Amid Health Care Shortage, Immigrants Are Rural America’s Saving Grace

Roberta Boltz keeps her doors unlocked at night. The former coal mine worker says it is just one perk of living in the small Pennsylvania town of Hegins.

But last Christmas morning, she had her first epileptic seizure, and her only worry about rural life took center stage: access to health care. There is no hospital in her community of 812 residents, and she says she does not trust the one closest to her.

“I’ve heard people say they wouldn’t send their dog to that hospital,” Boltz said. “They’re so understaffed.”

Seated upright in a platinum nightgown, with gauze covering her thin forehead, Boltz recently made the one-hour commute to Danville, Pennsylvania’s, eight-story, 559-bed Geisinger Medical Center to receive care, as she has done during several critical life moments. Geisinger treated her son’s Crohn’s disease when he was a child, and more recently, after her husband suffered a heart attack. 

Located beside a 300-acre forest, Danville is not much more urban than Hegins. With a population of 4,631, it could not by itself support a hospital this size that serves all of central Pennsylvania and has grappled with its own issue of filling medical staff positions.

Geisinger has tried to solve its own staffing problem by hiring immigrants from Jamaica, India, the Philippines, South Korea, Kenya, Cameroon, Nigeria, Ghana and others — many of whom have come to live in a borough (town) that is 94% white. 

In interviews with VOA, Geisinger staff referred to the nursing shortage crisis as one of its biggest supply-and-demand challenges. Despite being the region’s “employer of choice,” they say local talent recruitment alone has fallen short of their needs.

Big shortage

The entire United States faces a massive shortage of health care professionals over the next decade, including up to 120,000 physicians by 2030. One-third of currently active doctors in the country will reach retirement age during that span.

Unless the health care workforce gap is addressed, rural areas are likely to bear the brunt of its effects, says Andrew Lim, director of quantitative research at New American Economy, a bipartisan research organization.

“If you look at urban areas, there are over 200 doctors per 100,000 people. But if you look at rural counties, the number of doctors to go around is much less — something like 82 for every 100,000,” Lim told VOA.

The population of Danville more than doubles when Geisinger — with its 6,200 employees — is fully staffed. Among the workers: 415 internationally trained physicians and 57 foreign-born registered nurses.

“Not only is Geisinger trying to recruit (international nurses), many other health systems are,” Julene Campion, vice president of human resources at Geisinger, told VOA. “We could probably use another 100 easily (across the Geisinger network), but there aren’t enough available.”

“We’ve outgrown our ability to supply,” added Crystal Muthler, Geisinger’s vice president of nursing — a 30-year veteran. 

The community’s needs, combined with an aging workforce, she says, are ultimately what led Geisinger to reevaluate its staffing model and implement an international nurse initiative in 2018.

“We have to look at how we attract people to the area,” Muthler said. 

According to U.S. Bureau of Labor statistics, health care is projected to be the largest-growing sector of new job creation over the next decade, accounting for more than 1.3 million new jobs, roughly one-third of them for registered nurses.

But for those looking to find opportunity in the United States, while helping fill a critical shortage, obstacles remain.

Doctors have been impacted by the Trump administration’s travel ban, while some health aides and nursing assistants could be barred from getting a green card.

It is unclear whether Trump’s new immigration plan, announced on May 16, will help health care staffing. The merit-based system would favor immigrants who fall into broad “high-skill” categories, including “professional and specialized vocations,” at the cost of family-based and humanitarian immigrant visas.

‘Kindness is my language’

Even now, foreign-born health care professionals represent more than their share of the overall U.S. population; 14.7% of nurses and 22.7% of health aides are immigrants, according to NAE, compared to 13.7% of the population as a whole.

Thirty-five-year-old Hemoy Drummond, a recent Geisinger hire from Jamaica, has an EB-3 employment-based immigrant visa. She has 13 years of experience as a registered nurse.

“I was very nervous. It was a new setting, new expectations,” Drummond said. “But when I got here, I realized that people are kind. … I said, ‘That’s my language.'”

Danville, with its lush hillsides and nearby cornfields, reminds her of the sugar cane fields her father harvested in her native Clarkstown, Jamaica. Her community is safe. The mother of two can walk home alone after a late shift.

The nursing work is easier in Danville than in a short-staffed Montego Bay hospital.

“It’s easier to care for four to six (patients at Geisinger) than 18 (in Jamaica),” Drummond said. “I love to talk with (patients) that extra minute.”

Willing to stay

In town, locals generally welcome — or at least tolerate — their new international neighbors. 

“They’re magnificent!” remarked one woman on Danville’s Mill Street. “We’d be stupid not to let them into our country.”

Two hours southeast of Danville, along the Susquehanna River in Chambersburg, Pennsylvania, views are more mixed. A foreign-born doctor described Chambersburg as “where blue meets red.” 

Yet Chambersburg Hospital, too, has been trying to solve its health care staffing problems with immigrants.

In Chambersburg, population 20,878, VOA spoke with 10 foreign-born doctors from India, Pakistan, Bangladesh, Nigeria, Poland and Hungary. Nine of them expressed a willingness to remain in rural Pennsylvania long term, including Indian physicians affected by a per-country green card backlog that has placed their families’ future in limbo. 

​U.S.-born physicians do not want to go to Chambersburg, much less stay, explained Dr. Golam Mostofa, chairman of the department of hospital medicine at Chambersburg Hospital.

“Fifty percent of our hospital medicine physicians are foreign graduates,” Mostofa said. “If we interview 10 American graduates, maybe one shows up.”

Dr. Muhammad Khokhar, a gastroenterologist from Lahore, Pakistan, has been in Chambersburg for 16 years. He remains committed to the town, even after his sixth grade daughter’s classmates at a Montessori school accused her of making bombs.

