.يولد جميع الناس أحرارا متساوين في الكرامة والحقوق. وقد وهبوا عقلا وضميرا وعليهم أن يعامل بعضهم بعضا بروح الإخاء‎
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Sunday, October 14, 2007

How does it feel to die?

Anna Gosline is a science writer in Vancouver, Canada

IS IT distressing to experience consciousness slipping away or something people can accept with equanimity? Are there any surprises in store as our existence draws to a close? These are questions that have plagued philosophers and scientists for centuries, and chances are you've pondered them too occasionally.

None of us can know the answers for sure until our own time comes, but the few individuals who have their brush with death interrupted by a last-minute reprieve can offer some intriguing insights. Advances in medical science, too, have led to a better understanding of what goes on as the body gives up the ghost.

Death comes in many guises, but one way or another it is usually a lack of oxygen to the brain that delivers the coup de grâce. Whether as a result of a heart attack, drowning or suffocation, for example, people ultimately die because their neurons are deprived of oxygen, leading to cessation of electrical activity in the brain - the modern definition of biological death.

If the flow of freshly oxygenated blood to the brain is stopped, through whatever mechanism, people tend to have about 10 seconds before losing consciousness. They may take many more minutes to die, though, with the exact mode of death affecting the subtleties of the final experience. If you can take the grisly details, read on for a brief guide to the many and varied ways death can suddenly strike.


The "surface struggle" for breath

Death by drowning has a certain dark romance to it: countless literary heroines have met their end slipping beneath the waves with billowy layers of petticoats floating around their heads. In reality, suffocating to death in water is neither pretty nor painless, though it can be surprisingly swift.

Just how fast people drown depends on several factors, including swimming ability and water temperature. In the UK, where the water is generally cold, 55 per cent of open-water drownings occur within 3 metres of safety. Two-thirds of victims are good swimmers, suggesting that people can get into difficulties within seconds, says Mike Tipton, a physiologist and expert in marine survival at the University of Portsmouth in the UK.

Typically, when a victim realises that they cannot keep their head above water they tend to panic, leading to the classic "surface struggle". They gasp for air at the surface and hold their breath as they bob beneath, says Tipton. Struggling to breathe, they can't call for help. Their bodies are upright, arms weakly grasping, as if trying to climb a non-existent ladder from the sea. Studies with New York lifeguards in the 1950s and 1960s found that this stage lasts just 20 to 60 seconds.

When victims eventually submerge, they hold their breath for as long as possible, typically 30 to 90 seconds. After that, they inhale some water, splutter, cough and inhale more. Water in the lungs blocks gas exchange in delicate tissues, while inhaling water also triggers the airway to seal shut - a reflex called a laryngospasm. "There is a feeling of tearing and a burning sensation in the chest as water goes down into the airway. Then that sort of slips into a feeling of calmness and tranquility," says Tipton, describing reports from survivors.

That calmness represents the beginnings of the loss of consciousness from oxygen deprivation, which eventually results in the heart stopping and brain death.

Heart attack

One of the most common forms of exit

The "Hollywood Heart Attack", featuring sudden pain, desperate chest-clutching and immediate collapse, certainly happens in a few cases. But a typical "myocardial infarction", as medical-speak has it, is a lot less dramatic and comes on slowly, beginning with mild discomfort.

The most common symptom is, of course, chest pain: a tightness, pressure or squeezing, often described as an "elephant on my chest", which may be lasting or come and go. This is the heart muscle struggling and dying from oxygen deprivation. Pain can radiate to the jaw, throat, back, belly and arms. Other signs and symptoms include shortness of breath, nausea and cold sweats.

Most victims delay before seeking assistance, waiting an average of 2 to 6 hours. Women are the worst, probably because they are more likely to experience less well-known symptoms, such as breathlessness, back or jaw pain, or nausea, says JoAnn Manson, an epidemiologist at Harvard Medical School. Survivors say they just didn't want to make a fuss; that it felt more like indigestion, tiredness or muscle cramps than a heart attack. Then again, some victims are just in denial.

Delay costs lives. Most people who die from heart attacks do so before reaching hospital. The actual cause of death is often heart arrhythmia - disruption of the normal heart rhythm, in other words.

Even small heart attacks can play havoc with the electrical impulses that control heart muscle contraction, effectively stopping it. In about 10 seconds the person loses consciousness, and minutes later they are dead.

Patients who make it to hospital quickly fare much better; in the UK and US more than 85 per cent of heart attack patients admitted to hospital survive to 30 days. Hospitals can deploy defibrillators to shock the heart back into rhythm, and clot-busting drugs and artery-clearing surgery.

Bleeding to death

Several stages of haemorrhagic shock

The speed of exsanguination, as bleeding to death is known, depends on the source of the bleed, says John Kortbeek at the University of Calgary in Alberta, Canada, and chair of Advanced Trauma Life Support for the American College of Surgeons. People can bleed to death in seconds if the aorta, the major blood vessel leading from the heart, is completely severed, for example, after a severe fall or car accident.

Death could creep up much more slowly if a smaller vein or artery is nicked - even taking hours. Such victims would experience several stages of haemorrhagic shock. The average adult has 5 litres of blood. Losses of around 750 millilitres generally cause few symptoms. Anyone losing 1.5 litres - either through an external wound or internal bleeding - feels weak, thirsty and anxious, and would be breathing fast. By 2 litres, people experience dizziness, confusion and then eventual unconsciousness.

"Survivors of haemorrhagic shock describe many different experiences, ranging from fear to relative calm," Kortbeek says. "In large part this would depend on what and how extensive the associated injuries were. A single penetrating wound to the femoral artery in the leg might be less painful than multiple fractures sustained in a motor vehicle crash."


It's usually the toxic gases that prove lethal

Long the fate of witches and heretics, burning to death is torture. Hot smoke and flames singe eyebrows and hair and burn the throat and airways, making it hard to breathe. Burns inflict immediate and intense pain through stimulation of the nociceptors - the pain nerves in the skin. To make matters worse, burns also trigger a rapid inflammatory response, which boosts sensitivity to pain in the injured tissues and surrounding areas.

