Silverback

This is the Silverback of Group 13--we were within about 20 feet of him at this point--when we first stumbled upon him

Mother with Baby

This baby is about 3 weeks old...

Baby Gorilla

Here is a picture of a baby gorilla we saw who was tumbling about and beating his chest..

Trove of Endangered Gorillas Found in Africa

Wow this is great news!!!!

A grueling survey of vast tracts of forest and swamp in the northern Congo Republic has revealed the presence of more than 125,000 western lowland gorillas, a rare example of abundance in a world of rapidly vanishing primate populations..

Trekking with gorillas

Yesterday, we trekked with the silverbacks. It was literally one of the most awesome, surreal experiences of my life. To be in close proximity with such magnificent and powerful creatures was spell binding. The baby gorillas were very entertaining as well. Whether pounding their chests, climbing vines, or spinning in circles they were surprisingly playful. Unfortunately I don't think the internet is fast enough to let me post pics or videos here. We were within 6 to 10 feet of the gorillas. we were with Dianne Fossey nomenclatured group 13, which consisted of one silverback, 10 females, 8 children, and 6 juveniles. The only heart pounding moment is when the silverback started walking right up to us . We backed up very quickly as this 500 to 600 pound male ambled toward us. We didn't know if he was going to get very aggressive with us or what..We could even see the fear in our guide's eyes. Fortunately he stopped about 6 feet in front of us and pulled this long bamboo shoot down and started eating. Whew....
We escapted the fate of my friend Hunter (Medical Director of Orbis) who had his back slapped by a silverback on a prior trip.
I am still awestruck thinking about our experience.

Doctors and Patients: A Rocky Relationship

After a series of recent blog posts about doctors and patients, I’ve been surprised at the level of animosity many patients seem to have for their doctors.
The simmering distrust of the medical system — and the doctors who work in it — are the topic of my Well column this week, as well as a new Well video, “Do You Trust Doctors?” (see below). For their part, doctors aren’t at all surprised patients are angry.

Rwanda Genocide Museum

Funded by the Aegis foundation of the UK, the museum highlights the history of Rwanda leading to the genocide along the outer walls. Spiraling inwards one finds sculptures depicting the tragedy and pain; a room filled with 3x5 home shot photos of the victims--hanging along the walls ; a room filled with skulls with machete made inuries and arm and leg bones hacked off. There are other rooms with movie snippets of interviews of survivors that are absolutely heart wrenching....
As one beautiful young woman whose family was killed says,"I am destroyed. I cannot forgive. I am human. It is up to God to forgive..."

Rwanda Genocide Museum

A small plaque under a poster size picture of a beautiful young Rwandan child:

Favorite person: his big sister
Favorite song: Rwandan National Anthem
Favorite food: candy
Personality: always laughing
Cause of Death: Smashed against wall

Other causes of death recorded under other photos of children: clubbed to death, hacked with machete, stabbed in eyes and skull

Does Fructose Make You Fatter?

High-fructose corn syrup is a sweetener used in many processed foods ranging from sodas to baked goods. While the ingredient is cheaper and sweeter than regular sugar, new research suggests that it can also make you fatter.

The Impossible Art Of Li Wei

Chinese artist Li Wei from Beijing started off his performance series ‘Mirroring’ and later on took off attention with his ‘Falls’ series which shows the artist with his head and chest embedded into the ground. His work is a mixture of performance art and photography that creates illusions of a sometimes dangerous reality. Li Wei states that these images are not computer montages and works with the help of props such as mirror, metal wires, scaffolding and acrobatics.

Check out 14 more pics of Li Wei’s artwork over the various years after the jump.

Islands of Consciousness

A very cool (and trippy ?meditiative) flickr tool (via Photojojo). In a mysterious way, insights are gained into processing, synthesis, and integration of sensory perceptions."Step outside yourself" and consciously "watch" as your retinas scan the images, your acoustic cilia process the sounds, and your brain somehow fashions a silent narrative...

When Oleg Marakov pointed out the similarities between his piece of randomly arranged music Islands and my random movie creator Flickeur it was immediately clear that a combination of both projects would definitely result in something very interesting.

The result of this fusion - Islands of Consciousness - is not a simple combination of the two concepts but a great advancement. Sound and Images enter a very close relationship in which the randomly arranged musical phrases are taking direct influence on the visual outcome. So when you look at this piece keep in mind that all the visuals are assembled in realtime using photos downloaded from Flickr.com. All the transitions and effects are entirely random and only happening on you screen. Other people will see a movie and hear a soundtrack that is totally different from yours.

Whilst the basic idea of Flickeur - an endless virtual videoloop that is in perpetual metamorphosis - has remained I have altered the visual engine and the image selection algoritm in many aspects.

My Son, the Blogger: An M.D. Trades Medicine for Apple Rumors

For eight years, Arnold Kim has been trading gossip, rumor and facts about Apple, the notoriously secretive computer company, on his Web site, MacRumors.com.

It had been a hobby — albeit a time-consuming one — while Dr. Kim earned his medical degree. He kept at it as he completed his medical training and began diagnosing patients’ kidney problems. Dr. Kim’s Web site now attracts more than 4.4 million people and 40 million page views a month, according to Quantcast, making it one of the most popular technology Web sites.

It is enough to make Dr. Kim hang up his stethoscope. This month he stopped practicing medicine and started blogging full time.

Silverback Gorillas

Blogging may be sparse after next week as I will be in Rwanda and Uganda for a month.
I will be working with the fabulous Orbis Flying Eye Hospital.
Another highlight will include celebrating the birthday of my friend Amelia, with a group of friends, that will include a trek to see the famed Silverback gorillas, as shown in the video below...

How Doctors Get Paid

Kudos to The Happy Hospitalist.This blog post is one of the best posts I have ever read (on any subject). Make sure you read the whole thing.

The back bone of our nation's health care system is in shambles. Primary care, or better named, comprehensive care, is being hunted to extinction by the very system that needs it most. The Medicare National Bank and all its failed policies has destroyed the great value that comprehensive care brings to the table. The world is full of bumbling uneducated morons who make comments like, "screw the rich doctors", or "they're only in it for the money". I am here to present to you the economics of the current situation, so you can understand that the backbone is being destroyed.
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Several statistics are worth noting.

* In a practice expected to be fully supported by Medicare, which for all the single payer, government run fanatics out there is the equivalent scenario, you see that under the current government mandated payment system a comprehensive care physician making $150,000 a year in 1997 would be making $154, 279 a year, with out increasing the volume of services being performed. In other words, without increasing volume, a physician would be making no more now than they did 10 years ago. When you factor in the cost of living increases by the consumer price index (CPI), that physician would have to make $196,382 a year in 2007, just to maintain their lifestyle of 1997. It is no wonder why volume rules in a system that uses top line cost control measures. For comprehensive care physicians, that means double and triple booking clinics and hiring less qualified extenders. For specialists that means hiring extenders for all their low paying cognitive encounters and spending more time in the procedure lab making the much higher relative profit. And adding exponential cost to Medicare without an increase in quality.
* If the 2008 July 1st cuts are allowed to stand, a comprehensive care physician would earn 23% less now than they did in 1997, on an absolute basis. Adjusted for inflation, that is a 59% paycut from 1997.
* The current SGR mandated by Congress is set to make comprehensive care physician income on par with the average take home pay for all Americans in 4 short years. That means a college educated nurse will be making more than the average comprehensive care physician. The unionized laboror with a high school education will be making more than your comprehensive care physician.
* Based on current SGR economics mandated by your Congress, in five short years, your comprehensive care physician will be collecting welfare, earning the approximate equivalent of minimum wage.

This is not an alarm, this is a category 5 hurricane that has already swept through our health care system. Medical students with their $200,000 in debt are speaking with their wallets. According to the uneducated masses with the mentality that doctors make too much money, I should be collecting food stamps. In five short years, your government mandated health care system is set up to do just that.

An Open Letter to Medical Students: Please don't become primary care physicians!!

All the talk about the health care crisis is about the costs. All the solutions proposed to the health care crisis are aimed at making it more affordable.