“(When) you have invested so much in the community, and you have built up relationships with your partners and the practice, it’s difficult,” Khokhar said. 

“I’m here,” he added. “This is my retirement place.”

 

 

How One Pollution-Weary Asian Island Adopted Electric Vehicles

Electric vehicles have struggled to gain mass appeal in much of the world despite the fanfare surrounding Tesla Motors, the world’s best-selling brand of plug-in cars last year. Drivers worry about prices, comfort and what happens when a battery expires in the middle of a trip.

But in Taiwan, scooter vendor Gogoro doubles its sales every year largely because of a widespread battery exchange network supported by a central government that’s keen to control emissions. Gogoro designs what it describes as ride-able scooters as well as engines for other brands, filling what the chief executive officer calls earlier market voids.

“People say we’re the two wheels of Tesla, and in some ways, we are,” CEO and co-founder Horace Luke said. “We do a little bit of everything.”

The company, which launched in 2011, first had to prove that it could all be done.

“Nobody could believe that an electric vehicle could be cool and fun to ride, so we built that,” said Horace Luke, founder of Gogoro. “Nobody believed that you could swap batteries, so we enabled that.”

Battery swaps

Gogoro stands out among other electric scooter developers by working with Taiwan’s central government plus the city of Taipei to locate and pay for 1,300 battery swap stations. Those alleviate rider fears of running out of juice in mid-trip, a barrier to development of the world’s $17.43 billion electric vehicle industry.

Battery swap sites are placed every 500 meters in urban Taiwan, usually in obvious roadside locations. They turn up every two to five kilometers in other parts of the island. The central government pays half the cost of building the swap stations and offers publicly accessible land, Luke said. The government’s National Development Fund invested venture capital in Gogoro in 2014.

“You should have seen how hard it was for first 50 stations; it was almost impossible,” recalled Luke, 49, a Seattle native and former software designer who moved to Taiwan for the engineering talent and supply chain. He co-founded Gogoro in 2011. 

“And our consumers are the ones voicing out. They go to the government and say ‘I want this here’,” he said. 

Taiwan’s Environmental Protection Administration has set a goal of cutting greenhouse gas emissions 10 percent from 2005 levels by 2025 and hacking them by 20 by 2030. 

For the government now, Luke added, “it’s a win-win situation for them to adopt electric.” 

Gogoro’s stations do 90,000 swaps per day. Those transactions give Gogoro the data it needs to know where it should resupply batteries.

Worldwide, just “a handful” of countries have “significant market share” of electric cars, the independent, intergovernmental International Energy Agency says. Norway led in 2017 with 39 percent of new sales in 2017, followed by Iceland at 11.7 percent and Sweden at 6.3 percent.

Taiwanese still want to know more about their next battery, said Paul Hsu, co-founder of Okgo.life, a fellow Taiwanese electric scooter brand with an app that lists types and prices of batteries at the swap sites on its roster.

“Every rider has a plan for every trip. The riders know where they’re going but not how much money it will take to get there,” Hsu said. For example, he said, “a short trip should have a short-distance vehicle and a short-distance price.”

‘Fun to ride’

Gogoro has raised its sales as well by designing scooter models attractive to men who like bigger motorcycles along as well as vehicles aimed at female riders. Sales doubled last year and they’re on track to double again this year, Luke said. 

Total sales are about 160,000, or 16 percent of the total Taiwan scooter fleet. Tesla, by comparison, sold about 532,000 cars worldwide from 2012 to 2018.

Taiwanese adapted especially fast because of the earlier prevalence of gas-powered scooters. Riders were comfortable with the idea of scooters in general – just not the noise and pollution they kick up.

Tsai Cheng-yang, 36, an urban designer of the southern Taiwan city Tainan, has five electric scooters in his household. Compared to gas-powered scooters, he said, electric ones a quieter, give off less heat and lack the stench of fuel, he said. Operation costs are about the same, he said.

“If all vehicles were an electric powered, you’d feel it was quite peaceful, with no odors either, quite happy and a different experience,” Tsai said.

Gogoro plans to overcome competitors such as Yamaha and Aeon by selling motors to them, giving it a cross-brand presence, Luke said. “The idea is to create a platform allowing others to create their own vehicles,” he said.

US Treasury Says 9 Trade Partners Deserve Scrutiny Over Currency Practices

The Trump administration said on Tuesday that no major trading partner met its currency manipulation criteria but nine countries, including China, required close attention as Washington presses tariffs and negotiations to address trade deficits.

The Treasury Department, in a semi-annual report to Congress, said it reviewed the policies of an expanded set of 21 major U.S. trading partners and found that nine required close attention due to currency practices: China, Germany, Ireland, Italy, Japan, South Korea, Malaysia, Singapore, and Vietnam.

“No major U.S. trading partner met the relevant 2015 legislative criteria for enhanced analysis” as a currency manipulator, the department said in a statement.

President Donald Trump has imposed tariffs on $200 billion worth of Chinese imports and begun the process of imposing tariffs on another $300 billion in Chinese goods.

Talks to end the trade dispute between the two countries collapsed earlier this month, with the two sides in a stalemate over U.S. demands that China change its policies to address a number of key U.S. grievances, including theft of intellectual property and subsidies for state enterprises.

The Treasury Department said Washington believes direct foreign exchange intervention by the People’s Bank of China has been limited in the past year.

“Treasury will continue its enhanced bilateral engagement with China regarding exchange rate issues, given that the RMB (yuan) has fallen against the dollar by 8 percent over the last year in the context of an extremely large and widening bilateral trade surplus,” Secretary Steven Mnuchin said in the statement.

China needs to aggressively address market-distorting forces, including subsidies and state-owned enterprises, the Treasury statement said. Improved economic fundamentals would support a stronger yuan and help reduce China’s trade surplus with the United States, it said.

