The Bronx Ink

Ashley Love, the keynote speaker, at the Transgender Health Conference at Lincoln Hospital. May 13, 2011. Photo by: Linda Thrasybule.

The first step in addressing the health concerns of transgender people is to understand who they are. That was the overarching theme of the first ever health conference in the Bronx dedicated to highlighting a largely invisible community that advocates say is facing a number of challenges.

“We need to face issues of sexual violence, economic hardship and more importantly, discrimination among the transgender population,” said Catherine M. Abate, president and CEO of Community Healthcare Network, which held the conference at Lincoln Hospital on May 13 together with the Bronx Pride Center.

She urged participants to spread the word on the importance of transgender people getting quality health care in the city.

“We need to advance rights and services and make sure that providers are sensitive and understand the needs of transgender people,” she said.

Community Healthcare Network is a nonprofit organization that provides access to comprehensive community-based primary care, mental health care and social services in underserved communities.

“When you are born with a transsexual medical condition, it means that you’re neurologically intersexed, it means that your chromosomes are born different,’’ said Ashley Love, the keynote speaker. “A transsexual herself, Love, is an advocate for legal and medical protection for people born transsexual or intersex.

“Some people find out later that they have a variation of intersex, which means that they have female and male characteristics,” she said.

The term “transgender” can mean many things, including individuals making the transition from male-to-female, female-to-male, transsexuals, cross dressers and more. “A lot of different people fall under the umbrella of transgender,” said Samuel Lurie, director of Transgender Training and Advocacy, an organization that provides training for clinicians and service providers on the needs of transgender people.

“Some of them want to have medical intervention and some of them don’t,’’ he said. “Some of them want to live full-time in a gender different than what was assigned to them at birth and some of them may not.”

Lurie is a transgender male (female to male) who has trained 26,000 health care providers across the country on how to better understand and treat patients who are transgender.

Because transgender individuals do not conform to traditional gender roles, they often face stigma, discrimination and violence at some point in their lives, experts say. They also routinely lose jobs, homes and families when others find out about their gender. Even worse, complaints are never voiced by patients out of fear of rejection, ridicule or violence, Lurie said.

Little to no insurance coverage has left transgender individuals to find other ways to fund their transition. “Providers are seeing more and more transgender patients, and there is still a lack of information regarding care,” said Lurie.

The process of transition is a potentially dangerous period for transgender individuals. “It’s visible,” said Lurie. “People can know and see and can tell that you are either somebody who is gender different where they knew you before. I can’t tell you how dangerous this is. That’s how people find out. That’s how disclosure happens.”

Transition involves adjusting socially, physically, medically and legally to society. From taking cross gender hormones, deciding to have surgery to changing one’s name. “It’s a long process,” said Lurie. “It doesn’t happen overnight. It doesn’t happen over a weekend.”

The lack of access to health care has lead to serious health issues within the transgender community, advocates say. HIV/AIDS is currently an epidemic in the transgender population, in particular transgender women (male to female). Nearly 30 percent of transgender women in New York City were HIV positive, according to a 2008 Centers for Disease Control Study.

A 2011 report by the New York City Department of Health and Mental Hygiene noted that of the 206 new HIV diagnoses recorded between 2005 and 2009, 95 percent were transgender women and 5 percent were transgender men (female to male).

The report also states that out of these 206 new HIV diagnoses, close to 90 percent were black or Hispanic, which is a telling statistic on the high prevalence of HIV among minorities in the transgender community.

Since 2002, the Bronx Health Center, part of Community Healthcare Network, serves the transgender community by providing primary health care services, HIV counseling and testing, support group and weekly workshops. “We have around 180 transgender people accessing health care services at our center, said Dr. Luis Freddy Molano, vice president of HIV Programs & Services of Community Healthcare Network. “For the past three years, we’ve seen an increase this population.”

The transgender community currently has limited access to health services in the Bronx. The purpose of the conference was to reach out to other health care providers and community partners and raise awareness, said Dr. Molano. “We decided to make this effort and hopefully we’ll be able to do it again in the future.”

