Tag Archives: Health

Texas has highest maternal mortality rate in developed world, study finds

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As the Republican-led state legislature has slashed funding to reproductive healthcare clinics, the maternal mortality rate doubled over just a two-year period

The rate of Texas women who died from complications related to pregnancy doubled from 2010 to 2014, a new study has found, for an estimated maternal mortality rate that is unmatched in any other state and the rest of the developed world.

The finding comes from a report, appearing in the September issue of the journal Obstetrics and Gynecology, that the maternal mortality rate in the United States increased between 2000 and 2014, even while the rest of the world succeeded in reducing its rate. Excluding California, where maternal mortality declined, and Texas, where it surged, the estimated number of maternal deaths per 100,000 births rose to 23.8 in 2014 from 18.8 in 2000 or about 27%.

But the report singled out Texas for special concern, saying the doubling of mortality rates in a two-year period was hard to explain in the absence of war, natural disaster, or severe economic upheaval.

From 2000 to the end of 2010, Texass estimated maternal mortality rate hovered between 17.7 and 18.6 per 100,000 births. But after 2010, that rate had leaped to 33 deaths per 100,000, and in 2014 it was 35.8. Between 2010 and 2014, more than 600 women died for reasons related to their pregnancies.

No other state saw a comparable increase.

In the wake of the report, reproductive health advocates are blaming the increase on Republican-led budget cuts that decimated the ranks of Texass reproductive healthcare clinics. In 2011, just as the spike began, the Texas state legislature cut $73.6m from the states family planning budget of $111.5m. The two-thirds cut forced more than 80 family planning clinics to shut down across the state. The remaining clinics managed to provide services such as low-cost or free birth control, cancer screenings and well-woman exams to only half as many women as before.

At the same time, Texas eliminated all Planned Parenthood clinics whether or not they provided abortion services from the state program that provides poor women with preventive healthcare. Previously, Planned Parenthood clinics in Texas offered cancer screenings and contraception to more than 130,000 women.

In 2013, Texas restored funding for the family planning budget to original levels. But the healthcare providers who survived the initial cuts reported struggles to restore services to their original levels.

Indeed, the report said it was puzzling that Texass maternal mortality rate rose only modestly from 2000 to 2010 before doubling between 2011 and 2012. The researchers, hailing from the University of Maryland, Boston Universitys school of public health and Stanford Universitys medical school, called for further study. But they noted that starting in 2011, Texas drastically reduced the number of womens health clinics within its borders.

The report comes just as public health advocates are raising questions about Texass ability to prepare for the Zika virus, which is transmitted by a common species of mosquito and has been linked to severe birth defects. The World Health Organization has advised women in areas of local transmission to delay pregnancy.

Texas is one of several southern states where health officials say there is a risk of a local outbreak. But about half the state lacks ready access to OB-GYN care, making it difficult for women to obtain contraception or for pregnant women to confirm the health of their babies. Just this month, Texass health department drew fire for allocating $1.6m of the $18m the state budgets for low-income womens family planning to an anti-abortion group that does not provide basic health services.

There is a need to redouble efforts to prevent maternal deaths and improve maternity care for the 4 million US women giving birth each year, the authors said.

Read more: https://www.theguardian.com/us-news/2016/aug/20/texas-maternal-mortality-rate-health-clinics-funding

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23andMe is finally allowed to tell you if you have the genes for Parkinsons

The Food and Drug Administration finally gave 23andMe a long sought-after green light today to sell to consumers genetic tests and their accompanying health risk reports for up to 10 diseases, including late-onset Alzheimers and Parkinsons.

In November 2013, the FDA put a moratorium on 23andMes ability to provide any health information associated with its personal genome testing. Then a sliver of hope opened up in October 2015, when the FDA allowed the company to provide health and carrier status for those who might pass on a rare genetic disease. Shortly before that, and as sort of a trial run before opening up the floodgates, 23andMe was able to test for a genetic carrier disease called Bloom Syndrome, a rare recessive gene disorder characterized by shorter height and a predisposition to developcancer.

This morning the FDA announced it would allow 23andMe to also provide consumers with information on 10 diseases, including the following:

Consumers can now have direct access to certain genetic risk information, the FDAs director of the Center for Devices and Radiological Health Jeffrey Shuren said in a statement. But it is important that people understand that genetic risk is just one piece of the bigger puzzle, it does not mean they will or wont ultimately develop a disease.

