India Struggles with a “Silent Killer”: Depression

INDIA - India is the world's second most populous nation with some 1.4 billion people.  But the ex-British colony that once spawned transformational figures like Mahatma Gandhi has also gained global notoriety for a host of glaring social problems, including poverty and air pollution.

 Less well known is India’s dubious honor as the country with the highest percentage of citizens suffering from depression.

International agencies and the government's own national mental health care body estimate that 10% of India’s population -- or 140 million people -- suffer from moderate-to-severe depression, including 2% that suffer from depression severe enough to require hospitalization.  

But those figures probably underestimate the actual size and scale of the problem because studies show that millions of Indians, especially in rural areas, have never been diagnosed and may not even know that they suffer from mental illness.  

Some analysts estimate that as much as 36% of India suffers from a mental disorder.

India, with its plethora of traditional ethnic, religious and linguistic groups, shares with many other countries a deep resistance to modern psychiatry which has helped reinforce a deep social stigma about mental illness.   

Many families are still ashamed to admit that their parents, children or siblings have a debilitating psychiatric disorder, and may try to hide or disguise it, fearing that it suggests a weakness in their lineage or care practices.  

There is also a pervasive belief, especially in rural areas, that mental illness constitutes a curse or a form of karma that only supernatural intervention can "cure.”

In central and southern India lower-caste Indians still make pilgrimages to Hindu "healing temples" to beseech their favorite deities to assist their mentally ill loved ones.  Some also bring their relatives to local exorcists in the hopes to freeing them of “demon possession."   

Mental health officials that try to discourage these practices – even sending teams of psychologists to the temples -- have often been met with fierce resistance.

Many scholars believe that the real fault for India’s ongoing depression problem lies with the national government which has failed to develop a comprehensive mental health care system and whose medical establishment suffers from the same depression sigma afflicting the general populace.

In 1983, the government established a National Mental Health Program (NMHP) with headquarters in Bangalore.  It soon pledged to devote significant diagnostic and treatment resources to depression and a host of other mental disorders, including schizophrenia.                       

But despite steady increases in annual funding, the NMHP has largely failed to integrate mental health services into India’s primary care system, studies show.  For example, more than 60 per cent of people with mental disorders still access specialized care at poorly funded district hospitals.  In addition, there are extreme regional disparities in the government’s mental healthcare infrastructure. 

India has 443 public mental hospitals, but six states, mainly in the northern and eastern regions with a combined population of 56 million people – a third of the country -- are without a single mental hospital.

Demographic disparities are also wide – and growing.  A 2015 study among 1,000 hospitalized mental health patients found that mental illness and depression rates were much higher among the nation’s poor.  Elderly Indians are especially subject to depression and depression stigma, as are women, especially pregnant women and those suffering from HIV/AIDS.  Some scholars believe female depression rates – and their comparatively high suicide rates – are linked to domestic violence, conflict with relationship partners, and confining social roles.                                          

Some notable bright spots exist in India's approach to depression and mental illness in specific locales and among some social groups.  Sikhs in the northern Punjabi region have long viewed depression as a “natural” part of daily life and prescribe meditation, yoga and other practices to help relieve it.  Muslim Sufis have also approached depression with a greater spirit of acceptance than other groups, analysts say.

And there have been sporadic experiments in mental health outreach led by non-governmental organizations and specially-trained “lay counselors” that have demonstrated what committed professionals can achieve, with sufficient resources, even in the most forbidding of environments. 

But the number of mental health clinicians in India continues to lag far behind most of the world’s nations, including other countries in the developing world.   For example, the median number of psychiatrists in India is only 0.2 per 100,000 population compared to a global median of 1.2 per 100,000 population.

The median figures for psychologists, social workers and nurses working in mental health in India are almost as severe, according to figures compiled by the World health Organization (WHO).

While the national government, egged on by the WHO, continues to debate new grassroots policy initiatives, depression sufferers have begun receiving support from an unlikely source:  Bollywood.

Last October, after several of the nation's top film actors went public with their struggles against depression, a coalition of health advocacy groups, including two of India’s leading psychiatric associations, joined with them to launch the country’s first nationwide mental health awareness campaign. 

The Bollywood initiative has spawned a separate campaign by Indian college students and their counterparts at American universities to raise depression awareness among adolescents and youth.  Photographs of students holding placards with depression awareness messages are disseminated through Instagram, Twitter and other social media sites.

Many scholars believe it’s long overdue that India embraced social marketing techniques of the kind that have proven successful in the West in reducing stigma toward HIV/AIDS and other taboo illnesses, including mental disorders.

But time is running out.  Depression-related suicides are skyrocketing in rural areas, with the highest rates recorded among younger Indians who often lack the family and community supports their parents had.  Without an extraordinary social intervention, coupled with institutional reform experts fear that India’s debilitating depression syndrome could get even worse in the years ahead.

Sexual Abuse in Peacekeeping: A Not So Simple Answer

37-Year-Old Rape Victim, Mali, IDPS Bamako, Photo by Voice Nature World Plus

CENTRAL AFRICA - Since late March, the United Nations (UN) has come under fire on allegations that peacekeepers committed acts of sexual violence against civilian populations. The advocacy group, AIDS-free-world, made several leaked documents public in March of 2016 which implicated French soldiers and UN peacekeepers in acts of sexual abuse against the populations they were sent to protect. A large portion of these claims come from the Central African Republic, where French soldiers were deployed to help quell internal violence that began in 2013. The first allegations pre-date the establishment of the UN sanctioned peacekeeping mission, known as the Multidimensional Integrated Stabilization Mission in the Central African Republic (MINUSCA), which was authorized by the UN Security Council in April of 2014. Most of these were directed against French military personnel who were assisting African Union regional stabilization forces. Accusations of sexual abuse against peacekeepers from France, Gabon and Burundi were, however, reported after the establishment of MINUSCA and implicated the UN and its administration. Though many of these accusations are still under investigation, this information highlights the structural flaws within the UN that would allow such heinous acts to happen in the first place.

The current reports of sexual abuse are not the first the international organization has had to address. Sexual abuse on peacekeeping missions has been an ongoing problem within the UN system dating back to stabilization efforts in Cambodia during 1992. Most subsequent missions have also had at least some reports of misconduct, rape or abuse. With few exceptions, most accused perpetrators receive little to no punishment. This is because the UN itself, being an international organization, lacks any sort of power to legally prosecute individuals. Prosecution of criminal acts must be done by individual countries, and peacekeepers on a mission cannot be prosecuted by the host country in which they serve due to diplomatic immunity. Peacekeepers can only be prosecuted by their home country from which they originate. Most troop contributing countries for peacekeeping operations have, however, been reluctant to investigate and prosecute accused soldiers.

This leaves two questions regarding the widespread misconduct and sexual abuse. First, why has the UN been ineffective in addressing the structural challenges that allow such acts to manifest? Second, why are troop contributing countries reluctant to punish their own soldiers, especially in instances where misconduct is clear? The answers to these questions can come from current UN officials themselves. Parfait Onanga-Anyanga, UN Special Representative to the Central African Republic, said in an interview with Foreign Policy Magazine that “countries aren’t exactly queuing to contribute troops to peacekeeping missions.” This means that any measures that the UN might put forth, such as expelling contingents of troops with multiple allegations, would cause a backlash from those who provide troops and cut off a much needed resource. Thus politics often comes into play when addressing these types of allegations at the New York Headquarters.

In terms of holding soldiers accountable in their home country, we often see a lack of political will and capacity. Less than five percent of allegations end up with the home country of the soldiers legally prosecuting them. There has been a long held observation that those countries that do contribute soldiers often prioritize domestic legal matters as opposed to those that happen in a different country. Likewise, most troop contributing countries are unwilling to admit any wrong-doing or are unable pursue trial because the evidence collected by the UN does not meet national standards needed to prosecute. Thus, we are left with a situation where soldiers know they practically have immunity in certain cases of rape and other human rights abuses. Lewis Mudge of Human Rights Watch himself said: “They know very well that, legally, the hands of national authorities and the United Nations are tied.”

We are left with a sensitive political situation that may threaten the efficacy of current and future peacekeeping operations. While certain solutions, such as the suggestion to collect DNA from all soldiers for paternity testing might have some impact, the international community is still faced with the lack of political will, mostly on the part of troop contributing countries. Pressing or coercing such countries to prosecute their soldiers might backfire, and peacekeeping missions could end up understaffed. Again, this result could actually do more harm than good and might potentially destabilize the country in which justice is sought. The international community might be better served to address these problems by better connecting troop contributing countries to potential solutions. One such example is Hervé Ladsous’s proposal for a specialized military court in countries hosting peacekeeping operations. It was not said who should staff these theoretical courts, but perhaps allocating spots for those who contribute the most soldiers to the host country might create political will to hold peacekeepers who commit heinous acts of abuse accountable.

Contributing Journalist: @AdamWolf
LinkedIn: Adam Wolf

Obesity in China: A Plague of Affluence

CHINA - There is a big problem - one which has only gotten bigger in recent years. For the first time, researchers have confirmed that China is facing an ever-growing problem with obesity, an epidemic that has typically only plagued Western nations such as the United States. According to reports, China which previously ranked second among countries with rising rates of obesity finds itself in the unenviable position of surpassing the US in terms of percentage of obese citizens. “A new Gallup survey published on Friday shows that the obesity rate among adults surged in 2015 to a new high of 28 percent, or a 2.5 percentage point increase since 2008. That means the ranks of dangerously overweight Americans increased by 6.1 million adults over that seven-year period.” (Source: The Fiscal Times)

Lu Zhihao, 4, Foshan, Guangdong province March 28, 2011, Photo: REUTERS/Joe Tan

In many countries, especially those with emerging economies, obesity is associated with economic prosperity. For instance, in Mauritania, a practice called ‘gavage,’ the force feeding of girls to make them fat, is still practiced despite the obvious health risks. This practice is a consequence of societal norms of beauty which arose from the association of weight with affluence.  In this North African country where famine and starvation historically resulted in women being vastly underweight, being overweight signified the converse. Thus, obesity became alluring despite the grave health risks associated with it. However, in the affluent nation such as the U.S., obesity is the result of a complex confluence of factors, including stress, lack of exercise, smoking cigarettes, eating processed or genetically modified foods, or other known ‘fat’ culprits such as high fructose corn syrup.

