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India is likely undercounting heat deaths, affecting its response to increasingly harsh heat waves  

Posted on by Corts

BENGALURU, India — Months of scorching temperatures sometimes over 50 degrees Celsius (122 Fahrenheit) in parts of India this year — its worst heat wave in over a decade — left hundreds dead or ill. But the official number of deaths listed in government reports barely scratches the surface of the true toll and that’s affecting future preparations for similar swelters, according to public health experts. 

India now has a bit of respite from the intense heat, and a different set of extreme weather problems as monsoon rain lashes the northeast, but for months the extreme heat took a toll on large swaths of the country, particularly in northern India, where government officials reported at least 110 heat-related deaths. 

Public health experts say the true number of heat-related deaths is likely in the thousands but because heat is often not listed as a reason on a death certificate many heat deaths don’t get counted in official figures. The worry, they say, is that undercounting the deaths means the heat wave problem isn’t as prioritized as it should be, and officials are missing out on ways to prepare their residents for the scorching temperatures. 

All of India’s warmest years on record have been in the last decade. Studies by public health experts found that up to 1,116 people have died every year between 2008 and 2019 due to heat. 

Difficulties registering heat deaths 

As part of his work in public health, Srinath Reddy, the founder of the Public Health Foundation of India, has advised state governments on how to factor in heat when recording deaths. 

He found that as a result of “incomplete reporting, delayed reporting and misclassification of deaths,” heat-related deaths are significantly undercounted around the country. Despite national guidelines for recording deaths, many doctors — especially those in overcrowded public hospitals where resources are already strained — don’t follow it, he said. 

“Most doctors just record the immediate cause of death and attribution to environmental triggers like heat are not recorded,” Reddy said. That’s because heat deaths can be classified as exertional or non-exertional: Exertional is when a person dies due to direct exposure to high temperatures and non-exertional is when young children, older people or people with pre-existing health conditions become seriously ill or sometimes die from the heat, even if indoors. 

“The heatwave is the final straw for the second category of people,” said Dileep Mavalankar, former head of the Indian Institute of Public Health in Gandhinagar. “Most people dying during heat waves belong to this category but their deaths are not recorded as connected to the heat.” 

Mavalankar agreed the official number of heat deaths this year is an undercount. He said there were 40,000 recorded case of heat stroke, but only 110 deaths. “This is just 0.3% of the total number of heatstroke cases recorded, but usually heat deaths should be 20 to 30% of heatstroke cases,” he said. 

“We need to be counting deaths better,” Mavalankar said. “That is the only way we will know how severe the consequences of extreme heat are.” 
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In face of Russian attacks, Ukraine defends its monuments — and its identity

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As Ukraine’s war against Russia’s invasion drags on, Ukrainians are fighting to preserve their history. They say Russia is deliberately attacking cultural monuments in a bid to erase the country’s history and identity as a separate nation. For VOA, Anna Chernikova reports from Kyiv. VOA footage by Eugene Shynkar, Vladyslav Smilianets.
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USAID helps parts of Ukraine become energy independent 

Posted on by Corts

Russian shelling continues to degrade Ukraine’s energy system. Some parts of the country now have access to electricity for just a few hours a day. New generators aim to help supply residents with power and hot water. Tetiana Kukurika has the story, narrated by Anna Rice.
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Japan’s top court rules forced sterilization law unconstitutional   

Posted on by Corts

Tokyo — Japan’s top court ruled on Wednesday that a defunct eugenics law under which thousands of people were forcibly sterilized between 1948 and 1996 was unconstitutional.

The Supreme Court also declared that a 20-year statute of limitations could not be applied, paving the way for compensation claims from victims after years of legal battles.

“For the state to evade responsibility for damages payments would be extremely unfair and unjust, and absolutely intolerable,” the court in Tokyo said.

Japan’s government acknowledges that around 16,500 people were forcibly sterilized under the law that aimed to “prevent the generation of poor quality descendants.”

An additional 8,500 people were sterilized with their consent, although lawyers say even those cases were likely “de facto forced” because of the pressure individuals faced.

A 1953 government notice said physical restraint, anesthesia and even “deception” could be used for the operations.

“There are people who couldn’t be here today. There are those who died as well. I want to visit the grave of my parents and tell them we’ve won,” victim Saburo Kita, who uses a pseudonym, told reporters after the ruling.

Kita was convinced to undergo a vasectomy when he was 14 at a facility housing troubled children. He only told his wife what had happened shortly before she died in 2013.

“But a complete resolution of this issue hasn’t been realized yet. Together with lawyers, I will continue to fight,” said Kita, one of several victims who celebrated outside the court, some in wheelchairs.

Apology

The number of operations in Japan slowed to a trickle in the 1980s and 1990s before the law was scrapped in 1996.

That dark history was thrust back under the spotlight in 2018 when a woman in her 60s sued the government over a procedure she had undergone at age 15, opening the floodgates for similar lawsuits.

The government, for its part, “wholeheartedly” apologized after legislation was passed in 2019 stipulating a lump-sum payment of 3.2 million yen (around $20,000 today) per victim.

However, survivors say that was too little to match the severity of their suffering and took their fight to court.

Regional courts have mostly agreed in recent years that the eugenics law was a violation of Japan’s constitution.

However, judges have been divided on whether claims are valid beyond the 20-year statute of limitations.

Some ordered the state to pay damages but others dismissed cases, saying the window for pursuing damages had closed.

Prime Minister Fumio Kishida said the government would “swiftly pay damages based on the finalized ruling” and discuss “the new ways in which (victims) can be compensated.”

