I haven’t blogged anything since – more or less- I recovered from my heart attack in the middle of 2011 and deleted several entries I wrote about that time that reflected my emotional turmoil rather than reality. I hope things will be back to normal soon.
Me and Margaret a few months after I left hospital in 2007. Since my heart attack in 2011, she has been keeping me busy.
I sent this letter to Barry O’Farrel, MP, Premier of NSW. Considering the serious accusatiojns it made against NSW public servants, I expected a response that made some mention. The response did not, just my health issues, that I expect to be ignored. I hope I can scan the reply and append it to the end of this post.
Mr Barry O’Farrel, MP
27 Redleaf Ave
Wahroonga NSW 2076
2 May 2011
Dear Sir
In her farewell statement after the March election, Kristina Keneally said that the electorate had not deserted Labor, but Labor had deserted the electorate. She meant something else, but she was ironically so true. A few days earlier, a newspaper columnist had said Labor deserved to lose, since the government had spent the past several years partying instead of governing.
The truth was that since 2009, NSW had been controlled by blackmail, conspiracy, intimidation and incompetence by sections of the Public Service. For example, currently, HealthNSW knows how easily it could have reduced deaths in NSW public hospitals (due to hospital-acquired infections) by about 10,000 per year, since at least 2002, through an improvement in hygiene that would cost very little but save several billions per year in treatment costs. But just make one minister avoid mentioning this, and the blackmail begins.
We saw Della Bosca not prosecuted by the DPP for breaching the Oaths Act over “Iguanagate” in exchange for Rudd not cutting back on the Federal Public Service, then we saw him set up by the Public Service when he announced his 100-day plan to clean up the hospital system. We saw David Campbell set up the day before he planned to reveal which public servants were to blame for the 12-hour F3 fiasco. We saw thousands of dollars of police surveillance thrown away just so Verity Firth’s husband could be caught buying a single ecstasy ill. We have seen a number of politicians hauled before the public servants’ own court, the ICAC. We have seen public servants mishandle grossly government projects, such as the BER and building less shoddy public housing in NSW. And we have seen a number of politicians making decisions that would make their post-political lives wealthier.
The US CDC announced a 50% decrease in hospital-acquired infections, for only a 25% increase in handwashing, in a study published in 2001. A few years later, Austin Hospital in Melbourne found that spending $7000 per year on a nurse to oversee hygiene practices saved about $1.2 million annually. Two years ago, HealthNSW did it own study, that showed similar results to the CDC study, but only for non-invasive treatments (and for that reason, decided better hygiene was “too hard” to manage).
In financial terms, by spending less than $10 million hiring retired senior nurses to work part-time to guarantee the following of hygiene protocols and develop new ones for invasive procedures, HealthNSW would have over one billion dollars a year in treatment costs, and require no more hiring of general nurses. As well, enough spare beds would be made so that saved money could slash waiting lists and save 5-10,000 lives annually.
All the bureaucracy needs to control the government is to convince one senior politician to expediently do nothing, and then that politician and his/her power is permanently suborned by fear of criminal sanction.
After being under HealthNSW care for two months (top), and just before.
I was admitted to Liverpool Hospital on January 19th, 2007, in a semicomatose condition. After six hours, during which I suffered lung failure, I was choppered to intensive care at Bankstown Hospital. While the doctors were trying to diagnose me, my heart stopped. Blood tests revealed I had kidney failure, and liver failure, due top severe legionella sepsis that was partly resistant to antibiotics. My kidney failure was so severe that I needed four dialysis sessions to bring my blood back to some semblance of normality.
I spent four weeks in a coma, all on breathing support and dialysis. I was not expected to live to the end of the first week.
Unfortunately, my body weight was underestimated, and this together with the wrong diet and a high fever seemed to have caused some oxygen deprivation, mainly affecting the hindbrain and the lower system. When I was first exercised after regaining consciousness, I was both severely wasted and crippled. The former I survived, but the latter has not improved. The hospital offered no reason for my disability, but said I would return to normal within a three months. A transfer to a physiotherapy hospital was arranged by my sister, but the hospital refused. I later discovered it was because I had contracted MRSA while in the coma, and no other hospital would admit me (but I was not told any of this at the time).
