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The heavy news coverage of antibiotic-resistant staph infection known as MRSA worries the health care community and the general public. Dr. Rebecca Sunenshine, deputy state epidemiologist for the Arizona Department of Health Services, explains why it is so prevalent and what can be done about it.

Richard Ruelas:
Tonight on "Horizon": a group has filed an initiative that would ban state and university race and gender preferences in Arizona. Plus, how concerned should we be about the staph infection, MRSA? And the east valley partnership celebrates 25 years of hard work promoting the region. Those stories next, on "Horizon."

Richard Ruelas:
hello, and welcome to "Horizon," I'm Richard Ruelas. Three other states have already passed laws that ban affirmative action in state and local hiring and contracting, and in university admissions. Yesterday a petition drive was launched to get an measure on the ballot to do the same here in Arizona. It was filed by the group Arizona Civil Rights Initiative. Here to tell us what that initiative would do is Max McPhail, the executive director of the group. Thanks for joining us this evening.

Max McPhail:
thanks for having me, I appreciate it.

Richard Ruelas:
welcome to Arizona.

Max McPhail:
i've recently moved here.

Richard Ruelas:
tell us who is behind it and why Arizona, why now.

Max McPhail:
our chairman is Andrew Thomas, the Maricopa county attorney. He is interested in putting something like this on the ballot. One of the national figures, Ward Connerly, offered to lend his insight and knowledge to the effort. And just, it's not a ban alone, it makes it illegal for the state to discriminate based on race, gender, national origin and color, in three very specific areas, public contracting, public education, and public employment.

Richard Ruelas:
those areas are parts where race or gender cannot be considered?

Max McPhail:
you can't consider race in terms of who will get a contract, who will be hired or admitted into a college or university.

Richard Ruelas:
and again, finishing up on the "why now" thing, is it your understanding that Maricopa county attorney Andrew Thomas looked at other states?

Max McPhail:
I think he looked at Michigan and other states and said, our state needs something like that. And he had done some cursory analysis of different programs just within Maricopa County, there might be areas of granting racial preferences or discriminating against people based on race. Obviously, I feel that it is fundamentally flawed to be granting preference based on the way you look.

Richard Ruelas:
has he -- well, I guess, what programs right now do you think would be affected, especially the Maricopa county programs you mentioned?

Max McPhail:
one of the main ones we found is the city of Tucson, and you can register as a minority or a minority owning a firm, and you get preferences, up to 7% price preference on goods and services for contracts up to $25,000-150,000.

Richard Ruelas:
you can come in over the next lowest bid and still get the contract?

Max McPhail:
right. That's not only discriminatory or their gender, but it's hosing the taxpayers if they're paying a higher price for something. If you get a 5% bid preference, obviously we just find that is deplorable. I think our government should be in the vanguard of promoting equal opportunities, equal rights for all races, as well as gender, not specific groups.

Richard Ruelas:
when you get to universities, I know California did use a lot more race-based admissions policies. What has been your understanding of Arizona so far, as far as its use of race?

Max McPhail:
they've been doing some different stories on it. The law school says they use race holistically in their applications, they don't actually grant a preference. But, once you put your race down on an application and get categorized as that group, I fail to understand how that is not going to either be a plus or a minus point, or a mark against you or for you. Then the general university here at Arizona State says they don't take that into account. But I'd be curious to see if that's the case.

Richard Ruelas:
you mentioned Maricopa county programs are programs that caught Andrew Thomas' attention. Do you know what those might be?

Max McPhail:
this will not be affected by this initiative. But apparently there are separate court systems in Maricopa County for d.u.i.

Richard Ruelas:
if you are Native American?

Max McPhail:
yes.

Richard Ruelas:
those wouldn't be affected?

Max McPhail:
no, they wouldn't be affected by the initiative. There are higher-end programs that give people a boost up if they correct some type of underutilization in that field. Our policy and belief is there is no justification for racial discrimination for any reason. Diversity is not a reason to discriminate.

Richard Ruelas:
is there a major hue and cry from the public that they want this in Arizona?

Max McPhail:
I think actually when people read the language and hear what's going on behind the scenes, I think people do get very upset.

Richard Ruelas:
do you think you'll see more? Right now behind the scenes you have the one Tucson program. Andrew Thomas has mentioned the courts, but you say those aren't affected. And maybe admissions to law schools and universities could be.

Max McPhail:
here's what i printed out from the Arizona graduate program here. It is for the underrepresented graduate enrichment match, and this is for math programs, minorities are awarded 50% of research assistantships. That's just a blatant quota, and obviously they are unconstitutional. That's something we hope to correct with this initiative, as well.

