Kurdistan: An Explainer

Overview

On September 25, 2017, the Kurdistan Region of Iraq (KRI) held a referendum for its independence from Iraq. The referendum was called by the President of the KRI, Masoud Barzani. The KRI is known as a “semi-autonomous” zone in northern Iraq. 92% of the 3.3 million voters in the referendum voted or secession, with a turnout rate of 72.61%. The referendum was meant to apply to all of the territory that the Iraqi Kurds currently occupy, which they extended beyond the semi-autonomous region when they won back territory from ISIS in 2016 and 2017. Iraq’s president, Haidr al-Abadi strongly opposed the referendum, along with many surrounding countries and Western allies of the new Iraqi government. Turkey and Iran are home to many Kurds of their own, so they fear the ethnic group gaining more political power in neighboring Iraq. In Iraq, about 15-20% of the total population of 37 million is Kurdish.

KRI’s Preparedness for Independence

Although the people of the KRI clearly want independence, the KRI government is quite ill-prepared for statehood. It is deeply indebted and defended by a fighting force (the Peshmurga) that is deeply divided into multiple family-led factions. Additionally, President Barzani has extended his rule twice and shut down Parliament to when it threatened to limit his powers. There is no mechanism or agreement that enforces the Kurdish referendum, so secession is unlikely. Barzani nevertheless wanted to get the vote off before the KRI’s presidential elections on November 1st of 2017.

History of Kurdistan Political Status in Iraq

At the end of the Gulf War in 1991, Saddam Hussein allowed Kurdistan to become fully autonomous, though not independent from Iraq. In 2003, following the US invasion of Iraq, the KRI gave up its autonomy and became “semi autonomous,” meaning the US and Iraqi government had more power over the region. Since 2003, the KRI has increased its power by expanding the territory its forces control (which it won back from ISIS), and increasing its oil exports significantly.

Sources

The Economist: Sept 23rd, 2017

The BBC

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The Carbon Budget: An Explainer

What is the Carbon Budget?

The carbon budget is the amount of carbon dioxide the planet can release into the atmosphere before global temperatures raise to 2 degrees Celsius above pre-industrial levels (i.e., the year 1870). The 2015 Paris Climate Agreement set this goal of 2 degrees, but also expressed that the preferred goal should be to limit global warming to 1.5 degrees to prevent very undesirable changes to our climate. New research determines that our total carbon budget, beginning in the year 1870, is about 2.75 trillion tons of CO2. This is the total amount the planet can release and still stay below 1.5 degrees of warming. By 2015, we had already released just over 2 billion tons of CO2. And the planet’s temperature had increased by 0.9 degrees. The world’s annual CO2 emissions is about 40 billion tons as of now. So we have about 750 billion tons of CO2 left to release in our carbon budget, which will last about 20 years at our current rate of emissions.

What Needs to be Done

To end our CO2 emissions sustainably and stay within our carbon budget, researchers say we should cut annual emissions by about 1.1 billion tons of CO2, or 4-6%, per year. Fortunately, the rapid increase in annual carbon emissions has slowed significant and reached a plateau. We still need to improve a lot in a short amount of time to meet keep global warming below 1.5 degrees, however. The only other option is to develop new “carbon capture” technologies to take CO2 out of the atmosphere. These innovations are still a long way off.

Socialism: An Explainer

There are many different versions of socialism (Leninism, Stalinism, etc.), but they mostly fall under the category of Marxism. Karl Marx was a German philosopher and economist who wrote The Communist Manifesto and other influential texts. Marx’s big idea came at a time when many European countries were transitioning from monarchical systems to democratic and capitalist systems. Under the new capitalist economic system, the owners of the means of production, who Marx called the bourgeoisie, were exploiting the common laborers, or the proletariats.

Marx’s solution to this flawed economic system was to shift ownership of the means of production to the workers themselves, instead of the wealthy managers. To achieve this condition, means of production would first shift from powerful individuals to the state, and then to the general population. When the state owns the means of production, the society can be considered socialist. When the proletariat own the means of production, the society can be considered communist. No societies in our world are or have ever been truly communist. Even societies which we consider communist (China, USSR, North Korea), are socialist in practice. That is, the means of production are owned by the state. One reason that the transition between a socialist society and a communist society is so difficult is corruption. In order for the transition to occur, the government must give up all of its control. No government has ever been willing or able to do this, so a truly communist state has never existed as a result.