Those less in tune would find the trend of obesity on the rise in China incomprehensible. From a Western perspective, a country with nearly 1.4 billion citizens is certainly unable to adequately support, much less provide enough food to feed these many people. Thus, it is a conundrum how the plague of obesity has beset a nation in which many of the country's oldest residents vividly recall a time in which the opposite was true. It was during the brutal era of the great famines of China. This tragic part of China’s history is rarely discussed, nor do many young and modern citizens recall the horrendous circumstances in which 45 million people died. Following the Communist Party’s take over in 1949, a deadly combination of natural disasters and ill-conceived government policies resulted in farms being forcibly taken or farmers being ordered to produce food well beyond the capacity of their lands. These farmers were not allowed to consume the food they produced, and if they protested against this mistreatment they were maimed, tortured, or killed.

Shockingly, within less than 70 years, China has managed to go from one extreme to another. It has transformed itself from a nation torn apart by a cultural and political revolution, to one which churns out an astronomical number of exports to the tune of “US$2.282 trillion in 2015.” The top 10 products which the U.S. and other nations purchase from China include, “Electronic equipment, Machines, engines, pumps, Furniture, lighting, signs, Knit or crochet clothing, Clothing, Medical, technical equipment, Plastics, Vehicles, Iron or steel products, and Footwear.” (Source: World’s Top Exports)  The affluence which China has experienced as a result of becoming one of the world’s leading manufacturer is reflected in improved economic stability and social ascendancy which many of its citizens now realize. 

With more discretionary income and leisure time, Chinese citizens are now experiencing a trend which was once unimaginable.  Unprecedented increases in the rate of obesity among its citizenry, particularly with the country's youth, and predominantly in its male population. Boys seem to be at highest risk for this endemic predisposition towards obesity. Recent findings have shown that as of 2014, a staggering 17% of boys and 9% of girls under the age of 19 were reported as being obese, up from just 1% of each when the studies were first conducted in 1985. In addition to the issue of obesity, there has also been an increase in corollary non-communicative illnesses.

• Juvenile Diabetes: According to a 6 April 2016, World Health Organization news release, “Unhealthy lifestyles are also putting China’s children at risk of developing diabetes: more than 4 in 5 adolescents 11-17 years do not get enough physical activity, and rates of overweight and obesity in children are increasing rapidly: from less than 3% in 1985 to around 1 in 10 in girls and 1 in 5 boys in 2010.”

• Adult Diabetes: The estimated prevalence of diabetes among a representative sample of Chinese adults was 11.6% and the prevalence of prediabetes was 50.1%. Projections based on sample weighting suggest this may represent up to 113.9 million Chinese adults with diabetes and 493.4 million with prediabetes. These findings indicate the importance of diabetes as a public health problem in China. (Source: ResearchGate, Prevalence and Control of Diabetes in Chinese Adults)

• Hypertension: In 2010, the prevalence of hypertension increased to 33.6% (35.3% in men and 32.0% in women) or 335.8 million Chinese adults based on the China Noncommunicable Disease Surveillance 2010, which was conducted in a nationally representative sample of 98 658 Chinese adults aged at least 18. (Source: Journal of Hypertension in China)

• Heart Disease and Stroke: The European Society of Cardiology presented to the 27th Great Wall International Congress of Cardiology Asia Pacific Heart Congress the fact that “40%, the mortality rate due to cardiovascular disease (CVD) in China is amongst the highest in the world¹ and has been rightly described as an epidemic. Its population faces a catalogue of CVD risk factor statistics that expose high levels of obesity, diabetes, cholesterol and blood pressure, and a smoking habit within males that is proving stubborn to address. (Source: European Society of Cardiology)

These many obesity-related factors are causing growing concern among Chinese government officials, who worry that it will put increased burden on China's healthcare system which currently lacks the elasticity to handle non-communicable diseases such as obesity which is largely preventable.  In China, as in the U.S., the drastic changes in weight gain among its citizenry is also linked to a growing popularity for high-sodium and fatty foods (such as fast food), which are both inexpensive and readily available. Additionally, China struggles with the cultural acceptance of cigarette smoking, which is another deadly factor that contributes to a host of long-term illnesses. In the U.S. smoking has been advertised as deleterious to one’s health, and many people, especially those who are health conscious, find the practice anathema.

However, smoking isn’t viewed with the same negative connotations outside of the U.S. In Europe, Africa, and the Middle East smoking is a integral component of social interactions, and the same can be said of China. Smoking among the younger generation is on the increase, and this coupled with decreased levels of physical activity are contributing factors to the rise of obesity.  Their decisions to relocate to major cities to pursue high paying job and educational opportunities are the very things which now disadvantaged them. They have replaced low wages and physical labor, with jobs where they work long hours in cramped office spaces, under stressful conditions, which they relieve by smoking or drinking alcohol, neither of which are little more than palliatives.

Officials in both countries are now racing against the clock to aggressively combat a crisis that is both socially and economically complex. One which will take the combined efforts of the citizens, scientists, food producers, and the health care system to develop a long-term strategy for tackling this problem. Steps have been taken by both nations to raise public awareness of the problem through advertisement, anti-smoking campaigns, instructing doctors to provide BMI information to patients in addition to their weight, as well as promoting programs designed to help people develop better eating and exercise habits. Additionally, the creation of educational programs throughout China, such as those sponsored by the Joint US-China Collaboration on Clean Energy (Source: JUCCCE), have achieved some success in teaching kids the importance of eating healthy.

Here in the U.S. similar programs have been implemented with the goal of encouraging Americans to make positive healthy lifestyle changes, however, it is as difficult for the government of the U.S. as it is for China to convince people to adjust social norms. For example, as Americans have become more obese, manufacturers make clothes in larger sizes to accommodate increased girths. Many of these clothes are made in China which produces them in accordance with consumer demand. Though this correlation is simplistic, one thing is for certain - China and the U.S. would greatly benefit from moving beyond a relationship governed solely by economic expediency to one which protects the health of the two most important resources of their economic ecosystem - laborers and consumers.

The epidemic of obesity which plagues both nations has far reaching repercussions both economically and societally. The levels of economic prosperity, the ease of modern living, plentiful goods and services, and access to functional and unburdened health systems, are all things which are threatened should each nation fail to stop this scourge. It is imperative that we remember in meeting this daunting challenge that real change is only accomplished through implementing strategies which promise long-term success.

Waging a successful ‘battle of the bulge’ will be a slow and arduous undertaking, one which could best be viewed in terms of dieting.  One can lose a lot of weight quickly and just as easily gain it back and then some, or one can implement a regime that takes longer and requires more discipline, but ultimately leads to a gradual return to optimal health. Thus, it is important for us to remain cognizant of the pitfalls of focusing all of our effort on a single aspect of this epidemic to the exclusion of all others, because to do so would be akin to winning the battle, but losing the war.

Contributing Journalist: @JonEizyk
LinkedIn: Jon Eizyk

The Resurgence and Spread of Child Marriage in Modern Asia

ASIA - The phenomena of child marriage, the taking or marrying off a girl at an age that is well below what modern society deems socially acceptable, sounds like a practice that belongs in a history book rather than in the twenty-first century. However, though hard to believe, the practice not only exists in these modern times, but also that it is thriving. In fact, emerging evidence indicates that the marrying off these child brides is becoming more widespread in many parts of the world. Whether due to socioeconomic pressures or to cultural preferences, the world is witnessing a steady resurgence of the practice of child marriages in places such as Africa, the Middle East, and now more prevalent in Asia.

Asia - India Gujarat, Photo by RURO

One country in particular which has experienced an increase in the number of child marriages is poverty-stricken Bangladesh. This country has been identified in a report by the International Center for Research of Women (ICRW) as number 3 on a list of the top 20 countries with the highest incidents of child brides. This is because nearly 68.7% of all Bangladeshi girls under the age of 18 are married off to older men. The drastic rise in the practice has become so prevalent in recent years that researchers describe it as a full-blown “epidemic”. According to current estimates, nearly one third of girls in the country are married off before they reach the age of 15. This figure is staggering, and girls who are married off at such a young age often face high rates of domestic abuse, increased risks in childbirth, and the prospect of life-long poverty. Unfortunately, in many rural areas of countries with emerging economies young women are often considered a burden. It is these societal standards which is sanctioned and even encouraged that families use to justify pressing their young daughters into marriage to older men.

Concomitant factors such as poverty, lack of education, and the destabilization of the economy from natural disasters like typhoons, which are known for causing widespread destruction in Southeast Asian countries, also play a role in propagating acceptance of this practice. Parents often resort to marrying off their daughters in order to save money to pay for the education of their sons who are seen as better able to support the family once they reach the age of maturity. Bangladesh is not the only country to face the ever increasing problem of child marriage. Afghanistan is another country in the region known to the world as a region of innumerable human rights abuses.

Many of these abuses are due to complex forces, such as the oppressive patriarchal culture, the violent influence of the Taliban, and the subjugation of women who are often publicly executed. Given these influences the marriage of young girls to older men seems a foregone conclusion. Here, and most notably in the country's north-eastern province of Badakhshan, women experience the most extreme lack of independence. In this nation plagued by chronic food shortages, brought about by decades-long conflicts in the region, girls are being sold and traded off at an alarming rate. The money that the families get for the sale of their daughters enable them to purchase food, livestock, or other necessities.

The situation is particularly bleak in Badakhshan which according to a report by the United Nations (U.N.). Young girls experience some of the highest rats of abuses and death at the hands of their husbands who are often decades their senior. These men repeated and violently rape their young brides, who once they become pregnant do not allow them to access prenatal care with the intention of isolating these girls. According to the ICRW young girls are most afflicted by the following.

• Premature Pregnancy: Child brides almost always bear children before they are physically - or emotionally - ready.

