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Scum of the Earth

December 8, 2006 3 comments

Been meaning to write about this for awhile.

Is there a global threat in your Inbox?  Those spam email messages for fake Viagra are annoying, but they’re also the visible part of a growing trade in human misery.  Over half the commercial drugs in developing countries are counterfeit.  Some of the fakes actually contain a bit of the active ingredient of the real thing.  You take a weak but partially real vaccine, antibiotic, or ARV (anti-retroviral) drug, give it to sick people (usually poor), and you create living human factories for drug-resistant bugs.

AIDS and tuberculosis are a double-threat because one enables the other.  Not too many years ago the world was within shouting distance of completely wiping out TB, but the newest, antibiotic-trained strain of tuberculosis is “virtually untreatable”. The opportunity was lost and now the goal seems more elusive than ever.

When AIDS viruses are exposed to weakened ARV’s, they become immune to it as well.  Outright fake vaccines allow other endemic diseases to reestablish a foothold on populations.  Malaria kills millions of people each year and fake malaria drugs make for stronger malaria.

In addition to the immediate epidemiological consequences, there are political ones as well that make things worse.  Confidence in good medicine is undermined; policy makers lose the signal.  Spurious cures are touted and precious time is lost. 

For a world obssessed with terrorism and oil politics, and caught up in the emergence of new economies, this is a slow-motion disaster building steam.  It won’t stay in the ‘third world’ forever; some bright mind went and invented jet airplanes. 

Several things to consider:

First, this is an international problem, and it’s time to push for better UN leadership and real authority to meet global problems.  We might squirm at the notion of any real global authority but individual nations cannot act to fix this (and many other) problems. In particular, for all its power, the US cannot address this one alone.  Second, no pussy-footing around.  Nations that harbor and tolerate fake drug manufacture and sale may as well be harboring terrorist organizations; actually this is a far larger threat.  This is on a scale that warrants anything from covert action and economic sanctions to cruise missiles if the factory location is known.  It should be a capital crime on a level with war crimes to manufacture fake drugs. 

Third, drug authentication technology needs development NOW.  In terms of lives saved or lost, making sure the pills, injections, or tabs are real, is far more important than even developing the next new drug.  And as an issue of national security, it would be well worth our tax dollars to make sure that drug authentication technology is available all the way into small villages in the middle of nowhere.  It really IS a case of “fighting them there so we don’t fight them here”.

Behind the spam ads for erectile-dysfunction pills and other fake drugs are real people who are far more dangerous than their amusing little emails suggest.  Globalization created this threat, and only a global response can answer it. 

And it wouldn’t hurt to spread the word that buying any medication that way is not only personally risky, but creates a public health hazard too.

Links and notes:

Categories: Geeky, Safety & Health

The authority gradient

October 20, 2006 1 comment

Man-made disasters fascinate me.  Why was the space shuttle Challenger allowed to take off in conditions that violated NASA’s own rules?  How is it that captains of industry failed to consult an engineer on the condition of their dam on the South Fork of the Little Conemaugh river in Pennsylvania, ultimately obliterating Johnstown in 1889?  How did a mishandled safety test cause the worst nuclear accident in history?  Over the years I’ve read dozens of books about such events both large and small.

So naturally I taped Nova: The Deadliest Plane Crash on Tuesday night.  The episode set out to answer just how, on a fog-shrouded runway in the Canary Islands in 1977, did two fully-loaded 747 aircraft collide, killing nearly 600 people?

Pilot error, as it turned out, but the pilot who made the biggest error was KLM’s most experienced guy.  He trained other pilots and was so respected that KLM featured him in their adverts.  He was stone-cold sober and there was nothing bad going on in his life.  His lifetime of rationalism and care just… missed.

So what the hell happened?

Nova did a fantastic job presenting the sequence of events that led to the flaming horror.  I would love to have the episode shown in high school classes, tying together many areas of working life:

  • The Spanish separatist bomb that closed the airport both the planes (and many others) were supposed to use, diverting them to a smaller airport that could not handle their passengers

  • Economic pressures to take off again as soon as possible
  • The role played by passenger dissatisfaction
  • Sheer bad luck that the two 747’s were blocking the runway entrance from the other planes
  • The KLM pilot’s decision to fuel, not just for the short hop to a nearby island, but for the subsequent trip to the Netherlands
  • Overworked, underprepared tower crew, whose non-standard terminology contributed to miscommunication between the two planes and the tower
  • The narrow, poorly-marked runway at the small airport
  • Horrible timing of the weather, dropping visibility to less than 500 meters in a few minutes
  • Overlapping radio signals that obliterated two crucial pieces of information
  • The role of “cockpit culture”, which was found to have prevented the last, most important communication that would have saved all those people in spite of the other factors.