The system that exists in most countries of today’s world is a mixture between socialism and capitalism. Capitalism lets private business and the free market provide all of a society’s goods and services, while socialism pools money and resources from the citizens and lets the government reallocate these resources to provide goods and services to the people. If there were a spectrum with capitalism on one side (business leaders control the economy) and socialism (government controls the economy) on the other side, the United States would be close to the side of capitalism. And yet, even the United States government controls primary and secondary education for most of the population, health care for veterans, poor, elderly, and Native Americans, and social services like police, fire departments and libraries. Countries like Sweden and Canada would fall much closer to the socialism side of the spectrum. They manage to succeed economically and provide more services to their people from the state.

Source: NowThis World

Civil Unrest in Togo: An Explainer

Overview

In the month of September, 3 people were killed amidst anti-government protests. One of the victims was a 9-year-od boy. The President of Togo, Faure Gnassingbe has been in power for 12 years. His father, Eyadema Gnassingbe ruled the country for 38 years before that, beginning in 1967. These two men make up the longest-ruling family regime in Africa. They represent the Union for the Republic (UNIR) party, which holds 62 of the National Assembly’s 91 seats. When the public began showing signs of unrest earlier this year, UNIR promised to introduce a bill for presidential term limits to the National Assembly. It turned out that this bill would not apply retroactively, and would in fact allow President Gnassingbe to run again in 2020 and 2025. The bill failed, so the country will soon vote on the constitutional amendment in a referendum.

The Opposition

The opposition is made of many different factions, the most powerful being the National Alliance for Change (ANC) led by Jean-Pierre Fabre. Fabre came in second place in the 2015 presidential elections, but he and the ANC have begun to work with the Pan African National Party to defeat Gnassingbe as soon as possible. The politics in Togo are tied in many ways to tribal identities. The Gnassingbes actually come from a relatively small northern tribe called the Kabye, but they have filled the government and military with their tribemates, giving the group an outsized level of influence.

Comparison to The Gambia

Given the increasing levels of civil unrest, citizens of Togo may be seeking help from the Economic Community of West African States (ECOWAS), which was instrumental in ousting Yahya Jammeh of The Gambia. ECOWAS assembled troops at the border of The Gambia when Jammeh seemed he would refuse to give up his office after losing the presidential election. ECOWAS has not responded to the civil unrest in Togo so far. While the situation is not the same as in The Gambia, another complicating factor is that the president of ECOWAS is married to Faure Gnassingbe’s sister.

Source: The Economist, September 23rd

The Civil War in Yemen: An Explainer

For many years, Yemen has been the poorest country in the Arab region and suffered from many armed conflicts. But for the last two and a half years, Yemen has been in the midst of a devastating civil war. In 2014, Houthi rebels from the north overthrew the government with the help of certain sections of the Yemeni army. Other countries joined the fight in 2015 as Saudi Arabia assembled a coalition of Arab countries and the United States. The coalition began fighting the Houthi rebels to restore the former government. The two sides are still fighting, without a decisive victory for either side.

The damage to the country and its people has been severe. Bridges, hospitals and factories have been destroyed. The Saudi coalition has closed the Sana international airport, which has made it difficult for supplies to enter and for people in need of medical assistance to leave. Doctors and civil servants are no longer receiving pay. And in addition to the civilian casualties from the fighting itself, 500,000 people have been infected between June and August 2017, resulting in 2,000 deaths.

Cholera is a bacterial infection spread by water contaminated by feces. The sewage systems have failed, so when heavy rains came in April, many drinking wells were contaminated with waste. The disease is treatable with antibiotics, but many malnourished children in Yemen are left more vulnerable and are dying as a result.

The United Nations has labeled the situation in Yemen the world’s worst humanitarian crisis and requested $2.3 billion to help deal with it. 10 million people are in need of assistance, but only $964 million has been mobilized so far. The UN has also attempted to broker peace talks, all of which have so far failed. As of now, the Houthis are still in control of the capital city Sana. Fighting and the spread of disease continue as well.

