Rev. Danny Fisher

In an email today from the Save Darfur Coalition, Colleen Connors writes:

Last week, Senators Joe Biden and Dick Lugar introduced a new congressional resolution calling for the UN Security Council to authorize the immediate deployment of a strong UN/AU peacekeeping mission to Darfur with a tough mandate to protect civilians.

But so far only 13 senators have signed on to this critical resolution!

The UN Security Council is debating the deployment of a peacekeeping force this week.

[...]

By passing this resolution, the United States can increase pressure on other members of the UN Security Council to get serious on peacekeeping in Darfur.

The Senate resolution calls not just for a UN-authorized mission with a full mandate to protect civilians in Darfur, but also the rapid formation and deployment of that force. It also calls on international leaders to enact stronger sanctions on the Sudanese regime if it continues to obstruct a peacekeeping force.

We need as many senators as possible to show their support for the congressional resolution by Friday in order to send the UN a strong message that the United States wants action on Darfur.

Please take just a few seconds to write your senator by following this link.

In the same email, Connors mentions the Save Darfur Coaltion’s special project with partner Amnesty International: the album Instant Karma: The Amnesty International Campaign to Save Darfur. The double CD includes 23 John Lennon covers performed by contemporary pop artists such as U2, R.E.M., Green Day, Lenny Kravitz, The Flaming Lips, Aerosmith, Black Eyed Peas, Christina Aguilera, Avril Lavigne, and others. Proceeds from album sales will go directly to supporting Amnesty International’s urgent work on Darfur and other human rights crises worldwide.

Please do think about picking up a copy. It’s a great cause and a terrific collection of music. I purchased a copy of the album a few weeks ago, and it’s been on regular rotation ever since. I especially love Regina Spektor’s take on “Real Love,” as well as Dhani Harrison and Jakob Dylan’s “Gimme Some Truth,” The Flaming Lips’s “[Just Like] Starting Over,” Los Lonely Boys’s “Whatever Gets You Thru the Night,” Aerosmith & Sierra Leone’s Refugee Allstars’s “Give Peace a Chance,” U2′s “Instant Karma,” and the below cover from Green Day.

First, on the blog front, there is exciting news: the Buddhist Chaplains Sangha has been revived, and now includes some great new links. They’ve inspired me to update my own links section, in fact–stay tuned.

Anyway, please check the Buddhist Chaplains Sangha out at http://buddhistchaplains.blogspot.com.

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In my recent post about Michael Moore’s SiCKO, I encouraged readers to write letters to their elected officials in support of H.R. 676. Well, there is now an easier way to do this: just follow this link.

In addition, I encourage you to join MoveOn.org‘s campaign to urge Congress to support full funding for the State Children’s Health Insurance Program (S.C.H.I.P.) to provide coverage to millions of uninsured children. Sign the petition here.

Also, if you’re a California resident like me, please consider writing your senator and assemblyperson in support of Senate Bill 840. The action page at the SiCKO website explains:

The California legislature is again considering Senate Bill 840, which was vetoed by Governor Schwarzenegger last year. S.B. 840 will provide comprehensive, high quality health insurance for all Californians. The bill provides for:
1. One health insurance plan (single payer) that covers every California resident
2. High quality care and comprehensive benefits, and choice of your own personal doctor
3. Affordable for individuals, families and businesses

Nearly seven million Californian lack health insurance during all or part of the year. About 70% of these people are employed but do not receive employer-based insurance. Most insured Californians are “under-insured.” Under insurance means that you have health insurance but procedures or benefits are not covered or are only partially covered.

If you are a Californian who would like to write your senator and assemblyperson in support of S.B. 840, just follow this link.

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In another recent post I asked you to join the ONE Campaign in contacting your local media about the need to reform the Farm Bill. Well, the ONE Campaign is now asking supporters to call their members of Congress before the House of Representatives votes on the Farm Bill tomorrow.

On Thursday, the House of Representatives will consider the Agriculture Committee’s version of the farm bill which does little to help struggling farmers in the United States and around the world. The ONE Campaign recognizes the need to help poor farmers and rural families at home and abroad, and that is why we support the Fairness in Farm and Food Policy Amendment.

