The U.S. said it is hosting a senior-level Chinese delegation to witness its drug prevention and treatment efforts, even as the United States continues to battle opioid abuse that is killing more than 60,000 people annually.

The State Department said Tuesday the Chinese will visit drug abuse prevention programs in Washington and New York and highlight the role that U.S. agencies, private treatment centers and non-government community coalitions play in fighting drug abuse in the U.S.

An average of more than 160 people are dying every day in the U.S. from opioid abuse. But the State Department said the U.S.-Chinese effort to reduce the demand for illicit drugs adds to the two countries’ “recent productive cooperation” by imposing restrictive controls on synthetic opioids.

The State Department said it is aiming to cut drug abuse, “as addiction knows no national borders, and illicit drug use anywhere enriches transnational criminal drug traffickers.”

Last October, U.S. President Donald Trump declared opioid abuse a “national public health emergency.”
…

Health officials in the Democratic Republic of Congo began a vaccination drive to control an Ebola outbreak that has infected more than 50 people and killed as many as 25. But as aid workers and health experts say this vaccination drive is a careful, methodical process in which trust is a key element.

Health officials in the rural corner of northwest Congo that has been hit with Ebola say workers are seeking out those at the highest risk to vaccinate, a move that tries to cut off the virus at the pass while also making good use of the limited supply of the vaccine.

At the moment, officials have only 7,500 doses of the experimental vaccine.

World Health Organization spokesman Tarik Jasarevic explained the campaign, which began this week in the rural communities of Bikoro and Iboko.

“This is not a general mass immunization, as is being done for some other diseases,” he explained. “We are looking into people who have been in contact with those who tested positive for Ebola, and their contacts. So we make a ring around the person who contracted the virus.”

That is careful work and involves much more than medicine, said UNICEF field worker Jean Claude Nzengu.

He said workers go to the households to talk about the vaccination that stops transmission, the advantage of the vaccination, what the residents need to do, how to behave, and finally take them to be vaccinated.

Congolese health authorities first reported the Ebola outbreak in early May. This is not Congo’s first encounter with the often-deadly virus, which causes an acute, serious illness. The WHO puts the survival rate around 50 percent.

Trust

But as health officials learned when Ebola rampaged through West Africa, killing more than 11,000 people between 2014 and 2016, earning public trust is a major element of the fight.

Last week, three infected patients escaped from isolation units in the city of Mbandaka. Two were found dead a day later and the other was found alive and returned to quarantine.

Jasarevic said it takes cooperation from the entire community for an Ebola outbreak to be defeated.

“It is only human that people who have their relatives in isolation units want them to be at home, want them to be with their family at home in what could be the last moments of their lives,” he said. “But we need really to explain to everyone how disease is being transmitted. If a person who is sick is in an isolation unit, it not only increases the chance of survival for this patient, but it will also prevent the spread of the virus to the family.”

The vaccination drive began last week, with health care workers receiving the first doses.

The experimental vaccine, made by U.S.-based Merck pharmaceuticals, has been shown in trials to be safe for humans.
…

Every morning, Asma’u Muhammadu removes the wet sheets from her bed and sets them out to dry. She opens the door to let in the fresh breezes that will air out the smell of urine in the mud-walled room. Along with the sheets, she brings out wet rags she uses to line her inner garments.

“I am dealing with yoyon fitsari. I don’t know when the urine pours out from my body until I see it leaking down the sides of my legs,” says the 27-year-old woman.

Yoyon fitsari is the term used in the Hausa language to describe vesicovaginal fistula (VVF), a medical condition in which a hole between the birth canal and bladder leaves women unable to control their urine. Women with a hole between the birth canal and the rectum, rectovaginal fistula (RVF) experience uncontrollable leakage of stool. Some women have both VVF and RVF.

Some women are born with fistula, which is rare. Other causes include injuries sustained during pelvic surgery and hysterectomies, inflammation and infections in the genital area, and sexual violence.

But the leading cause of fistula is prolonged and obstructed labor. In Nigeria, between 400,000 and 800,00 women are currently living with fistula.

The World Health Organization describes fistula as “the single most dramatic aftermath of prolonged or neglected childbirth,” and estimates more than two million women live with fistula worldwide.

Young marriage only partly to blame

Nigeria has the world’s highest occurrence of obstetric fistula and the Nigerian government says early marriage is largely to blame. Often, the bodies of young wives are not physically prepared for childbirth. 

Muhammadu was married at 12 years old and had her first pregnancy at 15. She labored at home for two days before going to the hospital, but it was too late.

“On the fourth day, I gave birth and my baby wasn’t alive,” Muhammadu said. Her mother also has VVF fistula. They take care of each other.

But health workers say other cultural factors contributing to the high occurrence of fistula need to be addressed and focusing on early marriage oversimplifies the problem.

“I think we should de-emphasize the issue of early marriage as far as a direct cause of VVF is concerned,” says Dr. Bello Lawal, a fistula surgeon and the chief medical director at the Maryam Abacha Women and Children Hospital, the only one in the northwestern state of Sokoto that performs fistula repair surgeries.

“There are some traditional practices whereby a surgical procedure is carried out on a woman who is supposed to have a condition known as goriya, which is supposed to be a growth in the private part, that is supposed to be removed by the traditional barber, and in the process, they usually cause damage to the bladder or they cause damage to the rectum, and that can lead to recto-vaginal fistula or vesicovaginal fistula,” Lawal explains.

Traditionally in Hausa culture, barbers are called to remove goiters, remove enlarged tonsils, perform male circumcision and execute yankan gishiri, similar to female genital mutilation.

Goriya is said to be a tumor-like blockage of vaginal tissue, but Dr. Lawal said, “There is no tumor. Most of these cases, which we call goriya, are usually psychological cases.” Goriya is a form of the pseudoscience that has led to millions of women developing VVF.