Showing you have an increased risk for a particular disease doesnt mean you will get the disease, as Shuren said, but it is a point which led the FDA to ban 23andMe from offering this type of information previously. However, consumers may want to know if they need to take steps to prevent certain genetic diseases, such as breast cancer, and that is what these genetic health risk (GHR) tests intend to show. You may recall Angelina Jolie famously had removed both her breasts to ensure she never got the disease after discovering she, like her mother, had the BRCA gene, indicating she could develop breast cancer one day.

This announcement makes 23andMe the only company allowed to give out genetic disease reports to consumers (sans doctors prescription). Those who are already 23andMe customers in the U.S. will get these reports when they roll out later this month but it remains to be seen for other countries, due to regulations.

Information will be rolled out over time, according to a 23andMe spokesperson, but will start this month withLate-Onset Alzheimers Disease, Parkinsons Disease, Hereditary Thrombophilia, Alpha-1 Antitrypsin Deficiency and a new carrier status report for Gauchers Disease. Other tests will soon follow, 23andMe tells TechCrunch.

Read more: https://techcrunch.com/2017/04/06/23andme-is-finally-allowed-to-tell-you-if-you-have-the-genes-for-parkinsons/

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America Is Not the Greatest Country on Earth. Its No. 28

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Every study ranking nations by health or living standards invariably offers Scandinavian social democracies a chance to show their quiet dominance. A new analysis published this weekperhaps the most comprehensive everis no different. But what it does reveal are the broad shortcomings of sustainable development efforts, the new shorthand for not killing ourselves or the planet, as well as the specific afflictions of a certain North American country. 

Iceland and Sweden share the top slot with Singapore as world leaders when it comes to health goals set by the United Nations, according to a report published in the Lancet. Using the UNs sustainable development goals as guideposts, which measure the obvious (poverty, clean water, education) and less obvious (societal inequality, industry innovation), more than 1,870 researchers in 124 countries compiled data on 33 different indicators of progress toward the UN goals related to health.

The massive study emerged from a decadelong collaboration focused on the worldwide distribution of disease. About a year and a half ago, the researchers involved decided their data might help measure progress on what may be the single most ambitious undertaking humans have ever committed themselves to: survival. In doing so, they came up with some disturbing findings, including that the country with the biggest economy (not to mention, if were talking about health, multibillion-dollar health-food and fitness industries) ranks No. 28 overall, between Japan and Estonia.

Eradicating disease and raising living standards are lofty goals that have attracted some of the biggest names to philanthropy. Facebook Inc. founder Mark Zuckerberg and Priscilla Chan, his wife and a pediatrician, on Wednesday pledged $3 billion toward the effort. The new study itself was funded by (but received no input from) the Bill & Melinda Gates Foundation. The 17 UN Sustainable Development Goals (SDGs) themselves are a successor to the Millennium Development Goals, a UN initiative that from 2000 to 2015 lifted a billion people out of extreme poverty, halved the mortality of children younger than five years old, and raised by about 60 percent the number of births attended to by a skilled health worker

The research team scrubbed data obtained on dozens of topics from all over the world. For example, to make sure they had adequate data on vaccine coverage for each region, they looked at public surveys, records of pharmaceutical manufacturers, and administrative records of inoculations. We dont necessarily believe what everybody says, says Christopher Murray, global heath professor at the University of Washington and a lead author of the study. There are so many ways they can miss people or be biased. 

The U.S. scores its highest marks in water, sanitation, and child development. Thats the upside. Unsurprisingly, interpersonal violence (think gun crime) takes a heavy toll on Americas overall ranking. Response to natural disasters, HIV, suicide, obesity, and alcohol abuse all require attention in the U.S. 

QuickTake How Half the World Got So Big

Also noteworthy are basic public health metrics that America. doesnt perform as well on as other developed countries. The U.S. is No. 64 in the rate of mothers dying for every 100,000 births, and No. 40 when it comes to the rate children under age five die.

The U.S. isnt doing as well as it perhaps should compared with some countries in Western Europe, Murray said.

In all regions of the world and across the economic development spectrum, the problem of overweight children has grown worse, the study shows. 