The Fairness in Farm and Food Policy Amendment–Fairness Amendment–would limit commodity payments and redirect at least 10 billion dollars in savings into alternative-support systems for American farmers and other programs to support the livelihood of farm families, nutrition, and rural development while simultaneously helping small farmers from developing countries.

This historic amendment offered by Representatives Ron Kind (D-WI), Jeff Flake (R-AZ), Joe Crowley (D-NY), Dave Reichert (R-WA), Earl Blumenauer (D-OR) and Paul Ryan (R-WI), is supported by progressives, conservatives, farmers, churches, nutrition and environmental organizations, tax reform advocates, and both free and fair trade supporters. The diversity of support for real reform and fairness in America’s farm policy is unparalleled.

Dial 800-786-2663 before tomorrow to speak to your Member of Congress about the Farm Bill and the Fairness Amendment.

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Lastly, I received a couple of interesting forwards from Tom Armstrong at the indispensible Blogmandu.

The first is a fascinating and excitingly hopeful article from Slate by Darshak Sanghavi about the “cost effectiveness” of medically treating the world’s poor. The following is a very important chunk of the piece, and I strongly urge you to read it all.

Pediatric heart surgery is fabulously expensive, often costing hundreds of thousands of dollars per case in the United States. Thus it would be foolhardy, goes the thinking, to offer surgery to poor African children who live on less than a few dollars per week. Isn’t it better to invest in more cost-effective public-health measures, like mosquito netting to prevent malaria and vaccines against diarrhea? For decades, this kind of reasoning has been used to deny expensive but lifesaving treatments to the world’s poor, most notably for HIV infection, in favor of more cost-effective measures focused on prevention. Dollar-for-dollar prevention is supposed to yield greater aggregate quality-of-life benefits than actual treatment.

Yet this seemingly reasonable argument is not only weak, but unfairly rigged, so the world’s poor can never win.

The case against expensive treatments hinges on a statistic that economists use to compare medical interventions, called the “quality-adjusted life year.” Here’s how the sausage is made: How good a person feels is ranked on an arbitrary numeric scale and amortized over time. One QALY means the same thing as one year of perfect health, two years of half-perfect health, or four years of one-quarter perfect health. QALYs are an exchange unit that theoretically permits comparison between apples and oranges. Take a hypothetical example: pills that cost $200 for diabetics and give two years of half-normal health, versus a pancreas transplant that costs $5,000 and gives 10 years of one-fifth-normal health. The pills cost $200 per QALY, while the surgery costs $2,500 per QALY. If you believe that anyone really can tell half-normal health from one-fifth-normal health–and if you’re a health economist, you probably do–the pills deserve funding more than the transplant.

To ration care, a government or insurer determines how much a QALY is worth, and cuts health services with costs above where that line is drawn. This methodology hasn’t really changed medical care in the United States because the threshold for QALY-based rationing is set high. In an unprecedented 1972 decision to fund a specific medical problem, Medicare began paying for kidney dialysis, which costs roughly $50,000 per QALY. In effect, this created a de facto cost-benefit threshold, and people have gamed the system ever since. It’s not hard. As the British Medical Journal pointed out last year, most published studies of medical treatments in the United States find that all manner of medical treatments cost—voilà!—less than $50,000 per QALY. This also goes for HIV treatment in the United States. In 2001, for example, a group of Harvard researchers estimated in the New England Journal of Medicine that HIV medicines cost roughly $13,000 to $23,000 to give somebody a single QALY. The authors concluded the drug treatment for HIV was “highly cost effective and should be made available to all patients who can benefit from it.”

What’s easily affordable in rich countries, though, seems out-of-reach in poor ones where rationing thresholds are lower. Unfortunately, needy nations are stuck with figures conjured for countries where the ceiling is $50,000 per QALY. And the illusion of unaffordable treatment in poor areas is further bolstered by another insidious feature of QALY-based economics. In an experiment in the early 1990s, Oregon sought to ration health care by ranking all medical treatments, based on which yielded the most QALYs for the buck. Several odd findings emerged. Most notably, treatment of thumb-sucking and certain dental problems placed higher than treatment for cystic fibrosis and AIDS. Once these findings hit the media, Oregon abandoned the project and never rationed care.

