Organ donation: it’s for everyone

Yesterday, I had an article published at Galus Australis, which is a great website that features articles about Jewish life in Australia. I wrote about organ donation, as there are particular issues for Orthodox Jews when considering signing up as a potential donor.

For those less interested in the intricacies of Jewish jurisprudence, I’d like to present the Australian spin to the issue. This is a cheat of a post, because I’m going to pull some of the Galus Australis article into it, but I will add some further detail to assuage my guilt.

The good news for Australians is that we have a high rate of successful transplants. The bad news is that rates of organ donation in Australia are embarrassingly low for a developed country. According to the Organ and Tissue Authority’s website, around 1700 Australians are on a transplant list; last year, only half the organs needed were donated. (Fewer donors are needed than there are recipients, as one donor can save up to 10 lives, as well as providing non-essential [but life-changing] tissue, such as corneas to cure blindness.)

Fewer than one in five Australians have discussed their wishes regarding donation with their families. This is why donation rates are so low: people don’t know their loved one’s wishes and err on the side of refusal.

The Authority has a campaign running to encourage people to discuss their wishes regarding donation with their families. In many ways, this is more important than actually registering as a donor, as it’s the family, not the individual, that makes the ultimate decision. The message is pretty clear: register as an organ donor and talk about it with your family.

It can be uncomfortable to make plans about your body after death, and of course it’s highly unlikely that you will become an organ donor. But that’s precisely why it’s so important to have more potential organ donors willing and registered. It can also be helpful to consider registering for bone marrow donation and donating blood regularly; in the context of these living donations, the focus is taken off donation after death.

Together, these actions might save a life – or several – one day.

They’ve got the internet on computer nowadays

Some research doesn’t really need to done; or, at best, it’s quantifying something that everyone already knows. Much of the research into internet usage falls into this category. It’s on the increase? Really?

Apparently, more people are using the internet to keep in touch with family and friends, stay informed about current affairs (but they’re not willing to pay for news services), and for entertainment, including porn. (The latter is termed “sexual content” by the report I’m referencing here, CCi Digital Futures 2010: The Internet in Australia.)

OK, so we knew all that, but knowing some of the numbers is useful. And it’s interesting to glean people’s attitudes about what they think should be free online. But even though none of the facts and figures surprised me, there was a stand-out: 84% of Australian internet users surveyed thought that at least half the information online was reliable. Half!

No wonder Nigerian scams actually work — too many people’s bullshit meters are off. It’s easy to switch it on, folks. Any time someone forwards anything to you (whether it’s a wonderful story or a tragic one, or really useful tips, such as how to stay alive in an earthquake), don’t forward it on. Look it up on Snopes, or Google some keywords along with the word hoax. And reading people’s opinions on a forum is not research. Reading articles in peer-reviewed journals is.

I’m sure the percentage of reliable information online will probably never increase (yes, I’m a pessimist). And people probably won’t get more discerning. But I’ll keep replying to every stupid forward with the relevant Snopes link anyway.

(Thanks to xkcd for the comic.)

A simpler system. (Please?)

Health care in Australia is actually pretty good, compared to, say, Ethiopia. Still, there’s plenty of room for improvement. So I was interested in what would happen on 19 April, when COAG (the Council of Australian Governments) met to thrash out Rudd’s proposition to take over health care (currently divided between federal and state governments, the latter of which I personally believe should be abolished altogether).

I didn’t get my act together to comment on the results of the meeting earlier because I was busy with the aftermath of a hospital experience of my own — the birth of my second child. (I’ll get to birth politics in another post.) Since then, the Budget has yielded more health-related reforms to debate at dinner parties, but the agreement in April still holds my interest, and here’s why.

I’m generally a healthy person, so apart from a visit to emergency after spraining an ankle on a weekend, my main experience with the hospital system has been for natal (pre, peri and post) care. This was a fairly straightforward experience with my first child, at least in terms of continuity of care. With my second, however, things got a little complicated.

In retrospect, I didn’t help matters by choosing the “shared care” option of care. This meant that instead of taking the option of seeing the same midwife the whole pregnancy, I had most of my appointments with my general practitioner. This was more convenient for me and I like her, so it worked well until I was about 30 weeks’ pregnant and diagnosed with gestational diabetes. The midwife who broke the news to me slagged off my GP for not calling me to let me know (when actually she’d ordered the test so long before, I’d hardly expect her to be holding her breath for my borderline results).