The practice is also performed in cases of infertility.

Lack of skilled doctors 

Many women have had several failed fistula repair surgeries. Due to the stigma, most of them say their husbands divorced them. Dozens of former fistula patients live at the back of the Maryam Abacha Women and Children Hospital. They say they cannot go back home to face humiliation in their communities.

Only about a dozen doctors in Nigeria are skilled enough to perform the intricate fistula repair surgery, like Dr. Sunday Lengmang, a surgeon at the ECWA Evangel VVF Center in Jos.

Lengmang is considered one of the most skilled fistula repair surgeons in the world and the Evangel VVF Center is the only hospital in Nigeria that performs urinary diversion surgeries to handle complex fistula cases.

“Fistula affects the poorest of the poor in the poorest countries of the world,” he said, adding that this means the doctors working in this area must be highly motivated. 

“But apart from that, we also have the issue of the difficulty in finding doctors who have the skills,” he said.

With about 12,000 new cases reported around the country each year, the 14 Nigerian hospitals that perform repair surgeries are only able to handle about 5,000 operations, leaving an enormous backlog. USAID’s Fistula Care Plus says about 200,000 women in Nigeria are waiting for fistula surgeries.

Hospitals mostly rely on funding from outside of Nigeria. Donations fund the Evangel VVF Center, where surgeries are free of charge for patients. At other facilities, patients bear some of the cost of the surgery, which is about $300.

In her remote village, Muhammadu says her husband has stayed with her, despite her condition, and she is content. He has told her not to go the hospital for treatment since the fistula has not affected her ability to have babies. She has two daughters. 

She wants the fistula to go away, but says it is “destined by God to happen that way.”

This reporting was supported by Code For Africa, a data journalism initiative.
…

A computer was better than human dermatologists at detecting skin cancer in a study that pitted human against machine in the quest for better, faster diagnostics, researchers said Tuesday.

A team from Germany, the United States and France taught an artificial intelligence system to distinguish dangerous skin lesions from benign ones, showing it more than 100,000 images.

The machine — a deep learning convolutional neural network or CNN — was then tested against 58 dermatologists from 17 countries, shown photos of malignant melanomas and benign moles.

Just over half the dermatologists were at “expert” level with more than five years of experience, 19 percent had between two and five years’ experience, and 29 percent were beginners with less than two years under their belt.

“Most dermatologists were outperformed by the CNN,” the research team wrote in a paper published in the journal Annals of Oncology.

On average, flesh and blood dermatologists accurately detected 86.6 percent of skin cancers from the images, compared to 95 percent for the CNN.

“The CNN missed fewer melanomas, meaning it had a higher sensitivity than the dermatologists,” the study’s first author Holger Haenssle of the University of Heidelberg said in a statement.

It also “misdiagnosed fewer benign moles as malignant melanoma… this would result in less unnecessary surgery.” 

The dermatologists’ performance improved when they were given more information of the patients and their skin lesions.

The team said AI may be a useful tool for faster, easier diagnosis of skin cancer, allowing surgical removal before it spreads.

There are about 232,000 new cases of melanoma, and 55,500 deaths, in the world each year, they added.

But it is unlikely that a machine will take over from human doctors entirely, rather functioning as an aid.

Melanoma in some parts of the body, such as the fingers, toes and scalp, are difficult to image, and AI may have difficulty recognizing “atypical” lesions or ones that patients themselves are unaware of.

“Currently, there is no substitute for a thorough clinical examination,” experts Victoria Mar from Monash University in Melbourne and Peter Soyer of the University of Queensland wrote in an editorial published with the study.
…

Hundreds of women’s rights activist rallied in Belfast on Monday to put pressure on British Prime Minister Theresa May to reform Northern Ireland’s highly restrictive abortion rules after neighboring Ireland’s vote to liberalize its laws.

Voters in Ireland on Friday backed the removal of a constitutional abortion ban by two-to-one.

That leaves British-ruled Northern Ireland as the only part of the British Isles with a restrictive abortion regime, and May on Sunday faced calls from within her cabinet and the opposition to scrap Northern Ireland’s strict rules.

Not May’s call?

A spokeswoman for May said on Sunday changing the rules should only be undertaken by a government in Northern Ireland.

The province, divided between unionists who favor continued British rule and nationalists who want to unify with Ireland, has had no devolved regional government since January last year after a power-sharing agreement collapsed between the two communities’ main parties.

Activists gathered outside Belfast City Hall carrying placards emblazoned with messages such as “I am not a vessel” and “Mind Your Own Uterus.” They said it was May’s responsibility to act.

“1, 2, 3, 4, we won’t be silenced any more,” the crowd chanted. “5, 6, 7, 8, it’s time for May to legislate.”

Abortion is permitted in Northern Ireland only if a woman’s life is at risk or there is a risk to her mental or physical health that is long-term or permanent. It is not permitted in cases of rape, incest or fatal fetal abnormality.

Both Northern Ireland’s mainly unionist Protestants and its mainly nationalist Catholics tend to be more socially conservative than elsewhere in Ireland or Britain.

The main unionist party, the DUP, opposes liberalizing abortion laws, while the main nationalist party, Sinn Fein, backs some changes. DUP lawmakers in London provide votes needed to support May’s minority government.

Trip has its risks

It is estimated that around three women travel from Northern Ireland to England for an abortion every day, while others risk prosecution by self-medicating with abortion pills.

“It is awfully unfair that people here should not be able to get an abortion,” said schoolgirl George Poots, at the rally with her mother and brother. “At present they have to worry about travelling to England and I also think of the women who cannot travel.”

