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Liberation Africa/
David Wirmark
Liberal Party—General Secretary of the World Assembly of Youth—Member of the 1977 committee on sanctions against South Africa—Ambassador of Sweden to Tanzania Board member of the Swedish International Liberal Center
The interview was held by Tor Sellström in Stockholm 22 February 1996.
Tor Sellström: How did your involvement with Southern Africa begin?
David Wirmark: I was a young student in Uppsala and elected to participate as a representative of the Swedish youth in the first general assembly of WAY, the World Assembly of Youth, which took place at Cornell University, Ithaca, USA, in 1951. The theme was ‘Youth and Human Rights’ and I was participating in a commission that dealt with racial discrimination. There was a fellow delegate from Cameroon. His name was Etienne Noafu and he represented the Protestant youth, I recall. He made a very interesting plaidoyer for solidarity of youth the world over with the cause of equality and justice in South Africa. He also made a description of the South African situation in a document that was very detailed about the educational and the political system. It showed how things had gone backwards and that discrimination had become harder. There was a system which only allowed the white population to attain full citizenship. Of course, we were very shocked. I already knew from newspapers and articles that there was racial discrimination in South Africa and that the situation was getting worse, but I did not know the details. That made me struggle later in support of South Africa and against racial discrimination.
Of course, we were also shocked by the racial discrimination in the United States. We met many black American youngsters who worked for various youth organizations. They told us that they hoped that the system would cease, but that it would take a long time. At that time, we also discussed technical assistance and development aid, because President Truman had presented his Point Four plan. This struck me very much and determined more or less what I was going to devote my life to.
Tor Sellström: Were you then chairman of the National Council of Swedish Youth?
David Wirmark: No, that was a couple of years later, but when I came back to Sweden I was internationally concerned. At that time, a students’ association at Uppsala University devoted to international affairs invited a Swedish diplomat, Paul Mohn. He had an idea of inviting a thousand young people from the poor countries in Asia, Africa and Latin America to Sweden to learn how the Swedish society and democracy functioned.
Tor Sellström: Was that the famous Mohn Plan?
David Wirmark: Yes. Mohn was already rather old, but had wide international experience. He had been in Korea to supervise the armistice and before that—immediately after or during the war—he was responsible for administration in Greece. Particularly, I think that his period in Korea and Asia had made him interested in how we could make the youth of the developing world understand how a modern society functions and become aware of the rules and the values of the democratic system, local democracy etc.
Mohn wrote a pamphlet about this and one of the first speeches he gave in Uppsala—it must have been at the Foreign Policy Association—aroused a lot of enthusiasm. We took over the idea and the National Council of Swedish Youth proposed it to the Central Committee for Swedish Technical Assistance (CK), but I think that the older generation did not know exactly how to handle the proposal. They thought that it was interesting, but they also saw difficulties in implementing it. We never got full support from them. The interesting thing is that the Under-Secretary of State for Foreign Affairs at that time, Arne Lund-berg, made a speech on the First of May 1952 where he also took up the idea. That made us advance, but what happened in the end was that some youth organizations themselves raised money and brought a few people to Sweden.
We in the Liberal Youth League had one or two people here. I recall that we had a Korean who studied economy. Of course, the idea was that they should go back to their own countries and work for them, but he married a Swedish girl and stayed here. He became a good economist at Konjunkturinstitutet (The National Institute of Economic Research). But there were others who went back. The Centre Party Youth League (SLU) invited several people from Ethiopia and I think that the Social Democratic youth had young people from East Africa here. Paul Mohn spoke of one thousand young people, but we could never implement such a huge programme. There was a debate in Expressen. One article was against the plan, stating that the idea of learning democracy by coming to Sweden was a little bit naive. We replied that we did not want them to only study democracy, but also to practise and do some further training within their professional field, so that they could develop their knowledge while they were here. We thought that both things were important.
It is interesting to see that the questions of democracy and human rights later came much more to the forefront than they were at that time. It was only the youth that brought them forward and wanted to have this programme implemented. It might be because of the fact that WAY had made the Universal Declaration of Human Rights the basis for our work. We were accustomed to these questions.
Tor Sellström: Among the students who came to Sweden through the Liberal, Centre or Socialist youth, were there any from Southern Africa?
David Wirmark: Yes, in the Liberal youth we had one or two people from Zambia. The National Union of Students also invited foreign students to Sweden. They had, I think, six or eight medical students from Indonesia. Olof Palme was involved in that undertaking and I was involved from the Uppsala side, so we had some contact already then.
Tor Sellström: As chairman of the National Council of Swedish Youth and, from 1958, as general secretary of WAY, you had contacts at a very early stage with some of the future leaders of Southern Africa. You met Joshua Nkomo from Rhodesia as early as 1958 and also Kenneth Kaunda around that time. Just after he went into exile you met Oliver Tambo and you also met Nelson Mandela at a conference during his African tour in 1962. Could you comment on the relations that you established with the leaders of Southern Africa?
David Wirmark: Yes, we became very friendly. I met Joshua Nkomo several times. Kenneth Kaunda as well. When Kenneth Kaunda became President, he always received me when I came to Lusaka. I came rather often to Zambia in those years, because when I worked for WAY I travelled widely in Africa. Those were the years of liberation and I went to Africa on various occasions, for instance, every independence celebration. When Tanzania, Nigeria and Zambia became independent I was there and, of course, I met a number of leaders at the same time. Kenneth Kaunda is really a very close friend of mine. I met him in South Africa during the elections in 1994. We happened to stay at the same hotel. I did not know that he was there, but when I came down to the breakfast room I heard his familiar voice ‘Oh David, are you here?’
When Oliver Tambo was smuggled out of South Africa, I immediately—in April 1960— sent him a ticket through Seretse Khama in Bechuanaland. Seretse Khama replied that he had taken care of Oliver Tambo and that he had given him the ticket. Oliver Tambo then came to the first Pan African Youth Seminar in Tunis, where he gave a fantastic speech about the struggle for freedom in South Africa. It was on the basis of non-violence, which was the ANC policy at that time. Luthuli’s old policy. That laid the foundation for a friendship that went on for a very, very long time. Until the end. I saw him about one month before he died. I saw that his health was not as it should be. Of course, I knew that he had been in hospital in Sweden. I had met him there.