By Linda Thrasybule

On March 23, 2010, President Obama signed into law the Patient Protection Affordable Care Act, a sweeping piece of legislation that transformed health care policy in the U.S.

A year later, provisions in the law have been put into place, launching a number of programs that aim to lower insurance costs, improve quality of care and increase access. But what does that mean for the Bronx?

This central question was at the heart of a gathering of community leaders, local city officials, and health care professionals who came together at Hostos Community College Friday to discuss the impact of health care reform on the borough.

They urged state and local officials to reach out to community-based organizations and use novel approaches to spread the word about the changes to health care.

“We need to make a concerted effort in getting the information out,” said Carl Douglas, an official at the New York State Housing Authority, Department of Resident Support Services.

“It needs to filter down to the grassroots level,’’ he added. “That way, more folks will be able to hear about what’s going on.”

Trying to make sense of the vast information available can be daunting. Programs and initiatives are still broad in scope and vague to many. One of the most glaring challenges, say local officials, will be to explaining it in a simple, comprehensive way.

Although information regarding new programs and benefits is available on the website, www.healthcarereform.ny.gov, some Bronxites don’t have access to a computer. Even more challenging will be reaching out to non-English speaking communities.

The Bronx was recently ranked dead last in the 2011 County Health Rankings report, published by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. An estimated 27 percent of Bronx residents are in poor or fair health, compared to 16 percent in all of New York State.

“The Bronx has extreme poor health indicators across the board,” said Joann Casado, executive director of Bronx Health Link, a source for consumers and health and human service providers on health issues facing the Bronx. “We’re dealing with a community that is sick and we don’t like being sick.”

Here are some questions you may have about health care reform:

When does the health care reform take effect?

Enrollment in health insurance plans that will be available to the uninsured and underinsured doesn’t begin until summer 2013. Over the next two years, federal and state governments will promote, advertise and explain the structure of the new health care system.

Health insurance coverage goes into effect January 2014.

What is the health insurance exchange?

Individuals, small groups and small businesses will be able to choose an affordable health insurance plan through the exchange. The exchange will be designed to be a “one-stop shopping” option to purchase health insurance, help individuals choose the right coverage within their budget, compare options and learn about public programs. The exchange is still being developed.

How do I sign up for insurance?

Contact Community Health Advocates or call (888) 614-5400 to find out what you are eligible for.

Are there health reform changes happening now?

• Effective January 2011, seniors get a 50 percent discount on prescription drugs when they reach the coverage gap, also called the donut hole, or the point at which Medicare stops paying for prescriptions because you have spent the yearly limit of $2,840, according to the Centers for Medicare and Medicaid Services). Once that happens, you have to pay for your prescriptions out of your own pocket.

• Insurance companies can no longer drop you due to a pre-existing illness. The NY Bridge Plan is New York State’s Pre-existing Condition Insurance Plan providing comprehensive coverage to those with a pre-existing medical condition who have not had insurance for at least six months and who are U.S. residents. It is available now.

• Parents now have the option to cover their children under the age of 26 as long as the policy allows for dependent coverage.

Once the supplier of peanuts at Yankee Stadium, A.L. Bazzini Co., announced it will be moving its Hunts Point manufacturing plant to Allentown, Pa., in July, reports the NY Daily News. “Bazzini is a New York brand,” said Rocco Damato, CEO of the 125-year-old snack company that started in Manhattan. “This is not what we wanted to do. We had no choice.”

A Bronx blaze killed two adults and a teenager in a three-story house early this morning, reports the NY Post. More than 100 firefighters responded to the fire in the Tremont section of the Bronx. Four other people and four firefighters suffered minor injuries.

By Linda Thrasybule

The quiet devastation of Alzheimer’s is usually an experience families suffer from behind closed doors. But recently, Libby Embry, 63, shared her battle with the disease in a most unexpected way, tweet by tweet.

“I’m still me,” Embry wrote in a message meant to educate doctors about her condition. “I wanted to be treated with dignity and respect while I can still participate. I want to have a say.”