The authors lauded five countries in particular, one from each quintile, for their prominent gains:

  • Timor-Leste rebuilt its health service since 2000 after years of war. 
  • Tajikistan reformed its health system in the late 1990s and is winning a battle against malaria.
  • Colombia’s health insurance program reaches more people than ever and covers more scenarios, including cancer.
  • Taiwan enacted road-safety laws that reduced auto-related deaths there.
  • Iceland, which barely edges out Singapore and Sweden for the No. 1 spot, is credited for aggressive anti-tobacco policies and its publicly funded universal health-care system. 

The research group allowed organizers to harness peoples knowledge and expertise, local data sources, and quirky knowledge that only somebody locally may know, said Murray. But the UN goals were a tough starting point, given their nebulous categories and confusing terminology. The whole system has the intuitive clarity of Britain’s pre-1971 monetary system, with its pound (or quid), shilling (or bob),  pence, half-crown, and farthing. Economist William Easterly of New York University has ridiculed the SDGs as senseless, dreamy, garbled. But making fun of international bureaucratese is as easy as measuring progress toward the UN goals is hard. And thats exactly what the new Lancet enterprise doescombing the world of public-health research to measure where each nation succeeds, or needs work. 

The voluminous work that went into the paper may make measuring the UN goals on health seem even more daunting: The researchers were able so far to evaluate just 70 percent of the health-related indicators called for by the UN.

It may not be pretty, but we have no chance of success if we cant agree on whats critical, said Linda Fried, dean of the Mailman School of Public Health at Columbia University.

–With assistance from Hayley Warren in London.

Watch Next: Zuckerberg, Chan Pledging $3 Billion to Cure Disease 

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Read more: http://www.bloomberg.com//news/articles/2016-09-22/america-is-not-the-greatest-country-on-earth-it-s-no-28

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Billionaire Bloomberg to fund $5m public health projects in 40 cities worldwide

Exclusive: Melbourne, Accra and Ulaanbaatar among cities to benefit from funding pledged by former New York mayor to tackle issues from air pollution to obesity

Michael Bloomberg, the billionaire bte noire of both the sugar industry and the tobacco industry, famously fought for a ban on the sale of large-sized colas and other sweet drinks when he was mayor of New York and lost. Although that is not how he sees it.

We actually won that battle, he says. I have always thought if we had not been stopped by the court, it would have died as an issue. Nobody would have known about it. But the fact that it kept coming back to the newspapers was a gift in disguise because people started to think, Holy God, maybe full-sugar drinks are bad for me.

So what happened was consumption of full-sugar drinks around the world has gone down dramatically. If we had won the thing, I think it would have been less.

Bloomberg did plenty more for public health while mayor of New York, including imposing one of the first bans on smoking in bars and restaurants in 2003. Since then he has widened his sphere of influence, funding successful campaigns through his philanthropic foundation for sugar taxes in Mexico and Philadelphia and for curbs on smoking all over the world.

Now, appointed last year as the World Health Organisations global ambassador for non-communicable diseases meaning anything that can harm or kill you that is not infectious the eighth richest person in the world, worth an estimated $47.5bn, is taking his philosophy and his cash to 40 cities around the globe.

His offer, taken up by about 40 cities so far and officially launched on Tuesday, is $5m in assistance from Bloomberg Philanthropies as well as technical support for cities that choose to focus on one of 10 healthy lifestyle issues, including curbing sugary drink consumption, air pollution, promoting exercise and and bans on smoking. They range from affluent Melbourne in Australia to Cali and Medellin in Colombia, Accra in Ghana, Ulaanbaatar in Mongolia, Khatmandu in Nepal and Kampala in Uganda.

National and state governments collect taxes, but it is city governments that make things happen. 50% of people currently live in cities and that is projected to rise to 70% in the next decade or so. Cities are where the rubber meets the road, Bloomberg told the Guardian. The problems are in the cities and the solutions are in the cities.

Bloomberg is upbeat, indomitable and an independent thinker. He made his money in global financial services and has been a Democrat, a Republican and an independent at various times. He says he believes the war on sugar and tobacco, of which his foundation must be seen as the main global financial backer, is being won.

In parts of the world, clearly yes, and particularly on smoking, he said. In Europe nobody would have thought people wouldnt insist on smoking in an Irish bar or pub or an Italian restaurant, but the smoking campaign has really worked, reducing consumption in all of western Europe, north and south America and even in China.

But there are places where poor people live and they are still smoking and really damaging their lungs and they are going to die young. It is up to us to keep the battle going. Sugar is a little bit less developed but still working.

