American Public Health Association Anecdotal Report

Atlanta, GA, October 20 - 25

(This anecdotal report is almost all impressions and process.)

This is my first plane trip since September 11. In anticipation, I’ve been apprehensive about airport security procedures and the necessity to change my carefully honed packing system.

I had a 7 AM flight on Tuesday. As I was getting ready the day before, setting my alarm for 2 AM didn’t seem appealing and at the last minute, as long as it seemed I wouldn’t be sleeping much, I went stand-by on the red-eye, leaving at 10 PM and arriving in Boston for breakfast with my sister. The airport was not crowded nor was the flight, and though there was a uniformed military presence, the checking seemed uneven and cursory. Except that all computers had to be removed from their bags and passed separately through security.

I spent two days enjoying the fall foliage, wine reds, oranges, still some green, and then flew to Atlanta for the American Public Health Association Meeting. Security at Boston’s Logan was stricter - computers had to be booted up, everything in one of my bags was examined, even my wallet opened, and I felt as if the guard was clucking over what I choose to carry with me when I fly. Some boarding passes were specially marked for random checking - those people were kept from boarding until all were on board, then wanded and their carry-ons again checked. My flight was perhaps 3/4 full. The lines for checking in and for security were long, but partly because even though passengers were advised to arrive early, the ticket counter and security gates weren’t yet staffed so lines formed. It moved along reasonably well when the employees got started. People on the flight were friendly, perhaps more of a sense of camaraderie than a month ago. My seat mate was Portugese, Mediterranean complexion, and he had had three checks before boarding. He is ex-Air Force and said he didn’t mind at all.

Thinking back over the two flights, I’m still apprehensive about the increased scrutiny, my sense of surveillance, the intrusiveness of having my packed possessions inspected. It reminds me too much of inpatient days and it’s been hard for me to feel pleasant and calm while somewhere inside I’m remembering Nurse Ratchet & Co.

Around 9 PM I began to hear loud sounds very close by, explosions, bombs, ... ? I opened my hotel drapes to a firework display!

Saturday morning Laura Ciprotti and I had brunch, registered for the conference, introduced ourselves to the person in charge of the mental health booth display and spent several hours browsing through the program trying to choose how best to spend our time. Then I came back to my room and plotted my choices out on a timeline, made decisions between conflicts, ... All told, maybe four hours prep time! There are several revised sessions and a few new ones to highlight public health’s response to national health issues now. Those are the sessions that seem compelling to me.

The exhibit hall is very large, has maybe 1000 exhibitors, give-aways of pens, post-its, candy, condoms, Georgia peanuts, ... from lots of schools of public health, safe-sex educators, wellness providers. I staffed the mental health booth for one shift. Then Laura Ciprotti and I went to the mental health section business meeting and saw the inner workings of APHA and organizational politics, had pasta at the general reception, talked with a mental retardation specialist about how there is People First for people with mental retardation and NAMI for people with psychiatric disabilities and why one group of parents let go and the other didn’t. My conclusion from what he said, is that professionals began the emancipation of people with mental retardation.

I ran into Celia Brown and Pearl Johnson coming up to my room, and Carrie Kaufmann the next day.

Our hotel is two miles from the convention center and the center is very large and spread out. I’ve decided to leave the computer in my room and make these notes abbreviated. All the conference details and abstracts are at www.apha.org. The conference schedule is 200 pages long; it’s hard to choose – each section has available a handout for its subjects, but browsing across takes some researching. And it’s expensive here - the food vendors are at the sites - I haven’t found convenient other choices.

It’s been foggy in the mornings. Tall spires, ascending levels dotted with light, softened in the early light, disappear into the mist.

I attended the m h section business meetings - the emphasis was on APHA organizational issues and infrastructure and m h’s place rather than on policy and values.

There was discussion of the implications about anthrax-exposed sites being treated as crime scenes and hence sealed with the public health issues secondary - information dissemination restricted - how to balance social justice, health, crime

The opening session was held in a huge dark room - thousands of people - with six large overhead projection screens. It felt like being at a movie not a conference and I didn’t like the isolation of the dark room.