• Maternal Mortality: Girls younger than 15 are five times more likely to die during child birth or pregnancy than older women. Pregnancy-related deaths are the leading cause of mortality for girls aged 15 to 19 worldwide.

• Infant Mortality: Mortality rates for babies born to mothers under age 20 are almost 75% higher than for children born to older mothers. The children that survive are more likely to be premature, have a low birth weight, and are more at risk for contracting HIV/AIDS.

• Health Problems: Premature childbirth can lead to a variety of health problems for mothers, including fistula, a debilitating condition that causes chronic incontinence. Girls with fistula are often abandoned by their husbands and ostracized by society. There are approximately 2 million girls living with fistula, and 100,000 new cases every year.

• HIV/AIDS: Married girls may be more likely to contract sexually transmitted disease, including HIV/AIDS, than unmarried girls. Young girls are more physically susceptible to STD's, have less access to reproductive education and health services and are often powerless to demand the use of contraception. (Source: ICRW)

Girls under the age of 15 are most at risk to this tragic outcome because of their physical immaturity. These young girls also face the specter of contracting HIV from infected husbands. Experts are in agreement that the best way to counter this growing trend is by working to alleviate the country's desperately crippled economy.

While the prevalence of the practice is closely associated with poverty and destruction, this is not true in every country. China, for example, has experienced steady economic growth in the past several decades. Despite its overall financial stability, the country is also experiencing a rise in the number of child marriages. The increase in this practice is largely driven by political factors such as the long-standing one-child policy. This policy, first enacted in the late 1970's to alleviate China's issue with unchecked population growth, has in fact resulted in a problematic and wide scale gender imbalance. Thus, the country now has approximately 33 million more men than women in the country. Despite this, the cultural bias toward boys remains, particularly in the rural areas where parents routinely force their daughters to marry young so that they aren't a financial burden to the family.

Additionally, China’s gender gap has led to a dramatic rise in the rates of human trafficking. Young girls are being sold or kidnapped then smuggled out of the country to neighboring Vietnam. Those who aren't 'lucky' enough to be sold for purposes of marriage, face the horrifying specter of sex slavery. These girls, as young as 13-years-old, are sometimes sold by their parents who have been solicited by the smugglers to sell their daughters who are subsequently drugged as a means of controlling them while they are removed from their homes. The girls are then marketed to potential buyers and sold for the deplorable price of $3,000 or less.

Sadly, with the continued growth of China, and the growing need for increased human capital to produce low costs products which the West is increasing dependent upon. This has resulted in the rise of another type of enslavement of girls and women in the manufacturing sectors found in cities like Shanghai, Beijing, Tianjin, Guangzhou, and Shenzhen. Often chained to their work stations for up to 16 hours a day, they are not even allowed bathroom breaks in order to maximize high production at low costs.

The documentary 'Santa's Workshop' provides a chilling look into the abuse of the laborers in many Chinese factories. The majority of these workers are children and women. Thus, it is unfortunate and disheartening to realize that for a female to make it to adulthood having escape sexual enslavement or child marriage, is not a guarantee of avoiding future exploitation. There are many organizations dedicated to advocating for the rights of child brides, women, and forced labor, but this abuse, irrespective of the fact that it is occurring in locations quite foreign to us, should in no way inure us to the suffering these girls and women face. Nor to our obligation to remain engaged in trying to make a difference, even if this difference is as simple as sharing these statistics and stories with friends, family, and associates. In so doing we may become more conscious and conscientious, two things which help to complete us as human beings.

Contributing Journalist: @JonEizyk
LinkedIn: Jon Eizyk

MERS Outbreak in South Korea Hits Record High, 3 New Cases, 2 More Die

who says south koreas mers outbreak large and complex, photo courtesy of ritika patel

SOUTH KOREA - An outbreak of MERS (Middle East Respiratory Syndrome) in South Korea has led to 138 confirmed cases and 14 deaths, according to the World Health Organization (WHO). Just 17 hours ago news outlets reported 3 new cases with 2 more deaths.

A single traveler brought the disease to South Korea last month and since then it has spread exponentially overwhelming the healthcare system. Contributing factors include overcrowded emergency rooms, the sick and worried returning numerous times to hospitals, additional delays as medical professionals seek second opinions, coupled with an ill-trained medical community unfamiliar with the disease.

Currently, all cases have occurred have been traced back to a hospital where patient zero contracted the disease. Many citizens have started wearing surgical masks to protect themselves from infection. However, the larger community isn't taking any chances either and have subsequently closed more than 2,900 schools and quarantined 3,680 people. (Source: BBC).

An early setback has been a lack of government transparency. President Park Geun-hye has been accused of not being pro-active in his response and of withholding information about who has been infected. The mayor of Seoul, Park Won-soon, said that a now quarantined doctor attended a gathering of more than 1,500 people the day before he was diagnosed with the disease. (Source: New York Times)

However, the WHO has issued a statement that human-to-human transmission of the virus is only possible through very close contact. As long as reasonable measures are taken there is no need for panic. Currently, the WHO is working with scientists to better understand the disease, develop treatment strategies, and determine the best way to respond to the outbreak.

Although the disease is not well understood and has no cure, the spread of it has thus far been predictable. Most contagious diseases are opportunistic and are most easily incubated and spread in hospitals and other healthcare facilities due to close proximity of the infected. Although doctors and scientists are struggling to find a way to treat the infected, predictive and statistical models have proved invaluable in anticipating what part of the population is at greatest risks and thus help communities implement proactive precautions.

The disease originated in Saudi Arabia in 2012, and according to the Center for Disease Control (CDC) there is currently no vaccine to prevent MERS-CoV infection, but the South Korea outbreak is the largest outbreak outside of the Middle East. “MERS-CoV is thought to spread from an infected person to others through respiratory secretions, such as coughing. In other countries, the virus has spread from person to person through close contact, such as caring for or living with an infected person. (Source: CDC)

Contributing Journalist: @SJJakubowski
Facebook: Sarah Joanne Jakubowski

The Dirty Little Secret of Abuse of Old People

grandma got screwed, photo by ashley hill3

On Monday, June 15, nations around the world commemorated World Elder Abuse Awareness Day (WEEAD). Elder Abuse continues to be a significant issue in many societies as reports of mistreatment against older people is increasing.

The thought of harming an older person suggests severe dysfunction in the perpetrator, and with the plethora of local and international cases of abuse receiving public attention, governments are starting to create policies designed to institute safeguards against this type of abuse.

However, elder abuse cases remain, and with global recognition of the gravity and ubiquity of this crime, the healthcare establishment, in particular geriatric and psychology professionals have redoubled their efforts to analyze the root cause of this type of abuse while simultaneously working with law enforcement agencies and legislators to develop strategies to protect the rights of older people.

According to HelpAge International, an organization that “helps older people demand their rights, challenge discrimination and overcome poverty,” older people’s right to be free from violence is not protected under international law. This problem is especially prevalent in East Africa where much of HelpAge's work on elder abuse is focused on, and there are a significant number of cases.

One case involves a 67-year-old woman from Kenya who was abused by a relative, an attack that resulted in the death of her 90-year-old mother. The details of the attack are very disturbing as the woman narrated the incident:

“The man slashed me on my head and I immediately fainted. I still don't know what the reason was for that kind of brutality. I am very scared. I don't sleep well. When I hear any noise I am alarmed. In my dreams I see that person following me."

The unfortunate part is that her attacker was arrested but later released on bail. While the facts about bail are unknown, this calls into question the laws of protection in the region. Relatives are known to be one of the main perpetrators of elder abuse especially as the abuse by caregivers is a worldwide and complex issue. Stresses, caregiver burden, criminal history and substance abuse among other issues are risk factors that can lead to elder mistreatment, which in turn leads to poor health. Governments can improve their law enforcement agencies as well as the quality of life of caregivers and older people.

It is encouraging to know that governments will attend the Open-ended Working Group on Aging this July and support a United Nations (UN) convention to protect older people's rights. The purpose of the working group is to strengthen the protection of older people’s human rights around the world. Hopefully, this objective will achieve great strides as inadequate research into elder abuse makes the problem difficult to tackle. This is because elder abuse is largely a hidden problem.

According to Bridget Sleap, Senior Rights Policy Advisor at HelpAge International, “elder abuse is the least studied of the different types of violence in low-income countries as stated by the Global Status Report on Violence Prevention 2014”. This report, produced by the World Health Organization (WHO) and UN agencies, stated that of the 133 countries studied, two thirds do not have adult protective services to support older people.

Governments can do more to stop elder abuse and protect the rights of older people. It is vital that societies raise awareness, challenge and recognize that elder abuse and discrimination against older people are issues that deserve attention.

Contributing Journalist:  @SophieSokolo

Live Like You Were Dying | Tim McGraw

Tim McGraw's song 'Live Like You Were Dying,' serves as yet another reminder that each of us is allotted a certain amount of time here on earth. None of us knows the date or hour that we will be called home, which is why we should live as if we were dying.

Old Man with Pocket Watch, Photo by Adina Voicu

We often pity people with terminal illnesses, but in truth we all have a terminal illness because living is a terminal illness. We all are born and will die, it is just that some are more acutely aware of their impending demise. How would you live if you knew you would die soon?

Wouldn't you take the time to touch other people's lives in a more positive manner? Would you hold back from cursing out a driver who cut you off? Perhaps they just received a report from their doctor that so preoccupied them that they didn't even notice.

Would you care so much about office politics, celebrity gossip, jealousy, or despair over worldly or other ephemeral concerns? This was a wake-up call for me, and a remembrance to not judge others nor ourselves, but to start from where we are to live and to love!

Editor-in-Chief: @AyannaNahmias
LinkedIn: Ayanna Nahmias

United States Leads in Stealing Africa's Doctors

Pediatric doctors at Donka Hospital in Conakry, Guinea

The United States is stealing the world’s doctors — and from the very places that need doctors the most. Dubbed the “international brain drain,” the United States leads the way in attracting international doctors, especially those from Africa.