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When Bankstown refused to discharge me, I forced the issue and it relented on March 22nd. A few weeks later my GP sent me for an NMRI scan that revealed I had neural atrophy that was causing my disability, and it was not curable. I posted my discharge sheet on my blog, and a doctor from the UK NHS said the treatment I had been given was typical for VISA (now known as multi-resistant MRSA). I began online and other personal research into hospital hygiene, discovered how this might have happened. But both Bankstown Hospital and the HCCC said there was no record of me having MRSA.
I was contacted by an Australian MRSA sufferer (who was infected while having back surgery) who said his doctor would not even order a blood test to see if he still had MRSA, and he could only get medical treatment by presenting himself at the Emergency Departments of different hospitals. In September 2007, my carer assaulted me when Housing refused to even try to find me accommodation (she had been told I would only be in her care for three months). When I went to Fairfield Hospital to be treated for three cracked ribs and severe internal injuries, I mentioned I might have had MRSA, and the doctor treating me said that it was policy to not allow anyone who might have MRSA to be admitted. A few days later I had to be taken back to Fairfield by ambulance because my internal injuries had become painfully inflamed. I was placed in a single room, and only stayed overnight because the staff could find no one to take me home.
Finally, through the intercession of Ninos Koshaba with the Minister for Housing, the Fairfield Allocation Team was bypassed and a disabled residence suitable for me was built in October 2008, , part of the privately built complex purchased by Housing while under construction. Housing Fairfield did not like this.
In March 2009 I was admitted to Liverpool Hospital for respite (90 minutes home assistance each two weeks was not enough). After five days I was approached by a nurse who asked me if I had been cleared by Bankstown of MRSA. When I replied this had not done, I was moved to an isolated room and the cleaners given special anti-infection instructions to prevent me infecting the ward. No precautions were taken to protect other hospital patients, just some of the nursing staff. It was also at this time I learned that hospital doctors kept separate computer records to those they completed for the hospital.
My discharge papers from Liverpool mentioned neither the degree of my disabilities nor the actions taken to not allow me to spread the MRSA I might still have. Also, no tests of any kind were done to see if I still had MRSA. Three separate assessments argued I needed six free hours of home care each week in order to keep me out of a nursing home, but CatholicCare could only manage to get me 90 minutes a week from HACC.
I received a copy of a reply from the SSWAHS to the HCCC, with a hastily inserted paragraph saying that I had been found to be inexplicably infected with MRSA towards the end of my coma. But the letter did not explain why I was put under such strict infection control procedures for the MRAB I was told I had instead (which in my case was virtually impossible to get in Australia), and did not need strict infection control procedures.
The HCCC did nothing about being lied to, and the last word I received from them was that Bankstown said I should stop whining about being crippled, but be thankful I was alive.
A firm of solicitors approached me about my problems, after my discharge from Liverpool. While they wrote back, they said they could not take action on the basis of my medical records from Bankstown. But I was given a copy of most of the pertinent medical records from Bankstown and Liverpool.
I wrote to the Health Minister, John Della Bosca, but he was not told of my letter. Instead, Joe Tripodi hand-delivered a letter outlining my problems to him. Della Bosca wrote back to me, explaining he had told GILD to see what compensation for being crippled I should get.
I also wrote to Centrelink, asking for a medical assessment. This was refused on the grounds it would invade my privacy. So officially, I am not severely disabled and therefore denied the various types of assistance, including financial help to cover my increased costs. At least NSW Health and Disability is subsidising my 90 minutes per week cleaning help, and the RTA has accepted my doctor’s statement that I am mobility-impaired.
Shortly thereafter, I asked Housing Fairfield to install extra safety rails in the bathroom, as the ones installed by the builder were not adequate. Fairfield asked the SSWAHS to assess my needs, but Health replied to the Housing Campbelltown office, and nothing happened until I made additional representations threee months later. Then the Health assessor visited me twice, to confirm that I had not been crippled before I entered Bankstown Hospital, or that any medication I was on would make me crippled, before permission to install the safety rails was granted. I still do not have any protection from falling of the back porch onto the ground.
