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Tuesday, November 5, 2024

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Free health clinic for uninsured of Wise, VA, by Remote Area Medical. Source: Vanessa Potter Photos, http://tinyurl.com/cahf3l3

This week’s New England Journal of Medicine includes a study of the impact of expanding Medicaid coverage to more poor, uninsured adults under the age of 65 years. Comparing states that expanded their Medicaid coverage with surrounding states that did not, the Harvard School of Public Health researchers–Benjamin D. Sommers, M.D., Ph.D., Katherine Baicker, Ph.D., and Arnold M. Epstein, M.D.–reported that expansion of Medicaid eligibility is associated with reduced mortality,  a 25% increase in Medicaid coverage, 15% lower rates of uninsurance, a 21% reduction in cost-related delays in care, and a 3% increase in self-reported excellent or very good health.”

Senior Fellow, Nancy Cabelus, DNP, MSN, RN, is an international forensic nurse consultant currently working with Physicians for Human Rights on a program addressing sexual violence in conflict zones in central and east Africa.

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Nancy Cabelus

In recent weeks I visited impoverished areas in Kenya to specifically meet with women and talk with them about sexual violence.  In Kibera slum, the largest and most renowned slum on the African continent, I spoke one morning with 16 women.  The women I met with are HIV positive and receive antiretroviral (ARV) treatment.  I asked the women to whom they would turn if they or someone close to them were raped. All said that they would seek care from a doctor but most were not aware of places they could go where medical treatment was free. Only two reported that they would seek help from the police. Police are perceived as rude, accusatory, and often ask for bribes from women seeking help.  Two women stated they would speak to the tribal chief in the slum and eleven others said they would tell a trusted friend. None would tell a family member and would prefer to suffer in silence rather than deal with the stigma and family outcast attached to rape.