His attention is on non-communicable diseases more broadly now that includes air pollution and road traffic accidents as well as cigarettes, alcohol and bad food. Cities in poor countries may argue that they have too many other problems to spend time on sugary drinks, but, says Bloomberg, poverty, ill-health and poor education are all interlinked.

It will be harder to get the public behind you because they less understand the damage being done to their own health. But thats the challenge. The cities where its easy have probably already addressed the issue, he said.

Michael
Michael Bloomberg and WHO director-general Dr Margaret Chan Photograph: Bloomberg Phlilantropies

Bloomberg would not suggest it is easy to make the sort of changes he has pushed for in all these years.

I dont remember anybody objecting to the smoking ban when we put it in, although a lot of people wanted to take my picture and a lot of people gave me one finger waves, he said. If there was an easy solution to a complex problem, we wouldnt have the problem. If you want to make things better, youre going to be doing things that are tough.

The cities that commit to the Partnership for Healthy Cities can choose between curbing sugary drink consumption, passing laws to make public places smoke-free or banning cigarette advertising, cutting salt in food, using cleaner fuels, encouraging cycling and walking, reducing speeding, increasing seatbelt and helmet use, curbing drink driving or carrying out a survey to collect data on the lifestyle risks the city population runs.

Cape Town in South Africa was one of the earliest cities to commit and will focus on reducing the intake of sugary drinks. Its mayor, Patricia de Lille, says they are facing an epidemic of type 2 diabetes, caused by obesity. Diabetes is a silent killer, she said. We dont have the luxury to work by trial and error. Unfortunately we have to get it right first time.

London has also said it wants to be involved, although which issue will be the focus has not yet been revealed. It is a city with which Bloomberg says he has a complex relationship his former wife is British and his daughters hold dual nationality. He has an honorary knighthood from the Queen. He also has an honour from the City of London that he intends one day to cash in.

I do have the right to drive sheep across London Bridge and before I die, I want to do it one day at rush hour, just to see what happens, he said.

Read more: https://www.theguardian.com/society/2017/may/16/billionaire-bloomberg-to-fund-5m-public-health-projects-in-40-cities-worldwide

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A journey through a land of extreme poverty: welcome to America

The UNs Philip Alston is an expert on deprivation and he wants to know why 41m Americans are living in poverty. The Guardian joined him on a special two-week mission into the dark heart of the worlds richest nation

Los Angeles, California, 5 December

You got a choice to make, man. You could go straight on to heaven. Or you could turn right, into that.

We are in Los Angeles, in the heart of one of Americas wealthiest cities, and General Dogon, dressed in black, is our tour guide. Alongside him strolls another tall man, grey-haired and sprucely decked out in jeans and suit jacket. Professor Philip Alston is an Australian academic with a formal title: UN special rapporteur on extreme poverty and human rights.

General Dogon, himself a veteran of these Skid Row streets, strides along, stepping over a dead rat without comment and skirting round a body wrapped in a worn orange blanket lying on the sidewalk.

The two men carry on for block after block after block of tatty tents and improvised tarpaulin shelters. Men and women are gathered outside the structures, squatting or sleeping, some in groups, most alone like extras in a low-budget dystopian movie.

We come to an intersection, which is when General Dogon stops and presents his guest with the choice. He points straight ahead to the end of the street, where the glistening skyscrapers of downtown LA rise up in a promise of divine riches.

Heaven.

Then he turns to the right, revealing the black power tattoo on his neck, and leads our gaze back into Skid Row bang in the center of LAs downtown. That way lies 50 blocks of concentrated human humiliation. A nightmare in plain view, in the city of dreams.

Alston turns right.

Philip
Philip Alston in downtown LA. Photograph: Dan Tuffs for the Guardian

So begins a two-week journey into the dark side of the American Dream. The spotlight of the UN monitor, an independent arbiter of human rights standards across the globe, has fallen on this occasion on the US, culminating on Friday with the release of his initial report in Washington.

His fact-finding mission into the richest nation the world has ever known has led him to investigate the tragedy at its core: the 41 million people who officially live in poverty.

Of those, nine million have zero cash income they do not receive a cent in sustenance.

Alstons epic journey has taken him from coast to coast, deprivation to deprivation. Starting in LA and San Francisco, sweeping through the Deep South, traveling on to the colonial stain of Puerto Rico then back to the stricken coal country of West Virginia, he has explored the collateral damage of Americas reliance on private enterprise to the exclusion of public help.