Tor Sellström: You were a leading representative of the Liberal youth. Later on you were a Liberal member of parliament. Many of those who were active in the formulation of an opinion on South and Southern Africa in Sweden— people like Herbert Tingsten, Ivar Harrie etc.—came from the liberal camp. Would it be fair to say that liberals were the first to articulate an anti-apartheid and pro-liberation opinion in Sweden from the late 1950s?
David Wirmark: Yes, I think so. In the church, there were individual missionaries, in particular those who went to South and Southern Africa and saw the discrimination on the spot. Some of them—not all of them—became horrified and decided to devote themselves to efforts and programmes to struggle against this. On the liberal side it was natural, because liberalism is about freedom, and colonialism and racial discrimination are negations of freedom.
I was very much influenced by Julius Nyerere. He came to a seminar that we had in Dar es Salaam. Kenneth Kaunda was also there. Julius Nyerere addressed the seminar, arguing against the British thesis that you need to be prepared to become independent. He quoted Nehru, saying that he did not accept that you first needed a certain standard of education. Education is important for every individual, but independence is something more than just the technical standard you have in terms of education. It concerns an important political element, namely political human rights. He was refusing the argument that you need a period of preparation before democracy. He said that the best preparation for democracy and freedom is freedom itself. I thought that it was very well put, because it went very well with my liberal belief.
In the case of Zambia, it was a Liberal group in Sweden that made the collection of funds for Kaunda’s first election campaign in 1962, preceding independence. In that, for example, the Liberal Party chairman Bertil Ohlin and other personalities, both older and younger, participated. Among them was also Gunnar Myrdal from the Social Democratic Party, if I recall correctly. There was a mixture of political beliefs among those who supported the fund.
The Liberal Party Youth League was certainly the first political organization to take a clear stand on the Algerian struggle and freedom for the Algerian people. This we did in concordance with liberals in France, for instance, the group around Mendès-France and the journal L’Express. Of course, in Britain you also had important liberal newspapers, like The Guardian and The Observer, which played important roles in the debate and continue to do so, as also liberal politicians have done in Britain. I think that we in Sweden have been more or less part of the British progressive liberal tradition for the liberation struggles.
Tor Sellström: In 1969, the Swedish Parliament paved the way for direct government support to liberation movements in Southern Africa. All of these movements waged an armed struggle and some of them had a formal alliance with a Communist party. Most of them were considered to be in the ‘Soviet camp’. How did you in the Liberal Party look upon this?
David Wirmark: Of course, we knew that there were links between members of the liberation movements and the Communist parties or the Communist camp. But we were also convinced that they were not true Communists. They did not act like Communist party organizations. They were true national liberation movements. We never had any hesitation about ANC, for instance. All the time we also wanted that ZAPU of Zimbabwe should have some support. We were not guided by the question of whether they cooperated with the Communists. The important thing was that we were convinced that they wanted a free society and respect for human rights. They did not want a racial society. ANC had taken a very clear stand. They did not want the blacks to have more rights than the whites. They did not want to reverse the system, but a society where all citizens were equal.
Tor Sellström: Do you think that the very early and close personal relations between leading opinion makers—like yourself—and the leaders of the liberation struggle in Southern Africa, like Mondlane, Tambo, Nkomo, Nujoma etc., played a role regarding the understanding of the ideological orientation of the struggle?
David Wirmark: Yes, I believe so. Definitely. It had repercussions in two directions. It was important for the understanding in Sweden of the national liberation movements and their significance, but it also, I think, had the effect that the leaders of the liberation movements saw that they could get real, and perhaps even more efficient, support from the non-Communist world. This was an argument when they later on negotiated for political liberation. The fact that they got support from true democrats in the Nordic countries had an importance, both for ANC and the other liberation movements. Many of the leaders have said so to me. Nujoma, Nkomo and Kaunda have said so, and, of course, the Tanzanian leaders. I was ambassador to Tanzania between 1979 and 1985, but even before that time I knew Julius Nyerere and his colleagues very well. In particular, Rachidi Kawawa, who was Vice President but also others in the Tanzanian government, like Salim Salim and Oscar Kambona, who was at the time Foreign Minister, but then fell out with the party and with Julius Nyerere. They were very close to me.
Tor Sellström: Do you think that the Nordic countries were able to broaden the diplomatic space for the liberation movements in the polarized East-West divide?
David Wirmark: Yes. There was a time when the Soviet Union was very active in Africa and that created difficulties for the liberation movements. We were not in favour of the various Communist initiatives, for instance in Ethiopia and Angola, although most of us had to accept that MPLA had essential support from the Soviet Union. My line—and also that of the Liberal Party—was that it was not really up to the donor countries to decide which political inclination the liberation movements should have, other than in a broader sense. It should be democratic and respect human rights, but whether it should have a more socialist or another leaning was not for us to decide. That is why we advocated that in certain cases one should support several liberation movements. For instance, in Zimbabwe we thought that both ZANU and ZAPU should get support and they also got that when the non-socialist parties came into government. In Angola, we advocated that in accordance with what had been agreed between the African leaders, both MPLA and FNLA should get support. But Sweden went on with exclusive support to MPLA and did not change its stand. South Africa was a different case. There I became convinced from reports by, among others, Kenneth Kaunda that ANC was the main representative and that we did not need to extend support to PAC.
Tor Sellström: Was the difference that the Social Democratic Party tended to support only socialist liberation movements, while the Liberal Party supported nationalist movements independent of their ideological outlook?
David Wirmark: Well, I would not go as far as to say that they only supported liberation movements with a socialist outlook, but they did not want to support more than one movement in each country. I think that they argued in favour of that. As I said, in principle we argued for letting the Africans themselves decide within a rather liberal framework. In the case of Zimbabwe, Angola and South Africa we would at an early stage probably have advocated support to the two movements that we have been speaking about, but in the end it was only in Zimbabwe that it was implemented.
