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The Exploitation of Natural Resources and the People Who Extract Them by Doug Boucher

Fixing Health Care in the U.S. by Peter Caplan

The Effects of Patenting on Innovation by Jane Zara

Is the U.S. Criminal Justice System Bad for Everybody's Health? by Jane Zara

Letters from Prison - Anonymous

Is the World Overpopulated? by Peter Schwartzman and David Schwartzman

Energy – Thoughts on Equity and Justice by John Tharakan

How Much CO2 Emission is Too Much? by David Schwartzman

Why is the U.S. so Random About Syringe Exchange Programs? Excerpted from Scott Burris et al, Syringe Access Law in the US

The New Orleans Syringe Access Program - Anonymous

Books of Interest

Ask Dr. Science











The Exploitation of Natural Resources, and of the People Who Extract Them




Douglas H. Boucher


Department of Biology

Hood College

401 Rosemont Avenue

Frederick, MD 21701

(301) 696-3662





This paper was originally presented at the Ecological Society of America’s

 2006 Annual Meeting Symposium,

 “Linking Ecology and Environmental Justice”


A modified version will be published in a forthcoming issue

 of the Bulletin of the Ecological Society of America





            For most ecologists questions of environmental justice have often seemed to involve what our colleagues in the humanities and social sciences have called “the other”  -- other places, other people, other issues. Working in forests, fields and deserts, ecologists have often had little professional involvement with the urban habitats in which environmental justice concerns are paramount. They have seldom had much in common with the communities of racial and ethnic minorities, and of poor and working-class people in general, for whom environmental justice is an important issue. And the questions traditionally associated with environmental justice – the siting of dirty industries and toxic waste dumps, the spatial distribution of pollution and its health impacts, and the unequal distribution of the political and economic power needed to keep noxious substances out of one’s own backyard – are seldom considered to be fit research questions for ecologists. True, those who work in such places with such people on such issues may be ecologists, in the broad sense, but not of the Ecological Society of America variety.

            Yet, I will argue that there are profound questions of social justice in precisely those environments where we ecologists do most of our work. The natural resource sectors of the economy -- forestry, fisheries, agriculture, ranching, and mining, as well as the extraction of non-timber products from forests and other ecosystems – are characterized by profound inequalities and fundamental structural injustice. These manifest themselves in many ways: precarious and declining employment, low wages, communities under great economic and social stress, and minority workers subject to a variety of kinds of racial and ethnic discrimination. This is not just a question of economics, but of life and death: workers in the natural resource sectors are more likely to be killed in the process of earning a living, than any other workers in America.

            The natural resource sectors, although highly productive and profitable, are hemorrhaging jobs faster than any other part of the U.S. economy. Table 1 (data from US Department of Labor, 2005a), shows that both mining and the combined “Agriculture, forestry, fishing, and hunting” sectors have had declining employment over the past decade, and are projected to continue this trend in the coming decade, while jobs in the economy as a whole have and will increase at a rate of 1.2% annually. Three other sectors are shown for comparison. Construction is a typical employment-growth sector. Manufacturing, the subject of much concern about the disappearance of well-paying jobs, is projected to decline but not nearly as rapidly as in the natural resource sectors. And “educational services” – the sector in which most ESA members’ jobs would fall – is one of the healthiest in terms of job growth, both past and future. The Bureau of Labor Statistics recently summarized the future of the natural resources sector in clear terms: ““Employment Projections data indicate that employment in the agriculture sector will decrease 10.7 percent over the 2004-14 period, the steepest decrease among all of the industry sectors. Mining employment will decrease 8.8 percent. Total employment for all industry sectors is projected to increase 14.8 percent.” (US Department of Labor 2005b; emphasis in original).

            Work in extracting natural resources is generally poorly paid. Table 2 shows that average weekly wages for the “Agriculture, forestry, fishing, and hunting” sector are more than 43% less than for the economy as a whole. This trend holds for both farming and for forest-based sectors such as logging, hunting and trapping. Extraction of non-timber forest products – an enterprise that many ecologists have embraced enthusiastically, seeing it as a potentially “environmentally friendly” way to use natural ecosystems without destroying them – is in fact one of the most poorly paid.

            The exceptions to this general picture are interesting also. The higher weekly wage for fishing is partly an artifact of the presentation of the data as weekly averages, since fishing jobs often last only a few months of the year. However the higher-than-average wages for miners are a real phenomenon, and reflect the long and militant history of unions such as the United Mine Workers of America. Other natural resource sectors have had strong unions, with correspondingly higher wages, at times in the past, such as the Pacific Northwest loggers who were one of the strongest elements of the Industrial Workers of the World in the early twentieth century (Tyler 1967). Overall, however, work in extracting natural resources pays some of the lowest wages in the entire American economy.

            Some economists and politicians argue that these trends of disappearing jobs and low wages, while hard on certain workers and communities, are the inevitable result of the shift from agriculture to industry to service employment as a capitalist economy matures, and thus should not be seen as any kind of injustice. But however valid this argument may be, it is difficult to see how it justifies another feature of natural resource work: its high rates of death on the job. Figure 1 (US Department of Health and Human Services, 2004) shows that occupational death rates in the agriculture, forestry, and fishing industry average 4 to 5 times those in private industry as a whole. The danger of mining, as brought to public attention by several fatal coal-mine explosions in 2005 and 2006, is also great (Lee-Sherman 2006). No macroeconomic analysis can explain away the high risk of death  for those simply trying to make a living from natural resources.

            The low wages, diminishing employment and risk of death in natural resource industries puts a great deal of stress on communities dependent on these industries. Times are always tight in these communities, and families worry about whether their children will even be able to make a living in the towns where they grow up. Adding to these communities’ difficulties is the reliance of local school funding in the U.S. on the property tax, which often means utter dependence on a single resource extraction industry.

            The conventional view of race and ethnicity in America sees these as urban questions, and we often imagine rural communities based on agriculture, forestry or mining as white, English-speaking and stereotypically “middle American.” But in fact issues of race, language, color and immigration have long been important in these communities, and are becoming increasingly significant in the twenty-first century. Farm workers are already overwhelmingly overwhelming members of minorities in the U.S., with 72% being Hispanic men and 21% Hispanic women (US Department of Health and Human Services, 2004). More and more, forestry work is also done by Hispanics and other minorities, many of them immigrants on temporary work visas. Tree planting in the South (Immigrant Justice Project 2004), forest thinning in the West under the Bush Administration’s “Healthy Forests Initiative” (Knudson and Amezcua 2005), and non-timber forest product collection in several regions (McLain et al. 2005) are a few examples of this trend.

            Forest planting in the United States is overwhelming concentrated in the Southern states (Smith and Darr 2004), and more and more the tree planters are immigrants from Latin America and the Caribbean, allowed into the U.S. temporarily on  H2B visas. Because of their language and their immigrant status, they are subject to many kinds of abuse by forestry contracting companies. They commonly work more than 60 hours a week in difficult conditions (Figure 2), and are paid piece rates, earning well under the minimum wage of $ 5.15 an hour. Mary Bauer, director of the Immigrant Justice Project of the Southern Poverty Law Center which has represented many of the tree planters in court, has stated that they “may be the most exploited workers in the nation” (Immigrant Justice Project 2004).

            Similarly, large numbers of immigrant workers from Latin America do the work of the Administration’s “Healthy Forest Initiative”. As described in a three-part series in the Sacramento Bee (Knudson and Amezcua 2005), “ Across vast tracts of rugged ground from Maine to California, Latinos do the dirty work in America's woods.

They plant trees by the millions, thin out snarls of vegetation that stunt

the growth of commercial timber and slash away the dense mats of

brush and spindly trees that stoke forest fires. They are pineros, the men who work in the pines. They are the major source of manual labor in America's

forest industry, the muscle behind the Healthy Forest Initiative - often

paid in tax dollars to work on public lands. And they are being misused

and abused under the noses of government officials.”

          In recent years, environmentalists have promoted non-timber forest product harvesting as an alternative to timber cutting. Many of these products, such as morel mushrooms, floral greens, Galax and beargrass, are being collected by immigrants from Latin America and Southeast Asia. Even when this work is their principal employment, however, they generally earn low and uncertain incomes from it (McLain et al. 2005).

          For centuries enslaved African-Americans did most of the agricultural labor in the southern U.S., and after the Civil War millions of them became family farmers. However, over succeeding decades most of them have been driven off their land. So have most white farmers, of course, but in the case of African Americans the decrease has been three times as fast. In 1920 there were nearly one million black farm operators in the U.S.; by the end of the twentieth century their numbers had fallen to less than 17,000 (Bowser 1999).

          Besides the economic forces that affect all U.S. farmers, an additional factor has been important for African Americans – racial discrimination by the U.S. Department of Agriculture. In 1999 the USDA settled a class action lawsuit against it by the National Black Farmers’ Association, admitting decades of discrimination in farm support programs as well as in hiring. Settlement of this court case, described by lead lawyer Alexander Pires as “the most organized,

largest civil rights case in the history of the country” (Bowser 1999), was supposed to lead to compensation to the remaining thousands of black farmers. However, in the years since the settlement the USDA has denied compensation to nearly 90% of the farmers who applied, including 40% of those ordered to be “automatically” compensated in the court settlement (Environmental Working Group 2006).

          All in all, the social and economic conditions of the people who extract natural resources for US society are some of the grimmest of any Americans’. They suffer from low wages, vanishing jobs, and threats to the survival of entire communities. More and more, the work is being done by immigrants and racial and ethnic minorities, who are subject to abusive condition and many kinds of discrimination. And most fundamentally, these people must risk their lives in order to make a living – their jobs are the most dangerous of any sector of the US economy.

          When ecologists go out to work in forests and fields, these people and the injustices that they suffer are all around us. It is a matter of simple justice for us to notice.


Bowser, Betty Ann. 1999. Bitter harvest: discrimination on the farm. Public Broadcasting System Newshour with Jim Lehrer, 2 March 1999. Available online at:

Environmental Working Group. 2006. Obstruction of Justice: USDA Undermines Historic Civil Rights Settlement with Black Farmers. EWG, Washington, DC. Available online at:

Immigrant Justice Project, Southern Poverty Law Center. 2004. Beneath The Pines: Stories of Migrant Tree Planters. SPLC, Montgomery, AL. Available online at:

Knudson, Tom and Hector Amezcua. 2005. The Pineros: Men of the Pines. Sacramento Bee, 13-15 November 2005. Available online at:

Lee-Sherman, Deanna. 2006. Miners’ families pushing for safety: memorial service held for men killed over past year. Harlan Daily Enterprise, Harlan, KY, 5 August 2006, pg. 1.

McLain, Rebecca J., Erika Mark McFarlane and Susan J. Alexander. 2005. Commercial morel harvesters and buyers in western Montana: an exploratory study of the 2001 harvesting season. US Forest Service General Technical Report PNW-GTR-643

Smith, W. Brad and David Darr. 2004. U.S. Forest Resource Facts and Historical Trends. US Forest Service Publication FS-801

Tyler, Robert L. 1967. Rebels of the Woods: the I.W.W. in the Pacific Northwest. University of Oregon Books, Eugene, OR.

US Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. 2004. Worker Health Chartbook, 2004.  NIOSH, Cincinnati, OH.