The Guardian had unprecedented access to the UN envoy, following him as he crossed the country, attending all his main stops and witnessing the extreme poverty he is investigating firsthand.

Think of it as payback time. As the UN special rapporteur himself put it: Washington is very keen for me to point out the poverty and human rights failings in other countries. This time Im in the US.

David
David Busch, who is currently homeless on Venice beach, in Los Angeles. Photograph: Dan Tuffs for the Guardian


The tour comes at a critical moment for America and the world. It began on the day that Republicans in the US Senate voted for sweeping tax cuts that will deliver a bonanza for the super wealthy while in time raising taxes on many lower-income families. The changes will exacerbate wealth inequality that is already the most extreme in any industrialized nation, with three men Bill Gates, Jeff Bezos and Warren Buffet owning as much as half of the entire American people.

A few days into the UN visit, Republican leaders took a giant leap further. They announced plans to slash key social programs in what amounts to an assault on the already threadbare welfare state.

Look up! Look at those banks, the cranes, the luxury condos going up, exclaimed General Dogon, who used to be homeless on Skid Row and now works as a local activist with Lacan. Down here, theres nothing. You see the tents back to back, theres no place for folks to go.

California made a suitable starting point for the UN visit. It epitomizes both the vast wealth generated in the tech boom for the 0.001%, and the resulting surge in housing costs that has sent homelessness soaring. Los Angeles, the city with by far the largest population of street dwellers in the country, is grappling with crisis numbers that increased 25% this past year to 55,000.

Ressy Finley, 41, was busy sterilizing the white bucket she uses to slop out in her tent in which she has lived on and off for more than a decade. She keeps her living area, a mass of worn mattresses and blankets and a few motley possessions, as clean as she can in a losing battle against rats and cockroaches. She also endures waves of bed bugs, and has large welts on her shoulder to prove it.

She receives no formal income, and what she makes on recycling bottles and cans is no way enough to afford the average rents of $1,400 a month for a tiny one-bedroom. A friend brings her food every couple of days, the rest of the time she relies on nearby missions.

She cried twice in the course of our short conversation, once when she recalled how her infant son was taken from her arms by social workers because of her drug habit (he is now 14; she has never seen him again). The second time was when she alluded to the sexual abuse that set her as a child on the path towards drugs and homelessness.

Given all that, its remarkable how positive Finley remains. What does she think of the American Dream, the idea that everyone can make it if they try hard enough? She replies instantly: I know Im going to make it.

A 41-year-old woman living on the sidewalk in Skid Row going to make it?

Sure I will, so long as I keep the faith.

What does making it mean to her?

I want to be a writer, a poet, an entrepreneur, a therapist.

Ressy
Ressy Finley, who lives in a tent on 6th Street in Downtown LA. Photograph: Dan Tuffs for the Guardian

Robert Chambers occupies the next patch of sidewalk along from Finleys. Hes created an area around his tent out of wooden pallets, what passes in Skid Row for a cottage garden.

He has a sign up saying Homeless Writers Coalition, the name of a group he runs to give homeless people dignity against what he calls the animalistic aspects of their lives. Hes referring not least to the lack of public bathrooms that forces people to relieve themselves on the streets.

LA authorities have promised to provide more access to toilets, a critical issue given the deadly outbreak of Hepatitis A that began in San Diego and is spreading on the west coast claiming 21 lives mainly through lack of sanitation in homeless encampments. At night local parks and amenities are closed specifically to keep homeless people out.

Skid Row has had the use of nine toilets at night for 1,800 street-faring people. Thats a ratio well below that mandated by the UN in its camps for Syrian refugees.

Its inhuman actually, and eventually in the end you will acquire animalistic psychology, Chambers said.

He has been living on the streets for almost a year, having violated his parole terms for drug possession and in turn being turfed out of his low-cost apartment. Theres no help for him now, he said, no question of making it.

The safety net? It has too many holes in it for me.

Of all the people who crossed paths with the UN monitor, Chambers was the most dismissive of the American Dream. People dont realize its never getting better, theres no recovery for people like us. Im 67, I have a heart condition, I shouldnt be out here. I might not be too much longer.

That was a lot of bad karma to absorb on day one, and it rattled even as seasoned a student of hardship as Alston. As UN special rapporteur, hes reported on dire poverty and its impact on human rights in Saudi Arabia and China among other places. But Skid Row?

