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Show o Swili CeetM Uo!i - ' . i Supplement To: Gunnison Valley News - The Salina Sun Garfield County News - The Richfield Reaper VOLUME NUMBER 24 2 THURSDAY, JUNE 11, 1981 Rural Health Has Common Needs in Southern Utah By Nancy Bales Spotlight Writer Rural health care, "when more people are hit by cows than cars, was the definition provided by a local physicians assistant for visiting Washington, D.C. Health care experts. legislative policymakers had flown into Panguitch to spend the day assessing how their high level planning impacts the local level. The 25 Prior to landing in Panguitch the group was given a comprehensive aerial view as their plane flew over the vast and rugged Garfield County area. Viewing from the air its tiny communities, the expanse of its unusual terrain, and the few roads serving its remote areas, the group was better able to visualize some of the difficulties encountered in delivering quality health care to its residents. Lab technician Matthew Walker conducts tour of Rural Health Day visitors through clinical lab facilities at Gar- -' Before getting into the serious business of the day the sophisticated guests from all parts of the United States and England, were treated to another side of rural America. A traditional outdoor Dutch-ove- n meal, prepared by hospital employees and volunteers, surprised and delighted, overand, in their own words, whelmed the group, most of whom were city dwellers. field Memorial Hospital familiarizing them with modern updated equipment. Child Abuse: Ugly, Common Members of the visiting entourage included three staff members of the I : And an Increasing Problem By Thomas A. liability. Of the approximately 7,000 referrals in Utah in 1980, sixty percent were valid. Of those, about 90 percent involved neglect; the rest were cases of Halversen, M.D. Primary Childrens Medical Center Before the early 1960s, child abuse was not recognized as a significant factor in the deaths or physical and emotional disabilities of children. Since then because of increased awareness and less prevalent attitude that child abuse children are possessions is recognized as a common occurance that crosses all social, racial, religious, economic, and familial boundaries. ' It has been estimated that ten percent of the people in this country have seen or been involved in child abuse. There were one million documented cases in the United States in 1980, and experts believe that is only the tip of the iceberg. Abuse is not always easy to recognize, and perpetrators are certainly not quick to face the fact they have caused serious physical or emotional damage to children. Many people continue to believe it is their right to physically punish children as the sole means of establishing discipline. They regard any outside interference as a violation of that right and an unconstitutional intrustion into their privacy. But more and more states are adopting the policy of in- stituting mechanisms designed to protect the best interests of the child while documenting and defining abuse. ' Child abuse laws vary substantially from state to state, but the intention of Utahs 1978 Reporting of Child Abuse and Neglect Act is to protect the best interest of children, offer protective services to prevent harm to the children, stabilize the home environment, preserve family life whever possible, and encourage cooperation among the states in dealing with the The Act problem of child abuse. defines child abuse or neglect as damage or threatening damage to the physical or emotional health and welfare of a child through neglect or physical abuse. The invalid referrals were quickly expunged from the record. abuse happens in all races, all income levels, all social classes, all religions, and all types of marital relationships. There was no pattern based on those criteria. Profiles of abusive parents, (Continued on Page 8) sponsoring organization National Health Policy Forum (NHPF) and selected national and international health specialists. Garfield Memorial Hospital and Clinics had been chosen as the western showcase for rural health care because of its unique advances in innovative rural health programs already implemented. The National Health Policy Forum (NHPF) is a private, non-partis- organization located in Washington, D.C. which conducts educational programs for health specialists in Congress, the White House, the Department of Health and Human Services (DHHS) and other executive agencies. record discussions, a format which atpromotes the open, mosphere which has proven so valuable to participants. free-wheeli- inThe group, some twenty-fiv- e dividuals who deal directly with writing legislation concerning rural health care delivery, had flown from Washington D.C. into Salt Lake City this particular day to make what they term an on site visit, to cover some of the issues of rural health care. NHPF is recognized as a unique forum where influential policy makers can meet and discuss relevant health issues with national and international experts in a relaxed, unofficial and selective setting. The Forum also conducts site visits, such as the visit to Garfield Memorial Hospital, annually to study interesting or innovative health programs in other regions of the country. The Dutch-ovelunch, which began the days activities elicited from the widely traveled experts as much praise and expressions of amazement as the introduction which followed to the countys unique health care system. The Forum is not a lobby group and its success is based upon its ability to retain its objectivity and neutrality. Because of the Forums reputation for and issues fairly presenting thoroughly, NHPF meetings consistently attract the top echelon of and speakers Washington policymakers from all points along the political spectrum. Hospital employees and volunteers who are used to serving in many capacities because of limited hospital staff, took it in their stride to prepare southern Utahs traditional bit d mutton fry. For most of the guests this was the first such Dutch-ove- n meal ever tasted and to watch it being prepared was an even greater treat. n NHPF began in 1971 with a six monthly planning grant from the Carnegie Corporation. It has been funded since then by several foundations and private industry. The Forum was created in recognition of the need for health policy specialists from various parts of the federal government to meet each other on a continuing, - informal, basis in order to overcome problems of jurisdiction, partisanship and physical distance between agencies. NHPF plays a valuable role by fostering the cooperation and understanding essential to informed policymaking. A special advantage of the Forum is that speakers and pariticpants feel free to talk candidly. The NHPF conducts small, off-th- e- There are four categories of abuse. includes fracThe first physical tures, scrapes, bruises, internal injuries, and some burns. It has been d of to one-haestimated that all fractures in children under two years are the result of physical abuse. Fractures caused by abuse are different than fractures caused by accident, and the differences are usually obvious to radiologists. The same is true of scrapes, bruises, internal injuries, and some burns. Physical abuse is usually easy to identify, and