MacKenzie Bezos Pledges to Give Away Half Her Fortune

MacKenzie Bezos, who just months ago divorced the world’s richest man, has pledged to give away half her fortune to charity. 

The former wife of Amazon founder and chief executive Jeff Bezos is one of the 19 new signatories to the Giving Pledge who have promised to donate more than 50% of their wealth, the organization said. 

“I have a disproportionate amount of money to share,” MacKenzie Bezos said in a letter released Tuesday. “My approach to philanthropy will continue to be thoughtful. It will take time and effort and care. But I won’t wait. And I will keep at it until the safe is empty.” 

Bezos’ personal fortune is worth nearly $37 billion, making her the 22nd-richest person in the world, according to the Bloomberg Billionaires Index. 

The Giving Pledge was created by billionaires Warren Buffett and Bill and Melinda Gates in 2010. It asks the world’s wealthiest people to promise to give away half their wealth during their lifetimes or in their wills. 

Bezos’ former husband, who is worth an estimated $114 billion, has not yet signed the pledge but tweeted his support for his ex-wife’s decision.

“MacKenzie is going to be amazing and thoughtful and effective at philanthropy, and I’m proud of her,” he said on Twitter.

​Other billionaires who have signed the Giving Pledge include Elon Musk, oil baron T. Boone Pickens, Michael Bloomberg, Richard Branson, and WhatsApp co-founder Brian Acton and his wife, Tegan.

Sneezing a Lot? Handheld Allergen Detector Can Help

Whether you live in a city of somewhere more rural, there are always things in the air, invisible to the naked eye that could make you sneeze or cause major illness. Detecting these microscopic materials such as pollen, mold and pollutants could be time consuming and costly. A lab at the University of California, Los Angeles is trying to solve that problem by developing a handheld allergen detector for consumers. VOA’s Elizabeth Lee has the details.

Facebook Drops 51 Fake Accounts Traced to Iran   

Facebook has dropped 51 accounts, 36 pages, and seven groups after the cybersecurity firm FireEye revealed they were fake accounts originating in Iran.

Three Instagram accounts were also deactivated.

The FireEye report Tuesday says the phony accounts pretended they came from the United States and impersonated legitimate Middle Eastern news sources to push a pro-Iranian agenda.

Posts written in both English and Arabic included discussions about American and British politics, Islam, Arab minorities, and the influence of Saudi Arabia. The posts represented both conservative and liberal points of view.

One post said the best way to honor the memory of slain Saudi journalist Jamal Khashoggi was for the U.S. to stop sending aid to the Saudi coalition fighting Iranian-backed rebels in Yemen.

The fake posters even succeeded in getting letters to the editors published in a number of U.S. newspapers, includingThe Los Angeles Times and The New York Daily News.

The author of the FireEye report, Lee Foster, was careful not to directly blame the Iranian government for the illegitimate accounts, saying the investigation is continuing.

Facebook says it is also investigating and is sharing information with law enforcement.

“We’re constantly working to detect and stop this type of activity because we don’t want our services to be used to manipulate people,” Facebook said. 

It added it canceled the suspect accounts for their behavior, and not because of content.

50th Annual World Series of Poker Opens in Las Vegas

The annual World Series of Poker opened Tuesday in Las Vegas with dozens of scheduled card tournaments and a special event to celebrate the 50th run of a series known for minting millionaires each year. 

The seven-week poker festival is expected to again draw tens of thousands of players seeking a piece of a projected combined prize pool of more than $200 million. Buy-ins for the series’ 89 championship events range from $400 to $100,000. 

To celebrate the milestone, owner Caesars Interactive Entertainment has scheduled an awards ceremony and a $500 buy-in, rake-free tournament with a guaranteed prize pool of $5 million. The company is allowing fans and others to choose some of the players who will be recognized at the ceremony. 

“It’s absolutely a way to make them a part of it,” tournament spokesman Seth Palansky said. “The 50th year was a good time to reflect back on sort of where we’ve come both in poker and the World Series of Poker, but we wanted the fans and the players to decide what moments from our 50 years stood out to them.”

People can vote on seven categories, including fan favorite player, the series’ “favorite bad boy” and the four most important players in the tournament’s history. A panel will also put together a list of the 50 greatest poker players. 

Casino owner Benny Binion started the series in 1970 as an invitation-only event. Johnny Moss was declared the winner by the other men at the table and was given a trophy. 

Poker’s popularity in the U.S. erupted in 2003, when Tennessee accountant Chris Moneymaker entered a $39 online poker satellite contest, won an entry to the series’ famed no-limit Texas Hold `em main event and emerged victorious, winning $2.5 million and inspiring other amateur players. 

The series this year will run through July 16 at the Rio All-Suite Hotel and Casino, west of the Las Vegas Strip. Champions go home richer and with gold bracelets.

The tournament saw a record 123,865 entrants in 2018. The prize pool of over $266 million was divided among 18,105 participants. Twenty-eight of them earned at least $1 million.

Palansky said the tournament keeps going strong because organizers have been open to changes and feedback from players.

“Poker is a unique game. We are just the operator — we deal the cards, we provide the chips and the setup — but they play amongst each other. It’s a peer-to-peer game,” he said. “So, ultimately, the WSOP, we look at it as sort of in the trust of the players, and it’s our job to just listen to their feedback and provide the schedule that meets their needs and demands.”

The tournament’s famed main event starts July 3 with players staking $10,000 to buy in. ESPN and PokerGO will again provide live coverage.

Indianapolis resident John Cynn won the main event last year after playing more than 440 hands at the final table. His cut of the prize pool was $8.8 million.