Anti-abortion group Precious Life said Ireland’s vote would spur it to “up the battle to protect Northern Ireland’s unborn children.” “Northern Ireland is now the beacon of hope to the pro-life movement around the world,” leader Bernie Smyth said. 
…

Officials began vaccinating health workers and others on Monday in Bikoro, where Congo’s current Ebola outbreak was first declared at the beginning of May.

Congo’s Health Minister Oly Ilunga traveled to oversee the Ebola vaccinations of at least 10 people in Bikoro, where at least five of 12 Ebola deaths have happened.

Bikoro Hospital director Dr. Serge Ngalebato said he and other health officials were vaccinated for protection when treating Ebola patients.

“We who are on the front lines of caring for the sick. We are reassured,” he told The Associated Press by telephone. Monday’s vaccinations included three doctors at Bikoro Hospital, two health experts, two nurses, one representative of women in the community and one pygmy representative, he said.

The procedure, which is voluntary, will take time and follow up to make sure there is a positive response, Ngalebato said.

Congo’s vaccination campaign, which began in Mbandaka last week, is targeting more than 1,000 health workers and contacts of the sick in three health zones.

More than 360 people were vaccinated before Monday, said health ministry spokeswoman Jessica Ilunga.

As of Monday Congo updated that there were 54 cases of hemorrhagic fever:  35 confirmed Ebola cases, 13 probable and six suspected.

Amid worries of the spread of Ebola, several schools in the Iboko health zone, about 180 kilometers (112 miles) southeast of Mbandaka, have been closed, according to reports by U.N.-backed Radio Okapi.

Many residents in one of the Iboko localities told Radio Okapi that they prefer to stay at home to avoid infection, following the death of a woman who had Ebola in the nearby Bobala area.

One resident said that what they first thought were rumors were becoming reality with the death and that they were very scared to interact. Four confirmed Ebola deaths have taken place in the Iboko health zone, according to Congo’s health ministry.

Several heads of schools in the area also said they would suspend school activities to protect the children.

This is Congo’s ninth Ebola outbreak since 1976, when the hemorrhagic fever was first identified.

There is no specific treatment for Ebola. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding. The virus can be fatal in up to 90 percent of cases, depending on the strain.

Ebola is initially transmitted to people from wild animals, including bats and monkeys. It is spread via contact with the bodily fluids of those infected, including the dead.
…

Australia’s Great Barrier Reef, under severe stress in a warmer, more acidic ocean, has returned from near-extinction five times in the past 30,000 years, researchers said Monday.

And while this suggests the reef may be more resilient than once thought, it has likely never faced an onslaught quite as severe as today, they added.

“I have grave concerns about the ability of the reef in its current form to survive the pace of change caused by the many current stresses and those projected into the near future,” said Jody Webster of the University of Sydney, who co-authored a paper in the journal Nature Geoscience.

In the past, the reef shifted along the sea floor to deal with changes in its environment — either seaward or landward depending on whether the level of the ocean was rising or falling, the research team found.

Based on fossil data from cores drilled into the ocean floor at 16 sites, they determined the Great Barrier Reef, or GBR for short, was able to migrate between 20 centimeters (7.9 inches) and 1.5 meters per year.

This rate may not be enough to withstand the current barrage of environmental challenges.

The reef “probably has not faced changes in SST (sea surface temperature) and acidification at such a rate,” Webster told AFP. Rates of change “are likely much faster now — and in future projections.”

The World Heritage-listed site, which attracts millions of tourists, is reeling from successive bouts of coral bleaching due to warming sea temperatures linked to climate change.

Webster and an international team wanted to view the reef’s current plight within a longer-term context.

Over 10 years, they studied how it had responded to changes caused by continental ice sheets expanding and waning over 30 millennia.

Fish nurseries

Their research covers a period from before the “Last Glacial Maximum” or LGM — the peak freeze about 21,000 years ago during the last Ice Age.

The average sea level at the time was some 120 meters (394 feet) lower than today.

As sea levels dropped leading up to the LGM, there were two massive “death events” — about 30,000 and 22,000 years ago, the team found.

These were caused by the reef being exposed to air. What remained of it inched seaward to rebound later.

As ice sheets melted after the LGM, two die-offs — 17,000 and 13,000 years ago — were due to sea level rise, the team found. In these cases, the reef moved itself landward.

The fifth death event took place about 10,000 years ago, apparently due to a massive sediment dump amidst a higher sea level.

Webster said the GBR “will probably die again in the next few thousand years anyway if it follows its past geological pattern” as Earth is believed to be due for another ice age.

“But whether human-induced climate change will hasten that death remains to be seen.”

In April, a study said nearly a third of the reef’s coral was killed in a “catastrophic die-off” during a violent heatwave in 2016.

Changes in sea temperature and acidity can cause corals to “bleach” — ejecting the algae that live in their tissue and provide them with food.

Bleached corals are more susceptible to disease, and without enough time to recover, may disappear for good.

Coral reefs are home to about a quarter of ocean life, and act as nurseries for many species of fish.
…

More than three million cases of dengue fever, the world’s fastest-spreading tropical disease, could be avoided annually if global warming is capped at 1.5C, said a study that purports to be the first to show the health benefits of a cooler planet.

The mosquito-borne viral infection causes flu-like symptoms and can be fatal if it develops into severe hemorrhagic form.

The annual number of cases has increased 30-fold in the last 50 years, says the World Health Organization (WHO).

Using computer models, researchers from the University of East Anglia in Britain found that capping warming at 2 degrees Celsius (3.6 Fahrenheit) could cut annual dengue cases in Latin America and the Caribbean by up to 2.8 million by the end of the century.

A further half a million cases could be prevented if the rise in global temperatures is kept down to 1.5C, the report said, with parts of South America most likely to benefit.