Source: The New York Times

The Rohingya in Myanmar: An Explainer

Overview

The current conflict in Myanmar Rakhine’s state involves Rohingya Muslims, who practice a branch of Sunni Islam. Religous tensions developed in the majority Buddhist country in the 1970s, but violence has been on the rise in recent years. Many thousands of Rohingya have fled the country for neighboring countries (Bangladesh, Indonesia, Malaysia, Thailand).

History

The area that is now Rakhine state was governed by Great Britain until Burma became independent in 1948. The nation changed its name to Myanmar in 1989. Muslims arrived in Rakhine state as early as the 1400s, and continued to move there during British occupation.

Rohingya Status in Myanmar

The Rohingya are systematically discriminated against, and their Rakhine state suffers from deep poverty due to neglect from the government. The government has always refused the Rohingya official citizenship, but offers them temporary “white cards”, which allows for some rights. These white cards were revoked in early 2015 by then-President Thein Sein, and the Rohingya were thereby prevented from participating in that year’s election.

The Government’s Response

Aung San Suu Kyi’s National League for Democracy party won elections, but they have done mostly nothing to help the Rohingya people. Recently, Aung San Suu Kyi has at least assembled a committee to make suggestions for resolving the Rohingya’s plight in Myanmar. The committee is led by former UN Secretary General Kofi Annan, and their report is due to be released in August 2017.

The Recent Violence Began in 2012

In 2012, Buddhist nationals began killing Rohingya after a group of Rohingya men were accused of raping a Buddhist woman. The ethnic violence drove 120,000 Muslims into internment camps, which offered hardly any social services.

January 2014 – May 2015

Large numbers of Rohingya began to flee the country, making dangerous ventures overseas. 88,000 Rohingya left Myanmar by boat during this period.

October 2016 – January 2017

An additional 65,000 Rohingya crossed the border into Bangladesh. Violence against them had increased after they were accused of attacking security posts along the Myanmar-Bangladesh border. Many Rohingya homes were burned and aid (food, medicine) was prevented from reaching their villages. The UN Refugee Agency (UNHCR) and the Malaysian Foreign Minister both accused the Myanmar government of ethnic cleansing, which the government denied.

[Source: Council on Foreign Relations]

August 2017

A group of militant Rohingya attacked around 20 police posts and a Myanmar army base. In response, the Myanmar army and Buddhist vigilante groups are attacking Rohingya villages with fire and guns. Thousands more Rohingya are fleeing to Bangladesh to seek refuge, although food, housing, and medicine for refugees there are inadequate.

[Source: The New York Times]

Venezuela: An Explainer

Venezuela is suffering from severe food shortages, high crime rates, civil unrest, and an increasingly authoritarian executive. Many Venezuelans believe that President Nicolas Maduro and Hugo Chavez before him mismanaged the economy, leading to the current crisis. Oil prices have fallen and business corruption from the business elite are also contributing factors (Council on Foreign Relations).

In January 2016, power in the National Assembly shifted towards the opposition for the first time since before the year 2000. President Maduro has been taking steps to consolidate his own power and strip the legislature from a lot of its power. He is also attempting to revise the country’s constitution by forming a constituent assembly of 500 members who would be responsible for its drafting. In October 2016, Venezuela’s Supreme Court put an end to the National Assembly’s power to control the economy. In March 2017, the judicial branch briefly dissolved the National Assembly, but undid this after international outcry. Maduro was successful, however, in preventing his main political opponent from running for office for 15 years.

These autocratic measures from Maduro, along with the economic and social problems civilians are facing, have led to massive protests and international condemnation, including threats of expulsion from the Organization of American States. As of May 2017, 80% of Venezuela’s population wanted Maduro to step down. Frequent protests have turned violent, living 29 people dead since March. The government has taken steps to appease the population without much effect. The minimum wage increased by 60% in May, but inflation is so high that people were still unsatisfied. Despite the protests, any removal of the president would likely come from the military. Maduro has adopted the “chavismo” leadership style from Hugo Chavez, which gives the military a large amount of prestige, power, and responsibility. Until they turn against the president, they will protect him from civilians and maintian his status.