As burn intensities progress, some feeling is lost but not much, says David Herndon, a burns-care specialist at University of Texas Medical Branch in Galveston. "Third-degree burns do not hurt as much as second-degree wounds, as superficial nerves are destroyed. But the difference is semantic; large burns are horrifically painful in any instance."

Some victims of severe burns report not feeling their injuries while they are still in danger or intent on saving others. Once the adrenalin and shock wear off, however, the pain quickly sets in. Pain management remains one of the most challenging medical problems in the care of burns victims.

Most people who die in fires do not in fact die from burns. The most common cause of death is inhaling toxic gases - carbon monoxide, carbon dioxide and even hydrogen cyanide - together with the suffocating lack of oxygen. One study of fire deaths in Norway from 1996 found that almost 75 per cent of the 286 people autopsied had died from carbon monoxide poisoning.

Depending on the size of the fire and how close you are to it, concentrations of carbon monoxide could start to cause headache and drowsiness in minutes, eventually leading to unconsciousness. According to the US National Fire Protection Association, 40 per cent of the victims of fatal home fires are knocked out by fumes before they can even wake up.

Nearly instantaneous

Beheading, if somewhat gruesome, can be one of the quickest and least painful ways to die - so long as the executioner is skilled, his blade sharp, and the condemned sits still.

The height of decapitation technology is, of course, the guillotine. Officially adopted by the French government in 1792, it was seen as more humane than other methods of execution. When the guillotine was first used in public, onlookers were reportedly aghast at the speed of death.

Quick it may be, but consciousness is nevertheless believed to continue after the spinal chord is severed. A study in rats in 1991 found that it takes 2.7 seconds for the brain to consume the oxygen from the blood in the head; the equivalent figure for humans has been calculated at 7 seconds. Some macabre historical reports from post-revolutionary France cited movements of the eyes and mouth for 15 to 30 seconds after the blade struck, although these may have been post-mortem twitches and reflexes.

If you end up losing your head, but aren't lucky enough to fall under the guillotine, or even a very sharp, well-wielded blade, the time of conscious awareness of pain may be much longer. It took the axeman three attempts to sever the head of Mary Queen of Scots in 1587. He had to finish the job with a knife.

Decades earlier in 1541, Margaret Pole, the Countess of Salisbury, was executed at the Tower of London. She was dragged to the block, but refused to lay her head down. The inexperienced axe man made a gash in her shoulder rather than her neck. According to some reports, she leapt from the block and was chased by the executioner, who struck 11 times before she died.


The heart and the brain are most vulnerable

In accidental electrocutions, usually involving low, household current, the most common cause of death is arrhythmia, stopping the heart dead. Unconsciousness ensues after the standard 10 seconds, says Richard Trohman, a cardiologist at Rush University in Chicago. One study of electrocution deaths in Montreal, Canada found that 92 per cent had probably died from arrhythmia.

Higher currents can produce nearly immediate unconsciousness. The electric chair was designed to produce instant loss of consciousness and painless death - a step up from traditional hangings - by conducting the current through the brain and the heart.

Whether it achieves this end is debatable. Studies on dogs in 1950 found that electrodes had to be placed on either side of the head to ensure sufficient current passed through the brain to knock the creature out. There have been many botched executions - those that required several jolts to kill, or where flames leapt from the prisoner's head, in one case due to a damp synthetic sponge being attached to the electrodes on the prisoner's head, which was such a poor conductor it was heated up by the current and caught fire.

An analysis in 2005 of post-mortem remains from 43 prisoners sentenced to death by electrocution found the most common visible injuries to be head and leg burns where the electrodes were attached. The study's senior author, William Hamilton, a medical examiner in Florida, concluded that these burns occurred post-mortem and that death was indeed instantaneous.

However, John Wikswo, a biophysicist at Vanderbilt University in Nashville, Tennessee, maintains that the thick, insulating bones of the skull would prevent sufficient current from reaching the brain, and prisoners could instead be dying from heating of the brain, or perhaps from suffocation due to paralysis of the breathing muscles - either way, an unpleasant way to go.

Fall from a height

If possible aim to land feet first

A high fall is certainly among the speediest ways to die: terminal velocity (no pun intended) is about 200 kilometres per hour, achieved from a height of about 145 metres or more. A study of deadly falls in Hamburg, Germany, found that 75 per cent of victims died in the first few seconds or minutes after landing.

The exact cause of death varies, depending on the landing surface and the person's posture. People are especially unlikely to arrive at the hospital alive if they land on their head - more common for shorter (under 10 metres) and higher (over 25 metres) falls. A 1981 analysis of 100 suicidal jumps from the Golden Gate Bridge in San Francisco - height: 75 metres, velocity on impact with the water: 120 kilometres per hour - found numerous causes of instantaneous death including massive lung bruising, collapsed lungs, exploded hearts or damage to major blood vessels and lungs through broken ribs.

Survivors of great falls often report the sensation of time slowing down. The natural reaction is to struggle to maintain a feet-first landing, resulting in fractures to the leg bones, lower spinal column and life-threatening broken pelvises. The impact travelling up through the body can also burst the aorta and heart chambers. Yet this is probably still the safest way to land, despite the force being concentrated in a small area: the feet and legs form a "crumple zone" which provides some protection to the major internal organs.

Some experienced climbers or skydivers who have survived a fall report feeling focused, alert and driven to ensure they landed in the best way possible: relaxed, legs bent and, where possible, ready to roll. Certainly every little helps, but the top tip for fallers must be to aim for a soft landing. A paper from 1942 reports a woman falling 28 metres from her apartment building into freshly tilled soil. She walked away with just a fractured rib and broken wrist.


Speed of death depends on the hangman's skill

Suicides and old-fashioned "short drop" executions cause death by strangulation; the rope puts pressure on the windpipe and the arteries to the brain. This can cause unconsciousness in 10 seconds, but it takes longer if the noose is incorrectly sited. Witnesses of public hangings often reported victims "dancing" in pain at the end of the rope, struggling violently as they asphyxiated. Death only ensues after many minutes, as shown by the numerous people being resuscitated after being cut down - even after 15 minutes.

When public executions were outlawed in Britain in 1868, hangmen looked for a less performance-oriented approach. They eventually adopted the "long-drop" method, using a lengthier rope so the victim reached a speed that broke their necks. It had to be tailored to the victim's weight, however, as too great a force could rip the head clean off, a professionally embarrassing outcome for the hangman.