No one ever talks about access to health care. And with good reason -- because everyone knows, in their heart of hearts, that access to health care means access to physicians, and the only way to even attempt to guarantee access to physicians is to enslave them.

Many doctors are leaving the profession, because the bureaucracy is crushing them, preventing them from spending time practicing, and because they aren't getting paid enough for what they do. It is a senseless and useless argument to claim that doctors are being greedy and should accept whatever low payment we healthcare-needing consumers are willing to pay. It doesn't matter. There is nothing that can be done to stop a doctor from leaving the profession. You wouldn't even want to force a doctor to stay in the profession -- ask yourself if you would be willing to operated on a surgeon who didn't want to do the operation and was only there because he was threatened. Could you possibly trust the advice of a practitioner who hated what he did? Does anyone truly believe a mind can be forced, that good judgment can be elicited at

Countries Make Push to Increase Eye Donors

The non-acceptance of corneal transplantation in the third world continues to be a problem. It is encouraging to see that efforts to increase acceptance are being made in Syria. I should also acknowledge that Dr. David Paton, who started Orbis' Flying Eye Hospital, also started the first eye bank in the Middle East. (The article also quotes my friend, Dr. Hunter Cherwek, the current medical director of Orbis).
Orbis continues to promote corneal transplantation in every country it goes to. In fact, the article reminds me of an interview I and an Orbis colleague of mine, Dr. Ahmed Gomaa, did in conjunction with a local ophthalmologist in Enugu, Nigeria last summer. The interview was nationally televised and accepted calls from listeners. One caller asked, with great concern evident in his voice, whether or not a corneal donor would still be able to see in the after-life. The local ophthalmologist gave a colorful answer replete with Biblical references that convinced the caller that he would have vision in Heaven even if he donated his corneas. The entire exchange was quite charming, yet not one that would typically occur in most nationally televised debates in America.


Eye donation recently got a new public face in Syria, where the Grand Mufti, the highest official of religious law, pledged to donate his corneas upon death to help one of the thousands of people waiting for transplants there. In India, it is Bollywood film stars like Aishwarya Rai Bachchan, the former Miss World, who have pledged their eye tissue for transplant.
(..)
Doctors in Syria perform hundreds of transplants a year, said Dr. Said, director of the National Program for Blindness Control. But the supply of tissue from the United States has been dropping, and the corneas the country does get go only to wealthy people who will pay $1,000 or more per eye. A new eye bank in Syria is part of a regional effort to drum up corneal tissue in the Middle East and parts of northern Africa.
(..)
“As corneal transplants become more and more successful, there are more and more candidates for the procedure,” said Dr. Hunter Cherwek, medical director of the Flying Eye Hospital, a DC-10 airplane run by the nonprofit group Orbis that flies to various countries to train eye surgeons. “It truly becomes a supply and demand issue, where the techniques are expanding the demand.”

Orbis is working with a government agency to increase eye donations in Vietnam, where Dr. Cherwek estimates that “thousands, likely tens of thousands could benefit from corneal transplantation.”
(..)
The shortage of eye tissue in many places means that transplants are available only to the wealthy. Building domestic eye banks, experts say, could reduce the price of corneas and allow more people to get transplants. But the experts also say that such growth, however beneficial, is unlikely to improve a more basic problem: lack of access to eye care for the poor.

Saving Mothers, One at a Time

A good description of a typical health care scenario in Africa...

Sue Makin , the newest contributor to this blog, is an American Presbyterian missionary doctor working at a 190-bed mission hospital in southern Malawi. She has been working in Africa for the past 18 years. According to a 2007 study of global maternal mortality rates, more than two-thirds of deaths among Malawian women of reproductive age are linked to pregnancy or childbirth – a larger proportion than in any of the 171 countries in the study.

In spite of – or maybe, because of – the grim statistics on maternal health here in Malawi, a wonderful part of my job is training younger clinicians who will carry on the work after I have left. The lifesaving skills demonstrated by Sam Matandala, a clinical officer in training at our hospital, were a great encouragement to me last month
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...After she lost consciousness and the midwife grew frightened, the pregnant woman’s relatives loaded her onto a bush-bicycle ambulance and walked with her for about two hours to get to the hospital. She continued to bleed on the journey to the hospital.

As Sam rightly points out, women in Malawi, regardless of age, are not empowered to make decisions about their own health. When they are sick or giving birth, they must wait for their husband or other male relatives to decide when they should be taken to the hospital. This leads to delays – particularly when the decision-making man has gone far away from the village – and many women who come to the hospital at all come late, when complications have already set in.

China, Muslims and the Genocide

As my favorite NY Times columnist, Nicholas Kristof, points out that China not only supports the Bashir regimein Sudan, but also, along with Russia, amazingly vetoed a UN Security Council resolution for an arms embargo on Zimbabwe!!!

The BBC has uncovered evidence of Chinese military support for Sudanese forces in Darfur. Given the arrest warrant sought today by the ICC’s chief prosecutor for Sudan’s president on charges of genocide, that is reckless behavior on the part of China. It always astonishes me that China is so sensitive to its image being hurt by anti-government demonstrations, yet will sully its own image by helping out with genocide in Sudan.

It Takes a School, Not Missiles

Since 9/11, Westerners have tried two approaches to fight terrorism in Pakistan, President Bush’s and Greg Mortenson’s.

Mr. Bush has focused on military force and provided more than $10 billion — an extraordinary sum in the foreign-aid world — to the highly unpopular government of President Pervez Musharraf. This approach has failed: the backlash has radicalized Pakistan’s tribal areas so that they now nurture terrorists in ways that they never did before 9/11.

Mr. Mortenson, a frumpy, genial man from Montana, takes a diametrically opposite approach, and he has spent less than one-ten-thousandth as much as the Bush administration. He builds schools in isolated parts of Pakistan and Afghanistan, working closely with Muslim clerics and even praying with them at times.

The only thing that Mr. Mortenson blows up are boulders that fall onto remote roads and block access to his schools.

Mr. Mortenson has become a legend in the region, his picture sometimes dangling like a talisman from rearview mirrors, and his work has struck a chord in America as well. His superb book about his schools, “Three Cups of Tea,” came out in 2006 and initially wasn’t reviewed by most major newspapers. Yet propelled by word of mouth, the book became a publishing sensation: it has spent the last 74 weeks on the paperback best-seller list, regularly in the No. 1 spot.

Warning: Habits May Be Good for You

This article is definitely worth reading in its entirety...

A FEW years ago, a self-described “militant liberal” named Val Curtis decided that it was time to save millions of children from death and disease. So Dr. Curtis, an anthropologist then living in the African nation of Burkina Faso, contacted some of the largest multinational corporations and asked them, in effect, to teach her how to manipulate consumer habits worldwide.

Dr. Curtis, now the director of the Hygiene Center at the London School of Hygiene & Tropical Medicine, had spent years trying to persuade people in the developing world to wash their hands habitually with soap. Diseases and disorders caused by dirty hands — like diarrhea — kill a child somewhere in the world about every 15 seconds, and about half those deaths could be prevented with the regular use of soap, studies indicate.

But getting people into a soap habit, it turns out, is surprisingly hard.

To overcome this hurdle, Dr. Curtis called on three top consumer goods companies to find out how to sell hand-washing the same way they sell Speed Stick deodorant and Pringles potato chips.
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A few decades ago, many people didn’t drink water outside of a meal. Then beverage companies started bottling the production of far-off springs, and now office workers unthinkingly sip bottled water all day long. Chewing gum, once bought primarily by adolescent boys, is now featured in commercials as a breath freshener and teeth cleanser for use after a meal. Skin moisturizers — which are effective even if applied at high noon — are advertised as part of morning beauty rituals, slipped in between hair brushing and putting on makeup.

“OUR products succeed when they become part of daily or weekly patterns,” said Carol Berning, a consumer psychologist who recently retired from Procter & Gamble, the company that sold $76 billion of Tide, Crest and other products last year. “Creating positive habits is a huge part of improving our consumers’ lives, and it’s essential to making new products commercially viable.”

