Sunday, July 12, 2009

NYT: The Deadly Toll of Abortion by Amateurs

June 2, 2009
The Deadly Toll of Abortion by Amateurs
By DENISE GRADY

BEREGA, Tanzania — A handwritten ledger at the hospital tells a grim story. For the month of January, 17 of the 31 minor surgical procedures here were done to repair the results of “incomplete abortions.” A few may have been miscarriages, but most were botched operations by untrained, clumsy hands.

Abortion is illegal in Tanzania (except to save the mother’s life or health), so women and girls turn to amateurs, who may dose them with herbs or other concoctions, pummel their bellies or insert objects vaginally. Infections, bleeding and punctures of the uterus or bowel can result, and can be fatal. Doctors treating women after these bungled attempts sometimes have no choice but to remove the uterus.

Pregnancy and childbirth are among the greatest dangers that women face in Africa, which has the world’s highest rates of maternal mortality — at least 100 times those in developed countries. Abortion accounts for a significant part of the death toll.

Maternal mortality is high in Tanzania: for every 100,000 births, 950 women die. In the United States, the figure is 11, and it is even lower in other developed countries. But Tanzania’s record is neither the best nor the worst in Africa. Many other countries have similar statistics; quite a few do better and a handful do markedly worse.

Eighty percent of Tanzanians live in rural areas, and the hospital in Berega — miles from paved roads and electric poles — is a typical rural hospital, struggling to deal with the same problems faced by hospitals and clinics in much of the country. Abortion is a constant worry.

Worldwide, there are 19 million unsafe abortions a year, and they kill 70,000 women (accounting for 13 percent of maternal deaths), mostly in poor countries like Tanzania where abortion is illegal, according to the World Health Organization. More than two million women a year suffer serious complications. According to Unicef, unsafe abortions cause 4 percent of deaths among pregnant women in Africa, 6 percent in Asia and 12 percent in Latin America and the Caribbean.

Reliable figures on abortion in Tanzania are hard to come by, but the World Health Organization reports that its region, Eastern Africa, has the world’s second-highest rate of unsafe abortions (only South America is higher). And Africa as a whole has the highest proportion of teenagers — 25 percent — among women having unsafe abortions.

The 120-bed hospital in Berega depends on solar panels and a generator, which is run for only a few hours a day. Short on staff members, supplies and even water, the hospital puts a lot of its scarce resources into cleaning up after failed abortions.

The medical director, Dr. Paschal Mdoe, 30, said many patients who had had the unsafe abortions were 16 to 20 years old, and four months pregnant. He said there was a steady stream of cases, much as he had seen in hospitals in other parts of the country.

“It’s the same everywhere,” he said.

On a Friday in January, 6 of 20 patients in the women’s ward were recovering from attempted abortions. One, a 25-year-old schoolteacher, lay in bed moaning and writhing. She had been treated at the hospital a week earlier for an incomplete abortion and now was back, bleeding and in severe pain. She was taken to the operating room once again and anesthetized, and Emmanuel Makanza, who had treated her the first time, discovered that he had failed to remove all the membranes formed during the pregnancy. Once again, he scraped the inside of her womb with a curet, a metal instrument. It was a vigorous, bloody procedure. This time, he said, it was complete.

Mr. Makanza is an assistant medical officer, not a fully trained physician. Assistant medical officers have education similar to that of physician assistants in the United States, but with additional training in surgery. They are Tanzania’s solution to a severe shortage of doctors, and they perform many basic operations, like Caesareans and appendectomies. The hospital in Berega has two.

Abortions in Berega come in seasonal waves — March and April, August and September — in sync with planting and harvests, when a lot of socializing goes on, Dr. Mdoe said. He said rumor had it that many abortions were done by a man in Gairo, a town west of Berega. In some cases, he said, the abortionist only started the procedure, knowing that doctors would have to finish the job.

Dr. Mdoe said he suspected that some of the other illegal abortionists were hospital workers with delusions of surgical skill.

“They just poke, poke, poke,” he said. “And then the woman has to come here.” Sometimes the doctors find fragments of sticks left inside the uterus, an invitation to sepsis.

In the past some hospitals threatened to withhold care until a woman identified the abortionist (performing abortions can bring a 14-year prison term), but that practice was abandoned in favor of simply providing postabortal treatment. Still, women do not want to discuss what happened or even admit that they had anything other than a miscarriage, because in theory they can be prosecuted for having abortions. The law calls for seven years in prison for the woman. So doctors generally do not ask questions.

“They are supposed to be arrested,” Dr. Mdoe said. “Our work as physicians is just to help and make sure they get healed.”

