACID RAIN

Already choking on its own waste, Eastern Europe is also the acid rain dumping ground for the West, thanks to winds that bring pollutants from as far as Britain. In Poland more than 600,000 acres of woodland have been damaged; in Czechoslovakia, close to one million acres.







The Multiannual Wroclaw Festival of Integrity of the Human Person. dedicated to St John Paul II
Motto: Time for Enlightenment in Europe

Love Wroclaw's culture. Wroclaw, Poland, along with San Sebastián (Donostia in Basque), Spain, will be the European Capital of Culture in 2016. Wrocław wraz z San Sebastian (Donostia po baskijsku), Hiszpania, będzie Europejską Stolicą Kultury 2016 San Sebastián será Capital Europea de la Cultura en 2016 junto con Breslavia, Polonia 2016an Donostia hiria Polonia Wrocław hiriburuarekin bateria Europako Kultura Hiriburu izango dira.
Wroclaw, Poland, along with  San Sebastián (Donostia in Basque), Spain, the European Capital of Culture 2016
Wrocław wraz z San Sebastian (Donostia po baskijsku), Hiszpania, będzie Europejską Stolicą Kultury 2016
San Sebastián será Capital Europea de la Cultura en 2016 junto con Breslavia, Polonia
2016an Donostia hiria Polonia Wroclaw hiriburuarekin bateria Europako Kultura Hiriburu izango dira.

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The art of virginal charm - an irrepressible and an irresistible grace of virginity

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Miss Love of Wroclaw, Poland, World Virginity until Marriage Capital,
European Capital of Culture 2016


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The Wroclaw Virgins are Us!


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WROCLAW POLAND 2016
European Capital of Culture Europejska Stolica Kultury 2016 Capital Europea de la Cultura

Europako Kultura Hiriburu

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 Wroclaw Silesian Capital

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Wroclaw, Poland, the capital of Polish Silesia proud of its Roman Catholic past, present and future

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Saint Teresa Benedicta of the Cross, O.C.D. Roman Catholic nun, Virgin and Martyr
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How Edith Stein, a rebellious Jewish girl raised in Wroclaw
became a saint patroness of Europe and of World Youth Day


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SEDES SAPIENTIAE WRATISLAVIENSIS

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Mt Sleza  Silesian Sleza Mountain

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Stations of the Cross Droga Krzyżowa Křížová cesta Kreuzweg
Przełęcz Tąpadła - Szczyt Ślęży


MARCH OF VIRGINS UP TO THE MOUNT SLEZA

Web pages in Polish

Śląsk #1: Ślęża - korzeń Śląska od zamierzchłej przeszłości do teraźniejszości

Śląsk #2: Śląsk kolebką Polski

Śląsk #3: Dwieście lat prusactwa na Śląsku

Śląsk #4: Mapy

Źródło * Anna * Dzika * Przyroda * Góra * Ślęża * Śląsk * Polski

Ślęża

Towarzystwo Ślężańskie

Grupa Ślęży - fragment starej mapy i mapa turystyczna

Sanktuarium Ślężańskiej Matki Bożej Dobrej Rady w Sulistrowiczkach

Ziemia Ślężańska w internecie

MARSZ DZIEWIC NA GÓRĘ ŚLĘŻĘ



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