Venezuela’s dependence on oil has made it vulnerable to economic shock following the fall of global oil prices. When prices fell from $111 per barrel in 2014 to $27 in 2016, Venezuela’s weak economy fell into a downward spiral. This led to a 12% drop in GDP and an 800% increase in inflation. Oil accounts for 95% of Venezuela’s export earnings and 25% of its GDP. With such a lack of economic diversification, Venezuela has left itself at the mercy of a single commodity’s performance in the global market.

The current situation in Venezuela stems from the combination of Hugo Chavez’s leadership between 1998 and 2013. Chavez was corrupt and anti-American, but was a successful populist who reduced poverty. He was elected in 1998 on a populist platform. He promised to tackle corruption and use Venezuela’s oil wealth to reduce poverty and inequality. As President, he helped the poor by expropriating millions of acres of land and nationalizing hundreds of private businesses. These policies, in addition to food and housing subsidies, health care reform, and education reform, reduced the poverty rate from 50% in 1998 to 30% in 2012. Chavez secured consolidated his power by manipulating the Supreme Court and eliminating one chamber of Congress and removing term limits through a referendum. Geopolitically, Chavez tried to align the Latin American countries against the United States. In terms of economics, Chavez unwsisely utilized price controls and import subsidies to keep prices low. Soon enough, Venezuela was unable to sustain this system until it fell into freefall when oil prices dropped in 2016. Despite these mistakes, Chavez remained popular until his death in 2013 and was replaced through an election by the strongest “chavismo” candidate Nicolas Maduro. Maduro’s Venezuela ranks 166 out of 176 on Transparency International’s Perceived Corruption Index. His government still controls over 500 companies, though most of them are operating at a loss.

Venezuela’s failing economy is now creating a humanitarian crisis. 85% of basic medicines are unavailable or difficult to obtain. Infant mortality rates spiked from 11.6 per 1,000 in 2011 to 18.1 in 2016. Maternal mortality also doubled since 2008 to reach 130 per 100,000. 30% of school aged children are malnourished, and to make matters worse, Maduro has blocked the opposition-led Ntional Assembly from seeking international assistance. Crime has also been on the rise. 28,749 homicides occurred in 2016, which is the highest level ever recorded. As a result  of these health and crime issues, 150,000 people left the country in 2016 (Council on Foreign Relations).

The Power of a Sewing Machine in Northern Uganda – Part I

Creating Jobs in Oyam District

Between 1986 and 2006, northern Uganda suffered a violent insurgency by Joseph Kony and his Lord’s Resistance Army. In Oyam District where Global Health Network (U) works, most residents were forced to leave their homes and move into displacement camps. The population today has returned to over 300,000 residents but their outcomes in terms of education,  income, health remain very poor. Below are some examples:

Income – The average income per person is 70 cents a day, while the global extreme poverty line stands at $1.90 a day.

Education – 20,000 children from the district enter the first level of primary school, but only about 6,000 children finish primary school. 141 children complete secondary school.

Health – 191 out of every 1,000 children born die before the age of five.

To remind myself a human face within some of those numbers, I think back to meeting a woman named Molly who was 31 years old the first time I visited Uganda in 2013. She already had seven children and was planning for one more. Molly had been diagnosed with typhoid fever and had been prescribed pills that were offered for free at the nearest public hospital. The hospital was too far away for her to reach on foot, however, and she was unable to pay for a $5 repair that was needed to fix her bicycle. She told me she would wait one month until she had saved enough to fix her bike, then travel to the hospital for her free typhoid medication.

This story is exactly why poverty is so wrong. Five dollars was keeping Molly from free, life-saving medicine. So she would wait a month – while suffering from typhoid – to save up those five dollars. I spend a lot of time in rural Ugandan villages and I’ve met a lot of people who seem very happy. Their lives seem simple, but not necessarily bad. In fact, I often think about how aspects of their lifestyle would be an improvement on my own as an American. But then I visit a hospital or hear a story like Molly’s and I’m reminded about the terrible side of poverty. It’s not always visible, but it is unavoidable for just about everyone living below the extreme poverty line, struggling just to survive.