On October 20th, 2009, I wrote to Carmel Tebbutt, at her electoral office, outlining my problems and my previous actions. She never saw the letter, nor did her Parliamentary Secretary for Health, Dr Andrew Mc.Donald, who replied on 21st December 2009 to me with nothing but a litany of lies (including the supposed actions of GILD) that could have only been written by a public servant. I waited until September 2010 for action, before complaining that nothing had been done. I never received an answer.
The only good news I have is that I have been lent the old car owned by my nephew, since I can’t afford the taxi subsidy I now must only pay to visit medical people in places I cannot park. In October, I will have to find the money to reregister the car, or suffer imprisonment.
I have been a cripple for more than four years. It took two years of that time to finally get a Housing place where I could live independently. But is costs more to live as a cripple than the government pays. Does it make sense to you that my housing subsidy of $7000 per year would be increased to $7000 per week if I went into a high-dependency nursing home, to be in a virtual prison? In fact, I’d be better off if I had myself gaoled, since then I would have the run of the prison hospital, and a wheelchair I can’t afford to buy.
I am tired of being a cripple, and taking several times longer to do things that I can do. I am tired that I have been thrice assessed as needing six hours per week home help, paid for by the State, since thne State crippled me, and I don’t have the money. I am tired of Bankstown Hospital refusing to recognise my severe disabilities as happening while under its care. I am tired of being refused hospital treatment because I was infected with MRSA at Bankstown and other hospitals do not care to admit patients if they know they have had MRSA.
I am tired of being under continual medical, psychological and financial stress, and having to depend on charity because no one cares to take responsibility for making me a cripple. And the charity seems to have reached its limits. I am tired of having my life recklessly endangered because public servants, such as HealthNSW’s Ian Smyth, believe that a few hundred lives lost to hospital acquired infections is “a minor matter” (on a TV news report late last year).
In your speech after the March election, you said you planned to leave a legacy to NSW. Is this a legacy where politicians obey public servants at the costs of thousands of lives and billions of dollars, or one where politicians work for the benefit of the electorate?
Neville Angove
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By Neville J. Angove
I was watching the TV program, “The Boneyard: Biowaste.” In a segment on Tennessee’s “The Boneyard”, it was often mnisreferenced as “The Bodyfarm” I was once again treated to a repetition of a common fallacy by someone who should have known better, but was too ignorant to do some elementary fact checking (similar to a 2010 journalist).
The chap who initiated The Boneyard commented that mediaeval knights were actually only small people, about five feet in height or so. This is a common fallacy, and the small suits of armour that have survived from this period, along with the fact that many commoner entrances only had small doorways, is used as evidence to support this misconception.
The average height prior to the 1800’s was not much more than about five feet. This was due to poor diet. But poor diet was not a constraint amongst the wealthy. These people could afford suits of armour, for example. They could also afford large doors.
Several decades ago a museum guide commented that the kitchen doors to a mansion were small because of the average height of the users. Might be, except kitchen staff were unlikely to be poorly fed. The guide did not comment on why internal doors were as large as we use today, even those not seen by any visitors.
Small doors were common because of expense and defence. It cost money to make a large door or window, and only the wealthy chose to be ostentatious enough to do so. Of course, the back doors used by staff and hidden from view were only as large as needed. Smaller doors could also be only entered sideways, meaning that any invader had his defenceless back to one side.
It is true that a number of famous warriors were small. Admiral Nelson was small, but he had a commoner origin. Boneapart wasn’t as small as we think, but he also had a commoner origin. But nobles were well-fed and were fairly large people. In fact, only oversized men could wear suits of armour and wield mediaeval weapons.
Little armour used in mediaeval times survived to this day. A recent survey of Agincourt could only discover one coin and part of a knight’s spur. The rest of the metal was salvaged and recycled. The suits of armour that have survived were generally of two types: 90%-scale suits made by armorers as sales aids; or suits made for the adolescent males of wealthy noble households. None saw battle and so none needed recycling.
Anthropologists who have examined mediaeval noble skeletons and non-ferrous armour and weapons, and historians who have looked at the forced evolution of horses, will correct these misconceptions.
This type of unchecked error passes into common knowledge because its suits the misconceptions of those who should correct them. Perhaps we like the idea of the old nobility being smaller than modern man, because it makes us feel better.