And it all went downhill from there. I got a referral to an endocrinologist and a diabetes educator. I had to see an obstetrician to clear me to go back to shared care, and was transferred to a different obstetric team for that appointment, so that the appointment could be on the same day as the endocrinologist appointment.

Initially these changes, like the dietary changes and finger prick blood tests, were more of an inconvenience than anything else. But at 38 weeks, with work deadlines competing with my due date, I decided to skip my last endocrinologist appointment. I was meant to make a midwife appointment while I was there, but I figured I could see the GP instead. She was happy to give me a check-up but said that I really should be having my appointments at the hospital at that stage.

But we were both puzzled about who I should be seeing. The obstetricians had cleared me to go back to the GP but I’d been taken off my previous team, so I had no midwife to look after me. She called the shared care liaison officer and got a voicemail message. In desperation I tried to contact the diabetes educator and finally got lucky — another midwife, Fiona, answered the phone and squeezed me into her schedule. I made it to one appointment with her before my son was born.

The point of this story is that health care in this country is too complex, even for someone who’s fairly health literate. Communication between health professionals is poor. Outside of set appointment times, patients’ access to health professionals is pretty much non-existent. Fiona mentioned that the hospital was moving away from group midwifery (where women have one midwife looking after them for pregnancy and birth, which is obviously excellent) and more towards shared care — because the hospital was broke.

If this goes ahead, it will leave more women bewildered about where they fit in the system. When I worked as a medical receptionist, patients would often call to request a home visit when they really needed to have called an ambulance five minutes previously. Patients hold up GPs and even orthopaedic surgeons with their life stories, often (I think) because they genuinely don’t know who they really should turn to.

So when a government meeting promises to “[help] patients receive more seamless care across sectors of the health system”, all I can say is YES PLEASE. Whatever other criticisms can be levelled at Rudd and the current government, if they can actually achieve simplicity in health care, I’ll be impressed.

Carbon nutrition labels

Woolworths (or Safeway if you’re Victorian) may soon be providing information about the carbon footprint of the products they sell, according to today’s Sun-Herald.

This is probably a good thing, but I’m sceptical (naturally) about how well it’s going to work. What will be included in the carbon footprint? Will water and energy costs both be considered? How will the system by monitored, and by whom, unless the government is willing to get involved? And how long will it take for workarounds to be found (like labelling sugar as “evaporated cane syrup” on ingredients lists)?

On a larger scale, will it encourage industry back to Australia in the long term? (And at what cost to developing countries?)

Until these questions are answered, I’ll sit back and watch how this develops with interest.

Organics just aren’t sustainable

This post was originally dated 30 September 2007; technical difficulties have prevented its publication until now. Publication should now resume as “normal”…

Following Elizabeth Finkel’s blistering critique of organic food (which suggested that organic food is not better for you or the environment), Cosmos Online has published an opinion piece from Craig Meisner, an American professor based in Bangladesh.

Professor Meisner’s intimate knowledge of the true conditions in a developing country refute the assumptions often made when researchers try to determine if organic farming can feed the world. According to Meisner, the assumption that organic fertilisers and mulches are plentiful, even for the poor, is incorrect. Any change to current agricultural practices would require major changes, such as sacrificing fields growing food for fields growing legumes for fertilisers (the bacteria in legumes’ roots can fix nitrogen), which is too risky for the very poor when it means they might go hungry.

To me, the solution is simple: since the evidence shows the organic farming isn’t really that much better than modern conventional methods, those promoting organics should get off their high horse a little bit. For those who want (and are able) to pay the extra cash for the feel-good sensation of food with no “chemicals” (but possibly extra parasites and insects), that’s great — even more so for the farmers making money from it. But there’s no reason to foist that on everyone else, particularly if they live in a developing country.

Of course, there are issues with the toxicity of pesticides in the quantities used by farmers, including language barriers preventing sufficient understanding of warnings, but this needs to be addressed separately to the issue of organics vs conventional farming. Farmers deserve the best they can get out of their land.