Despite the public boasting of several prominent executioners in late 19th-century Britain, a 1992 analysis of the remains of 34 prisoners found that in only about half of cases was the cause of death wholly or partly due to spinal trauma. Just one-fifth showed the classic "hangman's fracture" between the second and third cervical vertebrae. The others died in part from asphyxiation.

Michael Spence, an anthropologist at the University of Western Ontario in London, Canada, has found similar results in US victims. He concluded, however, that even if asphyxiation played a role, the trauma of the drop would have rapidly rendered all of them unconscious. "What the hangmen were looking for was quick cessation of activity," he says. "And they knew enough about their craft to ensure that happened. The thing they feared most was decapitation."

Lethal injection

US-government approved, but is it really painless?

Lethal injection was designed in Oklahoma in 1977 as a humane alternative to the electric chair. The state medical examiner and chair of anaesthesiology settled on a series of three drug injections. First comes the anaesthetic thiopental to speed away any feelings of pain, followed by a paralytic agent called pancuronium to stop breathing. Finally potassium chloride is injected, which stops the heart almost instantly.

Each drug is supposed to be administered in a lethal dose, a redundancy to ensure speedy and humane death. However, eyewitnesses have reported inmates convulsing, heaving and attempting to sit up during the procedure, suggesting the cocktail is not always completely effective.

The reason, say Leonidas Koniaris at the University of Miami Miller School of Medicine, is insufficient thiopental. He and his colleagues analysed 41 executions by lethal injection in North Carolina and California, and compared anaesthetic doses to known effects in animal models, such as pigs. As the same dose of thiopental is used regardless of body weight, the anaesthesia produced in some heavier inmates might be inadequate, they concluded.

"I think that awareness is a real possibility in a large fraction of executions," says Koniaris. That awareness might include feelings of suffocation from paralysed lungs and the searing, burning pain of a potassium chloride injection. The effect of the paralytic, however, might mean that witnesses never see any outward signs of pain.

The Supreme Court is now going to review whether this mode of execution is legal.

Explosive decompression

It takes your breath away

Death due to exposure to vacuum is a staple of science fiction plots, whether the unfortunate gets thrown from an airlock or ruptures their spacesuit.

In real life there has been just one fatal space depressurisation accident. This occurred on the Russian Soyuz-11 mission in 1971, when a seal leaked upon re-entry into the Earth's atmosphere; upon landing all three flight crew were found dead from asphyxiation.

Most of our knowledge of depressurisation comes from animal experiments and the experiences of pilots in accidents at very high altitudes. When the external air pressure suddenly drops, the air in the lungs expands, tearing the fragile gas exchange tissues. This is especially damaging if the victim neglects to exhale prior to decompression or tries to hold their breath. Oxygen begins to escape from the blood and lungs.

Experiments on dogs in the 1950s showed that 30 to 40 seconds after the pressure drops, their bodies began to swell as the water in tissues vaporised, though the tight seal of their skin prevented them from "bursting". The heart rate rises initially, then plummets. Bubbles of water vapour form in the blood and travel through the circulatory system, obstructing blood flow. After about a minute, blood effectively stops circulating.

Human survivors of rapid decompression accidents include pilots whose planes lost pressure, or in one case a NASA technician who accidentally depressurised his flight suit inside a vacuum chamber. They often report an initial pain, like being hit in the chest, and may remember feeling air escape from their lungs and the inability to inhale. Time to the loss of consciousness was generally less than 15 seconds.

One mid-1960s experiment by the US Army Aeromedical Research Laboratory in New Mexico found that a chimpanzee had a period of useful consciousness of just 11 seconds before lack of oxygen caused them to pass out.

Surprisingly, in view of these apparently traumatic effects, animals that have been repressurised within 90 seconds have generally survived with no lasting damage.

Death - Delve deeper into the riddle of human mortality in the special report.

Thursday, September 13, 2007

HIV rates rise in gay New Yorkers under 30

HIV infection rates among New York City gay men under 30 years of age rose during the last six years, health authorities reported.

The majority of the new cases occurred among gay African-Americans and Latinos. Among gay men under 20 years of age, more than 90 percent of those diagnosed with HIV belonged to one of those two ethnic groups, the report read.

According to a study by the city Department of Health and Mental Hygiene, new diagnoses of HIV among gays in New York City increased by 33 percent during the last six years, from 374 in 2001 to 499 in 2006.

Gays between 13 and 19 years of age registered a high increase in HIV infection rates -- from 41 new cases six years ago to 87 in 2006.

Every borough in the city except Staten Island witnessed an increase in infection rates.

The Department of Health report did not offer possible explanations as to why rates of infection have risen among gay men under 30, and adolescents between 13 and 19 in particular.

Dr. Donna Futterman, director of the youth AIDS program at Children's Hospital of Montefiore, said teenagers in minority groups may feel more pressure to hide their sexual orientation.

"The pressure to hide their identity puts them in riskier situations than if they could openly date and express their wishes and expectations," Futterman said.

Health Commissioner Thomas Frieden urged young people to reduce their number of sexual partners, and use condoms more consistently.

Frieden pointed out that the current generation of young people is growing up without having seen friends die of AIDS, which could be giving them the false impression "that HIV is not such a terrible disease."

Tuesday, September 4, 2007

MAURITANIA: UN refugee agency calls for funds to get Mauritanian refugees home

An 18-year-old Senegalese government-issued refugee card. Cards like these were issued to Mauritanians expelled from their homes in 1989
The UN refugee agency is asking donors for US$7 million to help tens of thousands of Mauritanians return home nearly 20 years after ethnic fighting forced them to leave.

Forced from their homes and livelihoods in 1989 the refugees – living in Senegal and Mali – have long insisted that their return be supervised and backed by the UN refugee agency (UNHCR). In June the Mauritanian government formally requested UNHCR assistance with the repatriation.

“We call on the international community to help Mauritania turn this painful page in our history,” Moustapha Toure, spokesperson for the Mauritanian refugees, told IRIN.

Some 25,000 Mauritanians are expected to set off from Senegal and Mali next month in UNHCR-operated boats and trucks, with the refugee agency providing food and protection along the way as well as assistance to local communities.