Unfortunately (and here I am on my hobbyhorse again), the Internet is very good at perpetuating fallacies, and destroying electronic evidences of the truth.
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Body Death Race 200
Imagine you walk into a hospital vestibule. Or are carried in on a gurney. You can be young, old, ill, or just getting some elective surgery done. But you plan (or it is planned for you) to stay for about five or six days.
In the vestibule is a doctor with a gun. Lucky he is a bad shot, because he fires at you. Depending on circumstances, you might be the one in 10 he actually hits. In five or six days, you are out, or still suffering from the wound if you were shot. Except that one of each 20 shot at leaves the hospital in a body bag. That is about one in 200 admissions catches a disease while staying more than five nights in a public hospital, and leaves in a hearse.
In Australia, about 10% of patients acquire an infection while in hospital. One in 20 of those dies from the infection. That is about 600,000 people infected annually (at a cost of about $10 billion in treatment), and 30,000 dead.
The health system considers this to be efficient. So what if one in 200 patients die simply because they received an infection while a patient? So what if the infections cost $10 billion a year to treat?
Well, 199 patients didn’t die, and $90 billion was spent on other medical matters.
We consider 3000 dead on the roads each year to be a tragedy. But 30,000 dead each year because of poor hospital hygiene and incompetent supportive treatment, is just a statistic.
Go figure.
Just been watching a double episode of the British spy drama, “Spooks”. Been interesting to watch it evolve over the last three years.
This arc concerned a terrorist takeover of a Saudi trade mission in London, where Britain is to sign off on the sale of nuclear plants to Saudi Arabia. But what looks like an Al Aqaeda attack is actually a ploy by Israel’s Mossad to destabilise the agreement and send the country into turmoil. This would force the western countries to send in a peacekeeping force to ensure the flow of oil (hey, just like in Iraq, with the foreign companies getting the money, not the natives; or like the Indonesian invasion of East Timor, where the US and Indonesia would split the natural gas revenues if Australia could be persuaded to not intervene).
Of course, the gallant operatives of MI5, in spite of political and bureaucratic interference, managed to save the day. The single Mossad survivor ended up at Gitmo for a few years’ questioning, and all sides denied Israeli involvement because there was no proof. I thought about an SF story I read decades ago, where a spy was captured because his culture believed in circumcising males. British and US doctors must be damn stupid if they can’t tell the difference between clipped and unclipped males. The Mossad operatives were not trained from birth, and so would have been clipped. A good Muslim Al Qaeda terrorist would definitely not be clipped (would interfere with his enjoyment of the 72 houris he was promised in the afterlife). Wonder whether ignoring this was a plot device, or was everyone actually ignorant of the act of genital mutilation of males demanded by some cultures (I know of at least two women who had never seen a clipped male until they had seen my equipment, and I am far from unique in my experiences).
This brought to mind another information brief experience that occurred only the day before. I was watching a tape of the show “Air Crash Investigations”, concerning the flaw in the rear cargo door design of the DC-10 wide body. I the late 1970s, I had read a story in “The Reader’s Digest” about this matter, and it explained how the problem had only been found by chance when a plane managed to land after several had mysteriously crashed without evidence of the cause of the crash. It was put down to a combination of factors, but not highlighted was the known design fault by McDonnell Douglas.
The TV program related how the first known crash of the DC-10, the plane managed to land, and he US NTSB investigators concluded that the skill of the pilots had helped save the aircraft when the cargo door unlatched at 3500 metres in 1972. The door had not been closed properly by the ground crew. The same investigators examined the wreckage of another DC-10 crash in France two years later, and found that the same problem had occurred, in spite of McDonnell Douglas being told of the problem.
The bulk of the program concentrated on presenting evidence that McDonnell Douglas knew of the hazard two years before the first commercial flight, but had done very little (what was done was no stated), but after the first crash had not been ordered by the US FAA to correct it completely (even though a few fixes were recommended). Even so, the company did implement a few things. But publicity was avoided. In the French crash, the Turkish ground staff could not read the warnings written in English, and had not been told how to correctly close the cargo door. In spite of this, the program pilloried McDonnell Douglas, ignored the airlines’ incorrect training, and said that the outcome of a following court case killed the DC-10.
