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Transcripts

November 9, 2004

Host: Michael Grant
Topics:
· Flu facts;
· Iraq update;
· Stewart Udall
In-Studio Guests:
· Christine Mahon and Julie Frasco, Administrator, Community Health Nursing division, Maricopa Department of Public Health;
Noah Feldman, author of "Would We Owe Iraq;"

> Michael Grant:
Tonight on "Horizon," the flu season is upon us. But the vaccine is in short supply. What you should know about the flu. Fighting intensifies in Iraq. A talk with one of the architects of the Iraqi interim Constitution and a look at the political career of Stewart Udall. Those stories in a moment. Good evening. I'm Michael grant.

> Michael Grant:
As of last week Maricopa and Pima Counties reported flu activity according to the Arizona Department of Health and Services. Only one case is confirmed in Maricopa County as most of you know a flu vaccine shortage exists because of possible contamination of a vaccine plant in England. As a result of that the U.S. lost half its supply prompting health officials asking only those at highest risk of the disease receive the available flu vaccine. With us to talk about status of the flu is the administrator for the community health nursing division for the Maricopa Department of Public Health Christine Mahon and Julie Frasco. Good to see you. One case in Maricopa County and this is not our traditional flu season, right.

Christine Mahon:
Right. for Arizona, the flu season usually intensifies in the end of December, January and February.

Michael Grant:
Has it sort of shown up in other parts of the country?

Christine Mahon:
Actually flu cases reported in 26 states considered sporadic activity. It is hopefully going to be a light season and we don't know that until we are in it further.

Michael Grant:
What about the vaccine? Who should get it?

Christine Mahon:
Well, vaccine this year in particular is targeted at the most high risk and those are people who, if they get the flu would have the most serious complications. So the flu vaccine, effort of it is to prevent complications of the flu, not necessarily guaranteeing you won't get the flu. This year it is people over age 65, people 2 to 64 with a chronic underlying condition such as diabetes, asthma or other heart disease, problems like that, and children age 6 to 23 months also should get a flu shot.

Michael Grant:
We have heard about the mist recently. Its supply is not abbreviated, the same way as the shot, right? It's available.

Christine Mahon:
It is available. However, the quantity of it is less than the vaccine. The flu-mist, I believe it was 2 million doses produced. It is for another specific group, in that 5 to 49 in good health because it is a live vaccine. So that is the only group that could have that. That is a vaccine we are encouraging health care workers who are also considered high risk simply because they have the potential to spread it to those most vulnerable as well if they became ill they reduce the ability to care for people with many other problems in hospitals.

Michael Grant:
Pediatric flu vaccine available. which children are eligible? I think we have some addresses we can run here on the screen as you describe that for us.

Christine Mahon:
Yes, we do. The vaccines for children's program is a federal program that provides vaccines for children who either are uninsured or underinsured or Medicaid-eligible. In Arizona that's AHCCCS eligible. That's the bulk of the vaccine the department always has for routine childhood vaccinations. We have had our first shipment of that vaccine and we have just over 6,000 doses. We expect another shipment of an equal amount in a couple of weeks or next week, maybe. And we are not turning anyone away, however. We are encouraging people with insurance to check with their physician as they may have the vaccine as well. The reason this vaccine is not part of that supply that was reduced because of chiron is because it is in a smaller dose in .25 cc half the adult dose and comes in pre-filled syringes is and can only be used for this population.

Michael Grant:
Julie, I know the department is doing outreach programs. What kind of programs, gets the word out and that?

Julie Frasco:
Exactly, Michael. This is a really good opportunity for us before the flu season starts in Maricopa County to reach out to the public and stress there are lots of thing they can do to prevent the flu or if they get the flu to take care of themselves and neighbors. One thing the health department has been doing is working with school districts and different hospital providers, vaccine providers and Bashas' corporation and library district and getting out a cooperate and I have consistent message that explains to people what is the flu, if the vaccine is available, who needs to go get it. If you get the flu what you should do to take care of yourself and stressing prevention messages. If you are not feeling well, stay home, keep your children home. Cough into your elbow and throw away disposable tissues when you use them and wash your hands.

Michael Grant:
In fact, somebody commented from what your mom told you when you were growing up which covered a lot of those basic messages, I mean it is impractical -- It is practical advice and we forget because we are fixated on vaccines and shots and those thing.

Julie Frasco:
We do. We forget it is basic preventive health practices that will protect us from any kind of disease which your mom told you about, washing your hands and taking good care of yourself. regardless of vaccine available or not. What we want people to remember is vaccine is a success in this century and last century. Ultimately, the best measures to protect ourselves is taking good care of ourselves and practicing good health.