Part of the funds – about $1.7 million – is earmarked for protection and monitoring of refugees’ legal rights. “The authorities will provide returnees with the necessary documentation to ensure their access to civil rights, land and property in a dignified manner,” UNHCR says in its appeal.

After years of refugees’ apprehension about their status upon returning home, the newly elected Mauritanian government in July formally invited them, saying they could return safely and with dignity.

Of some 60,000 people who originally fled Mauritania, about 30,000 remain in northern Senegal and some 6,000 in Mali.

An initial survey conducted by UNHCR and Senegalese officials in July and August found that some 24,000 refugees in Senegal expressed a wish to return home. A few hundred refugees living in Mali are also expected to return.

UNHCR says given “the limited absorption capacity of return areas”, it expects to assist 7,000 people to return by the end of this year and the rest in 2008.

Helping local communities

Part of the funds will be used to build up health and education facilities as well as boost agricultural capacity in communities where refugees will return, UNHCR says.

“It is assumed that returning refugees have maintained regular contact with their relatives in Mauritania, which will improve reintegration prospects in their communities of origin,” UNHCR says in the appeal document. “However, as communities in Mauritania are already facing a shortage of resources, returnee families, consisting often of up to nine members each, will put an important strain on already scarce food and water sources.”

The appeal covers the construction of 35 wells and the building or rehabilitation of 20 health centres and 20 classrooms. In addition, it calls for agricultural tools and seeds for returnees as well as host communities.

Refugees will receive two months food rations from UNHCR and three months basic food rations from the World Food Programme to further mitigate the strain on local communities.

UNHCR says it is negotiating a tripartite agreement with the Senegalese and Mauritanian governments, intended to provide a legal framework covering property rights and legal documentation for refugees. The agreement is expected to be finalised before repatriation begins in October, the agency says.

Truth and reconciliation

While refugees have welcomed the assistance of their government and UNHCR, many are calling for a truth and reconciliation commission to discuss the events of 1989 once repatriation is completed, refugee spokesperson Toure told IRIN.

Mauritanian President Mohamed Ould Cheikh Abdallahi said in a speech in June: “I am urging all Mauritanians to get mobilised in order to welcome, as warmly and in as brotherly a manner as possible, our fellow countrymen and women in solidarity.”

“Our president has recognised the state’s responsibility to restoring our human rights,” Toure said. “We hope the international community will fully support that initiative so we can put ourselves firmly on the path of national reconciliation.”

Some 60,000 black Mauritanians were expelled from their country to neighbouring Senegal and Mali in 1989 when a border dispute erupted into ethnic violence. Thousands of Mauritanians living in Senegal at the time were also forced out.

Sunday, September 2, 2007

“Tactical Momentum” in Iraq and Our New Sunni “Friends”

In an August 25 article in the New York Times (”Hear a General, Hug a Sheik: Congress Does the Iraq Circuit,” by Sheryl Gay Stolberg and Damien Cave) we learn that the encouraging, but misleading, phrase “Tactical Momentum” is apparently being used by General David Petraeus in his briefings of the many Congressmen making the pilgrimage to Iraq of late. This phrase, or something similar, is likely to feature prominently in Gen. Petraeus’ report this month on the situation in Iraq.

That choice of words suggests that a process is underway inside Iraq of expanding and sustainable stability, which would have to involve the resolution of the deep ethno-sectarian rifts that have been tearing that already battered country apart. Gen. Petraeus and others speaking out in support of the current surge also commonly assert or imply strongly that the gains made in recent months in predominantly Sunni Arab areas of Iraq are the direct result of the surge. This simply is not the case.

By far, the gains made in mainly Sunni Arab portions of Iraq, especially al-Anbar province, are the result of rising anger among many Sunni Arabs over the abuses associated with al-Qaeda in Iraq cadres in their midst — resentment that has been building since 2004. This has very little to do with the current surge. Indeed, only around 5,000 additional US troops of almost 30,000 sent to Iraq since the beginning of the surge have gone to al-Anbar because the focus of the surge was the Baghdad area.

Furthermore, this alliance of convenience between US forces and Sunni Arab tribal notables and insurgents is bitterly opposed by the Shi’a-dominated Maliki government and its supporters because there is no desire on their part to have armed Sunni Arabs assemble more freely, acquire still more arms one way or another without US interference, or join local Iraqi security forces in large numbers. In effect, what has been going on is the formation, with US acquiescence, of Sunni Arab militias. Yet, by encouraging and exploiting this phenomenon, American troops, alongside such forces, have dealt severe blows to al-Qaeda in Iraq — perhaps the most encouraging successes in Iraq since 2003.

Nonetheless, those now helping us in al-Anbar and other largely Sunni Arab strongholds remain deeply opposed to the American occupation and fiercely oppose the Shi’a and Kurdish dominated government in Baghdad. This is why one senior American commander working with these elements reportedly has instructed his men not to trust our new best friends. If and when al-Qaeda in Iraq has been crushed, these same Sunni Arabs might well turn once again against the next two parties on their hit list. As a result, we would want to make sure that when that time arrives, we get out of their way as expeditiously as possible. This is almost certainly why General Odierno mentioned recently the possibility of pulling out of some areas in al-Anbar once they are “stabilized” (i.e. made free of al-Qaeda in Iraq).

There should be little reason to fear that once these Sunni Arab elements have defeated al-Qaeda in Iraq that, in the absence of US forces, these elements would invite the terrorists back in. Having betrayed such fanatical jihadists and fought against them alongside US forces, allowing them to return would carry the very real risk of bloody retribution.

Meanwhile, the profound political problems plaguing Iraq, which the surge was supposed to resolve by creating the necessary “space” or security environment, continue unabated. In fact, they appear to be worsening, in part because of the military cooperation between US forces and Sunni Arabs. Additionally, the Iraqi government remains dysfunctional. It is not only unable to pass the benchmarks so earnestly desired by Washington but, in fact, seems unwilling to do so because the idea of providing Sunni Arabs with a greater share of the political and financial pie (so Sunni Arabs will more readily buy in to the political process) is something anathema to many Shi’a and Kurds.