Problem is, the DC-10 died when engines began falling off just after takeoff. This was found to be due solely to incorrect maintenance procedures followed by the airlines, against McDonnell Douglas’s instructions. The DC-10 was quickly followed by the re-engineered DC-11. It was a damn good plane, but I have only seen it in service with the US military as an in-flight refueller, and In Japan where it was extremely popular until McDonnell Douglas died in the 90s.
My problem here is twofold. Firstly, a reputable magazine such as the “Digest” published a patently partisan feature that was definitely a pack of lies, designed to deceive. Either the magazine was bought, or the journalists were. Secondly, the TV show glossed over the role of poor airline staff training as being a major cause of the ultimate death of the DC-10. Why? Politically incorrect, especially at a time when airlines are being criticised widely for inadequate staff training and reduced staff numbers?
Today I noticed something strange about airline prices. Singapore Airlines was offering cheap return flights to London at about $2200 a seat economy and $10,000 business, while the same travel agent was offering seats to the same destination for $1585 economy and $4850 business. Singapore Airlines trying to move upmarket?
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Long Gap
I can’t believe that it has been over five months since I made my last blog entry. Abut that time the pain in my joints became so severe from my attempts at moving myself around that the quack prescribed meloxicam. It actually did ease the pain, but I think part of the effect was from removing any incentive to move. Getting up to type a blog entry was just too hard. And I have 15MB of unanswered e-mails to attest to my immobility!
After 18 months, I still can’t get an "official" recognition that I am crippled. It means I have to have a medical examination for every time I try to get some assistance. For example, even though I am pretty much now confined to a wheelchair or a walker, the housing people refuse to assess me as needing wheelchair-enabled accommodation. According to a source within Health, I have not be recognised as being crippled, since to do so would open up the door for asking why I was crippled in the first place, and why no follow-up was arranged after I was discharged from hospital!
Since Big Puddle jacked up its prices, I have registered my own web site, "www.nevangove.com", with "alarchdu@nevangove.com" as my primary e-mail addy. All e-mail sent there is forwarded here and by the time I finally move and change ISPs, my mail will be ISP-independent. The blog will still be available on Facebook, Windows Live Spaces and Geocities ("http://au.geocities.com/alarchdu/alarchdu.html"). With the current takeover offerings between Yahoo and Microsoft, I don’t know how long Geocities will stay there, since they now want to change its name to "http://au.geocities.yahoo.com/alarchdu", just as the changed my Yahoo e-mail to "alarchdu@yahoo.com.au". Maybe I’ll just cover all bases and copy everything over. Although I’d rather spend my limited time writing new stuff.
DEATH AND LIES
So Benazir Bhutto is dead, shot by a presumed Islamic fundamentalist, supposedly on the orders of Al Queada. Pakistanis have been rioting (19 dead at this time) and world leaders are falling over themselves in their arrogance to condemn such a disgrace. If Bhutto had been elected to office, the riots would have been worse.
At this stage, while the media (the ABC specifically) claims that there are riots against Musharraf and his US support, no one has hinted that perhaps moderate Muslims are involved in supporting Bhutto’s hard line against fundamentalists. Again, if Bhutto had been already elected to office, we might be seeing a moderate versus fundamentalist war erupting.
There has been little mention that one of Musharraf’s candidates was murdered a few days earlier. This shows that the official line is being muddied: a moderate killed at the behest of fundamentalists, but this is being ignored in favour of a Bhutto versus Musharraf feud.
Not surprisingly, world leaders are busy jumping into the fray, notably our Kevin Rudd and the US’s George Bush. What galls me is that non-prominent moderates and fundamentalists, political or apolitical, are being killed every day. But they just make the news as statistics.
What had made Bhutto’s murder a news item is that she was a prominent politician. It seems that people are fair game for murder if they are neither prominent nor political. But of course, prominent politicians are a breed apart.
All men are created equal, but politicians are more equal than others.
An interesting side issue is that Bhutto’s election in Pakistan would have shown every Muslim that moderation is what people want, not fundamentalism. This is not what the fundamentalists want. You just have to visit Afghanistan or Iraq to see this.