The United States, with its high salaries, attracts more international doctors every year than Britain, Canada and Australia combined. However, for every 1000 people, Africa has only 2.3 health care workers, while the United States has almost 25. Doctors emigrating in droves from developing countries for “greener pastures” are making an already critical health worker shortage ever more dire.

But this brain drain is not new. In countries like Ghana, some 61% of doctors produced in the country between 1986 and 1994 had already left the country by 1999. The financial loss from emigration like this has been extremely detrimental. The loss from this period of emigration in Ghana alone is estimated at over 5.9 million dollars.

Foreign MDs

Not surprising, foreign medical doctors make up a substantial proportion of the doctors workforce in some of the most affluent countries in the world. More than 34% of doctors practicing in New Zealand were from overseas in 2000.  And according to a 2010 report in the Economie Internationale other developed countries have extremely high proportions of foreign doctors, including the United-Kingdom with 31%, the United-States with 26%, and Australia and Canada with more than 20%.

This is in part the result of initiatives like the 1994 U.S. legislation proposed to allow foreign doctors on student visas access to stay in the U.S. if they agreed to work in some of the poorest places in the United States. Since then, over 8,500 African doctors have left Africa and gained jobs at American hospitals that were in short supply.

A sneaky initiative. It looks great from the outside from its ability to give African medical students the chance to work in the U.S. for higher wages but it does nothing but continue to keep those living in “periphery” countries ever more dependent on “core” countries.

This is described by most scholars as the dependency theory — an economic model that became popular in the 1960s as a critic of the way the United States, along with many western countries, exploits those in the “periphery” for their own gain.

Poor countries provide resources, in the form of raw materials, cheap labor, and a market to those countries in the core. While wealthy countries in the core perpetuate their dependence in every way possible — through control of the media, economic politics, banks and finance insinuations like the International Monetary Fund (IMF) and the World Bank, educational initiatives, cultural exploitation, and even sporting events like the World Cup.

Indeed, this exploitation is clearly exemplified by the emigration policies facilitating the exodus of medical doctors from Africa over the past decade. Of the 12 African countries producing the most medical graduates, 8 have seen a 50% increase from 2002 - 2011 in all graduates appearing in the U.S. physician workforce. Cameroon, Sudan, and Ethiopia each had over a 100% increase since 2002.

These policies in place, that are sucking up some of Africa’s greatest doctors, are just further methods of perpetuating the poorest country’s dependence on the wealthiest.

It becomes clear then that while the United States benefits, Africa only appears to benefit. The U.S. gains excess doctors, while Africa looses the few it barely has.

While the United Sates grows its ratio of 2.45 doctors for every 1000 people, countries like Mozambique see a decrease in the already alarming rate of .04 doctors for every 1000 people.

Health professionals around the world agree that human resources is the most key component to solving problems in global health. But it is often one of the most neglected components, with much more emphasis focused on managing disease outbreaks and not the people actually preventing diseases.

Oliver Bakewel, of the International Migration Institute, agrees with this logic in writing that “development practice has commonly seen a reduction in migration as either an (implicit or explicit) aim of intervention or an indicator of a programme’s success" in an 2007 report.

However some scholars at the World Bank disagree with the notion that migration is inversely proportional to success in African development. A 2014 article in The Atlantic headlined "Why the brain drain can actually benefit African countries," outlined their findings that suggest "one additional migrant creates about 2,100 dollars a year in additional exports for his/her country of origin.”

However, this argument does not look closely enough at the brain drain for specifically medical doctors.

The brain drain intersects more than just the medial field — it cross cuts every highly skilled profession. But the effects of the brain drain on the status of health care in Africa is much more harmful than that of the brain drain of — for example — African professors. The average increase of 2,100 dollars in exports will do nothing to solve the critical and immediate lack of medical doctors in almost every African country.

The time is here more than ever for the international community to play a more proactive role in addressing the international medical brain drain. Affluent countries like the United States should be held accountable for exploiting Africa for its doctors, while international policies should be put in place to help African governments increase wages for health workers and retain their much needed doctors.

Contributing Editor: @AustinBryan
LinkedIn: Austin Drake Bryan

To Spite Obama Health Insurance Companies and Pharmaceuticals Choose to Kill Citizens

WASHINGTON, D.C. – At midnight on December 31st the world retired 2014 to make way for 2015. For many it marked a night of festivities, parties, and insouciance. For others, like me, it was the day which marked the resetting of health insurance premiums, deductibles, and prescription coverages which would inevitably result in increased costs.

In the days prior, I frantically traveled to doctor's offices and pharmacies to get all of our prescriptions refilled before January 1st. In one instance, my son's pediatrician wouldn't authorize refills for his asthma medications without an appointment. Thankfully we were able to be seen by him on an emergency basis on the morning of December 31st. It was with grateful relief that he wrote all of the prescriptions needed and that I was able to get them filled before the pharmacy closed.

Unfortunately the insurance company would not authorize the refill of one of my son's most expensive medications until after the new year. One might think, with the figures I am about to report, that the medications to which I am referring are 'Brand Named' versus 'Generic.' However, this is not the case. In 2014, before I met my plan deductible, the generic version of one of his medications was $250 for a 30-day supply, while the cost for the brand name was $491. After I met my annual deductible, the costs of this medicine was reduced significantly to $50 for a 30-day supply of the generic which was a great costs savings for our household.

This reduction from my perspective directly correlated with the enactment of The Affordable Care Act (ACA) which was passed in 2010. The ACA, also known as 'Obamacare' made health coverage mandatory and also provided the means for the uninsured to purchase affordable insurance through exchanges which would help regulate the market prices. For me it was a blessing because it reduced my premiums and enabled me to purchase 'individual/self-pay' insurance without having to pay exorbitant premium fees because of 'preexisting' condition as defined by insurance companies such as Asthma, Cancer, Heart Disease, etc.

The cost to maintain this insurance is expensive, but compared to what I paid for COBRA Continuation Health Coverage in 2012, the 33 percent reduction in premium costs was a welcomed relief. I went from paying $1,660 per month to just over $550 per month for better coverage. The only catch was that my prescription costs increased significantly and thus the net/net was actually more like a 20 percent reduction in costs once this was factored in. However, providing the best healthcare for my son was non-negotiable and often meant that bills remain unpaid, and in some instances I didn't refill my medication or go to see the doctor when I needed.

Then, on November 14, 2014, The New York Times reported that "The Obama administration on Friday unveiled data showing that many Americans with health insurance bought under the Affordable Care Act could face substantial price increases next year — in some cases as much as 20 percent — unless they switch plans." Proponents of ACA asserted that this demonstrated that the legislation was working while Republican opponents pointed to these increases as proof that it is not.

As a parent and someone who is directly impacted by the ACA, I can categorically state that without it neither my son nor I would have insurance coverage. I couldn't have afforded to pay $3,000 a month in premiums and prescription costs because of 'preexisting conditions.' From my perspective the 2015 rate increases coupled with inflation in costs for generic medicines is a ploy devised by the insurance companies and pharmaceuticals to incite an already cash strapped American consumer to work against their own best interest. The premise that healthcare for average Americans was better prior to the passing of the ACA is ludicrous.

Me and millions of other Americans remember the heartache and pain of having to watch one's child suffer because an insurance company informed you that your child's healthcare costs would no longer be covered because of an "annual or lifetime" dollar limit. Other parents were faced with the necessity of mortgaging their homes, working several jobs, and making other sacrifices so that they could pay for expensive cancer or heart disease medicines. We all thought these days were behind us, but it turns out that 'we' have become collateral damage in what has been advertised as a war between the Republicans and President Obama.

In reality it is about greed. Providing access to affordable healthcare and prescriptions is not a luxury, it is a need. Parents like me are not 'lazy ne'er-do-wells' seeking to sponge off of the government. We are hard-working individuals who make difficult choices so that our children may live and grow up to be healthy contributors to society. The ACA provided us with hope for such a future, but insurance companies and pharmaceuticals have found a new way to game the system.

Anecdotally, it appears that since insurance companies are forced to insure people who may cost them money, they will make insurance available but the quality of that service is dependent on one's ability to pay for it. Thus, the better the insurance the greater the costs. However, this doesn't help them to recoup their losses (i.e. executives can't buy a new yacht, jet, exotic car, or mansion), so they turn to the pharmaceutical companies to further pressure consumers into lobbying for the dissolution of Obamacare.

When the media first began to report that generic medicine prices would increase substantially I worried but not much. Then, The Chicago Tribune reported on the rising cost of generic drug prices, and I became concerned but couldn't imagine an increase greater than a few percentage points. Then on January 3rd when I asked the pharmacists to fill the one prescription remaining from 2014, I was shocked to learn that the price increased from $50 for a 30-day supply to $391 for a 30-day supply. That was for GENERIC not brand name! I contacted my insurance company and was given a clearly ridiculous story that the cost of manufacturing the drug had increased.

Asthma can be a life-threatening condition and not taking his medication for a few days though not recommended, is not going to kill him. The same cannot be said of parents who have children with a terminal illness like cancer, in which treatment consists of multiple medications and a single prescription can cost upwards of $1,500 per month. Thus, the title of this article seeks not only to grab your attention, but also to help people understand that by taking away our ability to purchase life-saving medicine so that a pharmaceutical company can increase it's profit margin is immoral, reprehensible, and absolutely inhuman; and like it or not the choice to drastically increase the cost of generic drugs is tantamount to 'killing citizens.'

Follow Nahmias Cipher Report on Twitter Twitter: @nahmias_report Editor-in-Chief: @ayannanahmias

Related articles

• Motivation For Republican Obstruction And Lies About Obamacare (benniewiley.com)

• Obamacare's first year, in one tweet (vox.com)

• Obamacare forces health care companies to experiment, evolve (bizjournals.com)

• In 2015, Consumer Will Be King In Healthcare (techcrunch.com)

Human Trials to Test Ebola Vaccine Begin

WASHINGTON, D.C. - The National Institute of Health (NIH) has received approval from the U.S. Food and Drug Administration (FDA) to begin human testing of a new Ebola vaccine. This will be welcome news for the millions of Americans who now face the very real possibility of encountering someone with the disease or contracting it themselves.