  

Trial Begins in Oklahoma Lawsuit Against Opioid Maker Johnson & Johnson

A civil lawsuit brought by the state of Oklahoma against drugmaker Johnson & Johnson went to trial Tuesday over the company’s alleged role in the U.S. opioid epidemic. 

The first-of-its-kind trial, which holds opioid manufacturers responsible for the drug crisis gripping the country, could have a large impact on other states seeking similar compensation.

In opening statements, Oklahoma Attorney General Mike Hunter called the prescription opioid epidemic the “worst man-made public health crisis in the history of our state and country.”

Hunter further characterized Johnson & Johnson as being motivated by greed and having been engaged in “a cynical, deceitful multimillion-dollar brainwashing campaign.”

Drugmakers named in the lawsuit denied claims made by the state, which is located in the U.S. Great Plains. Two of those companies settled with the state before the trial began.

In an opening statement, Larry Ottaway, a Johnson & Johnson defense lawyer, told the court that Janssen Pharmaceuticals, a subsidiary of Johnson & Johnson, advertised its drugs in compliance with a Food and Drug Administration consensus that said opioids “only rarely caused addiction.”

The state of Oklahoma alleges Johnson & Johnson created a surplus of painkillers and is responsible for creating a “public nuisance.”

“If you have an oversupply, people will die,” said Brad Beckworth, a private attorney hired by the state of Oklahoma. In explaining some of the numbers behind the crisis, he told the court there were 135 opioid pills available for every adult in Cleveland County, which has a population of about 280,000. Cleveland County is where the trial is being held.

County District Judge Thad Balkman will decide the case, in lieu of a jury.

On Sunday, Israel-based Teva Pharmaceuticals Ltd. reached an $85 million settlement with the state. Teva said in a statement, “The settlement does not establish any wrongdoing on the part of the company. Teva has not contributed to the abuse of opioids in Oklahoma in any way.”

In March, Purdue Pharma, the maker of OxyContin, settled with the state for $270 million.

Other lawsuits

Nationwide, states, cities and tribal governments have brought more than 1,600 lawsuits against drugmakers, seeking compensation for money spent addressing the opioid epidemic.

According to the National Institute on Drug Abuse, there were 388 overdose deaths involving opioids in Oklahoma in 2017, a rate of 10.2 deaths per 100,000 persons. The national rate was 14.6 deaths per 100,000 persons.

In his opening statement, Attorney General Hunter said opioid overdoses had killed 4,653 people in the state from 2007 to 2017.

According to the U.S. Centers for Disease Control and Prevention, drug overdose deaths involving prescription opioids rose from 3,442 in 1999 to 17,029 in 2017, the latest year for such data. Drug overdose deaths involving any opioid — prescription opioids (including methadone), synthetic opioids and heroin — rose from 18,515 deaths in 2007 to 47,600 deaths in 2017, according to the CDC.

Smithsonian Appoints Lonnie Bunch as Its 14th Secretary

The founder of the Smithsonian Institution’s newest museum, which focuses on African-American history, has been selected to lead the institution’s entire system of museums and parks.

Tuesday, the Smithsonian Board of Regents appointed Lonnie Bunch as its 14th secretary, becoming the museum’s first African-American leader in its 173-year history.

The 66-year-old Bunch will guide the world’s largest museum, education and research complex, overseeing a $1.5 billion annual budget that helps fund 19 museums, nine research centers and the National Zoo.

Board of Regents chairman David Rubenstein said Bunch’s experience at three museums, reputation and fundraising skills separated him from other candidates.

The appointment comes less than three years after the opening of the National Museum of African American History and Culture (NMAAHC).

As its first director, Bunch oversaw an 11 year effort to collect more than 40,000 items before the museum opened on the National Mall in 2016. 

The museum immediately became one of Washington’s most popular attractions, drawing more than four million people in its first two and one-half-years.

George Mason University history professor Spencer Crew will serve as the NMAAHC’s interim director.

Lawyer Accuses Chris Brown of ‘Disrespect’ in Rape Case

The lawyer for a woman who filed a rape complaint in Paris against Chris Brown says the American singer-songwriter “has thumbed his nose at and shown disrespect for the French legal system” after he did not attend a formal meeting with the alleged victim on Tuesday.

Brown was arrested in January then released from custody without charge pending further investigation of the woman’s allegations that he and two other men raped her at the Mandarin Oriental Hotel in Paris. The Grammy winner called the accusation false.

“His failure to appear today is very unfair to my client, but I assure him that my client will not be deterred from seeking justice,” said American lawyer Gloria Allred, who traveled to Paris judicial police’s headquarters to assist her client at the meeting, which in France is called a confrontation.

The woman’s French lawyer, Jean-Marc Descoubes, said Brown was not legally obliged to attend the meeting. The two other suspects, both American, did not attend the meeting either, Descoubes said, adding he expects another date to be set.

“If he doesn’t show up a second time we will have to either ask for the preliminary investigation to be closed (to allow for an investigative judge take over the procedure) because we just can’t keep going like this. Or we will ask the prosecutor to put in place more coercive measures, a warrant to get him to come because the confrontation requested by our client is key to this case – a sexual abuse case,” he said.

Brown’s French lawyer, Raphael Chiche, did not immediately answer an email from The Associated Press seeking comment.

French police detained Brown and the two others in January on potential charges of aggravated rape and drug infractions. The Paris prosecutor’s office said at the time the investigation hasn’t been closed, but Brown was free to leave the country while it continued.

Allred said Brown “has betrayed the trust of the criminal justice authorities who allowed him to leave France expecting that he would honor his promise to attend the confrontation.”

The AP does not typically identify people alleging sexual assault unless they agree to be named or come forward publicly. Descoubes told the AP his client does not want to be identified.

