Monday, April 24, 2006

Cobb To Leahy


Date: Mon, 24 Apr 2006 12:22:59 +0100 (BST) From: Send an Instant Message "Dr Brian Cobb"
Subject: Copy of Letter to Senator Leahy

I realize that the Senator gets a lot of mail and cannot attend to most personally, but please strongly consider bringing this to his attention. He is the only one in Congress with sufficient interest in Nepal to make a difference at this most critical juncture. Thank you.

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Dear Senator Leahy:

We share an interest in and affection for the people of Nepal, and I know that you have championed their cause. I'm sure you're aware of some of the developments. US policy is misguided at the moment, and I think you will understand why.

The monarchy is moribund from self-inflicted wounds. Hubris, cruelty, greed, exploitation and incompetence have laid it low. The US position, greeting the king's sham offer of appointing a party-nominated puppet prime minister as the Magna Carta, has cost the US dearly. Decades of good will built up by Peace Corps volunteers, visitors and foreign aid are being squandered in a quixotic effort to force upon the people a king they loathe and need like a brain tumor.

I recognize that stability is the key US concern. Fears of anarchy leading to a Maoist coup are reasonable; in my view, an army coup is more likely and would be as bad, maybe worse. But our support of Gyanendra now, if successful, will only push more people into the Maoist fold.

A far smarter strategy is to work with the party leaders so when--not if, but when--the king decamps, a strong and stable transitional government can be put in place. The army and armed police should immediately be placed under UN, EU or retired Gurkha command, and the current officers held for trial.

After that, a constituent assembly or referendum could be held. There is no need to worry about the Maoists doing at the ballot box what they have been unable to do in battle; they're not that popular.

As one who has seen the immense brutality of the Nepali government, and as someone with great familiarity with Nepal, I assure you that the wisest course is to do, for a change, what we always claim we are doing and support democracy and human rights. Doing the right thing is the right thing to do.

It's time to help the Nepalese people find a safe passage to peace, democracy and human rights by throwing off a criminal, brutal, unconstitutional, incompetent and hated government.

On behalf of my many friends in Nepal, I implore you to use your good offices to help the people achieve their aspirations.

Brian Cobb, M.D.

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Date: Tue, 25 Apr 2006 03:07:15 +0100 (BST)
From: "Dr Brian Cobb"
Subject: Re: [DFN Blog] 18 Days Of April Revolution: Victory
To: DFN-Blog-owner@googlegroups.com

Dear Paramendra,

Good commentary. I have clarified the constitutional question I had; article 116 is unclear in English. But it appears that a CA can be called without royal consent.

I see we are in agreement about demilitarization. I have been beating that drum since 2002 and thought no one else thought that way. I am attaching an essay I wrote a while back.

I think you and I should collaborate on promoting demilitarization and formation of a national service corps.

Loktantra jindabad!

Brian

Paramendra Kumar Bhagat wrote:

http://demrepubnepal.blogspot.com/2006/04/18-days-of-april-revolution-victory.html

Constituent Assembly: 300 Seats Of Roughly Equal Population 1


The Moral Equivalent of War

By Prof. Dr. Brian Cobb

The brilliant and insightful physician, psychologist and philosopher Dr William James, a veteran of the US Civil War, gave a speech at Stanford University in 1906 in which he proposed a military-style national service corps that would be, as his title says, “The Moral Equivalent of War.” He understood that humans, especially young men, are drawn to aggression, conflict and displays of courage, making them prone to war; Nepal has certainly seen much evidence for his thesis. As many ex-soldiers do, Dr James later became a pacifist. Having seen war’s horrors firsthand, he realized its futility, suffering and insanity. At the same time, he admired the discipline and purpose of the military.

Dr James’s proposal makes sense. Those who would, under conventional circumstances, serve in the armed forces could direct the same energies against the problems of their nation. He calls for building infrastructure and contributing to production capacity by the corps, which would be organized along military lines. In economic terms, the money spent on maintaining an army would be investment, not consumption. Funds otherwise spent on guns and bullets could instead by spent for things that improve the lives of the citizenry.