 US Department of Labor, Bureau of Labor Statistics. 2005a. “BLS Releases 2004-14 Employment Projections”. Government Printing Office, Washington, DC. Available online at:

US Department of Labor, Bureau of Labor Statistics. 2005b. Industry at a Glance: Natural Resources and Mining. Government Printing Office, Washington, DC. Available online at:

US Department of Labor, Bureau of Labor Statistics. 2005c.  Employment and Wages 2004. Available online





Table 1. Disappearing jobs. Average annual rates of change of employment are given for the US economy as a whole (“Total”) and for the natural resource sectors (Mining and Agriculture, forestry, fishing, and hunting, with the latter subdivided between wage workers and the self-employed). For comparison, the same figures are given for three other sectors of the economy: construction, manufacturing, and the sector in which most ESA members fall, “Educational services”. Source: Table 1, “Employment by major industry sector, 1994, 2004, and projected 2014”, in US Department of Labor, Bureau of Labor Statistics. 2005. “BLS Releases 2004-14 Employment Projections”. Online at:



Employment by major industry sector, 1994, 2004, and projected 2014


Average annual rate of change, %

 Industry sector













 Agriculture, forestry, fishing, and hunting



      Agriculture wage and salary 



      Agriculture self-employed and unpaid family workers 










 Educational services 




Table 2. Low wages. Average weekly wages for industry and government as a whole (“Total”) and for natural resource sectors, including various subsectors of the “Agriculture, forestry, fishing and hunting” sector. Source: Table 2, “Private industry wages by six-digit NAICS industry and government by level of government, 2004 annual averages”, in US Department of Labor, Bureau of Labor Statistics. 2005c. Employment and Wages 2004. Available online at:



Private industry wages by six-digit NAICS industry and government by level of government, 2004 annual averages.


Average weekly wage







Agriculture, forestry, fishing and hunting


     Crop production


     Animal production


     Forest nursery and gathering forest products




     Hunting and trapping







Figure Legends


Figure 1. Death at work.  Annual rates of fatal occupational injury in the agriculture, forestry, and fishing industry and the private sector. Source: Figure 3-2 in Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. 2004. Worker Health Chartbook, 2004.  NIOSH, Cincinnati, OH.


Figure 2. Immigrant tree planters working in the mud in a southern pine plantation. Source: Immigrant Justice Project, Southern Poverty Law Center. 2004. Beneath The Pines: Stories of Migrant Tree Planters. SPLC, Montgomery, AL, page 6.


Figure 3. Injured working in forest thinning. “Eliseo Domínguez, who has worked in U.S. forests for seven years, bleeds from a cut he had received just seconds before as he took down a tree in Montana's Bitterroot National Forest in September [2005].” Source of picture and quotation: Knudson, Tom and Hector Amezcua. 2005. The Pineros: Men of the Pines, part 2. Sacramento Bee, 14 November 2005.




      Fixing Health Care in the U.S. -  can you get there from here? by Peter Caplan


   In a thoughtful article in a recent NY York Review of Books ambitiously entitled “The Health Care Crisis and What to Do About it”,  Paul Krugman diagnoses some of the major problems in the U.S. health care system and compares its performance with that of France, the UK and Canada.   Then he discusses various ideas for fixing it. His conclusion is that, in view of an array of powerful interests with enormous assets at their disposal, “things may have to get much worse before reality can break through…”


   Some interesting facts are presented that are worth setting out here.  One is that the government already pays ultimately for some 50% of all health care, a portion of that directly, through Medicaid and Medicare, the rest delivered through a chaotic system of private insurers, for-profit hospitals and subsidies and tax breaks - adding cost, Krugman points out, without adding value.  An alarming projection of present trends published by the Congressional Budget Office last year showed that, while in 2005 Medicare and Medicaid combined cost some 4.2% of our GDP (very similar to the amount spent on Social Security), 25 years hence  this is estimated to balloon to 13%, rising at an accelerating rate, while SS creeps up more or less linearly to only to 6%.  (The Social-Security-is-broke gang got their alarming figures by looking at the sum of SS, Medicaid and Medicare). 

    Now let’s look more closely at the medical part.  If we add to the 4.2% of GDP that government is presently laying out for the Medi programs, another 8% for private expenditures, we get a total public-plus-private spending of over 12% of the GDP, or about $1.5 trillion.  Of course this is larger in absolute terms than any other country; but it is the percentages that tell the tale:  Here in the US, the private share of health spending is 55% of the total; in Canada it is only 30%; in France, 24%; and in the UK, 17%.  At the same time the U.S. spends roughly twice as much per capita as each of the other three, so that we in this country pay for a much larger share of a much larger budget.

   What do we get for all of this spending?  Here things get nasty.  With a number of physicians and nurses per capita that is comparable to these other three advanced countries, we get the highest infant mortality, the lowest life expectancy, and have the fewest hospital beds.

Why are we paying so much? Is it just that everybody is sicker in the U.S., or is there a particular group spending a whole lot of money?  ?]   The widely cited rule is that  about 80% of the medical dollar is spent on about 20% of the people, and this group is predominantly elderly and/or relatively well-off.  

    So then to explain such a high average expense does the U.S. have a greater proportion of old folks than the other three countries?  No –  the U.S. in fact has fewer people in the over-65 and over-80 brackets than any of the other three, according to current Bureau of Census figures .

   These top 20% are heavy users of the most cost-intensive procedures and technology –  the coronary bypasses, the transplants of hearts, marrow, livers and other organs, maintenance  on expensive drugs, and diagnoses and life-support on expensive machines.  All of these items are not only costly, but becoming costlier and more frequently employed; and new ones are coming into use as new technologies become available.

    So, health care in the U.S. must get more expensive because of technology; but does that explain everything?  Have we been getting sicker? That’s debatable; there has been no significant increase in the incidence of cancer and cardiovascular diseases over recent years; and although there is a significant increase in diabetes, some of this may be due to   better diagnoses.  This topic is also addressed along with the larger question of putative effects of obesity  on health in a review in Scientific American.  In any case, the current diabetes statistics are similar among  the countries compared here.

    If we Americans aren’t in fact getting noticeably sicker, then where is all this health care money going?  Paperwork, inefficiency, duplication are the most-frequently cited. What about health care industry profits? The Institute for Health and Socioeconomic Policy, in its most recent (Dec 2005) annual study of hospital profits, found that the 4100 hospitals studied charged patients an average of 244% of actual expenses and that for the 100 most expensive hospitals this markup was almost 700%, and has remained at that level over the last 3 years.  The report goes further: chain hospitals charged more than independents and private for-profit hospitals charged more than government-operated ones.  Aggregate hospital profits were $26 billion in 2004 and have risen since; for drug companies, the world’s 13 largest alone had $62 billion in profits in 2004 (U.S. profits are difficult to find because as multinationals they tend to shift profits to subsidiaries in low-tax countries) and HMO profits are also running over $10 billion.  The well-paid top executives in HMO’s and big  Pharma typically pocket in the tens of millions annually.  Any large industry likes to promote itself; however nobody matches the efforts of the health care giants, which pour enormous resources into lobbying, campaign contributions and massive marketing and public relations blitzes.  A Public Citizen study put the number of drug industry lobbyists at 625 in 1999-2000 – more than one for each member of Congress.  As for research, a substantial portion is financed by the taxpayer, and it’s well known that much research is devoted to merely to developing highly-touted small variations on existing drugs, marketed as new drugs and used to grab new patents.


    The upward spiral of health care cost has caused increasing numbers of employers to give up provision of health insurance.  This throws large numbers of people into Medicaid, whose rolls have increased by 8 million people between 2000 and 2004 to reach close to 40 million, comparable with Medicare.  Being a combined state/federal program, it is vulnerable to budget cuts in financially-strapped states.    

   It’s long been clear that the way out of the present dilemma must be to de-privatize; to take health insurance and health care delivery partly or completely out of the marketplace, shutting down that failed swamp of waste, errors, incompetence and duplication of bureaucracies - and denial of coverage to the people most in need of insurance.  

   Wait a minute – if the government is the provider of health care delivery, why do we need  health insurance at all?  If we take the process to its logical conclusion, the whole health insurance system disappears , and we have free health, paid for of course by higher taxes. Given the inefficiency and incompetence in the present system, the money saved in insurance and medical bills should more than cover the amount spent on taxes.    Then, what about other components of the health care system , for instance research in pharmaceuticals?  Will scientists suddenly lose their motivation to do research if the funding for university labs were taken out of the hands of capitalists and taken over by the government?  Are chemists, astronomers, physicists and biologists simply going to decide that the universe is no longer worth exploring, if their paycheck and equipment is provided directly by the government?  Must the government, which is quite capable of running its own hospital system turn over all those billions to the private sector?

    But, assuming that caring for sick people is now safely in the hands of a smoothly-functioning, humane and minimally corrupt giant bureaucracy, let’s jump ahead to the next problem – caring for healthy people, i.e.,  prevention.  Confronted with continued rising costs for treating the sick, the government will certainly be motivated to free up some resources to look into avoiding diseases.  What about networks of free community-based walk-in clinics?  In a system where caring for the sick is entirely at public expense, it’s obvious that avoiding disease is in the interest of all.   Is this beginning to sound like Cuba, or just like an intelligent and humane way to run any modern health care system?

   An excellent discussion of frequently-heard objections to universal health-care systems was developed by the Hunger Action Network of New York State  and an exhaustive compilation of single-payer FAQ’s was assembled by Physicians for a National Health Program.     A universal health-care system would have to have strong safeguards against abuse by corrupt and repressive governments and mechanisms beyond the profit motive to encourage and reward innovations.  And, as technology progresses, new and ever-more complex diagnoses and treatments are invented and the whole system continues to push the limits of what society can pay for, the most difficult choices have to be faced: how to ration health care.  Now it’s the richest that get the best.

Almost anyone with a suffering loved one will want to find the best possible care, and no one wants to wait months to see a specialist.  So we inevitably face this kind of question: In a completely just society with universal health care, everybody has a right to every life-saving procedure?  As each organ fails to we have a right to a transplant?  And what about life-style-enhancing procedures?  As we get old and wrinkled shouldn’t we all get (aside from Viagra) plastic surgery, tummy tucks and hair transplants?   Time will tell..







Is the World Overpopulated?

Peter Schwartzman and David Schwartzman


Homo sapiens now numbers 6.6 Billion. In the U.S., we just passed the 300 million threshold. These numbers convince many that the root cause of the sorry state of society and nature is overpopulation. Mainstream media have been telling us this message for a long time. Are you convinced?


It is rather easy to look at big numbers or images of a crowded street (likely in cities of Asia or Africa) and think that population size must be a major contributing factor in the development of our current woes. Isn’t this why so many are hungry, sickly, and poverty-stricken? While this is the recurrent message we hear, it is largely untrue. The reasons why so many suffer are many but overpopulation is probably only a small and highly exaggerated part of this story. For example, the key reasons have more to do with us (the 18% living in the “developed” world) than them (the 82% living in the “developing” world). Coming to understand the reasons why humans are suffering and ecosystems are collapsing is paramount. Blaming others may be easy but it isn’t productive.


Carrying Capacity

First, the argument for overpopulation rests on the position that human populations (in cities, in nations, and in the world as a whole) have exceeded their “carrying capacity”—defined as the maximum population size that can be maintained into perpetuity given the resources and ecological services available. Locally (as in cities) this is definitely true; multi-million people cities cannot survive on the food and resources that are available locally. Despite this, some large cities see the bulk of their residents living relatively happily and healthily. This is only possible because resources from elsewhere serve the needs of these urban dwellers. Since so many are able to live far from where resources are found, this begs the question, “Are we living beyond the carrying capacity at the global level.” Recent work by Wackernagel and Rees on human’s ecological footprint suggests “yes,” we are—and this evidence seems to be just what the population reductionists have been looking for as proof of “global overpopulation.” However, carrying capacity is a dynamic concept, something these reductionists overlook. Specifically, if the 6+ billion humans on the planet today were to shift from using heavily polluting energy sources to clean ones, our collective impact would be less. Cleaning up polluted environments would likewise increase the carrying capacity of the planet.

