Throughout Africa, Asia, and Latin America public health professionals and paraprofessionals work to control serious, frequent and preventable causes of death and sickness among women and children. Despite international agreement about which health programs to implement and huge investments to support them, avoidable deaths remain high. One reason is the inadequate quality with which programs are implemented.
Assessing Child Survival Programs in Developing Countries provides local health system managers with basic principles for rapid precise program monitoring and evaluation in difficult tropical conditions. Joseph Valadez explains how to adapt Lot Quality Assurance Sampling (LQAS) as used in industrial quality control more than half a century ago, to assess health program coverage and technical quality of service providers. He shows that by examining no more than 19 children from a health facility catchment area a manager can judge whether coverage with child survival interventions has reached a minimal level, and how to observe health workers perform a task 6 times to judge their technical competency.
Joseph Valadez demonstrates that quick assessment is not necessarily dirty, and can provide the information needed to enhance child survival throughout the developing world. In that spirit Assessing Child Survival Programs in Developing Countries is a path breaking text book of modern health services research that both practitioners and students will find indispensable and understandable.
Asylum on the Hill is the story of a great American experiment in psychiatry, a revolution in care for those with mental illness, as seen through the example of the Athens Lunatic Asylum. Built in southeast Ohio after the Civil War, the asylum embodied the nineteenth-century “gold standard” specifications of moral treatment. Stories of patients and their families, politicians, caregivers, and community illustrate how a village in the coalfields of the Hocking River valley responded to a national movement to provide compassionate care based on a curative landscape, exposure to the arts, outdoor exercise, useful occupation, and personal attention from a physician.
Katherine Ziff’s compelling presentation of America’s nineteenth-century asylum movement shows how the Athens Lunatic Asylum accommodated political, economic, community, family, and individual needs and left an architectural legacy that has been uniquely renovated and repurposed. Incorporating rare photos, letters, maps, and records, Asylum on the Hill is a fascinating glimpse into psychiatric history.
An unflinching examination of the moral and professional dilemmas faced by physicians who took part in the Manhattan Project.
After his father died, James L. Nolan, Jr., took possession of a box of private family materials. To his surprise, the small secret archive contained a treasure trove of information about his grandfather’s role as a doctor in the Manhattan Project. Dr. Nolan, it turned out, had been a significant figure. A talented ob-gyn radiologist, he cared for the scientists on the project, organized safety and evacuation plans for the Trinity test at Alamogordo, escorted the “Little Boy” bomb from Los Alamos to the Pacific Islands, and was one of the first Americans to enter the irradiated ruins of Hiroshima and Nagasaki.
Participation on the project challenged Dr. Nolan’s instincts as a healer. He and his medical colleagues were often conflicted, torn between their duty and desire to win the war and their oaths to protect life. Atomic Doctors follows these physicians as they sought to maximize the health and safety of those exposed to nuclear radiation, all the while serving leaders determined to minimize delays and maintain secrecy. Called upon both to guard against the harmful effects of radiation and to downplay its hazards, doctors struggled with the ethics of ending the deadliest of all wars using the most lethal of all weapons. Their work became a very human drama of ideals, co-optation, and complicity.
A vital and vivid account of a largely unknown chapter in atomic history, Atomic Doctors is a profound meditation on the moral dilemmas that ordinary people face in extraordinary times.
In a fast-paced, complicated, and evermore dangerous world it is easy to become self-absorbed and consumed with our own problems. There is one place, however, where we put our self-centered concerns aside, and our deep, common humanity is profoundly touched. That place is where sick children dwell.
It is no less difficult—and perhaps even more difficult in many ways—for physicians who have chosen to attend to the health and well-being of gravely ill or dying children. Margaret Mohrmann has devoted most of her professional life to them, and in Attending Children she shares the remarkable education those children and their families have given her. Her narratives are both painful and hopeful, tragic and funny, full of remarkable characters and sometimes bizarre families.
Mohrmann has sifted through her thirty years as a pediatrician, and with poignancy, humor, and uncompromising honesty, she shares her sometimes stumbling but always deeply caring journey through a land where, sometimes, small hands have to be let go too soon. She introduces us to not only the physical challenges she, her colleagues, and her patients encounter, but the spiritual ones as well.
Attending Children is a unique experience as Mohrmann takes the reader on a doctor's rounds over many years to meet the faces and the struggles, the heartaches and the joys of being a pediatrician. In the case of Margaret Mohrmann and her patients, no one could ask for better teachers.
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