The government “sincerely apologizes” for the policy that “trampled on the human dignity” of victims, Kishida said, adding he would meet survivors in coming weeks to listen “face-to-face to their stories of suffering.”

A group of victims said on Wednesday it “wholeheartedly” welcomed the ruling.

“We cannot forgive the irresponsibility of the government and its lack of human rights awareness, as well as the fact that what is now described as the biggest human rights violation in Japan’s post-war history was left unaddressed for such a long time,” the group said in a statement.

Lawyer Koji Niizato said it was “the best ruling we could have hoped for.”

“Victims of the eugenics law put up a wonderful fight, one that influenced the Supreme Court and changed society,” Niizato said.
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France’s renowned Arles photo fest goes ‘beneath the surface’

Posted on by Corts

Arles, France — One of the world’s most renowned photo festivals, in the French town of Arles, returned this week with a timely ode to diversity at a moment when France is turning towards the far right.

The Rencontres festival, which runs until Sept. 29, is spread across 27 venues in the ancient cobbled streets of this former Roman town in Provence and has been running since 1970.

This year’s theme is “Beneath the Surface,” seeking to delve into diversity without the usual caricatures around minorities.

The star exhibition is a world-first retrospective for U.S. portrait artist Mary Ellen Mark (1940-2015), who worked for magazines like Life and Rolling Stone.

One of her celebrated images features an Icelandic child resting on the neck of a horse that focuses attention away from the boy’s disability.

Mark “devoted a lot of time and attention to her protagonists, in a few cases returning to photograph them again and again over the course of many years, forging close relationships with many,” said co-curator Sophia Greiff.

An example is Tiny, whom Mark followed from her years on the street falling into drug use, to tender moments with her children.

“What I’m trying to do is make photographs that are universally understood… that cross cultural lines,” Mark once said.

Elsewhere at the festival, Spanish photographer Cristina de Middel presents documentary and dreamlike work about migrants traveling from Mexico to the U.S.

She ignores the usual tropes around migration, presenting the crossing as a heroic epic of courageous men and women heading towards a new life.

By mixing documentary images with staged and poetic photos, “it gives each person back their personality and restores a level of humanity in their representation,” said festival director Christoph Wiesner.

He said the message was particularly vital given the rise of the far right in France, which is currently leading in legislative elections.

“Just because the situation is complex, we cannot just give up,” said Wiesner, highlighting the festival’s regular work on issues around feminism and anti-racism, including presentations in local schools. 

Other exhibitions this year include “I’m So Happy You’re Here,” featuring the work of 20 Japanese female photographers.

Another invites visitors into the “baroque of everyday life” in the Indian state of Punjab with shots of bizarre roof sculptures that locals have brought back after working abroad, including footballs, tanks, planes and lions.

French artist Sophie Calle presents her images alongside responses from blind people about their understanding of visual beauty.

“Green is beautiful, because every time I like something I’m told it’s green,” reads one caption alongside a shot of vivid grass.
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What was the ‘first American novel’? On this Independence Day, a look at what it started

Posted on by Corts

NEW YORK — In the winter of 1789, around the time George Washington was elected the country’s first president, a Boston-based printer quietly launched another American institution.

William Hill Brown’s The Power of Sympathy, published anonymously by Isaiah Thomas & Company, is widely cited as something momentous: the first American novel.

Around 100 pages long, Brown’s narrative tells of two young New Englanders whose love affair abruptly and tragically ends when they learn a shocking secret that makes their relationship unbearable. The dedication page, addressed to the “Young Ladies of United Columbia” (the United States), promised an exposé of “the Fatal consequences of Seduction” and a prescription for the “Economy of Human Life.”

Outside of Boston society, though, few would have known or cared whether The Power of Sympathy marked any kind of literary milestone.

“If you picked 10 random citizens, I doubt it would have mattered to any of them,” says David Lawrimore, an associate professor of English at the University of Idaho who has written often about early U.S. literature. “Most people weren’t thinking about the first American novel.”

What the first American novel was like

Subtitled The Triumph of Nature. Founded in Truth, Brown’s book is in many ways characteristic of the era, whether its epistolary format, its Anglicized prose, its unidentified author, or its pious message. But The Power of Sympathy also includes themes that reflected the aspirations and anxieties of a young country and still resonate now.

Dana McClain, an assistant professor of English at Holy Family University, notes that Brown was an outspoken Federalist, believing in a strong national government, and shared his contemporaries’ preoccupation with forging how a stable republican citizenry. The letters in The Power of Sympathy include reflections on class, temperament and the differences between North and South, notably the “aristocratic temper” of Southern slaveholders that endangered “domestic quietude,” as if anticipating the next century’s Civil War.

Like many other early American writers, fiction and nonfiction, Brown tied the behavior of women to the fate of the larger society. The novel’s correspondents fret about the destabilizing “power of pleasure” and how female envy “inundates the land with a flood of scandal.” Virtue is likened to a “mighty river” that “fertilizes the country through which it passes and increases in magnitude and force until it empty itself into the ocean.”

Brown also examines at length the ways novels might be a path to corruption or a vehicle to uplift, mirroring current debates over the banning and restrictions of books in schools and libraries.

“Most of the novels with which our female libraries are overrun are built upon on a foundation not always placed on strict morality, and in the pursuit of of objects not always probable or praiseworthy,” one of Brown’s characters warns. “Novels, not regulated on the chaste principles of true friendship, rational love, and connubial duty, appear to me totally unfit to form the minds of women, of friends, or of wives.”

Brown was likely more interested in shaping minds than in literary glory.

“The Great American Novel” is a favorite catchphrase but wasn’t coined until the 1860s. During Brown’s lifetime, novels were a relatively crude art form and were valued mostly for satire, light entertainment or moral instruction. Few writers identified themselves as “novelists”: Brown was known as a poet, and essayist and the composer of an opera.