Brown burst onto the music scene as a teenager and won a Grammy Award in 2011 for best R&B album for “F.A.M.E.”  He has had continued legal troubles since he pleaded guilty to the felony assault in 2009 of his then-girlfriend, Rihanna.

Pakistan Trying to Grapple With Its Biggest HIV Outbreak

A joint rapid response team of experts from the United States and the U.N. World Health Organization arrived in Pakistan Tuesday to support the response to the country’s “biggest” outbreak of HIV infections in a southern district where more than 700 people, mostly children, have been diagnosed over the past month.

Nearly 22,000 individuals have been subjected to blood screening since the outbreak was first reported in Larkana on April 25. The district, with an estimated population of 1.5 million, is located in Sindh province and it has previously also experienced repeated, though limited, outbreaks of the virus, which causes AIDS.

The major testing program is ongoing and local officials say hundreds of people line up everyday outside screening camps to get tested voluntarily after watching news on television about the HIV epidemic in their area.

“More than 80% of those infected are children less than 15 years old,” said Dr. Maria Elena G. Filio-Borromeo, UNAIDS’ country director for Pakistan and Afghanistan. She spoke to VOA from the Pakistani province where her agency is leading the coordination and facilitation of support from U.N. agencies to help local partners effectively respond to the crisis.

Borromeo noted that more than half the children affected are under the age of 5. “This poses a particular challenge. It is likely that they got the virus through unclean needles and syringes, or through unsafe blood transfusion,” she said.

The UNAIDS country chief would not, however, speculate on exactly what might have caused the HIV outbreak. “It is a very different profile of outbreak, so a thorough investigation is needed,” Borromeo emphasized.

She said that the 11-member visiting team of experts from WHO and U.S. Centers for Disease Control and Prevention (CDC) landed in the provincial capital of Karachi.

Borromeo added the team is visiting the country at the request of the Pakistani government and they would work closely with local partners to carry out the investigation for up to three weeks to ascertain the source of the outbreak and controlling it.

After the outbreak investigation, she stressed, a “huge amount” of work is expected ensuring that the root cause of the outbreak will be addressed, and future outbreaks will be prevented.

“In most cases, parents of the infected children have been tested negative for HIV, which is a rare and extremely worrisome finding,” according to Zafar Mirza, who is the advisor on health to the federal government.

Mirza said that used syringes being repackaged and sold in Pakistan, contaminated blood transfusion as well as a “faulty” infection prevention and control system in hospitals could be the factors behind the outbreak in Larkana.

“Either unsafe injections are spreading the virus in children or there is another reason that we have been unable to determine so far,” the Pakistani advisor explained.

He said he was hopeful the international rapid response team would be able to ascertain the reasons, noting the ongoing efforts to control and investigate the underlying causes of the HIV outbreak in Larkana were not sufficient.

Critics say the outbreak demonstrated “public health failure” particularly in Sindh, though the health sector elsewhere in Pakistan also faces critical challenges stemming from a lack of funding and priority.

Pakistani and U.N. officials do not rule out the possibility that the HIV outbreak is the outcome of shady medical practices in private as well as public hospitals.

Out of an estimated 600,000 unqualified doctors unlawfully practicing in Pakistan, 270,000 of them are working in Sindh, according to UNAIDS.

Mirza cautioned that reported cases of HIV/AIDS in Pakistan are far less than the actual magnitude of the problem. He says that official estimates put the number of HIV/AIDS carriers in the country at around 163,000.

“But only 25,000 of them are registered with our national and provincial HIV/AIDS treatment centers, and out of them, merely 16,000 visit the programs routinely to receive their medicine,” the advisor noted.

 

Desperate Zimbabweans Risk Lives in Abandoned Mines

Officials in Zimbabwe say the bodies of eight illegal miners have been retrieved from an abandoned gold mine about 50 kilometers north of Harare. The news Monday was a reminder of the risk faced by desperate illegal miners trying to make a living in the economically troubled southern African country. Matopo is a gold rich area in southern Zimbabwe, and some men there enter such mines, despite the danger involved. 

These men are illegal miners, using a metal detector to search for gold at the Nugget Mine, about an hour’s drive from Bulawayo, Zimbabwe’s second largest city. 

​Piniel Ndingi-Nyoni is one of those who entered the mine, despite the recent collapse of a mine shaft that killed four men. 

Ndingi-Nyoni says he has no choice but to take the risk. 

“Problems at home force me to do this. We need school fees, you need food, there are medical bills to take care of, so all that force you to stay in the bush. It is not funny at all. In this cold weather, we sleep in shacks while the wife is at home. At times, we can go for three months without getting anything,” Ndingi-Nyoni said.

​A few minutes later, the illegal miners disappeared into the bush at the sight of officials in the area. Once the coast is clear, they re-appear.

No man gives up, is the motto 42-year-old Edward Madyauta lives by. He says he has gold rush dreams. But he says on several occasions, he has gone for months on a wild-goose chase. 

What about fears of being trapped under, as what happened a few meters away?

“I do not fear death, because (I) usually get gold before depth gets past my height. So that can’t collapse on me. But those who go under have a higher risk of the shaft collapsing on them,” Madyauta explained.

On Monday, searchers found the bodies of eight men working an abandoned mine in Mazowe, north of the capital. It was the third fatal incident involving illegal miners this year. 

Polite Kambamura, deputy minister of mines, says the government is worried about the trend and has embarked on a campaign to urge people to stay away from abandoned mines.

​“We are going to call on owners of such mines to show cause why they are not mining. We are risking the lives of many people. If a mine stays for long without any activity, the ground will weaken up,” Kambamura said. “Some of those miners are going underground to mine on pillars. The moment they mine on pillars, then there is no more support and the ground will fall off.”