Currently, 357 people are being monitored in New York for possible exposure to the deadly virus, and Texas which was the epicenter for the first mortality from Ebola in the U.S. has been declared Ebola free.

According to the Los Angeles Times, "Nine people have been treated in the U.S. for Ebola, including Thomas Eric Duncan, a Liberian who died last month. One doctor, Craig Spencer, remains hospitalized in stable condition in New York."

The vaccine is undergoing a "human safety trial," which means it will be tested on "healthy human subjects to evaluate the immune response, identify any side effects and determine the appropriate dosage." (Source: NewLink Genetics)

The vaccine was developed by the pharmaceutical company Glaxosmithkline and the National Institute of Allergy and Infectious Diseases (NIAID), and is one of several being developed worldwide.

Earlier in the outbreak, the drug Zmapp was administered to seven aid workers. Five of the workers survived, though it's unclear how large a role the drug played in their survival. Due to the emergency status of the outbreak, treatments are not being monitored and tested as thoroughly as they would be if there was more time. Nevertheless, the U.S. Department of Health and Human Services has granted an $24.9 million 18-month contract with the manufacturer of Zmapp to expedite the development process.

VSV-EBOV is another experimental vaccine for the Ebola filovirus, developed by scientists at the Canadian National Microbiology Laboratory and is currently being tested in clinical trials in the U.S. at the Walter Reed Army Institute of Research in Silver Spring, Md. This vaccination purportedly does not induce any fever or other symptoms of illness. There is also evidence that this type of vaccine which can be administered orally or intranassaly as nose-drops may have potential as a treatment for those already infected. (Source: Wikipedia)

In Canada, permission has been granted for the vaccine VSV EBOV to be sent to Africa, but problems such as refrigeration during transport and storage have come up. Many of the villages that are most in need are in remote areas with bad roads, infrequent electricity, and and treatment is further hindered by the citizens mistrust of new technologies. It's clear that while developing a vaccine is an enormous step forward in the Ebola fight, there are still many political and practical obstacles to overcome.

Follow Sarah on Twitter Twitter: @nahmias_report Contributing Journalist: @SJJakubowski

Related articles

• Medical Research Institute Contributes to Vaccine Development Effort (defense.gov)

• Ebola Clinical Trials: Big Name Players In The Ebola Race (biospace.com)

• Ebola vaccine abandoned in 2008 after showing promise in trials (washingtontimes.com)

Beloved Actor Robin Williams, 63, Kills Himself

Robin Williams (1951 - 2014), Photo by Jay Paul

TIBURON, California -- Robin Williams, stand-up comedian and star of movies such as Mrs. Doubtfire and Good Will Hunting was declared dead at his residence on August 11 at 12:02 pm. Fans were shocked to learn that the man who caused so much laughter was suspected of taking his own life.

However, it's true that while Williams shared many laughs on-screen, his off-screen life was often marred by difficulties. In his 20s he was addicted to Cocaine, though he quit after the birth of his son and the death of his longtime friend and cocaine addict John Belushi died.

He also admitted to being an alcoholic and recovered to enjoy 20 years of sobriety -- until he succumbed to the disease once more in 2003. After three years of alcohol abuse and depression, a family intervention lead him to seek help. It's believed that the drinking was a main factor that lead to the divorce of his second wife. Throughout the remainder of his life, he would actively and sometimes with limited success continue to fight his demons, attending AA meetings regularly and, in 2014, checking into an addiction treatment center.

Despite his personal shortcomings, Williams found ways to leave the world better than he found it. He participated in many charities and even created one (the Windfall Foundation). His generosity was aimed most at children, and he donated to charities such as Children's Promise, which is a fundraiser for children's hospitals and other children's aid organizations, Smile Train, which helps raise money to fix cleft palettes, St. Jude's Research Hospital and UNICEF. In addition, he also donated to the Red Cross to help after the 2010 Canterbury earthquake in New Zealand and he frequently performed in Iraq and Afghanistan for US troops. Overall, he donated to almost 40 charities throughout his lifetime, often using proceeds earned directly from his comedy shows to benefit children, animals, the environment and worldwide healthcare.

In almost all aspects of his life, be it charity work, private shortcomings or to cheer a grieving friend, Williams used laughter as a healing mechanism. It's speculated that he may have had ADD, which he worked to his advantage in his spontaneous and erratic style of comedy. He also once admitted that he was never naturally one of the "cool kids" in grade school and used his funny antics as a means to make friends and fit in. The late Christopher Reeve, lifelong friend and fellow actor, once recalled that after Reeve was rendered a quadriplegic from a horse riding accident, it was Williams who made him laugh again. In the end, depression overtook Williams, but throughout his life he was the cause of much joy.

In honor of his memory, remember his humor and his good spirit. Watch his movies and laugh, and cry. He was more than his own personal failings, more than his untimely and unprecedented death. He was Mrs. Doubtfire, and Patch Adams and Genie from Aladdin. He was a father, a husband, a philanthropist and a role model to many.

Laughter a Threat to Chastity? Yes, Declares Turkey's Deputy Prime Minister

ANKARA, Turkey -- Chastity has long been a source of contention and in fact has often been used as a justification for the domination of women throughout the centuries in various parts of the world. It is another means by which some men seek to control women’s sexuality and reproductive freedom.

Though many people think of the issue of controlling women and forcibly “preserving” their chastity as a phenomenon unique to countries with emerging economies where young girls are routinely subjected to Female Genital Mutilation (FMG), these practices have been imported to the U.K. and other E.U. nations with high immigrant populations.

However, the West is not without guilt as similar overt restrictions and unsanitary practices were routinely implemented in Europe during the 16th century when men made their wives wear ‘chastity’ belts to prevent sexual intercourse during their long absences at sea or war.

The history of women being controlled subtly and overtly is a never ending battle; however, this week the war for equality reached ridiculous lows when Turkey’s Deputy Prime Minister, Bülent Arınç, stated in a speech that “among other activities that women laughing in public somehow contributed to the moral turpitude of the nation.

During his 28 July 2014 speech which was given on Eid al-Fitr, the official end of the month-long Islamic celebration of Ramadan, “Arınç described his ideal of the chaste man or woman, saying they should both have a sense of shame and honor.” (Source: Hurriyet Daily News)

This atavistic attitude at once casts sexuality as “unclean,” but also blames women for defiling themselves, a specious argument often used to justify rape, while also claiming that these 'loose' women constantly lure otherwise chaste men into debauchery and sin. In his speech, Arınç outlined his ideas of morality saying:

“Chastity is so important. It is not only a name. It is an ornament for both women and men. [She] will have chasteness. Man will have it, too. He will not be a womanizer. He will be bound to his wife. He will love his children. [The woman] will know what is haram and not haram. She will not laugh in public. She will not be inviting in her attitudes and will protect her chasteness.”

These ideas are not Arınç’s alone, but are an outgrowth of the conservative tenor of the Justice and Development Party (AKP) of which he is a prominent member. The AKP has been in power since 2002, and in the intervening years has shepherded over a subtle but systematic erosion of women’s rights.

Unbeknownst to many in the West, “Turkey had a thriving women’s rights movement in the 1980s and 90s, but has recently experienced a back slide in progress. Violence against women has doubled over the past few years, only one third of women are employed, and the country rates almost dead last in gender equality in education, health, politics, and the economy.” (Source: Huffington Post)

Women’s rights are being eroded on all fronts from wage equality and reproductive rights in the United States, to FMG in Sub-Saharan Africa, to the 'One Child Policy' in China, to chastity requirements in restrictive Middle East nations. Though many in the West and East have greeted Arınç’s comments with derision and mockery, this is no laughing matter.

Follow Nahmias Cipher Report on Twitter Twitter: @nahmias_report Editor-in-Chief: @ayannanahmias

Related articles

• Women Defy Turkey's Deputy PM, Who Said Women Shouldn't Laugh In Public (wnyc.org)

• Turkish Women Think Politician Who Says Ladies Shouldn't Laugh In Public Is Hysterical (thewire.com)

• Women shouldn't laugh in public, says Turkey's deputy PM (theweek.co.uk)

• Turkey's Deputy Prime Minister Tells Women Not To Laugh In Public (thinkprogress.org)

International Volunteer Series: Two Amazing Young Men Serve in Gumbo, South Sudan

Olivia Elswick, Asia CorrespondentLast Modified: 02:38 a.m. DST, 23 July 2014

Michael Gotta, Gumbo, South Sudan Volunteer

GUMBO, South Sudan -- In this final installment of the International Volunteer Series, I invite you to get to know Michael Gotta and Patrick Sabol, friends from the Franciscan University of Steubenville, now living together in Gumbo, South Sudan after feeling called to a year of mission work.

Mike majored in Biology with a minor in Chemistry and would like to work as a science teacher after his year in South Sudan is finished.

Pat received his degree in Finance with a minor in Management, and will live in Philadelphia where he plans to work in finance and investment analysis.  Read on to hear what these two fun-loving, and jubilant men have to say about their time in Africa.

What is a day in the life-like of a volunteer in South Sudan?

‪Mike: Our main duties have been as teachers and administrators in the secondary school here as well as teaching classes to the Salesian seminarians, but we basically are the community Swiss army knives, always doing something else on the side like making PowerPoints, taking photos, preparing the church for mass, events, etc. and being involved with the youth.

Pat: A typical day here at Don Bosco Juba for a Salesian Lay Missioner begins at 6:30 am with morning prayer in the volunteer house chapel followed by morning Mass in the parish church of St. Vincent de Paul. After mass everyone in the Salesian community eats breakfast and then head to their respective places of work for the day.

My specific job is working as an administrator at Don Bosco Senior Secondary School here in Gumbo. When I first arrived in South Sudan I was teaching English at the secondary school but due to a need for extra help in the administration office Mike and I were moved to working there full time.

Generally we deal with discipline, paperwork, registering new students, and assisting and meeting with visitors to the school. People come to play football (soccer), basketball, volleyball, and take part in various activities at the parish including Catechism classes, practice for choir and altar serving, among other activities. At the end of Oratory we close with a Rosary and goodnight talk, in the tradition of St. John Bosco. Afterwards we head back to our rooms to wash up and then head to the chapel for evening prayer and then end the day's activities with dinner.