When Che Guevara traveled around Latin America as a young medical student, he met a woman with asthma and a heart condition but without any access to the required treatment for her illnesses. He concluded that failures in access to health care are the most striking and egregious results of poverty. Witnessing these failures is enough to make someone demand a better system that cares for the people who face them. He wrote about his feelings in his memoir The Motorcycle Diaries:

“It is at times like this, when a doctor is conscious of his complete powerlessness, that he longs for […] a change to prevent the injustice of a system in which only a month ago this poor woman was still earning her living as a waitress, wheezing and panting but facing life with dignity. […] It is there, in the final moments, for people whose farthest horizon has always been tomorrow, that one comprehends the profound tragedy circumscribing the life of the proletariat the world over.”

While I was visiting different villages in northern Uganda during my 2013 trip, the topic of potential income-generating activities came up quite a lot. After all, more jobs would go a long way in improving the statistics listed above – they would raise incomes, pay for children to stay in school, and pay for transportation and medicine for those who are sick. Many of the women I met told me that they would like to learn tailoring. There aren’t many jobs available in a rural village without electricity and with a labor force that is largely uneducated and untrained. But a mechanical sewing machine works just fine in a remote village, and you can even make things that people in rich countries might like to buy. So tailoring seemed like a good way to help these women of Oyam District make some money. The next summer, we brought some sewing machines to Adyege parish and taught women there to make canvas tote bags, which they sold to students at the University of California. Today, we’re making even more tote bags and T-shirts for university students. We’re looking for the right market, the right customers, and the right products to match these women with a job that can be sustained and can earn them money for their families.

Generating incomes can have a major impact that extends to the entire community. Furthermore, a full social enterprise can help fund an organization like Global Health Network (U) while providing jobs that supplement the health services the organization already offers. We’re starting off small, but meeting and working with the women who make these items provides more than enough inspiration to keep moving forward.

South Sudan: An Explainer

Overview

There is a civil war going on in South Sudan. The war is being fought between two ethnic groups, which puts it at risk of turning into a genocide. The president of South Sudan, Salva Kiir, is from the Dinka ethnic group, while former Vice President Riek Machar is from the Nuer ethnic group. These two men lead the factions that are fighting each other and thousands of civilians who have gotten in the way. President Kiir rose to power in 2011 after a referendum liberated South Sudan from Sudan to the north. Riek Machar was his vice president until July 2013, when Kiir fired him. Civil war broke out in December 2013 and lasted until a peace agreement signed between Kiir and Machar in August 2015. Violence broke out yet again in July 2016 between the government and opposition forces and has continued since.

A History of the Conflict

The conflict between the northern and southern regions of what used to be Sudan began before the country had even gained independence. Egypt and Britain gave up their joint rule in 1956 and a new government was established in Khartoum. While the north embodied a Muslim/Arabic identity, the south continued to follow traditional beliefs of its 64 ethnic groups. The north ruled according to its Muslim/Arabic identity, and the south fought back in a civil war that lasted from 1955 to 1972. The Addis Ababa Peace Agreement of 1972 awarded Sudan’s southern region some autonomy, but that autonomy expired in 1983. As a result, another civil war broke out and lasted until 2005. This war was fought by a group from the south called Sudan People’s Liberation Movement (SPLM), of which Salva Kiir is now the leader. 1.5 million people were killed in the conflict. The 2005 Comprehensive Peace Agreement brought an end to the civil war and scheduled a referendum vote for secession of the south in 2011. The new nation of South Sudan was created as the outcome of this referendum in July 2011.

Civil War in the New South Sudan

The country’s president, Salva Kiir and vice president, Riek Machar did not get along and fell out in July 2013 when Machar was officially fired. Civil war broke out a few months later in December between Kiir’s Dinka ethnic group and Machar’s Nuer ethnic group. The violence was bad enough for the UN to make a rare decision to authorize peacekeepers to use force in order to protect civilians. The violence also prevented farmers from harvesting crops, which led to the worst food crisis in the world by July 2014. One third of South Sudan’s population (4 million people) were affected, and 50,000 children faced death by starvation.