He went on, “We as medical personnel think abortion should be legal so a qualified person can do it and you can have safe abortion.” There are no plans in Tanzania to change the law.

The steady stream of cases reflects widespread ignorance about contraception. Young people in the region do not seem to know much or care much about birth control or safe sex, Dr. Mdoe said.

In most countries the rates of abortion, whether legal or illegal — and abortion-related deaths — tend to decrease when the use of birth control increases. But only about a quarter of Tanzanians use contraception. In South Africa, the rate of contraception use is 60 percent, and in Kenya 39 percent. Both have lower rates of maternal mortality than does Tanzania. South Africa also allows abortion on request.

But in other African nations like Sierra Leone and Nigeria, abortion is not available on request, and the figures on contraceptive use are even lower than Tanzania’s and maternal mortality is higher. Nonprofit groups are working with the Tanzanian government to provide family planning, but the country is vast, and the widely distributed rural populations makes many people extremely hard to reach.

Geography is not the only obstacle. An assistant medical officer, Telesphory Kaneno, said: “Talking about sexuality and the sex organs is still a taboo in our community. For a woman, if it is known that she is taking contraceptives, there is a fear of being called promiscuous.”

In interviews, some young women from the area who had given birth as teenagers said they had not used birth control because they did not know about it or thought it was unsafe: they had heard that condoms were unsanitary and that birth control pills and other hormonal contraceptives could cause cancer.

Mr. Kaneno said the doctors were trying to dispel those taboos and convince women that it was a good thing to be able to choose whether and when to get pregnant.

“It is still a long way to go,” he said.

Monday, July 6, 2009

Diana Johnstone: Zionist Terrorists Destroy a Parisian Bookstore: Sarkozy looks on

July 6, 2009
The Raids on the Resistances Bookstore
Zionist Fanatics Practice Serial Vandalism in Paris

By DIANA JOHNSTONE

Paris.
COUNTERPUNCH.ORG
http://counterpunch.org/johnstone07062009.html

Thousands of books drenched in cooking oil – that is the latest exploit of the Zionist fanatics who regularly attack property and people in Paris and get away with it.

In the early afternoon of Friday, July 3, five men, mostly masked, stormed into the “Resistances” bookstore located in a quiet residential neighborhood of the 17th arrondissement in northwest Paris. To the startled women working in the shop, as well as two customers, they announcing that they were from the Jewish Defense League and began ripping books off shelves and tables, dousing them heavily with cooking oil, and then smashing four computers before leaving rapidly in a waiting vehicle.

The bookstore is owned and operated by Olivia Zemor and Nicolas Shashahani, who are also the leaders of the very active militant group CAPJPO-EuroPalestine (CAPJPO stands for Coordination des Appels pour une Paix Juste au Proche Orient). In addition to a wide collection of books on the Middle East and other subjects, including fiction, the bookstore has a reading room and a lending library, gives courses in English and Arabic, and possesses a modest but well-attended auditorium where authors are invited to speak.

Two and a half years ago, on December 7, 2006, a similar attack squad threw teargas grenades into the bookstore as a crowd was gathering to listen to the late Israeli author Tanya Reinhart and her companion, the Israeli poet Aharon Shabtai. On that occasion, Shashahani had to be treated for effects from the teargas but material damage was slight. This time, the entire shop is a shambles, with countless ruined books, and damage runs to tens of thousands of euros, according to Shashahani.

But, he stresses, this is only one in “hundreds of violent actions” carried out by the French version of the banned US Jewish Defense League in recent years. There is no reason to expect them to stop so long as they can count on indulgence on the part of French authorities and the silence of the mainstream media. The vandalism on the Resistances bookstore was reported by the French news agency AFP, but the dispatch was apparently carried only by the small tabloid Le Parisien and not by the major newspapers, much less by television. Usually, almost the only people who are informed about such events are in the politically active circles targeted for intimidation.

The general public remains ignorant of these aggressions, while it is regularly informed by television of even relatively minor acts of anti-Semitism – some of them imaginary (as the famous case a few years ago of the young woman who totally invented a story of being the victim of an “anti-Semitic assault” by blacks in the suburban commuter train in order to get attention from her family, and got the attention of everyone in France all the way up to the President of the Republic). Real “anti-Semitic acts” occur, but most are no more organized than school-yard insults. However, the publicity they receive serves to keep alive the notion that the very existence of Jews is under perpetual threat – the basic alibi used by the Jewish Defense League. The false claim that “the French government does nothing to protect Jews” is used as a pretext for aggressive “self-defense”.

