Infants Before Profits!

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San Francisco Socialist Action held a forum attended by over 70 people on March 30 entitled "Infants before profits: A symposium on the high Black infant mortality rate."

Socialist Action is reprinting major portions of the talks given by three of the speakers at the forum. These speakers are Renee Smith, a nurse midwife at Highland Hospital, Oakland, Calif.; Nan Bowe midwife family Nurse Practitioner; and Zakiya Somburu, coordinator of the Black Women Health Project and a member of the National Black Independent Political Party. In addition 1o the speeches, Ms. Bowe, who recently returned from Nicaragua, showed slides on health care in Nicaragua.

We're here today to address and protest the fact that 10,000 Black babies will die before their first birthday, at a rate two times greater than white babies. While the overall infant death rate has dropped (which includes white and Black babies), there has been a rise in the mortality rate of Black infants.

Infant mortality is a significant indicator of the state of a nation's health. The state of Black health has strong implications of racism. There are troubling interrelationships between racism, poverty, health care, and health status. To be faced with financial barriers to quality health care, but to also have to suffer from conditions that poverty causes is just too much. To be poor and a member of a racial minority is a heavy burden. I would like to add that other Third World allies are not far behind the Black infant mortality rate.

Here are some statistics: 80 percent of Black people live in or near poverty. Black income is considerably less-not to mention our unemployment level. One out of every two Black children is born in poverty. Black children are three times more likely to be born to a teenager. Forty-four percent of all Black children are born to single mothers; 50 percent of these women are on public assistance. Blacks have less resources and less access to health care. When you're poor, you're sicker, and so you tend to seek health care at a later stage.

A survey in Atlanta, Ga., asked Black women how they viewed their health. About 50 percent of Black women saw themselves in poor or fair health. The truth is that Black women have five times the childbirth complications that white women have due to the fact that we are poor in health, poor in nutrition, and our prenatal care is inadequate.

So when we look at why Black babies are dying, it's clear. It's because of institutionalized racism that breeds poverty and offers totally inadequate health care.

I work as a nurse-midwife at Highland Hospital. I work primarily with poor and Third World women. In 1983 the midwives delivered approximately 380 babies. The total hospital birth was approximately 1,000. Highland has many pros and cons. Some of the cons are poor nursing staff (there is definitely 16 Socialist Action April 1984 a shortage of nurses); no 24-hour pediatric or anesthesia; the worst technical equipment (our equipment falls apart all the time); tired staff; long waits in clinic, which is very discouraging-as you can imagine-having to wait five hours to see your practitioner.

One of the major pluses of Highland is the nurse-midwife services. The midwives practice comprehensive prenatal care. All of us believe healthcare is a right, not a privilege. When a woman comes in pregnant, she comes in with her history. Her pregnancy may not be her priority but her reality.

Does she have enough money for food? What is her housing situation? Can she figure out how to get on WiC la food program for low-income families]? Can she figure out how to get on AFDC [Aid for Families with Dependent Children]?

So what does comprehensive prenatal care mean? It means having a nutritionist, a social worker, a health educator, a public health nurse, a nurse-midwife, a doctor, all available for her and her family needs. At Highand we have nine prenatal clinics. So now we're doing about three-quarters of the prenatal care.

It is well documented that comprehensive healthcare can change prenatal and postnatal outcomes. Early exams plus enough-just enough-prenatal care can make a difference even if someone comes in during the second or third trimester. These continued exams can screen for (continued on page 15, in “"Good Morning, Revolution"”)

Socialist Action/Joe Ryan Nan Bowe speaking at March 30 Socialist Action forum.

Leonard Freed Nicaragua has a centralized system of health. You have regional hospitals, health centers, and health posts. And then in the frontlines are the brigadistas who go out into the rural areas to do the kinds of work you have to do in terms of sanitation, education and immunizations. The health brigadistas are sort of the cement of the healthcare system because at the village level they are really dealing directly with the people.

Under Somoza, very few received healthcare. Children had virtually no healthcare. Ninety percent of all the medical services were for 10 percent of the population. There was poor sanitation, only 20 percent of the population had access to sewage disposal, and only 40 percent had safe drinking water.

Because of the combination of poor nutrition and poor sanitation, diarrhea was a leading cause of infant death. In the 1970s, six out of every 10 children was malnourished. In 1976, the life expectancy was 53 years. Only a small percent of the population reached old age. Under Somoza, for example, infant mortality in Nicaragua was 121 per 1000. So that meant that for every 1000 babies born, 121 died.

For children less than one year, most deaths were related to infectious disease. Many, many babies died from tetanus, from cord infection. In other words, the cord was cut with a dirty instrument, and then babies developed huge abcesses in the cord because of poor hygiene. And this is true not just in Nicaragua. This is true all over Latin and South America.

In addition to the poor health conditions in general, in 1972 there was a major earthquake. Four thousand Nicaraguans died and 20,000 more were injured. To make matters worse, 13 out of the 37 hospitals were destroyed during the fighting against Somoza.

One of the priorities of the new government was maternal and child health. Mothers and children were 70 percent of the population. Fifty percent of the population was under 14. One of the campaigns developed in Nicaragua was a (continued 14)

We have learned much this evening from the well-informed panelists that have spoken to us. It is apparent from what we have heard that the human rights and welfare of pregnant women, infants, and children are not a priority to the wealthy rulers of this country.

The present inhumane, and profit-oriented policies are not unique to the Reagan or Deukmejian [governor of California] administrations. They flow from the very basis and nature of this political, economic, and social system called capitalism.

At the end of 1983, the 4th Quarterly Report stated that the nation's Gross National Product was just under $3.5 trillion. That was the value of all goods and services produced by this nation's working class and by the cheap labor exploited by U.S. multinational corporations in foreign countries.

However, because this is a government of the rich, by the rich, and for the rich, the overwhelming bulk of that immense wealth is not spent to uplift the living standards of the masses of Americans— and specifically to eradicate the high infant mortality death rate among BlackAmericans, other oppressed minorities, and impoverished whites.

A major priority of the wealthy rulers of the United States is their military expenditures. The current so-callec defense budget is almost $1 billion per day, and it is projected to be $1 trillion for the years 1984-88. Mondale and Hart each want it cut 4 or 5 percent, while Jackson wants it reduced from 20 to 25 percent. Why not end it entirely?

Pregnant women, mothers, healthcare workers and activists, and the tens of millions of America's working class are not involved in making any decisions regarding how the tremendous wealth produced by the working class is to be spent.

The United States is ranked 15th in infant mortality, far behind nations such as France, Japan, and Canada. And as we have heard, Black-Americans have the highest rate in the United States, with first place going to the Black community of Washington, D.C. With tens of thousands of infant deaths per year among Blacks and other oppressed sectors, Congress is going to consider the possibility of increasing medicaid payments to pregnant women by a paltry $200 million out of that almost $3.5 trillion GNP.

Twin parties vote cutbacks We cannot blame this callousness on either the Democrats or Republicans separately. We must blame both parties for their role in representing this profitsfirst, profits-last, and profits-always capitalist system against the needs and desires of the majority of America's people.

Cutbacks and other anti-human policies did not start with Reagan and the Republican Party, and they will not end if his Republican administration is replaced by a Democratic administration in the fall.

Funds were cut from food stamps, education, and housing programs by Jimmy Carter and his administration. Federal Medicaid payments were cut by (continued on page 1S)

----- pull-quotes -----

Renee Smith : «Black infant mortality up"

Nan Bowe: "Health first in Nicaragua"

Zakiya Somburu: «Make children a priority "