Canaries in the Coal Mine

Today’s read: What’s Killing America’s Black Infants – The Nation

Because pregnant women and infants are so vulnerable– in many ways, they represent the most vulnerable members of our society– their survival is a key indicator of a society’s overall health. And by this measure, we are quite sick.

The maternal and infant mortality rates in the United States, particularly in states like Texas and among certain groups– people of color and the poor– are shockingly high, and getting worse. In Texas, just 11.4% of pregnant women are African-American, but they represent 29% of the state’s maternal deaths. Nationally, the mortality rate for black infants is twice that of white infants.

When I worked in a Louisiana maternity ward, I was shocked to see these outcomes up close. It drove home exactly who is bearing the brunt of these realities, and what the world looks like when you’re living inside these numbers.

At the hospital, we were seeing poor outcomes- and even deaths- mostly for one simple reason: because the underlying population health was so poor. This is despite the fact that the US spends more money on health care than any other country in the world. I’m not chalking these poor outcomes up to bad health during pregnancy, or insufficient prenatal care, although that is a part of it. The reality is more complicated and starts much earlier.

The women that we saw were sick before they became pregnant: diabetes, hypertension (which was present even for many teenagers), poor diet and malnutrition. Some women were also struggling with drug and alcohol addiction and mental illness. Many were experiencing more than one of these conditions. Also present for so many– if not all– of these women: extreme stress, which is a medical condition, and we would be foolish to ignore.

During pregnancy, these predisposing factors led to sky-high rates of gestational diabetes and preeclampsia. Women struggled with insufficient or absent prenatal care, partly due to a lack of knowledge about coverage, and also a lack of providers, hospitals and/or transport in some neighborhoods. The rates of C-section was shockingly high. Their babies were born small, and they were born early — so early, that we cheered any time a mother made it to thirty-five weeks. Their pregnancies were complicated and high-risk, and the resulting negative health conditions continued after they give birth. This is not normal. It is unacceptable.

Because of the color of my skin, I was also witness to the utter apathy of so many of those who have an ability to make a difference. They conflated “common” with “normal” so many times that I stopped keeping track. Just because you see a phenomenon every day does not mean that it is to be expected or accepted.  It showed me how little regard we as a society hold for the health of certain women and their families. This is not only morally repugnant, it is criminal.


A brief history of the flambeaux

It’s Mardi Gras tomorrow, which means it’s one of the times where I miss New Orleans the most. Because out here, it’ll just be Tuesday. God, I miss that city; when I think about it I get a real ache in my chest. My shoulders pitch forward, and sometimes it’s hard to breathe.

But back to it. Mardi Gras is a time of celebration, wild behavior, and freedom: a time where no one works and the city takes its time to play, to celebrate itself, its history, its traditions.

There’s that word: tradition. Not unlike its sibling, heritage. In the South, we all know what that means. And Mardi Gras is also a time to remember these systems and how they are reinforced and resurface even (especially?) during times of civic celebration, times of tradition. In a city with such a long and winding history, replete with power shuffles, centuries of intermarriage and isolation between communities, and the most racist and inhumane elements of the deep South, the shadow of Jim Crow continues to lean on the city, stifling its progress, pressing on its back.

In New Orleans, segregation and intolerance take shape in their own way, the present crudely twisted by traditions both remembered and forgotten. Two Krewes continue to hold their balls, but no longer march. They’ve decided that cancelling their parades is preferable to integrating their membership. If there’s one constant, it’s that the past is never really passed.

One way to explore this twisted, deeply fascinating history is through the flambeaux, a familiar fixture to anyone who’s been to a real New Orleans Mardi Gras. The flambeaux are black men who carry propane tanks and torches to light the way for night parades, as floats roll by, carrying bodies which are mostly white underneath carnival masks.

“In the history of New Orleans Carnival celebrations, up until the legal unraveling of racial segregation (and arguably far after), the flambeaux were really the only “sanctioned” and protected way for Black people to cross the metaphysical race line of Mardi Gras. Black families who dared attend parades in the French Quarter or St. Charles Avenue would suddenly find themselves cornered by police dogs… To the entire world, the fabulous parades of Carnival, synonymous with New Orleans’ Mardi Gras, were enjoyed by whites only.”

For more: Lights Out: The Flambeau Carrier Strike of 1946

When the Numbers are More Optimistic Than We Are

Every year, I look forward to the annual letter from the Bill and Melinda Gates Foundation.

Either that line made you roll your eyes or it made you smile in recognition, that tiny moment when you find out that nerdiness is shared with someone else.

That’s my favorite thing.

But back to it. Of course this letter is something I look forward to: it’s written about the power of philanthropy, measurement, and progress. It’s about centering the experiences, lives and health of women. It’s about embracing what works, and moving forward, shoulder to shoulder with those you are working to help.

These two are the most exceptional kinds of people. Because they understand implicitly how the lives of others, those living in far-off and remote places, with few resources and no voice– they understand how those lives intersect and impact their own. That we are only as healthy and successful as the most vulnerable us. That’s what community is.

Gates Foundation Annual Report 2017