Demographic Snapshot

Currently 41% (2.7 billion) of the world’s population live in four Asia countries—China, India, Pakistan, and Bangladesh. The world’s human population has doubled since ~1965 and more than tripled since ~1930. However, population growth rates (i.e., the yearly percentage increase that the population grows) are currently at 1.2%, far smaller than their peak of 2.2% in the early 1960’s.  In 1950, the average adult woman was having 5 children during her reproductive life, now she is having almost half of that number (2.7). Population densities vary greatly throughout the world, with large densities found in “rich” countries (e.g., Japan has 880 people per sq. mile, The Netherlands has 1,030) and “poor” countries (e.g., China has 350 and Bangladesh has 2,540). Nutritionally, about 18% of the world’s population suffer from chronic malnutrition, 50% from micronutrient deficiency, and, perhaps most revealingly, 18% from the overconsumption of food.


To be sure, the world and especially urban areas in countries of the South are overpopulated, but only in the context of the carrying capacity of the present political economy in this world of extreme inequalities and not the alleged carrying capacity of the biosphere. Many cities in the global South are overpopulated, bursting with poor residents driven from rural areas as a result of the social impacts of the so-called green revolution and structural adjustment programs imposed by the International Monetary Fund (IMF). But other regions are actually now under-populated, such as rural areas in countries of Sub-Saharan Africa, devastated by AIDS, with population size arguably too low to restore and maintain sustainable agricultural production.


Yet, despite the conflicting evidence presented, it is commonly believed that overpopulation is some absolute phenomenon and will only get worse in the future. There are two fundamental reasons why this conclusion is highly misleading. One, the root cause for widespread misery and environmental degradation is the mode of production and consumption we have in the U.S. and the global system that maintains it. Two, the overpopulation myth leads to the promotion of policies that are terribly unjust and inhumane. Now to the evidence.


Why hunger?

People aren’t hungry because there isn’t enough food. People are hungry and malnourished because they aren’t getting the food that exists. On a world scale, there is more than enough food to feed everyone, although the dominant mode of agricultural production has huge negative impacts on humans and nature. Massive starvation, as observed in Ethiopia in 1973 and Bangladesh in 1974, didn’t occur because food wasn’t available. These famines, and many others, occurred because large numbers of the population didn’t have sufficient funds to purchase foods, even though food was available–hence an issue of distribution not limitation. While some countries, including the U.S., store away surplus grain production as a reserve, many human beings don’t get enough to eat on a regular basis. In many developing countries, large landowners harvest export crops (such as coffee and tobacco) rather than food crops for local people. A diet rich in meat requires nearly ten times the land than that of a strict vegetarian diet. Nearly 40 percent of U.S. land is used for grazing livestock. While some of this land is more fit for free-range grazing than vegetable crops, much of it would be more productive if grains and vegetables were grown. In a study conducted by The Union of Concerned Scientists, red meat is 18 times more polluting to waterways and 20 times more wasteful of land usage than an equivalent amount (by weight) of pasta; surprisingly, poultry meats are only 11 and 2 times more polluting, respectively.  Thus, hunger and malnutrition are the results of existing political economy not any real shortage of food. But can organic agriculture based on agroecology still feed the world's population without the well-known negative impacts of industrial agriculture? There is a very good case that it can. This case is being demonstrated by organic farmers around the world daily.


Density gone wild?

So much “overpopulation” propaganda appeals to images of overcrowding (busses, markets, streets, etc.). However, population density (i.e., people per square mile) isn’t correlated with abject poverty or early death (two supposed symptoms of “overpopulation”). Countries like Japan and the Netherlands are among the densest to be found, but also have some of the highest standards of living and the longest longevity. Some of the poorest countries also are very sparsely populated (such as Mali and Bolivia). Thus, high population densities do not by themselves cause abject poverty nor do low densities guarantee health and prosperity.


Wealth and Consumption

Wealth differences between nations are much larger than population differences. And because of this, affluence of the privileged (the product of the U.S.-style mode of production and consumption) may be the real “terror” on the planet. Let’s compare India and the U.S. as an example. India has about 4 times the population that the U.S. does. Yet, for all measures of affluence, the U.S.’s beats India by a much larger ratio. The U.S.’s per capita GNP (Gross National Product) is 12 times that of India’s. The U.S.’s per capita energy usage is 17 times larger. And, most lopsidedly, U.S. per capita car and truck ownership is 97 times higher. So affluence would appear to be a much more influential factor (than population size) in terms of resource use and waste production. (This point is made even more striking when one considers that even the little wealth that is found in India is concentrated in the hands of the very few. Therefore, the “overpopulated” masses have even less of an impact on the planet.) Additionally, the excessive concentration of wealth in the U.S., which has 371 billionaires (Germany is second among nations with a “paltry” 55), hints at how disproportionate power and influence is distributed and how great might be their impacts as well.



Is the world overpopulated because there are so many people dying every day from preventable diseases? Preventable indeed! Approximately 10,000 children die every day from preventable diseases, but the reason why isn’t population size;  rather it is because basic health care (including immunizations) to the world’s people is not provided. Ah, but this would be prohibitively expensive, wouldn’t it? Absolutely not. Providing basic health care and education is not expensive at all. Poor countries (and states), including Cuba, China, and Kerala (India) (see writings of Amartya Sen), are able to provide their people a long lifespan comparable to the countries of the global North.  The U.S. spends more than $480 billion a year on its military (more than the rest of the world combined) and has already spent more than $1 trillion on the Iraq war and occupation. According to Jeffrey Sachs, we could make sure that the world’s poor were “covered [with] basic needs in health, education, water, sanitation, food production, roads and other key areas” for only a cost of $160 billion annually; a mere pittance of the annual global military expenditure. One very promising approach is the Tobin tax, a small tax on global financial speculation, some $2 trillion a day; a 0.1% tax would generate $160 billion in 16 days, while helping to suppress financial instability.


Population Control

Driven by “logic,” chauvinism, sexism, and even the desire to exploit, the massive effort to control population growth in developing countries has taken many forms. Through aggressive funding of family planning programs (FPPs), wealthy nations provide reproductive assistance to poorer ones. And while many positive outcomes come out of FPPs (such as, improved access to contraceptives and reproductive education), in many instances, the mantra of “control”-ling population has meant that invasive and harmful technologies (such as Depo-Provera and copper-ringed IUDs) are/were introduced into poor women’s bodies throughout the world. These efforts caused unknown amounts of suffering in the form of excessive bleeding, infertility, loss of libido, and even cancer. There are safe and culturally sensitive ways to reduce population growth to stable rates. Interesting, most of these revolve around providing better economic and educational opportunities for women, who so empowered will use family planning technology.


Missing Females

One of the most shocking facts to come out of the population “control” efforts is the demonstrable deficit in the number of female children and adults. It is currently estimated that nearly 100,000,000 (yes, 100 million) females are missing from the world’s population. Because of a preference for sons (driven by male supremacist attitudes and practices), millions of girls are being taken out of the population stream. This “removal” is either done near or at birth (via abortion or infanticide) or while the daughter is very young (via lack of food and health care). Dowry systems in India (which direct bride’s families to give their daughter and a sizable monetary offering to the groom’s family) and the One-Child Policy in China (which began in 1978) seem to increase the proportion of males in their populations. So, how many of the 100 million girls that are missing owe their departure to a “population-control” paradigm? We don’t know, exactly. But it is very likely a significant fraction of the missing.

Environmental Issues
Is “overpopulation” driving most global environmental problems?” Note that nearly 25% of all the CO2 emitted into the atmosphere comes from the U.S. (and the bulk of the rest of it comes from other rich countries). How can invasive species proliferation, which is decimating habitats all over the planet, be blamed on "overpopulation" when its primary cause, globalization, is being driven largely by transnational corporations in their insatiable appetite for profit at the expense of nature? Can synthetic chemicals which make our rivers, oceans and airways toxic to us and other life forms be attributed to overpopulation when nearly all of these are produced by the same transnational corporations?" Is "overpopulation" responsible for the over-fishing of our planet's oceans when much of the fish caught is being consumed by affluent people far away from the point of catch? Doesn’t this all suggest that something other than population size is at the root of many of the significant environmental problems we face?

Last Gasp
Despite all of this evidence (contrary to mainstream accounts), some of you are still saying, “Look, I’ve seen the families that have too many kids. How can a poor family, here in the U.S. or in central Africa, support 6, or even 10, kids.  Doesn’t this prove that we have overpopulation?” Certainly, there are millions of families that have more children then they can support, but this doesn’t make the world overpopulated. And in countries where lots of families fit this description, it itself is not a sign that the country is overpopulated. Let’s consider why families are having more kids than they can support. Women (and their mates) have “too many” children for four concrete reasons:

(1) they have no access to safe and effective contraceptives; (2) the women have too few options other than being mothers (pronatalist doctrine still has a hold in many cultures and religions); (3) no social security system exists; and (4) the infant mortality rate is so high (so giving birth acts as a lottery ticket).

Thus, the reasons why some families (and communities) are having children in numbers that are unsustainable is a result of economic and cultural forces that promote such outcomes. By demanding the more equitable distribution (across and within nations and genders) of wealth, education, economic opportunities, and health care, family size will drop.

In conclusion, we should look beyond the mantra of “overpopulation” as the dominant agent of human and environmental damage. If the Earth is too crowded right now, it is because we have too many billionaires. Population stabilizes with the reduction of poverty, increased access to contraceptives and immunizations, and the education and empowerment of women. Global sustainability requires solarization, demilitarization, and agroecology not population control. The real challenge is political/economic, not population size. Another world is possible if the global "excess" population is sufficiently organized to force it into being, constraining the rule of capital enriching the few, immiserating the many.


To find out more:

Badgley, C., J. et  al. In press. Can organic agriculture feed the world? Renewable Agriculture and Food Systems.

Banister, J. (2004) "Shortage of Girls in China Today." Journal of Population Research, 21 (1), 19-45.

Boucher, Douglas, ed. (1999) The Paradox of Plenty: Hunger in a Bountiful World, Food First Books, Oakland, CA.

Deen, Thalif. (2006) “Millions of Starving Shame the World, U.N. Says.” Inter Press Service News Agency, Oct. 19.

Drago, Tito. (2006) “Hunger Due to Injustice, Not Lack of Food.” Inter Press Service News Agency, Oct. 16.

Schwartzman, David. (2006) “Our Future Solar Utopia: Another World is Possible!” Green Horizon Quarterly, Winter, 10-12.

Schwartzman, Peter. (1993) “Population Growth as a Problem in the Public Sphere: Current State of Play and Future Prospects.” Master’s Thesis. Virginia Polytechnic Institute.

Sen, Amartya. (1993) “The Economics of Life and Death.” Scientific American, May, 40-47.

“2006 World Population Data Sheet.” (2006) Population Reference Bureau, 12 pp.


Massive starvation, as observed in Ethiopia in 1973 and Bangladesh in 1974, didn’t occur because food wasn’t available.

Countries like Japan and the Netherlands are among the densest to be found, but also have some of the highest standards of living and the longest longevity.

If the Earth is too crowded right now, it is because we have too many billionaires.



Peter Schwartzman

Chair of the Environmental Studies Program at Knox College in Galesburg, Illinois, where he is raising two wonderful daughters with his wife, Huong. He is an avid Scrabble® player and enjoys finding OUGUIYA (on a rack of: AGIOYUU). He writes a monthly environmental essay for his local newspaper, The Zephyr ( He spent his recent sabbatical in Chicago volunteering with an Environmental Justice organization (LVEJO;, in an attempt to understand how people are making a difference in their communities at the ground level. This five-month mental and psychological journey taught him that inspiration from good people and great work is literally around the corner (or down the street). For no reason should peace-loving people feel isolated or helpless.

