Public health for the common defense
Yesterday and today, Jeff Jarvis has been listing a number of homeland defense recommendations for Tom Ridge to consider. Of all of them, the ones I think would reassure me the most would be the public health related items, such as getting information about new disease threats and diagnoses out pronto,. Foremost among the public health measures should be to have plans and infrastructure capable of handling surges of new patients. Look up "patient surge" and "smallpox" on Google, and you'll find articles like this one by Monica Schoch-Spana, Ph.D, in the March 2000 Biodefense Quarterly: "Hospitals Buckle During Normal Flu Season: Implications for Bioterrorism Response." Dr. Schoch-Spana writes:

The prevalence of crowded emergency rooms and ambulance diversions around the country during the 1999-2000 influenza season might suggest that an unusually potent virus was at work, sending sick people to the hospital in droves. Epidemiological data, however, made it clear that the recent flu outbreaks were nothing more than the annual appearance of a familiar respiratory illness, only appearing earlier than expected.

That patients' urgent demands outstripped the ability of many hospitals to respond with prompt and, in some cases, adequate care was less a result of the disease than underlying pathologies within the healthcare system. Beset with pressures to reduce costs and facing regional nursing shortages, hospitals today lack the flexibility to deal with even nominal upswings in demand, let alone the potential health crisis of a biological attack or pandemic influenza. [...]

Influenza is an annually occurring outbreak of an infectious disease with comparatively low morbidity and mortality rates, and an active vaccine campaign. That it creates profound hardships for U.S. hospitals is worrisome from a bioterrorism preparedness perspective. Appraising the 1999-2000 flu season, the President of the Maryland Nurses Association, Mary Beachley, concludes, "If a major super bug hit, we'd be in trouble. Our response in the short-term would be okay, but long-term care with large numbers of critically ill patients [would] be a problem." The efficiencies achieved through reduced bed capacity, staffing levels, and equipment ownership - survival strategies within a competitive health care industry - have left hospitals ill-equipped to deal with a mass casualty scenario.

There simply is no "give" in the current health care system, "no excess capacity or flexibility to handle things outside the norm, even the slightest blip," according to Virginia Hastings, Director of Emergency Medical Services for Los Angeles County. Efforts to prepare the country for a potential bioterrorist attack must include a severe accounting of the present state of hospitals - namely the fiscal conditions that have fostered profound inelasticity.

Luckily, there's a political model for fixing this I assume both fiscal conservatives and bleeding heart liberals can love: the Interstate highway system. That system, built on the public dime, was sold by Eisenhower as a military preparedness measure, to better allow tanks and other military hardware to be ferried hither and yon across these United States; many of the segments of that interstate system make little short-term economic sense, but as a whole, they ensured that military needs (however unlikely) for quick overland transport and relocation of heavy equipment could be met.

Likewise, I think we should consider a major public health initiative, that subsidizes and sponsors hospitals and hospital workers from doctors to nurses to paramedics, with the goal of higher preparedness for patient surges from bioterror attacks. Just as with some stretch of interstate highway in North Dakota or West Virginia, the beds and workers thus subsidized might not meet the strictly economic tests usually applied to a business proposition. But this isn't just a business proposition; it's providing for the common defense, against some of the plausible worst threats evil minds can conceive. We know those minds are at work. Let's provide for some homeland defense -- and not let the day-to-day benefits of a less precarious public health infrastructure bother us too much. posted by Thomas Nephew at 4:59:00 PM -- |    

 

The world court of a hundred days
...is the title of a rather good op-ed piece ("Das Weltgericht der hundert Tage"), by Josef Joffe in the current issue of the German news weekly Die Zeit. The subtitle translates to "The 11th of September, the war on terror, and the rediscovery of the best about the West". Joffe has remained pretty reasonable since 9/11, and this is a good summation from a friendly European perspective. He has some interesting insights about nation states, the EU, NATO, the UN, defense spending, and more:

Especially one state [has prevailed]: the "last superpower." America built a global coalition, gathering classic friends like England, ex-enemies like Russia, and not-yet-challengers like China. But as a practical matter, the USA conducted the war in Afghanistan alone: with bombers arriving from Missouri, from an all but inconceivable distance, dramatizing the global reach of this democratic empire like no other factor of the war in Afghanistan. The coalition was a legitimizing decoration - helpful, important, but not decisive. [...]

...after 9/11 it quickly became clear that venerable supranational institutions like NATO and the EU, which have been trying to amalgamate states' powers for fifty years, have slipped into the defensive. NATO did declare a state of collective self-defense, but thereafter played a side role in the first global war of the 21st century. It was an observer, not an actor. It was nation states which decided and acted, and specifically the great ones: America, then England, France and Germany. [...]