The Latest Developments – As of December 2016

It seemed the conflict might end in August 2015 when President Kiir and Vice President Machar signed a peace agreement. Machar returned to the country in April 2016 and was once again sworn in as vice president. Unfortunately, violence erupted yet again in July 2016, Machar fled after he claiming that Kiir’s forces attempted to assassinate him, and Kiir replaced Machar with an army general as the new vice president. The fighting has spread into the southern region of the country. Kiir’s government is seemingly mobilizing militias to target civilians from particular ethnic groups there and throughout the country. The United Nations has sent in expert observers who have warned of an impending genocide.

Solutions

Adam Dieng, the UN Special Advisor on Genocide Prevention suggested an arms embargo to the UN Security Council as a measure to keep weapons out of the hands of the fighters. In December 2016, Samantha Powers from the US put forward an arms embargo proposal to the Security Council, but the proposal failed with eight abstentions. Other possible solution are sanctions against South Sudan, a regional protection force in addition to the UN’s 14,000 forces, and a hybrid court to hold those involved accountable for crimes committed.

Casualties

Before South Sudan was even created, all of Sudan had endured Africa’s longest running civil war. Today, things are as bad as ever in the 5-year-old South Sudan. 200,000 people are seeking safety in UN emergency protection camps. 3 million South Sudanese in total have been forced from their homes. 600,000 of these have fled across the southern border to Uganda. It is estimated that 17,000 children are fighting in various militias. The unrest has led to very poor health outcomes, with 10% of children dying before the age of five. Rape has been recorded on a massive scale, with 1,300 cases documented between April and September 2016 in Unity State alone. There have been 50,000 total deaths since 2014.

Side Issue –  UN Peacekeepers’ Failure

When the fighting broke out in July 2016, there was a particularly gruesome attack on Terrain Hotel in Juba. On July 11, government troops entered the hotel and began killing, torturing, and raping victims inside. Victims included western aid workers, UN staff, and other civilians. There was a UN peacekeeping camp less than a mile away, but the UN troops never came to the rescue. The failed response led to the firing of the Kenyan commander of the UN troops after less than six months in charge.

My Action Plan in Trump’s America

On Tuesday morning, I put on a bracelet that my grandmother gave me and a ring my mom gave me, because I wanted them close on the day we were going to put a woman in the White House. Although it was illogical, it just seemed wonderfully romantic that I would have a reminder of two of the strongest women I know on the day the glass ceiling was finally shattered. I haven’t been able to take those two insignificant pieces of jewelry off since.

I’ve been trying to figure out what to say or do or even feel. This wasn’t a normal election; it wasn’t a normal presidential candidate. I watched in shock like half the country, feeling like I couldn’t breath properly, as we somehow created a President-elect Trump.

To say it simply, I am completely heartbroken. To be clear, it is not because my candidate didn’t win, not because the glass ceiling is as strong as ever, not because Republicans now have control of all branches of government, not because the country is utterly divided, but because America embraced a person who opposes every positive thing I believe and feel about our country. I have broken down in tears more times than I can count over the last few days. It feels like an attack on the things we have fought for as a nation and supposedly hold dear, equality, freedom, compassion, basic common decency.

And yet, I fully recognize that this heartbreak is nothing compared to the fear that my friends of color, of the LGBTQ community, Muslims, and all immigrants feel. The fear that survivors of sexual assault and violence feel, the dread that I think all women feel somewhere deep down that if they were ever assaulted or raped that they won’t be believed. If you think any of these fears are dramatic, they are not. A hate-filled America is already rising.

If nothing else, this election has made me come to recognize the true encapsulating bubble in which I live. Not only from being a part of a very liberal generation or living in a state I could not be prouder of, but also from living as a straight white person in a time when I did not truly recognize the extent of my own white privilege until late Tuesday night. I was shocked by the results, shocked that this country was as divided as it is, shocked that it could be as ignorant and as unfazed to a racist, misogynist bigot, as it is today. My own naivety is what probably hurts me the most.