David Schwartzman

Born in Brooklyn, NY, 9 months after the victory of the Soviet Red Army at Stalingrad, the decisive battle of WWII, hence a "red diaper baby". Educated at Stuyvesant HS, CCNY, Brown University (PhD in geochemistry,1971).  On the faculty of Howard University since 1973,
active in peace movement, DC Statehood (Green) Party since early 1990s, lately specializing in tax and budget issues. Member of International Committee of Green Party of the United States.
Researcher in biogeochemistry, astrobiology, environmental studies. Book: Life, Temperature, and the Earth, the Self-Organizing Biosphere (paperback, 2002), Columbia University Press. Two sons (Peter and Sam), two granddaughters (Camellia and Juniper), one dog (Cosmo).
Numerous papers of mine available at:, Marxism & Ecology, also stuff on D.C. Statehood and Human Rights.



Is the US Criminal Justice System Bad for Everybody’s Health?


The US imprisons its population at the highest known rate in the world.  By the end of 2004, approximately 7 million people in the US lived under the jurisdiction of the criminal justice system, and more than 2.2 million were in jail or prison (1).  Increased incarceration and a decline in the general welfare of communities in the US are attributed to economic globalization, rapid de-industrialization, de-unionization, and a steep decline in jobs and real wages for the working class in the US (2).  These negative effects on the prosperity of communities have been exacerbated by “punitive and ineffective drug laws, educational inequities, anti-union government interventions, regressive tax policies, stagnation of the minimum wage, disinvestment in social and legal services, discriminatory housing policies, including the abandonment of public housing.” (2 at p. 2) 

Youth in communities of color have been especially affected by these policies.  High school dropout rates have increased for young men of color, college enrollment levels have declined, and incarceration rates have grown.  More than 29% of African American males who are 15 years of age are likely to go to prison at some point in their lives, compared to 4.4% of white males of the same age.  (2 at p. 3)  Youth of color are disproportionately represented in the juvenile justice system, and this mass institutionalization of young men is astounding: Sixty-two percent of the population of residential juvenile justice facilities are minorities, 85% are boys and most likely lack adequate health insurance coverage (2). 

Prison exposes inmates to physical and sexual assaults by other inmates and guards, substance abuse, mental trauma and a host of communicable diseases (2, fn26).  Between 9-20% of federal inmates, especially new or homosexual inmates, were victims of rape, according to the Federal Bureau of Prisons (1,  fn28).  The national median of sexually attacked prisoners is about 14% (1).  Housing more than one inmate per cell, a common practice to deal with overcrowded prisons, is considered a major contributing factor to incidents of violence and sexual assault. 

Approximately one quarter of the people living with HIV/AIDS in the US have spent time in the correctional system. (1, fn5)  AIDS prevalence in 2003 was more than 3 times higher in state and federal prisons than in general US population (1).  Female inmates have higher HIV antibody seroprevalence than male prisoners, and there is a disproportionate burden of HIV infection among racial minorities.  African Americans comprised more than two thirds of prisons AIDS deaths, and in 2002, the percentage of deaths due to AIDS in prisons was more than twice that of the US general population . Injection drug users generally share injection equipment more in prison and sterilize it less because of scarce resources (1,  fn31).  The prevalence of Hepatitis C among prisoners approaches 40%, and co-infection with the two viruses is common in prisoners, and is associated with an accelerated course of Hepatitis C disease. 

Prisoners around the world have consistently higher rates of tuberculosis (TB) infection and disease than the general population.  In the US TB in prisons ranges in excess from 3-11 times the general population (3, fn3).  Inmates are more likely to have multiple risk factors for infection and progression to TB disease, and the progression to TB disease in HIV infected persons is often rapid and can cause outbreaks that are hard to control.  One study in Memphis, Tennessee showed that 43% of community residents with TB had been incarcerated in the same jail at some time before their diagnosis, and this jail had experienced a TB outbreak lasting several years (3, fn14).  Inmates are also more likely to have treatment outcomes that are incomplete because of their moving out of the jurisdiction or being lost to treatment supervision.  Incomplete therapy could lead to increased incidences of TB resistant populations.  So health departments should enhance capacity for tracking TB patients diagnosed or treated in correctional systems (9).

TB has long been an infection of great concern in prisons, because of its higher incidence compared to the community at large, and due to the ease and frequency of airborne transmission of TB bacilli in crowded conditions commonly found in prisons (1, fn 35).  One year of jail time in NY city prisons doubled the odds of developing TB disease in inmates who were not infected on entry into prison (3, 4).  TB outbreaks continue to evade infection control programs, reports have come from many correctional systems, including Alabama in 2003, Kansas in 2004, Florida in 2005 and Georgia in 2006 (1, 5).  Rapid spread of TB can be a consequence of segregated housing for HIV positive inmates.  Prisons in California and S. Carolina have experienced large TB outbreaks in designated wards for HIV (1, 5).  

Problems in prison medical care are vast, and include poor record keeping at initial screening, delay in diagnosis of symptomatic disease, lack of isolation of patient at time of diagnosis, lack of supervision or observation of medication ingestion, lack of follow up after completion of initial treatment, infirmary treatment in a setting with susceptible HIV patients, inadequate ventilation of patients’ rooms, transfers among different prisons, inadequate screening and testing of prison staff and inmate contact, and poor communication and education of staff and inmates of health care issues (1).  Effective education for staff and inmates and accurate information appropriately conveyed (e.g. for illiterate populations) could greatly improve conditions in prisons.

 In 1998, 11.5 million people were released from jails and prisons into communities in the US., so there is bound to be an impact between prisoners’ health and community health (1).   TB originating in prisoners has been transmitted to staff, visitors, external health care workers and community contacts.  The inconsistent treatment that often characterizes prisoners’ medical care can permit the development of multidrug resistant strains of Mycobacterium tuberculosis (MDR-TB)(1, fn38).   Outbreaks of MDR-TB occurred in US prisoners in the early nineties, spreading to patients in local hospitals.  Mortality was as high as 72-91% (3).  An MDR-TB strain originating from NY State Prison was shown to spread to Florida, Nevada, Georgia and Colorado within two years (7).

We need to stop this systematic and massive incarceration of our citizens.  Alternatives to incarceration will allow states to save money on correctional facilities, and provide for healthier citizens to more readily participate in society.  Interventions found successful in reducing the spread of disease in prisons around the world have been denied in the US prison system.  These include syringe exchange programs, condom and syringe sterilizing equipment access, and methadone maintenance treatment.

Despite these vast shortcomings in the US criminal justice system, increased efforts are now underway in various places to better assure continuity of care and follow up of AIDS and TB patients after their release from custody.  These include wrap-around services, including assisting with enrollment for housing, health care, drug rehabilitation, financial benefits, HIV counseling and psychosocial support.  Mental health courts with judges and staff trained to make determinations on mental illness and assign appropriate treatment have also been found to reduce recidivism for non-violent offenders (6).  Exemplary programs have been established in Rhode Island (reducing rate of return to prison by 26% of released women a year after their release) and New York (a reduction of 75% in HIV seroprevalence among inmates entering state prisons in NY for males and 40% reduction for females in 2003) (1).


1.   E. Kantor, HIV Transmission & Prevention in Prisons, HIV InSite Knowledge Base Chapter, April 2006,

 2.  Joint Center for Political and Economic Studies, Health Policy Institute, Dellums Commission Final Report at p. 2, November 2006,

3.  Public Health Agency of Canada, Tuberculosis Epi Update, Tuberculosis in prisons, March 2001,

4.  Bellin et al. Association of TB infection with increased time in or admission to the NYC jail system.  JAMA 1993, Vol. 269, No. 17, pages 2228-2231. 

5.  MacIntyre et al. Impact of TB control measures and crowding on the incidence of TB infection in Maryland prisons. Clin. Infect. Dis., 1997, Vol. 24, No. 6, pages 1060-1067; Malway et al., Multidrug resistant TB in the NY State prison system, 1990-1991, J. Infect. Dis. 1994, Vol. 170, pages 151-156; Centers for Disease Control and Prevention, TB outbreaks in prison housing units for HIV infected inmates, California.  1995-1996. MMWR, 1999, Vol. 48, pages 79-82; Centers for Disease Control and Prevention. Drug susceptible TB outbreak in a state correctional facility housing HIV infected inmates. South Carolina, 1999-2000. MMWR, 2000, Vol. 49, pages 1041-1044. 

6.  The National Drug Court Institute: Drug Facts,; see also Eleventh Judicial Circuit’s Criminal Mental Health Project,

8.  Ref. 3, citing Bifani et al., Origin and interstate spread of a NYC multidrug-resistant Mycobacterium tuberculosis clone family.  JAMA, 1996, Vol. 275, No. 6, pages 452-457.

9.  Nat’l Center for HIV, STD and TB prevention, CDCP, Tuberculosis among correctional inmates,


Letters from Prison

The following are excerpts from prisoners' writings describing their medical care and general wellbeing. The authors' names have been redacted.

As I know from personal experience the consequences in prison of insisting on proper medical attention and care is often long term isolation, suspension of privileges, and even death, despite the Americans With Disabilities Act, which states that publicly funded institutions, including prisons must take people as they find them (with whatever disease or handicap) and adopt to the individual person's needs and not expect the person's handicap and health to adopt to the, institution. This is federal and state law today, but the consequences for being sick today in prison are the same as they were years ago despite the United States Supreme Court rulings that the Americans With Disability Act applies to prisoners.

The first person I ever saw die in prison was in San Quentin's hospital in 1959. He was a heart patient in his mid-thirties. After surviving his first heart attack and then a second almost immediately, he recovered enough to begin demanding and constantly pestering prison and hospital staff for the proscribed medications, rehabilitations, and diets recommended then in 1969 for hart disease care and treatment; subsequently, after several short stays in the hole, he was locked up and isolated in a room alone in the hospital. I was on the same floor with him, hut lice everyone else on the floor was in an open room. I had been in the dark hole in the county jail, waiting trial for almost 9 months and had contacted hepatitis, a disease that than was rare epidemic among prisoners and remains even more so in prisons nationwide today. The heart patient's room was the only locked room. The floor nurse did not have key to this room and the guard who did have a key frequently disappeared for long periods of time from the floor to the other 2 floors in the building. When the heart patient rang for help, the guard was off the floor. The nurse could not unlock the door or leave her other patients to go look for the guard and her radio calls brought no response from him. There was nothing she or any of us could do to help the prisoner, except crowd around the floor and watch him through the slit in the door while he withered and grasped his chest and cried out for help, Finally passing out, then convulsing with the pain as he died. Twenty minutes later the guard came lumbering up the stairs with the big brass keys jingling on his belt. He had gone downstair to smoke in the breakroom. Every prisoners there knew hierophantically, that is, with every cell of his being the heart patient had one way or another been murdered deliberate) and purposely, through routine neglect. No, disciplinary action was taken against the guard, and such action is seldom if ever taken, then or now. For the handicapped, the sick and elderly prisoner the punishment of being ii prison is often a question of how to survive the neglect of his needs from day to day, even from moment to moment.

I do not know that the violent and brutal murders of prisoners today by guards equals or even comes close to the violence against prisoners by guards in the 1960's and 1970's nationally. At San Quentin guards carried leaded canes. They would isolate a prisoner in a cell above the North Block, cuff his hands and feet to the bed and beat him to death with the bone crushing canes. Another method consisted of handcuffing prisoner's hands above his head with his feet off the floor. Left long enough, his lungs' would collapse, crucifying and suffocating him to death. In more than one case guards isolated a prisoner in the South Cellblock hole, sticking a fire hose in his face, turning it on, and shoving the nozzle down his throat, drowning him. Many prison riot's written off in this period as spontaneous and unexplainable were a result of guard violence against prisoners.