Even he recognized the book’s lower stature, writing in the novel’s preface: “This species of writing hath not been received with universal approbation.”

How it became considered the first

The Power of Sympathy was commonly cited as the first American novel in the 1800s, but few bothered debating it until the 20th century. Scholars then agreed that honors should belong to the first written and published in the United States by an author born and still residing in the country.

Those guidelines disqualified such earlier works as Charlotte Ramsay Lennox’s The Life of Harriot Stuart and Thomas Atwood Digges’ Adventures of Alonso.

Another contender was Father Bombo’s Pilgrimage to Mecca, a prose adventure by college students Hugh Henry Brackenridge and Philip Freneau, both of whom went on to prominent public careers. Written around 1770, the manuscript was later believed lost and wasn’t published in full until 1975.

Brown’s novel was unexamined for so long that only in the late 19th century did the public even discover he had written it. Many had credited the Boston poet Sarah Wentworth Apthorp Morton, whose family had endured a scandal similar to the one in The Power of Sympathy.

In 1894-95, editor Arthur W. Brayley of the Bostonian serialized the novel in his magazine, identifying Morton as the author. But after being contacted by Brown’s niece, Rebecca Vollentine Thompson, Brayley published a lengthy correction, titled “The Real Author of the Power of Sympathy.”

Thompson herself added a preface to a 1900 reissue, noting that Brown was close to Morton’s family and alleging that the publication had been “suppressed” because Brown had bared an “unfortunate scandal.”

A clockmaker’s son, Brown was a Boston native, likely born in 1765. He was well-read, connected, culturally conservative and politically minded; one of his first published writings was an unflattering poem about Daniel Shays, the namesake for the 1786-87 rebellion of impoverished Revolutionary War veterans in Massachusetts. Brown is also the author of several posthumous releases, including the play The Treason of Arnold and the novel Ira and Isabella.

His unofficial standing as “America’s First Novelist” did not lead to broader fame. The novel, currently in print through a 1996 edition from Penguin Classics, remains more of interest to specialists and antiquarians than to general readers.

Brown was not yet 30 when he died in North Carolina, in 1793, from what is believed to be malaria. He apparently never married or had children. No memorials or other historical sites are dedicated to him. No literary societies have been formed in his name.

His burial site is unknown.
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Robert Towne, Oscar-winning writer of ‘Chinatown,’ dies at 89

Posted on by Corts

NEW YORK — Robert Towne, the Oscar-winning screenplay writer of “Shampoo,” “The Last Detail” and other acclaimed films whose work on “Chinatown” became a model of the art form and helped define the jaded allure of his native Los Angeles, has died. He was 89.

Towne died Monday surrounded by family at his home in Los Angeles, said publicist Carri McClure. She declined to comment on a cause of death.

In an industry that gave birth to rueful jokes about the writer’s status, Towne for a time held prestige comparable to the actors and directors he worked with.

Through his friendships with two of the biggest stars of the 1960s and ’70s, Warren Beatty and Jack Nicholson, he wrote or co-wrote some of the signature films of an era when artists held an unusual level of creative control.

The rare “auteur” among screen writers, Towne managed to bring a highly personal and influential vision of Los Angeles onto the screen.

“It’s a city that’s so illusory,” Towne told The Associated Press in a 2006 interview. “It’s the westernmost west of America. It’s a sort of place of last resort. It’s a place where, in a word, people go to make their dreams come true. And they’re forever disappointed.”

Recognizable around Hollywood for his high forehead and full beard, Towne won an Academy Award for “Chinatown” and was nominated three other times, for “The Last Detail,” “Shampoo” and “Greystoke.” In 1997, he received a lifetime achievement award from the Writers Guild of America.

“His life, like the characters he created, was incisive, iconoclastic and entirely (original),” said “Shampoo” actor Lee Grant on X.

Towne’s success came after a long stretch of working in television, including “The Man from U.N.C.L.E” and “The Lloyd Bridges Show,” and on low-budget movies for “B” producer Roger Corman. In a classic show business story, he owed his breakthrough in part to his psychiatrist, through whom he met Beatty, a fellow patient. As Beatty worked on “Bonnie and Clyde,” he brought in Towne for revisions of the Robert Benton-David Newman script and had him on the set while the movie was filmed in Texas.

Towne’s contributions were uncredited for “Bonnie and Clyde,” the landmark crime film released in 1967, and for years he was a favorite ghost writer. He helped out on “The Godfather,” “The Parallax View” and “Heaven Can Wait” among others and referred to himself as a “relief pitcher who could come in for an inning, not pitch the whole game.”

But Towne was credited by name for Nicholson’s macho “The Last Detail” and Beatty’s sex comedy “Shampoo” and was immortalized by “Chinatown,” the 1974 thriller set during the Great Depression.

“Chinatown” was directed by Roman Polanski and starred Nicholson as J.J. “Jake” Gittes, a private detective asked to follow the husband of Evelyn Mulwray (played by Faye Dunaway). The husband is chief engineer of the Los Angeles Department of Water and Power, and Gittes finds himself caught in a chaotic spiral of corruption and violence, embodied by Evelyn’s ruthless father, Noah Cross (John Huston).