That last item was the most interesting.  Few man-made disasters are the result of a split-second of inattention.  Usually a number of factors, individually quite improbable, must line up like the pins in a lock tumbler for the last, fatal mistake to make history.

Nova described the “authority gradient” of cockpit culture 30 years ago.  The Captain sat atop a more or less Olympian pedestal, pretty much immune from criticism.  Co-pilots and crew were not encouraged to question the Captain’s actions; indeed, to do so was to risk one’s career.  The more exalted the pilot’s reputation, the less anyone could say anything.

The Pan Am pilot made minor mistakes navigating in the fog and communicating with the tower.  The tower made minor mistakes communicating with both planes (and in listening to a soccer game while 600 lives hung in the balance).  And the KLM pilot, perhaps believing he had been given clearance to take off, powered up his engines…

“No!” said the co-pilot.  “We have not been given clearance to take off!”

The most senior, experienced pilot, chagrined, powers down.  There is more chatter.  Then he powers back up again, starting his plane down the runway in the dense fog…

1706:32.43 KLM 3 Is he not clear, then?
1706:34.10 KLM 1 What do you say?
1706:34.15 PA ? Yup.
1706:34.70 KLM 3 Is he not clear, that Pan American?
1706:35.70 KLM 1 Oh, yes. [emphatically]

Perhaps because of the KLM pilot’s very senior position, neither the copilot nor flight engineer questions the pilot again, and the impact occurs about 13 seconds later. Based on the Pan Am cockpit voice recording, investigators determined that the Pan Am flight crew saw the KLM coming at them out of the fog about nine seconds before impact. The Pan Am captain says “There he is … look at him! Goddamn, that [expletive deleted] is coming!” and his copilot yells “Get off! Get off! Get off!” The Pan Am pilot guns the engines but it’s too late. At 1706:47.44, the KLM pilot screams, and the collision occurs.
- Deadliest Plane Crash, Final Eight Minutes

When powering up the engines a second time, an opportunity existed to avoid the crash.  Clearance to take off had not been given, and both the co-pilot and flight engineer knew it.  But no further objection is made until the plane is hurtling down the runway at almost takeoff speed.

There are few good models for organizations to function with no authority gradient.  Extremely experienced, capable people are nearly always right, in a setting where being wrong can have terrible consequences.  But that is exactly the point; even a brilliant, experienced pilot can have one moment off his peak. In fact, it probably happens fairly often.  Usually, the moment passes without incident.  But if enough problems line up, and the authority gradient is too steep…

According to Nova, pilot training has changed in the years since the accident.  The authority gradient has been somewhat levelled.  Now pilots are taught to encourage questions or even negative feedback from crew.  The importance of dissent is proportional to the lives that hang in the balance.

I have seen this same phenomenon in one case study after another: the trusted, authoritative leaders were simply too powerful, or feared, or trusted, or even beloved to question, or did not conceive themselves as ever being mistaken, and the mind-blowing, catastrophic mistake that follows. 

The nagging voice of doubt is seldom popular, but it’s often a crucial view from another angle.

Hot tea

October 17, 2006 2 comments

It would hardly be surprising to learn that the British think Tea is good for you.  (In other news, the Pope is Catholic and the sky is blue.)  They say it doesn’t dehydrate you – “that’s an urban myth” – and of course it contains “antioxidants” and everybody knows how great those are.  :-/

My great-grandmother was about as Brit as they come, and that has filtered down to the current generation.  Even today I have two or three cups of tea every day along with whatever coffee comes my way. Lately, both have been decaf after 12:noon but oh-well.

A picture of a double-walled steel mug full of tea would be pretty boring, no?  Shown here is my little pocket flashlight shining through the glass carafe’ of our Mr Coffee tea-maker, which is really just a coffee-maker that we have dedicated to making tea.  We have another one that we use for coffee.

Categories: Geeky, Safety & Health

France careening toward smoking ban

October 8, 2006 6 comments

If you call a friend in Paris next year, and they seem even more rude than usual, it may not be their fault.  France – the whole country – is banning all outdoor smoking.  Said the Prime Minister:

“We started on the basis of a simple observation – two figures: 60,000 deaths a year in our country linked directly to tobacco consumption and 5,000 deaths linked to passive smoking.

“That makes more than 13 deaths a day. It is an unacceptable reality in our country in terms of public health,” he said.