Many guards today, however, seem to feel it their right to mistreat prisoners, constantly picking at them with petty abuse, equivalent to child, spousal, or elderly abuse, relentlessly making their life miserable. The ‘righteousness' of these guards is encouraged as they are toll in training classes that prisoners are sub- human offenders in prison: to he punished. This ignores the many court rulings that again and again have stressed prisoners are in prison as punishment. The difference escapes most people, including prison guards. It is a difference the courts give lip service to, but refuse, except in rare instances to enforce. Being in prison, the lost of freedom is the punishment and no salt needs to he poured on the wound. The failure to enforce the courts' ruling can and does make life unbearable for prisoners especially the elderly, sick, and handicapped as they seem in their helplessness to constantly attract the predator guards, the bullies, but it is more abominable than it sounds as other guards and administrative staff often actively participate in the abuse, acquiescing in and upholding unfounded and outrageous accusations. Righteous is simply a desire for order, which the 'righteous' impose upon others, seeking it where it does not exist, with words, but just as surely with blood, words paling next to blood and the pain aid suffering it causes. Prison is a controlled environment. Nothing is spontaneous or just happens here. Everything that happens is methodically organized, organized, regulated, and is an abuse of practiced cruelty that happens on purpose, hypocritically and mendaciously, guards deliberately punishing the sick and elderly for being old and ill, and the handicapped for being handicapped, often beyond the point of death.

Since 1959 1 have seen many men in prison medical care die. In 2003 at Northeast Correctional Center, Bowling Green, Mtissouri, 27 prisoners died in a nine month period while in the prison infirmary or in an ambulance, leaving the prison on the way to a city hospital. These deaths were listed as ' natural causes '. However, due to the high number of deaths, an investigation in 2004 was instituted by Correctional Medical Services, the employer of the medical personal at the prison responsible for the care, or neglect of prisoners, leading to the 27 deaths in 2003. The findings were a foregone conclusion, clearing the medical staff of any wrong doing. Neglect was never mentioned. Even so, in 2004 there were only 6 deaths in 12 months, and in 2005, only 4 in 12 months. The 2003 medical staff, including doctors had been completely replaced by mid-2006 with new staff.

I was on the yard at San Quentin sick to death for 3 months in 1969 before I was finally able to convince a doctor to take a blood sample and send it to the lab to check for hepatitis. The doctors employed at San Quentin, like many of the guards were old retired army men, although there were also doctors who were prisoners. They worked as doctors in the hospital's emergency room. These wore the guys you wanted- to stay-friendly- with as San Quentin could erupt into a blood bath without warning and the emergency room had earned the. reputation of being able to successfully patch-up any stabbing victim, if he could survive his wounds long enough to reach it.

The medical, civilian, prison doctors back then were mainly useless with age, half blind, slow, and often mentally fixated on ancient medical procedures or theories as to what caused disease and what could or could not be done about it, if anything. I had a female doctor, a visiting specialist tell me that prisoners, being young and generally healthy, mostly survived despite what was done to them by the medical profession at San Quentin. Not much has changed in the last 40 years, except the number of prisons built in the last 25 years in the U.S. has provided an outlet to employ doctors who otherwise would be un-employable. In 2002 at Eastern Correctional Center, Pacific, Missouri, I received the records of the chief physician at the prison from the Missouri Board of Curing Arts, the licensing and oversight agency for Missouri doctors. This doctor had killed 2 women in Ohio while performing hysterectomies that after their death were determined to be completely unjustified. Performing unnecessary operations seemed to be a habit with him. His hospital privileges were suspended and the Curing Arts Board had barred him from- practicing medicine in Missouri, except as a Correctional Medical Services doctor at a correctional institution with the additional restriction he could not cut or operate on any prisoner and could only act in a supervisory capacity when examining prisoners. However, the fact of his title, MEDICAL DOCTOR, was sufficient enough for Correctional Medical Services to install him at the institution as its CHIEF PHYSICIAN.

The information about this doctor came to me as a result of a suit I intended to file against him. In December, 1982, 1 had a heart attack that all but destroyed the left chambers of my heart. Then I had another heart attack in March, 1983. At this time the doctors gave me a 50% chance of surviving 2 years. I beat the odds. But then in August, 1995 1 had a third heart at6ck. The 1985 attack was followed by a quadruple by-pass operation. In 1987 1 had another heart attack that pretty well finished off the left side of my heart. In 1992, after being out of prison for 15 years I was sent to prison in Missouri for 60 years for a rape that was never committed and would have been physically impossible for me to commit with my heart condition. In 1,998 while at Missouri State Prison I had anotherheart attack. At 3 AM 2 rookies guards were working in the cellblock. On hearing my cry of "man down!” they came on the run to open my cell and the cellblock door downstairs, letting me out of the cellblock to cross the prison yard in the dark to the infirmary. An ambulance quickly arrived, rushing me out of the prison to the city hospital and into the emergency room. Doctors performed another quadruple plus two by-pass. In 2001 I was transferred from Missouri State Prison, max security, to the medium security Eastern Correctional Center at Pacific. One of the medications procribed after the 1998 by-passes was an anti-clogging agent. It kept the blood cells from sticking to the artery walls. T doctor at Eastern Correctional Center in 2003 discontinued it when his tosses deemed it too expensive. Neither he nor they had examined me. The decision was made for economic reasons without consulting me or informing roe until after the medication was discontinued. After I let it be known I intended to file suit against the doctor and his bosses at Correctional Medical Services, filing a grievance against the doctor, asking the medication be reinstated, my custody level was raised and I was transferred to the maximum security prison at Bowling Green. I dropped the suit as my condition worsened at Bowling Green.

This medication had been proscribed for, me by the cardiologist who had performed he by-pass with the recommendation I continue on it for life. Normally, even during the yearly physicals, prisoners complaints are ignored, and even hen the institution gives into a complaint, it constantly is on guard to t k.- back what it has given. However, after a routine trip to the cardiologist’s is office in June, 2003, Plavic, which also keeps the blood cells from sticking to the artery walls and is expensive was proscribed by the cardiologist. I received Plavic and thought then I had won this battle, though my complaint had gotten me transferred from a medium security institution to a Max security institution with an electric fence around it guaranteed to kill anyone who touched it. There is, of course, no winning the war, and sometimes winning simply means holding on to yourself, knowing who you are beyond the circumstances of the abuse and standing your around.

Releasing me from my cell, during the heart attack in 1998 was against prison regulations and not everyone has been so lucky. In plain words it was a miracle these particular young guards happened to be working and aware of my heart problems, so that they took it upon themselves to release me from the cell. Proper procedure would have been for the guards to phone the infirmary and ask a nurse to come to the cellblock. I have seen and watched with dread similar situations unfold with prisoners waiting up to an hour and longer; in their cells for help to arrive from the infirmary. Often in such emergencies cellblock guards radio the hospital guard and are informed just to stand-by and see how the situation develops, or the cellblock guards phone the infirmary nurse on duty only to he told she is busy and can not go to the cellblock for someone who probably has nothing more wrong than a belly ache or had nerves. Generally, even when a prisoner is sent to the infirmary It night, nurses who may or may not be licensed registered nurses, or even qualified MTA's, do not want to bother the doctor on call and will put off phoning him as long as they possible can. The doctors themselves are reluctant to order a prisoner to he taken out of the orison to the local city hospital. There is also the problem that many prisons are located away from towns and cities and ambulances take 20 to 45 minutes just to arrive at the prison, taking another 10 to 20 minutes to enter, pick-up, and leave the prison with the patient. However, survival for cardiac arrest is measured in minutes. After 19 minutes there is a zero chance of surviving.

At Bowling Green the institution cells contained a panic button. Since entering prison in 1992 I have been allowed to carry 'nitro' in sublingual tablets with the instruction that after I have taken 3 to contact the institution infirmary immediately. After 3 bout of heart pain that resulted in me taking 3 nitro I pressed the cell's panic button at 3 in the morning. A female guard took 20 minutes to respond from the control bubble at the center of the wing 50 feet from my cell. She asked what was wrong. I told her, and she shook her head, telling me, "That's no reason to declare an emergency." The next morning after I returned from sick call to the housing unit I was called into the caseworkers office behind the bubble and informed the guard had written me a conduct violation for declaring an emergency when no emerge y existed. Not a word was said about the guard overruling the doctors orders or making medical decisions. I was locked in my cell for 15 days, only able to leave it for meals.

Between 1992 and 2004 I had not received a single conduct violation. At Bowling Green between November, 2004 and June, 2005, I received 5 conduct violations. Two of the 5 were for refusing to stand on a chair and wash walls. One was for refusing to sign an enemy waver when neither I nor the so called enemy knew what the caseworker was talking about; the fact he was black and I was i,hite and from Selma, Alabama being the caseworker's deciding factor. The foil" being for pushing the runic button, and the last for failing to get off the phone when told to hang tip ( I simply did not1 n gone had said anything to me, the order supposedly issued to me from across the room, 30 feet away),

During this same period my cell was searched and tore up everyday by the sam` guard. I was in the hole 3 times, twice illegally without any conduct viol violati n being written ft reason given to me. The first time for 4 days, the se nd time for 5 days; then the third time for 15 days with a conduct violation for refusing to sign the enemy waver. The black guy signed the waver. "or me to sign it simply because I am from Selma, would have been labeling myself as a racist, which just isn't so. In this same time I was filing grievances constantly against the guards And medical personal as my heart medicines were administered erratically, often as they were not order on time or because they had been 'misplaced,' There was nothing I could do, except file grievances, which are always ignored. On several occasions the doctors at Bowling Green intervened on my behalf and ordered the medications sent from the drugstore in town. Eventually, I collapsed in the hole and was taken by ambulance to the hospital in Jefferson City, a 2 hour ambulance ride. I spent nearly weeks in hospital, recovering from the abuse at 3owlAng Green. When I returned to Bowling Green I was kept in the infirmary in a private room from the end of July, 05, to June, O6, when I was transferred deeper into the shadows that are the Missouri penal system to the max security prison at Licking, Missouri. For the last 5 months I have been permanently assigned to a 4 man dorm in the prison's infirmary. As soon as I arrived here the Plavic was discontinued. There is nothing I can do about it, except file a grievance that no one will nay attention to. Staphylococcus is rampant here, as it is over the entire prison system. I developed a boil on my chest. It busted. My hands and feet are often swollen and my feet are infected with staph. There is a guy here who lost both his lens because he had sores on them that the prison doctors could not get to heal, so they cut off his legs.

There is no special diet for heart patients and no fresh fruit or fresh vegetables here, and the meat is all 66% processed chicken, or else turkey made into sausage or franks. Only one guy has died in the 5 months I have been here. I knew him at Missouri State Prison. He was an older man and was back in prison on a parole violation after being out for 12 years, caught with a 12 pack of unopened beer in the hack seat of his car. He was 50 at the time. That was 9 years ago. He recently lost his wife and told me he had taken several falls in his cell and had hurt his hip. His hips were a deep, blotchy purple; so were his thighs and both his arms. When he came in the dorm he asked me what I thought. I told him that something serious was wrong, maybe with his liver. He said, "Well, I'm through with it anyway. They can have it." The doctor urged him to get out of bed, but he refused and after a day or 2 laid in the bed and defecated on himself. They moved him to a cell by himself. Within 10 days he was dead. A guard said his liver failed, but it was his heart. They had tore it out and stumped on it once too often, and it simply quit working. xxx I should have asked you, how many words. This is somewhere around 2,500. If you can use it fine, it not -- why not?