When Twitter emerged in 2007, its use was to post your daily rant in 140 characters or less. Like its predecessor on the social network frontier, Facebook, Twitter’s popularity has stretched across all kinds of communities to become a sounding board to share, exchange and discuss ideas. In health care, more patient communities are using Twitter as a way to initiate dialogue about a particular disease or voice health concerns to doctors.

On January 25, Albert Einstein College of Medicine of Yeshiva University in the Bronx, along with MDChat, a TweetChat designed exclusively for doctors, and the Alzheimer’s Association, organized its first-ever tweet chat for early stage Alzheimer’s disease patients who have been diagnosed with the disease at a younger age. For the non-initiated, a TweetChat is an organized group of users who hold a conversation via Twitter.

An estimated 5.4 million Americans are living with Alzheimer’s disease. Of those with the disease, about 4 percent are under age 65, according to the Alzheimer’s Association. It is among the top 10 causes of death in the U.S. that cannot be prevented, cured or slowed.

Paul Moniz, director of communications and marketing at Einstein College of Medicine, came up with the idea while brainstorming with Phil Baumann, an R.N. and founder of MDChat and RNChat, a Twitter account set up for doctors and nurses.

“Paul and I had been talking about MDChat and how we could use TweetChat to give people with a condition an opportunity to share their stories,” Baumann said.

Einstein spokesman Moniz, previously a television reporter, recalled working on a series profiling early-stage, younger-onset Alzheimer’s patients.

“What amazed me was that so few people hear from the patients once a diagnosis is made,” he said in an email. “Questions from friends, colleagues, even family members are directed to caregivers–something that is hurtful to patients who are still functioning at a high cognitive level.”

Moniz’s experience working on the series led him to the idea of organizing a TweetChat giving early-stage patients an opportunity to share their frustrations with doctors, nurses and other health care professionals.

Moniz thought it would give doctors a better understanding of how to offer support when giving a diagnosis and information resources to a patient who receives such news.

The Alzheimer’s Association in Chicago agreed to help out and found two patients—Libby Embry and Gwen Richards—willing to participate in the TweetChat.

Baumann kicked off the hour-long chat by having both women tell their story for the first half hour followed by a Q & A session. Participants were told in advance that tweets shared by these women were their words, feelings and experiences, typed by the Alzheimer’s Association team since neither patient knew how to use Twitter.

Despite the limited number of characters per tweet, the chat allowed both women to tell their stories clearly and succinctly.  Embry shared her experience receiving her diagnosis, the difficulty of letting family and friends know and the frustration of being excluded in the treatment process.

Embry, a teacher, was 59 years old when she was first diagnosed. “The problems at work were not being able to do the computer work,” she tweeted. “Forgetting meetings and classes. I felt like I could not continue teaching. My colleagues had to do all the work for me. Covering for me.”

Eventually, Embry was forced to retire even though she didn’t want to. “I thought if I could get out from under the stress of teaching I could get my life together,” she tweeted. “I was wrong.”

Embry’s symptoms began to affect her home life. She would get lost and not find her way home. She couldn’t find the hair salon or the grocery store, places that she went to every day. Although she tried to cover it up as best she could, her family began to notice.

After seeing three doctors, she was prescribed medication that has helped her think and speak clearly again. “Within a week, I felt as if someone were slowly pulling cotton out of my head,” she tweeted.

A month after she was diagnosed, Embry contacted the local chapter of the Alzheimer’s Association. “I got more from Alzheimer’s Association than from doctors. My family doctors didn’t know what to do,” she tweeted.

Embry participated in the chat so that family doctors or general practitioners could better understand how to treat the disease. “Most family physicians don’t know about Alzheimer’s and they have a lot of misperceptions,” she said in a phone interview.

Embry also wanted to convey the importance of medication. “Doctors say medication won’t help but they should leave that up to the patient,” she said. “There is no cure for this disease so medication is the answer, even if it works temporarily.”