What does thumb-sucking in Oregon have to do with AIDS in Africa? Oregon’s experience showed how small improvements in huge numbers of relatively healthy young people (for example, millions of kids whose happiness is 1 percent higher since they don’t thumb-suck, whatever that means) rack up QALYs faster than big improvements in a small number of really sick people (for example, a few dozen chronically ill folks with cystic fibrosis whose happiness is 10 percent higher from pricey antibiotics to treat their pneumonias). That’s why—to economists, if to almost nobody else—it seemed fine to rank the treatment of thumb-sucking over cystic fibrosis, since it yielded the greatest overall QALY benefit.

With this logic, Africans with AIDS and expensive heart troubles never will qualify for life-saving drugs or surgeries. As the thumb-sucking example shows, QALYs dictate that paying for cheap preventive care will always win over expensive treatments, like those for AIDS. In 2002, the Lancet reviewed the medical literature and concluded that preventing HIV transmission to uninfected Africans (for example, via condoms distribution and education) was almost 1,000 times more cost-effective at generating QALYs than treating AIDS victims with expensive antiviral medications.

So, QALYs are unscientific, subject to powerful bias, recklessly applied out of context, and inherently biased toward prevention and away from treatment. But they make for devastating—and powerfully misleading—sound bites. The argument comes down to this: Doesn’t it seem absurd to pay $23,000 to buy drugs to get one year of good health for an African with AIDS, when you can get the same amount of wellness for 1,000 Africans for the same cost?

But because they are based on retail prices of drugs and existing infrastructure in rich countries, such figures often overestimate costs for large-scale relief and treatment efforts in the developing world. The seeming high cost of treatment over cheaper prevention encourages inertia.

Enter physicians like Dr. Paul Farmer of the aid group Partners in Health, who endured all kinds of naysaying and began treating poor rural Haitians with antivirals for AIDS by getting donations from wealthy Western donors and buying the drugs outright at retail prices. They were tired of seeing HIV-infected people die. In late 2005, a revealing New England Journal of Medicine report proved that Haitians with AIDS—though living in impoverished conditions—were organized enough to handle all the drugs and did just as well medically as patients treated in the United States. Suddenly, treating AIDS in poor countries seemed possible.

And an obvious truth emerged: Health-care costs, upon which the entire pyramid of QALY-based analysis sits, are totally elastic and negotiable. As demand for the drugs in poor countries skyrocketed, countries like Thailand and India took advantage of their arcane patent laws and began manufacturing generic versions of the expensive drugs. When Brazil also threatened to allow generic manufacture of AIDS antivirals, drug companies rapidly negotiated local manufacturing licenses and deep discounts. Today, almost all 186,000 Brazilians needing AIDS drugs get them for free from the government.

[...]

In the end, spending hundreds of thousands of dollars for his heart surgery isn’t a good QALY buy, if one is inclined to think in that erroneous way. But you can also think like Dr. Aldo Castaneda, the former chief of pediatric cardiac surgery at Harvard Medical School. At the height of his career in the 1990s, he moved to Guatemala to help found a children’s heart center, and there has operated on thousands of children at a tiny fraction of the costs in America.

Recalling how people responded when he announced his intention to treat heart disease among poor Guatemalans, Casteneda says, “They told me that I was crazy.” His patients, one can assume, disagree.

The other item from Tom was sent in response to my post on Independence Day. It is “A Patriotic Pledge” by Lama Surya Das.

I Pledge Allegiance

To this World Country,

To earth and sea and air, cherishing

All creatures, known and unknown,

seen and unseen,

And to the United State of America

And all the republicans, democrats, homeless,

And melting-pot others

For which it stands

In Oneness,

Within God,

Indivisible

All ways,

In truth and inner freedom, liberty,

Social justice, equality and happiness,

Fulfillment and health insurance

For all,

De-light & harmony

for
Ever.

I appreciate Tom sending both of these remarkable pieces, and I thank him for them.

Thanks to The Tricycle Blog/The Worst Horse for pointing this out.

