January 16, 1993
Recognizing these responsibilities, Rosewood had in the past set up two security buildings -- one for males and one for females -- for this group of disabled persons, with fences surrounding the buildings.
Then the state, in its infinite wisdom, appointed an out-of-town "expert" to administer the program for the mentally retarded.
One of his first actions was to have the fence around the male building torn down. The effect of violence, molestation and break-ins in the neighborhood was almost immediate. It is true that fences do not look good, especially when we are not dealing with criminals but with unfortunate people who do not have the mental capacity to care for themselves independently, nor the judgment to control their instincts and impulses.
However, what is the alternative?
Without a fence the person must either be contained inside a secure building, not being able to enjoy the grass, the trees, the sun and the air of the outdoors or he may and does make the community unsafe.
With an appropriate fence the building does not need to install the stark security structures and the people living there can enjoy the outdoors and pursue activities commensurate with their abilities, such as ball play, exercise, picnics etc.
Whenever a person, either by training, medication (horrible thought!) or just by maturation becomes less impulse and instinct driven and more self-controlled, he would be able to leave the security facility for more open settings, at first within the institution and later even in the community.
Rather than just shifting the problem from one county to another, it would make much more sense to provide a "least restrictive" environment that is as humane and esthetically pleasing as possible, while at the same time considering the needs and rights of the individual patient and protecting the rights and security of the surrounding community.
Kurt Glaser, M.D.
Baltimore
The writer is a former clinical director of Rosewood State Hospital.
Governor Picks Wrong AIDS Scapegoat
I have had the unique experience of being twice appointed to and twice fired from Gov. William Donald Schaefer's Council on HIV Prevention and Treatment.
I have had the opportunity to watch Maryland's governor twist and squirm in his attempt to deal with the admittedly difficult issues surrounding the HIV epidemic.
Unfortunately, Governor Schaefer has not been alone among political leaders in not providing the moral, administrative and policy leadership needed to deal with a health crisis of such major proportions.
While our state leaders have agonized over a politically safe response, many Marylanders have become infected, many have gone without necessary treatment and many have died.
Governor Schaefer discovered early on that a council was a safe (and inexpensive) way to deal with the crisis. Not only does a council shunt responsibility to a volunteer committee, but it has provided a convenient scapegoat when the issue did not go away and did not improve.
It took two years before a person with HIV infection was appointed to the council by Governor Schaefer. (Imagine a minority commission or women's commission without a minority or women serving on it). The administration consistently failed to provide information the council requested, and Governor Schaefer met once with the council during six years.
Despite the lack of attention and support, the council has still provided significant impact on the Maryland's response to AIDS.
The council has recently completed two comprehensive reports on prevention and treatment. In Annapolis, the council's rational voice in an otherwise politically charged debate has been instrumental in halting short-sighted legislation that simply reflected the fears of the uninfected.
The real failure in AIDS policy in Maryland rests with Governor Schaefer, not with the council as he contends. No health crisis in recent history has demanded stronger policy leadership from national and state leaders; and no epidemic in recent memory has received so little.
If Governor Schaefer wants to bring Maryland into the forefront of AIDS prevention, treatment and care, he must do the following:
* Talk about AIDS. The governor must forcefully express hicommitment of state resources and compassion for the infected.
* Provide resources. Relying on federal funds is not enoughCutbacks in Maryland's medical assistance program will devastate the HIV population and lack of prevention resources will insure the spread of this horrible disease to those not yet infected.
* Provide leadership in the legislature. Governor Schaefer must stop tacitly approving misguided legislation which does nothing to ameliorate the epidemic but only makes politicians feel good. The governor must stop supporting legislation which violates the civil rights of persons with HIV and drives people away from testing and early intervention.