(..)
Those and other studies revealed that as much as 45 percent of what we do every day is habitual — that is, performed almost without thinking in the same location or at the same time each day, usually because of subtle cues.
For example, the urge to check e-mail or to grab a cookie is likely a habit with a specific prompt. Researchers found that most cues fall into four broad categories: a specific location or time of day, a certain series of actions, particular moods, or the company of specific people. The e-mail urge, for instance, probably occurs after you’ve finished reading a document or completed a certain kind of task. The cookie grab probably occurs when you’re walking out of the cafeteria, or feeling sluggish or blue.
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“We could talk about germs until we were blue in the face, and it didn’t change behaviors,” Dr. Curtis said. So she and her colleagues asked Unilever for advice in designing survey techniques that ultimately studied hundreds of mothers and their children.

They discovered that previous health campaigns had failed because mothers often didn’t see symptoms like diarrhea as abnormal, but instead viewed them as a normal aspect of childhood.

However, the studies also revealed an interesting paradox: Ghanaians used soap when they felt that their hands were dirty — after cooking with grease, for example, or after traveling into the city. This hand-washing habit, studies showed, was prompted by feelings of disgust. And surveys also showed that parents felt deep concerns about exposing their children to anything disgusting.

SO the trick, Dr. Curtis and her colleagues realized, was to create a habit wherein people felt a sense of disgust that was cued by the toilet. That queasiness, in turn, could become a cue for soap.
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Their solution was ads showing mothers and children walking out of bathrooms with a glowing purple pigment on their hands that contaminated everything they touched.

The commercials, which began running in 2003, didn’t really sell soap use. Rather, they sold disgust. Soap was almost an afterthought — in one 55-second television commercial, actual soapy hand washing was shown only for 4 seconds. But the message was clear: The toilet cues worries of contamination, and that disgust, in turn, cues soap.

For Students in Kenya, Medicine Seems to Improve Attention Span

Giving schoolchildren in rural Kenya regular doses of malaria medicine, even if they weren’t obviously sick, seemed to improve their attention span in school as it protected them from anemia, a study has found.

The study, published last week in The Lancet, was conducted by researchers from the London School of Hygiene and Tropical Medicine, Harvard and four Kenyan institutions.
(..)
All the students were poor — 97 percent studied by kerosene lamps or candles at home. Nearly half had malaria parasites but no fever when the study began. In malarial areas, it is common for anyone surviving to age 5 to develop some immunity.

The drugs — sulfadoxine-pyrimethamine and amodiaquine — do not contain artemisinin, the newest malaria drug, but are inexpensive and considered safe.

All the students were also treated for intestinal worms, which can cause anemia — a low red-blood-cell count.

New Saudi Arabian University will have a Western Feel

:Another excellent blog on all things Saudi: xrdarabia.com...brings attention to an interesting article in the LA Times..

The Los Angeles Times runs a story on King Abdullah University of Science & Technology (KAUST and the potential it holds. The piece also notes the obstacles it faces and raises the question of how it will interface with the traditional Saudi society around it. Doubts are raised that a new ‘Western enclave’ will achieve very much, but there’s strong opposition to some of the school’s goals, such as co-ed education. Worth a look.

New Saudi Arabia university will have a Western feel
Jeffrey Fleishman

THUWAL, SAUDI ARABIA — Up the corniche, along a coast where boats carrying pilgrims bound for Mecca sailed for centuries, a thicket of cranes rises over whitewashed mosques along the Red Sea.

Steel flashes and blowtorches glow as 20,000 workers build a $10-billion university ordered up by a king who hopes Western ingenuity will revive the economy of this ultraconservative Muslim nation. When finished next year, King Abdullah University of Science and Technology will offer coed classes, Western professors, a curriculum in English and other touches loathed as dangerous liberalism by Islamic fundamentalists.

Why We Are Happy

Tongue in cheek post from the always interesting Saudi Jeans...

When John Burgess published a recent post on Crossroads Arabia titled “Happy Saudis!” I was like “Huh!” The post links to a chart from a study conducted by the World Values Survey based at the University of Michigan Institute for Social Research which states that Saudi Arabia is the 26th happiest country in the world. “It’s widely believed that it’s almost impossible to raise an entire country’s happiness level,” says Ronald Inglehart, political scientist at U-M and the director of the World Values Surveys.

The “surprising finding” has prompted me to think what possibly could be the reasons behind the overwhelmingly positive attitude of my countrymen…

Your life will be flashed before your eyes

Prototype contact lenses that include LEDs and circuits could become a tiny personal display..

Dance Even if Nobody Is Watching

Count me in as one of Matt's fans--watch as he celebrates all over this great globe...

I am late to the Matt Harding fan club, but like four million other viewers before me, I can’t stop watching this man dance.

Mr. Harding is a 31-year-old YouTube sensation featured in The Times this week for an uplifting video that shows him dancing a sort of a jig, described by my colleague Charles McGrath as “an arm-swinging, knee-pumping step that could charitably be called goofy.” Mr. Harding dances alone, and he dances with lemurs, underwater and with children and crowds at various locations around the world.

Where the Hell is Matt? (2008) from Matthew Harding on Vimeo.

Sudan Leader To Be Charged With Genocide

UNITED NATIONS, July 10 -- The chief prosecutor of the Internationals Criminal Court will seek an arrest warrant Monday for Sudanese President Omar Hassan al-Bashir, charging him with genocide and crimes against humanity in the orchestration of a campaign of violence that led to the deaths of hundreds of thousands of civilians in the nation's Darfur region during the past five years, according to U.N. officials and diplomats.

Not a Moment Too Soon, I Thought of Tim Russert

I am someone who hates to quit. But after the third time the group had to stop and wait for me, I decided I had no choice. I watched them pedal away, then lay down in the grass.

I was angry and scared. For the first time my body had given out on me, and I had no clue what was going on. Besides the nausea, my only symptoms were a persistent cough and an overwhelming feeling that something was not right.

I called my wife and got a ride home.

After showering, I lay down in bed and started thinking. Though I am a 50-year-old guy with a stressful job and a little too much around the middle, I had a clean bill of health. I had good cholesterol numbers and a great doctor, and recently I had passed a cardiac stress test.

That’s when Tim Russert popped into my head. In the last couple of weeks, like almost every middle-age man, I had taken a very personal interest in every detail of his story. Yes, he was overweight. But hadn’t he just passed a stress test?

That’s when the light went on...
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Because at the right moment I thought of Tim Russert, I am one of the lucky ones. I get to hug my wife and my kids, understand how wonderful my friends are and realize exactly how much I love my life. It is a debt I can never repay

Pricey Drugs Put Squeeze on Doctors

SAN FRANCISCO -- Long a burden for patients, hyperexpensive cancer drugs are causing economic havoc for another constituency in U.S. health care: doctors.

American doctors rarely used to let costs factor into their treatment decisions. But rising prices -- some cancer drugs now cost more than $100,000 a year -- are dramatically changing that ethos in the field of oncology. Money issues are now disrupting relationships with patients, causing doctors to go into debt and threatening to interfere with treatment options.
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Driving the problem is a new generation of drugs -- including Avastin from Genentech Inc. and Erbitux from ImClone Systems Inc. -- that are transforming cancer care, providing oncologists with the first new options in decades for desperately ill patients. But several months of treatment on these drugs can equal the down payment on a home or a child's college tuition.
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The average wholesale cost for a course of Avastin to treat one type of lung cancer, for example, is $56,000, according to Genentech. It can take 90 days to be reimbursed by Medicare or private insurance plans and even longer for patients to hand over their co-pays. Assuming insurance does cover a course of Avastin, a 20% co-pay comes to $11,200.

Oncologists say this is forcing them into new and nerve-racking territory: weighing costs alongside a drug's potential effectiveness.
(..)
John P. Whitecar Jr., an oncologist in Columbus, Miss., says 89% of his cancer patients are on government insurance. He has watched his income plunge 75% in the past three years because of rising treatment costs and declining reimbursements. He says he's borrowed money to keep his office afloat, and trimmed staff through attrition. Recently, he began sending patients whose health plans reimburse him less than his costs across the street to the local hospital for their chemotherapy infusions.

For the Brain, Cash Is Good, Status Is Better

New research shows for the first time that we process cash and social values in the same part of our brain (the striatum)—and likely weigh them against one another when making decisions. So what's more important—money or social standing? It might be the latter, according to two new studies published in the journal Neuron.