If the Royal Nepal Army were placed under UN command to voluntarily disarm the Maoists, ensure the integrity of all-party (including the CPN-Maoist) parliamentary elections, then disarm itself to become, integrated with the Maoist Army, a national service corps, the energies of 150,000 or more people could be harnessed to build roads, extend the electrical grid, construct and teach in schools, staff healthcare facilities, and otherwise contribute to the reconciliation and development the nation so badly needs. There would be no danger of military dictatorship, army atrocities or coups d’etat.

Of course this means abandoning the fiction that the RNA could defeat India or China if they attacked, but it’s not a delusion to which reasonable people would cling. By placing security under the police, there will be judiciary and ministerial accountability.

Few people in Nepal want an absolute monarchy or a Panchayat-style government; more and more are calling for a republic. However, the monarchy can be reinvented for the 21st century, avoiding both the uselessness of a purely ceremonial royalty and the autocracy of a politically dominant one. The Shah dynasty could become a force for good, leading a noble effort to develop the nation and serve the citizens. His Majesty could create a secure and respected niche by supervising a corruption-free, efficient, human force to fight poverty, illiteracy and disease. He could become, in James McGregor Burns’s terms, a transformational leader rather than a transactional one.

A parliament elected under the 1990 constitution could amend it or negotiate a constituent assembly. Insisting on a constituent assembly as a precondition for peace seems likely to fail, as the King would almost certainly reject it and, in any case, it would take much longer to establish democratic governance than having elections and seating a parliament first. Even if royal opposition precludes an eventual constituent assembly, a representative government under the present constitution is surely preferable to another decade or more of war and misery.

The American proposal to reunify monarchy and parties without Maoist participation can offer only continued bloodshed and preclude elections. No one thinks the continued prosecution of the war will result in defeat of the Maoists, so it makes no sense to delay reunification of all three factions if satisfactory terms can be agreed to. As things stand the war is more a reflection of intransigence over strategies than of stated principles and goals. All factions would gain by cooperating, compromising and doing what is best for Nepal.

How many more families will have to grieve, how many more people will have to be maimed, how many more displaced and denied education and medical care before sanity and decency prevail? Immoral war must yield to the moral equivalent of war and the energies of the Kingdom be directed toward creating a just, lawful, progressive, educated and prosperous land.

Henry David Thoreau observed, “For every thousand men hacking away at the branches of evil, there is one hacking at the roots.” We must recognize that the roots of this war are injustice, caste discrimination, exploitation, corruption, poverty, lack of opportunity and frustration. It is time to direct the country’s energies to the roots.



The Moral Equivalent of War

By Prof. Dr. Brian Cobb

The brilliant and insightful physician, psychologist and philosopher Dr William James, a veteran of the US Civil War, gave a speech at Stanford University in 1906 in which he proposed a military-style national service corps that would be, as his title says, “The Moral Equivalent of War.” He understood that humans, especially young men, are drawn to aggression, conflict and displays of courage, making them prone to war; Nepal has certainly seen much evidence for his thesis. As many ex-soldiers do, Dr James later became a pacifist. Having seen war’s horrors firsthand, he realized its futility, suffering and insanity. At the same time, he admired the discipline and purpose of the military.

Dr James’s proposal makes sense. Those who would, under conventional circumstances, serve in the armed forces could direct the same energies against the problems of their nation. He calls for building infrastructure and contributing to production capacity by the corps, which would be organized along military lines. In economic terms, the money spent on maintaining an army would be investment, not consumption. Funds otherwise spent on guns and bullets could instead by spent for things that improve the lives of the citizenry.