As disciples of Meir Kahane, the JDL not only favors purifying an enlarged Eretz Israel of Arabs, but wants to bring the fight against Arabs and “Islamofascism” to France itself. Debate is not their style. After training in Israeli martial arts, they carry on their fight by physical means, attacking Arabs, Muslims and defenders of the Palestinian cause. The JDL is an informal group of a few hundred members, rather than a registered organization with a headquarters. The French police, adept at infiltrating every sort of political group, certainly must know who and where they are, but they seem never to be disturbed after one of their raids. Moreover, unless the aggressors identify themselves, victims cannot be sure whether they are being attacked by the LDJ or by Betar, an older Zionist youth organization founded back in 1929 by Vladimir Jabotinsky and close to Likud. Both use similar methods, and probably overlap, although the LDJ, as the more radical of the two, is said to be draining members from Betar.

In the rare cases when Zionist fanatics are actually arrested and put on trial, they are usually treated with uncommon indulgence. In December 2003, a group of pro-Palestinian students were violently attacked by the usual suspects. A Palestinian student suffered grave eye injuries. Faced with lackadaisical police, the students carried out their own investigation, leading to the conviction on September 16, 2004 of one Anthony Attal. He was given a suspended sentence of ten months.

LDJ or Betar members also have the advantage of a “sanctuary” – Israel. On October 25, 2006, a 68-year-old pro-Palestinian radical militant, Ginette Hess Skandrani, was attacked in her own home by three unknown men who beat her savagely, explaining only “you know why”. Hospitalized, her head wounds required several stitches. Last February 4, her aggressors were finally convicted and sentenced, but:

-- one of them, Ruben Colleu, was sentenced to two years in prison, of which 18 months were suspended – but he had already fled to Israel.

-- the second, Stevel Elie, was sentenced to three years in prison – but the French court had already given him permission to go to Israel “to do his military service” in Tsahal.

-- Only the third, Mike Sfez, was still around. Like Colleu, 18 months of his two year sentence were suspended, and the remaining six months could be transformed into social work.

Only recently, large squads of presumed LDJ thugs have attacked theater-goers outside a benefit for children of Gaza and attacked persons of Arab appearance on their way to a meeting of diverse groups scheduled to discuss the “Boycott-Divestment-Sanctions” movement.

The LDJ has its apologists in the police. On June 5, 2006, the head of the small right-wing Christian union “Action Police CFTC”, Michel Thooris, praised the LDJ and Betar for “performing a public service mission by defending people and property”. He was not publicly reprimanded by his big boss, the minister of the Interior at that time, Nicolas Sarkozy.

The double standards of Sarkozy’s tough “law and order” policy are all too obvious. His ostentatious policy switch from a certain traditional French balance in the Middle East to strong support for Israel is only likely to encourage the LDJ in its feeling of impunity. This spring, a commercially successful author, Paul-Eric Blanrue, was unable to publish his book on “Sarkozy, Israel and the Jews” in France, and was obliged to find a publisher in Belgium. Still worse, the usual French distributor of his Belgian publisher refused to distribute the book in France. His press conference in Paris was unattended by any journalist and his book, which carefully documents Sarkozy’s policy of wooing Jewish support in France by aligning with Israel and attacking the “riffraff” in the suburbs, has been ignored by French reviewers.

Even though the market is saturated, there is always room in the media, however, for laments that France’s secular tradition is threatened by the “communitarianism” of… Muslims. The ideological and violent provocations of fanatic Zionists are rarely singled out as the main cause of this disturbing trend. Of course, France’s many militant intellectual Zionists do not resort to the methods of the LDJ and Betar. But the theme of Jewish victimhood, which is constantly present in schools, in cinema, in political discourse and in the media, provides a congenial atmosphere for the pathological violence of the Jewish militias in France, and for the indulgence with which they are treated.

The situation is scarcely improved by the extreme fragmentation of the Palestine solidarity movement in France Рwhich can be seen as just one aspect of the endemic sectarianism of the French left. The various victims of LDJ or Betar violence Рsuch as CAPJPO, Ginette Skandrani, the comedian Dieudonné, etc., etc. Рare often not on speaking terms with each other, so that even if they all profess solidarity with Palestine, there is very little or no solidarity between them.

However, one may hope that the July 3 attack on the Resistances bookstore may arouse a broader protest than other recent attacks, quite simply because of the strong connotations of destroying books. A protest demonstration has been called for the evening of Wednesday, July 8, to demand that the government finally ban the JDL, just as it has already been banned in the United States and Israel. This will be an opportunity to show solidarity in resistance to the most active form of fascism in France today.

