Revisiting: U.S. Sales of Chemical & Biological Weaponry to Iraq

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Bayer, FDA, Knowingly Sell HIV Contaminated Drugs Abroad

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Robert Gallo: The Man Who Created Aids

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Professor Charged in Deadly Alabama Shooting, Goes Ballistic after Tenure Denied

Kristin M. Hall

HUNTSVILLE, Ala. (Feb. 13) -- A biology professor at the University of Alabama in Huntsville who authorities say opened fire at a faculty meeting is facing a murder charge after the shooting spree that left three dead and three wounded.

Amy Bishop, 42, was charged Friday night with one count of capital murder, which means she could face the death penalty if convicted. Three of Bishop's fellow biology professors were killed and three other university employees were wounded. No students were harmed in the shooting, which happened in a community known for its space and technology industries.

According to media reports, Bishop was upset after being denied tenure.

UAH student Andrew Cole was in Bishop's anatomy class Friday morning and said she seemed perfectly normal.

"She's understanding, and was concerned about students," he said. "I would have never thought it was her."

Bishop, a neurobiologist who studied at Harvard University, joined the UAH biology faculty as an assistant professor in fall 2003. She was taken Friday night in handcuffs from a police precinct to the county jail and could be heard saying, "It didn't happen. There's no way. ... They are still alive."

Police said they were also interviewing a man as "a person of interest."

University spokesman Ray Garner said the three killed were Gopi K. Podila, the chairman of the Department of Biological Sciences, and two other faculty members, Maria Ragland Davis and Adriel Johnson.

Three others were wounded, two critically, in the gunfire, which Davis' husband, Sammie Lee Davis, said occurred at a meeting over a tenure issue. The wounded were identified as department members Luis Cruz-Vera, who was listed in fair condition, and Joseph Leahy, in critical condition in intensive care, and staffer Stephanie Monticello, also in critical condition in intensive care.

Sammie Lee Davis said his wife was a researcher who had tenure at the university.

In a brief phone interview, he said he was told his wife was at a meeting to discuss the tenure status of another faculty member who got angry and started shooting. He said his wife had mentioned the suspect before, describing the woman as "not being able to deal with reality" and "not as good as she thought she was."

Bishop and her husband placed third in a statewide university business plan competition in July 2007, presenting a portable cell incubator they had invented. They won $25,000 to help start a company to market the device.

Robin Conn, The Huntsville Times / AP
Medical workers take two shooting victims from the Shelby Center on the campus of the University of Alabama-Huntsville to an ambulance on Friday.

Biology major Julia Hollis was among the students who gathered to support each other and try to make sense of the news.

"When someone told me it was a staff person and it was faculty I was in complete denial," said Hollis, 23, who had taken classes with two of the instructors who were killed. "It took me a bit for it to sink in."

Students offered varying assessments of Bishop.

Andrea Bennett, a sophomore majoring in nursing, described Bishop as being "very weird" and "a really big nerd."

"She's well-known on campus, but I wouldn't say she's a good teacher. I've heard a lot of complaints," Bennett said. "She's a genius, but she really just can't explain things."

Bennett, an athlete at UAH, said her coach told her team Bishop had been denied tenure and that may have led to the shooting.

Amanda Tucker, a junior nursing major from Alabaster, Ala., had Bishop for anatomy class about a year ago. Tucker said a group of students complained to a dean about Bishop's performance in the classroom.

"When it came down to tests, and people asked her what was the best way to study, she'd just tell you, 'Read the book.' When the test came, there were just ridiculous questions. No one even knew what she was asking," said Tucker.

But Nick Lawton, 25, described Bishop as funny and accommodating with students.

"She lectured from the textbook, mostly stuck to the subject matter at hand," Nick Lawton said. "She seemed like a nice enough professor."

Sophomore Erin Johnson told The Huntsville Times a biology faculty meeting was under way when she heard screams coming from a conference room.