I think that political reality was part of the decision in the other two cases. In the case of Angola, UNITA was impossible according to my and others’ belief by the fact that they had so openly welcomed South African support. But we argued for FNLA for a long time. Olle Wästberg went there and wrote a book about the struggle. There were quite a few Swedes who had contacts with the FNLA side. Of course, in all camps one could see that some rather harsh methods were used, but I think that there was no major difference between, for instance, MPLA and FNLA in terms of the methods.
I would also say that if you had taken the liberal viewpoint you might have had a freer trade of opinions, which would have been positive. On the other hand, many of those that I thought were the best among the Africans advocated the one party system. So did Nyerere, Kawawa and others in Tanzania and so did Tom Mboya in Kenya. He wrote a very famous article in the American journal Foreign Affairs, defending the one party system. His main argument was that the tribal differences made it very difficult to make a multi-party system work.
I never bought that argument. I had various articles published by SIDA on this question. I have also written other things on the question of whether the developing world can have full democracy in our sense. My argument was that it is possible. It is not easy, but it is possible. One should strive for that. I was always against those who said that these were bourgeois or Western freedoms, because according to me human rights and fundamental freedoms are the same all over the world. They are universal and, therefore, if people want them, they should be allowed to. I found in Africa— also in the one party states—that many of my friends came to me and complained about the lack of freedom at a personal level. They either wanted to go to a country in Europe to have a period of greater freedom of expression or to change the system. I am also convinced that the British electoral system—the single constituency principle, where the winner takes all—is not very conducive to a fully fledged interplay of opinions and full democracy. I think that a proportional system could have helped to form a greater understanding of the need for an opposition and how to deal with an opposition.
Tor Sellström: So you think that there is something in the statement that support to one ‘sole and authentic’ liberation movement was partly detrimental to a well functioning parliamentary democracy upon independence?
David Wirmark: One has to emphasize that it may be one cause, but I would say that in the case of South Africa I had no grudges about only supporting ANC. I think that they had such a solid base in the struggle for human rights that they will not be averse to the opposition or to other parties. In fact, I think that South Africa might well be the case that paves the way for a more open system in other countries in Africa. Even Nyerere has recognized that the one party system had its drawbacks. Well, I think that it would not have harmed to support several liberation movements in one country, but one should not invent a movement in order to get a better democracy. It is the people who decide which their movements are. In the case of Mozambique, for example, FRELIMO was the only liberation movement, so why should one worry? It was up to them to decide the movements and also about the future democratic system, but what one has to attack is the philosophy of making a virtue of the one party state, because I do not think that it has a virtue.
Tor Sellström: Was the question of armed struggle in your view a difficult issue when it came to the anchoring of support in the Swedish public opinion and in parliament?
David Wirmark: Within the Liberal Party, we had a discussion on this. Of course, there were those who said that we could not support movements that used violence. In the case of ANC of South Africa, they changed their policy and entered into a period of armed struggle. The majority line within the Liberal Party was that it was up to them to decide which method they wanted to use. We knew that the apartheid government used violence to a great degree and it was in our view difficult to criticize ANC’s stand. But we made it clear that we could not support the military struggle. We could not give aid to arms and military equipment.
Tor Sellström: When the non-socialist coalition succeeded the Social Democratic government in 1976, it not only continued the support to the liberation movements, but increased the assistance. It also introduced the first sanctions’ legislation against South Africa. Was the Swedish government ever the object of international pressure from the West—the United States and Great Britain, particularly—to end the support?
David Wirmark: I have no recollection of any pressure from the West on Sweden to change the policy with regard to the liberation movements. I think that the other Western countries simply knew that we were right and that we had a case.
When I was ambassador to Tanzania, there was nobody who tried to get us less involved with the liberation movements. Instead, what was important was that the various major powers—the United States, the UK etc.—in the Tanzanian context were very interested in the Swedish viewpoints and what we understood to be the viewpoints of the Tanzanians, because they knew that we had very good contacts with them. We had a close cooperation between the Nordic countries, but also with the Dutch and the Canadians, although they were not so outspoken as we were. I recall that we had a celebration for both ANC and SWAPO every year in Dar es Salaam. The Swedish ambassador was always invited to speak. I still have my speeches from that time. Once I also represented all the ambassadors to the President of Tanzania at a diplomat gathering at State House. I spoke about South Africa and I could go quite far. The pressure was not on us. It was rather the other way around, that the others were pressurised.
Tor Sellström: As ambassador to Tanzania, you were the head of a Swedish mission that was responsible for a lot of support to ANC. Do you think that there was a sound distribution of responsibilities between the political and the aid offices in the Swedish embassy?
David Wirmark: Yes, I have no complaints. I thought that it worked well and that the SIDA personnel was competent. Of course, the major cause was that in a country like Tanzania we had very good SIDA representatives. The heads of SIDA were always selected with great care and we were consulting regularly. They knew of my interest in the liberation movements and they knew that I had been a member of the board of SIDA for a long time. There was no attempt to play one side against the other. I would say that it worked well. The decisions about the support were also mainly taken in Sweden.
Tor Sellström: Is it your understanding that there was a satisfactory system in place when it comes to financial control of the funds disbursed to the liberation movements?
David Wirmark: Yes, I believe so. As far as I know, we had no complaints during my time.
Tor Sellström: SIDA used a flexible system of quarterly payments in advance. Do you think that it worked well?
David Wirmark: I think that it was necessary to have a flexible system in order to make things work well. At the same time, it was necessary to check that the money really was used for the purpose that it was said to be used for. In most cases, this could be done satisfactorily afterwards, but, we were, of course, also involved in the planning of various programmes. It was not only that money was paid out at an early stage. We were also involved with the planning side and the liberation movements were open to us. I was often invited by ANC to Morogoro for discussions. They also received SIDA missions and various other people.
Tor Sellström: One important issue is the question of liberation and liberty. We know of crises within the liberation movements, such as the Shipanga crisis in SWAPO, abuse in ANC and SWAPO camps in Angola, human rights violations in MPLA etc. Did you discuss these matters with the leaders of the liberation movements?