It is also a fact that the EU, the boldest community-building project in history, had to acknowledge its limits in these hundred days. It wasn't functionaries of the Union, High Commissioner Prodi, or the diplomatic junketer Solana who played lead roles, but rather the heads of government Blair, Chirac, and Schröder. How could it be otherwise? Questions of life and death, war and peace are still decided by sovereign states legitimated by democratic mandates. Nothing is changed about that by the Euro, the first joint currency in history that seeks recognition without a state.

If the EU wants to be a strategic power, it will need to rethink thoroughly. Its armed forces sought to make a military virtue of financial necessity: they were to be nimble and lightly armed, just the opposite of the cold war armies and their reliance on mass and firepower. But the battle of Afghanistan teaches surprising lessons for the future: it wasn't the compact special forces units or the intelligent long-distance weaponry that shot their way to victory. It was those old acquaintances, mass and firepower. Fat-bellied B-52s carried their cargo halfway around the world. Flying Hercules-type "cannon boats" chased Taliban tanks with their machine guns. Expensive fighter bombers like the F-15 and F-16 supported the ground troops of the Northern Alliance. Overhead, satellites directed rockets to their targets. Everything was directed by high speed reconnaissance and command systems that Europeans can only dream of. Aircraft carriers stood in the background, able to send their bombers to battle around the clock thanks to an expensive air tanker logistics system. The lightly armed ground troops only made their appearance at the end.

Afghanistan shows that a EU rapid deployment force of 60,000 will not be nearly enough to make Europe a great power, let alone give it the potential to intervene independently of the "last remaining superpower." Democratic societies fear bodybags [literally: tin coffins -TN], and thus invest billions upon billions on long distance weaponry, reconnaissance and logistics systems to spare their soldiers direct contact with the enemy. Those like the Germans who choke on a few hundred men for deployment to the Balkans or Afghanistan, who don't want to spend more than 1.5% of GDP on the military, should not make grandiose plans.

Measured against 9/11, 2001 was an "annus horribilis." ... But Westerners discovered something very precious among the terror and the rubble, that they took for all too granted until now: a way of life worth defending.

Up to 9/11 a Westerner could fancy himself cushioned in the apparent security of a post-modern era -- where he could mix and match values and sensibilities with "anything goes" arbitrariness, without running any real danger of losing his rights and privileges to the state or the church. ... But in reality the separation of throne and altar is better than the merciless mullah state of the Taliban, that gilds arbitrary power with the purported will of Allah. Respecting the other is good, but better yet is constitutional law that doesn't just enumerate human rights like freedom of speech, of religion and of association, but actually guarantees them.

Only that which has been threatened becomes precious. The shock of 9/11 was medicinal, as was the retaliation. The world can breathe a little easier -- no bad omen for 2002.

Josef Joffe is one of the lead columnists for Die Zeit; I don't know if calling him the "David Broder" or "Tom Friedman" of German journalism quite hits the mark, but it's close. Overall, this is a pretty good piece, I think, although calling 9/11 "medicinal" or "curative" is a bit too cold-blooded; I could have done without it, let alone the victims in New York, Virginia, and Pennsylvania. But I realize he means the "wake-up call" effect of 9/11. That attack was going to happen whether it was 9/11/2001, 9/11/2002, or some other date, and more may still happen. Best to know it, and deal with it.

Joffe can go ahead and slightly exaggerate European nation state contributions to the current reasonably successful state of affairs; they contributed what they were asked to contribute, with the attendant debates any responsible nation would have (the U.K. towered above the rest, bless them). I suppose I can't tell whether Joffe actually wants the EU to become a superpower, with the true, elected sovereignty over diminished nation-states and defense spending he seems to recognize that would require. On the whole, he seems to prefer that it become or remain a NAFTA-like mercantile agreement, which I would agree with; personally, I've never quite understood which major problems the Euro and the EU are fixing at a reasonable cost, but I'm not German or European, so good luck with all that. The "Euro" train has long since left the station, obviously. I assume, hopefully, that with people like Joffe, Germany, Europe, and/or the European Union will remain basically friendly allies of my country for the foreseeable future.

Still, as the Japanese say: "the nail that stands out gets pounded down." That is, it may not be in Europe's narrow interest to attain military and symbolic parity with the United States, let alone pre-eminence; it may instead be in their narrow interest to find cheap ways to display independence of the United States, while remaining basically militarily dependent on them should common interests be endangered. It is in no small part simply U.S. pre-eminence that put us in Al Qaeda's cross-hairs. Some power would always find it necessary to prevent the conquest of a resource like the Saudi oil fields, some power would probably help guarantee Israel's existence amid its enemies; then Al Qaeda types would hate that power. What's in it for Europe or Europeans to raise their hands for either role, if the U.S. will play it for them? Rather the opposite; for example, the E.U. provides substantial subsidies* to the Palestinian Authority. This can easily be read as protection money -- and arguably well-spent in a craven sort of way.