Influenced by the fiction of Raymond Chandler, Towne resurrected the menace and mood of a classic Los Angeles film noir but cast Gittes’ labyrinthine odyssey across a grander and more insidious portrait of Southern California. Clues accumulate into a timeless detective tale and lead helplessly to tragedy, summed up by one of the most repeated lines in movie history, words of grim fatalism a devastated Gittes receives from his partner Lawrence Walsh (Joe Mantell): “Forget it, Jake, it’s Chinatown.”
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Biden announces measures to protect against extreme weather

Posted on by Corts

As the Caribbean sees its first Category 5 hurricane of the year, scientists warn that extreme weather is here to stay due to climate change. Aru Pande reports from Washington, where U.S. President Joe Biden on Tuesday announced new climate resilience measures. Kim Lewis contributed to this report.
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FDA approves 2nd Alzheimer’s drug that modestly slows disease

Posted on by Corts

WASHINGTON — U.S. officials have approved another Alzheimer’s drug that can modestly slow the disease, providing a new option for patients in the early stages of the incurable, memory-destroying ailment. 

The Food and Drug Administration approved Eli Lilly’s Kisunla on Tuesday for mild or early cases of dementia caused by Alzheimer’s. It’s only the second drug that’s been convincingly shown to delay cognitive decline in patients, following last year’s approval of a similar drug from Japanese drugmaker Eisai. 

The delay seen with both drugs amounts to a matter of months — about seven months, in the case of Lilly’s drug. Patients and their families will have to weigh that benefit against the downsides, including regular IV infusions and potentially dangerous side effects like brain swelling. 

Physicians who treat Alzheimer’s say the approval is an important step after decades of failed experimental treatments. 

“I’m thrilled to have different options to help my patients,” said Dr. Suzanne Schindler, a neurologist at Washington University in St. Louis. “It’s been difficult as a dementia specialist — I diagnose my patients with Alzheimer’s and then every year I see them get worse and they progress until they die.” 

Both Kisunla and the Japanese drug, Leqembi, are laboratory-made antibodies, administered by IV, that target one contributor to Alzheimer’s: sticky amyloid plaque buildup in the brain. Questions remain about which patients should get the drugs and how long they might benefit. 

The new drug’s approval was expected after an outside panel of FDA advisers unanimously voted in favor of its benefits at a public meeting last month. That endorsement came despite several questions from FDA reviewers about how Lilly studied the drug, including allowing patients to discontinue treatment after their plaque reached very low levels. 

Costs will vary by patient, based on how long they take the drug, Lilly said. The company also said a year’s worth of therapy would cost $32,000 — more than the $26,500 price of a year’s worth of Leqembi. 

The FDA’s prescribing information tells doctors they can consider stopping the drug after confirming via brain scans that patients have minimal plaque. 

More than 6 million Americans have Alzheimer’s. Only those with early or mild disease will be eligible for the new drug, and an even smaller subset are likely to undergo the multistep process needed to get a prescription. 

The FDA approved Kisunla, known chemically as donanemab, based on results from an 18-month study in which patients given the treatment declined about 22% more slowly in terms of memory and cognitive ability than those who received a dummy infusion. 

The main safety issue was brain swelling and bleeding, a problem common to all plaque-targeting drugs. The rates reported in Lilly’s study, including 20% of patients with microbleeds, were slightly higher than those reported with competitor Leqembi. However, the two drugs were tested in slightly different types of patients, which experts say makes it difficult to compare the drugs’ safety. 

Kisunla is infused once a month compared to Leqembi’s twice-a-month regimen, which could make things easier for caregivers who bring their loved ones to a hospital or clinic for treatment.
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Study: Climate-induced disasters significantly weaken Pakistan’s societal resilience

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islamabad — A new study has revealed that recent floods in Pakistan have substantially weakened its societal resilience in coping with and recovering from such disasters as the threat from climate change continues to grow.

The London-headquartered independent global charity Lloyd’s Register Foundation said Tuesday the findings are part of the latest edition of their flagship World Risk Poll Resilience Index.

The study also highlighted that the number of Pakistanis who have experienced a disaster in the past five years has more than doubled since 2021, increasing from 11% to 27%.

“This increase has been driven primarily by the extensive floods that hit the country in 2022, affecting regions containing around 15% of the population,” the study said.

The report noted that community and society resilience scores declined sharply in the regions most affected by the floods, particularly in the southern Sindh province.

“These scores declined because people reported losing confidence in the support of the government, community and infrastructure — at a national level, those who said their government cared ‘not at all’ about them and their well-being rose from 60% in 2021 to almost three-quarters [72%] in 2023.”

Meanwhile, the country’s already low individual and household resilience levels failed to improve, with Pakistan ranking in the bottom 10 globally for both resilience scores, according to the report.

Nancy Hey, the director of evidence and insight at Lloyd’s Register Foundation, urged policymakers in Pakistan to prioritize rebuilding and strengthening the resilience of the most affected communities.

She said this would better prepare them to face natural hazards and other potential causes of disasters in the wake of the growing threat of climate change.

“For residents of Pakistan, catastrophic flooding is largely responsible for the doubling in disaster experience since 2021. This may have led to a ‘reality check’ for residents in terms of how prepared they feel for such events, with community and societal resilience particularly negatively affected,” Hey said.

In 2022, Pakistan’s southern and southwestern regions experienced devastating floods triggered by climate change-induced unusually heavy monsoon rains, killing more than 1,700 people, affecting 33 million others, and submerging approximately one-third of Pakistan.

The South Asian nation of about 245 million contributes less than 1% to global carbon emissions but bears the brunt of climate change.

The country’s weather patterns have changed dramatically in recent years, and it officially “ranks fifth among the countries most affected by global warming.”

April was recorded as the wettest month in Pakistan since 1961, with more than double the usual monthly rainfall, killing scores of people and destroying property as well as farmland.