David Wirmark: Yes, I discussed them with those persons that I was most involved with. For instance, I took up delicate questions with Oliver Tambo, but I did not take up the issue of the Angolan camps, because it happened after my time.
Tor Sellström: The so-called Shipanga affair involved three friendly actors from the point of view of Sweden, namely SWAPO, Zambia and Tanzania. Shipanga was never sentenced, but kept in jail in Zambia and in Tanzania for a long period. Did Sweden or the Nordic countries put any pressure on SWAPO or the host governments to have him tried in a court of law?
David Wirmark: I was not involved in that and I am not sure that it was the case. If there were things that I thought were not correct during my time in Tanzania, what would happen was that I first took them up with somebody among the Tanzanians that I knew was involved with the liberation struggle and then with the movement itself. But I had never any orders from home to do so. If they were taken up at the official negotiations, it must have been by the Ministry for Foreign Affairs or SIDA.
Tor Sellström: Internationally, and perhaps particularly in Southern Africa, Olof Palme has to a large extent come to personify Sweden, the Nordic countries and a commitment to liberation. Did Palme earlier than others in the Social Democratic Party support the liberation process in Southern Africa?
David Wirmark: That I really do not know, but he had contacts with the liberation movements and when he committed himself to the liberation cause, he did so with all his mind and all his force. I recall when he came to Tanzania. That was when the Socialist International had a conference in Arusha in 1984. He invited me to participate. He knew my views since a very long time back. He also made a state visit to Tanzania at the same time and I helped to prepare his official speech. But he really came to life when he made his intervention in Arusha. That was his life, but, of course, he was limited by his social democratic policy.
We liberals had argued for more funds to the various countries in Southern Africa. More than the Social Democratic government, and Palme knew this. When I was in parliament, he visited Zambia where he made a famous speech about the border of decency with Rhodesia. I put a question to him in parliament and said: ‘If this is the border of decency, should you not increase the support to Zambia?’ He had some difficulty in giving a reply to this question, because he knew that we had argued for more aid to Zambia than his own government. I also see from the memoirs of Ulla Lindström that she at a certain time had to argue against him regarding the level of aid. She advocated more aid than he, so I am not sure that he always was heading the movement for more support. But it was clear that he was convinced and that he found this very important.
Tor Sellström: Is there anything you would like to add?
David Wirmark: I would say that Southern Africa is a region where Swedish politics has played a role. We have made our impact and the Nordic countries have made an impact. We should be proud of that, because we really have had a significance and everybody has respected that. The British have respected it and the Americans have respected it. The Americans were never in Africa and American politicians were never very loyal to the colonial system. They wanted freedom for Africa, because they also thought that freedom was the best way of combatting Communism. As far as I know, we never had any criticism from the US because of our policy of support to Southern Africa. In individual cases, like in Angola, they might have thought that we landed wrong with our exclusive support to MPLA, but that is how it was. I think that our support to ANC in South Africa was well understood because of the political realities. Some of my best friends in the United States were very convinced that ANC was the organization to support and that it was the most representative. However, the most important thing is that we made a difference in terms of South Africa. We should play those cards well. We should not forget that role.


Wellness Workability
Holistic approach to understanding, managing, and healing illness, inflammation/disease, gene mutations & a healthy state of mind.
Autoimmunity/ AIP Diet
Mental Health/Mental Illness
Diet/ Weight Loss
Essential Oils with ongoing education…
Gene mutations
Gut Health/ IBS/ SIBO/ Leaky Gut
Traditional vs. Alternative Medicine
Chromosomes are the thread-like structures in cells that contain genes. We have 46 chromosomes, arranged in 2 sets of 23. Genes are in the DNA of each cell in our bodies. They control how the cell functions, including how quickly it grows, divides and lives. Genes control how our cells work by making proteins. The proteins have specific functions and act as messengers for the cell. Each gene must have the correct instructions for making its protein. This allows the protein to perform the correct function.
Researchers estimate that each cell contains 30,000 different genes.
A gene mutation is a permanent alteration in the DNA sequence that makes up a gene, such that the sequence differs from what is found in most people. Mutations range in size; they can affect anywhere from a single DNA building block (base pair) to a large segment of a chromosome that includes multiple genes.
Gene mutations can be classified in two major ways:
Hereditary mutations are inherited from a parent and are present throughout a person’s life in virtually every cell in the body. These mutations are also called germline mutations because they are present in the parent’s egg or sperm cells, which are also called germ cells. When an egg and a sperm cell unite, the resulting fertilized egg cell receives DNA from both parents. If this DNA has a mutation, the child that grows from the fertilized egg will have the mutation in each of his or her cells.
Acquired (or somatic) mutations occur at some time during a person’s life and are present only in certain cells, not in every cell in the body. These changes can be caused by environmental factors such as ultraviolet radiation from the sun, or can occur if an error is made as DNA copies itself during cell division. Acquired mutations in somatic cells (cells other than sperm and egg cells) cannot be passed to the next generation.
Majority of breast cancer cases are not caused by inherited genetic factors. It’s estimated between only 5-10% of breast cancer cases are passed from mother or father to children. Most breast cancer cases are associated with somatic mutations in breast cells that are acquired during a person’s lifetime, and they do not cluster in families. The number one factor we can control in terms of preventing cancer is what we put in our mouths and on our bodies.
In hereditary breast cancer, the way that cancer risk is inherited depends on the gene involved. For example, mutations in BRCA1 and BRCA2 genes are inherited in an autosomal dominat pattern, which means one copy of the altered gene in each cell is sufficient to increase a person’s chance of developing cancer. Although breast cancer is more common in women than in men, the mutated gene can be inherited from either the mother or the father.
Most disease-causing gene mutations are uncommon in the general population. However, other genetic changes occur more frequently. Genetic alterations that occur in more than 1 percent of the population are called polymorphisms. They are common enough to be considered a normal variation in the DNA. Polymorphisms are responsible for many of the normal differences between people such as eye color, hair color, and blood type. Although many polymorphisms have no negative effects on a person’s health, some of these variations may influence the risk of developing certain disorders.