intervention by the state and the courts is often indicated. one-thir- They were fascinated with lab technician Ron Hatchs expertise in this traditional form of outdoor cookery rooted so deep in Garfields history. Hosts Jim and Sybil Taylor had put forth an unusual effort to see that everything was in special order for the occasion where an additional 25 guests representing county government, and Pangutich City government southern Utah medical facilities. Hospital administrator Robert Kruse introduced the head of the visiting entourage, Marion Ein, a director of the NHPF, who explained the purpose of their visit and the reason for selecting Garfield Memorial Hospital. Panguitch Mayor Wallace G. Lee welcomed the visitors and expressed his satisfaction with the hospital and its continually expanding services. Garfield County School Supt. Henry Jolley, a member of the hospital board of directors expressed his pride to be a part of rural America. He told the guests that their policymaking was essential to the maintenance of the high quality of health care the county had enjoyed. lf Following Jolleys remarks, the large group was divided into three smaller ones and transported to the Hopsital and clinic for a closer look. Conducting the three groups on their guided tour were hospital administrator Robert Kruse, director of nursing Susan Kirby technician Ron and lab and Hatch. The second category is sexual abuse and exploitation, laws that apply in those cases presume that no child under the age of 14 is capable of giving consent, and that sexual abuse cases involve friends of the family. Children should be taught that they have control over their bodies and that they do not have to permit intimate contact. Intervention by the state and the courts is a common resource when sexual abuse and exploitation can be documented. third category is emotional abuse, which is less straightforward. It refers to treating children in a demeaning and belittling fashion that does not promote healthy and development. Such cases are difficult to judge, but are nevertheless of legitimate concern. The state and the courts will usually not attempt to intervene, relying instead on private agencies that can provide psycological counseling. bar-b-que- This must be the creme de la creme of rural hospitals commented one of the visiting policymakers and also reflected the opinions of most in the three groups. Among the many postiive features pointed out by tour members were the overall superior layout of both the hospital and clinic as well as its unusual decor. They were especially impressed with clinical laboratory equipment and generally surprised to find equipment throughout The Physicians Assistant at Garfield Memorial Hospital Bob McCullough, addressed policymakers during panel discussion using huge map of Garfield County to emphasize the problems encountered in such a vast area. the hospital so self-estee- m Bruises Heal With Tobacco Help Tobacco may be hazardous to your health if smoked but not if applied to bruises, according to a Brigham Young The fourth category is neglect and Unviersity researcher. abandonment, situations that are fairly Dr. Rulon S. Francis, a professor of obvious. In caes where children have physical therapy in the BYU Human clearly been abandoned or physically Performance Research Center, said nonabuse and includes causing neglected, the courts will usually not studies he has conducted on rats show accidental physical or mental injury, hesitate to get involved. Emotional that bruises treated with tobacco heal sexual abuse, sexual exploitation, or neglect, however, is difficult to sub- 20 faster than untreated percent or treatment repeated negligent stantiate; for that reason, the courts bruises. maltreatment. to in. move hesitate Physical neglect does include failure to provide proper In a report published in Athletic The Act requires that cases of abuse the law in medical Utah care, although Training magazine, the professor said or suspected abuse be reported to exempts parents or guardians who are he was prompted to investigate the either die police, sheriff, or the Division legitimately practicing religious healing effects of tobacco after BYU of Family Services. Willful failure to beliefs. athletic trainer Marv Roberson B report is a class misdemeanor, and returned from the 1971 Balkan Games medical professionals or institutions in Yugoslavia with stories of the sucsued in civil can and nave been Once child abuse became recognized use of ( commercially court for failure to notify authorities of as a serious problem, attempts were cessful abuse cases Perosns or institutions made to identify the kinds of parents manufactured tobacco substances on bruises of basketball players. that make such reports in good faith most likely to be come abusive. Results are immune from civil or criminal of investigations showed that child Roberson obtained a few cans for use . the United States, and after they ran out, he began making his own tobacco poultices. and is not good for man, but is an herb for bruisees and all sick cattle, to be used with judgment and skill. When Dr. Francis decided to scientifically evaluate the effect of tobacco on healing, he was surprised to find practically no previous research on the subject. The magazine article says Dr. Francis set up an experimentally validated traumatizing unit to During the middle ages and on into the years immediately preceding the era of modern medicine, tobacco in various forms was employed as a medicinal for maladies ranging from rheumatic pains to toothache, the professor said. Today, tobacco is Commercially distilled tobacco juice was then painted on the thighs of 40 of the specimens for a period of two weeks. The other 40, the control group, were painted with distilled water. in negatively associated with such notorious maladies as carcinoma and emphysema. He was further intrigued by a statement of Mormon prophet Joseph Smith who, in 1833, said that tobacco is not for the body, neither for the belly. uniformly bruise the anesthetized rats. thighs of 80 lym- phocytes, plasma cells, macrophages, etc.) and the size of the bruises were monitored. Dr. Francis discovered that the tobacco-treatetissue contained 20 percent more healing cells and the size of the bruises decreased 20 percent faster than in the n tissue. d Having an opportunity to tour the hospital and clinic facilities helped the visitors to beome familiar with the rural medical operation and offered excellent preparations for the panel discussion slated for later in the day. 1 his capacity as associate director of the southern region for Intermountain Health Care (IHC) but more familir to many as the former administrator of Garfield Memorial was Douglas Fonnesbeck, Monroe. Fonnesbeck acted as moderator for the panel discussion which confronted the problems and successes in delivering health care in a rural setting. Attending Both the number of healing cells (granular white blood cells, Notable also was the versatility of the hospitals six swing beds; a newer treatment concept providing for care of the patient from the acute stage through any long term care that is necessary. in Leading off the hour long discussion was Garfield physician Stan Bezek, who outlined the development of Garfield Memorial Hospital and (Continued on Page 8) |