Diana Johnstone is author of Fools’ Crusade: Yugoslavia, NATO and Western Delusions (Monthly Review Press). She can be reached at diana.josto@yahoo.fr

Sunday, July 5, 2009

Robert F. Kennedy Jr.: Obama Breaks Hearts in Appalachia

A President Breaks Hearts in Appalachia

By Robert F. Kennedy Jr.
Friday, July 3, 2009
http://www.washingtonpost.com/wp-dyn/content/article/2009/07/02/AR2009070203022_pf.html

Mountaintop removal coal mining is the worst environmental tragedy in American history. When will the Obama administration finally stop this Appalachian apocalypse?

If ever an issue deserved President Obama's promise of change, this is it. Mining syndicates are detonating 2,500 tons of explosives each day - the equivalent of a Hiroshima bomb weekly - to blow up Appalachia's mountains and extract sub-surface coal seams. They have demolished 500 mountains - encompassing about a million acres - buried hundreds of valley streams under tons of rubble, poisoned and uprooted countless communities, and caused widespread contamination to the region's air and water. On this continent, only Appalachia's rich woodlands survived the Pleistocene ice ages that turned the rest of North America into a treeless tundra. King Coal is now accomplishing what the glaciers could not - obliterating the hemisphere's oldest, most biologically dense and diverse forests. Highly mechanized processes allow giant machines to flatten in months mountains older than the Himalayas - while employing fewer workers for far less time than other types of mining. The coal industry's promise to restore the desolate wastelands is a cruel joke, and the industry's fallback position, that the flattened landscapes will provide space for economic development, is the weak punchline. America adores its Adirondacks and reveres the Rockies, while the Appalachian Mountains - with their impoverished and alienated population - are dismantled by coal moguls who dominate state politics and have little to prevent them from blasting the physical landscape to smithereens.

Obama promised science-based policies that would save what remains of Appalachia, but last month senior administration officials finally weighed in with a mixture of strong words and weak action that broke hearts across the region. The modest measures federal bureaucrats promised amount to little more than a tepid pledge of better enforcement of existing laws.

And government claims of doing everything possible to halt the holocaust are simply not true. George Bush gutted Clean Water Act protections. Obama must restore them.

First, the White House should fix the "fill" rule the Bush administration adopted in 2002 to allow coal companies to use streams as waste dumps. Under this perverse interpretation of the Clean Water Act, 2,000 miles of Appalachian streams have been interred under mining waste. Obama could reverse the "fill" rule to reflect its original meaning, which forbids waste matter from being dumped into waterways.

Second, the Interior Department should strictly enforce the widely ignored "buffer zone" rule that forbids dumping waste within 100 feet of intermittent or perennial streams.

Third, our laws require companies to restore mined areas to their original condition. The administration should end the absurd fiction that extraction pits filled with unconsolidated rocks and rubble where trees will never grow and streams will never flow are "reclaimed."

Fourth, current law forbids the issuance of "fill" permits that will cause "significant degradation" to waterways. It is absurd for the Army Corps of Engineers to endorse the canard that filling miles of streams is not causing significant degradation. The president should require the Corps to deny and rescind permits where operations will cause downstream damage.

Fifth, the Clean Water Act requires mining operators to prove that they can restore the "function and structure" of affected streams. Operators have never been compelled to make the functional or structural analyses of the aquatic ecosystem required by the act. Obama should order his officials to stop ignoring this requirement.

Sixth, the administration should enforce the law requiring an environmental impact study for each permit when a mine "may have significant environmental impacts," individually or cumulatively. The Corps of Engineers routinely allows coal operators to escape this mandate - an illegal practice that should stop.

Instead of acting to enforce these laws, administration officials indicated last month that they will allow more than 100 permits to go forward while they carefully review their regulatory options. If they act accordingly, the ruined landscapes of Appalachia will be Obama's legacy.

President Obama should go to Appalachia and see mountaintop removal. My father visited Appalachia in 1966 and was so horrified by strip mining - then in its infancy - that he made it a key priority of his political agenda. He complained that Appalachia, with our nation's richest natural resources, was home to America's poorest populations, its worst education system, and its highest illiteracy and unemployment rates. These statistics are even grimmer today as mining saps state wealth. In 1966, 46,000 West Virginia miners were collecting salaries and pensions and reinvesting in their communities. Mechanization has shrunk that number to fewer than 11,000. They extract more coal annually, but virtually all the profits leave the state for Wall Street.

The coal industry provides only 2 percent of the jobs in Central Appalachia. Wal-Mart employs more people than the coal companies in West Virginia. Last week a major study documented how coal imposes a net cost to Kentucky of more than $100 million per year. Coal is not an economic engine in the coalfields. It is an extraction engine.

Obama has the authority to end mountaintop removal, without further action from Congress and without formal rulemaking. He just needs to make the coal barons obey the law.

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The writer is senior attorney for the Natural Resources Defense Council.