How are you able to handle all of your responsibilities while keeping a healthy work and personal life balance?

Mike: That's the million-dollar question! I’ll go weeks where I am worn down to the bone between the craziness of the school and just this place and struggle to find rest and peace on the weekend, basically hiding out in my room--which makes me feel like I am in a cage--and other times where the school is relatively calm and I am able to even find some peace during the week and enjoy spending time with the people here.

I am introverted, so after a while it gets to me if I don’t find alone time… which is impossible as a volunteer on mission. But in the end, daily personal prayer roots me and keeps me sane and able to love through it all and I know I will be rewarded in heaven for persevering.

Pat: It is very difficult considering we basically live at work. The only place to really find peace is in your bedroom but you are constantly on-call and may be called out any day of the week to do some work. We do not really have much of a personal life other than resting in our rooms when nothing is going on in the school and parish.

What prepared you for this job?‬‬

Mike: My faith in Christ is really want prepared me. Honestly, if I was an agnostic or something I think I would have failed here a long time back. Human weaknesses that I was unaware of due to my comfortable first-world life style, which is funny to say because I would consider my family lower-middle class in the U.S. This has made it very hard for me – for example: when I can’t have something simple like variety of food or even just the peace and quiet of being alone – would have taken away my joy (and very nearly have) more than once this past year if it were not for my roots in Christ.

Pat: Considering I did not study education when I first began teaching at Don Bosco it was definitely a huge challenge and took some getting used to. But through prayer and perseverance after some time it wasn't so difficult and became very rewarding and enjoyable. I do think that my studies helped with the administration side of things a bit though. I think what prepared me most for working in South Sudan that I learned in university was to trust in the Lord and stay strong in my faith. I never intended on using my degree here in Gumbo, I came because of my Catholic faith and desire to serve the church through this ministry.

Has there been a defining moment in your life that made you decide to take the direction you did?

1  Next Page » 2 3 4 5 6

Published: 23 July 2014 (Page 2 of 6)

Mike: It has really been a culmination of how I was raised, influence from my older sisters to do mission trips in college, and my overall drive to become a saint as people moved me to see how important faith is. Grace works in mysterious ways and I think that God’s given me an overabundance of it in my life and I felt a great urge to respond to it by heading to the mission field.

Pat: I cannot say that there was one specific moment. It was a culmination of things. It began with my first foreign mission trip to Mexico when I was in high school. That was what first got me thinking about doing long-term mission work after college.

Then, during my time at Franciscan I really grew in my faith and love for Christ, which only increased my desire to serve as a missionary. I went on another mission trip during spring break to Ecuador with students from Franciscan in the spring of that school year and a few weeks after I was starting the process with the Salesian Lay Missioners and the rest is history.

What drew you to working in South Sudan?

Mike: Several things for why I went to South Sudan:

• I wanted to teach and didn’t have the funds or the desire to spend extra time somewhere learning a new language pre-mission year, which was a requirement in many of the other places where teaching was a good possibility;

• I have dreamt of going to Africa since I can remember, so I asked for either South Sudan or Ethiopia;

• South Sudan was said to be a very difficult site and I wasn’t interested in a sugarcoated year of mission;

• South Sudan’s Juba site was very new and there was the possibility of beginning new activities and ministries, which I thought could be really awesome.

In the end, South Sudan was where I was placed, and it has been very difficult, but exactly what I needed.

Pat: I felt called to being a missionary for a year, and loved the mission of the SLM program, but there was never a specific place in mind. Yet, I always had thoughts about possibly doing service in Africa so that was where I ended saying I would like to go if possible. When the opportunity of serving in South Sudan was presented to me I couldn't have been happier.

What were your thoughts about South Sudan before you arrived and how have they changed or stayed the same?

‪‬Mike: Like I said, I thought it would be hard because I was told it was. That has not only stayed the same, but I think it can even be expounded upon: People here are stubborn beyond belief (and I hear Tonj is 10X worse), people expect you to help them and don’t show much gratitude, there is suffering left and right, and their politicians seem to care so little about the people who are suffering which means that the suffering here is mostly self-inflicted and thus makes it difficult to be sympathetic of.

Also, it’s Africa – don’t we all expect to see a giraffe or wildebeest at some point? No dice. In fact, in terms of fauna I cannot say I have seen anything typically African-esque except huge storks that look like they eat small children and gross camel spiders.

Pat: I really did not know what to expect. Growing up in the U.S. whenever you hear Sudan you immediately think war, refugees, rebels, etc. But those things did not worry me and we were ensured that the current situation was peaceful. I knew it would be a great opportunity to help in a country that after years of struggle had finally put the fighting behind them and were moving forward. It is definitely exciting times here in South Sudan and there are a lot of groups including religious and aid organizations working hard to develop this country and build a bright future for its people.

Yet, even during this year South Sudan experienced another huge obstacle to this dream as a new political conflict emerged between the government and rebel forces led by former Vice President Riek Machar. But, once again the people here have really come together during this difficult time and things are once again looking up. It has been beautiful to experience the people come together to pray and work for peace in South Sudan.

How have you adjusted to simple living?

Mike: I forget sometimes what carpet feels like… but I long for it. I could honestly live simply for the rest of my life, and I am definitely going to live much more simply than I did formerly when I return home. But, some things you have had your whole life and you truly don’t realize that “absence makes the heart grow fonder” – seriously, carpet?

And just having choices, especially with food. I don’t mind rice and beans basically every meal, but having the option to change it up is beautiful. I don’t really care that I am sitting in my sweat all the time and that it is always 90 + degrees here… I mean, I love colder weather (my ideal temp is more like 40-55 degrees, for real) but you adjust within a few months.

‪‬‬ 1 2 Next Page » 3 4 5 6

Published: 23 July 2014 (Page 3 of 6) ‪‪‪‬ In the end, if I could just return to my family every 6-months or so I think I could do mission forever… but I know I am not called to that.

Pat: I have definitely adjusted to the simple living. It was one of the things I really desired coming into this experience. At times it can be hard and I definitely miss some of the comforts of home but life here has helped me to grow as a person and rely less on worldly possessions.

What are the hardest parts about living there?

Mike: The lack of change. We go months without leaving the compound sometimes. Maybe it is somewhat our fault – but because we are white in what some consider the country with the darkest people in the world, we stick out like sore thumbs, so going into the village or moving anywhere gets not just looks but endless calling of “Aboona!” (Father) and “Kahwyja!” (White person/foreigner) as we pass and then the community eventually hear that we were moving about. So like I said, we feel a bit trapped and almost prisoners to our site which is 100% the hardest thing about it here.

Pat: The hardest part for me is probably the monotony of life here at times. We may stay in the compound for weeks at time without really going anywhere or doing anything outside of the normal daily schedule. Living in the compound makes it hard to find peace as well. There are always activities taking place and so it's hard to leave your room and not get pulled into doing some work.

Do you ever feel unsafe?

‪Mike: December 15th, 2013 was the scariest, least safe I had ever felt in my life. For about two weeks following that I also felt very unsafe. Since then, I feel for the safety of many of the citizens of South Sudan, but I feel completely safe.

Pat: I have not felt unsafe here in Gumbo besides during the end of December when there was fighting in Juba and the surrounding areas. At that time there was a lot of uncertainty and it seemed that the situation was only going to get worse. However the fighting quickly moved north to the oil feeds and Juba once again became quiet for the most part. Since that time I have never felt that I was ever in any danger.

‪What is the most rewarding part about living there?

Mike: The cultural diversity and the ability to participate in the lives of people really living a day-to-day life of struggle. In just the school alone  we have South Sudanese, Ugandans, Kenyans, a Malawian, an Indian, and Americans. In the community we have Indians, Kenyans, Americans, Spanish, a Vietnamese, a Malawian, South Sudanese, a Burmese, Koreans, Canadians, a Brazilian, and Ugandans.

We definitely have different ideas and different ways of representing those ideas, but it is beautiful to work with these differences and see how things get done (although often slower and probably with more disagreements) here. The people here are really struggling to pay school fees, have money for food each day, etc. yet they still press on and often seem much happier than those I know with the most lavish comforts in the U.S. ‪ Pat: The most rewarding part for me comes from spending time with the youth in the parish community. I really value the time spent with the people just talking, playing, and praying with them. It brings me a lot of joy and fulfillment.

What is your best memory so far?

‪‬‬Mike: Probably Christmas day when after mass I spent time with some of the students who lived near the parish in their home, just talking and enjoying some homemade baked goods, and then later being invited to spend time with the coach of the Don Bosco Football team, and see his home and meet his family, along with him driving me around on his motorbike to see the area of Gumbo, which I would not have seen any other way. It was just such a real day, and only a little over a week after South Sudan had that horrible experience with the coup attempt. It was the first time I felt at home.

Pat: On Easter Monday the Salesian community including the priests, sisters, brothers, seminarians, and lay staff and volunteers had a picnic on the Nile River. It was a great day and Mike and I got to take a swim in the Nile which was a great memory. Not many people back home can say they have done that!

What is the most heartwarming experience you’ve had and what is the most heartbreaking?

Mike: This is pretty simple, but it hit me hard: a student named Camilo, a new student at our school this year, was at evening games in the community sitting by the volleyball court. I saw him and several of our students there watching and playing volleyball so I walked over to greet them and talk with them. Camilo and I began to talk and somehow we got on the topic of me leaving. He told me that he would want to leave the school if I left because I made the days enjoyable. I was blown away. A simple, yet entirely genuine comment from him that hit me in the face and made me almost uncomfortable to know. It was actually a mix of both heartwarming and heartbreaking because it made me realize what I was going to be leaving.