Unfortunately, many political figures across the political spectrum back here in the US don’t understand what is happening in Iraq. Supporters of the Bush Administration believe recent successes relating to Iraq’s Sunni Arabs are the result of the surge and that Iraq can be progressively stabilized by a continued US presence. Many of those on the other side of the political spectrum believe there has not been much success and to the extent there is, any progress would support the Administration’s case for remaining in Iraq.

Neither view holds water. The success in Sunni areas is real, but Iraq’s lethal ethno-sectarian fault-lines remain and opposition to occupation among our new Sunni Arab allies has not waned. The latter almost certainly will demand that we withdraw from their areas of Iraq once we finish helping them destroy the terrorists in their midst.

Consequently, lest we risk renewed resistance in predominantly Sunni Arab areas of the country farther down the road, the US should do just that. This would allow us to pull out of the previously most dangerous portions of Iraq in a more orderly and peaceful fashion. To avoid getting caught in the middle between Sunni and Shi’a, Washington should not wait too long before ordering a withdrawal from the rest of the country too.

Wayne White

Child marriage a neglected problem

Two years ago, in the western Malian village of Korera-Kore, a 13-year-old girl was forced into marriage during her school summer holiday. She died after complications during sex on her wedding night.

This young Malian, whose case was documented by a local organisation called the Coordination of Women’s Associations and Non-governmental organisations (CAFO), is one of more than 60 million women globally who were married or in union before the age of 18, according to estimates by the UN Children’s Fund (UNICEF).

Campaigners say forced early marriage, or child marriage, is a problem that has been largely untouched by the international community. In Mali it is considered by the research organisation Population Council as “one of the most severe crises of child marriage in the world today”; the few workers in this field say progress is too slow.

“There hasn’t been a really concerted effort to address the issue [at the international level],” said Naana Otoo-Oyortey, a founding member of the Forum on Marriage and the Rights of Women and Girls, a network of mostly UK-based organisations who campaign against early marriage and violence against women. “It’s been a neglected issue.”

Otoo-Oyortey said unlike female genital mutilation/cutting, which is prohibited in many international conventions, child marriage receives little visibility and little funding from donors for programmes to reduce the practice, despite its link to increased rates of maternal mortality, fistula and HIV/AIDS.

Legal framework

In Mali, a girl is legally allowed to wed at the age of 15 with the consent of her parents. In some cases, girls younger than 15 can wed with the authorisation of a judge.

A government bill that would, among other things, raise the legal age of marriage to 18 has been on the books for five years, but has yet to be passed.

“Now, it’s a question of political will,” said Bakary Traoré, technical adviser on children at the Malian Ministry for the Promotion of Women, Children and Family.

According to Founé Samaké, lawyer and member of the Clinique juridique des femmes maliennes, a legal aid clinic, Malian law punishes the abduction of women for forced marriage by one to five years in prison. When the abducted girl is less than 15 years old, the sentence is up to 10 years of forced labour and, at the discretion of the judge, an injunction banning the convicted person from specified places for up to 20 years.

But enforcing the law is an “arduous task”, Samaké said, because family members are often accomplices in the forced marriage.

Slow decline

In Mali, according to the latest statistics from the 2001 Demographic and Health Survey, 65 percent of women aged 20-24 were married by the age of 18, one of the highest rates in the world. Nationwide, 25 percent of girls were married by the age of 15, and one in 10 married girls aged 15-19 gave birth before age 15.

While this marks a decrease since 1987, when 79 percent of Malian women married as children, advocates say the numbers are not dropping fast enough, largely because not enough people are working on the subject.

“The global trend has been a slow decline,” said Nassra Abass, a consultant in UNICEF’s child protection section in New York. “[But] there’s definitely a lot more that we can do.”

She said UNICEF’s focus has been on reducing female genital cutting (FGC), a movement that has “momentum”, unlike child marriage, honour killings and other traditional practices considered harmful by the UN.

“There have not been very many resources or much time invested in early marriage. There aren’t many programmes running. That’s why the decline is slow,” Abass told IRIN.


The mild decline in early marriage in Mali has been attributed to the few education and awareness raising programmes that do exist.

In the western Malian region of Kayes, where 83 percent of girls are married by the age of 18, particular effort has been paid to informing people of the risks of early marriage.

According to the UN Population Fund (UNFPA), girls aged 15-19 are twice as likely to die during pregnancy or childbirth as women aged 20-24. Among girls aged 10-14, the risk is five times greater. Early onset of sexual activity has also been linked to increased risk of HIV/AIDS because child brides are less likely to be educated and more likely to have unprotected sex with older men who have had more sexual partners.

New research by CAFO of Nioro du Sahel, one of Kayes’s largest cities, showed that in Kayes, between 2005 and May 2007, at least 10 girls - many not yet teenagers - lost their lives because of complications after their wedding nights, sometimes due to haemorrhaging after forced intercourse.


As a result, in July, CAFO joined with UNICEF, the government department responsible for the promotion of women, and the union of independent radio and TV stations, to organise the first public awareness campaign in the region of Kayes. It included a three-day workshop with religious and community leaders, informing them of the dangers of early marriage and helping them produce messages against early marriage to be broadcast in the local media. A similar workshop took place in the eastern region of Gao in June.

“We were ignorant. We married girls at 9, 10, 11 or 12 years old. Now, we’ve seen the reality. We will no longer practice this,” Diawara Mamadou, head of the town of Gogui and one of 12 community representatives present at the workshop, told IRIN.

For the last two years, UNICEF has also been working with communities in three regions of Mali - Segou, Mopti and Kayes - to inform residents of the risks, help them abandon the practice, and set up committees that will intervene in cases of early marriage. UNICEF in Mali has set up an internal working group to better coordinate work on early marriage, and hopes to extend these programmes nation-wide.

“[In Mali], we are the only ones interested in this problem,” said Fabienne Dubey, assistant programme officer for education at UNICEF-Mali. “I don’t know of other organisations working on this. It is still very rudimentary.”

Photo: IRIN
Women do a lot of cooking, cleaning and manual work in Mali. Education is poor
UNFPA runs educational programmes focusing on reproductive health that include, but do not specifically target, early marriage. Starting in 2008, UNFPA will make early marriage more of a priority, according to reproductive health programme officer Mariam Cissoko.