But with Zimbabwe’s economy in meltdown and no recovery in sight, one wonders if any of the miners, like Nyoni and Madyauta in Matopo, will listen to the advice.

D-Day’s 75th Anniversary Renews Interest in Some Classrooms 

Kasey Turcol has just 75 minutes to explain to her high school students the importance of D-Day — and if this wasn’t the 75th anniversary of the turning point in World War II, she wouldn’t devote that much time to it.

D-Day is not part of the required curriculum in North Carolina — or in many other states.

Turcol reminds her students at Crossroads FLEX High School in Cary that D-Day was an Allied victory that saved Europe from Nazi tyranny and that the young men who fought and died were barely older than they are. She sprinkles her lesson with details about the number of men, ships and planes involved in the landing at Normandy while adding a few lesser-known facts about a Spanish spy and a deadly military practice conducted six months earlier in England.

Losing resonance

In the U.S. and other countries affected by the events on June 6, 1944, historians and educators worry that the World War II milestone is losing its resonance with today’s students.

In France, which was liberated from German occupation, D-Day isn’t a stand-alone topic in schools. German schools concentrate on the Holocaust and the Nazi dictatorship. And despite having been part of the Allied powers, in Russia, the schools avoid D-Day because they believe it was the victories on the Eastern Front that won the war.

“History has taken a back seat” in the U.S. because of the focus on science and math classes, said Cathy Gorn, executive director of National History Day in College Park, Md. 

In the U.S., teaching about World War II varies from state to state. It’s often up to the teachers to decide how much time they want to give to individual battles like D-Day.

California framework

California’s History-Social Science Framework, adopted in 2016, includes for sophomores an expansive unit on World War II that covers how the conflict was “a total war,” the goals of the Allied and Axis powers and how the fighting was fought on different fronts. The unit also includes a section on the Holocaust. 

In New York, school officials are using the D-Day anniversary to review the curriculum and “make recommendations on how the current average time of 90 minutes of World War II study in a school year can be strengthened, expanded and mandated.” 

There are special programs available to immerse select students in the history of D-Day. 

For eight years, National History Day sent 15 pairs of students and teachers to Normandy to immerse them in the history of D-Day. The high school sophomores and juniors would research individual soldiers close to them — relatives or people from their hometowns — who died. On the last day, the group visited a cemetery where each student read a eulogy for his or her individual soldier. 

Teachers also have outside resources. The National World War II Museum offers an electronic field trip through D-Day and provides suggested lessons plans.

In North Carolina, history is taught through “conceptual design” with connections to themes such as geography, economics and politics, said Meghan Grant, coordinating teacher for secondary social studies in Wake County schools.  

The lessons are based on a method of teaching social studies that was developed in 2013 and used by about half the states, said Larry Paska, executive director of the National Council for the Social Studies. Paska said it may focus on asking students a question like, “What makes an event a turning point in the war?” Students then will use difference sources of evidence to back up their answers.

‘This is the moment’

As part of her D-Day lesson, Turcol tells her class of juniors and seniors that the Germans thought an attack from the Allied forces wouldn’t be possible.  

“It’s too stormy. It’s too risky,” she said. “And what do we do? Yeah, we find a glimmer of hope. On June 5th, the skies kind of clear. The moon kind of shines. And we’re like, ‘This is the moment. This is what is happening.’ ”

She tells students that Gen. Dwight Eisenhower kept D-Day plans on the “down low.”  

Turcol plays a few minutes of a documentary about D-Day to “show you the true humanity of the war,” she says.  

“You saw the German praying … asking for his mother, father, asking for this to be over. Not everybody is on the same message in Germany,” she says. “Everybody here is a father, a mother, a brother, a cousin, a friend. So every life matters.”

Students in Europe also receive dramatically different lessons on D-Day depending on where they live.

Because of Germany’s history, any hint of militarism remains a taboo. While battles like D-Day, Stalingrad and the Operation Barbarossa invasion of Russia might be mentioned briefly in schools, they tend to be lumped together in broad overviews of the war. Individual teachers do have leeway, however, to pursue topics that capture the attention of students. 

The curriculum is similar from state to state. In Berlin high schools, for example, curriculum guidelines include the history of the war under the overall focus on “the collapse of the first German democracy; Nazi tyranny,” which includes classes on Nazi ideology, resistance movements, the Holocaust and World War II.

Similarly, Bavaria’s ninth-grade curriculum focuses primarily on explaining how the Nazis came to power and their anti-Semitic ideology and genocidal policies, with the war taught briefly as part of their “expansion and conquest policies.”  In the 11th grade, the focus is even more directly on the Holocaust, and the curriculum guidelines note specific dates to be learned, including the anti-Jewish “Kristallnacht” pogrom in 1938.

The Russian narrative on D-Day has remained almost unchanged since the days of the Soviet Union. Historians and schoolbooks describe the invasion as a long-awaited move, happening after the course of WWII had already been shaped by Soviet victories in the battles of Stalingrad and Kursk and other battles on the Eastern Front.

Even in the country where D-Day occurred, the assault doesn’t have a central place in the teaching of World War II. The history of 20th century conflict is taught in France as a theme and no longer as a chronological list of major battles.

A week of lessons ‘not possible’

“We no longer teach as we did before, what we called ‘the history of battles,’ ” says Christine Guimonnet, who teaches history at a high school west of Paris and is secretary-general of the APHG, a French association of history and geography teachers. “Everyone will, of course, speak about June 6 because it was a major moment in the war, but we’re not going to spend a whole week on it. That’s not possible.” 

As long as they are still teaching the broader themes, French teachers may home in on specific events, like D-Day, to organize study projects and, if they have the budget, trips to Normandy beaches, museums or screenings of The Longest Day, a 1962 film about the events of D-Day. 