I was feeling pretty depressed, he told the Guardian later. The endless drumbeat of horror stories. At a certain point you do wonder what can anyone do about this, let alone me.

And then he took a flight up to San Francisco, to the Tenderloin district where homeless people congregate, and walked into St Boniface church.

What he saw there was an analgesic for his soul.

San Francisco, California, 6 December

The
The Gubbio project at St Boniface in San Francisco. The church opens its doors every weekday at 6am to allow homeless people to rest until 3pm. Photograph: David Levene for the Guardian


About 70 homeless people were quietly sleeping in pews at the back of the church, as they are allowed to do every weekday morning, with worshippers praying harmoniously in front of them. The church welcomes them in as part of the Catholic concept of extending the helping hand.

I found the church surprisingly uplifting, Alston said. It was such a simple scene and such an obvious idea. It struck me Christianity, what the hell is it about if its not this?

It was a rare drop of altruism on the west coast, competing against a sea of hostility. More than 500 anti-homeless laws have been passed in Californian cities in recent years. At a federal level, Ben Carson, the neurosurgeon who Donald Trump appointed US housing secretary, is decimating government spending on affordable housing.

Perhaps the most telling detail: apart from St Boniface and its sister church, no other place of worship in San Francisco welcomes homeless people. In fact, many have begun, even at this season of goodwill, to lock their doors to all comers simply so as to exclude homeless people.

As Tiny Gray-Garcia, herself on the streets, described it to Alston, there is a prevailing attitude that she and her peers have to contend with every day. She called it the violence of looking away.

Coy
Coy Catley, 63, in her homeless box made of cardboard sheets on a sidewalk of Tenderloin, San Francisco. Photograph: Ed Pilkington for the Guardian


That cruel streak the violence of looking away has been a feature of American life since the nations founding. The casting off the yoke of overweening government (the British monarchy) came to be equated in the minds of many Americans with states rights and the individualistic idea of making it on your own a view that is fine for those fortunate enough to do so, less happy if youre born on the wrong side of the tracks.

Countering that has been the conviction that society must protect its own against the vagaries of hunger or unemployment that informed Franklin Roosevelts New Deal and the Great Society of Lyndon Johnson. But in recent times the prevailing winds have blown strongly in the youre on your own, buddy direction. Ronald Reagan set the trend with his 1980s tax cuts, followed by Bill Clinton, whose 1996 decision to scrap welfare payments for low-income families is still punishing millions of Americans.

The cumulative attack has left struggling families, including the 15 million children who are officially in poverty, with dramatically less support than in any other industrialized economy. Now they face perhaps the greatest threat of all.

As Alston himself has written in an essay on Trumps populism and the aggressive challenge it poses to human rights: These are extraordinarily dangerous times. Almost anything seems possible.

Lowndes County, Alabama, 9 December

Aaron
Aaron Thigpen discusses the poor sewage conditions in Butler County. Improper treatment has put the population at risk of diseases long believed to be extinct in the US. Photograph: Bob Miller for the Guardian


Trumps undermining of human rights, combined with the Republican threat to pare back welfare programs next year in order to pay for some of the tax cuts for the rich they are rushing through Congress, will hurt African Americans disproportionately.

Black people are 13% of the US population, but 23% of those officially in poverty and 39% of the homeless.

The racial element of Americas poverty crisis is seen nowhere more clearly than in the Deep South, where the open wounds of slavery continue to bleed. The UN special rapporteur chose as his next stop the Black Belt, the term that originally referred to the rich dark soil that exists in a band across Alabama but over time came to describe its majority African American population.

The link between soil type and demographics was not coincidental. Cotton was found to thrive in this fertile land, and that in turn spawned a trade in slaves to pick the crop. Their descendants still live in the Black Belt, still mired in poverty among the worst in the union.

You can trace the history of Americas shame, from slave times to the present day, in a set of simple graphs. The first shows the cotton-friendly soil of the Black Belt, then the slave population, followed by modern black residence and todays extreme poverty they all occupy the exact same half-moon across Alabama.

There are numerous ways you could parse the present parlous state of Alabamas black community. Perhaps the starkest is the fact that in the Black Belt so many families still have no access to sanitation. Thousands of people continue to live among open sewers of the sort normally associated with the developing world.