What works

“The most important thing that a national government should do is ensure enforcement of its own laws,” said Kathy Selvaggio, senior policy advocate at the Washington, DC-based International Center for Research on Women, an organisation lobbying the US government to spend more of its aid money fighting early marriage.

She said legal enforcement must be combined with programmes that provide alternatives to early marriage by increasing the levels of education and economic opportunities of girls.

“Where you have successes in combating child marriage, [as in India and Ethiopia], they’ve been these comprehensive approaches,” Selvaggio told IRIN.

The Malian government does consider child marriage a form of violence against women, and “there is a whole policy to fight against violence done to women,” according to Kanté Dandara Touré, national director for the promotion of women at the Ministry for the Promotion of Women, Children and Family.

She said the national committee for the fight against detrimental practices does include early marriage in its sensitisation work, using media, community leaders and theatre, but no government programme targets early marriage exclusively.
''...It's a question of priorities, and right now female genital cutting is at the top...''

“It’s a question of priorities,” and right now “female genital cutting is at the top,” Touré said, noting that more than 90 percent of Malian women are circumcised.


Making early marriage a political priority is a necessary first step for change, according to maternal mortality research by Professor Jeremy Shiffman, of the Maxwell School of Citizenship and Public Affairs of Syracuse University.

“In Honduras, safe motherhood became one of the country’s foremost health priorities, and between 1990 and 1997, the country experienced a 40 percent decline in its maternal mortality ratio, one of the most significant reductions in such a short time span ever documented in the developing world,” he wrote in a May 2007 article in the American Journal of Public Health.

He found that nine factors shaped the degree to which maternal mortality reduction emerged on the national policy agenda, including efforts by international agencies to establish a global norm concerning its unacceptability; financial and technical resources from international donors; the degree to which national advocates coalesced as a political force; the generation of national attention for the cause; and the existence of competing health causes.

Monday, August 27, 2007

Celebrity Politics, Political Celebrities

by Darrell M. West

Diana, princess of Wales, with a victim of a land mine explosion in Angola, 1997. Tim Graham/Getty Images It is the Age of Celebrity in the United States. Glamorous movie stars run for elective office and win. Former politicians play fictional characters on television shows. Rock stars and actresses raise money for a variety of humanitarian causes. Musicians, athletes, and artists speak out on issues of hunger, stem cell research, international development, and foreign policy. Princess Diana herself was known for her campaigns against landmines and global poverty. Indeed, some observers claim that celebrity humanitarianism began with her actions.

But celebrity activism is nothing new. For years, celebrated writers, artists, and non-politicos have spoken out on issues of the day. For example, Mark Twain’s political satire and quips twitted many a prominent public figure. Ernest Hemingway was involved in a number of foreign and domestic controversies of his era, such as the Spanish Civil War. Charles Lindbergh gained fame as the first pilot to fly solo, nonstop across the Atlantic, and then used his new-found prominence to lead America’s isolationist movement in the 1930s and 1940s.

In the 1960s and 1970s, a number of singers and actors became active in civil affairs. Folksinger Arlo Guthrie did political benefits to back Chilean freedom fighters. Phil OchsMarlon Brando raised money in 1966 for the United Nations International Children’s Education fund for famine relief. organized a tribute to President Salvador Allende, who was assassinated during a military coup. Actor

In 1971, Beatles star George Harrison performed a concert for Bangladesh to raise money for starving refugees. He persuaded Bob Dylan, Ringo Starr, Billy Preston, and others to play at Madison Square Garden and their joint concert raised $240,000 for the United Nations Children’s Fund for Relief to Refugee Children of Bangladesh. Singer Harry Chapin led efforts to alleviate world hunger. From 1973 to 1981, he raised half a million dollars per year to fight hunger.

Throughout the Vietnam war, a number of celebrities spoke out against administration policies. In 1968, actor Robert Vaughn worked in the “Dump LBJ” movement, and celebrities such as Paul Newman, Tony Randall, Myrna Loy, and Leonard Nimoy labored on behalf of presidential candidate Eugene McCarthy. In 1972, actor Warren Beatty organized celebrities for Democratic presidential candidate George McGovern, while John Wayne and Sammy Davis, Jr. supported Republican Richard Nixon.

In the 1980s, a series of “No Nukes” concerts organized by Musicians United for Safe Energy raised awareness about the danger of nuclear energy. Following that effort, Jackson BrowneLinda Ronstadt and James Taylor played benefit concerts in New York City to raise money for a nuclear freeze. helped to build the nuclear freeze movement designed to stop the arms race. In the summer of 1982, he along with

Meanwhile, Stevie Wonder lent his voice to the battle against apartheid in South Africa and in favor of a Martin Luther King, Jr. national holiday within the United States. In the mid-1980s, Irish rocker Bob Geldof conceived of Live Aid concerts to raise money for starving people in Ethiopia. After seeing a BBC film documenting the starvation and famine in Ethiopia, he organized two giant 1985 concerts called “Live Aid” that reached over a billion people and raised over $140 million for the people of Ethiopia.

Seeing the success of this effort, Willie Nelson organized a “Farm Aid” concert for American farmers. Joining with Neil Young, Bob Dylan, and John Cougar Mellencamp, the group raised money and consciousness about the plight of the rural poor. Mellencamp recorded songs about farmers on his Scarecrow and Lonesome Jubilee albums and testified in support of the Family Farm Bill. Singer Bruce Springsteen headlined an Amnesty International Human Rights Now tour along with Sting, Tracy Chapman, and Peter Gabriel. This worldwide effort called attention to the problem of political prisoners in a variety of countries.

Boxer Muhammad Ali & actor Michael J. Fox campaigning against Parkinson's disease; Ron Sachs/Corbis More recently, actor Michael J. Fox has given speeches and worked for candidates who supported stem cell research. Hoping to find a cure for Parkinson’s research, Fox has appeared frequently with boxer Muhammad Ali; he featured prominently in Democratic efforts to regain control of the U.S. Congress. Actress Mia Farrow has campaigned to raise awareness about mass genocides. Actress Angelina Jolie has worked extensively on issues of international development, world hunger, and child adoption.