Richard Ruelas:
and there's an educational component as you move forward, you hope to find more of these programs to stamp out.

Max McPhail:
yeah.

Richard Ruelas:
what would be the enforcement? Would it just be complaint-driven? If there is someone who thinks races is being used?

Max McPhail:
so obviously you can file discrimination suits. And the federal government has criteria for how you pursue racial discrimination. But it would be up to the attorney general to enforce the law so that no city governments or county governments are actually employing racial preferences.

Richard Ruelas:
do you have a website up yet?

Max McPhail:
yes, it's being worked on, but it's Arizonacri.org.

Richard Ruelas:
I imagine soon they will be able to read the initiative and there's only one page, article 32 to the constitution. I'm sure we'll talk again. Thanks for joining us here on "Horizon."

Max McPhail:
thank you very much.

Richard Ruelas:
you've probably heard about the antibiotic-resistant staph infection known as MRSA, and that there is growing concern that the rates of MRSA are rising. In a moment, a state health official will explain why it's so prevalent and what can be done about it. A warning: if you're finishing up dinner, there are images of infected wounds in that story.

Merry Lucero:
Dr. Tim Kuberski is an infectious disease specialist. He is visiting patient David Cunningham at north mountain hospital. He was originally hospitalized in May 2006, for a severely fractured leg. He had been home, healing well, but something wasn't right. Before long, he learned he had an infection called methacillin resistant staphyllococcus aureus, commonly called MRSA.

Tim Kuberski:
when they did the surgery, they had to put in devices to knit the bone together. If that gets an infection, that creates problems. You have to take out the hardware that's in there to get rid of the infection. So this is his second time coming back. The first time his tibia, the lower leg bone, was infected. We took out the hardware and gave him antibiotics. Now his femur, the upper bone in his leg, has an MRSA infection, also. This one kept his bone from healing. Now we have to do another surgery on his leg to take out the hardware that's in there. These are pretty big operations to do. He's otherwise healthy.

David Cunningham:
this has been slowing everything down. My body has been fighting all this infection. This upper one we've been dealing with, this was about 18 months we've been waiting. I had three inches of bone missing here, so there was a big section for it to grow in. Well, it's grown in, but now the infection is so high it's fighting the infection, and won't let the bone finish healing.

Merry Lucero:
once the infection subsides, he must have more surgeries on his leg.

David Cunningham:
we've been trying to get everything under control. It's frustrating because i want my leg back to work as close as possible to normal. But I just want to be done with surgeries. They say we've probably got three more to go. I've had 10; we're getting ready for the 11th. I'm thinking maybe at 13 we're going to be done, but time will tell.

Merry Lucero:
cunningham's infection was inside his leg. But MRSA often presents as a skin abscess. Staph bacteria are found on the skin or in the nose of about one third of the population. Healthy people can be colonized with MRSA with no ill effects, but can pass the germ to others.

Tim Kuberski:
this organism has the ability to hang on for long periods of time. If you get a little break in your skin, it goes to that place, and sets up a little infection. All of a sudden you've got some pus, an abscess.

Merry Lucero:
the bacteria has been around a long time as a major concern to people with health issues. Recently, it is infecting people who are otherwise healthy.

Tim Kuberski:
Originally it started out as being a problem in the hospital, presumably because of antibiotic pressure, this got antibiotic therapy resistant. Suddenly, this organism has moved from the hospital environment into the community, where average people are getting it on their skin and getting abscesses. That's what's frightening about this particular organism. It has the capability of moving into the community and infecting normal people. Out of 100 infections of normal people, two or three will get very serious infections and end up in the hospital.

Merry Lucero:
the percentage of people with MRSA on their skin is going up.

Tim Kuberski:
it's a huge problem in the community where it wasn't ten years ago. I think that's where the emphasis is: how do you control an epidemic in the community? In the hospital, we can identify abscesses, isolate those patients, put them on an antibiotic and keep them from spreading it. When you're out in the community, it's very difficult within the family, say, to prevent transmission from one person in the family to another. It's a very difficult problem under those circumstances.

Merry Lucero:
to prevent further spread, Doctor Kuberski emphasizes education for patients on the right hygiene, and antibacterial body wash, and cleansing of the inside of the nose, in addition to antibiotics.

Tim Kuberski:
You would instruct the emergency room doctors: when you give that antibiotic, you give them a little bottle of soap, a little thing of wash and instructions, and say, look, you go home and do this, follow the directions closely, or other people in your family are going to get it. You have to put a little threat in there, because what's going to happen is that person's going to take it home, and there could be five or six other people that are affected by it. I think that's a way of solving the problem.