“There is growing concern about the potential impacts of climate change on human health,” said lead author Felipe Colón-Gonzále.

“This is the first study to show that reductions in warming from 2C to 1.5C could have important health benefits.”

Since the year 2000, climate change has caused severe harm to human health by stoking more heatwaves, the spread of some mosquito-borne diseases and under-nutrition as crops fail, according to a Lancet report last October.

Current national pledges to curb emissions put the world on track for a warming of about 3C above pre-industrial times, far above the goal of “well below” 2C set at a 2015 summit in Paris.

The WHO has previously estimated there could be 250,000 extra deaths a year between 2030 and 2050 because of climate change.

“Understanding and quantifying the impacts of warming on human health is crucial for public health preparedness and response,” said co-author Iain Lake in a statement.

“Clearly a lot more needs to be done to reduce (carbon dioxide) and quickly if we are to avoid these impacts,” he said.

Dengue infects around 390 million people worldwide each year, with an estimated 54 million cases in Latin America and the Caribbean, according to the study, published in the Proceedings of the National Academy of Sciences (PNAS).

There is no cure for dengue and medical experts recommend early detection and expert care as the most effective way of overcoming an infection.
…

Archaeologists using drones have discovered more than 25 geoglyphs etched into a swath of coastal desert in southern Peru near the Nazca Lines, a culture ministry official said Monday.

Most of the newly found geoglyphs, which include figures of a killer whale and a woman dancing, appear to have been made by the Paracas culture more than 2,000 years ago, hundreds of years before the Nazca people created similar giant drawings nearby, said Johny Isla, an archaeologist who heads the culture ministry’s conservation efforts in the region.

An additional 25 geoglyphs that had previously been spotted by local residents have also been mapped with drones, Isla said.

Drones “have allowed us to broaden our documentation and discover new groups of figures,” Isla said on a tour of the geoglyphs in the province of Palpa.

But unlike the Nazca lines, most of which can only be seen by flying above them, many of the so-called Palpa Lines were carved into hillsides and can be seen from below, Peru’s culture ministry said in a statement.

The geoglyphs created by the Nazca and Paracas cultures are striking reminders of Peru’s rich pre-Columbian history and are considered archeological enigmas, as no one knows for sure why they were drawn, or so large and for so long.

“In total we’re talking about 1,200 years in which geoglyphs were produced” in the region, said Isla.

Declared a UNESCO world heritage site in 1994, the Nazca Lines have faced damage by squatters looking for land to settle on and motorists veering off a nearby highway.

In 2014, environmental group Greenpeace apologized to Peru for staging a picture to protest dirty fuels at the Nazca geoglyph of a hummingbird, which government officials said was damaged as a result.

Isla said the Greenpeace incident prompted the culture ministry to ramp up efforts to protect archaeological sites in the region, helping lead to the new discoveries.

“We still haven’t walked among them, we’ve only taken pictures. This is the first stage of research,” Isla said.
…

Indian Prime Minister Narendra Modi said on Sunday he expected around a 30 percent drop in the number of vehicles entering Delhi, as he opened two new expressways around the capital aimed at decongesting its streets and reducing deadly pollution.

A damning report by the World Health Organization this month said India was home to the world’s 14 most polluted cities, with Delhi ranked sixth most polluted. Air quality has worsened over recent winters, prompting Modi’s office to directly monitor measures to clean up the capital’s air.

“The expressways will greatly benefit the people of Delhi National Capital Region (NCR) by reducing pollution and will bring down traffic jams,” Modi said.

The NCR is a rapidly urbanizing and polluted area around New Delhi that is one-third the size of New York state, but houses 2.5 times more people.

Illegal crop burning in farm states surrounding New Delhi, vehicle exhausts and swirling construction dust have contributed to what has become an annual crisis.

The 135-kilometer (84-mile), six-lane Eastern Peripheral Expressway was built in 17 months at a total cost of around 110 billion rupees ($1.62 billion), the government said.

More than 50,000 vehicles that transit the capital city on their way to other destinations would no longer need to enter New Delhi, Transport and Highways Minister Nitin Gadkari told reporters on Saturday.

It offers signal-free connectivity and is the first green highway fully lit by solar power, has drip pumps for watering plants alongside the highway and has rain water harvesting. Modi also opened an initial stretch of an 82 km Delhi-Meerut highway, which is India’s first 14-lane.

Modi’s administration is marking its fourth year in office this weekend and has vowed to speed up infrastructure development as it heads into a national election in 2019. 
…

Another person has died in Congo of a confirmed case of Ebola, bringing the number of fatalities to 12, said the country’s Health Ministry.

The new death happened in Iboko, a rural area in northwestern Equateur province, said the Health Ministry statement released Sunday. There are also four new suspected cases in the province, said the statement.

Congo now has 35 confirmed Ebola cases.

Health workers have identified people who have been in contact with confirmed Ebola cases in three areas in Equateur province, the rural areas of Bikoro and Iboko and Mdbandaka, the provincial capital of 1.2 million that is a transport hub on the Congo River.

Congo’s health minister Saturday flew by helicopter to Bikoro and Iboko to see the deployment of health workers who will be tracing those who have been in contact with Ebola cases and inoculating them with a new experimental vaccine. Health minister Oly Ilunga was accompanied by representatives of the World Health Organization and UNICEF. The vaccination campaign in those rural is to begin Monday.

The vaccination campaign is already under way in Mbandaka, where four Ebola cases have been confirmed. About 100 health workers have been vaccinated there as front-line workers face high risk from the virus, which is spread via contact with the bodily fluids of those infected, including the dead.