What is MTHFR?
Methylenetetrahydrofolate reductase is a gene mutation that, in a nutshell, prevents the cells in our bodies from methylating properly.
MTHFR mutations affect everyone differently, and symptoms can vary from long-term health issues to hardly any noticeable changes in overall health. Research has shown an association between MTHFR mutations and several health problems including:
Neurological issues
Neurol tube defects
Congintal cardiac malformations
ADHD (Attention Deficit Hyperactivity Disorder)
This gene mutation can be found all over the world. It is estimated that, at least, 40% of the US population has this gene mutation. Unfortunately I do, and I’m here to tell you I’m passionate about it. I’ve lost grandparents to Alzheimer’s and I want to remember who my family and friends are until I die – let’s say at 103. I also lost my mom to breast cancer (who was unaware of the MTHFR within her body). It causes a methylation problem and every cell in our bodies must methylate properly to function. The types of food we eat and the supplements we (must) take is the armor we have to prevent/ control this mutation.
What is CD33?
CD33 is a sialoadhesin molecule and a member of the immunoglobulin supergene family. CD33 is an excellent myeloid marker and is commonly used for the diagnosis of AML (acute myeloid leukemia).
CD33 mRNA expression is specifically increased in microglia, and expression in autopsy brain tissue is associated with more advanced cognitive decline. The amyloid-beta peptide (Aβ) cascade hypothesis predicates that Aβ accumulation is the fundamental initiator of Alzheimer’s disease (AD), and mounting evidence suggests that weakened Aβ clearance rather than its overproduction is the major cause of Alzheimer’s disease.
What is Apoe?
The APOE gene provides instructions for making a protein called apolipoprotein E. This protein combines with fats (lipids) in the body to form molecules called lipoproteins. Lipoproteins are responsible for packaging cholesterol and other fats and carrying them through the bloodstream. Maintaining normal levels of cholesterol is essential for the prevention of disorders that affect the heart and blood vessels (cardiovascular diseases), including heart attack and stroke.
There are at least three slightly different versions (alleles) of the APOE gene. The major alleles are called e2, e3, and e4. The most common allele is e3, which is found in more than half of the general population.
Researchers estimate that between 40 and 65 percent of people diagnosed with Alzheimer’s have the APOE gene mutation.
It’s a gene mutation that puts us at a higher risk for dementia, Alzheimer’s disease, and cardiovascular disease and I happen to have it. They estimate that 25% of the US population has this mutation. It’s particularly important to get tested for this if you have a family history of dementia/Alzheimers. Please don’t assume you will get it and there’s nothing you can do about it. It’s also important to know which allele you have. For example: I’ve been eating a low carb diet for about 2 years now. This is bad because years of research shows, based on my allele, I should be plant based. There are also natural supplements that help prevent the risks associated with the mutation.
For more information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908458/
The risk of developing type 1 diabetes is increased by certain variants of the HLA-DQA1, HLA-DQB1, and HLA-DRB1 genes. These genes provide instructions for making proteins that play a critical role in the immune system.
The HLA-DQA1, HLA-DQB1, and HLA-DRB1 genes belong to a family of genes called the human leukocyte antigen (HLA) complex. The HLA complex helps the immune system distinguish the body’s own proteins from proteins made by foreign invaders such as viruses and bacteria.
To see more information about these gene mutations, see the blog section–> https://wellnessworkability.com/category/gene-mutations/
Autoimmunity (24)
Diet / Weight Loss (37)
Dietary Supplements (22)
Gene Mutations (11)
Gut Health / SIBO / IBS (19)
Heath & Nature (2)
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Mental Health/Mental Illness (25)
Traditional Medicine vs Alternative Medicine (9)
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The Fred Hollows Foundation | 24/05/17
Home Latest 2016 Annual Report
It's a record: more than 1 million eye operations and treatments in one year!
In 2016, The Fred Hollows Foundation achieved record-breaking results.
With the help of our partners, we performed 1,004,975 eye operations and treatments, trained 78,450 surgeons, nurses and health workers, advocated to local and national governments and equipped 120 medical facilities. We changed the lives of millions of people around the world, all thanks to generous support from people like you.
Watch the video, read the highlights, or download the 2016 Annual Report to learn more about our impact in 2016.
Helping people see
Treating and preventing the main causes of avoidable blindness – including cataract, trachoma and diabetic retinopathy – remains at the core of what we do. There are 36 million people around the world who are blind, yet four out of five don’t need to be. We’re working tirelessly to change this. In some countries where we work, as little as $25 can restore sight and give someone the future they deserve.
Thol's story
A simple 15 minute operation was all it took to give Thol’s children their mother back. Thol was blind from cataracts for two years, unable to leave the small wooden platform that was her family’s home in northern Cambodia. Her children fended for themselves and survived by fishing and collecting rubbish on the streets. The Foundation supported Thol’s surgery at Oddar Meanchey Provincial Hospital. When her patches were removed she was overcome with joy as she caressed her baby son, Cheet. It was the first time she had seen him clearly. With her independence restored, Thol is now supporting her family by selling fish and frogs at the local market. “My big wish was for my children to be able to go to school,” Thol said. Now her dream has become reality.
Investing in people
We know that teaching the teachers first is the best way to create sustainable change. That’s why we’re empowering local people to identify, refer and treat eye disease in more than 25 countries around the world. With the help of our partners, we’ve trained thousands of surgeons, nurses, community health workers and teachers.
Mercy's story
"I get emotional when I see parents weeping at the mention of their children being blind due to cataracts,” said Mercy Mbayi. Mercy works as a nurse at the Sabatia Eye Hospital in Kenya, where staff restore sight to more than 100 people a week. As a mother of six, she can empathise with their situation and often carries children in her arms to and from the theatre while reassuring anxious parents. Mercy regularly travels hundreds of kilometres as part of the hospital’s community outreach screening team which identifies and refers patients for treatment. She also trains Ophthalmic Nurse Assistant students who are supported by The Fred Hollows Foundation during their three month placement at the hospital. Mercy’s passion for her work is evident in everything she does. “It brings me joy when I see children receive their sight back. It is definitely a new beginning for the family and the entire community. It’s hard to explain how wonderful that is to watch.”