University police secured the building and students were cleared from it. There was still a heavy police presence on campus Friday night, with police tape cordoning off the main entrance to the university.

The Huntsville campus has about 7,500 students in northern Alabama, not far from the Tennessee line. The university is known for its scientific and engineering programs and often works closely with NASA.

The space agency has a research center on the school's campus, where many scientists and engineers from NASA's Marshall Space Flight Center perform Earth and space science research and development.

The university will remain closed next week and all athletic events were canceled to give students and staff time to grieve. Counselors were available to speak with students.

It's the second shooting in a week on an area campus. On Feb. 5, a 14-year-old student was killed in a middle school hallway in nearby Madison, allegedly by a fellow student.

Mass shootings are rarely carried out by women, said Dr. Park Dietz, who is president of Threat Assessment Group Inc., a Newport Beach, Calif.-based violence prevention firm.

A notable exception was a 1985 rampage at a Springfield, Pa., mall in which three people were killed. In June 1986, Sylvia Seegrist was deemed guilty but mentally ill on three counts of murder and seven counts of attempted murder in the shooting spree.

Dietz, who interviewed Seegrist after her arrest, said it was possible the suspect in Friday's shooting had a long-standing grudge against colleagues or superiors and felt complaints had not been dealt with fairly.

Gregg McCrary, a retired FBI agent and private criminal profiler based in Fredericksburg, Va., said there is no typical outline of a mass shooter but noted they often share a sense of paranoia, depression or a feeling that they are not appreciated.

Associated Press Writers Phillip Rawls and Desiree Hunter in Montgomery, Ala., Thomas Watkins in Los Angeles, and Jacob Jordan and Daniel Yee in Atlanta contributed to this report.
Filed under: Nation, Crime, Top Stories




http://www.aolnews.com/crime/article/3-dead-in-shooting-at-university-of-alabama-huntsville/19356792

UK Court Publishes Details of Alleged CIA Torture

Theunis Bates Contributor

LONDON (Feb. 10) – A London court on Wednesday ordered the British government to disclose confidential U.S. intelligence showing that a British resident and former Guantanamo Bay inmate suffered "cruel, inhuman and degrading treatment" while in American custody.

U.K. Foreign Secretary David Miliband had previously refused to allow the publication of U.S. material dealing with the treatment of Binyam Mohamed, who was arrested in Pakistan in 2002. Divulging this information, warned Miliband, could jeopardize Britain's intelligence-sharing deal with the U.S. and damage future anti-terror operations.


Leon Neal, AFP / Getty Images
A London court ruled Wednesday that the British government must disclose confidential U.S. intelligence regarding the treatment of former Guantanamo Bay detainee Binyam Mohamed, pictured here at a fundraising event last year.

However, three of the country's top judges dismissed these protests, pointing out that similar material concerning Mohamed had already been published in the United States.

This once-top secret intelligence – which was passed from the CIA to British security service MI5 in 2002 – can now be read on the U.K. Foreign Office Web site. The document supports Mohamed's claim, which he made repeatedly since his release from Guantanamo in 2009, that while British intelligence agents may not have taken part in his torture, they knew it was happening.

The document addresses a period soon after Mohamed's arrest, when he was being held by Pakistani interrogators at the request of the U.S. under suspicion of receiving training from al-Qaida in Afghanistan. It reveals that Mohamed was subjected to "continuous sleep deprivation," had been chained up throughout interrogations and was exposed to "threats and inducements" that played on his fear of being "removed from United States custody and 'disappearing.' " This treatment, the paper continued, led to Mohamed's being kept on suicide watch.

In their summary of the case, the London judges said, "Although it is not necessary for us to categorize the treatment reported, it could readily be contended to be at the very least cruel, inhuman and degrading treatment by the United States authorities."