As cultural director at Normandy’s Caen Memorial, Isabelle Bournier deals daily with school groups that tour the museum. French children often aren’t familiar with the details of D-Day, partially because fewer families have relatives who lived through the war and can pass on their stories, she said.

Students from Normandy are different from the broader French student population, she said.

“All families are more or less impregnated by this history. It is part of us,” Bournier said. 

Swiss Scientists Trying Carbon Capture in Their Own Backyard

The idea of pumping excess carbon emissions underground has been around for a while. As the process gets cheaper and more practical scientists are testing new ways to lock away their greenhouse gases. VOA’s Kevin Enochs reports.

Desperate Zimbabweans Risk Death in Disused, Unlicensed Mines

Zimbabwe’s disused mines continue to be a death trap for poor and desperate illegal miners in search of the precious minerals to earn a living. Columbus Mavhunga travelled to Matopo a gold rich area about 500 kilometers south of Harare, where mining continues despite some having been trapped earlier this month.

Overfishing Off Senegal Is Threatening Fish Stocks

Overfishing in Senegal is crippling a once-prodigious artisanal industry long relied on to help feed the West African nation’s population. Moreover, this crisis is happening at a time when climate change is reducing the amount of food grown on land. To learn more, VOA’s Salwa Jaafari met with traditional fishermen outside the capital, Dakar.

Fiat Chrysler Proposes Merger With Renault

Fiat Chrysler proposed a merger Monday with Renault, a union that would create the world’s third biggest automaker.

The merger, if it happens, would vault the new company, with annual sales of 8.7 million vehicles, into a position ahead of General Motors and behind only Volkswagen and Toyota, both of which sell about 10.6 million.

The merger could give the combined companies a better chance in the battle among auto manufacturers to build new electric and autonomous vehicles.

Investors in both companies showed their initial approval of the announcement, with Renault’s shares jumping 15 percent in afternoon trading in Paris and Fiat Chrysler stock up more than 10 percent in Milan. The proposal calls for shareholders to split ownership of the new company.

Fiat Chrysler said the deal would save the combined companies $5.6 billion annually with shared payments for research, purchasing and other expenses. The deal does not call for closure of any manufacturing plants but the companies did not say whether any employees would lose their jobs.

The deal would give Fiat access to Renault’s electric car technologies, allowing it to meet the strict carbon dioxide emission standards the European Commission is enacting.

For its part, Renault might be able to gain ground in the U.S. market because of Fiat’s extensive operations in North America.

The French government owns 15 percent of Renault and said it supports the merger, while adding that “the terms of this merger must be supportive of Renault’s economic development, and obviously of Renault’s employees.”

 

AI Phones, PCs Edging Into Global Consumer Technology

Artificial intelligence-driven phones that turn photos into 3D images and PCs with interactive speakers will come a step closer to reality this week during Asia’s biggest consumer technology show.

 

Organizers of the Computex Taipei show with 1,685 exhibitors — including a who’s who of global high tech companies — call artificial intelligence one of their top 2019 themes.

 

Microchip developers Intel, Nvidia and Qualcomm are expected to talk up their latest gear during the four-day show that opens Tuesday. Memory chip maker Micron Technology says it will exhibit a “broad portfolio of memory and storage” for artificial intelligence.

 

“My personal expectations toward AI this year are quite high,” said Helen Chiang, general manager of market research firm IDC in Taipei. “Whether from the perspective of the information systems or the technology, I’ve got some anticipation for these device-plus things.”

 

Artificial intelligence — AI for short — lets computers make human-like decisions based on data collected from hardware. Classic examples available to common users now include speech recognition, e-mail spam filters and personal assistants such as Siri and Alexa.

 

Apps, speakers and 3D images

 

Almost all the world’s chief hardware and software developers say they are researching what they else can do with AI. That push promises more functions that will be built into PC operating systems and mobile phone apps.

Forrester Research, a leading industry advisory firm, predicts that artificial intelligence will reach a market value of $1.2 trillion per year by 2020 as investment triples from 2018.

 

Consumers should expect in the short term to find AI-assisted matchmaking apps, more chatbots used by financial services companies to talk with customers, and new tools for processing financial data, said Jamie Lin, founding partner of AppWorks Ventures, a startup accelerator in Taipei.

 

One app designer is working with a Taiwanese smartphone company on AI technology that would turn camera images into 3D scenes, Lin said.

 

“Pretty soon you’re going to see phone device ODMs (developers) coming to the market where phones that are able to capture 3D images are loaded with software to help you turn that 3D image into content that can be used for different formats, for example games or 3D playbacks of sceneries,” he said.

 

Among AI-enabled hardware, “smart” speakers are especially likely to reach mass markets next year, Lin added. Consumers will be able to ask them questions such as the day’s weather forecast or the latest NBA scores, he expects.

 

Speakers already make up the highest growth category among “smart home devices” because of their “easy” voice interface, Forrester said in a May 21 report.

 

The rapid expansion of AI consumer products may not last. The market research firm Gartner forecasts that growth in the business value of artificial intelligence will slow through 2025 from a peak of 70 percent to just 7 percent as companies end up seeking “niche solutions that address one need very well.”

But the show host Taiwan is forecasting a boom for now. Premier Su Tseng-chang said in mid-May the government would help train 10,000 people every year to work in AI research and development. Taiwan, a global tech hardware hub since the 1980s, already has enough engineering knowhow to draw big-name Silicon Valley firms such as Google and Microsoft to open local R&D centers.

Computex 2019

 

Among the Computex exhibitors, Microsoft will show AI-enabled software and applications, said Mark Linton, general manager for Microsoft’s partner-devices unit. AI features included in its Office 365 software already direct the PowerPoint program to make downloaded images “gel” into its presentations, he said.