Equipment and Technology
Fred Hollows believed in giving people independence by providing them with the tools they needed to get the job done. The Foundation is continuing this philosophy by building and equipping medical facilities around the world. From outreach screening units and community health centres, to regional hospitals and national training facilities, we’re providing the technology needed to deliver high-quality eye care.
Faith's story
By equipping our partner hospitals with the latest technology, we can deliver high-quality eye care to people like Faith from the remote Trans Mara region in Kenya. Faith was born blind from cataracts. Abandoned by her parents, she was taken in by her Aunt Helen, who, despite having five children of her own, was determined to give Faith a better life. “I would sell all my cows, everything we have, to give her sight,” she said. Helen’s determination paid off and Faith’s cataracts were removed at Sabatia Eye Hospital by Dr Ollando, an ophthalmologist trained by The Foundation. Since her surgery, Faith has transformed from a young girl who used to hide her face in the folds of her aunt’s skirt, to a boisterous and playful three-year-old with a bright future ahead of her. Every day she used to ask her Aunt Helen, “Can I go to school today?” Now, with her sight restored, she can.
Indigenous Australia Program
Our commitment to Aboriginal and Torres Strait Islander people is grounded in Fred’s deep respect for their right to good health. We are determined to Close the Gap on Indigenous health. By working with partners, we’re providing culturally appropriate services to people in remote and underserviced areas.
Tracey's Story
Tracey Howard was a young woman when she had her eyes examined by Fred Hollows in Broome, Western Australia, in the late 1970s. Fred’s visit was one of 465 that he and his team made to Aboriginal and Torres Strait Islander communities during the National Trachoma and Eye Health Program, a three-year crusade to treat trachoma in Australia. While Tracey, now 73, had no idea who the doctor was, she was surprised to see him on television a few years later. “I didn’t know much about him,” she said. “Then I heard he was the one who travelled the world and he became very well-known. I couldn’t believe he was the doctor man who checked our eyes.” Her encounter with Fred Hollows was the start of a long connection. Fast forward 40 years, and Tracey had a cataract removed this year, thanks to The Fred Hollows Foundation’s partnership with The Lions Eye Institute.
Gabi Hollows, Founding Director
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She Sees
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North Memorial Medical Center v. Gomez
Roy v. City of Little Rock
Thus, before a procedural due process claim can be mounted, the claimant must show that he enjoys a…
Sac & Fox Tribe of the Mississippi v. United States
Movers Warehouse, 71 F.3d at 718 (quoting Craft v. Wipf, 836 F.2d 412, 416 (8th Cir. 1987)). See also, North…
Full title:NORTH MEMORIAL MEDICAL CENTER; UNIVERSITY OF MINNESOTA HOSPITAL AND…
Court:United States Court of Appeals, Eighth Circuit
Date published: Jun 30, 1995
United States Court of Appeals, Eighth Circuit
holding that in order to have a protected property interest, one must have a "legitimate claim of entitlement to [the property]"
Summary of this case from Sac & Fox Tribe of the Mississippi v. United States
Submitted December 12, 1994.
Decided June 30, 1995.
Kent G. Harbison, of Minneapolis, MN, argued, for appellants.
Kim Buechel Mesun, St. Paul, MN, for appellee.
Appeal from the United States District Court for the District of Minnesota.
Before MCMILLIAN, Circuit Judge, JOHN R. GIBSON, Senior Circuit Judge, and SHAW, District Judge.
The HONORABLE CHARLES A. SHAW, United States District Judge for the Eastern District of Missouri, sitting by designation.
JOHN R. GIBSON, Senior Circuit Judge.
North Memorial Medical Center, University of Minnesota Hospital and Clinic, Cannon Falls Community Hospital, and Canby Community Health Services, appeal from the district court's entry of summary judgment in favor of Maria Gomez, Commissioner of the Minnesota Department of Human Services. The Hospitals sought a declaration that the Department interpreted a 1989 amendment to Minn. Stat. § 256.9695(1)(b) (1994) in violation of the Boren Amendment, 42 U.S.C. § 1396a (a)(13)(A) (Supp. V 1993), the regulation that effectuates the Boren Amendment, 42 C.F.R. § 447.253(a) and (e) (1994), and the due process clause of the Fourteenth Amendment to the United States Constitution. We affirm the judgment of the district court.
The Honorable Diana E. Murphy, then Chief Judge of the United States District Court for the District of Minnesota, now United States Circuit Judge for the Eighth Circuit.
The Hospitals are participants in Minnesota's Medicaid program. Medicaid is a joint federal-state program providing medical services, including in-patient hospital care, to needy persons. The Hospitals are paid according to a payment rate which the Department sets. There are several types of rate determination appeals which are described in detail in the district court's opinion. North Memorial Medical Ctr. v. Steffen, Civ. No. 4-92-706, slip op. at 2-3 (D. Minn. Apr. 4, 1994). We need concern ourselves only with the "case-mix" appeal which is at issue in the present case. The purpose of a "case-mix" appeal, which may be filed at the end of a rate-year, is to review the adequacy of the current year's payment rate. This is accomplished by calculating the difference in the mix of Medicaid patients served during the current rate year as compared with the mix of Medicaid patients served during the 1981 base year.
Before August 1, 1989, there were no deadlines for the filing of "case-mix" appeals, and generally the Hospitals waited for the Department to issue settle-up notices for a given rate year before submitting a case-mix appeal. The settle-up notices contained the information the Hospitals needed to file their case-mix appeals. Although the Hospitals admit that they could have compiled the information contained in the settle-up notices themselves, because the process was time consuming and there were no deadlines, the Hospitals typically waited until they received the settle-up notices before filing their appeals. Often the Department would not send settle-up notices until several years after the end of a rate year.