Richard Ruelas:
is it over yet? I didn't want to look at the wounds. Joining me now with more on MRSA is Dr. Rebecca Sunenshine, deputy state epidemiologist for the Arizona department of health services. You see that stuff all day.

Rebecca Sunenshine:
we sure do, we hear a lot about it.

Richard Ruelas:
let us know how widespread the problem is in the state, and -- well, how many people have been infected?

Rebecca Sunenshine:
let me start with the fact that there are two different kinds of MRSA. We've already discussed it is a drug-resistant form of staph infection or staph aureus. One occurrs in hospitals or health care facilities, for quite some time. The other kind we refer to as community MRSA. That tends to affect healthy people, healthy students, especially on athletic teams. And typically, it has a much milder outcome than the kind in the hospitals.

Richard Ruelas:
okay. The kind in the hospitals is something you also don't want to get.

Rebecca Sunenshine:
you don't want to get either one. But I think what's important to emphasize, the kind in the hospitals are by far the most likely to affect sicker patients who have more medical problems. They've already had issues going on in their leg, breaks in their skin. A lot of times people in the I.C.U. with central lines, they'll have problems and the infection becomes invasive. But in the community, with healthy individuals with intact skin, they may get a skin infection where the staff just gets in the surface of the skin. I think kind of an ugly red, even painful boils, or sometimes something that looks like acne or an ulcer. But as long as that's treated right away, and you go to a health care provider and it's drained -- it may or may not need antibiotics, and that will resolve typically pretty well.

Richard Ruelas:
so the community version of that virus has not spiked, as far as you know, in Arizona?

Rebecca Sunenshine:
well, this is what's important. Arizona department of health services tracks invasive MRSA infections. The kind that get into the blood or brain or spinal cord or bones, we know about, and those are the ones that are typically health care. We don't track the minor skin infections due to MRSA, because they're so common we don't track them.

Richard Ruelas:
I guess, is the fear overblown? We're reading a lot of articles about it. It can be traced back to maybe a misinterpretation of a science journal article?

Rebecca Sunenshine:
we don't want to downplay MRSA. It's very important that people take it seriously, and take the necessary precautions to prevent it, like wash their hands. But people are definitely really worried about MRSA in the community, when it's very easy to treat and very easy to prevent. So what they need to do to prevent MRSA from spreading in the community is to wash their hands. If someone has an infection, keep it covered with a clean, dry dressing. Avoid sharing personal items like towels or soap or razors. If folks do that in the schools, on athletic teams and just in everyday life, you can prevent yourself from getting an MRSA infection.

Richard Ruelas:
since we started hearing about this a few weeks ago, the danger now is not greater than it was say six months ago in the community?

Rebecca Sunenshine:
no, nothing has changed in the last six months in the community. As you pointed out, there was an article that the CDC published on invasive MRSA, and that's the kind that get in your bloodstream and is very serious, affects sick people. That estimated that there were about 19,000 deaths in the United States in 2005, from invasive MRSA. But that's very different than the community MRSA. We don't know how many infections there are from community MRSA, but then we know it's very common, and it rarely will turn into anything serious, like an invasive infection.

Richard Ruelas:
so the article was talking about mainly serious infections from the hospital?

Rebecca Sunenshine:
health care related, exactly, if you're already sick in intensive care, but as long as you wash your hands and do some basic hygiene.

Rebecca Sunenshine:
and keep those wounds covered with a clean dry dressing.

Richard Ruelas:
we did have to warn our viewers.

Rebecca Sunenshine:
and athletic teams, we can't stress that enough for schools. Those folks are getting turf burns, cuts in their skin and blisters all the time, so they're at a little bit higher risk.

Richard Ruelas:
thanks for joining us.

Richard Ruelas:
kids voting, expanded freeways, and east valley silent witness program, just some of the projects spearheaded by the east valley partnership, celebrating its 25th anniversary this year. I'll talk to the president of the organization and one of its founders in a minute. First, here's more on the east valley partnership.


Mike Sauceda:
in 1982, the east valley partnership was formed to help that side of the valley compete with the 800-pound gorilla, the City of Phoenix. The competition was for health care, transportation, social services, and government funding. It includes community, business, education, and government leaders. The partnership represents 16 different cities, towns, area, and Indian communities in the east valley. The partnership actively advocates in areas such as economic development, education, transportation, product, arts, behavioral health, and other important areas with the overall goal of providing leadership, supporting economic development, and improving the quality of life in the east valley. Membership is open to those living, working, or having business interests in the east valley. Individual, corporate, tribal and municipal memberships are available. Over the years, the partnership championed proposition 300, built freeways, and founded kids voting in Arizona. The partnership also addressed other issues including the Cardinal stadium, tourism, behavioral health funding, and they founded the east valley silent witness program.