I’ll say it’s more than 13 deaths a day; try dividing 65,000 by 365.  It leads one to be a bit skeptical of their figures.  But undeniably cigarettes are dangerous; people know this, still smoke anyway, and resent messages from the nanny state to make them stop.

The transition isn’t likely to go smoothly.  A friend of mine who visited France a couple years ago described it this way: “Everything was really expensive, the food was great, the cities were beautiful, all the women looked like models, and everybody smokes.”

There’s a Saturday Night Live routine in there somewhere…

Categories: Geeky, Safety & Health

Shooting in Canadian college

September 13, 2006 6 comments

A mass shooting at a college in Montreal:

The man, clad in black, entered the canteen of Dawson College, in central Montreal, at lunchtime.

Some students fled in terror from the campus as he opened fire, while others barricaded themselves in classrooms. The dead woman was in her 20s. At least six of the injured are in a critical condition in hospital.

Montreal’s chief of police, Yvan Delorme, said the gunman was killed by officers after they stormed the building. Later, he told RDI Television that the young woman had died of her injuries in hospital.

Dawson College students described how the shooting began at about 1245 local time (1645 GMT), and how a total of 20 shots were heard over a half-hour period.

One witness described how the gunman, dressed in a black trench coat and military boots, appeared emotionless as he carried out the shooting. “He said nothing. He had a stone cold face… He just started opening fire,” said student Soher Marous. Others told of how he pursued terrified students along corridors and up stairwells. Those who could not escape barricaded the doors to classrooms and hid themselves under their desks…
BBC News: Gun rampage at Canadian college (emphasis mine)

You can read the whole article, and its companion article, “We hid under our desks”, and not see the phrase that originally caught my eye and prompted me to record the URL for later blogging.  Best I can remember it; “Police were seen with guns drawn, sheltering behind parked autos outside the building”.  But in the nine hours since seeing the article, that phrase is gone, replaced by the first phrase highlighted above.

When the Columbine shootings took place, the police secured the perimeter, established communication lines, connected with federal authorities, and did everything by the book while the two killers stalked around the school shooting people.  It would seem that police departments have at least learned the public-relations lesson of not letting that impression stand.

Still, note the second highlighted phrase: “20 shots heard over a half-hour period”.  The killer had a half-hour to wander around while the police got ready to “storm the building”.  I accept that there are probably good procedural reasons for this but the lesson is clear: if some whacko starts stalking around your building with a gun, you are on your own.

Categories: Geeky, Safety & Health

Steve Irwin: one last, short, painful learning experience

September 5, 2006 2 comments

As we all know by now, Steve Irwin died by perhaps the most unusual means possible – only 16 other recorded deaths from stingray strikes.  I wasn’t going to do a post about it because so many other bloggers have done very interesting posts covering the irony of it all. 

But it’s been a learning experience, which would probably please Irwin a lot. I always thought stingrays were beautiful but harmless; now I know better: 

Apparently the venom of a stingray has three components; two which cause tissue necrosis and one, serotonin, which causes intractable, irremediable pain.  You have heard of serotonin before because it is a neurotransmitter, sometimes in short supply for people who are clinically depressed (hence the use of seratonin reuptake inhibitors to treat clinical depression).  So a little serotonin is good, but you don’t want a huge jolt of it injected in a wound.

In the searching of all this I saw some videos of stingrays and must say, they are incredibly beautiful animals.

Who knew this weekend would be so educational?  Rest in peace, Steve Irwin.

Categories: Geeky, Safety & Health

Open thread 3 on poverty: Health Care

July 27, 2006 15 comments

HEALTH CARE… LuckyJohn19 alluded to the fact that if you don’t take care of certain things, you will pay for it in the end.  People are as much an infrastructure of our country as bridges, and are even more important.  I am in favor of basic socialized medicine.  No heart transplants, thank you, nor extreme measures to eak out a few more weeks of life, but working people should be able to count on basic care…

Other industrialized countries – many quite wealthy – manage this and actually get MORE for their money than we do.  Fact is, our health system spends more to get less than any other in the world.  Hard statistics of infant mortality and longevity bear this out.

Of course I have no objection to the wealthy buying extra insurance for extreme measures.  That is what drives medical advancement, after all, the way auto-racing drives vehicular engineering.  Today’s cheap, basic care was yesterday’s cutting-edge miracle.

Much has been made of the medical malpractice crisis.  But you can bet that 80% of the insurance payouts go to pay for the screwups of the worst 5% of the doctors.  Insurance companies need to refuse to insure those doctors, effectively putting them out of the business.  Hard-nosed actuaries that they are, they should be able to distinguish between risky work like OB/GYN and a pattern of truly stupid mistakes.