Both the 9/11 attack and the retaliation happened outside Europe. The Atlantic and Pacific oceans themselves may be less of a shield against likely future enemies than simply being a second-tier, fence-sitting country like France, Canada, Japan or "Europe." Perhaps their dragnets for Al Qaeda suspects will raise the stakes to the point where they become primary targets themselves; but I'm guessing they may never suffer 9/11-like attacks.

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* Der Spiegel: The EU has budgeted 179 million Euros per year since 1995, and has loaned 1.5 billion Euros together with member nations between 1994 and 1998 alone.

Translation notes: I translated "Gericht" in the title as "court," but it also means "judgment" or "verdict." Also, I translated "bescheiden ihren eigenen Garten bestellen" as "should not make grandiose plans"; the literal translation is "humbly tend their own garden." posted by Thomas Nephew at 12:48:00 PM -- |    

 
Top science stories of 2001
Fundamentally, life has the chance to get better when we learn new things and how to use them. Here's a link to some of that kind of hopeful news for 2001: Scientific American: News In Brief: Top Science Stories of 2001. As they put it:

Many events of the past year are now easily forgotten, hidden in shadows cast by the former World Trade towers, the Pentagon wreckage, the anthrax deaths and an ongoing war. But 2001 did witness a number of important happenings in science and technology both before and after the terrorist attacks—including the 100th anniversary of the Nobel Prizes.

Among them: stopping light in its tracks, cloning endangered species, human genome analysis, placebo effect questioned, planetary system akin to our own, the Chandra X-ray observations of the Sagittarius A-star black hole, glass-eating sea floor microbes, single molecule circuits, and on and on. I say it with perfect admiration: Gee whiz! Have a look. posted by Thomas Nephew at 1:16:00 PM -- |    

 

Good, clean fun
From Rand Simberg (via Joanne Jacobs, and doubtless soon via everyone else): "Media Casualties Mount As War Success Continues"

But just as we started to move out seriously, with fusillades of stories about Vietnam analogies, and the futility of just chasing down terrorists without addressing why the world hates us, the Taliban and Al Qaeda started to collapse without warning. We came under fire ourselves. Huge shellbursts of cruel reality and vicious satire were exploding all around us, and dangerous facts were whizzing just past our ears, sometimes right in one and out the other..."

From James Lileks, on Stephanie Salter's embarrassing "W.W.J.D.?" piece (for those of you wondering what that means: it stands for "What would Jesus do?"):

Salter’s message is quite clear: when the guy in the seat next to you starts lighting his sneakers, whistle a happy Psalm. Tell him you love him. Seek peace, and as you hurtle down into the cold cold ocean, wrap yourself in your heavy Ghandi cloak for warmth. The cycle of violence has been stopped!

My personal answer to Salter (besides "Good grief!") is that this is not about vengeance (although I'm not as against that as Jesus might be), but about prevention; also, I think we've all had our fill of people purporting to know what's on God's mind for a while. But where's the fun in just saying that? Both pieces are best read in their entirety. (I don't need to agree with every single Simberg jibe re Clinton to appreciate a nicely done satire). I wonder if Salter has woken up in a cold sweat lately, thinking "No! I couldn't have written that!" I suppose not.

I suppose I share in feeling let down by many "intellectuals" since 9/11. Confronted with the likes of Chomsky, Pinter or Sontag, I have to think of Peter Lorre's line in Casablanca, "You despise me, don't you?", and Bogart's response, "I suppose I would if I gave you any thought." But others I've been willing to think well of, from Le Carre to Schlesinger to Vidal (who seemed sane enough to write a great book on Lincoln) to Achenbach to Arundhati Roy (eloquent in denouncing India's development of the atomic bomb) to ... why go on, have been eye-openingly wobbly or worse about "recent events." So I was disappointed.

Luckily for me, everyone's entitled to be wrong now and then, but (unluckily for me) if you proudly publish it, you deserve to get taken down a peg or reconsidered altogether just as much as you'd deserve applause or reconsideration for well-done work. By the same token, I'm finding myself in the Krauthammer school of "pound 'em" foreign policy more often these days, and more appreciative of Safire for speaking his conservative mind clearly on military tribunals and the like. So there you have it: the always changing situation called life in the real world.