The next few weeks are crucial in determining whether the outbreak can be brought under control, according to the World Health Organization. Complicating factors include its spread to a major city, the fact that health workers have been infected and the existence of three or four “separate epicenters” that make finding and monitoring contacts of infected people more difficult.

WHO Director-General Tedros Adhanom Ghebreyesus told a meeting in Geneva on Saturday that ”I am personally committed to ensuring that we do everything we can to stop this outbreak as soon as possible.”

WHO is using a “ring vaccination” approach, targeting the contacts of people infected or suspected of infection and then the contacts of those people. More than 600 contacts have been identified.

WHO also is accelerating efforts with nine neighboring countries to try to prevent the Ebola outbreak from spreading there, saying the regional risk is high. It has warned against international travel and trade restrictions.

This is Congo’s ninth Ebola outbreak since 1976, when the hemorrhagic fever was first identified.

There is no specific treatment for Ebola. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding. The virus can be fatal in up to 90 percent of cases, depending on the strain.

 
…

Streams flowing in the south of England may hold clues to the search for life on Mars. VOA’s Steve Baragona has more.
…

Smog, industrial waste and contaminated water are just a few of the environmental problems facing many of the biggest cities today. But there is another type of pollution that’s becoming increasingly prevalent in our cities: noise pollution. Medical experts say people exposed to constant noise can suffer from a variety of psychological and physical ailments. As Saleem Shayan reports, it’s a particularly serious problem in megacities like Karachi in Pakistan where noise is a constant companion.
…

The World Health Organization’s annual conference ended on a high note Saturday, with the organization’s director general praising delegates for giving him a strong mandate to implement an ambitious program of reforms and initiatives that will improve global health.

WHO chief Tedros Adhanom Ghebreyesus paid homage to his predecessor, Margaret Chan, saying the reforms begun under her leadership to make the World Health Organization more responsive and better able to tackle emergencies were now paying off.

“The current Ebola outbreak in the Democratic Republic of the Congo has demonstrated exactly that. … Let me assure you that I am personally committed to ensuring that we do everything we can to stop this outbreak as soon as possible,” Tedros said. “And the commitment of the government, of course, and the leadership is at the center, which we really admire.” 

The World Health Assembly, the decision-making body of the WHO, passed a number of resolutions aimed at improving global health. Some deal with diseases that have plagued humanity for centuries, while others are newly emerging.

But all these decisions, Tedros said, involve commitments to make the world a healthier, safer place. For example, he noted the assembly had approved a road map to reduce deaths from cholera by 90 percent by 2030.

“You endorsed our five-year strategic plan on polio transition, to strengthen country health systems that could be affected by the scaling down of the Global Polio Eradication Initiative,” he said. “You passed resolutions on tuberculosis and noncommunicable diseases. … And you have agreed to increase the development and use of digital technologies to improve health and keep the world safe.”

Tedros urged the delegates to go back to their countries with renewed determination to work every day for the health of their people. How well they succeed in this endeavor, he said, will be measured by the outcomes, by whether they result in real change on the ground.
…

The UN children’s fund warned the Ebola outbreak in Democratic Republic of Congo threatens the health and well-being of children, and special care must be taken to help them survive. 

Ebola is highly contagious, killing between 20 and 90 percent of its victims, and the UN children’s fund is engaging communities in the fight against Ebola.  UNICEF spokesman, Christophe Boulierac said schools are crucial for minimizing the risk of transmission among children.

“UNICEF is scaling up prevention efforts in schools across all three affected health zones,” he said. “This includes on-going efforts to install hand washing units in 277 schools and supporting awareness raising activities reaching more than 13,000 children in Mbandaka, Bikoro and Iboko.” 

Previous outbreaks of Ebola in DRC and most recently in the horrific epidemic in West Africa have shown the high-level of trauma experienced by children at the loss of family members.   Boulierac told VOA orphaned children often become social outcasts because of their association with this fatal disease.

“There is as you mention, rightly, the risk of stigma and the risk that the child when his father, his care-giver, his mother is affected; the child is psychologically affected,” he said.

Boulierac said UNICEF is taking preventive measures, including providing trained therapists to families affected by the Ebola outbreak and helping children cope psychologically with the trauma of losing loved ones.
…

Real-world debates permeate this year’s Venice Biennale on architecture, from commemorating spaces once part of the U.S. slave trade to maintaining the delicate status quo at religious sites in the Holy Land.

The sprawling exhibition, which opens Saturday for a six-month run, reflects not only on the political implications of what gets built but also on the empty spaces in between.

“We have to be aware of the political issues in order to make buildings which protect, in so far as we can, the status of the human being in the world,” said Shelley McNamara, co-curator with Yvonne Farrell of the main exhibition, “Free Space.” “We are acutely aware of the things that are threatening the quality of life of human beings.”

Israeli Pavilion

The Israeli Pavilion, subtitled “structures of negotiation,” outlines the consequences of multiple claims on revered religious places and how daily use defines monuments.

It doesn’t comment on how the Trump administration’s recent decision to move the U.S. Embassy to Jerusalem from Tel Aviv might impact the Middle East conflict. But the curators agreed it is easy to draw inferences.

“What we know is that sometimes political events have a very heavy impact on the status quo of the holy places and vice versa, and even if the equilibrium of the status quo in the holy places is for some reason violated it has an influence on the political situation,” said the pavilion’s co-curator Tania Coen Uzzielli.

Take the Church of the Holy Sepulchre in Jerusalem, revered as the place of Jesus’ crucifixion and burial and one of the pavilion’s five case studies. The exhibit features a color-coded, three-dimensional model of the church made for an Ottoman-era pasha to make clear which denomination controlled which area.

In the early part of the last century, a conflict over who had the right to clean a raised stone in the church courtyard led to violence, said pavilion co-curator Deborah Pinto Fdeda.