Michael Grant:
What are symptoms of the flu.

Christine Mahon:
People mix up flu and cold and label everything the flu. Really delineating symptom is fever. You usually do not have a fever with a common cold. You also have a cough with the flu and you have generalized muscle aches and pains and usually feel pretty miserable.

Michael Grant:
Is it primarily respiratory?

Christine Mahon:
Yes, it is. It is a respiratory infection and transmitted that way when you cough or sneeze and comes out into the environment and gets on surfaces. That's why hand washing is so important. It is a respiratory infection transmitted by sneezing, coughing and spreading that virus from me to you if I had the infection.

Michael Grant:
Let's say I think I have it. You know, what do I do? Are home remedies a good idea? Do I not pass go? Not collect $200 and go directly to my doc? What's the best early response methodology?

Christine Mahon:
Those are all good questions and it depends on what your risk factors are. If you are in a high risk group and unable to get a flu shot this year and suspect you have early symptoms of flu such as I describe including the fever and the aches and you believe you have been exposed to someone with the flu, it is a good idea to call your doctor because there are anti-viral medications available and must be prescribed in the first few days of the onset of symptoms. They will again reduce the morbidity or real serious side effects from flu if you can get them early.

Michael Grant:
How dangerous is it?

Christine Mahon:
The flu?

Michael Grant:
Yeah.

Christine Mahon:
It sort of depends on what your risk factors are. For instance, if you are a very fragile with many medical problems, the flu may put you at risk for pneumonia and pneumonia is what really will cause the most damage and put you at greatest risk of dying from the flu. It depends on your own underlying medical conditions. Most healthy people, you feel sick a week or so, fight it back and back to your normal life, similar to the cases with the young child where they are fine and back to normal. That's what happens with most of us.

Michael Grant:
I know some outreach programs are trying to target specific at-risk groups, get the message obviously to kids and others who are at risk, correct?

Julie Frasco:
Yes. That's true. One of the programs we were thinking we would like to make sure the public is aware of, the county health department is working to purchase actually mascots that will be able to travel to all the schools throughout the valley and teach kids about good hand washing practices and teach children about what is the flu. It will be a flu-bug character and available up on our county web site and going to be a comic character we hope to use in the years to come and basically bring awareness of what is the difference between the cold and flu and when is it important to stay home and take good care of yourself or seek a doctor.

Michael Grant:
Here is the most important question of them all. have you memorized the address for the county's web site?

Julie Frasco:
Yes, I have.www.maricopa.gov/flu.

Michael Grant:
I hate to do this to you again. People are now scrambling for a pen. Give it to me one more time.

Julie Frasco:
www.maricopa.gov/flu.

Michael Grant:
That takes you to a variety of information. Julie Frasco, thank you for joining us, and Christine Mahon, thank you. We will keep our fingers crossed.

Michael Grant:
American forces are battling through the rebel-held city of Fallujah and violence may complicate the administration's intentions to hold elections in Iraq. A leading expert on Islam, author of the book "Would We Owe Iraq" recently at ASU to give a lecture for the study of religion and conflict. Noah Feldman was advisor to the Iraqis creating the interim constitution of that country. Larry Lemmons caught up with Feldman at the Biltmore.

Larry Lemmons:
In the introduction to your book "What We Owe Iraq" you mentioned on the plane and your colleagues were reading. The reading materials were about the occupation of Japan and Germany. Do you think policymakers haven't really researched or understood enough about Islam?

Noah Feldman:
That's definitely been true. We did not have enough people who spoke Arabic on the ground in Iraq and still don't have enough people who studied Arabic or studied Islam in a serious way and that needs to change. Unfortunately, that can't change overnight. It takes years to bone up on a new language and think of the world from a different religious perspective and that's a high priority for us nationwide and it's affected our judgment frequently. We hear Islam and think to ourselves that must mean radicalism and it does not. In Iraq, the loudest voices for democracy has been those of the Shiite religious leaders like Ayatollah Sistani, democratic and Islamic and we believe that can work together.

Larry Lemmons:
You were an Iraqi constitutional advisor and when Americans think of a constitution they usually think of our own liberal secular sort of constitution. Do you think the Iraqi constitution will have the same values as Iraq?