A session held in a medium size room organized by the Peace Caucus on War and Public Health overflowed the room. A session on the federal, state, and local responses to September 11 held in a huge room had less people. A resolution drafted by the maternal and child health section is being circulated which calls for humanitarian not military interventions.

The schedule goes from 7 AM to 8:00 PM with half hour breaks to get from one place to another. The bathroom and food lines are long - it takes the whole half hour to do one of the other. The venue is both the convention center and a number of hotels. It’s very hard to sample things in more than one track, for instance disability or social justice, because the locations may not be contiguous and the social and business sessions for all sections are at the same time. So it’s really several dozen mini-conferences in one place with one exhibit hall and one opening, one closing, one theme.

Celia Brown, Pat Deegan, David Oaks, Pearl Johnson, Vanessa Jackson and Diane McCarty spoke at a seminar for Atlanta consumer/survivors that Larry Fricks organized: The Struggle for Civil and Human Rights for People with Psychiatric Disabilities. Yvette Sangster and Atlanta people were there, maybe 25. Afterwards a reception with the whole mental health section at the Martin Luther King center.

There’s been a lot of discussion about terrorism. As I listened to the discussion of using fear as a tactic, I was continually reminded of TAC’s violence initiative, how they augment and distribute their database of incidents. There’s also an anti-Israel atmosphere - I’ve only heard one side of a 5000 year old story. One man wearing a yarmulke walked out of a major session in anger at the speaker’s unacknowledged bias. I went to a session on Palestine sponsored by the Peace Caucus and was struck by the lack of balance in the presentations and the call for the US to withdraw support from Israel. One man self-identified as a Jew, wondered at the one-sidedness, was told that the US media is biased towards Israel so the other side must get its information out. There was a recommendation for one state, not two, in the area, which, because of family planning values, would have an Arab majority. After the session ended, there was networking, a few with the man, many with the speakers. Throughout I kept thinking of consumer/survivor concerns, discussions of commitment at NAMI/TAC meetings, discussions of PACT outpatient commitment, c/s discussions about human rights and social justice and it seems to me it’s all propaganda, this Palestine presentation as well. Maybe a debate format is the only way to really put the issues out. Ron Thomson likes this format.

Overheard: A NY study of Kendra’s law’s impact finds that 10% of those committed stayed the same and 30% of those committed got worse. (I have no more details; I’ll let you know when I hear more.)

The Gates Foundation is exploring the concept of alliances and their value. They began with a definition: an alliance shares decision-making, resources and accountability.

Scapegoating is a way to understand and control; assigning blame to a known person manages individual fear and anxiety.

Alternatives to war are concepts of restoration (restorative

justice) and reconciliation (Tutu, S Africa). There is a trend towards a globalization of (Western) values; if it continues it will also reduce animosities.

A primary outcome measurement is "compliance with advice."

Laura noticed there were SOCSI application forms at the SAMHSA information booth.

The front entrance to the Westin was closed, for construction. Only people with room keys or conference registration cards were allowed in the motor lobby door.

I went to a session on primary health care which noted the increasing health inequities. It was held in a large room, chairs 30 rows deep, 30 seats across. The dias and screen were too low to see except from the very front and it was strange to sit neatly in rows with nothing to look at listening to a disembodied voice. The question was asked in that session: "Who has the most at stake?" and the answer was the individual health service user.

Public health is about equity and focuses on crisis and prevention. Wellness of course occurs, but it is as a result of the equity emphasis, a lifting up of those who have no access to the minimum level, rather than a lifting up of the health of all citizens to the top layer.

I walked from one site to another and was struck by how many people on the streets were wearing badges - some from the APHA conference, some other meetings, some employment identifications.

Laura and I went to the closing mental health section business meeting and we will be included on the program committee for next year. We will need lots of consumer/survivor answers to the Call to ensure some representation. The meeting will be in Philadelphia, November 9 - 13.