In May and June, Pakistan experienced relatively hotter heat waves, with temperatures in some districts rising to more than 52 degrees Celsius for days. The hot weather prompted authorities in May to temporarily shut down education for half of Pakistan’s schoolchildren to protect them from heatstroke and dehydration.

The United Nations has warned that an estimated 200,000 Pakistanis could be affected by the coming monsoon season and flash floods, as national weather forecasters project above-normal rainfall.

Prime Minister Shehbaz Sharif reviewed preparations for the monsoon season at a special meeting Tuesday and formed “a high-level committee” to handle potential emergencies, his office said in a statement.

National Disaster Management Authority officials told the meeting that all relevant institutions and Pakistani troops remain on “high alert” in vulnerable districts. They were quoted as saying that “adequate stocks” of boats, tents, drainage pumps, medicines and other essential items were available for people in areas prone to rain-related disasters.”
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Alliance sets sights on minerals needed for global shift to green energy

Posted on by Coeco

The U.S. government’s representative to the Minerals Security Partnership, an alliance of mostly Western countries that aims to speed the development of energy mineral supply chains, said last month that a Chinese company was using “predatory” tactics to hold down the price of cobalt mined in the Democratic Republic of Congo. Henry Wilkins looks at what this means for Africa.
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Panama’s traditional pollera dress faces uncertain future

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Panama’s pollera is the country’s beautiful, elaborate and very expensive national dress, and one of the most recognized Latin American traditional costumes. But production of the gorgeous garment faces an uncertain future. Oscar Sulbarán explains why in this story narrated by Veronica Villafañe. (Camera: Oscar Sulbarán; Produced by: Veronica Villafañe)
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Shakespeare Library reopens in Washington with rare artifacts on display

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Washington, D.C., home to the world’s largest collection of William Shakespeare’s works, has unveiled a treasure trove that most have never seen. The Folger Shakespeare Library reopened its doors after a four-year long renovation, revealing the most valuable part of its collection to the public for the first time. Maxim Adams visited the library.
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Street medicine teams search for homeless people to deliver lifesaving IV hydration in extreme heat

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Phoenix — Alfred Handley leaned back in his wheelchair alongside a major Phoenix freeway as a street medicine team helped him get rehydrated with an intravenous saline solution dripping from a bag hanging on a pole.

Cars whooshed by under the blazing 96-degree morning sun as the 59-year-old homeless man with a nearly toothless smile got the help he needed through a new program run by the nonprofit Circle the City.  

“It’s a lot better than going to the hospital,” Handley said of the team that provides health care to homeless people. He’s been treated poorly at traditional clinics and hospitals, he said, more than six years after being struck by a car while he sat on a wall, leaving him in a wheelchair.

Circle the City introduced its IV rehydration program as a way to protect homeless people from life-threatening heat illness as temperatures regularly hit the triple-digits in America’s hottest metro. Homeless people accounted for nearly half of the record 645 heat-related deaths last year in Maricopa County, which encompasses metro Phoenix.

Dr. Liz Frye, vice chair of the Street Medicine Institute that provides training to hundreds of health care teams worldwide, said she didn’t know of groups other than Circle the City administering IVs on the street.

“But if that’s what needs to happen to keep somebody from dying, I’m all about it,” Frye said.

As summers grow warmer, health providers from San Diego to New York are being challenged to better protect homeless patients.

Even the Boston Health Care for the Homeless Program, featured in last year’s book, “Rough Sleepers,” now sees patients with mild heat exhaustion in the summer after decades of treating people with frostbite and hypothermia during the winter, said Dr. Dave Munson, the street team’s medical director.

“It’s certainly something to worry about,” said Munson, noting that temperatures in Boston hit 100 degrees with 70% humidity during June’s heat wave. Homeless people, he said, are vulnerable to very hot and very cold weather not only because they live outside, but they often can’t regulate body temperature due to medication for mental illness or high blood pressure, or because of street substance use.

The Phoenix team searches for patients in homeless encampments in dry riverbeds, sweltering alleys and along the canals that bring water to the Phoenix area. About 15% are dehydrated enough for a saline drip.  

“We go out every day and find them,” said nurse practitioner Perla Puebla. “We do their wound care, medication refills for diabetes, antibiotics, high blood pressure.”

Puebla’s street team ran across Handley and 36-year-old Phoenix native Phillip Enriquez near an overpass in an area frequented by homeless people because it’s near a facility offering free meals. Across the road was an encampment of tents and lean-tos along a chain-link fence.  

Enriquez sat on a patch of dirt as Puebla started a drip for him. She also gave him a prescription for antibiotics and a referral to a dentist for his dental infection.

Living outside in Arizona’s broiling sun is hard, especially for people who may be mentally ill or use sedating drugs like fentanyl that make them less aware of surroundings. Stimulants like methamphetamine contribute to dehydration, which can be fatal.

Temperatures this year have reached 115 degrees (45 Celsius) in metro Phoenix, where six heat-related deaths have been confirmed through June 22. Another 111 are under investigation.

“The number of patients with heat illnesses is increasing every year,” said Dr. Aneesh Narang, assistant medical director of emergency medicine at Banner Medical Center-Phoenix, which treats many homeless people with heat stroke.

Narang’s staff works frequently with Circle the City, whose core mission is providing respite care, with 100 beds for homeless people not well enough to return to the streets after a hospital stay.

Extreme heat worldwide requires a dramatic response, said physician assistant Lindsay Fox, who cares for homeless people in Albuquerque, New Mexico, through an initiative run by the University of New Mexico’s School of Medicine.

Three times weekly, Fox treats infections, cleans wounds and manages chronic conditions in consultation with hospital colleagues. She said the prospect of more heat illness worries her.