“Tens of people died,” she said. “It is through the usage of places over time that these communities gain or lose power.” Yet even there the status quo evolved: “Today the Latins and Orthodox agree to clean it as if the other doesn’t exist.”

​US pavilion

The U.S. pavilion comments on the meaning of citizenship as governments dictate who belongs and who doesn’t.

Amanda Williams and Andres Hernandez created, in collaboration with Shani Crowe, “a pocket of retreat” in the courtyard behind a protective veil of black braids. The refuge is built on a rail, symbolizing the underground railroad that helped bring slaves to freedom. It projects upward, toward a better future.

“The piece tries to embody that trajectory from fighting and surviving for your citizenship to thriving,” Williams said.

Inside, a group called Studio Gang brought 800 stones from a 19th century landing in Memphis linked to the slave trade. Co-curator Ann Lui said the project was about “taking a moment to think about these fraught sites” without proposing, yet, how to remember them.

Saudi Arabia

Saudi Arabia is one of six countries participating for the first time in the architectural Biennale, with a project that focuses on urban sprawl in the kingdom’s four major centers: political capital Riyadh, religious capital Mecca, the oil city of Dammam and the port city of Jeddah.

“The sprawl is the result of the oil boom but the result of the sprawl is actually social isolation,” said curator Sumayah Al-Solaiman.

Participation in the Biennale is yet another sign of recent opening in Saudi Arabia, giving Saudis an important chance to communicate their experiences directly to the world.

“I think it is becoming more and more relevant to be involved in things that relate in art and culture,” said architect Abdulrahman Gazzaz. “I think it is truly fascinating to us to be present at such a wonderful shift in the dynamic of the country.”

​The Vatican

The Vatican also is participating for the first time in the Biennale of architecture after joining the contemporary art fair in 2013 and 2015. The Holy See entrusted world-renowned architects including Norman Foster to create chapels in a wooded area on an island in the Venetian lagoon.

Curator Francesco Dal Co said the woods provided a metaphor “of where you get lost in life” and the chapels “are always a place of encounter, meeting experience and orientation.”

The chapels may stay on as a permanent presence on San Giorgio island after the Biennale closes on Nov. 25.
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Gene therapy could potentially allow doctors to cure some of the deadliest types of cancer and rare hereditary diseases with one injection. The FDA recently approved the use of three anti-cancer drugs, all based on genetically modified human cells. Scientists say up to 80 percent of all types of cancer will respond to gene therapy treatments in the future. And that’s just the tip of the iceberg, as Daria Dieguts reports.
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Scientists who track pollution have discovered traces of antibiotics and the pain reliever oxycodone in some Puget Sound mussels.

KIRO-TV reported this week that the Washington Department of Fish and Wildlife obtained clean mussels from Penn Cove on Whidbey Island and put them in different areas to test for water contamination.

Scientists worked with the Puget Sound Institute to analyze the data and discovered three out of 18 locations came back positive for trace amounts of oxycodone.

State Fish and Wildlife biologist Jennifer Lanksbury said the contamination most likely came through wastewater treatment plants.

She said the chemicals might be having an impact in fish and shellfish in the areas.

Mussels at a restaurant or store are safe to eat because they come from clean locations, Lanksbury said.
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A coalition of conservation groups sued the Trump administration on Thursday, accusing the government of slashing protections for migratory birds.

At issue is the Migratory Bird Treaty Act, which the National Audubon Society and other plaintiffs say has been undermined. In the past, the act helped hold parties responsible for actions that killed or injured migratory birds.

But in December, the Trump administration said energy companies and other businesses that accidentally kill migratory birds will no longer be criminally prosecuted.

“As you can imagine, many causes of bird fatalities — including oil spills — could fall into this ‘unintentional’ category, so we’re taking the administration to court,” David Yarnold, president and CEO of the National Audubon Society, a plaintiff in the lawsuit, said in a statement.

Plaintiffs also include the American Bird Conservancy, the Center for Biological Diversity, and Defenders of Wildlife. The lawsuit was filed in the U.S. District Court for the Southern District of New York.

Defendants are the U.S. Department of the Interior, U.S. Fish and Wildlife Service and Daniel Jorjani, the Interior Department’s principal deputy solicitor.

The U.S. Attorney’s Office for the Southern District of New York, representing the government in the lawsuit, declined to comment. Representatives for the Fish and Wildlife Service, interior and justice departments also declined comment.

The Trump administration’s December move, in a legal memo from the Interior Department, reversed a longstanding practice at the agency and a last-minute rule implemented by the outgoing Obama administration. It came after several appeals courts ruled that the government was interpreting a century-old law aimed at protecting birds too broadly.

In the legal opinion, Jorjani said that a 1918 law that officials have used to prosecute those who kill birds “incidentally” as part of doing business was really aimed at preventing poaching and hunting without a license.

The Migratory Bird Treaty Act “applies only to direct and affirmative purposeful actions that reduce migratory birds, their eggs, or their nests, by killing or capturing, to human control,” Jorjani wrote.

The memo is already being followed, the lawsuit said, and one or more companies constructing natural gas pipelines were told they may cut down trees with nesting birds during the breeding season.

The conservation groups request that the court vacate the memo and declare the defendants “revert to their prior, correct longstanding interpretation and policy,” the lawsuit said.
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The World Health Organization (WHO) says people diagnosed with Ebola must be kept isolated to prevent the spread of the highly contagious disease. The WHO has updated the number of Ebola cases since the outbreak started in the Democratic Republic of Congo on May 8, confirming 31 of 52 probable and suspected cases, including 22 deaths.

The escape of two Ebola patients earlier this week from a treatment center in Mbandaka, a city of more than one million people, has raised fears of a rapid spread of the disease. The families of the patients reportedly helped them leave.