1 2 3 Next Page » 4 5 6

Published: 23 July 2014 (Page 4 of 6)

Most heartbreaking… again, so many that it is difficult to pick one. I will speak of the losses of both our first principal and then one of our students. Fr. Patrick Soreng was such a kind, loving person and we only were able to work with him for a mere two weeks before he passed. Then, maybe a month or so later, one of our oldest students, Elijah, a 30-some-year-old veteran who always used a cane due to injuries sustained in the line of duty, died suddenly one day. He was such a hard worker, always coming to school ahead of time to study, and so humble as a student for someone of such life experience. Both deaths were unexpected and so close together; they rocked the community, really opening up my eyes to how short life can be – we think we are in control of it until we see life flash before our very eyes in those we are close to.

Pat: The most heartwarming experience for me so far has been witnessing the large amounts of children and teens the regularly attend Mass and Adoration in the parish church. It is something you don't see much in America. You will walk into Adoration on Friday evening and 90% of the people there are under 20 years old. The youth here have so much faith and love for Christ and it is beautiful to see and to pray with them. The most heartbreaking experience for me has been seeing firsthand what the selfishness of political leaders and hatred between tribes in South Sudan has done to thousands of innocent people here. We have a refugee camp here in Gumbo which is run by the Salesians with the help of various aid organizations and Mike and I were here when most of these refugees arrived here after fleeing their homes and losing their loved ones.

What do you think you will remember the most?

Mike: The hardship. Death. Life. My love for my students. The stubbornness of South Sudanese (especially Dinka and Nuer). Living with a religious community. The richness of and struggles of diversity.

Pat: I think I will remember the people the most. My students at the secondary school, the people of the parish community, and of course all of those in the Salesian community here. They have really become family to me in a lot of ways, especially the fellow lay volunteers.

What lessons will you take with you?

Mike: Patience. Love is always primary. Know what you need and don’t be afraid to ask for it/make time for it, regardless of how others might perceive you for it. Being rooted in something (for me my faith) can help you overcome any obstacle if you really do believe in it.

Pat: I have learned so much during my time serving here in South Sudan, but I think most of all I have learned to put complete trust in God. I could have never made it through life here without Him and I will take this with me forever.

Can you tell me about one person who has impacted you?

‪‬‬Mike: This girl Monica. She’s probably 9 or 10, and she always comes to oratory and Rosary, and even now that she has received her baptism and first communion she has started attending daily Mass. She is so friendly and always helping her little sister, Theresa, and although she doesn’t know much English she always greets me with a smile and will say she is good. I don’t know, but it is just these kids who show such maturity in a place full of parentless children who barely eat, have hardly anything to wear, and just nothing to their name but still have that natural goodness and responsibility that most 25-year-old Americans who have been given everything since they were born and have nothing to complain about are lacking.

Pat: A few weeks ago I met a young boy names James who recently relocated to Gumbo with his family. He is one of those people who upon minutes of just meeting you know they are just such a genuine loving person. James is probably about 14-years-old while I am 23, but I strive to be like him every day. He just knows how to love and is so strong in his faith at such a young age. I will always remember him and feel so blessed to have been able to meet him and spend time with him. He is a saint in the making for sure.

Do you find that women are treated differently than men at your site?

‪‬‬Mike: Locals are definitely treated differently by locals. South Sudanese women are valuable to their families in that they prepare food, clean the home, and will one day get their fathers money or cows from a dowry when they get married. This isn’t every man here, but 95% of them. They seem equal in school, but they definitely are not. Oddly, women here don’t complain about it. It’s like they are so ingrained to think that this is how life is that I honestly never have heard one complaint about it. Maybe some of the women in politics are advocating for better rights, but the general public, possibly just due to lack of education, do not seem too worried about anything changing.

Pat: Culturally South Sudan is very different from what I was used to in the U.S. Women are still considered second-class citizens for the most part here. They are expected to get married when they are very young and raise families. It has been sad to see young women at the school leave due to these pressures and be treated poorly due to these mentalities.

1 2 3 4 Next Page » 5 6

Published: 23 July 2014 (Page 5 of 6)

What are the most critical problems faced by people in your area?

Mike: Daily struggle for money – most don’t really have jobs and there is not enough land to cultivate, so how do they get money? Then the kids who are working age, who in the U.S. could possibly help support their families, are trying to get an education so then again they cannot work. It is just a bad economic country. They need to either become intense farmers in this country or have programs geared specifically to forming a job market in cities and even rural towns and villages.

Pat: Due to the recent conflict, disease and famine have become huge issues. South Sudan faces one of the largest famines seen in recent history. Due to the fighting between government and rebel troops causing so many to flee their homes no one was around to plant crops before the rainy season began. So now the nation is racing to plant crops and they are running out of time. There has also recently been a cholera outbreak in Juba. The war has brought more problems than just the death of thousands from the fighting. More people face death due to post war problems.

I read recently about a Christian woman in Sudan who was publicly beaten for denouncing her Muslim faith and marrying a Christian man. How often do you hear about these kinds of things?

Mike: I heard that story – but religion is as free as can be here. No one is killed for being Muslim or Christian, except maybe in the far north of the country, but even that I have not actually heard any stories of it happening.

Pat: Here in South Sudan most people are Christian. The fighting between Muslim and Christians is what led to the creation of South Sudan. So here you do not hear of the persecution of Christians very often if ever. I heard about this as well and it is such a sad story but is the only case of this I have heard during my time here in South Sudan.

Do you think American media portrays the situation in Sudan differently than the experience you’re having?

Mike: Hah! Yes. Media only shows extremes, good or bad--usually the bad, though. Sudan and South Sudan surely have big time problems that should not be overlooked – but we hear only about the Sandy Hooke shooting and not about the day-to-day normal runnings and life-giving and good events occurring in thousands of other schools across the country. We hear about LeBron cramping up in the NBA Finals game, but probably not about some kids who were given court-side tickets to watch their first NBA game.

You see, media tells us what makes a headline, what draws attention, and not what life is about. Life is life, and suffering occurs in America just as it does here. It is very necessary to be aware of it, but not if we then overlook our own lives. Don’t worry so much about LeBron cramping; he has trainers galore to help him recover. Worry about your family and friends, and worry about the difference you can make in your community. Here is South Sudan I am not doing anything extraordinary, but I am attempting to love these people in the ordinary day-to-day, which is really the same today as it was when the fighting started – people lack things of necessity like clean water and daily food.

We stopped helping Haiti for the most part once we stopped hearing about it in the news; Haitians are still really struggling and were struggling prior to the devastation of the hurricane. American media lets us feel good for helping with big problems when we hear about them, but our neighbor needs our help every day. I didn’t come to South Sudan when the fighting started, and I didn’t leave once it started; I came to be with these people in their day-to-day, and that is during extremes and through normality.

Pat: I think it is definitely blown out of proportion in the international media. Don't get me wrong, South Sudan has experience many problems including the recent conflict and the struggles that have stemmed from it. But, I think the news makes people think that you cannot go anywhere in South Sudan without running into armed rebels, but that is not the case. Most areas of South Sudan are currently peaceful.

What is a common misconception about South Sudan that people often have?

Mike: I might be taken prisoner tomorrow by rebels. I even thought that when the fighting first happened. Not even close to being true. It might still be rudimentary here, but first world countries have enough of their foot in the door of South Sudan that, unlike in the 1980s, 'Mike the Kahwyja' is as safe in South Sudan as a squirrel in Central Park.

Pat: I think most people do not even know it is a country. You say South Sudan and they only hear Sudan and they think fighting and war. But there is much more to these people. There is a lot of good here and there is not just fighting and poverty.

Have you ever had a “this is my home” feeling?

Mike: Yeah, since about mid-December. The fighting made me feel more at home, more one with the people. When in January they told us we were headed to Kenya for safekeeping, I didn’t want to go because I knew I was supposed to remain in my home, South Sudan. To this day I am so used to this place and the life that it is home.

1 2 3 4 5 Next Page » 6

Published: 23 July 2014 (Page 6 of 6)

Pat: Its crazy to think about but yes I have. I think I really realized it when during January when Mike and I were sent to Kenya while the situation was worsening in South Sudan. During that time we just wanted to go back to Juba and be with the community and people there. We missed Gumbo so much. That was when it first hit me that Gumbo has become my home in a lot of ways.

Do you ever feel like you really belong there?

Mike: Apart from it being home and feeling like home, I still feel majorly like an outsider. If I knew fluent Arabic, maybe that would be a bit different, but it is still hard to overcome my white skin. No one is “racist” per se, but there is definitely the constant reminders that I am white and that has many connotations, I imagine, often not very different from the ones African-Americans might have of White Americans. But, knowing I cannot walk through Gumbo without every person looking at me makes me highly aware that I am an outsider and don’t really belong. The only place I feel that sense of belonging is within our compound, but here I also feel trapped.

Pat: Its funny that this comes after the question about it feeling like home because it does feel like home but I cannot say that it feels like I belong. After almost 10 months of living here I still can't walk outside and not be stared at by everyone. I feel at home here most of the time and I know that I am supposed to be here during this time to serve and give of myself to this mission and the church but I don’t know that I "belong" here.

Do you What is the most interesting or surprising thing you’ve observed or been a part of?

Mike: When we had many Nuer people from the local area who were afraid of being killed for their ethnicity come to our place after the initial fighting to stay for some time, I felt like I was part of the underground railroad or something, hiding people on the move. It was really something you see in movies but never think you will be part of. Late at night we moved them from the school to the Church where we thought they would be safer, posting guards around the outside… and then the fear in my heart going back in the dark to my room some ways away, imagining the sound of gunshots as Dinka’s came and slaughtered those people we had left in the Church. That is honestly something I will never forget and neither “interesting” nor “surprising” really do justice to describe how it felt to be part of it.

Pat: How much western culture has affected the youth of South Sudan--in good and in bad ways.

Are there any political or social issues you feel passionate about?

Mike: I am very passionate about changing hearts to love and not be revengeful, hopefully causing an end to tribalism. That is, in my opinion, the biggest social issue in this country and it needs to be solved or more people will just continue to die for it during small conflicts.

Pat: As for as in South Sudan I just feel passionately that the people here need to let go of tribalism and come together as a nation. Many of South Sudan's leaders call themselves Christians yet are fueled by hatred and selfishness. I hope and pray that they will one day learn to love and put the people of this country before themselves.