Highs in Albuquerque can hit the 90s and don’t fall enough for people living outside to cool off overnight, she said.

“If you’re in an urban area that’s primarily concrete, you’re retaining heat,” she said. “We’re seeing heat exposure that very quickly could go to heat stroke.”

Serious heat stroke is far more common in metro Phoenix, where Circle the City is now among scores of health programs for the homeless in cities like New York, San Diego and Spokane, Washington.

Circle the City, founded in 2012 by Sister Adele O’Sullivan, a physician and member of the Sisters of St. Joseph Carondelet, now has 260 employees, including 15 doctors, 13 physician assistants and 11 nurse practitioners. It annually sees 9,000 patients.

Grants, donations and other gifts account for about 20% of the funding. Most of the rest comes from insurance payments for services provided through Medicaid and Medicare.

Circle the City works with medical staff in seven Phoenix hospitals to help homeless patients get after-care when they no longer need hospitalization. It also staffs two outpatient clinics for follow-up.  

“This partnership allows us to offer the best outcomes for our patients,” said Craig Orsini, social work manager at St. Joseph’s Hospital and Medical Center in Phoenix.

Often that’s a few weeks in respite care or, for less acute needs, a stay in one of a handful of medical beds at the downtown shelter for things like dressing changes for wounds. Someone who needs months to heal might go to a skilled nursing facility.

While patients recover, Circle the City works to find longer-term transitional shelter such as those for people 55 and older, or in permanent housing. About 77% of respite patients are sent somewhere other than the street or an emergency shelter.

“We try to find the best fit for people,” said Wendy Adams, Circle the City’s community outreach supervisor.

Circle the City medical staff distributes tens of thousands of water bottles each summer and tries to educate people about hot weather dangers, said Dr. Matt Essary, who works at one of five mobile clinics that stop outside soup kitchens and other services for homeless people. 

Essary said Circle the City is also considering a blood analysis tool to detect electrolyte imbalances caused by dehydration.

“You can see right away how dehydrated they have become because it’s so hard to draw their blood,” he said. Other possible symptoms include headache, extreme thirst, dizziness and dry mouth.

“We also see a lot of people with surface burns,” Essary said of the wounds common in broiling Phoenix, where a medical emergency or intoxication can cause someone to fall on a sizzling sidewalk.

Rachel Belgrade waited outside Circle the City’s retrofitted truck with her black-and-white puppy, Bo, for Essary to write a prescription for the blood pressure medicine she lost when a man stole her bicycle. She accepted two bottles of water to cool off as the morning heat rose. 

“They make all of this easier,” said Belgrade, a Native American from the Gila River tribe. “They don’t give you a hard time.” 
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Meta risks fines over ‘pay for privacy’ model breaking EU rules

Posted on by Coeco

Brussels, Belgium — The EU accused Facebook owner Meta on Monday of breaching the bloc’s digital rules, paving the way for potential fines worth billions of euros.

The charges against the US tech titan follow a finding last week against Apple that marked the first time Brussels had levelled formal accusations under the EU’s Digital Markets Act (DMA).

The latest case focuses on Meta’s new ad-free subscription model for Facebook and Instagram, which has sparked multiple complaints over privacy concerns.

Meta’s “pay or consent” system means users have to pay to avoid data collection, or agree to share their data with Facebook and Instagram to keep using the platforms for free.

The European Commission said it informed Meta of its “preliminary view” that the model the company launched last year “fails to comply” with the DMA.

“This binary choice forces users to consent to the combination of their personal data and fails to provide them a less personalized but equivalent version of Meta’s social networks,” the EU’s powerful antitrust regulator said in a statement.

The findings come after the commission kickstarted a probe into Meta in March under the DMA, which forces the world’s biggest tech companies to comply with EU rules designed to give European users more choice online.

Meta insisted its model “complies with the DMA.”

“We look forward to further constructive dialogue with the European Commission to bring this investigation to a close,” a Meta spokesperson said.

Meta can now reply to the findings and avoid a fine if it changes the model to address the EU’s concerns.

If the commission’s view is confirmed however, it can slap fines of up to 10 percent of Meta’s total global turnover under the DMA. This can rise to up to 20 percent for repeat offenders.

Meta’s total revenue last year stood at around $135 billion (125 billion euros).  

The EU also has the right to break up firms, but only as a last resort. 

In EU’s crosshairs

Under the DMA, the EU labels Meta and other companies, including Apple, as “gatekeepers” and prevents them forcing users in the bloc to consent to have access to a service or certain functionalities.

The commission said Meta’s model did not allow users to “freely consent” to their data being shared between Facebook and Instagram with Meta’s ads services.

“The DMA is there to give back to the users the power to decide how their data is used and ensure innovative companies can compete on equal footing with tech giants on data access,” the EU’s top tech enforcer, commissioner Thierry Breton, said.

The commission will adopt a decision on whether Meta’s model is DMA compliant or not by late March 2025.

The EU has shown it is serious about making big online companies change their ways.

The commission told Apple last week its App Store rules were hindering developers from freely pointing consumers to alternative channels for offers.

The EU is also probing Google over similar concerns on its Google Play marketplace.

Apple and Meta are not the only companies coming under the scope of the DMA. Google parent Alphabet, Amazon, Microsoft and TikTok owner ByteDance must also comply.

Online travel giant Booking.com will need to adhere to the rules later this year.

Privacy complaints

Meta has made billions from harvesting users’ data to serve up highly targeted ads. But it has faced an avalanche of complaints over its data processing in recent years.

The European data regulator in April has also said the ‘pay or consent’ model is at odds with the bloc’s General Data Protection Regulation (GDPR), which upholds the privacy of users’ information.