A second letter from prison (11/06)

I have a doctor's order that states my disabilities and conditions that need to be observed for me to continue to exist, that is, for me to be able to continue to survive in any prison environment. One condition is no prolonged standing; another condition is marked twice by the doctor, "no, no, cold."

Like most prisoners at NECC I have never been issued any winter clothing, nor any rain gear. Yet, everyday I am forced to face the elements to go outside the cell house to the messhall, if I want to eat, or to go to the infirmary to pickup the medications I need. No matter how cold the weather I am forced daily to either go out in the cold or stay inside and go without meals. I miss many meals. Some days I miss all 3 meals because it is too cold or too wet and cold for me to go outside without winter clothing and rain gear.

On 12/20/04/, although I informed CCA Watson that I needed supplies from the Canteen, but was not feeling well and could not, safely stand outside in a long Canteen line in the cold predicted for 12/22/04. Ms. Watson informed me there was nothing she could do to help. The, situation was the same I faced daily, deciding if I dared go outside in the cold or rain to eat at the mess hail or to the infirmary to pickup medications, or if I dared do without eating and/or medications that day. Ms. Watson said I could write Mary Riordan, ASO, and ask her for help. I doubted the ASO would get back to me by 12/22/ and decided to wait and hope the weather would improve, but on 12/22 the weather was as predicted, 13 degrees with 15 to 25 mile- an hour winds, resulting In a wind chill factor near zero. I went to the Canteen, stood in line, and after 20 minutes was admitted to the building with nothing more than mild chest pains. The pains continued. throughout that day. By 11 PM I had a chill and was soon in a cold sweat. My calves and, thighs, lower back and shoulders cramped with every muscle aching, so that my body felt exactly like I had the flue. I could not lay down and was too weak to stand up. I began vomiting around 12 AM. The muscles across my stomach and lower chest continued to contract and cramp. By 12:45 I was in something of a panic, afraid my chest would cramp, causing my heart muscles to react. By this time, due to heart pain, I had already taken 3.nitro tablets, and I actually did not know if it was going to- get worse or not.

I had my first heart attack over 20 years ago and these stress attacks have occurred whenever I have over-exerted myself. When they occur I have been told by the doctors and the nurses through the years and while. here at NECC that due to my medical history I am to, come to: the infirmary. At pproximately 1 AM on 12/23/04, I pressed the cell call buzzer. Very shortly thereafter a CO I Carla Yokem came to my cell. I informed her that I was supposed to go to the hospital. I toldd her about the chill, cold sweats, and vomiting, and the cramps moving up into my chest. I even. demonstrated with my hands the progress of the cramps up from my abdomen into my chest. She asked if I was declaring a medical emergency and I said no, that I needed to go to the hospital because of my heart condition, that the nurse needed to see me there or come see me here in the cell house. She responded that the nurse would not come to see me and that they would not take me to the hospital unless I "fell out." I then told her again about the vomiting and asked if she could at least ask the nurse for some Mallox as my throat and stomach was raw. CO Yokem left and when she came back said the nurse said I did not have an order for Mallox and the nurse would not did give me any. I then asked CO Yokem if she could help me with some Mallox for my throat. She said she was not a medical person. She was holding an MSR and said the nurse said I should report on Nurse Sick Call at 11 AM. She asked if I wanted the MSR. She was standing outside the cell door and I was lying at the far end of the bed from the door. I responded, "I do not want you people to give me any fucking thing." The "you" was the third person "you" and not directed exclusively at CO I Yokem, and it simply meant all I wanted was for " you people " to do your jobs. CO Yokem left, after a time another officer came back and demand I come with him downstairs to the back office. I had continued to vomit until just a few minutes before this officer showed up, but the chill had broken and I was no longer cramping, and was now extremely faint. The fact of my condition was no fact at all for this officer or for the sergeant and CO I Yokem, waiting in the back office. CO Yokem had written a violation, stating I had shown "insulting behavior" towards her. I have no idea what she means by insulting behavior. My behavior was concerned with my own misery and suffering, but, as I have told her, I am grateful for the violation as it documents the neglect and indifference to the sick and handicapped at NECC.

That one human being could inform another human being that they have been in a cold sweat with cramps and vomiting for the past two hours and have a bad heart condition and need to see a doctor, and have that human being not only ignore them but lock them in a cell without assistance is incredible, but true and common at NECC!

On 12/23/04, I reported to sick call, informed the nurse what had happened, and she said I should have come to the infirmary and "with your history" need to be examined at the time of the incident. I told her the officers refused and said the only way I could get to the infirmary was to "fall out," which I was not going to do. She said I should talk to the caseworker, meanwhile she would refer the matter to the chronic care nurse and schedule me to see the doctor. I attempted to speak to Ms. Mertz about the above and she said, she could not talk about it, but in any case, I would have to have the doctor put it in writing.

I have had the doctor put in writing the restrictions under which I am able to live with my handicap, but putting said 'restrictions in writing for the staff at NECC has had no effect on the staff, except to encourage them to ignore the doctor's orders. I am classified as L-4, handicapped, and was transferred to NECC because I needed "around the clock nursing." I have not received any nursing around the clock or otherwise while at NECC. There is no Catch 22 in any of it. The NECC staff simply does. not want to do what the doctor orders nor what the law demands. In fact, I have received 6 violations while confined at NECC, all of them related to being handicapped. Four of them were dismissed. Two of these 4 actually challenged the doctor's orders! The 5th was dismissed, then reinstated with sentence suspended, although the reason for the reinstatement violated ADA rules. The 6th is the above violation by CO Yokem, which thankfully documents the abuse common at NECC where a call for help is met with a violation for "insulting behavior," meant not only to discourage the prisoners asking, for help, but to discourage other prisoners from pressing the call buzzer. and asking for help.

Today is 12/26, and I have spent the last 3 days attempting to recover from the attack on 12/22 caused by standing outside in the cold. I have not seen a doctor, have not received any nursing aide, and no one has inquired about my condition.

On 12/20/04, after standing in the cold in the Canteen line a black prisoner suffered a heart attack. He was forced to kneel backward in the seat of a wheelchair, hanging onto the backrest with both hands as he was slowly wheeled across the yard to the infirmary where he received CPR until the ambulance arrived and he was taken out to be pronounced dead on arrival. What humanity is this that does not recognize itself?



Energy – Thoughts on Equity and Justice

John Tharakan


The availability of and access to energy have long been understood as a primary determinants of standard of living and level of development. There is tremendous disparity in both the per capita energy use and quality of energy available to different nations as a whole, as well as to different classes and groups within those nations. These differences are reflected in the standards of living experienced by people inhabiting these various socio-economic niches.  As the world struggles with the eventuality of running out of oil, the potentially catastrophic global consequences of unrestrained combustion of fossil fuels and the putative arrival of Hubbert’s peak - when it will cost more energy to extract the oil then the oil itself can provide - and as alternative energy sources from solar, wind and biomass to nuclear are being put forth as the sustainable energy sources of the future, it is critical that we also examine energy use and allocation. More importantly, we must interrogate the equity of the delivery, distribution, and pricing of this essential resource, and the impact these have on global income distribution and the alleviation of poverty.


In the United States and most of the global industrialized and developed North, it is generally understood that individuals have an equal right to representation in politics, clean air and water, a clean environment, functioning sewage and sanitation utilities and adequate energy supplies. The basic civic belief in these rights may have been fundamental, and in concept is wonderfully egalitarian, but the reality was far different. Approaching that egalitarian vision necessitated various measures that lead, albeit after much struggle and against stiff resistance, to the Civil Rights Act, clean air and water acts and amendments, environmental justice legislation, and the regulation of energy utilities. Despite all the legislation, inequities still abound. Voters are illegally deleted from rolls. Environmental quality appears to be a function of race and income level. And of late, deregulation of many utilities has lead to energy cost and supply fluctuations not beneficial to the consuming public, despite what the neo-cons and free marketers will have you believe.


Nevertheless, the passage of this legislation speaks to a fundamental social belief that all have an equal right to life-essential items such as air, water, food, shelter and a clean environment. When we think globally, we believe and espouse the same.  This is well and good, as long as its not imposed through military action, regime change, pre-emptive wars, and under punitive financial structural adjustment programs that serve only to target the weaker sections of any society and punish pro-poor and development- friendly policies.  As energy supplies dwindle and costs surge in this first decade of the 21st century, it is important to extend this egalitarian thinking and conceptualization to energy as a resource that needs to be democratically available and accessible to all.



In December 1948, the UN General assembly adopted the Universal Declaration of Human Rights. Article 25 proclaims that “...[E]veryone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services…”.  Without access to adequate energy sources, there will be no food, clothing, housing or medical care. This is a truism that is universally understood, yet almost sixty years on, the World Bank estimates that over a billion people on this planet still have no electricity. They rely on biomass combustion for energy for cooking and animal power for locomotion and work.  In the global North, availability of electricity is taken for granted, as is the availability of high quality energy for transport, commerce and industry. In the poor villages of the global South, however, rural electrification has yet to reach millions of people and animal power is still the main form of motive energy available. With only this type of “low-quality” energy available, development is severely handicapped and societal progress, measured in terms of improvements in standard of living and quality of life indices, is minimal.

To understand equity in energy distribution, it is instructive to divide the world according to population, energy use and purchasing power. The earth now includes over one hundred and eighty countries. The richest of these are the Group of 7 (G7) comprised of the US along with the UK, Canada, Germany, France, Italy and Japan, representing roughly 12% of the world’s population which includes the 5% in the US. The Organization of Economic Cooperation and Development (OECD) nations include the G7 as well as some twenty five  additional countries, twenty of which are in Europe, the others being Australia, New Zealand, South Korea, Mexico and Turkey. Put together, this is another 7% of the world’s population.  Aside from Mexico and Turkey, these are all “developed” nations with mature industrial economies.  The rest of the world, which includes the other 81% of the world’s population, is what is commonly referred to as the global South.  If one now examines energy distribution and use in these groupings of nations, the shocking inequity of energy use and availability becomes clear.


The US, with 5% of the world’s population, uses a little over 8,000 kilograms of oil equivalent (kgOE) per capita, which amounts to 24% of the world’s produced energy. The rest of the G7 countries, comprising 7% of the world’s population, use about 4,200 kgOE, or 18% of the world’s energy.  The OECD, without the G7, has another 7% of the world’s population and uses about 2,800 kgOE, or about 13% of the energy.  Meanwhile, the rest of the world together, roughly 81% of the global population, uses a mere 857 kgOE per capita, or around 45% of the world’s energy.  To be sure, within each of these regions, there will be wide degrees of variability in actual energy use, especially within the rest of the world.  China and India, for instance, are the world’s two fastest growing economies, and sectors of each of these nations’ billion-plus population live in comparative luxury with no energy limitations. If one looks at the upper middle class in India, for example, electricity availability is taken for granted, whether through the grid or individual generators, and locomotion is in an air-conditioned fossil fuel-powered vehicle, sometimes several. My landlady in Chennai, India, and her husband and with two sons in college, have four vehicles between them, including a high-powered sports car and a petrol-guzzling SUV; they are not the exception in India’s upper middle class. They do, however, constitute a paltry 10% (some estimates are as high as 20%) of India’s billion plus population. Similar stories abound in China.


At the same time, it is clear that energy quality and availability are essential for development.  In very poor countries, where per capita incomes are $300 or less, the main source of energy for cooking is wood and dung, the use of which contributes to diminished indoor air quality and attendant health problems.  Lighting is minimal, contributing to decreased education and literacy levels, and transportation and work is through animal power, with concomitant impacts on the pace of development. In the fast-developing economies of India and China, the vast majority of the population still relies on biomass and animal power.  As we move up the income chain, fossil fuels start to replace the use of wood and dung for cooking, and electricity becomes available for lighting. According to one assessment (Barnes and Toman, Note 2), when per capita income levels reach about $1,500, transition to modern fuels and energy sources becomes complete.  This, however, belies the extremely wide variability of calculated average national per capita incomes within particular countries.