Noah Feldman:
Iraqi constitution when it comes about, all we have is an interim constitution will probably look pretty different from ours. It will have, for example, Islam the official religion of the state for sure where our constitution prohibits the establishment of one religion or religion in general and it will almost certainly provide a role of Islam in law saying something like Islam is a source of law. Again, our country doesn't not have that and the Iraqi constitution almost certainly as the interim constitution has, strong guarantees equality for men and women. Actually nothing in our constitution saying that but a constitutional norm and guarantees of religious liberties like our constitution does. It will have guarantees for the states to treat people fairly when arrested and subject to trials instead of arbitrary arrests and those basic rights protections that we enjoy will be in there and the hard part is enforcing them to practice. We Americans are justly proud of our constitution not just for being good in writing but being pretty good in practice and lots of countries have beautifully written constitutions never applied. It takes time and a government to believe in the constitution and takes people outside of the government to call the government to a town if it fails to follow what the constitution says it should do.

Larry Lemmons:
Elections are due to be held in January. What do you see as the real possibility about a constitution being forged and accepted by the Iraqi people.

Noah Feldman:
I think that for elections in January to work, it needs to be safe enough and enough of a country for all the different factions in the country to participate, that means not just the Shiite and Kurds who have been more likely not all of them more likely aligned with the transitional government with the U.S. but the Sudanese who live in the famous Sunni triangle who have been excluded for the most part from politics and many whom are sympathetic to violence and insurgency. We have elections there, too, even if people are hostile to us. What we need to have happen is a negotiation between all the Iraqis over the constitutional deal. If you leave out one party for negotiations, then the negotiations won't put an end to the violence.

Larry Lemmons:
You mentioned to some degree the tensions between the Sunnis and Shiites. Also what can you say about the Kurdish people. How do they fit into that?

Noah Feldman:
Kurds in Iraq most of them live in the northern part of the country. Since the first gulf war, most were accustomed to running their own affairs and had their own semi country autonomous region north of the no-fly zone. They don't want to give that up. They want to join the Iraqi states in some kind of federal union with a lot of states rights and want the ability to make their own decisions for ordinary lives and some would like more power than that. Some would like all-out dependence which leaders are wary of and ordinary people like and some want the power they have had enabling them to be protected. The negotiation will have to take place will have to take into account those interests. In the end, the leadership is prepared to stay inside the country and not declare independence. It will be tricky and especially tricky. oil in Iraq is in and around the flash point City of Kirkut which straddles the Kurdish area and central Sunni area and no one will give up the oil without a fight. We need the country to stay together to avoid a fight and over the oil in Kirkut.

Larry Lemmons:
Could there be problems with Turkey if that occurs?

Noah Feldman:
Turkey is nervous about the possibility of independent Kurdistan. Turkey have a Kurdish minority and if Kurds can have their own country why can't the Kurdish Iraq have their own country and carve out a section. One of the things Kurdish people have been trying to do in Iraq is convince Turks they will not happen and Turks are worried about it and that's another reason to be concerned about possible independence in the region.

Larry Lemmons:
You mentioned about having an ethical rather than an imperialistic approach to nation building. What is idealistic and you mentioned how you felt about Iraq before you arrived and were on the ground.

Noah Feldman:
I think we have to behave ethically because we conquered a country with 27 million people in it and they didn't ask us to invade. We are responsible to a good extent to avoid the country falling into a civil war and Somalia-like situation where it could be worse even with what they lived under with Saddam. Sometimes you have to put their interest, Iraqis interest ahead of our own narrow interests. That's the idealistic part of it. It is hard to put someone else's interest first. The realistic part is we and the Iraqis really need to see an Iraq that's functioning, reasonably stable, reasonably legitimate democracy because there's no other option for Iraq. It is too late to set up a new dictator. Maybe you could have done that if you got rid of Saddam. We abolished the army. We need to set up something to have Iraqis share power. The realistic part is we in the United States can't afford a civil war and chaos with 10% of oil reserves within a day's drive of another 30% of the world's oil reserves and that's something I saw on the ground with Iraq. We have not executed the way we ought to have. We have not provided security on the ground for Iraqis the way we should have. They are not feeling safe and secure. That's not a myth, that's the truth. Unless we can provide a secure environment they can't negotiate their way to a stable solution.

First people need order. Then they can work toward law.

Larry Lemmons:
What are the challenges ahead for Iraq? What can we expect in the upcoming months?