Doctors Press Senate to Undo Medicare Cuts

Facing cuts in Medicare payments, Dr. David D. Richardson, an ophthalmologist in Los Angeles County, closed his practice last week to all but emergency patients and those needing surgery.


WASHINGTON — Congress returns to work this week with Medicare high on the agenda and Senate Republicans under pressure after a barrage of radio and television advertisements blamed them for a 10.6 percent cut in payments to doctors who care for millions of older Americans.
(..)Democrats need just one more vote to pass the bill, and they hope to win over Republicans who were hit by advertisements over the recess. The advertisements assert that Republicans have been protecting “powerful insurance companies at the expense of Medicare patients’ access to doctors.” The commercials were aimed at 10 Republican senators, including seven up for election this fall.

But President Bush has vowed to veto the bill, so the fight — and the uncertainty — could continue for weeks.

Mr. Bush and many Republicans oppose the bill because it would finance an increase in doctors’ fees by reducing federal payments to insurance companies that offer private Medicare Advantage plans as an alternative to the traditional government-run Medicare program.
(..Dr. David D. Richardson, 40, an ophthalmologist in Los Angeles County, closed his practice last week to all but emergency patients and those needing surgery.

“I love practicing medicine,” Dr. Richardson said, “but I would lose more money by keeping my office open than by pulling it back to a skeleton crew. Just like a physician in the emergency room, I try to reduce the hemorrhaging.”

In Topeka, Kan., Dr. Kent E. Palmberg, senior vice president and chief medical officer of the Stormont-Vail HealthCare system, said its 70 primary care doctors were “no longer accepting new Medicare patients as of July 1 because of the draconian cut in Medicare reimbursement.”

Dr. Gerald E. Harmon, a family doctor in Pawleys Island, S.C., said he decided last week that he would not take new Medicare patients “until further notice.”

“This is not what we enjoy doing,” says a notice in his waiting room. “It is what we must do to maintain financial viability.”
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In an interview, Dr. Barrett said: “I lose money whenever I operate on a Medicare patient. In the last week, a number of doctors have told me they will quit seeing new Medicare patients or will cut back on the amount of Medicare work they do.
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But independent studies have repeatedly found that the private plans cost the government more per person than traditional Medicare.
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On the other side of the issue, military families have joined doctors and AARP, the advocacy group for older Americans, in lobbying for the bill.

Happy Liberation Day, Rwanda

Rwanda is perhaps the only country besides the United States where July 4th is a national holiday. And while it is true that Rwandans have great admiration for the U.S., the Fourth of July is only coincidentally a shared day of celebration.

In 1994, that date marked the end of the Rwandan Genocide, and the birth of the new government that rose from the ashes. This Friday, the nation will be celebrating its 14th year of peace and the growing prosperity that has been the result. This is a virtually unbelievable, unpredictable achievement in light of the forces that aligned to prevent it.

What does peace and development look like in Rwanda? Housing projects are springing up; per capita income is up; and health indicators are dramatically improved, with more than 50,000 people receiving the AIDS drugs they need via some of the best delivery mechanisms in all of Africa. Two international-quality malls have sprouted up in Kigali and are doing a brisk business; international banks are eyeing the market; internet service is still the cheapest per megabyte (and fastest) in all of Africa.

The Luckiest Girl

This year’s college graduates owe their success to many factors, from hectoring parents to cherished remedies for hangovers. But one of the most remarkable of the new graduates, Beatrice Biira, credits something utterly improbable: a goat.
“I am one of the luckiest girls in the world,” Beatrice declared at her graduation party after earning her bachelor’s degree from Connecticut College. Indeed, and it’s appropriate that the goat that changed her life was named Luck.

Beatrice’s story helps address two of the most commonly asked questions about foreign assistance: “Does aid work?” and “What can I do?”

GOP fears fallout from Medicare fight

More on the Medicare reimbursement fight...

(Hat tip to Freeze)

The Bush administration moved Monday to assure doctors that coming cuts in Medicare reimbursements would take a few days to kick in, buying time for Senate Republicans to recover from a vote that has Sen. Arlen Specter scrambling to explain himself and GOP aides wondering why their party’s leadership has risked infuriating a loyal constituency.

The Score: Physicians 355; Insurers 59: Blood on the Senate Floor

Good explanation of recent medicare physician fee cut issue in Congress...

In this case, Senate liberals should have not compromised in the first place. They should have stuck to their guns, and insisted on cutting the corporate welfare that Medicare Advantage insurers are receiving. Medicare cannot afford it. And, as the House vote shows, many independents and conservatives understand that the windfall is unwarranted. Medicare is not getting good value for its dollars.

More insights here

Bono

Tim Adams speaks to Bono about the origins of the Make Poverty History campaign and persuading a reluctant Bush administration to provide over $50 billion in aid to Africa

Combat One Plague, Risk Another?

Scientists have genetically engineered a malaria-resistant breed of mosquito that can out-compete non-modified mosquitoes in nature, the BBC reports.Releasing the mosquitoes into the wild could be a winning and cost-effective strategy to combat a disease that kills 1 million people worldwide each year and has dire financial consequences for countries where it is endemic.

But the risks of unleashing the GM mosquitoes are completely unknown, and researchers say it may be 10 years (and 10 million lives lost) before the insects are set loose in nature. The Overcoming Bias blog wonders if it’s worth the wait.

The question is a classic example of the Ellsberg Paradox, which claims that we prefer measurable risk to immeasurable uncertainty. Dubner and Levitt wrote about it in relation to nuclear energy.

Excursions in Medical History: Cataract Surgery

Not so back in the day, oh, maybe 2500 years ago. As the American Academy of Ophthalmology recounts, the earliest form of cataract surgery was couching, a procedure described in 5th century B.C. Sanskrit manuscripts.

This involved displacing the lens away from the pupil and into the vitreous cavity. Centuries later discission, or needling to break up the cataract into pieces, was practiced. In the mid-1700's Jacques Daviel of France and Samuel Sharp of London began surgically removing the lenses from their patients with "the services of a strong assistant...to hold the patient's head still." Local anesthetic drops would not ease the pain and terror of the procedure until 1884.

Officials Praise New Test for Drug-Resistant TB

Considering that 1/3 of all humanity has been exposed to TB and that MDR-TB (multiple drug resistance TB) is an increasing problem, this is indeed good news...

A new test that can detect multiple-drug-resistant tuberculosis in two days instead of the standard two to three months promises to help significantly improve treatment and prevent the spread of the airborne infection, the World Health Organization said on Monday.

Multiple-drug-resistant TB, or MDR-TB, is a growing public health problem in the world. Five percent of new TB cases are resistant to first-line drugs. That is 450,000 of the nine million new TB cases that are detected each year, the W.H.O. says.

Won’t You Be My Neighbor?

This article describes what I found to be one of the most unique aspects of life in America, especially salient to me after living abroad for many years...

According to social scientists, from 1974 to 1998, the frequency with which Americans spent a social evening with neighbors fell by about one-third. Robert Putnam, the author of “Bowling Alone,” a groundbreaking study of the disintegration of the American social fabric, suggests that the decline actually began 20 years earlier, so that neighborhood ties today are less than half as strong as they were in the 1950s.

Why is it that in an age of cheap long-distance rates, discount airlines and the Internet, when we can create community anywhere, we often don’t know the people who live next door?

Anxious in America

My fellow Americans: We are a country in debt and in decline — not terminal, not irreversible, but in decline. Our political system seems incapable of producing long-range answers to big problems or big opportunities. We are the ones who need a better-functioning democracy — more than the Iraqis and Afghans. We are the ones in need of nation-building. It is our political system that is not working.

Get Out of Your Own Way

Remarkably, Robert Pirsig wrote about this phenomenon from a humanistic background many years ago in the classic, "Zen and the Art of Motorcycle Maintenance--An Inquiry into Values."

Fishing in the stream of consciousness, researchers now can detect our intentions and predict our choices before we are aware of them ourselves. The brain, they have found, appears to make up its mind 10 seconds before we become conscious of a decision -- an eternity at the speed of thought.