North Memorial filed a successful case-mix appeal for the rate year 1984. The Department did not complete processing the 1984 appeal until the spring of 1990. North Memorial contends that even if it wanted to file a case-mix appeal for 1985 or later years, it could not because it did not know what its adjusted base year rate would be until the Department finished processing the 1984 appeal. North Memorial argues that the regulations then in effect required that a permanent adjustment be made to the base year costs in the years following a successful appeal. The Department contends that the regulation then in effect did not require that successful case-mix appeals be included in the adjusted base year costs for following years, and that North Memorial misconstrued the regulation.
On June 1, 1989, the Minnesota Legislature amended the Medicaid program and enacted Minn. Stat. § 256.9695(1)(b) (Supp. 1989), which required that all case-mix appeals be filed with the commissioner within 60 days of the end of the rate year. The Department interpreted this new statute to mean that all appeals filed after its effective date, August 1, 1989, must comply with the 60-day deadline, including appeals that related to rate years before 1989.
The length of time to file a "case-mix" appeal was amended from 60 days to 120 days effective August 1, 1990. Act of May 3, 1990, ch. 568, Art. 3, § 18, 1990 Minn. Laws 1859.
The district court entered summary judgment in favor of the Department, rejecting each of the four arguments asserted by the Hospitals. Slip op. at 16. First, the district court rejected the Hospitals' argument that the Department was applying the statute retroactively in violation of Minn. Stat. § 645.21 (1994). The court concluded that because the Eleventh Amendment barred consideration of this issue, it lacked subject matter jurisdiction. Slip op. at 6-8.
Second, the district court rejected the Hospitals' argument that the Department's application of the statute violated the Boren Amendment, 42 U.S.C. § 1396a(a)(13)(A), which requires that state Medicaid plans provide reasonable and adequate payment for hospital services. Id. at 8-10. The district court reasoned that the Hospitals had several years in which to file their appeals, but did not do so, and that after the passage of the statute in 1989, there was an additional 60-day window period before the statute became effective in which the Hospitals could have filed their appeals. Id. at 10.
Third, the district court rejected the Hospitals' argument that the Department's application of the deadline violated 42 C.F.R. § 447.253(a) and (e), a regulation promulgated under the Boren Amendment. The regulation requires that Medicaid agencies provide Medicaid providers with an appeals procedure. The district court concluded that the Hospitals had not been deprived of an opportunity to appeal, but had failed to exercise their right to appeal within the prescribed time limits. Slip op. at 11. The district court reasoned that the Hospitals "are sophisticated players in the healthcare industry," who "should have been aware of the passage of the appeals statute, and taken steps to protect their interests." Id. at 12.
Finally, the district court rejected the Hospitals' argument that the Department's interpretation of the statute eliminated their vested property right to file "case-mix" appeals for the years ending in or before 1989 without notice and, therefore, violated their right to due process. Slip op. at 12-16. The district court concluded that the Hospitals had an obligation to "stay abreast of changes in the law that affected them, and to request written clarification of policy interpretation" and, therefore, received sufficient notice of the change in the appeals deadline. Id. at 15-16.
On appeal, the Hospitals do not challenge the district court's dismissal of their Minn. Stat. § 645.21 claim, but otherwise reassert the arguments which the district judge dealt with so capably.
We review a district court's grant of summary judgment de novo, and apply the same standards used by the district court. Langley v. Allstate Ins. Co., 995 F.2d 841, 844 (8th Cir. 1993). Summary judgment is appropriate only if the record, when viewed in the light most favorable to the non-moving party, shows that there is no genuine issue of material fact and that the moving party is entitled to judgment as a matter of law. Fed.R.Civ.P. 56(c); see, e.g., Celotex Corp. v. Catrett, 477 U.S. 317, 322-23 106 S.Ct. 2548, 2552-53, 91 L.Ed.2d 265 (1986).
The Hospitals contend that the Department's refusal to allow appeals for rate years ending prior to 1989 violates the Boren Amendment, which provides:
A state plan for medical assistance must
(13) provide —
(A) For payment of the hospitals services . . . which the State finds, and makes assurances satisfactory to the Secretary, are reasonable and adequate to meet the costs which must be incurred by efficiently and economically operated facilities in order to provide care and services in conformity with applicable State and Federal laws, regulations, and quality and safety standards and to assure that individuals eligible for medical assistance have reasonable access . . . to inpatient hospital services of adequate quality. . .
42 U.S.C. § 1396a(13)(A). The Hospitals argue that by refusing "case-mix" appeals for rate years before the deadline became effective, the Department is failing to comply with the Boren Amendment's requirement that it provide Medicaid providers with reasonable and adequate payment for their services.
The Hospitals' reliance on the Boren Amendment is misplaced. The Boren Amendment was designed to assure that state reimbursement rates remained reasonable, and to afford states greater flexibility to adopt "`reimbursement methodologies'" that would "`promote the efficient and economical delivery of [medical] services.'" Wilder v. Virginia Hosp. Ass'n, 496 U.S. 498, 506, 110 S.Ct. 2510, 2515-16, 110 L.Ed.2d 455 (quoting H.R. Rep. No. 97-158, 97th Cong., 1st Sess., Vol. 2, at 293 (1981)). The Hospitals do not contend that the Department's adoption of a 60-day appeals period is unreasonable or results in a system of payment which is inherently inadequate. Rather, the Hospitals contend that the Department's application of the 60-day appeals period as a bar to pre-1989 appeals resulted in inadequate payment. The Department may place reasonable deadlines upon appeals without running afoul of the Boren Amendment. The 60-day appeals deadline which the Department imposed was reasonable. The Hospitals had sufficient time in which to file appeals before the statute was enacted, but failed to do so. After the legislature enacted Minn. Stat. § 256.9596(1)(b), the Hospitals failed to take advantage of an additional 60-day period before the deadline became effective in which they could have filed their pre-1989 appeals. The Hospitals' failure to comply with the applicable deadline does not make the Department's payment system unreasonable or inadequate. If the Hospitals failed to receive adequate payment as a result of the Department's denial of their appeals, they have no one to blame but themselves.
The Department points out that the shortest appeal period at issue in this case is 244 days.
