Special Order No. 40; I heard of this policy on one of the podcasts that I listen to, and thought that was really smart thinking so I decided to look into its origins.  After reading about this I gained a lot of respect and admiration for the late Darryl F Gates, Los Angeles Police Chief 1978 – 1992.  While Chief Gates was also known for aggressive policing in LA, he was the one who in the interest of public safety and community collaboration with law enforcement enacted this very important policy for his police department.  This rule prohibited LA police officers from initiating contact with anyone for the sole purpose of learning their immigration status and ruled out arrests for violation of U.S. immigration law. Over the years this has been adopted in various forms by many other police departments across the country[i]

Today the Trump administration in its aggressive stance on illegal immigration is looking at this policy and making efforts to withhold federal law enforcement funding from cities and counties that have adopted this policy. There are currently more than 400 sanctuary cities in the US today and whilst the Trump administration’s efforts to force such jurisdictions especially big cities like Chicago, Los Angeles and San Francisco to change policies related to local policing and immigration may have little real impact on decades long policies that police departments believe keep their cities safe, the constant wrangling over such issues is not conducive to the health of both legal and illegal immigrants in this country.


Immigration-and-violent-and -nonviolent-in-US
Crimes statistics for immigrants in our correctional facilities – Source: The Sentencing Project

Current LA police Chief Charlie Beck said his department will follow its decades-old policy of keeping officers focused on local crimes, leaving federal violations such as entering the country illegally in the hands of immigration officials. He reported that since January 2017 there has been a 25% drop in sexual assault and 10% reduction domestic violence reports by Latino women. Some counselors involved in cases of domestic abuse involving Latino women reported that some complainants have withdrawn their cases.  These withdrawals are due to fears among these women that either they themselves or their abusers could be deported if they went forward with their cases[ii]. The economic benefits of tighter and aggressive immigrations statutes and its impact on public safety in this country has been seen by many individuals involved in these issues to be mostly negative[iii]. That may be why no other person than Darryl Gates a Los Angeles police chief renowned for aggressive policing was the one who proposed and instituted this policy. The one reason why this has been adopted by more than 400 cities and counties across the county is because it keeps our cities safe. Up until his death in 2010 Chief Darryl Gates supported this policy which has come under attack by several presidents and politicians in various municipalities. Special Order No.40 has not only survived close to 40 decades in its city of origin Los Angeles; it has actually been adopted by several cities and counties across the country. If tougher immigration enforcement breeds crime then I believe our law enforcement officials will no better.


Data from The Sentencing Project on immigration and crime

After 38 years Special Order No. 40 a policy enacted by a Los Angeles Police Chief who was accused of racism in several instances still survives today, more than 7 years after his death.  Today in America the seed that was planted by Darryl Gates and has flourished and spread far across the country is under attack by the Trump administration. Our president has promised to keep us safe and I would like to believe that he is sincere when he says he is for public safety. Any attempt at using reduction in federal law enforcement funding to force cities to change a policy that most police officers believe works to satisfy a small minority of his electorate is federal overreach and violates the 10th Amendment.

I would like to remind Mr. Trump that he did not win the popular vote he only won 46.1% of the popular vote and Hillary Clinton won 48.2%. A recent poll suggests that only 30% of republicans and 11% of democrats support tougher immigration enforcement[iv]. This suggests that all his executive order on illegal immigration is not supported by a majority of American voters and is mostly unpopular among local law enforcement. I would like to let our president know that we trust the decisions of our local municipalities on how best to keep us safe. I don’t believe Americans want our presidents to determine how our police departments keep us safe


[i]  Smith D, Los Angeles Times, Feb. 5th 2017, How LAPD’s Law-and-order chief revolutionized the way cops treated illegal immigration, http://www.latimes.com/local/lanow/la-me-ln-special-order-40-retrospective-20170205-story.html


[ii] Michael Balsamo, The Independent, March 22 2017, Latino population in LA reporting fewer sex crimes over deportations fears; http://www.independent.co.uk/news/world/americas/la-latinos-sexual-assault-reports-drop-donald-trump-immigration-fears-a7642956.html


[iii] Nazgol Ghandnoosh and Josh Rovner, The Sentencing Project, March 17th 2017, Immigration and Public Safety, http://www.sentencingproject.org/publications/immigration-public-safety/#IV. Police Chiefs believe intensifying immigration law enforcement undermines public safety


[iv] Mark Hensch, The Hill March 17 2017, Poll: Most support path to legal status for illegal immigrants, http://thehill.com/homenews/news/324435-poll-most-say-citizenship-path-top-immigration-priority






“Guns don’t kill, people do”, the gun lobby has been touting this mantra for years in the United States whilst our numbers on gun violence continues to rise. Studies however show a very strong correlation between gun ownership and gun violence. Currently in the US research on the impact of guns on homicides and suicides is poorly funded since public funding for such research has been limited significantly by legislation driven mainly by lobbies mostly funded by the NRA (National Rifle Association).  I have no problems with gun ownership and respect the rights of Americans to own guns. In 1993 Kellerman and his colleagues published their research on the risk of gun ownership. This study which was funded by CDC (Center for Disease Control and Prevention) revealed that having a gun in the home led to higher likelihood of gun violence against a family member, friend or loved one.  The common reason most individuals get guns is for protection against home invasions however these guns that are supposed to protect us from intruders end up killing those we love. That was the main message from the Kellerman study. This research which was published by the New England Journal of Medicine (N. Engl. J Med 1993; 32: 1084 – 91)1 was too much for the NRA.  In 1996 Congress then passed a measure drafted by then Representative from 4th Congressional District in Southwestern Arkansas, the late Jay Dickey limiting CDC’s ability to spend funds “to advocate or promote gun control”2. The NRA hoped to eradicate the injury center entirely but actually ended up achieving more than they expected.  Whilst this bill did not prevent the CDC from funding studies on the impact of guns on violence its impact was very far reaching, the National Center for Injury Control and Prevention was closed down and its director Mark Rosenberg lost his job. Mark Rosenberg is still a strong advocate for research on gun violence and is currently the CEO of the Task Force for Global Health a not for profit working to improve health in developing countries.