Their findings challenge conventional notions of choice.
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In ways we are only beginning to understand, the synapses and neurons in the human nervous system work in concert to perceive the world around them, to learn from their perceptions, to remember important experiences, to plan ahead, and to decide and act on incomplete information. In a rudimentary way, they predetermine our choices.

A Life's Lesson

When somebody dies, we tell his story and try to define and isolate what was special about it—what it was he brought to the party, how he enhanced life by showing up. In this way we educate ourselves about what really matters. Or, often, re-educate ourselves, for "man needs more to be reminded than instructed."
(..)The beautiful thing about the coverage (of Tim Russert's death) was that it offered extremely important information to those age 15 or 25 or 30 who may not have been told how to operate in the world beyond "Go succeed." I'm not sure we tell the young as much as we ought, as clearly as we ought, what it is the world admires, and what it is they want to emulate.

In a way, the world is a great liar. It shows you it worships and admires money, but at the end of the day it doesn't. It says it adores fame and celebrity, but it doesn't, not really. The world admires, and wants to hold on to, and not lose, goodness. It admires virtue. At the end it gives its greatest tributes to generosity, honesty, courage, mercy, talents well used, talents that, brought into the world, make it better. That's what it really admires. That's what we talk about in eulogies, because that's what's important. We don't say, "The thing about Joe was he was rich." We say, if we can, "The thing about Joe was he took care of people."

The young are told, "Be true to yourself." But so many of them have no idea, really, what that means. If they don't know who they are, what are they being true to? They're told, "The key is to hold firm to your ideals." But what if no one bothered, really, to teach them ideals?
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After Tim's death, the entire television media for four days told you the keys to a life well lived, the things you actually need to live life well, and without which it won't be good. Among them: taking care of those you love and letting them know they're loved, which involves self-sacrifice; holding firm to God, to your religious faith, no matter how high you rise or low you fall. This involves guts, and self-discipline, and active attention to developing and refining a conscience to whose promptings you can respond. Honoring your calling or profession by trying to do within it honorable work, which takes hard effort, and a willingness to master the ethics of your field. And enjoying life. This can be hard in America, where sometimes people are rather grim in their determination to get and to have. "Enjoy life, it's ungrateful not to," said Ronald Reagan.

Eyes Bloodshot, Doctors Vent Their Discontent

I think that perhaps we are close to if not at the point that the attorneys and insurance companies, including medicare, have "won"--to the point that patients don't get care and doctors are "throwing in the hat/surgical cap..."

In a survey last year of nearly 2,400 physicians conducted by a physician recruiting firm, locumtenens.com, 3 percent said they were not frustrated by nonclinical aspects of medicine. The level of frustration has increased with nearly every survey.

“It will take real structural change in the work environment for physician satisfaction to improve,” Dr. Mark Linzer, an internist at the University of Wisconsin who has done extensive research on physician unhappiness, told me. “Fortunately, the data show that physicians are willing to put up with a lot before giving up.”

Red Wine May Curb Fat Cell

Red wine appears to protect the heart and prolong life. Now a new study suggests it may also be a weapon against obesity.

A Search for Answers in Russert’s Death

It is not clear whether Mr. Russert’s death could have been prevented. He was doing nearly all he could to lower his risk. He took blood pressure pills and a statin drug to control his cholesterol, he worked out every day on an exercise bike, and he was trying to lose weight, his doctors said on Monday. And still it was not enough.

If there is any lesson in his death, his doctors said, it is a reminder that heart disease can be silent, and that people, especially those with known risk factors, should pay attention to diet, blood pressure, weight and exercise — even if they are feeling fine.

“If there’s one number that’s a predictor of mortality, it’s waist circumference,” said Dr. Michael A. Newman, Mr. Russert’s internist.

Blind Men and The Diabetes Elephant

Blind Men and The Diabetes Elephant

Walking a little can go a long way

What if there was something simple you could do every day that would burn calories, be good for your heart, and help you stay young. You'd do it, right?

Wind-Powered Rotating Skyscraper in Dubai

Dubai continues to set standards and, why not with all the money the little kingdom has in the bank.

M-POWERED Car for Diabetics

At this year's ADA scientific session at Moscone Center in San Francisco, Medtronic Diabetes unveiled its new M-POWERED car, a Lincoln sedan equipped with a system that wirelessly incorporates a patient's continuous glucose monitor with a dashboard to make driving safer for those who can go from 120 to 60 mg/dl within a matter of seconds.

Boost for Africa green revolution

I am glad the UN, through this initiative, is targeting infrastructure, which affects not only food supply but also health care throughout the developing world.
I recall a conversation with a shopkeeper in Freetown who flew to Dubai to buy rice, even though 100 miles away in Sierra Leone there were verdant rice fields. The problem is that it took 8 hours by car each way to get to the rice fields. The roads were muddy, pock marked and quite hazardous--as I experienced on my way from Freetown to the eye clinic in Serabu, where I worked...

A US government aid agency has formed an alliance with a group headed by former UN chief Kofi Annan to try to boost African agriculture.

Mr Annan has called for a "green revolution" to solve the food crisis.

The new partnership aims to invest in Africa's inadequate infrastructure, as well as developing new seeds and fertilisers.

Mr Annan says that 40% of African crops are lost after being harvested - a problem which new roads could ease.

American Aid Is Seized in Zimbabwe

JOHANNESBURG — Zimbabwean authorities confiscated a truck loaded with 20 tons of American food aid for poor schoolchildren and ordered that the wheat and pinto beans aboard be handed out to supporters of President Robert Mugabe at a political rally instead, the American ambassador said Wednesday.

Jackie Greene in Reno

Jackie Greene put on a powerful performance last Thursday at the great outdoor venue: Bartely Ranch.
For more pics by the talented photographer, Candice Towell, click here..

Albinos, Long Shunned, Face Threat in Tanzinia

Discrimination against albinos is a serious problem throughout sub-Saharan Africa, but recently in Tanzania it has taken a wicked twist: at least 19 albinos, including children, have been killed and mutilated in the past year, victims of what Tanzanian officials say is a growing criminal trade in albino body parts.

Nadia

Pops Staples

Let's start Friday with some serious soul music!

First Catholic church for Saudi Arabia

Negotiations are underway to build the first Catholic church in Saudi Arabia with King Abdullah lending his support for its construction.

The Power of Kindness

“It is much safer to be feared than loved,” writes Niccolò Machiavelli in The Prince, a classic 16th-century treatise advocating manipulation and occasional cruelty as the best means to power. Nearly 500 years later, Robert Greene’s The 48 Laws of Power, the best-selling bedside reading of foreign policy analysts and hip-hop stars alike, would have made Machiavelli’s chest swell with pride.
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These seductive notions are wrong. A new science of power has revealed that power is wielded most effectively when it’s used by people who are attuned to and engaged with the needs and interests of others. When it comes to power, social intelligence—reconciling conflicts, negotiating, smoothing over group tensions—prevails over social Darwinism.

Why social intelligence? Because of our ultrasociability. We accomplish most tasks related to survival and reproduction socially, from caring for our children to producing food and shelter. We give power to those who can best serve the interests of the group. Leaders who treat their subordinates with respect, share power, and generate a sense of camaraderie and trust are considered more just and fair.

Social intelligence is essential not only to rising to power, but also to keeping it. My colleague Cameron Anderson and I studied the structure of social hierarchies within college dormitories over the course of a year, examining who is at the top and who remains there. We’ve consistently found that it is the socially engaged individuals who keep their power over time.
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They also mistakenly believe that power is acquired strategically in deceptive gamesmanship and by pitting others against one another. Here Machiavelli failed to appreciate an important fact in the evolution of human hierarchies: that with increasing social intelligence, a person’s power is only as strong as the status given to that person by others.

The Science of Sarcasm (Not That You Care)

There was nothing very interesting in Katherine P. Rankin’s study of sarcasm — at least, nothing worth your important time. All she did was use an M.R.I. to find the place in the brain where the ability to detect sarcasm resides. But then, you probably already knew it was in the right parahippocampal gyrus.