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12/28: final paragraph split. posted by Thomas Nephew at 12:44:00 PM -- |    

 

Niemöller update
I was very pleased that the Niemöller translation was such a welcome Christmas gift for Jeff. Like him, I feel I've found new friends on line and via e-mail since starting this blog, and Jeff is one of the best.

Jeff has posted the entire translation to his web site. Readers will see (at least for a while) that I drew a blank on two words, "Trost" and "schwerwiegend", which I left in capital letters in the translation. For the record, "Trost" means "comfort," and "schwerwiegend" means "weighty" or "profound" (literally: heavy-weighing). There are also a few other errors of omission and doubtless of commission as well, but the gist of the translation is O.K., I think. Feel free to let me and/or Jeff know of any errors, I'll pass the message along to Jeff. posted by Thomas Nephew at 10:58:00 AM -- |    

 

Ding, dong, the Osama is dead (I hope)
...or he might as well be. As Charles Johnson of "Little Green Footballs" points out, if Bin Laden were alive, he'd want to prove it with something more recent than the latest video, apparently dated 12/11/2001 or so. But if this is simply the best he can do, that's an encouraging sign, too. This from MSNBC:

A Pakistani newspaper on Tuesday quoted a Taliban leader as saying that he had attended a funeral for bin Laden, who he said had died of a lung ailment in Tora Bora, where al-Qaida fighters made a last stand and where bin Laden was last said to have been sighted.

As for "Crusader hatred against Islam": no, Osama, it's garden variety -- but well-armed -- hatred against you and your nasty buddies, bub. You weren't looking well: trouble sleeping? Where's the old gang? That Kalashnikov doing you any good?

I'm just not in a "turn the other cheek" mood, and haven't been for a long, long while; to tell the truth, I haven't been since Lockerbie a long time ago. As if I needed reinforcing, we were in Union Station tonight, and saw an exhibit of World Trade Center rubble: twisted steel girders, concrete rubble, pictures of victims. To top it off, Maddie was along, and naturally she asked what happened. Never kid a kidder, and especially never kid a kid kidder: she knows this bothers us and that we haven't told her everything. I told her a little more, and told her as usual when this comes up that the crash is over now and we are safe. So I lied, so sue me.

Destroy Al Qaeda, root and branch. Somalia, Philippines, wherever. It won't make us safe, but it will make us safer, and that will just have to do.

Sorry for the abrupt change of mood from the prior post. posted by Thomas Nephew at 2:41:00 AM -- |    

 

Merry Christmas
Thanks for dropping by. I wish you and yours a merry Christmas and a happy new year.

For some nice writing about Christmas, 2001, see Jeff Jarvis' "Merry Christmas, World." I had a look at the Martin Niemöller Christmas 1944 Dachau sermon Jeff highlighted; it is an impressive and moving profession of faith under the worst possible circumstances. I can't claim it's a faith I share, but I often find myself looking in the window, so to speak. From Niemöller's sermon, the questions I often ask myself, and the answer of a man convinced of God and his goodness:

...Humanity has accustomed itself to leading its life without God. My dear friends, I would like to not be misunderstood; I do not mean those people who describe themselves as “godless,” and who claim from purportedly scientific, philosophical, or political reasons: “There is no God,” to whom we after all do not belong; I really mean we ourselves, as we are gathered here, we who have not lost the custom of beginning and ending our days with prayer, but to whom God seems so infinitely distant, that we believe he doesn’t care about our planet. Indeed it does seem as if He had left this world to its own devices, so that humans could wreck it completely. And from this sentiment it takes only a tiny step to the doubting question: Should God care about me, about a small, pitiful little human in a time in which hundreds of thousands and millions die miserably?[...]

And we, dear friends, who are cut off from the world out there, inactive spectators of all their battles and convulsions, we, who have many hours every day to look inward and become clear about ourselves, we, who often so painfully lack peace of heart, because we do not look on God and His word, but rather on mankind and its doings – should not our inner sense be especially open for the message of the Christmas evangelium; shouldn’t the word of great joy be especially relevant to us, who know fear – fear of death and fear of life?! So let us today on Christmas Eve ask the Lord Jesus Christ that He, who came in to this world alienated from God in order to save it, should also come to us, bring us his salvation and grant us his joy! – Amen.

I did my hurried best to translate the whole text for Jeff. It has given me some food for thought this holiday season.