The crisis was revealed by the Guardian earlier this year to have led to an ongoing endemic of hookworm, an intestinal parasite that is transmitted through human waste. It is found in Africa and South Asia, but had been assumed eradicated in the US years ago.

Yet here the worm still is, sucking the blood of poor people, in the home state of Trumps US attorney general Jeff Sessions.

A disease of the developing world thriving in the worlds richest country.

The open sewerage problem is especially acute in Lowndes County, a majority black community that was an epicenter of the civil rights movement having been the setting of Martin Luther Kings Selma to Montgomery voting rights march in 1965.

Philp
Philp Alston talks to a resident. Many families in Butler and Lowndes counties choose to live with open sewer systems made from PVC pipe. Photograph: Bob Miller for the Guardian

Despite its proud history, Catherine Flowers estimates that 70% of households in the area either straight pipe their waste directly onto open ground, or have defective septic tanks incapable of dealing with heavy rains.

When her group, Alabama Center for Rural Enterprise (Acre), pressed local authorities to do something about it, officials invested $6m in extending waste treatment systems to primarily white-owned businesses while bypassing overwhelmingly black households.

Thats a glaring example of injustice, Flowers said. People who cannot afford their own systems are left to their own devices while businesses who do have the money are given public services.

Walter, a Lowndes County resident who asked not to give his last name for fear that his water supply would be cut off as a reprisal for speaking out, lives with the daily consequences of such public neglect. You get a good hard rain and it backs up into the house.

Thats a polite way of saying that sewage gurgles up into his kitchen sink, hand basin and bath, filling the house with a sickly-sweet stench.

Given these circumstances, what does he think of the ideology that anyone can make it if they try?

I suppose they could if they had the chance, Walter said. He paused, then added: Folks arent given the chance.

Had he been born white, would his sewerage problems have been fixed by now?

After another pause, he said: Not being racist, but yeah, they would.

Round the back of Walters house the true iniquity of the situation reveals itself. The yard is laced with small channels running from neighboring houses along which dark liquid flows. It congregates in viscous pools directly underneath the mobile home in which Walters son, daughter-in-law and 16-year-old granddaughter live.

It is the ultimate image of the lot of Alabamas impoverished rural black community. As American citizens they are as fully entitled to life, liberty and the pursuit of happiness. Its just that they are surrounded by pools of excrement.

This week, the Black Belt bit back. On Tuesday a new line was added to that simple graphic, showing exactly the same half-moon across Alabama except this time it was not black but blue.

blue belt south

It depicted the army of African American voters who turned out against the odds to send Doug Jones to the US Senate, the first Democrat from Alabama to do so in a generation. It delivered a bloody nose to his opponent, the alleged child molester Roy Moore, and his puppetmasters Steve Bannon and Donald Trump.

It was arguably the most important expression of black political muscle in the region since Kings 1965 march. If the previous entries in the graphic could be labeled soil, slavery and poverty, this one should be captioned empowerment.

Guayama, Puerto Rico, 10 December

So how does Alston view the role of UN rapporteur and his visit? His full report on the US will be released next May before being presented to the UN human rights council in Geneva.

Nobody expects much to come of that: the world body has no teeth with which to enforce good behavior on recalcitrant governments. But Alston hopes that his visit will have an impact by shaming the US into reflecting on its values.

My role is to hold governments to account, he said. If the US administration doesnt want to talk about the right to housing, healthcare or food, then there are still basic human rights standards that have to be met. Its my job to point that out.

Alstons previous investigations into extreme poverty in places like Mauritania pulled no punches. We can expect the same tough love when it comes to his analysis of Puerto Rico, the next stop on his journey into Americas dark side.

Three months after Maria, the devastation wrought by the hurricane has been well documented. It tore 70,000 homes to shreds, brought industry to a standstill and caused a total blackout of the island that continues to cause havoc.

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She Was Watching A TV Show When She Noticed Something Weird About The Host’s Neck

When you watch TV, you usually shut your brain off and just enjoy what’s in front of you. Watching television doesn’t require much thought or attention, and literally anyone can do it.

Luckily for the host of a show called Flip or Flop, one of the people watching was paying attention. A viewer noticed something odd about Tarek El Moussa’s neck, so she emailed the production company and told them that El Moussa needed to see a doctor immediately.

The lump on his neck was actually a malignant tumor. El Moussa has thyroid cancer.

The lump was removed immediately.

Sadly, the cancer had already spread to his lymph nodes.