U2 frontman Bono dances with an African AIDS orphan, 2002; Patrick Olum/Reuters Princess Diana was active in the fight against landmines. U2 Singer Bono created the DATA organization (Debt, AIDS, Trade, Africa) to fight poverty and has toured Africa with administration officials in an effort to encourage debt relief for poor countries. Ocean’s 13 stars George Clooney, Brad Pitt, and Matt Damon used their Cannes Film Festival release to publicize the Darfur genocide.

Arnold Schwarzenegger. 2003;  Jonathan Alcorn—ZUMA/Corbis While celebrity activism is not new, several trends over the past few decades have given celebrities new prominence in debates over public policy. Changes in the structure and operation of the media have contributed to a celebrity culture that provides actors, musicians, and athletes a platform from which to speak out. The line between politics and entertainment has blurred to the point where actors such as Arnold Schwarzenegger have become politicians and former politicians such as Senator Fred Thompson star in prominent television shows.

With the rise of new technologies such as cable television, talk radio, blogs, and the Internet, the news business has become very competitive and more likely to focus on famous personalities. Tabloid shows such as “Access Hollywood” attract millions of viewers, glorify celebrities, and provide a “behind-the-scenes” look at the entertainment industry. Reporters stake out “star” parties, and report on who is in attendance. The old “establishment” press has been replaced by a news media that specializes in reporting on the private lives of politicians and Hollywood stars.

Changes in public opinion have given celebrities stronger credibility to speak out on political matters. From the standpoint of political activists, celebrities are a way to reach voters jaded by political cynicism. In the 1950s, two-thirds of Americans trusted the government in Washington to do what is right. Presidents had high moral authority, and citizens had confidence in the ethics and morality of their leaders.

However, following scandals in Vietnam and Watergate, economic stagflation, and controversies over Iran-Contra and Monica Lewinsky, the public became far less trusting. They no longer are confident about political leaders and are less likely to trust their statements.

When asked whether they trust the government in Washington to do what is right, two-thirds of Americans currently express mistrust. Citizens feel that politicians are in it for themselves and that they serve special interests. An electorate that trusts politicians to tell the truth has been replaced by a public that is highly skeptical about rhetoric and intentions.

Saturday, August 18, 2007

Uganda rejects a gay rights call

A gay activist in Uganda wearing a mask
The gay activists in Kampala wore masks in case of recognition
Uganda will not give equal rights to gays and lesbians nor has it plans to legalise homosexuality, Ethics Minister James Nsaba Buturo has said.

He was responding to a call from the Sexual Minorities Groups in Uganda (Smug) which for the first time held a press conference demanding recognition.

They also accused the police of brutality and harassment.

The gay community is estimated by activists to number 500,000 in Uganda where they face much discrimination.

The BBC's Joshua Mmali in the Ugandan capital, Kampala, said many of those present at the press conference on Thursday wore masks, fearing to show their faces.

We have had enough of the abuse, neglect and violence
Smug leader Victor Juliet Mukasa

Smug leader Victor Juliet Mukasa said she had been a victim of inhuman treatment.

She said police raided her home in 2005, took away documents and arrested her guest, whom they later forced to strip naked.

"We were treated in a degrading and inhumane way. Many of us have suffered similar injustice," she told journalists.

"We are here today to proclaim that these human rights violations are completely unacceptable. We have had enough of the abuse, neglect and violence."

But Mr Buturo told the BBC News website that homosexuality was "unnatural" and denied claims of police brutality and rights abuses.

"If they were being harassed, they would be in jail. We know them, we have details of who they are," he said.


At the press conference, gay activist Dr Paul Ssemugoma called for education on same sex-relationships to reduce the incidence of HIV and other sexually-transmitted diseases among the gay community.

Uganda has won praise for its vigorous campaign against HIV/Aids.

It has helped to reduce the prevalence of the virus - which reached 30% in the 1990s - to single-digit figures.

Activists also hit out at the church, accusing the clergy of demonising them.

A Kenyan gay man, who had travelled to Kampala to show solidarity with his Ugandan counterparts, said homosexuals in East Africa are forced to live double lives.

"These people are subjected into being in forced marriages to cover up, yet they suffer inside," he said.

Wednesday, August 15, 2007

Exhibit showing gay Jesus inspires fracas

A melee broke out in Sweden outside a photography exhibit depicting Jesus as a homosexual.

Artist Elisabeth Ohlson Wallin created the Ecce Homo exhibit 10 years ago, and it has been controversial ever since.

On Sunday, a group of young people tried to set fire to a poster at the Jonkoping Kulturhuset, The Local reported. Staff members tried to stop them, leading to a fight involving about 30 people, said Tony el Zouki, the director of the Kulturhuset.

Jonkoping is a major center of the Swedish Evangelical movement.

If this is some Christian group, then I really do not understand them. The message of Christianity is that people should understand and love each other, el Zouki said. I really can't see how this can have a Biblical explanation.

Sunday, August 12, 2007

RockOut artists in their undies

Sex and rock and roll go together like black leather and fresh whipped cream (so we've heard). So in honor of National Underwear Day, we contacted some of the sexy and talented emerging musicians we've featured on our RockOut channel and asked them to join in the skin-baring fun by sending us pics of themselves in their undies.

We told them not to hire professional photographers, but to take the shots themselves and just go wild. We also left it totally up to them to imagine creative settings for their photo shoots and take their own pictures. In other words: Express yourselves in your undies.

And express themselves they did!

Jim Verraros shot himself in boxers in bed, listening to music. The smile says it all. Punk-rock band the Dead Betties barbecued on the beach in their tightie-whities, then they took it to the laundromat for more clean fun. Hip-hop sensation in the making (and Tyra Banks best-friends-forever) Josh Klipp just knocked it out plain and simple in white briefs and tank, while indie rocker Dudley Saunders showed how at home he feels in boxers and a backpack.

Homosexual Teens coming out earlier to more accepting Environment

Josh Delsman, an 18 year old from Fort Lauderdale, Fla., reluctantly revealed he was a homosexual at age 14 after a friend told middle school officials, who later informed his parents.

"I didn't want to come out," Delsman said. "But I realized I was gay a lot younger than that. I knew when I was 8 or 9, but I just didn't know what to call it."