World Health Organization spokesman Tarik Jasarevic called the incident very unfortunate, but not unexpected.

“It is only human that people want to be with their loved ones and family want them to be at home in what could be the last moments of life,” he said.  “… Keeping a sick person at home not only decreases the chances of survival for this person, because this person is not receiving supportive treatment. It is also putting at risk the whole family.”

Ebola is highly contagious. The virus is transmitted through direct contact with infected bodily fluids. The fatality rate is between 20 percent and 90 percent.

Jasarevic said it is important to improve efforts to engage with communities so they understand how the virus is spread and how they can protect themselves from becoming infected.

“People who fall sick go to an isolation unit and receive treatment because that treatment will significantly increase their chances of survival,” he said. “…Getting IV fluids, getting antibiotics as a supportive means, if necessary, is something that reduces the risk of that.”

Jasarevic said it is important to trace every person who has come into contact with an Ebola patient. Those who have been identified are likely to receive an experimental vaccine that has shown good protective qualities, he added.

Since a vaccination campaign began on Monday, he said 154 people have been inoculated. They include high risk health workers and some particularly vulnerable people from local communities in Mbandaka.
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Two Ebola patients who fled a hospital quarantine area in the Democratic Republic of the Congo later attended a prayer meeting, potentially exposing at least 50 participants to the dangerous virus.

The incident demonstrates the risks of limited public awareness of Ebola and how the virus spreads. So governments and aid groups are boosting efforts to educate the public as part of a broader response to an Ebola outbreak that as of Thursday was suspected in 52 cases of hemorrhagic fever. Of those, 31 have been confirmed as Ebola, with 13 likely and eight possible, the DRC health ministry said. The death toll was revised from 27 to 22, but it’s expected to grow.

“We try to raise awareness and tell people that, no matter their beliefs, it is crucial for patients to remain in health centers for treatment,” the health minister, Dr. Oly Ilunga Kalenga, told VOA in a phone interview. “This is part of the community awareness campaign, and it must continue and reach all groups in the population.

“Religious and traditional leaders must be involved, because there are many beliefs surrounding the Ebola virus,” Kalenga said, later adding that a pastor helped officials find one of the patients who fled.

​How it starts, spreads

The disease, initially transmitted to humans from wild animals such as fruit bats, monkeys and forest antelope, spreads through direct contact with an infected person’s bodily fluids. Early symptoms can include fever, sore throat, fatigue, muscle pain and headache. Symptoms can take up to 21 days to emerge.

The outbreak’s epicenter is in a remote area of northwestern DRC, in Equateur province. Several cases have been confirmed in its provincial capital, Mbandaka, where the patients had fled from the Ebola treatment center. The city has more than 1 million residents, heightening the risk of further infection.

“The hospital where it currently is located is in the middle of the city, with many people coming and going,” Kalenga said. So health officials have decided to relocate the treatment center, run by Medecins Sans Frontieres (MSF) / Doctors Without Borders, to a site outside the city. That facility is expected to open later this week.

​Coordinated messaging

Aid groups, coordinated by the World Health Organization, have been working to support the Congolese government’s response.

A Red Cross team arrived earlier this month in Equateur province with supplies including chlorine disinfectant, safe burial kits and informational posters.

“The most important tool that we have, the only tool to tackle viruses, is information and sharing it,” Julie Hall, special adviser on health for the International Federation of Red Cross and Red Crescent Societies (IFRC), said in a video clip posted Thursday on Twitter.

The IRFC also posted an animated, one-minute video explaining safe burial practices and why they should be observed.

​Dangers of misinformation

WHO spokesman Tarik Jasarevic said health workers have hit stumbling blocks in explaining the risks of Ebola and how an experimental vaccine, introduced this week in Congo, might help.

Some people see Ebola as witchcraft, he told VOA. Health workers and burial teams have reported threats amid rumors that they’re bringing the disease with them.

Misinformation also helped fan the West Africa outbreak that began in late 2013 and, over the course of more than two years, killed at least 11,300 people in Guinea, Liberia and Sierra Leone. Reports surfaced of attacks on health workers or burial teams accused of disrespecting corpses.

It took aggressive, targeted messaging to allay fears and change behaviors, said Jennifer McQuiston, an official with the U.S. Centers for Disease Control and Prevention and an expert on infectious disease. She had deployed to Sierra Leone’s capital as the Ebola caseload there “started rising dramatically” in October 2014.

An international communications group had assembled 200 critical messages,important but hard to absorb at once, McQuiston recalled in a phone interview Thursday. So, guided by data on where and how Ebola was spreading, the group “came out with an Ebola ‘big idea of the week.’”

First up: “Safe burials save lives.” McQuiston said people were urged to accept burial teams with protective gear and disinfectant to safely remove bodies, characterizing this as an honorable measure. They also were encouraged to “pledge that if you died of Ebola, you would want your loved ones to give you a safe burial.”

Another week, the message was to “seek early treatment, to deconstruct the myth that people [with Ebola] were better off at home,” McQuiston said. “Going to an Ebola treatment center gives you a much better chance of surviving, and it’s going to save your family’s lives.”

Messages were delivered across radio, TV, social media and billboards, including in picture form, essential in areas with low literacy rates.

McQuiston’s detail lasted less than two months, and she returned to the United States.

“I actually went back to Sierra Leone a year later, in October 2015, and they were on the cusp of being declared Ebola-free” by WHO, she said. “They were proud. They changed their behavior.”

​Control measures

With the current DRC outbreak, health experts have rolled out an information campaign that encourages vaccinations not only for front-line health workers but also for relatives and friends of those who have contracted Ebola. The WHO said some 10,000 people should be vaccinated within the next month.