Enough of that. Take care! Enjoy your family and friends as I will mine -- especially my little girl, Maddie, who is my own singing, dancing, laughing proof that life is good. Tomorrow: Lincoln logs and Angelina Ballerina. In the less timeless words of Homer Simpson: Woo hoo! posted by Thomas Nephew at 11:54:00 PM -- |    

 

Saudi Arabia: background on Wahhabism and the House of Saud
This post was prompted by an e-mail from Jim Henley, who is working out his own views on these subjects in his ever-interesting "Unqualified Offerings" blog, most recently today with Saudi dearies, and Almost but not quite. I agree with him on many points, including the basic one that I don't think the House of Saud had a direct connection to the 9/11 attacks. Rather than being accomplices to those attacks, I think they may have been and may continue to be criminally negligent: they are "merely" not inclined to work very hard to stop terrorists operating from their soil, as opposed to being terrorist lackeys like the Taliban were.

Saudi Arabia possesses two strategic assets: the cheapest-to-extract large oil reserves on the planet -- and Mecca. The one makes it too important to the West to lose, the other makes it likely too dangerous for the West to take. I think the House of Saud is a family that has entered into two symbioses to preserve its status as the controllers of these two assets.

The Mecca symbiosis came first. (The following is cribbed liberally from Milton Viorst's book In The Shadow of the Prophet, which I've mentioned before; see the chapter "The Saudi Dilemma"). In 1744 one Muhammad ibn Abd al-Wahhab (b. 1703) got together with an ambitious chief named Muhammad ibn Saud, living in the village of Diriyah -- now on the outskirts of the similarly named Riyadh -- to make a deal: Saud would provide the military muscle, Wahhab the "unitarian" ideology. That essentially totalitarian ideology proclaimed that any rethinking of Islam was heresy (bid'a: innovation), and that only Wahhab's way -- a return to (his version of) the era of the rashidun, i.e., Mohammed and his immediate successors -- would do. Viorst writes:

In theory, the Saudi Monarchy is the executive, the Wahhabi "ulama"[clergy] the moral guide. In practice, the relationship is more complex. The two institutions, while allies, are often rivals, each tugging constantly at the other ... The clerics prefer to call the head of the House of Saud "Imam", to convey the holy source of his power; the Saudi monarch, having adopted the title Cusotodian of the Two Holy Mosques to assert his piety, lieks being called "King," though in Arabic the title has a foreign ring that clerics scorn. Yet, while each hierarchy tries for a leg up on the other, the acknowledge their mutual dependence. Whatever the Saudi dissidents' current demands for reform, history suggests that the regime has survived this long precisely because it has never, in its basic structure, given serious thought to reform at all.

The second symbiosis, with the United States, was caused by Saddam Hussein. Hussein's attack on Kuwait resulted in the House of Saud's epiphany that they needed permanent protection from their more populous, industrial neighbor. In the long run, this second symbiosis is incompatible with the first one: infidel U.S. bases on Saudi soil are hard for Wahhabites to square with their old-time religion view of Islam's holy land. Many Saudis both inside and outside the House of Saud feel they made a Faustian bargain with the United States to protect themselves from Iraq; these critics more or less share Bin Laden's distaste and even revulsion for Westerners in their holy land, but most probably believe it was the only realistic way to be sure of protection from Iraq. Viorst writes:

To many Saudis, basing infidels on the holy soil was not just a religious but a political lapse, defaulting on the compact by which the Saud family rules. [Said one university professor,] "...we all knew that soldiers from other countries were defending us because we were unable to defend ourselves... The West seems to think that the impact of the war was cultural, that we were upset by women in T-shirts driving jeeps. There's some truth to that... but the more fundamental truth is that we felt the royal family had let us down."[...]

"The King, deep down, is less rigid than the clergy," an editor of an Islamic paper said to me. "By Saudi standards, he is probably very enlightened. But the people are Wahhabi, and I'm not sure how much social change the people want."

I introduce all of this background mainly to point out that there is a built-in opposition to the House of Saud -- the Wahhabite clergy -- which may have more credibility with Saudis and more freedom of action than many of us were aware. I think it's conceivable and plausible that the Saudi religious police who smuggled Al Harbi into Afghanistan did so on their own, in opposition to the House of Saud, U.S. bases in Saudi Arabia, and the United States.

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A note to readers: I posted an even longer version of this last night, then had second thoughts a minute later. So I deleted it -- but forgot to hit "publish", meaning it stayed on the web for some 24 hours. While I could restore it to this blog, I like the revised piece better: it has more information, less speculation on my part, and meanders a bit less. I think the point (see last sentence) is pretty much the same; much of the first half or so is exactly the same. I'll save the old version to this web page, in case anyone has cited anything from it or cares for some other reason. PS: I see now that Jim Henley did, making me wish I hadn't gone down this path at all. Sorry for the inconvenience, everyone. posted by Thomas Nephew at 12:41:00 AM -- |