I was in Yellow Springs, OH, this past week assisting with the visit of the Chökyi Nyima Rinpoche to Antioch College and the Yellow Springs Dharma Center. Regular readers of this blog may recall mention of Rinpoche in this post and this post (with picture) from my time in India. As you can imagine, it was wonderful for me to be able to see Rinpoche again, this time in the United States.

Rinpoche, for those of you who don’t know, is quite a remarkable teacher, and he has made numerous noteworthy contributions to the development of Tibetan Buddhism. The flyer for his visit describes him and his work well:

Chökyi Nyima Rinpoche is the abbot of Ka Nying Shedrup Ling Monastery and the founder of Rangjung Yeshe Institute, a college for Buddhist Studies in Boudhanath, Nepal.

Born in Tibet and educated at Rumtek Monastery in Sikkim under the guidance of H.H. Karmapa, he is the holder of Barum Kagyu and Nyingma lineages. Rinpoche is a scholar and master of both Dzogchen and Mahamudra practice. He has taught meditation and philosophy to many Western students, while also supervising a large shedra

or traditional monastic training center in Nepal.

He regularly teaches in Europe and North America where he has meditation centers in Denmark, Germany, and California. Since 1984 Rinpoche has taught meditation to students on the Antioch College Buddhist Studies Program in Bodh Gaya, India.

Rinpoche is the author of several books including The Union of Dzogchen and Mahamudra, Indisputable Truth and Present Fresh Wakefulness.During his visit, Rinpoche taught on the “Four Keys of the Buddha’s Teachings,” or what are also known as the Four Dharma Seals–anitya (impermanence), dukkha (suffering), anātman (the lack of an inherent existence), and nirvāṇa (peace). He also explained meditation from the perspective of each of the three Buddhist vehicles–the Śrāvakayāna (the “Vehicle of the Hearers”), Mahāyāna (the “Great Vehicle”), and Vajrayāna (the “Adamantine Vehicle”).

Rinpoche’s talk was evenly divided between his self-proclaimed “broken English” and Tibetan. Translating Rinpoche’s Tibetan was Erik Pema Kunsang, co-director of Rangjung Yeshe Translations and Publications in Kathmandu. I have seen Erik translate on several occasions (for both Rinpoche and Rinpoche’s brother Drubwang Tsoknyi Rinpoche III), and I’ve always appreciated his calm, clear, and serious approach to translation. He is wonderful at what he does–when he speaks for Rinpoche, it feels as though no single modicum of the teachings has been lost in translation.

Again and again in the teachings, Rinpoche came back to the importance of exchanging selfishness for compassion and lovingkindness. As he spoke, I frequently thought of one of my favorite passages from his Present Fresh Wakefulness:

In Shantideva’s The Way of the Bodhisattva, there is an instruction: “When you look upon another being, do so gently, with loving eyes and a smiling face.” Appreciate other beings with this attitude: “With the help of these beings, I can develop the precious enlightened attitude, bodhichitta. With the help of these beings, I can progress towards Buddhahood. The fact that it is possible for me to train in the six paramitas, in the four means of magnetizing and so forth, and in the vast activities of a bodhisattva, is only possible because of other beings–so, thank you very much!” The teaching of The Way of the Bodhisattva continues, “Speak gently; speak softly; speak meaningfully. In your heart be free of conceit and hypocrisy, be free of rivalry and aggression. Always keep a sincere and compassionate frame of mind.”

When we study the words of the Buddha and understand their meaning, something should change in us. A person who learns and reflects about Buddhism should simultaneously diminish his or her involvement in selfish emotions. Compassion and understanding should grow further and further. If that is the case, you can say that learning and understanding are progressing correctly. [1]Rinpoche’s teachings really reinvigorated my practice, as did my stay at the Yellow Springs Dharma Center. I had visited the center a few times years back when I was an undergraduate at nearby Denison University, but this was the first time I had spent an extended period of time there. A fair amount had changed since my last visit, but I still found it the vibrant practice center I remembered.

Among the many magnificent American Dharma centers, the Yellow Springs Dharma Center is special in its ecumenicism:

The Yellow Springs Dharma Center is a place for the practice of meditation and the study of Buddhist principles (dharma) serving various Buddhist traditions. This environment supports the development of compassion, generosity, and clarity in our community. The Center exists to encourage an awareness of our thoughts, words and actions on our world.

