Paging Dr. Dean
We'll see how much play this Boston Globe
story on Vermont's "shocking" neglect of the state mental hospital
gets in the national press. So far, I've found nothing about it in the New York Times
or the Washington Post
, and it was in the local Vermont news section of the Globe
WATERBURY, Vt. -- When federal inspectors emerged from Vermont's tiny state mental hospital this summer, they described conditions that can best be called archaic.
Patients paced the halls, or sat in isolation, while staff members ignored them. One woman had not bathed in more than four months. A man had not had his psychiatric evaluation updated since he was admitted -- in 1980. When night came, patients on one ward were ordered to bedrooms that were locked from the outside, with no access to bathrooms.
During the review, the situation got worse: Within a span of six weeks, two patients committed suicide in their rooms. One, a 19-year-old woman whose treatment plan specified that she be stripped of her shoelaces, hung herself with a shoelace, according to an advocate who had represented her in grievances against the hospital.
The revelations, shocking anywhere, came as a particular surprise in Vermont, a state much admired for its progressive mental health policies.
In his run for president, former governor Howard Dean moved early to stake out the territory of mental health for himself, delivering a speech Sept. 12 that promised "real solutions to the mental health care crisis" and holding up the Vermont system as a model.
But the state's neglected mental hospital shows the limits of the Vermont success story. Last month the hospital lost its right to collect an annual $700,000 in funds from Medicaid and Medicare -- a rare sanction that was brought against only one psychiatric hospital in the country last year, of 477 that receive the funds. The small community of mental health activists and providers here found themselves examining the old shared dream that the state hospital would no longer be necessary. In the end, they say, what happened was that the most seriously mentally ill patients had fallen off government's radar.
In 1995, Governor Dean announced that the state hospital would be closed for good within two years. The red-brick campus was a potent reminder of a past when patients spent days in straitjackets; in a 1990 survey ranking Vermont as having the nation's best state mental health system, the Public Citizen Health Research Group said the state had "designated itself as a national experiment," discharging patients from the hospital "with an enthusiasm bordering on evangelistic fervor." The hospital population had dwindled from 1,300 to an average of 50 patients at any given time.
But in the eight years that have passed, that number has stayed virtually unchanged.
This summer, in a scathing report, surveyors from the Centers for Medicare and Medicaid Services charged that patients were not receiving treatment of any kind. A surveyor interviewed "Patient D," who appeared "distinctly paranoid." The patient's treatment plan did not include antipsychotic treatment, because the patient had refused medication, but instead included such limited goals as "persuade patient to release old psychiatric information" and "verbalize an understanding that the findings of his neurological evaluations do not support heavy metal poisoning."
Therapy sessions were canceled for lack of interest, as patients paced the halls or sat alone in their bedrooms.
Last week, Vermonters were struggling to square their ideology with the reality that state authorities still need to lock mentally ill people in an institution -- and that they will continue to do so indefinitely. Peter Van Vranken, who was Dean's health policy adviser when he was governor, said he "really [doesn't] have an answer" to how the hospital was allowed to deteriorate.
Will the press call Howard Dean on this blatant failure in one of his signature issues? I don't know. Dean doesn't seem to have his own personal Molly Ivins to make (or extend) her career by blaming him for every failure of any kind in Vermont during his governorship, holding each of them up to her internal fun-house mirror and then projecting the magnified and distorted images across the national stage.
Poor News For Iraq Reconstruction
It looks like the Administration may partially cave to international wishes
and non-US donated reconstuction funds and programs will be handled by a new World Bank/UN agency. Expect the same dismal performance in Iraq that has already been caused by UN control of reconstruction in Afghanistan
Another Link In The Chain
The Christian Science Monitor
spent some time in Northern Iraq interviewing Ansar al-Islam prisoners held by the Patriotic Union of Kurdistan (PUK). Scott Peterson's article
(via Bjorn Staerk
) throws some bones to the "Bush lied" crowd:
But the picture now emerging shows, too, how Washington exaggerated aspects of the threat from the 600 to 800 Ansar members.
Ansar was once part of a long-term Al Qaeda dream to spread Islamic rule from Afghanistan to Kurdistan and beyond. But that idea was embryonic at best, and when US forces attacked Afghanistan in October 2001, Al Qaeda support for Ansar dried up.
And despite the later arrival of some Afghan veterans and Arab fighters - and a new influx of donor cash - Ansar for 1 1/2 years was isolated, manipulated by both Iraq and Iran, and locked in stalemate with far superior Kurdish forces. Its "poison factory" proved primitive; nothing but substances commonly used to kill rodents were found there.