Ethiopian-born Mohamed, 31 -- who moved to the United Kingdom as a teenager and converted to Islam in 2000 – has long denied having any connections to terrorism and says he was simply arrested for being in the wrong place at the wrong time. He claims he flew to Pakistan in May 2001 to help kick a drug habit and later that year headed to Afghanistan, as he wanted to see a "pure" form of Islam under the Taliban.

On his return to Karachi airport in 2002, Mohamed was held on charges of using a false passport and handed over to American authorities, who put him on an "extraordinary rendition" flight to Morocco, where he was tortured. (He says a Moroccan torturer named Marwan slashed his chest and genitals with a scalpel during interrogations.)

Mohamed was then taken to a "dark prison" run by the U.S. in Afghanistan, where he says he was forced to listen to a recording of rapper Eminem, played at deafening volume, continually for a whole month. His next stop was Guantanamo.

The U.S. eventually dropped all charges against Mohamed. On his return to the U.K. in '09, he lodged a civil damages lawsuit against the government, which he accused of being complicit in his torture, since an MI5 officer had interviewed him when he was held in Pakistan. In 2008, Britain's High Court ruled that MI5's involvement in Mohamed's mistreatment had gone "far beyond that of a bystander or witness to the alleged wrongdoing."

Wednesday's revelations are part of a revised version of that 2008 ruling, which – on first release – was missing seven paragraphs of comments from the judges. The foreign minister had appealed against the publication of those specific lines, but on Wednesday the Court of Appeal declined his request.

Human rights activists have celebrated the release of the blocked paragraphs and are now calling for a full public inquiry into the affair. "It has been clear for over a year that the Foreign Office has been more concerned with saving face than exposing torture," said Shami Chakrabarti, director of campaign group Liberty. "These embarrassing paragraphs reveal nothing of use to terrorists, but they do show something of the U.K. government's complicity with the most shameful part of the war on terror."

There are likely to be more revelations about Mohamed's apparent mistreatment in coming months. U.K. police are investigating the MI5 agent who questioned Mohamed to find out if he broke any British laws on torture. According to Clive Stafford-Smith, Mohamed's lawyer, the seven paragraphs released Wednesday are just "crumbs" and there is "a vast body of other information out there showing Binyam Mohamed was abused."
Filed under: Nation, World




http://www.aolnews.com/world/article/uk-court-publishes-details-of-alleged-cia-torture/19353061

TUBERCULOSIS - HAITI: POST-EARTHQUAKE

************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Fri 5 Feb 2010
Source: The New York Times [edited]



At a fly-infested clinic hastily erected alongside the rubble of the
only tuberculosis sanatorium in this country, Pierre-Louis Monfort is
a lonely man in a crowded room. Haiti has the highest tuberculosis
rate in the Americas, and health experts say it is about to
drastically increase. But amid the ramshackle remains of the hospital
where the country's most infected patients used to live, Mr Monfort
runs the clinic alone, facing a vastness of unmet need that is as
clear as the desperation on the faces around the room.

"I'm drowning," said Mr Monfort, 52, flanked by a line of people
waiting for pills as he emptied a bedpan full of blood. All of the
hospital's 50 other nurses and 20 doctors died in the earthquake or
have refused to return to work out of fear for the building's safety
or preoccupation with their own problems, he said. Mr Monfort joked
that the earthquake had earned him a promotion from a staff nurse at
the sanatorium to its new executive director.

In normal times, Haiti sees about 30 000 new cases of tuberculosis
each year. Among infectious diseases, it is the country's 2nd most
common killer, after AIDS, according to the World Health Organization.
The situation has gone from bad to worse because the earthquake set
off a dangerous diaspora. Most of the sanatorium's several hundred
surviving patients fled and are now living in the densely packed tent
cities where experts say they are probably spreading the disease. Most
of these patients have also stopped taking their daily regimen of
pills, thereby heightening the chance that there will be an outbreak
of a strain resistant to treatment,experts say.