According to Baumann, the chat received a positive response. “Physicians and nurses who participated were genuinely enthused—and maybe even surprised—at how much they learned from Gwen’s and Libby’s stories through the medium of tweets,” he said.

“All of us have a need to tell our stories in our own way,” Baumann added.

He sees Twitter as a uniquely equipped mechanism for a uniquely human impulse. “Key details come out of that 140 character limit,” he said. “It extracts these little gems and I think it’s the direction we’re heading.”

Click here for more stories on the Digital Bronx.

The Fulton Fish Market, one of the oldest fish wholesalers in Hunts Point, filed for Chapter 11 bankruptcy this week. The company lost a lot business in 2009 and 2010, according to Crain’s New York.

The company hopes to recover from bankruptcy, but it is currently more than $10 million in debt, reports the Daily News.

Founded in the early 1900s, the family-run business, based in the Bronx, delivers seafood, including whole fish, fillets, live shellfish and breaded, smoked, canned or frozen products, to more than 1,000 customers in the tri-state area.

At the Children’s Hospital at Montefiore, a group of students, mostly parents, have learned a life-saving skill — how to perform CPR, also known as cardiopulmonary resuscitation. The FDNY provided instruction on how to perform chest compressions and mouth-to-mouth rescue breaths using inflatable plastic dolls nicknamed “Rescue Annie,” reports the Daily News.

Performing CPR on infants and children is different than on adults because most adults suffer cardiac arrest due to heart problems; in children heart stoppage often stems from breathing problems such as lung disease, said Scott Ceresnak, a cardiologist at Montefiore.

An estimated 95 percent of sudden cardiac arrest victims die before reaching the hospital, according to the American Heart Association.

Bronx Borough President Ruben Diaz Jr., at his second State of the Borough address. (Photo by: Kitama Cahill-Jackson)

By Linda Thrasybule

Bronx Borough President Ruben Diaz Jr., sounded the call for a more unified Bronx in his second State of the Borough address Thursday.

Diaz delivered the speech to  a full house at De Witt Clinton High School in the northwest Bronx. In attendance were city political heavy hitters such as New York City Comptroller John C. Liu, City Council Speaker Christine C. Quinn and New York City Public Advocate Bill de Blasio.

Diaz announced several initiatives his office plans to pursue in the coming year, such as hosting the borough’s first education summit and expanding the successful “Peace in Our Streets” initiative against gun violence.

Diaz highlighted successes in the Bronx, crediting the Bronx Overall Economic Development Corporation, which serves the economic development arm of his office, for pushing more than $32 million in funding into the borough’s economy to businesses wide and small.

“My administration has and will continue to make intelligent economic development a reality,” Diaz said. “We have taken major steps to market the Bronx to new businesses, to support our existing businesses, and to grow the overall economy of our borough.”

He noted that his office would continue its fight to remove PCBs, a dangerous chemical that has been used for many years in the construction of school buildings.

“The response to this issue has been grossly inadequate,” he said. We need a faster response. The health of our children is at risk.”

Diaz echoed a theme he underscored in last year’s address — the lack of a world-class hotel in the Bronx. He said his office is working with the New York City Economic Development Corporation to bring a hotel to the area near Yankee Stadium.

“We have begun discussions with multiple developers who have shown a keen interest in building a hotel, complete with street-level retail, restaurants, entertainment, catering and convention space just blocks away from the stadium,” he said.

Diaz received thunderous applause for denouncing last year’s brutal anti-gay attack, in which a group of teens were charged with viciously beating several young men in Morris Heights, calling it “sickening.” He announced the creation of a new task force of clergy and community leaders from different  faiths, ethnicities and sexual orientations, to combat  hate crimes. “We need to show Bronx solidarity and make sure these incidents don’t happen again,” he said.

He ended his address by calling on all Bronxites to come together to support efforts to make the borough a better place to live.

“It is time to let the world know once again that the Bronx is a place of success,” Diaz said. We face challenges—in education, in the economy, in making our borough a greener place. But we are all committed to the rebirth and continuing revitalization of our ‘One Bronx.’”