What you may not have realized is that perceiving sarcasm, the smirking put-down that buries its barb by stating the opposite, requires a nifty mental trick that lies at the heart of social relations: figuring out what others are thinking. Those who lose the ability, whether through a head injury or the frontotemporal dementias afflicting the patients in Dr. Rankin’s study, just do not get it when someone says during a hurricane, “Nice weather we’re having.”

Experts Revive Debate Over Cellphones and Cancer

What do brain surgeons know about cellphone safety that the rest of us don’t?

What Your Eyes Say About Your Mood

Has anyone ever told you that you looked sad or tired when you weren’t? If the problem isn’t your mood, it might be your face, according to a study in the medical journal Plastic and Reconstructive Surgery.

Food Relief For Africa 'Insufficient,' GAO Says

Efforts by the United States and multilateral agencies including the World Bank to reduce hunger in sub-Saharan Africa have been "insufficient," with foreign aid to the region failing to flow into agricultural development projects vital to the ability of poor countries to feed themselves, according to a report to be released this morning by the U.S. Government Accountability Office.

Issued ahead of a major United Nations summit in Rome next week to address the global food crisis, the report suggests that the failure to invest in African agriculture has contributed to the problems unfolding in the region as food prices soar worldwide. High dependence on imported food has been blamed for Africa's worse spike in hunger in years, with skyrocketing prices sparking unrest and food shortages in a number of nations, including Mauritania and Somalia.

The report, a draft copy of which was obtained by The Washington Post, additionally describes U.S. aid efforts in sub-Saharan Africa as fragmented and misdirected. It says, for instance, that a Bush administration initiative to "end hunger in Africa" launched in 2002 effectively amounted to a repackaging of existing programs and came with no new funding.

At the same time, USAID, the main humanitarian aid arm of the U.S. government, has shifted away from promoting better crops, focusing instead on providing emergency food aid "to the detriment of actions designed to address the fundamental causes of these emergencies, including low agricultural productivity and other factors."

A Past at Rest in Rwanda

KIGALI, Rwanda -- It happened just 14 years ago -- the slaughter of roughly a million people here in only 100 days. "More people had been killed more quickly than in any other mass killing in recorded history," writes Martin Meredith in his book "The Fate of Africa."

And yet today there are few visible traces of the genocide that began in April 1994. It's not that Rwandans have forgotten, but that they seem to have willed themselves to live in the present. That makes this place feel different from other post-conflict states I know, such as Iraq and Lebanon, where the past and present are congealed in a wound that never heals.

During a week spent traveling the country, I found that Rwandans rarely brought up the events of the past. They almost never named the ethnic groups involved in the 1994 genocide -- the Hutu perpetrators and the Tutsi victims. Expatriates would speak a kind of code, referring to "H's" and "T's."

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For Rwego, it was not a question of forgetting but of continuing: "Why had I remained alive? So that I should do something for others." He got top grades in school, earned a medical degree and now is a doctor with Rwanda's national AIDS research organization. He is a reserved, stoical man, like most Rwandans I met, but as he told this story, he brushed a tear from one eye.

If you visit the Kigali Memorial Center here, you will look into the very heart of this tragedy. The story is meticulously told: from the Belgian colonialists' decision in the 1930s to assign Hutu and Tutsi racial identities to people who had lived together for centuries; to the rise of "Hutu Power" as a racist ideology to sustain a corrupt Rwandan elite; to the planning for genocidal killings during the early 1990s, which the West knew about but did nothing to stop; to the final result, the slaughter of men, women and children, as recorded in the tableaux of the Children's Memorial:

"Francine Murengezi Ingabire. Age: 12. Favorite sport: Swimming. Favorite food: Eggs and chips. Favorite drink: Milk and Fanta Tropical. Best friend: Her elder sister Claudette. Cause of death: Hacked by machete."

The Florida Revelation . . .

The Sunshine State has about 3.8 million people without insurance, or about 21% of the population, the fourth-highest rate in the country. The "Cover Florida" plan hopes to improve those numbers by offering access to more affordable policies. As even Barack Obama says, the main reason people are uninsured isn't because they don't want to be; it's because coverage is too expensive.

But the Florida reform, which both houses of the legislature approved unanimously, renounces Mr. Obama's favored remedy: It nudges the government out of the health-care marketplace. Insurance companies will be permitted to sell stripped-down, no-frills policies exempted from the more than 50 mandates that Florida otherwise imposes, including for acupuncture and chiropractics. The new plans will be designed to cost as little as $150 a month, or less.

Mr. Crist observed that state regulations increase the cost of health coverage, and thus rightly decided to do away with at least some of them. It's hard to believe, but this qualifies as a revelation in the policy world of health insurance. The new benefit packages will be introduced sometime next year and include minimum coverage for primary care and catastrophic expenses for major illness.

Monkeys Control a Robot Arm With Their Thoughts

Cool video at the NY Times link...

Two monkeys with tiny sensors in their brains have learned to control a mechanical arm with just their thoughts, using it to reach for and grab food and even to adjust for the size and stickiness of morsels when necessary, scientists reported on Wednesday.

Iraq: One Winter Soldier's Tale

In the spring of 2008, a conference was held on the outskirts of Washington, DC. Entitled Winter Soldier: Iraq and Afghanistan, it harkened back to the Winter Soldier testimonies held three decades ago during the Vietnam War. Of the testimonies we filmed, this one, by Iraq War vet Jon Michael Turner, was the most compelling and intense.

When Hostility Melted for the ‘Funny Accent’

Go to the link for the surprising end of this story...

I apologized, but the family was livid. Especially the elder son, a middle-age man with a diamond earring and a habit of jerking his head as he spoke, long blond hair flying. They had been in the E.R. more than six hours, he protested.

“I’m sorry you had to wait,” I apologized again.

The daughter — slim and soft-spoken — asked where I was from, adding, by way of explanation, “The accent.”

I was used to the question. “Nigeria,” I said, and apologized anew for my delay.



After that, I thought everything went well. But the next day, the son filed a complaint with the hospital administration. That was when I decided they did not like me. Maybe their father was too good to be cared for by a black man, an African no less, one they probably thought believed in the healing powers of rocks and trees and the voodoo dance. At least that was how one woman put it after I refused to prescribe antibiotics for a viral upper-respiratory infection.

From then, I had done my best to avoid the children, though I always called to update them on their father’s condition.

WARNING: This Will Give You Nightmares

How sad--please consider a donation...I have seen much advanced pathology in Africa like this Doctor--however I have never seen noma...

It sure did me. I was working at the Schweitzer hospital in Africa when a mother brought her two-year-old child to us. Even wrapped in a sheet, it was obvious that he was unnaturally thin, his elbows too pointy, his back too bony. The odd thing was that she had a sheet over his head. He cried weakly and pushed at it every so often, but she kept the sheet in place. This mom didn’t speak, or make eye contact. She wasn’t impatient, like she knew there was nothing anyone could do. She just sat, listless in a chair, waiting for her turn. The other moms, as if they already knew, had edged away from her in the crowded waiting room, leaving a circle of empty chairs around her. I thought for a moment, when I walked to her, that I smelled a whiff of something. A sickly sweet smell - the smell of human decay and rot, the smell of a corpse left in the sun. But surely that wasn’t possible. This kid was moving.
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I’d been in Africa for months already. I’d seen things that I thought had hardened me, permanently. I’d seen worms slithering in people, maggots foaming out of a child’s ear, leprosy that ate away limbs - you name it. Nothing could shock me. Or so I thought. She followed me to the exam room. Why did this woman ignore my greeting and carry her child, wordless, as a tear slid down her cheek? What was under that sheet?

It was a nightmare. One you personally can stop from ever destroying another child again. And I’m going to tell you how.