At the city's General Hospital, Dr Megan Coffee said, "This right here
is what is going to be devastating in 6 months," and she pointed to
several tuberculosis patients thought to have a resistant strain of
the disease who were quarantined in a fenced-off blue tent. "Someone
needs to go and help Monfort, or we are all going to be in big trouble."

A further complication is that definitively diagnosing tuberculosis
takes weeks. So doctors are instead left to rely on conspicuous
symptoms like night sweats, severe coughing and weight loss. "But look
around," Dr Coffee said. "Everyone is thin, everyone is coughing from
the dust and everyone is sweating from the heat."

Dr Richar D'Meza, the coordinator for tuberculosis for the Haitian
Ministry of Health, said his office and the World Health Organization
had begun stockpiling tuberculosis medicines. "We are very concerned
about a resistant strain, but we are also getting ready," he said,
adding that he is assembling medical teams to begin entering tent
camps to survey for the disease. "This will begin soon," he said. "We
will get help to these people soon."

For Mr Monfort, it is not soon enough. He scavenges the rubble daily
for medicines and needles. He sterilizes needles using bleach and then
reuses the bleach to clean the floors. In his cramped clinic, 8 of the
sickest and most contagious patients lay on brown- and red-stained
beds. He said he had lost count of how many more were sleeping in
other pockets alongside the hospital. Hundreds come daily to pick up
medicine. Outside the clinic, the air is thick with the sickening
smell of rotting bodies. Occasionally a breeze carried a waft of char
from small cooking fires nearby, offering a respite from the stench
and the flies.

Mr Monfort began to explain that his biggest problem was a lack of
food. Suddenly a huge crash shook the clinic. A patient screamed.
Everyone stood still, eyes darting. A man outside yelled that another
section of the hospital had collapsed. People looking for materials to
build huts had pulled wood pilings from a section of the hospital
roof, which then fell as the scavengers leapt to safety, the man said.
Mr Monfort looked to the ground silently as if the weight of his
lonely responsibility had just come crashing down. "These people are
dying and in pain here," he said. "And no one seems to care."

The dire scene at Mr Monfort's clinic speaks to a larger concern: as
hospitals and medical staff are overrun by people with acute
conditions, patients who were previously getting treatment for cancer,
HIV, and other chronic or infectious diseases have been pushed aside
and no longer have access to care.

At the Champ de Mars, [a man] sat on a curb, one shoe missing, his
blue polo shirt torn, his head cupped in his hands. "I have TB, and I
am also supposed to get dialysis every other day," he said, explaining
that he was a doctor's assistant before the earthquake and meticulous
about his treatments. "I have not had dialysis in 3 weeks, and I feel
my blood is rotting from inside." Waving his hand over a sea of tents
and tarpaulins, he added, "It is like this country."

Back at the clinic, Mr Monfort struggled to fix an IV that had missed
the vein and was painfully pumping fluids under a patient's skin.
Another ghost of a man hobbled to the doorway on crutches, moaning for
help. "Please wait, please wait," Mr Monfort said in a tense whisper.
The biggest source of stress, Mr Monfort said, is that his 3 children
and wife are living on the street because the earthquake destroyed
their home. His wife begs him daily to stay with them. Instead, unpaid
and without a mask or gloves to wear, he walks to the sanatorium each
day at 6 am and stays until 8 p.m. when most of the patients drift to
sleep. "Why don't you just leave us to die?" asked [a patient]. Mr.
Monfort looked offended by the notion. But he did not answer and the
question seemed to stick with him.

The ancient Greek playwright Aeschylus once wrote that there was a
type of suffering so intense that, even in our sleep, it bores into
the heart until eventually, "in our own despair, against our will," it
taps into a terrible wisdom. After several minutes in silence, Mr
Monfort spoke of that wisdom. He referred to it as a "strange hope"
that had sprung from the suffering of his patients and the loss and
abandonment of his fellow staff members. "These people here are dying,
but they keep me alive," he said. "I know they are hurting more than
me and not complaining. So," he said, handing another walk-in patient
a packet of pills, "I must continue."