Tarek had to undergo radioactive iodine therapy, which meant that he had to be isolated from his family for their protection. Thankfully, the cancer hasn’t spread any further, and he will find out in a week or so if he is cancer-free.

(via People / Ultra Facts Blog)

Luckily, this TV host has loyal fans who are knowledgeable enough to watch his back. Who knows what would have happened otherwise?

Read more: http://www.viralnova.com/neck-tv/

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The Gambia bans female genital mutilation

President Yahya Jammeh outlaws practice that affects three-quarters of women in west African country

The Gambia has announced it will ban female genital mutilation (FGM) after the Guardian launched a global campaign to end the practice.

The president, Yahya Jammeh, said last night that the controversial surgical intervention would be outlawed. He said the ban would come into effect immediately, though it was not clear when the government would draft legislation to enforce it.

FGM involves cutting female genitalia often when girls are young to remove their labia and clitoris, which often leads to lifelong health complications, including bleeding, infections, vaginal pain and infertility. More than 130 million women worldwide are subjected to the procedure in Africa and the Middle East.

The practice is widespread in many African countries, including the Gambia, where 76% of females have been subjected to it. The age at which FGM takes place in the Gambia is not recorded, but it is reported that the trend of practicing FGM on infant girls is increasing. By the age of 14, 56% of female children in the country have had the procedure.

Highlights of the Guardians global media campaign to help end FGM

Jaha Dukureh, an anti-FGM activist whose campaign to end the practice in the country has been supported by the Guardian, spent the past week meeting cabinet ministers in the Gambia and sent them articles from the newspaper to inform them about the issue.

Im really amazed that the president did this. I didnt expect this in a million years. Im just really proud of my country and Im really, really happy, she told the Guardian. I think the president cared about the issue, it was just something that was never brought to his attention.

Jammehs announcement came late last night, as the president was visiting his home village on Kanilai as part of a nationwide tour. The announcement was unexpected for both campaigners and public.

The amazing thing is its election season. This could cost the president the election. He put women and girls first, this could negatively affect him, but this shows he cares more about women than losing peoples votes, said Dukureh.

Dukureh will return to the Gambia on Tuesday to thank Jammeh for the ban and to help with drafting the legislation that will enforce it.

A ban on FGM would be a significant development on an issue that has proved controversial and divisive in the Gambia, with some arguing that FGM is permitted in Islam, the major religion in the country.

Senior Muslim clerics in the Gambia have previously denied the existence of FGM in the Gambia saying instead that was is practiced is female circumcision. In 2014, state house imam, Alhaji Abdoulie Fatty told Kibaaro News, I have never heard of anyone who died as a result of female genital mutilation (FGM)… If you know what FGM means, you know that we do not practice that here. We do not mutilate our children.

Jaha Dukureh: Im really amazed that the president did this. I didnt expect this in a million years. Photograph: Mae Ryan for the Guardian

Mary Wandia, the FGM programme manager at womens rights campaign group Equality Now said: The ban is an essential first step towards ending FGM and we commend President Jammeh on finally announcing it.

A law must now be enacted and properly implemented to ensure that every girl at risk is properly protected. The government needs to show strong commitment and prioritise this issue in a country where three quarters of women have been affected and reductions in prevalence have been slow to materialise.

Though support for FGM is widespread in the Gambia, reports have shown that public support for the practice has dropped in recent decades among women across all age groups.

Support for the continuation of the practice is strongest among the countrys richest women and varies dramatically in different ethnic communities, with 84% of Mandinka women supporting the continuation of FGM compared with 12% of Wolof women.

This year FGM was banned in Nigeria, which joined 18 other African countries that have outlawed the practice, including Central African Republic, Egypt and South Africa.

Somalia, which has the highest prevalence of FGM in the world, has indicated it would like to end the practice, with a spokeswoman for the ministry for womens affairs saying it was committed to make this happen despite significant resistance in the country. Currently, 98% of girls aged between four and 11 are subjected to FGM in Somalia.

The Guardian launched a major campaign to end FGM around the world in 2014, with the support of the campaign petition website, Change.org.

The Guardian Global Media campaign works closely with local activists in the Gambia, Kenya and Nigeria to help them provide education and awareness on the issue and hope to expand the campaign to Sierra Leone, Senegal and Uganda next year.

Read more: http://www.theguardian.com/society/2015/nov/24/the-gambia-bans-female-genital-mutilation

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