 

“There’s no doubt that AI is a transformative area of the technology industry, and over time it will prove to be a major investment area for Microsoft and I think the industry as a whole,” Linton said. “And really the benefits that we’re looking to get there is to make systems and applications smarter, more intuitive.”

 

A lot of AI-linked gear is expected to surface this year at the show’s InnoVEX segment. This zone for startups grew last year to 388 exhibitors, and 456 have registered for the event this week.

 

Gartner anticipates that startup firms working with AI will overtake Amazon, Google, Microsoft and IBM this year in “driving the artificial intelligence economy” for businesses.

 

The Taipei show, now in its 38th year, expects to draw 5,508 exhibition booths, up nearly 10 percent over 2018. The number of exhibitors should rise 5%, the organizer said in a pre-show statement.

 

Ghana Just Scratching Surface of Illegal Gold Mining

Only the chirping of birds and insects break the silence at a gold mining site in the Eastern Region of Ghana, right at the foot of the Atewa forest reserve.

Caterpillar excavators stand still, as the two Ghanaian companies operating them wait for a new mining permit  a process that has been in the works for months.

But a fresh pile of sludge spilt over a patch of vegetation suggests the mine is being operated illegally.

Felix Addo-Okyreh, who works for Ghana’s Environmental Protection Agency (EPA), says the sludge — referred to as slime’ in mining jargon — is dirty waste water created when gold is separated from sediment, sometimes with the help mercury. It is stored in dams on the site.

“It rained heavily last week. The embankment of the dam was weak. It got broken, and this is the result,” he says.

The toxic slime landed a few meters away from a stream that flows into the Birim, a river supplying water to millions of people in the capital Accra.

Ghana cracked down on illegal small-scale gold mining in 2017, after the national water company warned that the chemicals discharged by what is locally known as galamsey could force the country to import all its drinking water within the next two decades.

That year the government set up a military task force to dismantle illegal mining sites and imposed a 20-month ban on all small-scale mining to give nature a breather. Satellite imagery and digital technologies are being used to better monitor mining activity.

Yet Global Forest Watch data released last month shows the rate of deforestation in Ghana increased by 60 percent in 2018, faster than in any other part of the world. The country lost 1.13 percent its primary forest last year, in part due to gold mined illegally and often siphoned away by Chinese buyers.

Daniel Kwamena Ewur, an officer for conservation group A Rocha, said the ban pushed more small-scale miners to work within the protected Atewa forest, operating at night when security officials are off duty.  

Local authorities and NGOs have started training illegal miners to learn alternative livelihood skills such as soup-making and farming bees. But critics doubt these activities are economically viable.

“It’s kind of scratching the surface of the core issues of livelihood driving people,” said Nafi Chinery, Ghana country manager for the New York-based Natural Resource Governance Institute.

Chinery believes the anti-galamsey campaign has been more about politics than impact. “We don’t have enough data about who is actually involved in galamsey,” she added.

Around 1.1 million Ghanaians were estimated to work in small-scale mining before the ban, which was lifted in December, accounting for around 30 percent of the country’s annual mineral production. 

EPA’s head of mining Michael Ali says the government is now going to great lengths to “sanitize” the gold industry by formalizing galamsey sites, being stricter with paperwork and cracking down on the use of mercury.

“The mission is to reduce it to the barest minimum,” said Ali. “We cannot eliminate it completely, unless the citizens themselves police it.”

The EPA has reclaimed ten acres of illegally mined land around the Atewa forest, near the southeastern town of Kyebi. Trees were planted to encourage residents to take initiative and help meet an ambitious reclamation target of more than 7,000 square kilometers of land by 2022.

In the nearby town of Sagymase, 65-year old cocoa farmer Janet Achampong does not know what to do about the gaping pit left on land she leased to illegal miners five years ago. She cannot afford to fill the hole herself and reconvert it to farmland.

The government has acknowledged money is short and says it is seeking support from the international community. In Sagymase, Norwegian donors are funding the reclamation of six acres of galamsey land over the next four years.

A Rocha’s Ewur is facilitating the project, but is wary of planting trees and food crops in soil that has been mixed with chemicals.

“There is some quantity of mercury in the belly of this land,” said Ewur. “I would not eat the mangoes that grow here.”   

Scientists Find Gold-Loving Fungus In Australia

A fluffy pink fungus that decorates itself with gold nanoparticles has been found in Western Australia. Researchers believe the fungus is an indicator of gold deposits and hope the discovery will help miners narrow down where to dig.

Scientists in Australia have found a fungus that can bond with gold particles. It releases a chemical called superoxide that can dissolve gold in the soil. It is then able to mix this dissolved metal with another chemical to turn it back into solid gold, in the form of tiny nanoparticles.

So why does this gold-loving fungus have an attraction to this precious metal? The research team believes by interacting with gold in this way it can grow faster and bigger relative to other fungi that do not.

The research has been carried out by Australia’s national science agency.

The Commonwealth Scientific and Industrial Research Organization, the CSIRO, believes the discovery could be a new way to mine gold. The fungi could be markers that indicate the presence of gold, and narrow down the area where exploratory drilling would be most beneficial.

The study’s author is Dr. Tsing Bohu, a CSIRO geo-microbiologist.

“I think this is probably very novel because gold is very inert generally speaking but we found actually this fungus can interact with gold by dissolving gold. So I think it is very novel and it is also very important for mining and other industrial [processes] like leaching, so [it] has some potential applications,” he said.

The fungus was found in soil at Boddington, 130 kilometers south-east of Perth in Western Australia.

The research has been published in the journal Nature Communications.

Australia is the world’s second-largest producer of gold, but its output is expected to fall unless more deposits are discovered.

In recent weeks, two Australians have stumbled upon large gold nuggets worth tens of thousands of dollars in Western Australia and the state of Victoria.