Ireland — a major hub for online tech giants operating in the 27-nation bloc — has slapped Meta with massive fines for violating the GDPR.

The latest complaint by privacy groups forced Meta last month to pause its plans to use personal data to train its artificial intelligence technology in Europe. 
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Space Pioneer says part of rocket crashed in central China

Posted on by Corts

Beijing — Beijing Tianbing Technology Company said Sunday that the first stage of its Tianlong-3 rocket under development had detached from its launch pad during a test due to structural failure and landed in a hilly area of the city of Gongyi in central China.

There were no reports of casualties after an initial investigation, Beijing Tianbing, also known as Space Pioneer, said in a statement on its official WeChat account.

Parts of the rocket stage were scattered within a “safe area” but caused a local fire, according to a separate statement by the Gongyi emergency management bureau.

The fire has since been extinguished and no one has been hurt, the bureau said.

The two-stage Tianlong-3 (“Sky Dragon 3”) is a partly reusable rocket under development by Space Pioneer, one of a small group of private-sector rocket makers that have grown rapidly over the past five years.

Falling rocket debris in China after launches is not unheard of, but it is very rare for part of a rocket under development to make an unplanned flight out of its test site and crash.

According to Space Pioneer, the first stage of the Tianlong-3 ignited normally during a hot test but later detached from the test bench due to structural failure and landed in hilly areas 1.5 km (0.9 mile) away.

A rocket can consist of several stages, with the first, or lowest, stage igniting and propelling the rocket upward upon its launch.

When the fuel is exhausted, the first stage falls off, and the second stage ignites, keeping the rocket in propulsion. Some rockets have third stages.

Space Pioneer says the performance of Tianlong-3 is comparable to SpaceX’s Falcon 9, which is also a two-stage rocket.

In April 2023, Space Pioneer launched a kerosene-oxygen rocket, the Tianlong-2, becoming the first private Chinese firm to send a liquid-propellant rocket into space.

Chinese commercial space companies have rushed into the sector since 2014 when private investment in the industry was allowed by the state.

Many started making satellites while others including Space Pioneer, focused on developing reusable rockets that can significantly cut mission costs.

The test sites of such companies can be found along China’s coastal areas, located by the sea due to safety reasons.

But some are also sited deep in the country’s interior such as Space Pioneer’s test center in Gongyi, a city of 800,000 people in the central province of Henan.
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LGBTQ+ Pride Month culminates with parades in New York, San Francisco and beyond

Posted on by Corts

New York — The monthlong celebration of LGBTQ+ Pride reached its exuberant grand finale on Sunday, bringing rainbow-laden revelers to the streets for marquee parades in New York, Chicago, San Francisco and elsewhere across the globe.

The wide-ranging festivities functioned as both jubilant parties and political protests, as participants recognize the community’s gains while also calling attention to recent anti-LGBTQ+ laws, such as bans on transgender health care, passed by Republican-led states.

“We’re at a time where there’s a ton of legislation, anti-LGBTQ+ legislation,” Zach Overton, 47, said at the New York parade. “It feels like we’re taking a step backwards in the fight for equality and so it’s a great moment to come out and be with our community and see all the different colors of the spectrum of our community and remind ourselves what we’re all fighting for.”

Thousands of people gathered along New York’s Fifth Avenue to celebrate Pride. Floats cruised the street as Diane Ross’ “I’m Coming Out” played from loudspeakers. Pride flags filled the horizon, and signs in support of Puerto Rico, Ukraine and Gaza were visible in the crowd.

This year, tensions over the Israel-Hamas war in Gaza are also seeped into the celebrations, exposing divisions within a community that is often aligned on political issues.

Protesters temporarily blocked the New York parade on Sunday, chanting: “Free, free, free Palestine!” Police eventually took some of them away.

Pro-Palestinian activists disrupted pride parades earlier in June in Boston, Denver, and Philadelphia. Several groups participating in marches Sunday said they would seek to center the victims of the war in Gaza, spurring pushback from supporters of Israel.

“It is certainly a more active presence this year in terms of protest at Pride events,” said Sandra Perez, the executive director of NYC Pride. “But we were born out of a protest.”

The first pride march was held in New York City in 1970 to commemorate the one-year anniversary of the Stonewall Inn uprising, a riot that began with a police raid on a Manhattan gay bar.

Nick Taricco, 47, who was at the New York parade with Overton, said he attended Friday’s opening of the Stonewall National Monument Visitor Center, where President Joe Biden spoke. Taricco said he has concerns about politics in the U.S., including the presidential election.

“Even given how old he is, I still think that’s the direction we need to go in,” Taricco said of Biden. “But it’s a very uncertain time in general in this country.”

Ireland Fernandez-Cosgrove, 23, celebrated at the New York parade.

“New York City is a great place to live, but this is one of the only days where you can come out and be openly queer and you know you’re going to be OK and safe about it,” she said. “I came out here today with my partner to be able to be ourselves in public and know that other people are going to be supporting us.”

In addition to the NYC Pride March, the nation’s largest, the city also played host Sunday to the Queer Liberation March, an activism-centered event launched five years ago amid concerns that the more mainstream parade had become too corporate.

Another one of the world’s largest Pride celebrations also took place Sunday in San Francisco.

Tens of thousands of revelers packed sidewalks along Chicago’s parade, a scaled-back event from previous years. City officials shortened the North Side route and the number of floats this year from 199 to about 150 over safety and logistical concerns, including to better deploy police into evening hours as post-parade parties have become more disruptive in recent years. Chicago’s parade, one of the largest in the U.S., routinely draws about 1 million people, according to the city. Sunday’s crowd estimates were not immediately available.