After the woman gently put her child on our thin clinic pallet, I pulled back the sheet. Noma is what I was taught to call what I saw. This child’s face had begun to rot, while he was still alive. A gaping, gangrenous hole had opened at the left corner of his baby mouth and ate away his cheek - it ate all flesh, and then into bones, leaving white skull edges exposed. His upper lip was mostly gone and the hole was now big enough to eat away the end of his nose, leaving sinus holes gaping, coated with a thin layer of pus. The smell, as he exhaled, was enough to make me swallow hard. I was horror-struck, but even worse was the fact that he saw my face, and, like any sweet little kid, I scared him - looking at him like that, and he reached his thin arms up to his mama and his crusty eyes tried to fill with tears and what was left of his mouth tried to distort into a normal cry, tugging at fraying, rotting flesh, part of his tongue was gone and I realized the horror of it all - that he was trapped, hurting, rotting before he was dead and, even though I thought it couldn’t be worse, I saw his poor mother swallow hard and walk around me and reach to stroke his hair. But she didn’t do what all the women in Africa do when their babies cry at the doctor’s - she didn’t offer him her breast. And you could see that she felt horrible for not doing it, but how could she when all that was left of his mouth and face was this living, hurting, horror-struck gangrenous hole? He was bereft.

That, my lovely reader-friends, is the face of noma. That experience, when I cried in Africa in front of this mother and when I weep now even thinking about it again, is why I’m asking everyone to recognize this new, long-overdue cause. I know we’re all disaster-exhausted. I know it’s hard to reach inside for yet one more tug on our tugged-to-the-point-of-breaking heartstrings. But Noma is something that no one, no child, should ever be forced to suffer. It is a horror beyond all horrors. And it’s completely, cheaply preventable.

And, with the price of food skyrocketing, it’s likely to attack more and more children.

Noma, to put it simply, is when there is not enough nutrition and germs overgrow the mouth and the child’s immune system fails under the onslaught without nourishment - the germs start to eat away at the flesh of the person. It begins in the mouth, where we all have lots of germs, and it keeps going through flesh and bone. Usually it is fatal - when the mouth begins to disintegrate, a vicious spiral begins because the child can’t eat. But if it is recognized early and aggressively treated with simple things like vitamins and nutrition and sometimes antibiotics, children can be saved. Even when they’re saved, however, these children are often outcasts - disfigured for life, for no greater sin than not having enough to eat when they were young. Noma is often believed to be a curse, and whole families can be stigmatized. Today, over 100,000 children a year suffer this horror. Noma strikes wherever there is hunger - Asia, South America, and Africa. And yes, noma existed here, both in the United States and Europe, until the last century when we became wealthier nations.

Here’s how you can help. Say no to noma. Noma no more, is what I’d call this campaign. Give a bit - even the cost of one day’s coffee, just $3. Don’t stress about whether it’s enough - anything is good. Go to www.nonoma.org for more info - 100% of proceeds go to direct services.

Suu Kyi's house arrest extended

Burma's ruling junta has renewed pro-democracy leader Aung San Suu Kyi's house arrest.
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The decision came at a tricky time for the generals, who have been criticised for their response to Cyclone Nargis.

Ms Suu Kyi's party won a resounding election victory in 1990, but she was denied power by the military.

The 62-year-old National League for Democracy (NLD) leader has spent more than 12 of the last 18 years in detention.

Police bundled a number of opposition activists into a truck as they marched on Tuesday from the NLD party headquarters to her lakeside villa in Rangoon.

Correspondents had expected her house arrest - which has been renewed annually - to be rolled over for another year.

BRUCE COCKBURN - If I Had A Rocket Launcher

The Magnifying Glass Gets an Electronic Twist

PEOPLE who lose part of their sight to macular degeneration, diabetes or other diseases may now benefit from some new technology. Several portable video devices that enlarge print may help them make the most of their remaining vision.Swipe one of the devices over an airline ticket, or point it at a medicine bottle on a shelf, and all of the fine print is blown up and displayed in crisp letters on a screen.

Sturdy desktop video-based systems that magnify print have long been available, but lightweight, portable devices have become popular only in the past decade, as the size of consumer electronics products in general has shrunk. The new hand-held models typically weigh 9 ounces or less and can enlarge the print on closeby or more distant objects: users can pass the magnifier over a menu in a dimly lit restaurant, for example, or aim it at a grocery display on a store aisle.
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The devices have a substantial drawback, however, when compared with a $40 magnifying glass: They typically cost $700 to $1,300, and Medicare and most private insurance plans usually do not pay for them, said Robert McGillivray, low-vision specialist at the Carroll Center for the Blind in Newton, Mass.

Myanmar’s Cyclone Survivors Still Waiting for Food

PYAPON, Myanmar — The roads of the ravaged Irrawaddy Delta are lined these days with people hoping to be fed.

After lifetimes living off the land, poor farmers have abandoned their ruined rice paddies, setting up makeshift bamboo shelters, waiting for carloads of Burmese civilians who have taken it on themselves to feed those who lost everything to Cyclone Nargis.

Few of those who wait say they have received anything from the government, other than threats.

“They said if we don’t break our huts and disappear, they will shoot us,” one man in the village of Thee Kone said over the weekend before a police jeep approached. “But as you can see, it’s raining now. We are pleading to the police to give us one more day and we will be gone far, far from the road, as they wish.”

A red sign on a stake along one road read: “Don’t throw food on the roads. It ruins the people’s good habits.”
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I don’t know how the government is helping us,” said Ko Htay Oo, 40, in Kungyangon, a delta town 30 miles south of Yangon, Myanmar’s main city. He said the only aid he had seen was delivered by other Burmese citizens.

“I am no beggar, so I didn’t eat anything in the past two days,” he said, leaning against a roadside palm tree. “Besides, you shouldn’t compete with kids for begged food.”

Those who have gotten government help say it is not nearly enough.
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Dead bodies floating down the Pyapon River are no longer strangers to us,” said Daw Khin Kyi, a resident. “Some of these bodies still wear gold necklaces and bracelets, so some people went out to collect them in the first few days. But now, after many days, nobody goes near. Fish are nibbling at the bodies.”

Ma Ye Ye Tan, a 17-year-old from a hamlet down the river, survived the cyclone. She had arrived at the home of a Pyapon relative several days after the cyclone with virtually nothing on, shivering in monsoon rain.

Now, she said, she did want to go back to her village, which is filled with death. She is not sure what happened to her parents.

“After the cyclone came and went, we continued to hear people shouting in the darkness, but when village men went to search for them, they could find no one,” she said. “We think they are ghosts shouting. I am afraid of ghosts.”

The Derek Trucks Band -- Sahib Teri Bandi (Crossroads 2007)

Presenting the amazing Derek Trucks:

Sudan's Macabre Display Of Victory Over Attackers

KHARTOUM, Sudan -- A week after Darfur rebels launched an audacious attack on this sand-swept capital, Sudanese President Omar Hassan al-Bashir presided over a macabre exhibit aimed at crushing any doubt as to which side won.

With state TV cameras set up across a dusty field, he surveyed a row of battered and bullet-holed Hilux trucks that government forces had seized from the rebels. Bashir raised an ivory-tipped baton, and hundreds of security forces cheered, waving shoes, T-shirts and other clothes allegedly stripped off the doomed fighters.

Then he strolled past a 200-yard-long photo gallery, a grotesque display of burned and dismembered bodies, allegedly those of the rebels. Each image was underlined with the same caption in Arabic: "summary of failure."

Food Costs Push Bangladesh to Brink of Unrest

DHAKA, Bangladesh -- As a seamstress, Abida Dulalmia makes $1.25 a day embroidering cartoon characters on Disney T-shirts and stitching pockets on jeans for Target. In this jumbled, hazy metropolis, her salary was once coveted. Now it hardly seems enough.

With inflation starting to climb into the double digits in Bangladesh and food prices soaring around the world, Dulalmia spends as much as 80 percent of what she makes solely to put food on the dinner table.

"We work really hard," the 25-year-old mother of two said on a recent day, wiping perspiration from her daughter's forehead in the muggy heat of their airless, one-room home. "Why can't we afford to eat?"
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Bangladesh is among at least 33 countries, many with shaky governments and destitute populations, that are at risk of serious political unrest if food prices keep rising, according to a recent World Bank study. In some countries, the consequences of the food crisis are already playing out. Haiti's prime minister, for example, was forced to step down last month after riots in Port-au-Prince.
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In this country, the crisis is compounded by natural disasters that have destroyed wide swaths of farmland. Many Bangladeshis have migrated from rural areas to the capital as "climate refugees," driven out by floods and cyclones that some scientists believe have intensified because of rising global temperatures. Now, in the relative safety of Dhaka, illiterate, often unskilled laborers are being hit by economic calamity as high inflation and surging food prices make their lives more difficult.

