New Danish surveillance system

Abortion re-think in Poland Poland’s lower house of parliament, the

Sejm has adopted a major amendment to the controversial law on conceived life of 1992. This amendment restores the legal right of a woman to terminate her pregnancy on the grounds of "adverse circumstances of life" or "difficult personal circumstances". It also authorises the termination of pregnancies in private clinics. The current law restricts it to state hospitals and health-care facilities. The present law-itself a compromise : between traditional Roman Catholics who wanted a total ban on abortion and the advocates of abortion on demandrestricts grounds for the termination of pregnancy to severe medical grounds and threat to the woman’s life or health, a

yet during 1993 the birthrate in Poland fell. This, opponents of the "prolife" law say, proves that there has been a huge rise in illegal abortions and "abor-

grounds",

New Danish surveillance

system

tion-tourism", in particular to the KalinThe National Health Hoard acknowledge : that treatment can vary widely between ingrad region of Russia. The passing of the amendment was hospitals and different regions but as yet it has not come up with a remedial plan. But greeted with triumph by member of parBarbara Labuda liament (Freedom this problem cannot be solved from the Union), who heads the Parliamentary top, say Danish doctors, who have decidWomen’s Group, which had sponsored it.: ed to tackle the inequities themselves. The amendment, Mrs Labuda emphasis- : Among the treatments with the greatest es, leaves the decision on what constitutes geographical variation are caesarean sec"difficult circumstances" to the woman tion and prolapsed intervertebral disc. In and her doctor, and allows the pregnancy the county of Arhus, the doctors perform to be terminated three days after an oblig: caesarean sections on 8 out of 100 women atory counselling session. Attempts by giving birth. However, in the counties some

MPs

to

impose

some

system of:

of Funen and

Frederiksborg

the rate is

checks, or the need for a magistrate’s: double. In Naestved the doctors order rest order, before the abortion is permitted, at home to patients with disc prolapse, in were rejected by the Sejm. : Esbjerg prompt surgery is recommended. severely damaged fetus, or (with a magisWhether the amendment becomes law But now something is on its way in the trate’s permission) pregnancy resulting :’, is still open to question. President Lech: area of slipped-disc treatment. from incest or crime. It virtually outlawed a strict Catholic, has made it clear: Walesa, "We will establish a database in order for with women a prenatal testing (except even if the amendment is endorsed that, to of gather all facts and results of slippedfamily history genetic abnormalities), the Senate (Upper House), he will not disc treatments. The wards will deliver the by medical researchers and, complained, ., imposed severe constraints on work in: sign it. Whether such a Presidential veto information to the base, and every third month the latest news on the treatments human genetics. However, before the new would be constitutionally valid is, howno means clear.: ever, by will be compiled and made available to the vast of abortions in law, majority the doctors, thus making it possible to Poland were performed on "socialVera Rich make direct comparisons. In this way we

Russian children’s camp Chernobyl nuclear accident, a new, purpose-built rehabilitation centre has been opened at Malakhovka, near Moscow, for the children of those involved in the clean-up following the accident. Although sited in Russia, the

Eight

years after the

will receive children from all countries of the Commonwealth of Independent States (CIS). : Camps for children at risk from the aftermath of Chernobyl have been a feature of the three affected republicsBelarus, Ukraine, and Russia-since the extent of the fallout was reported in 1989. Since then, similar facilities have been made available to children living near other radiation accidents. This, however, seems to be the first time that the problem of the children of the "liquidators", those emergency workers and soldiers who had to extinguish the fire and build the concrete "sarcophagus" over the damaged reactor (often without appropriate protective clothing or remote-handling equipment), has been specifically addressed. The children attending the Malakhovka centre will undergo not only a course of treatment designed to improve their general but also "socialhealth, : psychological rehabilitation". The break-up of the Soviet Union meant a fragmentation both of Chernobyl relief work and of the database of the consequences of the accident. The problem of the liquidators is even more complex. Anecdotal evidence from individuals suggests that, at least on occasion, the amount centre

will get an updated knowledge on what is of radiation they received was best for the patients in this particular under-reported. After finishing their (necfield", says Dr Claus Manniche, director essarily brief) tour of duty, they were disof the acute back-pain service which persed to hospitals throughout the Soviet: serves the large county of Århus. Union-deliberately, it is said, in order: Nine wards will start participating in a that the damage they had suffered should few months, and come next summer the not show up on the union-wide statistics of : database surveillance system is supposed radiation-related disease. to be nationwide, with 22 orthopaedic, How far the fathers’ exposure to radianeurosurgical, and rheumatic wards tion can be related to the children’s health attached to the base. At first the system is of course, highly debatable. The majoriwill be anonymous-"not all doctors are ty of the children going to Malakhovka particularly keen on publishing bad will have been born before their fathers news", says Manniche. He adds that the went to Chernobyl. (Even those liquidadatabase will also automatically select the tors whose fertility was not affected by unit with the best performance, which can exposure to radiation are often reluctant be used as a role model for others. to father a child for fear of the genetic : But the overall of the initi: ative is to find the purpose consequences.) best way of treating The cost of maintaining a child at the these patients and to level out the geocentre is high by Russian standardsdifferences. This is important graphical about US$6 a day, in a country where for Danish patients who, since October, professional salaries are of the order of: 1992, have had the right of free choice of $30 a month-to say nothing of soaring hospital. At present the variations in practravel costs. And, although there has been tice are large, but patients have no way of much charitable involvement in constructknowing what kind of treatment they ing the centre-both from western chariwill get. ties and Russian former Olympic: Each year there are 10 000 new cases of champions-the parents will have to meet people with slipped-discs in Denmark, the cost out of their special liquidators’ v and this is the first time a surveillance sysbenefits. Nevertheless, although this year tem is to be used on such a large group of the centre will operate during the summer patients. According to the working group only, it will eventually be open all the year behind the plan, the surveillance system round, taking children in batches of 100 . could successfully be used in the treatto 150 at a time. If one assumes an averment of a number of other conditions, age stay of two weeks, then the eventual thus securing higher quality and a greater planned intake will be of the order of of

deliberately

7000 children Vera Rich

a

year.

:

degree

homogeneity.

Kaare Skovmand

1563