Noah Feldman:
The first and important challenge is establish security on the ground. We have been trying to do that by ramping up Iraqi security forces alongside U.S. forces and in the long run that may not be enough. We may need more U.S. forces to achieve this security and that's a painful truth and one we basically have to acknowledge. There can't be elections unless people are secure in knowing they will not be shot or blown up on the way to elections. next is hold elections, something we can get security and hold elections which is a practical problem. A lot of Iraqis and a lot of people who want to vote and don't have voter roles and counting the ballots which is never easy as we know from our own experiences will continue to be a problem for them, too. It can be done and will require more resources. The third and we hope final step in the elections is for us to keep the peace while Iraqis negotiate a new constitution. That will build on the interim constitution, I hope. I hope it will take good elements and involve revisiting of the concern and issues that the Iraqis themselves care about and are important to them. In the end, it is the Iraqi's constitution. Their country. They have to be the ones who live with it in the long run and they have to be the ones to make the decision.

Larry Lemmons:
Thank you for talking to us, Noah.

Noah Feldman:
My pleasure.

Michael Grant:
Re-election of President Bush whose father was president and grandfather was a senator reminds us of the political tradition which drives some families in Arizona the name Udall embodies the families frequently devoted to the call of public service. Here is a look back at the career of the brother of Mo, father of Tom and the uncle of Mark. Stewart Udall.

Stewart Udall:
My name is Stewart Lee Udall. They loathe the oldest boy up with the family name. I was born in 1920 in St. John's, Arizona which was a wonderful, small town. My grandfather Udall was sent to be the bishop from Kanab, Utah down to St. John's, and that was 1880. This little town about 800 Mormons and 600 Spanish from Santa Fe Catholics, I have to believe this small town environment produced challenges and gave you opportunities so that you knew what society was all about and you knew how to lead people. I met my wife at the University of Arizona. And we had a courtship for about a year, and we got married. We immediately had six children just like my parents. I ran for congress at the age of 34. In 1954, I was kind of what you call a new deal liberal. That's what we called ourselves then. Because we thought because we had seen that government could do good things for communities and for people and the new deal did that. Arizona only had two congressmen. I had the whole state except Maricopa County, and I won. And I was elected four times. And the senators during my time in congress were Carl Hayden and Barry Goldwater. So there was just four of us. We had to work closely together. So we had a lot of things in common. And we let our friendship be more important than political differences. You don't see that much anymore. of course the big issue was there all during my time in government was civil rights. conservation and resources, environment became a big issue. As a westerner, resource development, building dams, having more national parks, having wildlife refugees and systems. They are all important and I said many times that the Colorado Plateau up from the Grand Canyon up in Southern Utah and Northern Arizona, Monument Valley and so on is the most scenic area in the world. That's a big statement to make. But I believe it.

Udall helped John Kennedy win his presidential campaign in 1960.

Stewart Udall:
I didn't campaign to be secretary of interior. After the election, I didn't lift a finger. I was in Tucson. And I think Bobby Kennedy called and said can I come to Washington and the president wanted to announce me as secretary of interior. That was the very same week that Robert Frost came through Tucson and I had become his friend and best friend in Washington and I had the idea of Kennedy inviting Frost to be on the inaugural program and I proposed it to him and he thought it was a good idea and did it. There was a lot of excitement and satisfaction after that election. There was a feeling of a new start, real new start. So it was an exciting time for me. To be the first Arizonan in the president's cabinet. This was a period of expansion of the park system, getting started on wilderness protection, doing more to preserve wildlife. The country was just ready for it. I wrote things. I gave speeches. And I think that preaching and writing that I did may have been important in terms of educating the country about this new era we were moving into where clean air and clean water and protecting the environment were crucial aspects of the United States policy. It was a wonderful period, I think, for the country. It was a wonderful time to be secretary of interior. I have two histories. One is Arizona, and one is national. I am afraid in the last 20 years or so, cynicism has developed that diminished respect for public service. It saddens me to see it because I think the future of the country always rests in having elected leaders, local, state, national who do want to improve the country and improve opportunities for all of the people. And I think that will always be important. It is an integral part of our kind of democracy. You judge your life at the end not just by whether you have accumulated wealth, whether you have a record of service to a community in one way or another, but you have to judge yourself by your children. I just want to be seen as a person who did a few good things. That's what I will... I'll settle for that.

Merry Lucero:
For the first time ever, the Arizona Department of Education released profiles of 448 of its small and alternative school including charter schools. The findings 71 small schools rank underperforming of the 71, 59 are charter schools. Find out how they ranked Wednesday on "Horizon."

Michael Grant:
Thursday "Horizon" will present a special Veteran's Day program. Friday please join us for the journalists round table. Thank you for being with us on this Tuesday evening. I'm Michael Grant. Thank you. Have a good night.

Larry Lemmons:
The Stewart Udall segment was made possible by the Arizona Humanities Council.

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