The morning after the election, my sister told me she had never felt more American, never felt so willing to fight for her country, to fight for what she believed. I could not have felt farther from that. I felt utterly defeated. Not only for all the reasons I have already named, but also for my own field, public health, a field that struggles constantly and consistently for equality, equity, and the improvement of lives, believing that small actions can truly change the world. This was a defeat of everything we uphold as basic principles of our work.

I don’t want this statement to be just a complaint or my own personal journal entry of all my feelings. This election made me hopeless and defeated, but I also know I can’t stay in that state for long. So this is my action list, a personal to do list to tell the government that they do not have, as Paul Ryan so joyfully put it on Wednesday, “a mandate” from the American people. I’m starting with the simple things that I can do, and those issues I feel educated enough on to properly and confidently articulate. Mostly, I’m starting with healthcare, simply because I know it, and that is enough of a start for me to act. I may not be fully motivated to take this on yet, but this is my first step and I encourage everyone to make your own list and take the first step too.

  1. Have an honest frank conversation, and try very hard not to yell my head off, at anyone who tries to tell me Trump will not repeal the ACA, or the Affordable Care Act (i.e., Obamacare). BECAUSE HE WILL. A number of news articles have said he has already gone back on his campaign promise and said he may just amend the ACA, which might be true. But this is so misleading it makes me cringe. The two aspects of Obamacare Trump wants to keep are minor, pre-existing conditions and staying on your parent’s plan until you are 26. These are crucial, but they are also bipartisan reforms that were discussed way before Obama was elected. Everything else, he wants to destroy, including taking away insurance from 20 million people who gained it through the marketplace, improvements in coverage of mental health care, and free preventative services.
  1. Educate myself on what he plans to replace Obamacare with. There are a few good explanations from the Wall Street Journal, Vox, and The Atlantic.
  1. Spam the hell out of Republican Representatives and Senators reminding them for the need for healthcare reform and declaring that they should not repeal the ACA until they have a replacement. If they absolutely insist on repealing the ACA, they need to replace it immediately. We cannot afford to leave 20 million people uninsured. I’m starting with the Republican representatives of San Bernardino and Orange Country, traditional red districts in Southern California that both went blue this election, for the first time since the 1930’s in the latter. They do not have a mandate at all and I feel the need to remind them of this. First and foremost, I’m starting with Ed Royce, the Representative of the district in which I grew up, who will soon receive dozens of emails and letters to his Brea office and Washington offices. For those in my hometown, here is his contact info: http://royce.house.gov/contact/getintouch.htm.
  1. Remind everyone that you can still enroll in the ACA’s marketplace. If you enroll now, you are guaranteed insurance through 2017, at least in states with their own marketplace, such as California. And one other thing to remind your representatives of, enrollments have surged since Tuesday night. Insurance = access to healthcare, remind your representatives of that everyday while they attempt to repeal it.
  1. I really can’t believe I have to say this, but declare over and over and over and over and over again that vaccines do not cause autism and smoking does kill, although Donald Trump and Mike Pence don’t seem to think so. I won’t even address this, because I will scream.
  1. Continue to advocate for syringe exchange and keep the federal government accountable to maintain the current funding allowances for harm reduction efforts. Without such efforts, we should prepare for HIV and Hepatitis outbreaks similar to that in Indiana.
  1. Educate myself on methods of birth control. I have a few wonderful yet ridiculous friends who always joke that I am their doctor. I realized this week, that this might be frighteningly accurate if/when Obamacare gets repealed and if Planned Parenthood gets defunded, as health educators will begin to be a very big source of health information for those who no longer have affordable access to physicians. Thus, I believe I have a responsibility to know the best and most accurate health information, especially in regard to women’s health. As many have said, IUDs will last for 5 years and are currently free with health insurance. There are 5 main types, learn about them.
  1. In that same regard, support Planned Parenthood. Women’s sexual and reproductive health under Trump and Pence are beyond terrifying.
  1. Lastly, this is not health related, but it’s simple. Support a free press by actually paying for it. I just subscribed to the New York Times, which cost me less than what I pay each month for Netflix.

This is a starting point and hopefully continually evolving. My actions are limited if they are alone, so make a list too, because it is the only way we can move forward.