Tuesday, November 20, 2007

Misplaced Modifiers

Today I typed the words "oil, Nov. 20, 2007" into the New York Times home page. There were 21 hits -- 21 stories today contained the word oil.

A few of them were cooking oil -- I'll look into that at some point. I was amazed at how often the word oil is used as a modifier -- as in
"a 5.1 magnitude earthquake jolted Iran's oil-rich southwest "
"ties have strengthened between the two oil-producing states since 2003"
"which has made a legal claim for millions from the oil fortune of the model's late husband"

so these are places where oil is brought into conversations that have nothing to do with oil... implying that oil is inherent somehow in the conversation. As when a woman's clothes are brought in to a news article, or a man's earnings. Things that are valuable in one context become what a thing is talked about in all contexts, giving it the appearance that money should make it more important to us (the reader). This has implications in the realm of how much attention we pay to disasters, politics and war -- as well as relief -- Katrina v. San Diego ...

But in chosing my one thing I learned today -- I chose the following article. The oil is buried as it is in the adjectival clauses above -- but here's the story:
Cuba is having trouble keeping great doctors because they don't have enough money to pay them. They figured out this amazing win-win situation -- where by they pay their own doctors a lot of money to treat Venezuelan patients. They do this in exchange for -- OIL.

In recent years, the program has allowed Cuba to use its doctors as barter for subsidized Venezuelan oil...

Oil.


A Health System’s ‘Miracles’ Come With Hidden Costs

Jose Goitia for The New York Times

Patients at the Ramón Pando Ferrer eye hospital in Havana.


Published: November 20, 2007

HAVANA, Nov. 16 — A shiny new tour bus pulled up to the top eye hospital in Cuba on a sunny day this month and disgorged 47 working-class people from El Salvador, many of whom could barely see because they had thick cataracts in their eyes.

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Jose Goitia for The New York Times

Dr. Eric Montero with Reina López, of El Salvador.

Among them were Francisca Antonia Guevara, 74, a homemaker from Ciudad Delgado whose world was a blur. She said she had visited an eye doctor in her home country but could not pay the $200 needed for artificial lens implants, much less pay for the surgery.

“As someone of few resources, I couldn’t afford it,” she said. “With the bad economic situation we have there, how are we going to afford this?”

Cuba’s economy is not exactly booming either, yet within two hours Ms. Guevara’s cataracts were excised and the lenses implanted, with the Cuban government paying for everything — including air transportation, housing, food and even the follow-up care.

The government has dubbed the program Operation Miracle, and for the hundreds of thousands of people from Venezuela, Central America and the Caribbean who have benefited from it since it was started in July 2004, it is aptly named.

Yet the program is no simple humanitarian effort, and it has not come without a cost. The campaign against vision loss serves as a poignant advertisement for the benefits of Cuban socialism, as well as an ingenious way to export one of the few things the Cuban state-run economy produces in abundance — doctors.

Cuban doctors abroad receive much better pay than in Cuba, along with other benefits from the state, like the right to buy a car and get a relatively luxurious house when they return. As a result, many of the finest physicians have taken posts abroad.

The doctors and nurses left in Cuba are stretched thin and overworked, resulting in a decline in the quality of care for Cubans, some doctors and patients said.

The Cuban authorities say they have treated more than 750,000 people for eye conditions like cataracts and glaucoma since the program started.

At the same time, Cuban doctors have set up 37 small eye hospitals in Latin America, the Caribbean and Mali. Twenty-five of the centers are in Venezuela and Bolivia, whose leaders have close ties to the Castros. The hospitals are staffed with more than 70 top-notch eye surgeons from Cuba and hundreds of other nurses and ophthalmologists.

Dr. Sergio M. Vidal Casali, 84, has worked at the Ramón Pando Ferrer Cuban Institute of Ophthalmology for more than 50 years, specializing in diseases of the retina. He said the heavy flow of foreign patients through the hospital, combined with the exodus of several physicians to other countries, had hurt his department. “I don’t like it, really,” he said. “It’s wonderful for the people, but not for us. It disturbs our work.”

Dr. Reynaldo Rios Casas, the director of the institute, said the first days of the program were hectic. Eye surgeons worked in three shifts, keeping the hospital’s operating rooms going all day and all night. It was not uncommon for a single surgeon to perform 40 operations in a shift.

“It was really heroic,” he said. “We were operating day, afternoon and night.”

Since then, Dr. Rios says his hospital has been training new eye doctors at an astounding rate of 2,100 this year, half of them surgeons. The hospital’s budget has been increased tenfold and its equipment upgraded. It now has 34 operating theaters with state-of-the-art equipment, including two outfitted for advanced laser surgery techniques.

One advantage of the program is that it has given young surgeons a steady flow of patients on whom to hone their skills. Just this year, they have performed 394 cornea transplants at the hospital, he noted. “Our specialists have an incredible amount of experience,” he said. “What specialist in the world can do dozens of cornea transplants a year?”

In recent years, the program has allowed Cuba to use its doctors as barter for subsidized Venezuelan oil and to forge closer relations with other countries in the region, including those, like El Salvador, that have not been historically close to the Communist regime here.

Of course, the people who have their sight restored could not care less about the political and economic repercussions of the program. For them, the offer of free surgery was a dream come true.

Mrs. Guevara, whose husband is a retired construction worker from San Salvador, said she had given up hope of seeing again. She heard about the Cuban project on a Mayan radio station. “I never imagined anyone would help me the way they have helped me,” she said as she waited for surgery. “I thought I was going to end up blind.”

Near her in the waiting room was Reina López, 58, of San Vicente, El Salvador, who has not been able to see for 13 years because of cataracts. Her daughter, Adilia Reyes, 33, said she had cared for her mother since she lost her sight. The family, including four children, survives on her father’s salary of $3 a day, plus whatever fruit can be sold at a market on Saturdays.

“For the poor, this is a tremendous benefit,” she said, as she guided her mother to a presurgery test. “If it works, we’ll be so grateful.”

Downstairs in the cafeteria, Manuel Agustín Isasi, 33, a professional fencing coach from Islas Margaritas in Venezuela, was eating a lunch of pork, rice and beans, able for the first time in years to see his food with both eyes. Three years ago, he had been whitewashing his home when he accidentally burned both corneas with a bucket of quicklime. The accident ended his fencing career.

He had been one of the first to receive a cornea transplant in his left eye when the program started, he said. Then, in early November, doctors in Havana replaced the cornea in his right eye. He was unabashed in his praise for the Cuban government and for President Hugo Chávez of Venezuela.

“I would have remained completely blind,” he said, fixing a reporter with a swordsman’s gaze. “Vision is half of one’s life.”

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