Although poverty had started to slowly recede over the past decade in this nation of 150 million, there are renewed fears that inflation could undo its decades of progress and once again make it the "basket case" of the world, as it was once dubbed by U.S. Secretary of State Henry Kissinger.

Junta Offers Showcase Camps, but Most Burmese Lack Aid

From Bruce Cockburn's song, "Postcards from Cambodia"..

This is too big for anger,
it’s too big for blame.
We stumble through history so
humanly lame
So I bow down my head
Say a prayer for us all
That we don’t fear the spirit
when it comes to call
The surrealism in Myanmar continues--the latest from the New York TImes:


HLINETHAYA RELIEF CAMP, Myanmar — The 68 blue tents are lined up in a row, with a brand-new water purifier and boxes of relief supplies, stacked neatly but as yet undelivered and not even opened. “If you don’t keep clean, you’ll be expelled from here,” a camp manager barked at families in some tents.
The moment, at what has been billed as a model camp for survivors of Cyclone Nargis, captured a common complaint among refugees and aid volunteers: that the military junta that rules Myanmar cares more about the appearance of providing aid than actually providing it.
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In the village of Ar Pyin Padan, a few minutes’ walk from here and just an hour’s drive from the center of Yangon, 40 families who lost nearly everything they owned crowded a rundown two-story school building. They had pushed desks together to serve as makeshift beds.

Here, deliveries of relief supplies are so infrequent that the refugees say they draw lots to get a small share whenever a donation comes in. For drinking water, one said, the township authorities “threw some medicine” into a nearby pond and told the villagers to drink from it.

Now the authorities are allowing no more refugees into the school. Instead they are trying to evict those who are already there so that the building can be used as a balloting station on Saturday.

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The aid runners are coming under increasing pressure from the government.

Twenty of Mr. Thura’s team members have received calls from the police warning that they will be punished if they continue their work. On Sunday, he said, his photographer, U Kyaw Swar Aung, was arrested and has not been heard from since. He had been traveling around the delta making videos of dead bodies, crying children and villagers who went insane after the storm and distributing them as DVDs.

Meanwhile, Mr. Thura said the government seemed less focused on aid than on making sure there were no more scenes like those to film. In one place, he said he saw a pile of floating bodies clogging the narrow mouth of a stream after they were dumped into the water by soldiers on a cleanup operation.

“Then the soldiers used dynamite to blow up the bodies into shreds,” he said.

Jill Bolte Taylor: My Stroke of Insight

Fascinating discussion of the brain from a neuroscientist who has had a stroke...

Jill Bolte Taylor got a research opportunity few brain scientists would wish for: She had a massive stroke, and watched as her brain functions -- motion, speech, self-awareness –- shut down one by one. An astonishing story.

Why Zappos Pays New Employees to Quit—And You Should Too

irst, some background. As most of you know, Zappos sells shoes—lots of them—over the Internet. The company expects to generate sales of more than $1 billion this year, up from just $70 million five years ago. Part of the reason for Zappos’s meteoric success is that it got the economics and operations right. It offers customers a huge selection—four million pairs of shoes (and other items, such as handbags and apparel) in a warehouse in Kentucky next to a UPS hub. (If Imelda Marcos visited that warehouse she'd likely have a coronary on the spot.) It also offers free delivery and free returns—if you don’t like the shoes, you box them up and send them back to Zappos for no charge.

So the value proposition is a winner. But it’s the emotional connection that seals the deal. This company is fanatical about great service—not just satisfying customers, but amazing them. The company promises free, four-day delivery. That’s pretty good. But most of the time it delivers next-day service, a surprise that leaves a lasting impression on customers: “You said four days, but I got them the next morning.”
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This is a company that’s bursting with personality, to the point where a huge number of its 1,600 employees are power users of Twitter so that their friends, colleagues, and customers know what they’re up to at any moment in time. But here’s what’s really interesting. It’s a hard job, answering phones and talking to customers for hours at a time. So when Zappos hires new employees, it provides a four-week training period that immerses them in the company’s strategy, culture, and obsession with customers. People get paid their full salary during this period.

After a week or so in this immersive experience, though, it’s time for what Zappos calls “The Offer.” The fast-growing company, which works hard to recruit people to join, says to its newest employees: “If you quit today, we will pay you for the amount of time you’ve worked, plus we will offer you a $1,000 bonus.” Zappos actually bribes its new employees to quit!

Why? Because if you’re willing to take the company up on the offer, you obviously don’t have the sense of commitment they are looking for. It’s hard to describe the level of energy in the Zappos culture—which means, by definition, it’s not for everybody. Zappos wants to learn if there’s a bad fit between what makes the organization tick and what makes individual employees tick—and it’s willing to pay to learn sooner rather than later. (About ten percent of new call-center employees take the money and run.)

Spot Crime in Your Neighborhood

Crime-mapping mashup SpotCrime pulls data from city police records and news sources and plots it in an easy-to-snoop fashion. Choose a city, a time frame, and the types of offenses you want to see, and you can mouse-over the pinned icons to see thumbnail descriptions, or click an item for a full read. The site claims that humans are working in the background to make sense of

Study Finds Big Social Factor in Quitting Smoking

Smokers tend to quit in groups, the study finds, which means smoking cessation programs should work best if they focus on groups rather than individuals. It also means that people may help many more than just themselves by quitting: quitting can have a ripple effect prompting an entire social network to break the habit.

The study, by Dr. Nicholas Christakis of Harvard Medical School and James Fowler of the University of California, San Diego, followed thousands of smokers and nonsmokers for 32 years, from 1971 until 2003, studying them as part of a large network of relatives, co-workers, neighbors, friends and friends of friends.
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Dr. Christakis described watching the vanishing clusters as like lying on your back in a field, looking up at stars that were burning out. “It’s not like one little star turning off at a time,” he said. “Whole constellations are blinking off at once.”

As cluster after cluster of smokers disappeared, those that remained were pushed to the margins of society, isolated, with fewer friends, fewer social connections. “Smokers used to be the center of the party,” Dr. Fowler said, “but now they’ve become wallflowers.”

Myanmar Mourns Victims of Cyclone

It is heartbreaking that a natural disaster of such magnitude has hit such a gentle people, but it is nauseating that a government would deny international aid to people dying...Pictures of our
trip to Myanmar from two months ago can be found here




BANGKOK — Myanmar began three days of national mourning for cyclone victims Tuesday, one day after agreeing to let its Southeast Asian neighbors help coordinate foreign relief assistance following the devastating Cyclone Nargis more than two weeks ago.

The supply of aid and the entry of relief workers from countries outside the Southeast Asian bloc will continue to be limited, said Singapore’s Foreign Minister George Yeo after an emergency meeting in Singapore of the Association of Southeast Asian Nations, or Asean, which includes Myanmar. But the move was taken as a signal that Myanmar’s reclusive military rulers had bowed somewhat to international pressure to allow more outside aid.
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Older Brain Really May Be a Wiser Brain

When older people can no longer remember names at a cocktail party, they tend to think that their brainpower is declining. But a growing number of studies suggest that this assumption is often wrong.

Instead, the research finds, the aging brain is simply taking in more data and trying to sift through a clutter of information, often to its long-term benefit.

The studies are analyzed in a new edition of a neurology book, “Progress in Brain Research.”
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A broad attention span may enable older adults to ultimately know more about a situation and the indirect message of what’s going on than their younger peers,” Dr. Hasher said. “We believe that this characteristic may play a significant role in why we think of older people as wiser.”

In a 2003 study at Harvard, Dr. Carson and other researchers tested students’ ability to tune out irrelevant information when exposed to a barrage of stimuli. The more creative the students were thought to be, determined by a questionnaire on past achievements, the more trouble they had ignoring the unwanted data. A reduced ability to filter and set priorities, the scientists concluded, could contribute to original thinking.

This phenomenon, Dr. Carson said, is often linked to a decreased activity in the prefrontal cortex. Studies have found that people who suffered an injury or disease that lowered activity in that region became more interested in creative pursuits.