Next, the Hospitals argue that the Department's interpretation of Minn. Stat. § 256.9695(1)(b) violated 42 C.F.R. § 447.253(a) and (e), which was promulgated under the Boren Amendment and provides that:
(a) State Assurances. In order to receive [Health Care Financing Administration] approval of a State plan change in payment methods and standards, the Medicaid agency must make assurances satisfactory to HCFA that the requirements set forth in paragraphs (b) through (i) of this section are being met, must submit the related information required by § 447.255 of this subpart, and must comply with all other requirements of this subpart.
(e) Provider Appeals. The Medicaid agency must provide an appeals or exception procedure that allows individual providers an opportunity to submit additional evidence and receive prompt administrative review, with respect to such issues as the agency determines appropriate, of payment rates.
42 C.F.R. § 447.253(a), (e). The Hospitals assert that the Department's interpretation of § 256.9695(1)(b) cut off any meaningful and reasonable appeals procedure for Medicaid providers to contest the Department "case-mix" rate decisions for rate years ending in or before 1989.
Nothing in the record supports the Hospitals' contention that the Department's interpretation of § 256.9695(1)(b) resulted in the implementation of an unreasonable appeals procedure. As we set out above, each of the Hospitals, at the very least, had a 60-day period in which to file their pre-1989 "case-mix" appeals. The Hospitals argue that the imposition of a 60-day appeals period without notice is unreasonable. However, as participants in the Medicaid program, the Hospitals had a duty to familiarize themselves with the legal requirements of the appeals process and obtain a written agency interpretation of the statute. See Heckler v. Community Health Servs., 467 U.S. 51, 64-65 104 S.Ct 2218, 2225-27, 81 L.Ed.2d 42 (1984) (holding that a Medicare provider was responsible for familiarizing itself with the legal requirements of cost reimbursement and obtaining an agency interpretation of the applicable regulations). Furthermore, 42 C.F.R. § 447.253(e) requires only that the Department provide Medicaid providers "an opportunity to submit additional evidence and receive prompt administrative review . . . of payment rates," it does not impose any notice requirements. Therefore, we conclude that the Hospitals received ample notice and had an opportunity to appeal, as required under 42 C.F.R. § 447.253(a) and (e).
Finally, the Hospitals argue that the Department's interpretation of Minn. Stat. § 256.9695(1)(b) violates the due process clause of the Fourteenth Amendment, because it deprived them of their property interest in pre-1989 appeals process without notice. The district court concluded that the Hospitals were sufficiently notified of the change in the appeals deadline by the broad language of the appeals statute and the case law interpreting similar statutes and, therefore, were not deprived of due process. Slip op. at 14-15. We find it unnecessary to consider whether the Hospitals were deprived of due process, because we conclude that the Hospitals did not have a protected property interest in the pre-1989 appeals process.
Although it is not clear from the briefs, it appears that the Hospitals are asserting only a procedural due process claim. In order "to make out a substantive due process claim, [the Hospitals] must show that the law violated one of [their] fundamental rights." Walker v. City of Kansas City, 911 F.2d 80, 93 (8th Cir. 1990), cert. denied, 500 U.S. 941 111 S.Ct. 2234, 114 L.Ed.2d 476 (1991); see also Lemke v. Cass County 846 F.2d 469, 471 (8th Cir. 1987) (en banc) (per curiam) (Richard Arnold, J, concurring) (stating that the application of substantive due process should be "strictly limited"). The Hospitals make no arguments which even begin to approach this standard. Thus, we address the Hospitals' argument only as a procedural due process claim.
"The Fourteenth Amendment's procedural protection of property is a safeguard of the security of interests that a person has already acquired in specific benefits." Board of Regents v. Roth, 408 U.S. 564, 576, 92 S.Ct. 2701, 2708, 33 L.Ed.2d 548 (1972). In order to have a protected property interest one must "have a legitimate claim of entitlement to [the property]." Id. at 577, 92 S.Ct. at 2709. Property interests are "created and their dimensions are defined by existing rules or understandings that stem from an independent source such as state law." Id., Ikpeazu v. University of Neb., 775 F.2d 250, 253 (8th Cir. 1985).
The Hospitals rely upon Littlefield v. City of Afton, 785 F.2d 596, 600 (8th Cir. 1986), to support their claim that they have a protected property interest in the pre-1989 appeals process. In Littlefield, we held that "an applicant for a building permit ha[d] a constitutionally protected property interest in the permit," because the only requirement under state law and the city ordinance for the issuance of the permit was compliance with city ordinances, a condition the plaintiff had fulfilled. 785 F.2d at 602. Thus, the Hospitals are correct in their assertion that "a legitimate claim of entitlement can arise from procedures established in statutes or regulations adopted by states." Id. at 600. However, the Hospitals ignore a fact which was critical to the Littlefield court's holding. The Littlefield court reasoned that the ordinance at issue "significantly and substantially restricted" the City's decision making power and, therefore, created a constitutionally protected property interest. Id. at 602. In the present case, no statute or regulation significantly or substantially restricts the Department's authority to implement a 60-day appeals deadline. Thus, the Hospitals' interest in the pre-1989 appeals process amounts to nothing more than "an abstract need or desire," which is not sufficient to establish a protected property interest. Roth, 408 U.S. at 577, 92 S.Ct. at 2709.
The portion of Littlefield which addresses substantive due process has been abrogated. See Lemke, 846 F.2d at 470-71.
For the foregoing reasons, we affirm the judgment of the district court.


Positively Bob Dylan
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Called home by the Highlands
Happy 2008, Bob! This time it was probably Scotch and not Champagne Bob was drinking at his New Year's party.- He and his brother David are said to have spent the time in Bob's new $4 million home in the Cairngorms Mountains of the Highlands - west of Aberdeen. After one year of renovating the Scottish castle it seems that finally it's ready for moving in.
Dylan mentioned his passion for Scotland on several occasions, the last track on his 1997 album "Time Out Of Mind" is "Highlands". In 2004 he accepted an honorary degree from St. Andrews University - he had only done this once before (Princeton, 1970). He his also regularly performing live in Scotland, and his classic song "The Times They Are A-Changin’" from 1964 is based on an old Scottish folk song by Hamish Henderson.
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