What really matters

“What really matters” underwent a reevaluation by many in the United States following the tragic events of September 11, 2001. These personal evaluations and reevaluations were symbolized by phone calls to family members and friends to be assured of their well-being. Many Americans found their sense of security badly shaken, so much so that travel decreased perceptibly. There were other effects. In a sample of Manhattan residents, posttraumatic stress disorder and depression rates were 2 to 3 times higher after 9/11, according to a study by Galea et al. (2002). The emergency department of New York’s St. Vincent Hospital treated 264 persons on 9/11, of whom 51 were in critical condition, as compared with the usual 160 to 180 people (Ostrowski, 2001). The painful part for the health care providers who prepared emergency triage was that more people didn’t survive to be treated by them. One of the most important ramifications of the 9/11 attacks is the change in national and local funding priorities. New areas of concern have emerged or been reinforced. Research is being conducted on the “immediate and long-term worker and community health protections arising from theWorldTradeCenter attacks” (National Institute of Environmental Health Sciences Press Office, 2002). These efforts include chemical protection clothing/decontamination and special training for construction, support, and transit union workers, and health assessments of rescue and clean-up personnel. In addition to funds for infrastructure, monies have also been allocated to identifying terrorists at home and abroad, supporting the defeat of the Taliban andAl Quaeda, and the stabilization of the government in Afghanistan. As important as these programs are, the concern, however, is with the deflection of funds from other priorities. As MacIntyre (2002) stated, “The richest country on earth will provide fewer health services to fewer people, with and without HIV. Minorities, the poor, and the unemployed will suffer most. Progressives will argue that securing the health of a nation is part of a national defense. They will remind us that all emergencies are local and advocate for our local public health departments. It will be an uphill battle” (p. 4). Kruger (2002) worries as well about the effects of robbing Peter to pay Paul, with Paul, of course, being Afghanistan. “The World Bank also believes that the attacks have slowed down global growth rates, condemning millions more people to poverty. Even more shocking is the Bank’s estimate that 10,000 to 20,000 moreAfrican childrenwill die as a result of the attacks. So as aid dwindles, the hopes of an improvement through ordinary economic growth are also lessened” (p. 18). In this issue of JANAC, we examine the impact of 9/11 on HIV/AIDS, not the virus, but the hosts, care providers, community, and society. The authors of the articles in this issue share their personal lives with us as well as their considered opinions and research. Some of what is stated will resonate with your own thoughts; other ideas will challenge you anew. My gratitude to all of the contributors who were always gracious with my queries and requests. And while for each of youwho read this issue and ponder for yourself the impact of 9/11 andwhat reallymatters, perhaps our collective response needs to be renewal and rededication to all we hold dear—personally and as a society.