[Byline: Ian Urbina]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Photo of a hospital in Haiti today

- Mod.JW]

[Following the devastation caused by the earthquake on 12 Jan 2010
that centered about 10 miles (15 kilometers) southwest of Haiti's
capital, Port-au-Prince, the interruption of treatment for chronic
diseases (such as, TB, HIV, diabetes, end-stage renal disease,
hypertension) and loss of patient follow-up were likely to cause
significant problems. However, even before the earthquake,
tuberculosis and HIV infection were major public health problems in
Haiti. The following is extracted from USAID report on tuberculosis in
Haiti available at
:

Haiti has the highest per capita tuberculosis (TB) burden in the Latin
America and Caribbean region. After HIV/AIDS, TB is the country's
greatest infectious cause of mortality in both youth and adults (6814
deaths in 2007). Haiti is among the 8 priority countries identified by
the Pan American Health Organization (PAHO) for TB control in the
region. According to the World Health Organization's (WHO's) 2009
Global Tuberculosis Control Report, Haiti had and estimated 29 333 new
TB cases in 2007 [incidence of 306 cases per 100 000 population].
...The DOTS [that is, directly observed therapy, the internationally
recommended strategy for TB case management] treatment success rate
was 82 percent in 2006, a slight increase from 78 percent in 2003.
DOTS coverage fell to 70 percent in 2007 compared with 91 percent in
2006, though it was still above the 2005 level of 55 percent. However,
in some highly dense metropolitan settings, such as areas in
Port-au-Prince, coverage can be as low as 13 percent. ...

Since 1998, the Ministry of Health (MOH) has supported the DOTS
strategy in order to strengthen the national TB program, the Programme
National de Lutte contre la Tuberculose (PNLT -- National Prtogram of
the Fight Against TB), and approved national guidelines and norms for
TB control in 2002. However, the program lacked political and
financial support from the government, and there is a lack of skilled
technical human resources at the central level of the PNLT. A major
problem in combating TB is that co-infection with HIV can run as high
as 30 percent in some urban areas. Strong stigma and cultural barriers
attached to TB also interfere with case detection and adherence to
treatment. Multidrug-resistant (MDR) TB has increased from 1.4 percent
in 2004 to 1.8 percent in 2007 [among new cases]. ...

WHO has issued a public health risk assessment to facilitate the
response of those aiding the earthquake-affected population in Haiti
available at
.

Haiti and the Dominican Republic occupy the Caribbean island of
Hispaniola in the Greater Antillean archipelago. A
HealthMap/ProMED-mail interactive map of Hispaniola can be found at
. - Mod.ML]

[see also:
Meningococcemia, fatal - Dominican Republic ex Haiti 20100206.0401
2009
---
Tuberculosis, XXDR - USA: FL ex Peru 20091230.4387
Tuberculosis, MDR - China 20090114.0151
2008
---
Tuberculosis, XDR - Austria ex Romania 20080803.2373
Tuberculosis, MDR, XDR - Peru 20080412.1337
Tuberculosis, XDR - Namibia 20080403.1231
Tuberculosis, XDR - UK (Scotland) ex Somalia 20080322.1094
Tuberculosis, MDR, XDR - Worldwide: WHO 20080228.0813
Tuberculosis, MDR - South Africa 20080208.0521
Tuberculosis, MDR - Papua New Guinea 20080206.0478
Tuberculosis, XDR - Botswana, South Africa 20080118.0222
2007
----
Tuberculosis, XDR, MDR: genome sequences 20071122.3780
Tuberculosis - Uganda (02): MDR, susp. RFI 20071004.3284
Tuberculosis, XDR - South Africa (11): fugitives 20071002.3251
Tuberculosis, XDR - worldwide (02) 20070623.2034
Tuberculosis, XDR, airplane exposure - multicountry (USA, France,
Canada, Czech Rep.) 20070529.1738
Tuberculosis, XDR, 2003-2006 - Europe (Germany, Italy) 20070403.1132
Tuberculosis, XDR, 1993-2006 - USA 20070322.1005
Tuberculosis, XDR, 1991-2003 - Spain 20070302.0738
Tuberculosis, XDR - worldwide 20070205.0456
........................................ml/mj/jw
*##########################################################*
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U.S. to Blame for Lack of Access to Pediatric Critical Care, Experts Say