Last week President Trump asked Dr. Murthy the Surgeon General appointed by the Obama Administration to resign. Among all his attributes Dr. Vivek Murthy has been a strong supporter of gun control and his confirmation was stalled in the senate mostly on that account. Dr. Murthy had signed a letter in 2012 by Doctors for America which he founded in 2009 calling for gun control legislation.  Fortunately he stood his ground on this issue reinforcing the need for American to follow a prevention based culture with regards to health with the inclusion of gun control. The Orlando Pulse club gun man had two guns a Sig Sauer MCX .223 which takes an AR-15 magazine with 30 rounds of ammunition and a Glock G17 with 17 round of ammunition.  What this means it that such a gun man can fire 47 shots before he needs to reload. In a crowded night club this is a disaster, he killed 49 people and wounded 53.

The Federal Assault Weapons Ban of 1994 included limits regarding magazines that could hold more than ten rounds unfortunately this ban expired in September 2004. Since the ban expired due to a sunset provision in the law some reports suggest the average number of deaths in mass shooting has increased.

a Sig Sauer MCX .223
A Sig Sauer MCX .223 – One of the guns used by the Orlando night club shooter
Glock 17
Glock 17 a hand gun that carries 17 rounds of ammunition used by the Orlando night club shooter

I wonder whether Dr. Murthy’s clear and open support for gun control has anything to do with his removal from office before the end of his term. If that is the case I am worried about where we are going as a nation.  Surely a Surgeon General should be able to voice his concern on the impact of guns on our society3. We cannot respect any part of the constitution over another but I personally would give a lot more weight to the first Amendment than to the Second. We should however be careful in the manner in which we use either of these rights because as we are aware they can both kill and must be handled with care.


1.       Kellermann, Arthur L., et al. “Gun ownership as a risk factor for homicide in the home.” New England Journal of Medicine 329.15 (1993): 1084-1091.

2.       Jamieson, Christine. “Gun violence research: History of the federal funding freeze.” Psychological Science Agenda 27.2 (2013).

3.       Trump administration fires Obama-appointed surgeon general who called gun violence a ‘public health issue. ‘http://www.nydailynews.com/news/politics/trump-admin-fires-surgeon-general-called-guns-health-issue-article-1.3088358


Prevention saves lives – Meningitis in a resource constrained setting -by Dr. Teddy Totimeh – A physician in Accra, Ghana

Four students have died. One after the other over a ten day period. And the diagnosis is only certain now, after they died. In a country with 5000 doctors, multiple teaching hospitals, a Ministry of Health, and a Health Service, this is not acceptable. Especially if the country has had 60 years to build a system. It is not right. If there was a war going on, it would be excusable. If there was famine, civil unrest, natural disaster… maybe, this would be easy to ignore. Not in this Ghana. Not at this time.

On the other hand, considering that there are 2 newly built, multimillion dollar, appropriately commissioned centers of excellence in the same city waiting for medical staff to start working in them months after completion; and that there are 3 hundred physicians newly trained, who have been sitting at home for six months unemployed. There are municipal hospitals in regional capitals run almost completely by physician assistants… it is not surprising, that 4 students will die, in rapid succession, and we have no idea why.

And in 2017, we are able to yield our intellects to rumors of spiritual deaths, and panicked desertions of schools, distributing potentially infected patients, unscreened, into the wider society without prophylaxis. In 2017, we still have no way of anticipating the meningitis season, and vaccinating the vulnerable populations in the endemic areas, and educating them so that if students in crowded dormitories in these areas present at the hospital with fever and chills, there is someone there prepared to make the diagnosis and administer treatment.

And we have a media, with reporters, repeating the theories debunked decades ago, about heat causing meningitis. We have communication departments in the Ministry of Health, Ghana Health Service, Ghana Education Service and there is not a single public service announcement on meningitis. And four students have died already! We have a media blitz on galamsey (illegal gold mining) and our impending water deprivation, and not a single poster on meningitis in the meningitis season, so that whoever first saw those four could have resisted the urge to dismiss the students as malaria infected. It was BBC which broadcasted the tens of deaths in nearby Nigeria, just weeks ago. It was BBC which informed listeners about a new strain, that had become more virulent in this epidemic. We have media that monitor the global news. We have strategists who follow the infectious disease trends. And not even the multiple deaths in the country next door, could alert us.

Four students have died of a preventable disease. And no one will resign, no one will take responsibility, not the headmaster, not the nurses at the sick bay, not the physicians who missed the diagnosis, not the governmental agencies who did not inform. No one will step up and say why this should not happen in a civilized country, and why it should not happen again because something can be done about it.

Four students have died. And this week the students have come back to the school in their numbers for academic reasons… some exam coming up. And someone in leadership at the school is on radio, and acting surprised that the students actually turned up. And I have not heard anything about the screening that is supposed to have started as the students started turning up, or the vaccines that are being arranged to be transported to the locality, or the strain of bacteria that has been isolated, and if it is the same as killed scores in nearby Nigeria.

And 4 students have died already.


Posting from Teddy Totimeh a colleague working in Accra, Ghana