Richard Ruelas:
here to tell us more about the east valley partnership is Charles Wahlheim, one of the group's founders and a former publisher of the mesa tribune. We'll start with you, Mr. Roc Arnett. How might the east valley be different if you hadn't formed the partnership?

Charles Wahlheim:
I think the east valley had always been kind of paranoid vis-à-vis the Phoenix 40 and the paper and that sort of thing. I was talking to Eddie Barber one time about the fact that the Phoenix 40 seemed to have more authority and political juice than even the state legislature or the governor. Then Eddie called a meeting at empire of about five or six people and talked about the concept of putting together the partnership on a more democratic basis, where everybody could join and that sort of thing, and that's how it started. Eddie really was the one that started it, more than myself.

Richard Ruelas:
sort of a nicer east valley version of the Phoenix 40.

Charles Wahlheim:
very democratic.

Richard Ruelas:
has it been difficult to hold the coalition together as it's spiraled out in different counties?

Roc Arnett:
actually it's not difficult, because people want to be involved, they want to participate. We interact with all the government and business and education leaders in Tempe, Chandler, Gilbert, Mesa, in Pinal county. Chuck Bacchus, a former chair of our group, says that our east valley runs all the way to Florence junction. So we have been collaborating and bringing those folks together from the entire east valley.

Richard Ruelas:
but with so many different interests, has it been difficult through the years? We see cities in the east valley fighting over where a car dealer will go, or things like that. How do you guys keep people focused on the bigger picture?

Roc Arnett:
we try to focus on more regional issues. We have been pushing the superstition vistas program, which is the far east, and the Williams gateway airport, now referred to as the Phoenix-Mesa gateway airport. So we worked on much larger issues. Hopefully we don't get involved in the city politics.

Richard Ruelas:
something like the Williams gateway airport, back in the 80's, Phoenix was going to strong-arm and wouldn't have been very pleased at a feeder airport. Have you seen a different climate from not only Phoenix but the cities in the west valley?

Charles Wahlheim:
Sky Harbor is a land locked airport on 2,000 acres and it's growing like crazy. They're going to be faced with the same thing midway airport is facing. They had to come find some kind of reliever airport. I don't think they did it out of the goodness of their heart, I think it was a necessity.

Richard Ruelas:
do you see the climate changes, a bigger metro area?

Charles Wahlheim:
I really think it's getting a lot better, and a lot of that credit goes to roc for working with the communities and everything. Maybe not being as abrasive as I used to be when I was a publisher.

Richard Ruelas:
how do you see that battle between the east valley and the west side?

Roc Arnett:
there are still those local skirmishes as you would expect. But since Michael Crow came to town and we're competing with the world, our competitors are not Glendale, not the west side or Scottsdale, our competitor is China and India. We need to work as we are a regional group moving forward in the economy. I'm seeing more and more of that happening with the business coalition and other things that are coming together, with which we are working.

Richard Ruelas:
25 years ago when you started this, did you have a vision of what the east valley might look like? And have we hit that point?

Charles Wahlheim:
well, I was trying to create a mythical market so that we could sell newspapers and be successful, you know. And honestly, I wish I would have come up with a better acronym to name the area. I called it east valley, and that stuck. Here we are. But some of the things, like kids voting and some of the things this organization has done makes you pretty proud. And the freeways, absolutely. That's where this half cent sales tax came from, from the east valley partnership.

Richard Ruelas:
your guys are celebrating your 25th anniversary Thursday, November 8, at the ASU Polytechnic campus. It's open to the public?

Charles Wahlheim:
that's correct.

Roc Arnett:
you can get all the information you want.

Richard Ruelas:
thank you both for joining me. See you here for the 50th.

Both:
thank you very much.

David Majure:
more than six million people live in Arizona, a number expected to double in only 40 years. How do we grow so fast without destroying the views and values that make Arizona such a great place to live? Meeting at the Grand Canyon, Arizona Town Hall participants tried to answer the question is tried to answer. Coming up Wednesday on "Horizon."

Richard Ruelas:
thanks for joining us on this Tuesday evening. I'm Richard Ruelas, have a good evening.

Max McPhail:Executive Director, Arizona Civil Rights Initiative;Dr. Rebecca Sunenshine:Deputy State Epidemiologist, Arizona Department of Health Services;Charles Wahlheim:Founder, East Valley Partnership and former publisher of the Mesa Tribune;

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