DISEASE SITUATION, POST-EARTHQUAKE - HAITI
******************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Tue 2 Feb 2010
Source: Haiti: Operational Biosurveillance [edited]



Haiti Epidemic Advisory System
------------------------------
The UN Health Cluster [the Global Health Cluster, under the leadership
of the World Health Organization, is made up of more than 30
international humanitarian health organizations that have been working
together over the past 2 years to build partnerships and mutual
understanding and to develop common approaches to humanitarian health
action. See
]
is now sending teams of individuals to assess various areas of Haiti.
Over 246 responder organizations signed up as part of the Health
Cluster, and reports of activities were requested from all of them.
However only 46 reports were received. This implies an operational
distraction towards the immediate priorities of food, water,
sanitation, and shelter provision to the refugees, among other more
urgent priorities. As a result, situational awareness for infectious
disease events remains limited and heavily depending on
non-traditional surveillance methodologies.

Diarrheal illness
-----------------
Current reports indicate an active trend of increasing incidence in
the IDP [? internally displaced persons] camps. Periodic rainfall
predicted this week [week of 1 Feb 2010], with sustained rains in the
PAP [Port au Prince] area anticipated beginning in March.
Precipitation may further compromise indigenous water sources and
exacerbate what limited sanitation is available.

Pandemic H1N1
-------------
Current reports indicate an active trend of increasing respiratory
disease in the IDP camps. There has been no formal evaluation or
laboratory confirmation of pH1N1 [pandemic H1N1] to our knowledge.
Advisory issued on 2 Feb [2010] based on the observation that patient
transfers for ventilator beds has been extremely difficult,
particularly in regards to pediatric beds. Those at risk for severe
clinical outcomes from pH1N1 infection include children and pregnant
women. Further, we have documented in multiple countries adverse
clinical outcomes seen in indigenous peoples with poor access to
adequate healthcare, as is the case in Haiti. With the coming rains in
March to encourage crowding in IDP camps, the potential for outbreaks
is moderate. No evidence of pandemic vaccine deployment campaigns by
responding agencies in Haiti. Potential to see serious pediatric
illness requiring pediatric intensive care and ventilatory capabilities.

Anthrax
-------
Extremely difficult to assess actual risk under present conditions.
Prudence suggests a conservative, vigilant, and proactive posture.
Prior post detailed risk factors for Artibonite Valley, which
historically has seen a peak of human cases in the May-June time frame.

Dengue
------
Risk for outbreaks is moderate with the coming sustained rains in
March. Vector breeding sites will increase, as will the potential for
dengue transmission. Heaviest transmission typically seen in the later
half of the year. We have not seen plans yet for mosquito nets
provided to IDP camps.

Pediatric mortality in Haiti
----------------------------
We have been following multiple reports of a commonly observed problem
with disasters in undeveloped or developing countries: lack of
specialized care for children. Specifically, lack of access to
pediatric critical care services.

"On most days, at least one patient died, usually a child."
"It's ridiculous how many kids die from diarrhea, and it's going to
get worse with all the people crowded together... When the rains come,
it could be a slaughter."

"A 15-year-old got gangrene 3 days after being told she would be
heading to Miami for medical care. On Friday, she lost the lower half
of one leg and the foot on the other. Another 14-year-old, whose name
frenzied doctors can't recall, died on Tuesday."