After some time away from Bodh Gaya, I especially enjoyed visiting the bodhi tree growing on the grounds of the center. This particular tree was grown with seeds from the tree at the Mahabodhi Mahavihara, which I spent a lot of time around last fall and during my previous stay at Bodh Gaya in 1999. That tree, of course, is the descendent of the bodhi tree the Buddha himself was said to have been sitting beneath when he attained enlightenment.

All things considered, it was a marvelous, inspiring trip. I’m so glad to have gone, and I wish that similar opportunities will come your way. I leave you with a photograph of Rinpoche and I taken by my dear friend Kerry Lucinda Brown.

WORKS CITED:

1. Chökyi Nyima Rinpoche, Present Fresh Wakefulness: A Meditation Manual on Nonconceptual Wisdom (Boudhanath, Hong Kong & Esby: Rangjung Yeshe Publications, 2002), 75.

One of the great things about helping my parents move down south is that I’ve been able to begin a pilgrimage of sorts to some of the American Civil Rights Movement’s most important historical sites. First on the list is the place where North Carolina A&T State University students Joseph McNeil, Jibreel Khazan (formerly Ezell Blair, Jr.), Franklin McCain, and David Richmond invigorated the movement in 1960: the Greensboro Woolworth’s.

Within one week, the “Greensboro Four” achieved nothing short of changing the course of American history. The webpage for the documentary film February One: The Story of the Greensboro Four succinctly charts that week:

February 1, 1960

Four North Carolina A&T State University students enter Woolworth’s and make small purchases, saving their receipts to prove they are customers. The take seats at the whites-only lunch counter. Denied service, they remain seated. Police arrive, but are unable to take action against the four students due to lack of provocation. Woolworth’s closes early to end the incident, but the Greensboro Four vow to return the next day.

February 2, 1960

The Greensboro Four return to Woolworth’s and sit at the lunch counter. Reporters and local TV news crews gather at the store. The intense television coverage helps spread the protest to High Point, NC by the next day.

February 3, 1960

By opening time, students are scrambling to get seats at Woolworth’s, but there is also a growing opposition of whites who taunt the demonstrators. National news begins to carry the story and the protests spread to Winston-Salem, NC.

February 4, 1960

Female students from Bennett College and as well as three white students from Greensboro Women’s College join the sit-in. The protests effectively paralyze Woolworth’s and other nearby businesses.

February 5, 1960

About 300 students are now protesting at Woolworth’s. The sit-in movement spreads to almost 40 other cities across the country.

February 6, 1960

An estimated 1,000 protesters and observers fill Woolworth’s. The sit-in spreads to the nearby Kress department store, bringing downtown Greensboro to a virtual standstill. Both Woolworth’s and Kress close early after receiving a bomb threat.

February 7, 1960

A&T students vote to suspend demonstrations to give city and store officials a chance to comply. Negotiations fail, and students resume the sit-in.

By July 26th of the same year, Woolworth’s integrated the lunch counter.

The site of the old Woolworth’s in downtown Greensboro will soon be home to the International Civil Rights Center & Museum. In their vision statement, the organizers write:

The International Civil Rights Center and Museum exists to ensure that this valuable piece of American history is properly acknowledged, and the experiences of the Greensboro Four, their supporters, and the larger community are not relegated to a footnote in history. This pivotal act of courage is remembered as a significant step toward equality, hastening an end to the painful reality of segregation and Jim Crow.

The International Civil Rights Center and Museum exists as a testimony to courage. It is a gift from the people of North Carolina to the nation and the world. We build this monument for the benefit of posterity–to educate future generations and stand as a bridge that links the past, the present, and the future.

I’m glad to have been able to see and spend a bit of time at this place that played such an important role in the development of our country for the better.

May all beings have happiness and the causes of happiness;
May all be free from sorrow and the causes of sorrow;
May all never be separated from the sacred happiness which is sorrowless;
And may all live in equanimity, without too much attachment and too much aversion,
And live believing in the equality of all that lives.