The main interviews, however, show that the two primary Administration points—Ansar was a subsidiary of Al Qaeda and was receiving support from Baghdad—were accurate (emphasis added):
As an Arab speaker in the ethnically Kurdish group, Gharib was transferred in 2001 to Sargat, where Arab fighters were based in their "Ghurba Katiba" (or "Stranger's Unit"). "Even the Arab Afghans who came did not exceed 50 in total, and included people unfamiliar with guns who probably never fired a bullet in their lives," says Gharib.
Despite the broad inexperience, among them were several jihad veterans. A few Kurds were also Afghan war veterans, and proved to be powerful trainers.
Al Qaeda was held up as the model. "This was the sense of everybody, that we were linked to Al Qaeda," says Sangar Mansour, a short, wiry detainee with a youthful face and thin moustache. "[We] looked like Al Qaeda, gave orders like Al Qaeda, trained like Al Qaeda, and used their videotapes" of Afghan operations.
"Some non-Kurds had US military uniforms, that they put on when the [US] attacks started," Mr. Mansour says. He saw a worn photograph one of his friends kept under his pillow, of Ansar security chief Ayub Afghani, eating with Osama bin Laden.
Arab militants had begun to trickle into northern Iraq to join the Kurds well before Ansar was officially formed in December 2001. Their presence helped bolster the isolated Kurdish militants.
"Many people grew more committed to this fighting, because they thought: If foreigners are coming here to fight, this must be serious, this must be real," says Diyar Latif Taher, a Kurdish Islamist detainee. He says the number of foreigners never exceeded 90. "They did not say they were members of Al Qaeda, but whenever there was a successful Qaeda operation - an ambush, or hitting a US base in Afghanistan - they were celebrating," says Mr. Taher. Bin Laden was "praised."
"[We] shared the same ideas [with Al Qaeda], and we should be impressed with their leaders, their tactics and their victories, and feel sorry for their losses - otherwise we would not be true believers," says Gharib. "There was this dream of declaring jihad in this part of the world, and kicking out secular authority. And this dream got larger."
But keeping away from the manipulations of local powers was not easy. The Iranians flooded the Ansar area with extremely cheap food supplies, then stopped them abruptly, to squeeze concessions out of Ansar.
Baghdad played a similar role, by using smugglers and middlemen to provide dirt-cheap weapons to Ansar. "Then it stopped - boom! - and you had to beg for it, and make concessions," Gharib says. "I tell you, Ansar was the biggest buyer [from Baghdad]."
Hussein's support to Ansar provided him with two benefits. First, they were attacking his PUK enemies on the ground where he couldn't reach them with airpower because of the US/UK imposed Northern No-Fly Zone. And second, because they were mostly Kurdish and were based northeast of Baghdad, it allowed the US anti-war crowd to make specious claims
and pose Chomskian questions
that, while actually displaying the questioner's deviousness or cluelessness, nevertheless managed to score points among the faithful for their distorted version of events.
UPDATE - October 21, 2003: Judicious Asininity points to Deroy Murdock's latest in NRO, "Saddam's Terror Ties," which highlights both Hussein's proven ties to terrorists and those which are circumstantial or subject to dispute. Murdock concludes:
If one has the time or professional duty to connect these dots, a portrait emerges of Saddam Hussein as sugar daddy to global terrorists, including al Qaeda and perhaps the 9/11 conspirators. Why won't Team Bush paint this picture? One administration communications specialist told me the government is bashful on this front because these links are difficult to prove. Yes, but prosecuting the informational battle in the war on terror is not like prosecuting a Mafia don, with wiretaps, hidden cameras and deep-cover "stool pigeons." Evidence of terrorist ties can be even more shadowy than a Costa Nostra whack job. While this makes metaphysical proof elusive, the White House and relevant agencies owe it to America's national security to highlight what they know about Saddam Hussein and terrorism, even if some of the evidence against him is only circumstantial.
Assuming he wishes to sway domestic and global opinion, President Bush and his administration should guide Americans and the world through the sometimes-murky data and identify the patterns and conclusions that arise. While Saddam Hussein never may endure a courtroom cross-examination, plenty already exists in the public record (and surely more should be declassified) to confirm that his ouster, the liberation of Iraq and its current rehabilitation were and are necessary phases of the war on terror. The president and his top advisers should present the case, not haphazardly, but systematically and in as comprehensive, well-documented, and well-illustrated a fashion as their vast resources will allow.