"[Another woman] is still waiting to leave. The quake ripped the skin,
muscles and tendons off her leg. She has to be completely sedated
every time her dressing is changed."
"These are not optimal conditions... This is a dirty, grassy hospital.
It is not the Johns Hopkins ICU."

Lack of access to pediatric critical care stems from several problems:

1. Lack of field-capable pediatric critical care resources that
includes neonatal capabilities

2. Limited capability at military facilities on the ground in Haiti

3. State of Florida blocking transfers from Haiti to appropriate
facilities, claiming lack of financial reimbursements

4. Political sensitization around alleged abduction of children by
missionaries at the Dominican Republic border

5. HHS [? USA Department of Health and Human Services] criteria for
patient transfer claimed to be rigid, "case by case", and inflexible.

6. DHS [? USA Department of Homeland Security] blocking admission to
the United States for patients without paperwork, visas, etc. where a
significant portion of these children are without guardians, parents,
or paperwork.

From a pediatric point of view, we have been primarily concerned
about diarrheal disease, respiratory disease, dengue, and malaria as
primary killers of children during this time. The reasoning for this
prioritization is due to relative ease in control. Vaccination
campaigns are already underway for diphtheria, tetanus, and pertussis.
We would assume given the public health and medical personnel's
publicized concerns about measles they will extend coverage to include
measles. However the disruptors mentioned above have the ability to
spread quickly and kill many children under the present conditions,
and especially during the rainy season due to the difficulty in
gaining effective control.

It has been suggested at the UN Health Cluster that formation of the
IDP camps represents a better sanitary situation than the slums of
Port au Prince. While that may be the case for a short time, a
combination of crowding, pressure on limited and undeveloped
sanitation capacity, and the coming rains will rapidly put this idea
to the side.

Haiti's children remain at serious risk. Lack of access to appropriate
care and appropriate public health intervention will ensure continued
high fatality rates in the weeks to come.

Cubans engaged in vector control
--------------------------------
Cuban anti-vector specialists have cleared areas from rats and
rodents, have fumigated them and implemented measures to control
vectors. However, the demand of these tasks is beyond their
possibilities, in view of the prevailing hygienic situation. This is
the 1st time we've seen a dedicated effort to conducting a vector
control campaign, albeit likely of limited value due to the sheer
magnitude of the problem.

Sepsis, gangrene, tetanus, and lack of pediatric intensive care
---------------------------------------------------------------
"They returned to their respective hospitals in [the States] over the
weekend after sweating through 20-hour shifts in a 150-bed hospital
north of Port-au-Prince crammed with 400 patients. They slept on the
floor, helplessly watched many Haitians die in their care, and used
cardboard, ironing boards, and anything else they could find as
makeshift operating tables.

The 1st patient, a 13-year-old boy, came to the hospital with a
mangled leg after he was rescued from beneath a pile of rubble. The
doctors pinned his leg back together using prosthetics and tools they
had brought with them; during the surgery, he was awake and singing.
Later, a mother came to the hospital carrying her unconscious 2-week
old baby, a girl infected with sepsis. The surgeons resuscitated her
but were without a pediatrician. They then tried bringing the baby and
her mother to a nearby US Navy ship, only to find they did not have
the proper physician there, either. They eventually boarded a UN
ambulance, roaming across treacherous roads to a main Haitian
hospital, only for the baby to die upon arrival." - medical response
team from California.

"The conditions are really dire, but we have no choice. Each procedure
has to be carried out that day, to avoid the onset of gangrene.
Fortunately I have everything I needed for anaesthetics and pain
management. The pharmacy was in another building that hadn't been
destroyed. It's complicated and frustrating not having all the
equipment at hand. I saw a tetanus case, a child of 10 years. She was
convulsing on the 1st day, and stiff, with spasms, by the 2nd. Tetanus
is hard to treat if you're not properly equipped. You need to
administer a sedative to relax the patient, and then monitor her
really closely, as her breathing can stop. This patient was on oxygen,
and we monitored her as best we could, but it was a hit-and-miss
affair. We needed a properly equipped intensive care unit, where there
weren't so many risks. The worst, the most annoying thing, was that we
had breathing apparatus in the cargo plane, but as we'd been delayed,
it wasn't yet installed." - pediatric anesthesiologist with MSF
[Medecins Sans Frontieres].