Delsman, along with two straight classmates, went on to found a Gay Straight Alliance at his high school. GSAs are clubs in schools that promote tolerance and acceptance of all students.

"We were tired of hearing 'that's so gay' and other LGBT (Lesbian, Gay, Bisexual, Transgender) slurs," Delsman said.

Ritch Savin-Williams, who chairs Cornell University's human development department and wrote the book "The New Gay Teenager," said kids are "coming out" sooner these days.

According to Savin-Williams' book, as reported in the Albuquerque Journal, the average age people used to come out was in their mid-20s, but that has dropped to the mid-teens over the last two decades.

And anecdotally, the median age for high school students to come out is between 15 and 17, according to Kevin Jennings, founder of the Gay, Lesbian and Straight Education Network.

Media's role

Jennings, a 44-year-old former high school teacher who took the organization from a local school-based group to a national one during the 1994-95 school-year, said he believes coming out earlier is directly related to the greater accessibility of information from the Internet, TV and people's peers.

"In my generation, it was very rare to come out in high school. I didn't really know or understand the language for it. They [teens today] have a language to explain what they're feeling that wasn't available to teens in the past," Jennings said.

Part of the reason that young people are coming out sooner may be that as a whole, Generation Nexters -- those aged 16-25 -- are more accepting of homosexuality in general.

Nearly six in 10 people in that age bracket say "homosexuality is a way of life that should be accepted by society," according to a survey released by the Pew Research Center in January. In comparison, the same survey found that only 50 percent of those aged 25 and older felt the same way.

Greater exposure to media images of gay people also has increased homosexuality's awareness and acceptance.

Like Jennings, Jennifer Santiago, a 20 year old who identifies herself as straight, thinks her generation has more exposure to images of LGBT people in the media than ever before, and that for her generation meeting a gay person is not uncommon.

But Santiago thinks many of the images in the media are not positive. One example is MTV's reality program "The Real World."

"On 'The Real World' they always make the one gay person and make it insane. They find the craziest person who is gay and put that person on the show. It's stereotypical. My friends aren't like that," she said.

Some say, however, that the increase in LGBT images across media are encouraging teens to take up a lifestyle they might not have chosen otherwise. Additionally, some socially conservative groups say the teenage years are too chaotic to make decisions about "sexual identity."

"All kids around puberty are confused about who they are," Barbara Swallow of Free Indeed Ministries, a Christian organization that counsels people away from homosexuality, told the Albuquerque Journal.

"Then they're told it's acceptable to be whatever you want to be -- homosexual, bisexual, transgender," she added. "That's not the way God created it."

In an interview with USA Today, Peter Sprigg of the Family Research Council said that "Homosexuality is harmful to society, and young people have no business committing to a sexual identity until they're adults."

On the other hand, experts such as Dr. Jack Drescher of the American Psychiatric Association, who has studied programs that attempt to alter sexuality, say that pretending to be heterosexual when you're not is bad for teens.

"They are not learning social skills, but developing hiding skills," he told the Albuquerque Journal. "In the process, they lose the ability to know who they are."

Emergence of clubs that promote tolerance

Currently more than 3,000 GSAs across the country are registered with the Gay, Lesbian and Straight Education Network, a group that works to create safe school environments for all students, regardless of sexual orientation or identification.

Many of the clubs have been founded by students who identify themselves as straight, or "straight allies"; they see the direct impact that bullying and discrimination has on their peers.

"Kids with privilege are saying 'this isn't OK by me anymore.' They witness this everyday. They want to make a difference and this is something that they can do. Washington seems very far away. But they can make a difference in their schools," Jennings said.

Delsman, who says coming out is a life-long process, said he's directly seen the positive effect these clubs can have on school environments and students. There's less bullying and fewer discriminatory comments.

"My friend [who] just came out two weeks ago, he moved down from Albany. He had never met another gay person before," Delsman said. "He came down here and the environment was so much better. It was so amazing because I know that 10 years ago he wouldn't have been able to do that at all."

Erik Stegman, a 24-year-old UCLA law student and current co-chairman of GLSEN's National Leadership Council, said the student-run movement helps build confident leaders.

"I became more confident than ever before. This is who I am. On a personal level, I absolutely think it was a positive experience. I gained a lot. We all have to mature real fast coming out," he said.

He said he would like to "turn the whole country's attitude toward what it means to be GLBT, especially as you're young, change the perception that it's a disadvantage, that it's something to feel sad about, guilty about."

-- By Annie Schleicher

Friday, August 3, 2007

As Time (no) goes by / ¡Cómo no pasa el tiempo!;

Hitler is like a Pils: goes always. And still once.
El Hitler parece a un Pils: va siempre. Y todavía una vez.

Friday, July 27, 2007

Razzia against refugees in Oujda (Morocco)

Using the opportunity of the summer vacation when the Oujda university students are not present, Moroccan security forces carried out a raid on the campus, which has served as a space to live for the migrants for quite some time, in the early morning of 26 July 2007. This searching and raid action was very vigorous and the biggest of its kind since the well-known incidents of Ceuta and Melilla. More than 450 persons have been arrested.

Big razzia against refugees in Oujda (Morocco)

Using the opportunity of the summer vacation when the Oujda university students are not present, Moroccan security forces carried out a raid on the campus, which has served as a space to live for the migrants for quite some time, in the early morning of 26 July 2007. This searching and raid action was very vigorous and the biggest of its kind since the well-known incidents of Ceuta and Melilla. More than 450 persons have been arrested.
According to the information from some migrants who could escape and Morrocans living near the campus, police, military and supporting forces surrounded the migrants around 4 o'clock in the morning, arresting, maltreating and beating them down in a brutal and violent manner with straps and batons made of hard rubber. Then they took them and made them enter their police vehicles.
The migrants fleed from the campus towards the neighbouring forest, chased by police forces and their dogs. The security forces passed over the refugees' camp with a bulldozer. They destroyed and burned down everything that was there. Everyone is now talking about several persons injured, but up to now their exact number is not clear yet.

The police continue to do patrols on the campus and in the neighbouring quarters, looking for migrants.

At the moment this report is sent, information is coming in that a first group of migrants were made to enter two police cars at the police station. There is no doubt that they are going to be taken to the Algerian border.