When I worked at Fred Hutchinson Cancer Research Center in Seattle I was struck by the chemicals researchers routinely tossed away—often down the drain. It seemed paradoxical that the attempt to understand cancer involved the manufacture of some nasty carcinogens.

Of course, in the big scheme of things the amount of chemicals used in cancer research is small. And almost any positive endeavor has its shades of grey.

Take the Bill and Melinda Gates Foundation. Its role in public health has been extraordinary—but as a report in the Los Angeles Times reveals, the financial arm of the foundation invests in companies that spew some pretty toxic stuff, and may otherwise undermine the mission of the foundation.

These investments include oil companies that pollute regions of Africa where the foundation operates and a health care company embroiled in lawsuits for allegedly unnecessary surgeries. The Times claims that at least 41% of the foundation’s assets, or $8.7 billion, are in companies that “countered the foundation’s charitable goals or socially concerned philosophy.

Unlike some other philanthropies, such as the Ford Foundation, the Gates Foundation has apparently set up a firewall between its investment and granting arms—to try to keep the fund as flush as possible.

It may be easy to quibble with some of the standards used by the LA Times to criticize the Gates Foundation. Nonetheless, with an endowment boosted by Warren Buffett to more than $60 billion, it seems that the foundation could wield its substantial investment power in ways more in keeping with its public health mission.

Posted by Charlotte Schubert at 05:33 PM | Permalink | Comments (1)

I’m now a certified East-Coaster and so I did the only right thing for my holiday—went to Florida. But I haven’t quite caught on to the drill—since for beach reading I passed by numerous candy-colored books and Janet Evanovich mysteries.

Instead, I chose a topic I at times found disturbing: “Birth: The surprising history of how we are born,” by Boston Globe reporter Tina Cassidy.

The book, published this fall, introduces the reader to birth methods and fads through the centuries—such as fish bladder vacuum extractors, strange levers, and “twilight sleep,” a drug mixture that made women forget their memories of pain (as well as childbirth). In the middle ages women squatted over incense smoke and consumed fungal extracts to speed delivery. In mid-20th century, many women were routinely tied down during labor, their pubic hair shaved and newborns stashed in nurseries.

Cassidy examines the prestige of midwives in some communities and their persecution in medieval Europe. One witch-hunting guide proclaimed that “No one does more harm to the catholic faith than midwives.” Church leaders believed God intended women to suffer, and for centuries resisted attempts at pain relief.

Chronicling the rise of obstetrics as a medical profession, Cassidy describes harrowing rates of infant and child mortality in unsanitary city maternity wards. Even by 1932, 4.5 percent of women died from childbirth in New York City hospitals. Home delivery by midwives was generally safer; in regions of colonial America maternal death rates were 1 percent or lower.

Now, in the United States and many other countries a woman’s chances of dying in childbirth are less than 20 in 100,000 births.

But all is still not well. In Afghanistan, Angola, Niger and Sierra Leone women lack access to even basic care, and more than 1600 out of 100,000 women die.

Cassidy also questions whether some of today’s practices have a sound scientific basis. It was not until the 1950’s that a researcher even bothered to rigorously document the length of the stages of labor. That researcher laments that doctors often take these averages as a benchmark today, viewing women with longer labors as candidates for cesarean section. Even now, it seems to me that basic questions remain unanswered, such as the exact linkage between premature contractions and premature delivery.

Rates of cesarean section become more disturbing every year. In United States the rate is 29 percent, and it’s above 35 percent in Italy, Mexico and South Korea—soaring above levels regarded as acceptable by the World Health Organization, and above rates in countries with records of safer deliveries.

Cassidy relays these statistics along with breezy anecdotes of women giving birth on the Boston subway, of placentaphagy (eating the placenta), and male involvement in birth—such as tribes where the men flagellate themselves while their partner labors. I might not recommend it for the beach, but I’d give Cassidy’s book a higher page-turning rating than an Evanovich paperback—and I’m still thinking about it days later. I can’t help but be unsettled.

Obstetricians may have eliminated some of the more drastic methods of previous centuries, but it’s clear that something is still seriously amiss with how we are born.

Posted by Charlotte Schubert at 05:24 PM | Permalink | Comments (0)

So I'm a big tea drinker. And like most tea drinkers from India (and Britain), I like my tea strong and sweet and with plenty of milk. And I've always thought how great it was that with every cup, I was also becoming healthier. Tea is supposed to have antioxidants and help prevent heart disease, stroke and cancer.

Imagine my dismay when German researchers announced yesterday in the European Heart Journal that adding milk to tea completely wipes out those benefits.

Black tea, such as Darjeeling, on its own relaxes the arteries and helps blood flow, perhaps by producing nitric oxide. But when the same tea has 10% skimmed milk, those effects apaprently disappear. The scientists say this could be because milk proteins block the production of nitric oxide. This may explain why British tea drinkers don't show the same benefits as East Asian ones, who tend to drink green tea without milk.

The study doesn't seem definitive to me--it still needs to be confirmed by other groups--so I think I'm just going to hope, as I sip this milky tea, that it's not so black and white as that.

Posted by Apoorva Mandavilli at 05:04 PM | Permalink | Comments (1)