Additional parades were scheduled in Minneapolis and Seattle.

On top of concerns about protests, federal agencies have warned that foreign terrorist organizations and their supporters could target the parades and adjacent venues. A heavy security presence was expected at all of the events.
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Hurricane Beryl strengthens into Category 4 storm as it nears southeast Caribbean 

Posted on by Corts

SAN JUAN, Puerto Rico — Hurricane Beryl strengthened into what experts called an “extremely dangerous” Category 4 storm as it approaches the southeast Caribbean, which began shutting down Sunday amid urgent pleas from government officials for people to take shelter.

Hurricane warnings were in effect for Barbados, St. Lucia, Grenada, and St. Vincent and the Grenadines. Beryl’s center is expected to pass about 112 kilometers south of Barbados on Monday morning, said Sabu Best, director of Barbados’ meteorological service.

“This is a very serious situation developing for the Windward Islands,” warned the National Hurricane Center in Miami, which said that Beryl was “forecast to bring life-threatening winds and storm surge.”

Beryl was located about 570 kilometers east-southeast of Barbados. It had maximum sustained winds of 215 kph and was moving west at 33 kph. It is a compact storm, with hurricane-force winds extending 30 kilometers from its center.

Beryl is expected to pass just south of Barbados early Monday and then head into the Caribbean Sea as a major hurricane on a path toward Jamaica. It is expected to weaken by midweek, but still remain a hurricane as it heads toward Mexico.

Historic hurricane

Beryl had strengthened into a Category 3 hurricane on Sunday morning, becoming the first major hurricane east of the Lesser Antilles on record for June, according to Philip Klotzbach, Colorado State University hurricane researcher.

It took Beryl only 42 hours to strengthen from a tropical depression to a major hurricane — a feat accomplished only six other times in Atlantic hurricane history, and with Sept. 1 as the earliest date, according to hurricane expert Sam Lillo.

Beryl is now the earliest Category 4 Atlantic hurricane on record, besting Hurricane Dennis, which became a Category 4 storm on July 8, 2005, hurricane specialist and storm surge expert Michael Lowry said.

“Beryl is an extremely dangerous and rare hurricane for this time of year in this area,” he said in a phone interview. “Unusual is an understatement. Beryl is already a historic hurricane and it hasn’t struck yet.”

Hurricane Ivan in 2004 was the last strongest hurricane to hit the southeast Caribbean, causing catastrophic damage in Grenada as a Category 3 storm.

“So this is a serious threat, a very serious threat,” Lowry said of Beryl.

Reecia Marshall, who lives in Grenada, was working a Sunday shift at a local hotel, preparing guests and urging them to stay away from windows as she stored enough food and water for everyone.

She said she was a child when Hurricane Ivan struck, and that she doesn’t fear Beryl.

“I know it’s part of nature. I’m OK with it,” she said. “We just have to live with it.”

Forecasters warned of a life-threatening storm surge of up to 3 meters in areas where Beryl will make landfall, with up to 15 centimeters of rain for Barbados and nearby islands.

Long lines formed at gas stations and grocery stores in Barbados and other islands as people rushed to prepare for a storm that has broken records and rapidly intensified from a tropical storm with 35 mph (56 kph) winds on Friday to a Category 1 hurricane on Saturday.

Warm waters were fueling Beryl, with ocean heat content in the deep Atlantic the highest on record for this time of year, according to Brian McNoldy, University of Miami tropical meteorology researcher. Lowry said the waters are now warmer than they would be at the peak of the hurricane season in September.

Beryl marks the farthest east that a hurricane has formed in the tropical Atlantic in June, breaking a record set in 1933, according to Klotzbach.

“Please take this very seriously and prepare yourselves,” said Ralph Gonsalves, the prime minister of St. Vincent and the Grenadines. “This is a terrible hurricane.”

Bracing for the storm

Thousands of people were in Barbados for Saturday’s Twenty20 World Cup final, cricket’s biggest event, with Prime Minister Mia Mottley noting that not all fans were able to leave Sunday despite many rushing to change their flights.

“Some of them have never gone through a storm before,” she said. “We have plans to take care of them.”

Mottley said that all businesses should close by Sunday evening and warned the airport would close by nighttime.

Kemar Saffrey, president of a Barbadian group that aims to end homelessness, said in a video posted on social media Saturday night that those without homes tend to think they can ride out storms because they’ve done it before.

“I don’t want that to be the approach that they take,” he said, warning that Beryl is a dangerous storm and urging Barbadians to direct homeless people to a shelter.

Echoing his comments was Wilfred Abrahams, minister of home affairs and information.

“I need Barbadians at this point to be their brother’s keeper,” he said. “Some people are vulnerable.”

Meanwhile, St. Lucia Prime Minister Philip J. Pierre announced a national shutdown for Sunday evening and said that schools and businesses would remain closed on Monday.

“Preservation and protection of life is a priority,” he said.

Looking ahead

Caribbean leaders were preparing not only for Beryl, but for a cluster of thunderstorms trailing the hurricane that have a 70% chance of becoming a tropical depression.

“Do not let your guard down,” Mottley said.

Beryl is the second named storm in what is forecast to be an above-average hurricane season, which runs from June 1 to Nov. 30 in the Atlantic. Earlier this month, Tropical Storm Alberto came ashore in northeastern Mexico with heavy rains that resulted in four deaths.

The National Oceanic and Atmospheric Administration predicts the 2024 hurricane season is likely to be well above average, with between 17 and 25 named storms. The forecast calls for as many as 13 hurricanes and four major hurricanes.

An average Atlantic hurricane season produces 14 named storms, seven of them hurricanes and three major hurricanes.
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