(Most likely this is true of any risk-prone occupation.  Who would be surprised to learn that 80% of charges of police brutality focus on the worst 5% of cops?  Professions need to get better at – pardon the expression – “policing” themselves.)

Healthy people work better, and small employers could reach farther if they weren’t trying to manage basic health care.  Some things are better done wholesale and health care is one of them.

Notes: see also

  1. Capitalism vs Socialism

  2. Education
  3. Health care
  4. Social programs
Categories: Geeky, Safety & Health

Wind farms across country stopped by political maneuver

May 31, 2006 4 comments

WASHINGTON, May 31, 2006 (UPI)—The U.S. government has ordered work stopped on more than a dozen wind farms, saying the giant turbines might interfere with military radar.

Not buying that for a minute.  The new wind turbines are about 310 feet tall.  How low does military radar need to go?  I suppose a threatening plane could fly 200 feet off the ground in a circle around the turbines…

But supporters of wind power say the reason for the actions is political and has little to do with national security, the Chicago Tribune reported Wednesday.

In one instance, critics say, a group of wealthy vacationers believe a proposed wind farm off the Cape Cod, Mass., coast would spoil the view of the ocean from their summer homes.

Ah.  Call me cynical, but that, I can believe.

The attempt to stop the planting of 130 turbines in Nantucket Sound has led to a moratorium on new wind farms across Illinois, Wisconsin, Minnesota, North Dakota and South Dakota, the Tribune reported…
- Post Chronicle: Government blocks wind farm plans

Great.  A bunch of wealthy people (including Ted Kennedy) are whining about the Cape Wind Project and it puts a stop to a part of our national energy portfolio. 

Yes, some people don’t like windmills.  Are they the same people who want action on global warming?  Wonder how their precious cape will look after sea level comes up five feet or so?  What will it do to their tourism industry if their quaint New England towns are under water?  Will they be petitioning the government for levees?  How quaint will that look?

It’s the 21st century now.  We need a more diverse energy portfolio, and not just for environmental reasons.  We especially need to take advantage of environmental energy differentials.  By their nature, such differentials are more diffuse than concentrated energy sources like coal or oil, so will necessarily require large structures to harvest.  If they’re waiting for the environmentally perfect (and concentrated!) energy source to come along, it’s going to be a long wait.  We just don’t have that kind of time.

A picture is worth *cough* a thousand words…

May 27, 2006 17 comments

“The public are being asked to choose a series of picture warnings to appear on cigarette packets beginning next year. People can give their opinion on a range of images designed to highlight the dangers of smoking on a website set up by the Department of Health.

Evidence shows that images have a greater impact than written health warnings alone, and they have already been introduced in some countries. “
- BBC News: Graphic images deter smokers

Two thoughts:  First, this campaign is much better than banning cigarettes.  Just get the facts out there and let people decide.  From a government perspective, you can’t save every individual from their own bad choices, so it’s better to preserve freedom and avoid creating a black market (which would surely happen).

Second, this is the right way to convey the message.  As design guru Don Norman says, “Signs don’t work” because people don’t read them.

Categories: Safety & Health

This is why we have a ‘shortage’ of landfill space

May 25, 2006 4 comments

It’s odd, I know, but I like to look in dumpsters.  Trash is where you see the whole chain of consumer value from the other side; what are people willing to pay to get rid of?  In this case, it’s a couple hundred 4-foot fluorescent light tubes.  Each one contains a few milligrams of mercury but they’re going to a plain old landfill alongside my dinner leftovers.

I commute on a bicycle and my route takes me past this dumpster, which is near a large building.  It has this many bulbs in it about twice a month.  And that’s just one building.  Multiply it by all the superstores and hospitals and… well you name it… and you get a pretty significant amount of mercury.  In landfills it is turned into particularly nasty organic compounds by bacteria, the kind that feed on my dinner leftovers.  These compounds can outgas with the methane that landfills constantly produce.

‘Simple’ solution?  (OK, not so simple) separate out toxic and non-toxic trash.  Then there’d be no shortage of space for bulky, non-toxic trash.  And we’d keep the mercury out of the biosphere.

Think it would cost a lot?  Many lakes and streams in Illinois can no longer produce edible fish due to mercury.  That’s a huge industry, shot down.  Much of the mercury comes from from burning coal, but a goodly amount of it – and other nasty chemicals too – comes from dumpsters like this.  Big economic impact. 

That’s why landfills need elaborate containment systems, and an expensive political process to locate them far from people with enough clout to mount an effective protest.  I have a hunch it would be cheaper to deal with the toxic stuff separately when you account the real cost.