If the Royal Nepal Army were placed under UN command to voluntarily disarm the Maoists, ensure the integrity of all-party (including the CPN-Maoist) parliamentary elections, then disarm itself to become, integrated with the Maoist Army, a national service corps, the energies of 150,000 or more people could be harnessed to build roads, extend the electrical grid, construct and teach in schools, staff healthcare facilities, and otherwise contribute to the reconciliation and development the nation so badly needs. There would be no danger of military dictatorship, army atrocities or coups d’etat.

Of course this means abandoning the fiction that the RNA could defeat India or China if they attacked, but it’s not a delusion to which reasonable people would cling. By placing security under the police, there will be judiciary and ministerial accountability.

Skeptics should recall that prior to Gyanendra’s ascension to the throne, Nepal was effectively demilitarized. The army was small, poorly trained, weak and ill-equipped. It had not even one aircraft and its rifles were World War I vintage. Its role was only to guard the King and to put on dog and pony shows on state occasions.

Henry David Thoreau observed, “For every thousand men hacking away at the branches of evil, there is one hacking at the roots.” We must recognize that the roots of this war are injustice, caste discrimination, exploitation, corruption, poverty, lack of opportunity and frustration. Now that democracy has been restored it is time to direct the country’s energies to the roots and, a century on, Dr James's proposal seems the best way to do it.



Namaste everyone.
Several organizations have asked for a formal proposal for my planned program. Here is the preliminary version. Let's hope it is accepted by someone and we can continue our good work.
Brian, April 26
Proposed Nepal Institute of Emergency and Critical Care Medicine
Dr Brian Cobb
There has been a lot of progress in health care in Nepal in the past decade or two, but emergency care has lagged behind. As in the rest of south Asia, there are no trained emergency physicians, no modern emergency/trauma units, no trained emergency nurse specialists or emergency medical technicians, no life support ambulances. My Blue Cross team arose to fill a void by providing advanced level care in the field. I had trained 14 volunteers in the Basic Trauma Life Support program of the American College of Surgeons. Despite my warnings from the beginning, most proved unsuited as our work became more dangerous. Within one week I was down to two. Unfortunately we were shut down by Kamal Thapa’s machinations, but our mission remains.
My idea centers on establishing a non-profit Institute of Emergency and Critical Care Medicine. It would contract to operate the Emergency Department (ED) of an existing hospital, preferably a teaching facility, staff it and carry on research and training programs.
The care component can be divided into prehospital services using ambulances staffed with emergency medical technicians or nurses and equipped with life-saving equipment and drugs, and a modern emergency department configured to deliver immediate, skilled, state of the art care for all types of emergencies, including trauma.
The educational component can be divided into 4 programs:
  1. A four-year MD in Emergency Medicine to prepare skilled, knowledgeable emergency physicians. In the US EM is the most sought after training, accepting only students in the top 5% of the medical school class, and is the most cognitively demanding and diverse.
  2. A four-year BScN in Emergency Nursing to train male and female nurse specialists.
  3. An Emergency Medical Technician-Paramedic program of two years’ duration to train personnel for ambulance and ED duties. This includes advanced trauma, pediatric and cardiac life support skills.
  4. A series of 3 to 5 day courses for practicing doctors and nurses, as well as medical students, in various aspects of emergency care such as Advanced Cardiac Life Support, Advanced Pediatric Life Support, Basic and Advanced Trauma Life Support, Integrated Management of Pregnancy And Childbirth, toxicology and others.
Another option would be to create a free-standing institute which could then transfer stable patients to other hospitals of the patient’s choice. It would have ED, OT and ICU capabilities only. I was half-jokingly thinking that a small portion of the palace, which is centrally located, could be put to that use!
In the US we have to earn a BSc before entering medical school, and during that time I worked as a firefighter-paramedic while studying. I sat on the EMS advisory council from the age of 18 and helped design the EMS system in place today. I have spent my entire adult life working in emergency medicine. Accordingly, I have the breadth of experience and skills to create a program that will fill a void in Nepal’s health care system and contribute to the health and safety of the wonderful people of Nepal.
I would like to find a partner institution to develop this innovative effort.

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