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Sickle cell programs stir concern

Harboring thoughts of the genocidal possibilities of sickle cell screening, black physicians seemed almost relieved to turn their attention to federal programs for hypertension screening. 

The more cautious participants in the National Medical Assn. meeting attacked the proliferation of sickle cell screening programs for their lack of concern for those identified with sickle cell trait or disease. They noted that many programs fail to include appropriate counseling services for those identified and added there have been instances where blacks have been refused employment and health insurance just because they carried sickle cell trait.
  
"The confidentiality and voluntary nature of these tests should be maintained," said Roland B. Scott, MD, chief of pediatrics at Freedman's Hospital, Washington, and a sickle cell authority.
  
Dr. Scott continued that there is wide-spread confusion among the lay public (blacks and white) about the differences between sickle cell anemia and trait.
  
"Even the literature put out by HEW is confusing," he noted.

THE PHYSICIAN added he deplored the use of the sickle cell problem by unscrupulous or misguided fund raisers and promoters across the country. 
  
But there was a cadre of apparently angry young black physicians at the meeting who claimed sickle cell screening programs are out-and-out white racist plots of black genocide.
  
"I question the extraordinary generosity of the federal government," stated Alyce C. Gullattee, MD, associate professor of psychiatry, Howard U. "Our government tends to be somewhat euthanistic even though it does not say so. It's always easier to eliminate difficult problems than find way to treat them."
  
Dr. Gullattee claimed that she knew of instances where sterilization had been recommended for children as young as 12 years because they carried sickle cell trait.

"I BELIEVE our American government has found its most subtle method for carrying out its racist policy of controlling black survival," she charged.
  
George C. Gardiner, MD, an internist with Philadelphia's Health Law Project, added, "I think we're being diverted from the many problems of dissent in our communities. We're being diverted from hypertension, lead poisoning, poor nutrition and poor housing. They are trying to obtain our loyalty by what amounts to a drop in the bucket."
  
Nevertheless the NMA House of Delegates endorsed sickle cell screening programs, in concept, if they put proper emphasis on counseling.
  
Even HEW Secretary Elliot L. Richardson, during his address to the NMA House, admitted that sickle cell disease kills only 340 black Americans yearly, while one of every seven blacks suffers from hypertension and this vast disease yearly claims approximately 13,500 black lives.

EMERSON C. Walden, MD, NMAs outgoing president, said he believed the federal government's new hypertension program was a direct result of NMA efforts during the past year to convince government officials that hypertension is not only a bigger problem than sickle cell in the black community but also a more treatable one.
  
While in Kansas City, Secretary Richardson pleaded for the support of black physicians in launching the hypertension program.
  
"That is my principal reason for being with you today," Richardson told the delegates, "To solicit your support and to ask you to carry the message and effort into your own communities."

THE NMA HOUSE promptly offered the secretary assistance and then created its own 20-member hypertension task force headed by John B. Johnson, MD, chairman of the NMA scientific assembly and professor of medicine at Howard.
  
Dr. Johnson said the NMA effort will try to avoid duplicating the national effort. But he added that since twice as many black Americans die of the disease as white Americans, the NMA "would be derelict—if we did not do something to help stem the tide of this devastating disease."
  
"We will assume a reinforcing and supporting role towards the federal program," Dr. Johnson contined. "We will get involved with the black community health centers, private agencies, and churches to get the word to the public."

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