My belief is that it doesn’t matter of the victim was Kevin Rudd or a lift driver in Melbourne (to bring the issue back home). A human being was killed promoting his/her beliefs, and that is what counts. The prominence of the victim should not feed the appetites of the spin doctors.
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A day later, and the death toll now stands at over 30, and Pakistan is at a standstill. A fundamentalist leader rejects it was a terrorist attack, arguing that a good Moslem male would not take a shot at a woman. Huh? I suppose a husband killing is wife for adultery, or his daughter for promiscuity, does not count? How about sending a woman to gaol because her students (not her, mind you) named a teddy bear "Mahommed"? Another attempt to disguise the fact that Bhutto’s death was religiously motivated?
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It is hard to gather definitive information about the incidence of MRSA in Australia. Part of the problem is that national figures are gathered by the Federal Government, based on the input from the various state health departments, hospitals, and medical practitioners. These figures are heavily compromised by the poor quality of the data filtering up the information chain, and the degree of data-massaging done at each level.
For example, the NSW Department of Health is loathe to mention any data containing those dreaded letters, "MRSA". As of today, the earliest press release I can find mentioning MRSA is several years old. A search of the Department’s web site only includes three references (out of nearly 4000) to MRSA, so anyone doing any research would conclude that this is not a big topic. One of those references, which include the protocols hospitals should follow regarding any hospital acquired infections, has been so emasculated by censorship cuts that it is effectively useless.
Hospitals are reluctant to use any of the acronyms that describe any multiple-resistant bacterial strains. The occurrence of such infections is effectively under reported. In my case, "MRSA" was never used. The infection was referred to as simply a "staph infection" (which is hospital-speak for MRSA), for which Vancomycin was prescribed. That the MRSA might have been resistant to this antibiotic (therefore the presence of the rarer form termed "VISA" was possible) could only be inferred from the additional prescription of the antibiotic Timetin (luckily, Vancomycin mitigates many of the more harmful effects if Timetin). Therefore, this MRSA infection might go unnoticed by those higher up the information chain.
Medical practitioners are also loathe to report the presence of MRSA in patients presenting themselves for treatment. The best way to do this is simply to report that "nothing could be done for this patient", and not mention MRSA at all (as was done with two MRSA patients I know). Of course, MRSA is most likely accidentally (or deliberately!) described as just another infection or weeping sore, allowing the patient to happily spread the infection throughout the community.
Therefore much of the data referred to in this post has to be inferred from that made available through overseas sources. This data is frightening enough. The fact that our own governments and medical practitioners are hiding the truth from us is absolutely terrifying! The fact that while figures do not lie, but liars can figure, just clouds the issue.
In the UK, the various hospital trusts have reported infection rates of MRSA ranging from a high of 0.7 per 10,000 patient days to as low as 0.05 per 10,000 patient days. To put this is context, the worse-case figure indicates an infection rate about half the annual road death rate. Basically, you make two visits to a hospital one year, and you are just as likely to be infected by MRSA as you are to be killed in a road accident. But this figure is inapplicable to the individual (talk about damned lies and statistics).
The large majority of hospital stays are of short duration. Cases of MRSA-infection would not be noticed. Where an infection is noticed, and the medical practitioner calls for a blood-culture to test for MRSA, five days is needed for a positive result. If the infection is not severe, the patient would be discharged before the result is known, and the blood-culture consigned to the medical waste bag. he worse-case results really represent a rate of one serious infection per patient, per 100 patients kept hospitalised for over three weeks. Extrapolating further, if you stay in hospital for two months or more, you have a better than even chance of contracting MRSA.
These figures hide the fact of how likely you are to be infected if you have multiple hospital visits. My MRSA infection occurred during my third hospital stay in 30 years. Extrapolating from the above figures, double your chances of being infected with MRSA with each doubling of your separate hospital stays. And for each doubling of the length of each stay, quadruple the chances of infection.
No wonder that the health authorities are treating MRSA so cavalierly. They are receiving artificially reduced figures deliberately presented in such a way as to hide the real incidence of MRS. infection. For you, unfortunately, this means you are far more likely to get a diagnosed MRSA infection in your lifetime than be injured in a road accident, and then carry the infection around the community. You are more than 100 times as likely to get an undiagnosed MRSA infection and do the same.
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