What are your hopes for the people you’ve interacted with?

Mike: That they have seen my love for them and care for them and recognize Christ through it. That I can leave here and the people will desire a better life for themselves and their country and achieve it through hard work and perseverance, along with constant growth in their faith.

Pat: I hope they stay close to Christ and live their lives to serve and love others before all else.

Anything else you’d like to add?

Mike: God blessed me with a beautiful journey this year. I learned way more than I would have just working a normal job, and I wouldn’t trade it for the world. It was definitely not what I expected, but it just reconfirmed to me that we shouldn’t have expectations because we will just get let down – we should just do everything with the desire to be the best we can be in and through it.

Pat: No, I think that covers it, thank you for the opportunity to share some of my experiences. God bless!

Return to Page 1 »

Follow Olivia on Twitter Twitter: @nahmias_report Asia Correspondent: @OCELswick

Related articles

• Don Bosco society doing yeomen service (thehindu.com)

• Memorial of Saint John Bosco, priest (cadberry.wordpress.com)

Generation Z, Tobacco Free?

Michael Ransom, Contributing EditorLast Modified: 11:45 p.m. DST, 8 July 2014

Butts2, Photo by Dave Hull

UNITED KINGDOM -- Could the generation born after the year 2000 be the first generation in the Western world to be cigarette free? Doctors throughout the United Kingdom are hoping so.

The British Medical Association (BMA) has voted in favor of a law that would ban the sale of cigarettes to the newest generations, while grandfathering-in older age groups, who would still have legal access to the tobacco product.

The effort is extremely controversial, and would effectively signal the beginning of the end of cigarette production. The curbed cigarette consumer market would continue to age, and cigarette companies would slowly close up shop.

But, could this move have negative consequences? Many people are saying so. With any sort of prohibition, such as the alcohol prohibition in United States during the 1920s and 30s, people do not give up habits and addictions overnight in response to the legal status of the product in question.

Some groups are warning that this measure could backfire, and tobacco sales could explode on the black market. And in these underground markets, there would be no way to deny cigarette sales to minors.

Critics claim that youth smoking rates could actually increase, maybe even by drastic proportions. But this fear is not enough to change the recent strategy of the BMA. If the British Parliament agrees with this prestigious medical organization's take on nicotine addiction, then serious changes could be forthcoming.

The BMA does not recommend the prohibition without some quantitative backing. The association of doctors cite a study in which two out of every three people interviewed wished they had not begun smoking in the first place. According to the BMA, the proposed initiative could help Generation Z avoid the deadly habit, before they pick up their first cigarette.

Follow Michael on Twitter Twitter: @nahmias_report Contributing Editor: @MAndrewRansom

Related articles

• U.K. doctors vote to ban smoking for anyone born after 2000 (thestar.com)

• Doctors vote for ban on UK cigarette sales to those born after 2000 | Society | theguardian.com (theguardian.com)

• UK doctors seek permanent ban on selling cigarettes to those born after 2000 (rinf.com)

• Big Tobacco - So Much for the Global Crutch (investorplace.com)

• Ban new smokers, call from doctors (bbc.co.uk)

WHO, West African Ministers of Health Develop Ebola Strategy

Sarah Joanne Jakubowski, Ghana CorrespondentLast Modified: 13:50 p.m. DST, 07 July 2014

Ebola outbreak in Guinea, Photo by Photo by International Federation of Red Cross and Red Crescent Societies

ACCRA, Ghana -- Last week an Emergency Ministerial Meeting was held in Accra to discuss the growing Ebola epidemic.

The disease, which can have up to a 90% fatality rate, started in rural Guinea then spread to neighboring Liberia and Sierra Leone. Without intervention, it will continue its international invasion.

The World Health Organization (WHO) says the proposed strategy to treat, control and prevent Ebola will cost $10 million and would need to be put into place within the next six months.

Representatives called on the African Union and The Economic Community of West African States (ECOWAS) for the funds.

The plan would set up an Ebola treatment and research center in Guinea as well as smaller centers in other affected areas. Funds will go to training and deploying staff, providing medical equipment and supplies to affected or at-risk regions and educating the public.

An emphasis was placed on research, both to develop treatments and cures and also social research to gauge public understanding and reaction to the disease. However, Africa's research facilities were described as "weak" and a request for global collaboration among scientists was issued.

When asked if border control was a viable solution to control the spread of the disease, the idea of country-wide quarantines was shot down.

Ministry of Health & Social Welfare (MOHSW) Liberia explained that there were so many border crossing points it would be impractical to watch all of them. The Minister went on to say that while his country was able to stop several travelers who were carrying the disease, there were many false positives and possibly cases where infected travelers were not yet showing symptoms and so got through. A key problem was that Ebola can incubate unnoticed for up to 21-days in a seemingly healthy person.

Some traditional practices can help spread diseases, and doctors across the region are urging people to seek assistance from trained doctors or one of the international organizations that are on the ground providing help, education, and intervention. Organizations such as UNICEF Liberia, The International Federation of Red Cross and Red Crescent Societies (IFRC), and Medicins Sans Frontieres.

These organizations in conjunction with local doctors and government health officials urged all West African citizens to take precautions when handling the sick and deceased. Practices involving delayed burials and prolonged contact with the dead facilitate disease spread.

"People don't know what they're dealing with" explained, emphasizing the need to especially educate churches, those whose jobs involve handling the dead, as well as the need to educate family members about Ebola so that the sick can seek immediate treatment to avoid infecting others.

This is a very urgent issue, and though citizens in the West may feel that they are immune from this disease, it takes just one person to breach the borders of any Asia, Middle East, European Union, or North/South American countries for the deadly virus to become a global pandemic.

Follow Sarah on Twitter Twitter: @nahmias_report Africa Correspondent: @SJJakubowski

Related articles

• Is Ebola heading to a city near you? (examiner.com)

• As Death Roll Rises, Eleven Nations Agree On Joint Strategy To Combat 'Unprecedented, Out Of Control' Ebola Outbreak (publichealthwatch.wordpress.com)

• Ebola 'threatens more West African nations' (aljazeera.com)

• Suspected Ebola Case Reported In Accra (modernghana.com)

Omani Woman Nora Al-Daher, Gambled and Lost £2m in One Night, then Refuses to Pay Casino

UNITED KINGDOM, London - There is such a thing as gambling addiction, problem gambling, or ludomania which is the urge to continuously gamble despite harmful negative consequences or a desire to stop. Pathological gambling is considered by the American Psychiatric Association to be an impulse control disorder rather than an addiction. However, for the DSM 5.0, Pathological Gambling is being considered as an Addictive Disorder as opposed to an impulse-control disorder. (Wikipedia) Then, there is the question of personal responsibility. In today's modern world there are a number of means to avoid the consequences of irresponsible or downright bad behavior i.e. if one is rich enough, if one can claim mental defect, or you can simply run away.

Casino Gambling Chips, Photo by Mike Jack

None of these options absolve the person of responsibility, but having a disorder such as a gambling addiction could potentially mitigate the ultimate judgment in the case of someone gambling away their savings, house, and car, thus leaving them in a position whereby they are unable to meet credit obligations.

Nora Al-Daher, whose husband is the foreign minister of Oman, told the High Court that she is a gambling addict. She was testifying in a suit which she brought against the exclusive Ritz Club in London where she gambled and lost £1million, but only after she had lost an equal sum earlier that night at other casinos around the city.

It is interesting to note that according to Islamic scholars gambling, is categorically forbidden, as is drinking alcohol. So, this begs the question of how Mrs. Al-Daher was able to lose millions of pounds, a sum which 99.9% of the world's population will never realize in their lifetimes? According to court documents, "between 1999 and April 2012, The Ritz alone had received more than £20million in buys-ins from Mrs. Al-Daher, of which she lost more than £7million." (Daily Mail U.K.)

Her credit was extended by The Ritz because of her previous good payment history, and as a valued customer they wanted to accommodate the self-proclaimed addict. However, this time she wrote checks, which in the parlance of the poor, "bounced" and were not honored by her bank because of "Non-Sufficient Funds."

The idea that someone with access to that amount of money would be frivolous enough to gamble it away, and then refuse to pay the debt, disparages people of lesser means who have gambling addictions. With her extreme wealth she could have sought the best addiction treatment in a private and exclusive environment.

She could have also settled her debt and informed in advance all the casinos that she frequented and were known to extend generous credit to her, that she has a gambling addiction, and ask that they cut her off much like a bar tender is now legislated to no longer serve alcohol to a patron who is clearly intoxicated.

Instead, Mrs. Al-Daher called foul play after the fact, and used the condition to justify her not settling the debt. It is not as if she doesn't have access to the money, but it is curious that her checks bounced. Perhaps, this time her husband refused to provide her with the money to pay her debt, but in any case The Ritz should not be made the scapegoat.

Personally, I am against gambling, so this article is not written in support of these institutions that regularly fleece millions of customers each year in casinos all over the world. The fact that gambling, once illegal in many countries, has been granted the veneer of respectability under the guise that the taxes which they pay are used to better the communities in which they reside, does not confer upon them beneficence.

The logic behind the marketing scheme used to convince communities to allow these establishments to operate in their midst, is that by paying large sums in taxes to local and state governments, these funds can in turn be used by these governments to improve schools, social services, etc. However, in fact this premise is about as valid as the claims that cigarettes are safe and do not cause cancer. The fact that exorbitant taxes are paid is akin to bribery because very little of this money trickles down to the people or communities that are professed to benefit.

That said, this case has yet to be adjudicated, but in this court of opinion......she played, she lost, she has the millions, so she should pay the piper.

Follow Nahmias Cipher Report on Twitter Twitter: @nahmias_report Editor-in-Chief: @ayannanahmias

Related articles

• Nora Al-Daher sues The Ritz casino after losing £2m at card table (thisismoney.co.uk)

• Nora Al-Daher sues The Ritz casino after losing £2m at card table, claiming it 'took advantage' of her (dailymail.co.uk)

• Gambling Addiction Treatment Sparse As Mass. Gears Up For Casinos (wbur.org)