Raw field response conditions in Haiti
--------------------------------------
Email from Alison Thompson sent to her parents in Sutherland Shire
(Sydney) on 24 Jan 2010. Subject: Hell in Haiti

"Hi mum and dad -- I won't be around when they announce my award on
[26 Jan 2010]. I am with Sean Penn, Diana Jenkins, Oscar, and 15
doctors embedded in the US 82nd Airborne (USA) Division. Dante would
describe it as hell here. There is no food and water and hundreds
dying daily. The aid is all bottlenecked and not reaching here.

The other day I assisted with amputation (holding them down) while
they used a saw to cut a young boy's leg off with no pain killers.
Today I went with a strike force and army patrol in hummers into the
streets and walked 5 miles through the camps set up on every street
corner. Sewage and bodies stench is everywhere. As I attend to a
patient 30 people crowd around me and it's hard to breath. I nearly
fainted today as the sewage smell went straight down my throat. I went
white and dizzy but couldn't sit down as sewage is running through the
streets. There is much infection and it feels like the job is too big.
No antibiotics anywhere

"Good news, today our New York doctors evacuated 18 patients with
spinal injuries out to Miami and we're all so excited. Our MASH unit
[US Mobile Army Surgical Hospital] is in the 82nd's air base
overlooking a refugee camp of over 50 000 people. The refugees start
singing Christian songs at 4 am and line up for food until the army
hands it out at 8 am (that's if there is any food). On the 1st night I
was in the nearby jungle camping under the stars with my team and woke
up to the beautiful music drawing me to them. I thought it was a
church and we went to find it and came across the 82 Airborne camp and
the refugee camp. (That's how we ended up here, as it wasn't safe to
stay where we were even though we had our own security force). We are
totally self sufficient with food, gas, and medicines and have a
private donor (Diana Jenkins who was a refugee in camps in Bosnia as a
child -- her family died of starvation in the camps.) Sean Penn is
here purely as a volunteer and is cutting through bureaucracy to get
aid moving and food water and medicines to the people. There is no
agenda but to save lives. Helicopters fly overhead and it feels like
Viet Nam. That night 50 000 people sung me to sleep and they sing
every night for the world to save them. There is always hope but she's
not here right now.

Alison xxx"

--
Communicated by:
James Wilson, MD
Executive Director
The Global Institute For Disruptive Events (GuIDE)


More reports of typhoid & tetanus
----------------------------------
From a team of 15 San Francisco Bay Area physicians: treated cases of
tetanus and typhoid fever.

From a team of physicians from Yale-New Haven Hospital: treated a
6-year-old girl with typhoid peritonitis.

[These reports from the field give a vivid picture of the scale of the
disaster caused by the earthquake in Haiti. Hundreds of thousands of
people are displaced, many with injuries sustained in the earthquake,
acute infections, or chronic illnesses, all in immediate need of
shelter, food, clean water, sanitation, and medical care.

WHO has issued a public health risk assessment to facilitate the
response of those aiding the earthquake-affected population in Haiti,
available at
.

Haiti and the Dominican Republic occupy the Caribbean island of
Hispaniola in the Greater Antillean archipelago. A
HealthMap/ProMED-mail interactive map of Hispaniola can be found at
. - Mod.ML]

[Gideon (Global Infectious Disease & Epidemiology Network) is
providing a free download of "Infectious Disease of Haiti". It is
available at
. -
Mod.LM]

[see also:
Tuberculosis - Haiti: post-earthquake 20100207.0409
Meningococcemia, fatal - Dominican Republic ex Haiti 20100206.0401
........................................ml/mj/jw
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