The per capita income, or purchasing power parity, for the US is roughly $36,000, for the rest of the G7 it is about $26,000, for the OECD without the G7 it is about $14,000 and for the rest of the world it is about $3,800. These are average numbers, calculated as the gross national product (GNP) divided by the total population and they do not reflect income distributions in the countries.  In fact, disparity in income distribution has grown over the past thirty years in the US as well as the world. In 1970, the top fifth of the US population received 43% of the national income, while in 2000, their share had risen to close to 50%; meanwhile, the bottom 20% share of income fell from 4.1% to 3.6%. From an income perspective, the middle class worldwide has been dwindling. In 1960, the upper fifth of population received 70% of income, the 2nd through 4th fifths (the ostensible “middle classes”) received 27.5%, while the lowest fifth received only 2.3% of world income. By 1999, the upper fifth had increased their share of global income to almost 90%, while the middle fifth’s share decreased to about 9% and the bottom fifth to only 1%!  The rich are indeed getting richer, the poor poorer and the rate at which this is happening has been accelerating.


These trends are, not surprisingly, reflected in energy use. The wealthy use more energy, burn more fossil fuels and consume more resources. This appears to feed on itself, contributing to a spiral of increasing energy use by the wealthy few tied to increasing shares of global wealth going to the same.  As inequity in wealth increases, inequity in energy use increases, not only for oil but total energy. If we are to make a difference in the lives of the global poor, we must address this inequity in energy use. As the emerging economy’s of India and China rapidly expand with their growing appetites for energy, and as the upper middle classes there emulate lifestyles similar to that of the upper middle classes in the global North, they will seek to corner more of the limited energy market, making less available for lifting and improving the quality of life and standard of living of the world’s poor.  Indeed, if we are to promote development with pro-poor policies, it is imperative that they be provided more energy and this can only happen if the share of energy consumed by the wealthy of the world is reduced. This may seem like asking them to reduce their standard of living, which is an unlikely possibility. In a fossil fuel-driven world, these resources are limited, and the powerful will not give up their resource use without struggle.


A multi-pronged strategy for energy resource development and energy use and pricing policies is essential to see real development on a global scale and the elimination of poverty world-wide. The strategy must incorporate development of alternate renewable energy sources such as solar, wind and biomass. It must seek to reduce and limit energy use by the wealthy through appropriate pricing, taxation and fees. Only when we come to some level of parity in energy use, will we see wealth and resources begin to be distributed more evenly and any real dent made in global poverty.


For additional readings on energy and equity, please see:

  1. Ivan Illich, Energy and Equity, available at:
  2. Barnes, DF and Toman, FA, Working Paper: Energy, Equity and Economic Development, Initiative for Policy Dialogue, Columbia University; available at:
  3. See, for example, Hubberts Peak:
  4. Universal Declaration of Human Rights, available at:
  5. Mukherjee, A. “Measuring Inequity”, accessible at:


How much CO2 emission is too much?

Submitted by David Schwartzman. Source: RealClimate article: 6 Nov 2006 Filed under: Climate Science Greenhouse gases IPCC

This week, representatives from around the world will gather in Nairobi, Kenya for the latest Conference of Parties (COP) meeting of the Framework Convention of Climate Change (FCCC) which brought us the Kyoto Protocol. The Kyoto Protocol expires in 2012, and the task facing the current delegates is to negotiate a further 5-year extension. This is a gradual, negotiated, no doubt frustrating process.

By way of getting our bearings, a reader asks the question, what should the ultimate goal be? How much CO2 emissions cutting would it take to truly avoid "dangerous human interference in the climate system"? On the short term of the next few decades, the line between success and excess can be diagnosed from carbon fluxes on Earth today. Humankind is releasing CO2 at a rate of about 7 Gton C per year from fossil fuel combustion, with a further 2 Gton C per year from deforestation. Because the atmospheric CO2 concentration is higher than normal, the natural world is absorbing CO2 at a rate of about 2 or 2.5 Gton C per year into the land biosphere and into the oceans, for a total of about 5 Gton C per year. The CO2 concentration of the atmosphere is rising because of the 4 Gton C imbalance. If we were to cut emissions by about half, from a total of 9 down to about 4 Gton C per year, the CO2 concentration of the atmosphere would stop rising for awhile. That would be a stunning success, but the emission cuts contemplated by Kyoto were only a small step in this direction.

Eventually, the chemistry of the ocean would equilibrate with this new atmospheric pCO2 concentration of about 380 ppm (the current concentration), and its absorption of new CO2 would tail off. Presumably the land biosphere would also inhale its fill and stop absorbing more. How long can we expect to be able to continue our lessened emissions of 4 Gton C per year?

The answer can be diagnosed from carbon cycle models. A range of carbon cycle models have been run for longer than the single-century timescale that is the focus of the IPCC and the FCCC negotiation process. The models include an ocean and often a terrestrial biosphere to absorb CO2, and sometimes chemical weathering (dissolution of rocks) on land and deposition of sediments in the ocean. The models tend to predict a maximum atmospheric CO2 inventory of about 50-70% of the total fossil fuel emission slug. Let's call this quantity the peak airborne fraction, and assume it to be 60%.

The next piece of the equation is to define "dangerous climate change". This is a bit of a guessing game, but 2°C has been proposed as a reasonable danger limit. This would be decidedly warmer than the Earth has been in millions of years, and warm enough to eventually raise sea level by tens of meters. A warming of 2° C could be accomplished by raising CO2 to 450 ppm and waiting a century or so, assuming a climate sensitivity of 3 °C for doubling CO2, a typical value from models and diagnosed from paleo-data. Of the 450 ppm, 170 ppm would be from fossil fuels (given an original natural pCO2 of 280 ppm). 170 ppm equals 340 Gton C, which divided by the peak airborne fraction of 60% yields a total emission slug of about 570 Gton C.

How much is 570 Gton C? We have already released about 300 Gton C, and the business-as-usual scenario projects 1600 Gton C total release by the year 2100. Avoiding dangerous climate change requires very deep cuts in CO2 emissions in the long term, something like 85% of business-as-usual averaged over the coming century. Put it this way and it sounds impossible. Another way to look at it, which doesn't seem quite as intractable, is to say that the 200 Gton C that can still be "safely" emitted is roughly equivalent to the remaining traditional reserves of oil and natural gas. We could burn those until they're gone, but declare an immediate moratorium on coal, and that would be OK, according to our defined danger limit of 2°C. A third perspective is that if we could limit emissions to 5 Gton C per year starting now, we could continue doing that for 250/5 = 50 years. One final note: most of the climate change community, steered by Kyoto and IPCC, limit the scope of their consideration to the year 2100. By setting up the problem in this way, the calculation of a safe CO2 emission goes up by about 40%, because it takes about a century for the climate to fully respond to rising CO2. If CO2 emission continues up to the year 2100, then the warming in the year 2100 would only be about 60% of the "committed warming" from the CO2 concentration in 2100. This calculation seems rather callous, almost sneaky, given the inevitability of warming once the CO2 is released. I suspect that many in the community are not aware of this sneaky implication of restricting our attention to a relatively short time horizon.

Note: responding to suggestions in the comments, some of the numbers in the text above have been revised. November 7, 2:31 pm. David

Why is the U.S. So Random About the Syringe Exchange Program?

Excerpts from a review article by Scott Burris et al (1) on syringe (and needle) exchange laws and programs (SEPs) are provided below. This serves as a primer for navigating the politics and laws of SEPs, as well as illustrating the contorted history of SEPs in the US.

"Access to sterile syringes through syringe exchange programs (SEPs) has been associated with decreased rates of needle sharing, decreased prevalence and incidence of blood borne infections such as HIV and hepatitis B and C, and increased rates of entry into drug treatment a Syringe access is regulated by state law. The legal regulation of syringe access varies from state to state but takes one or more of three forms: syringe prescription laws and regulations; other pharmacy regulations or miscellaneous statutes imposing a variety of restrictions on the sale of syringes by pharmacists or others; and drug paraphernalia laws prohibiting the sale or possession of items intended to be used to consume illegal drugs (2 ). Laws on drug possession also may be applied in a manner that in practical terms regulates the possession of syringes, and so must also be considered for their possible effects on syringe access (3). Syringe access is regulated by state law. The legal regulation of syringe access varies from state to state but takes one or more of three forms: syringe prescription laws and regulations; other pharmacy regulations or miscellaneous statutes imposing a variety of restrictions on the sale of syringes by pharmacists or others; and drug paraphernalia laws prohibiting the sale or possession of items intended to be used to consume illegal drugs.2 Laws on drug possession also may be applied in a manner that in practical terms regulates the possession of syringes, and so must also be considered for their possible effects on syringe access (3). The primary policy questions have been the legality of over-the-counter sales of syringes to IDUs, the legality of syringe possession by IDUs, and the authority of public health officials or private sector providers to initiate access interventions. [T]here has been an ongoing debate for many years over what, if any, syringe access research or program activities could be conducted with federal funding. Meanwhile, syringe access programs have depended on state or local funding, philanthropy, and the work of volunteers to operate. In the USA, the first SEP was introduced in 1988, in Tacoma, Washington, and spread from there with the help of NGOs such as the National AIDS Brigade, the North American Syringe Exchange Network and Act-Up. Expert reviews of the science supported syringe exchange (4), but early commentators generally assumed that syringe exchange was illegal in the United States unless explicitly authorized by state law (5). By 1995, there were at least 55 SEPs operating in 46 cities in 21 states (6). A review of the legal strategies used to implement these SEPs found that 27 programs in ten jurisdictions had been authorized by law or court decision, or were in a state without a syringe-related law. Thirteen programs were operating without any change in law, backed by local governments exercising their legal authority to protect public health. At least nine SEPs were operating without any claim to legal authorization (7). In November 1988, a federal ban on U.S. funding for SEPs was enacted (8). Provisions stated that the ban on federal funding could be lifted only if the President of the United States or the US Surgeon General determined that SEPs reduced the transmission of HIV infection and did not increase drug abuse. Later Department of Health and Human Services appropriations acts prohibited funding for NEPs “unless the President of the United States certifies that such programs are effective in stopping the spread of HIV and do not encourage the use of illegal drugs.” (9) The legislative restrictions included a proviso that would allow funding if it were certified that syringe exchange reduced HIV incidence without increasing drug abuse. Because there was also an administrative ban on research to evaluate NEPs from 1988 to 1991 (10), this was the quintessential Catch- 22. In 1998, Secretary of the Department of Health and Human Services, Donna Shalala issued the required findings, but the Clinton administration, in the face of continuing opposition in Congress and from its own Office of National Drug Control Policy, declined to seek funding for syringe exchange programs or research. The Surgeon General reiterated the Secretary’s findings in 2000 (11). Nevertheless, since 1999 the annual Labor/Health and Human Services appropriations bills have contained a ban on federal funding of syringe exchange (12). For many years there has also been an annual battle over the Congressional budget appropriation for the District of Columbia. Riders to the fiscal year 2001 not only prohibited the District from funding syringe exchange, and but also barred the privately funded SEP from operating close to public housing and within 1000 feet of a school (13). After vigorous lobbying from proponents of SEPs, the fiscal year 2002 appropriation removed the restrictions on the operation of the private SEP, but maintained the ban on federal funding (14). Despite the lack of federal funding, by 1999 there were over 160 SEPs in operation in 39 U.S. states, the District of Columbia and Puerto Rico (15). But syringe access law is much more complicated than a simple list of laws can show. Although many of these laws are generally similar from state to state, there is in fact a great deal of state-to-state variation in legal syringe access for IDUs. Moreover, legal researchers have increasingly recognized that the legality of different means of syringe access depends upon the form of access (syringe exchange or pharmacy, e.g.), the legal status of the person providing the access (e.g., a physician), the particular combination of laws and case decisions in the state and the attitudes of people who enforce the laws where the access provider wants to operate.