Health officials are identifying and monitoring those who’ve come in contact with infected individuals.

Meanwhile, Kalenga said “all the people” traveling in and out of Mbandaka were being monitored for elevated temperature that might indicate infection. In the West African outbreak that began in late 2013 and killed more than 11,000, airport monitors used non-contact thermometers.

Nigeria, too, has reactivated temperature screening at its land borders, airports and seaports. The continent’s most populous country, with 186 million residents, experienced an outbreak in July 2014 that left seven dead. The WHO pronounced it Ebola-free that October.

Information campaigns also promote washing hands with a chlorine solution to kill the virus.

Handwashing stations have surfaced in public places. UNICEF has set up them up at entrances to schools, and teachers have been instructing students to forgo regular greetings of hugs or handshakes. During the West African outbreak, youngsters waved to or bumped elbows with each other.

This reporting originated in VOA’s Africa Division. Contributors include Paul Alexander and Carol Guensburg.
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A British university student has created a range of watercolor paints made from discarded cosmetics. An example, she says, of how the so-called ‘circular economy’ can help improve the environment. It could also be a way for cosmetics companies and retailers to reduce waste and make more money. VOA’s Julie Taboh has more.
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Lava entered the ocean from a third flow Thursday, marking the third week of a Hawaii volcano eruption that has opened up nearly two dozen vents in rural communities, destroyed dozens of buildings and shot miles-high plumes of ash into the sky.

Low lava fountains were erupting from a nearly continuous 2-mile-long (3.22-kilometer) portion of the series of fissures that have opened in the ground, scientists said Thursday. The fountains were feeding channelized lava flows down to the coast. The eastern-most channel split, creating three ocean entries.

Since the eruption began May 3, Hawaii County has ordered about 2,000 people to evacuate from Leilani Estates and surrounding neighborhoods.

Hawaii officials have said they may need to evacuate 1,000 more people if lava crosses key highways and isolates communities in the mostly rural part of the island where the Kilauea volcano is erupting.

A blocked highway would cut people off from the only route to grocery stores, schools and hospitals.

The U.S. Marine Corps said Thursday that it has sent two CH-53E Super Stallion helicopters from a base near Honolulu to help if more evacuations become necessary. Each helicopter can carry 50 passengers.

20 vents, 50 buildings

The volcano has opened more than 20 vents in the ground that have released lava, sulfur dioxide and steam. The lava has been pouring down the flank of the volcano and into the ocean miles away.

Lava has destroyed 50 buildings, including about two dozen homes. One person was seriously injured after being hit by a flying piece of lava.

There continues to be intermittent explosions at the summit that have been sending plumes of ash into the sky. On Wednesday, the volcano belched a plume that reached about 7,000 feet (2,133 meters), scientists said. Right before the explosion, there was a 3.9 magnitude earthquake at the summit.

“We are kind of in this steady state,” said Wendy Stovall, a scientist at the U.S. Geographical Survey. There’s no indication about whether lava volume will increase or decrease, she said. The continued explosions are expected to “last a little while longer.”
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Two dying Ebola patients were spirited out of a Congo hospital by their relatives on motorcycles, then taken to a prayer meeting with 50 other people, potentially exposing them all to the deadly virus, a senior aid worker said Thursday.

Both patients were vomiting and infectious and died hours after the prayer session in the river port city of Mbandaka, Dr. Jean-Clement Cabrol, emergency medical coordinator for Medecins Sans Frontieres (Doctors Without Borders), said.

Democratic Republic of Congo is racing to contain an outbreak of the disease, which spreads through contact with infected bodily fluids including vomit and sweat.

The Health Ministry said late Thursday that a new case had been confirmed in the town of Bikoro and another in the nearby village of Iboko, where the epidemic is thought to have started.

This brought the total number of confirmed cases to 31, it said in a statement, out of 52 suspected cases.

Ninth outbreak in Congo

Congo’s ninth recorded outbreak of the disease is thought to have killed at least 22 people so far, according to government figures released Wednesday, fewer than the last estimate of 27, after some of those deaths turned out not to be Ebola.

“The escape was organized by the families, with six motorcycles as the patients were very ill and couldn’t walk,” Cabrol told a news briefing in Geneva after returning from the affected region. “They were taken to a prayer room with 50 people to pray.

“They were found at two in the morning, one of them dead and one was dying. So that’s 50-60 contacts right there. The patients were in the active phase of the disease, vomiting.” The patients got out of the isolation ward Monday.

Earlier reports did not give details of the escape or where they went afterward. A third patient who left the ward survived.

Health officials started trying to trace the motorcycle drivers and other people who came into contact with the patients as soon as the escape was reported, Dr. Peter Salama, head of emergency response at the World Health Organization (WHO), told Reuters on Thursday.

“From the moment that they escaped, the (health) ministry, WHO and partners have been following very closely every contact,” he said.

‘Hard to predict’

WHO’s three-month budget for the crisis has been doubled to $57 million to carry out a complex operation in a remote, forested area, Salama said.

“All it takes is one sick person to travel down the Congo River and we can have outbreaks seeded in many different locations … that can happen at any moment. It’s very hard to predict,” he said, referring to the river linking the trading hub of Mbandaka to the capital Kinshasa, whose population is 10 million.

“It is going to be at least weeks and more likely months before we get this outbreak fully under control,” Salama said.

There have been major advances in medical treatment of the virus since it ravaged West Africa in 2014-2016, including the use of an experimental vaccine to protect medical staff.

But local skepticism about the dangers and the need to isolate infected patients continue to complicate efforts to contain it. In past outbreaks, mourning relatives have caught the hemorrhagic disease by touching the highly contagious bodies of dead loved ones, sometimes by laying hands on them to say goodbye. 
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