Burris and colleagues (16) used legal research and survey techniques to identify the legal strategies used by SEPs to operate in the US. Their analysis identified considerable uncertainty in the legal status of syringe exchange, uncertainty that reflected not only the complexity of the relevant statutes but also the interplay of multiple statutes and the practices of law enforcement and public health officials. Uncertainty about the legal status of syringe exchange was considerably different than clear illegality. SEPs, the study found, could successfully operate without explicit authorization in a climate of uncertainty; likewise, absent a clear legal prohibition in state law, local governments often had the authority under public health laws to operate or authorize SEPs."

1. Burris, S, Strathdee, S.A. and J. S. Vernick., Syringe Access Law in the United States , A State of the Art Assessment of Law & Policy, Center for Law & the Public’s Health at Johns Hopkins & Georgetown Universities, Nov. 30, 2002,
2. L. O. Gostin, and Z. Lazzarini, Prevention of HIV/AIDS among Injection Drug Users: The Theory and Science of Public Health and Criminal Justice Approaches to Disease Prevention, 46 Emory Law Journal 587 (1997).
3 Scott Burris, Joseph Welsh, Mitzi Ng, Mei Li, and Alyssa Ditzler, State Syringe and Drug Possess14 Health Omnibus Programs Extension of 1988.
3. Health Omnibus Programs Extension of 1988.
4. P. Lurie, A.L. Reingold, and Bowser. B. (eds.), The Public Health Impact of Needle Exchange Programs in the United States and Abroad: Summary, Conclusions and Recommendations (1993); J. Normand, D. Vlahov, and L.E. Moses, Preventing HIV Transmission: The Role of Sterile Syringes and Bleach (1995); National Commission on AIDS, the Twin Epidemics of Substance Abuse and HIV (1991); Office of the Surgeon General, Evidence based Findings on the Efficacy of Syringe Exchange Programs: an Analysis from the Assistant Secretary for Health and Surgeon General of the Scientific Research Completed since April 1998 (2000)
5. Lurie et al., supra note 4; L. O. Gostin, The Interconnected Epidemics of Drug Dependency and AIDS, 26 Harvard Civil Rights-Civil Liberties Law Review 113 (1991); Centers for Disease Control and Prevention, Syringe Exchange Programs-- United States, 1994-1995, 44 MMWR - Morbidity & Mortality Weekly Report 684 (1995).
6. Centers for Disease Control and Prevention.
7. S. Burris, D. Finucane, H. Gallagher, and J. Grace, The Legal Strategies Used in Operating Syringe Exchange Programs in the United States, 86 American Journal of Public Health 1161 (1996).
8. Health Omnibus Programs Extension of 1988.
9. Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 1990; Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 1991.
10. D. Vlahov, D.C. Des Jarlais, E. Goosby, P.C. Hollinger, P.G. Lurie, M.D. Shriver, S.A. Strathdee. Case study: Needle Exchange Programs for the Prevention of HIV Infection (forthcoming 2002).
11. Office of the Surgeon General, Evidence based Findings on the Efficacy of Syringe Exchange Programs: an Analysis from the Assistant Secretary for Health and Surgeon General of the Scientific Research Completed since April 1998 (2000)
12. Departments of Labor, Health And Human Services, And Education, And Related Agencies Appropriations Act, 2002.
13. Personal communication, Ms. Paola Barahona, 2001.
14. District of Columbia Appropriations Act, 2002.
15. P. O. Coffin, B. P. Linas, S. H. Factor, and D. Vlahov, New York City Pharmacists' Attitudes toward Sale of Needles/Syringes to Injection Drug Users before Implementation of Law Expanding Syringe Access, 77 Journal of Urban Health 781 (2000).
16. S. Burris, D. Finucane, H. Gallagher, and J. Grace, The Legal Strategies Used in OperatingSyringe Exchange Programs in the United States, 86 American Journal of Public Health 1161 (1996).

The New Orleans Syringe Access Program - Anonymous

The following is an example of the trials and tribulations involved in keeping a much needed syringe access program open in post-Katrina New Orleans.

The New Orleans Syringe Access Program (NOSAP) began offering clean syringes, dirty disposal and other injection supplies to injection drug users (IDUs) in May 2006. Given the severe post-Katrina reduction of pharmacies, treatment programs and individuals (including diabetics, from whom the majority of injection drug users in the housing projects purchased their syringes); it became apparent that the need in New Orleans for clean syringes and harm reduction education is great. NOSAP meets that need by providing clean injection equipment to any persons who request it. The only limitation to access is for unmarried persons who are under the age of 17 years, as stipulated by state law.

Currently, the Access Program is open on Tuesdays and Thursdays from 1-2:30pm at the edge of the French Quarter and is easily accessible by foot and public transportation. The program is advertised by local HIV prevention street outreach workers and during HIV testing sessions; however, word of mouth through the IDU community has proved to be the best advertisement.

At NOSAP, clients are able to dispose of dirty syringes and obtain clean injection equipment, including syringes, cookers, water, cotton and tourniquets. Clients are also offered personal sharps disposal containers, wound care and hygiene kits, and educational literature. If requested, referrals are provided to detox/treatment facilities and other social and medical services. No identification is needed and persons accessing NOSAP may remain anonymous if they choose. A short intake (15 questions) for first- time visitors is the only requirement to receive services.

At this time there is no budget for this program. Currently, three volunteers are running the program during their lunch hours, using supplies that have been donated from concerned community members and friends.

Public health data in post-Katrina New Orleans is a bit difficult to ascertain as it is still being collected. Before the hurricane, it was estimated that there were 11,914 IDUs living in the New Orleans area. The Louisiana Office of Public Health HIV/AIDS Program (HAP) stated in 2005 that 16% of persons with HIV/AIDS living in the city reported injection drug use as a risk (with an additional 8% of persons reporting both male-to-male sexual contact and injection drug use as risks.) Since the hurricane, it is estimated that 39% of the city’s population has returned to New Orleans, meaning that current IDU population estimates can be placed around 4,646. HAP’s second quarter 2006 report states that 68% of people living with HIV/AIDS have returned to the city.

It is noteworthy to mention that estimates from the household population survey do not capture the transient and marginalized populations currently in New Orleans, such as migrant laborers, the homeless and the marginally housed; therefore, it is reasonable to assume that the returning injection drug using population may be higher than the 39% applied to the general population. It is also worth noting that each year during the high season (October – May) New Orleans sees a large influx of visitors and travelers, including injectors, who come to the city for the many festival events, including Halloween, New Years, Mardi Gras and JazzFest. Anecdotal evidence from NOSAP clients also suggests that an increase of risk behaviors, including drinking, drug use and unprotected sex, accompanies the tourist season.

Since NOSAP began collecting client intake information and syringe disposal and distribution numbers in May 2006, 1,043 syringes have been distributed and 589 have been disposed. Often, distribution of syringes was limited by short supply and the novelty of the program. With increased availability of supplies and recognition of the program, NOSAP expects that it will distribute a minimum of 18,000 sterile syringes in the next year, reaching approximately 400 clients.

NOSAP has intaken 32 clients since May 2006. (Please note that many of our clients are “satellite sources” meaning that they are often obtaining syringes and disposing of equipment for several people who are not willing/ able to come to the exchange site)

Of the clients directly served by the syringe access program since May 2006: · Average age of injectors is 27 years · Average length of time injecting is 7.25 years · 75% of clients reported sharing syringes and/or works in the last 6 months · Average number of times injecting per week is 20 · 72% are homeless or marginally housed · 48% female, 52% male · 87% white, 4% African-American, 3% Latino, 6% Other


Books of Interest

  • The AIDS Pandemic, Complacency, Injustice, and Unfulfilled Expectations, by Lawrence O. Gostin
  • - "Gostin tackles the hard social, legal, political, and ethical issues of the HIV/AIDS Pandemic"
  • Betrayal of Trust: The Collapse of Global Public Health, Laurie Garrett
  • - A chilling exploration of the decline of public health infrastructures.
  • The Privatization of Health Care Reform, by M. Gregg Bloche
  • - looks at the transformation in American health care delivery and financing led by the private sector"


    Ask Dr. Science

    Dear Dr. Science,     I remember reading in your earlier (May 1, 2006) newsletter that several countries, including Iraq and Kuwait, are now contaminated due to depleted uranium explosives furnished by the US and other worldwide manufacturers. I also understand that the largest environmental catastrophe in the history of the Mediterranean Sea is now underway due to Israel's bombing of Lebanon's oil reserves, and now exacerbated by Israel's usurpation of the surrounding airspace and sea. My questions are these: 1. What environmental laws and criminal laws now exist to hold responsible parties financially accountable for this environmental devastation that they are causing? 2. Is it true that environmental treaties are merely voluntary? How can this be? 3. I am vaguely aware of eco-terrorism laws about which Bush proudly boasts. These "eco-terrorist" laws are being used on environmentalists in the US to imprison them for over 20-30 years. And as I understand it, the acts for which these environmentalists are being imprisoned have caused no human bodily harm. Can such laws be used against responsible parties for these international acts of eco-terrorism, e.g. against responsible officials in the US and in Israel, as well as against weapons manufacturers for all of the devastation and long- term pollution they are generating in the Mediterranean and in Iraq? I look forward to your response. Thanks, Just Curious about Justice

    Greenpeace: Lebanon Oil Spill Could Take a Year to Cleanup 45-BD62-4D4B-9F16-559AF4BCFD27.htm http://www.rollingsto co http://www.democracynow.or g/ tyendorse.shtml http://www.democracynow.or g/ Dr. Science replies:    Whether and how much Israel will be held accountable is a very good question. And the answers are not exactly pouring in. Water laws and treaties are complicated, and it seems that several approaches are being taken to cover the costs, mostly by international donors, and not including Israel. Lebanon's Environment Minister, Yacoub Sarraf, said that Lebanon was pursuing legal actions against Israel on two levels, at the International Court of Justice at The Hague and at the United Nations. Regarding lawsuits by individuals, some Lebanese Americans have attempted to sue Israel and the US for their slow evacuation of US citizens, but these law suits have not come to fruition.

    An Oil Spill Update was provided from the World Conservation Union (IUCN) was provided in mid- September by Patricia Hawes of the IUCN Ecosystem Management Programme ( that follows:

    Gonzalo Oviedo reported that IUCN had established a task force to address the environmental impact in Lebanon with particular attention to the oil spill. IUCN's WESCANA has been active working with a number of different organizations on these issues, especially the Lebanon Ministry of Environment (IUCN member), UNEP, OCHA and several IUCN members. The work in the last few weeks has been intense but successful and IUCN's active engagement has been highly appreciated by partners. IUCN has been given the role of assessment, planning, liaising with donors and monitoring (not implementation). IUCN presented a documentary in a meeting in Stockholm that was brought by the Ministry of the Environment in Lebanon. IUCN's task force has produced a 6-month work plan in cooperation with the other related organizations and about a dozen project proposals for short and medium-term action. IUCN WESCANA had asked BBP for support on oil spill management guidelines from the private sector. BBP (through our Shell contacts) managed to obtain such guidelines from the International Petroleum Industry Environmental Conservation Association (IPIECA) Oil Spills Response Working Group and forwarded them to IUCN's WESCANA team.

    See also for recent environmental policy and law papers. .