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Luis Miguel Goitizolo

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RE: ARE WE NOW IN THE END TIMES?
9/21/2015 11:35:00 AM

Tens of thousands protest in Turkey against Kurdish violence

Associated Press

Turkey's President Recep Tayyip Erdogan salutes supporters as tens of thousands of flag-waving demonstrators rally to denounce violence by Kurdish rebels, in Istanbul, Turkey, Sunday, Sept. 20, 2015. Speakers condemned terrorism and the violence which has rocked eastern Turkey since the resumption of fighting between the military and the Kurdistan Workers' Party, or PKK. The separatist group is considered a terror organization by the Turkey, the U.S. and the EU.(Presidential Press Service/Pool photo via AP)


ISTANBUL (AP) — Tens of thousands of flag-waving demonstrators rallied in central Istanbul on Sunday to denounce violence by Kurdish rebels as the country's prime minister pledged damnation for the separatists.

Speakers condemned terrorism and the violence which has rocked Turkey since the resumption of fighting between the military and the Kurdistan Workers' Party, or PKK. The separatist group is considered a terror organization by the Turkey, the U.S. and the EU.

At the rally, Prime Minister Ahmet Davutoglu roared into the microphone as Turkish flags waved.

"Yes, those who want to divide this country, those who want to separate this country by wrecking it, may they be damned!" he said. "God willing, they will be damned."

The protest was held under the banner: "Millions of breaths. One voice against terror" and was widely promoted across the city. The protests took place under heavy police protection, including sharpshooters, and searches at the entrance.

The rally featured a video montage of, among other things, President Recep Tayyip Erdogan set to stirring music.

"Choose a job you love and you will not have to work a day in your life" (Confucius)

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Luis Miguel Goitizolo

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9/21/2015 3:49:56 PM

AP Investigation: Bungling by UN agency hurt Ebola response

Associated Press


KENEMA, Sierra Leone (AP) — Something didn't smell right.

As a worker at Kenema Government Hospital mixed a batch of chlorine on a broiling August day, he noticed it didn't have its typically strong, bleach-like odor. Concerned, he turned to a consultant with the World Health Organization, who tested the disinfectant and found barely any active ingredient.

"I was deeply shocked," the consultant, Jerome Souquet, wrote in an email to his boss in Freetown, Sierra Leone's capital. Souquet said the consequences of using the ineffective chlorine "could be catastrophic, and cause immediate infection of all the staff."

Questionable chlorine was just one of a toxic mix of avoidable problems faced by Ebola responders in Kenema last summer as the outbreak was spiking. Weak leadership, shoddy supplies and infighting exacerbated a chaotic situation at a critical front in the battle against the virus, an Associated Press investigation has found. More than 40 health workers died in Kenema — a devastating loss in the fight to control an epidemic that has claimed more than 11,000 lives.

In March, AP reported that senior officials at WHO's Geneva headquarters resisted calls to declare Ebola an international health emergency — the equivalent of an SOS signal — on political and economic grounds. But newly obtained documents, recordings of conference calls and interviews with key players on the ground show that even after the alarm was raised, WHO and others struggled to put together a decisive response.

The World Health Organization's Director-General Dr. Margaret Chan — whose U.N. agency is charged with leading the fight against global outbreaks — demanded the dispatch of vehicles and equipment, but penny-pinching meant only a trickle of cash made its way to frustrated responders. Supplies were so scarce that body bags — which protect aid workers from exposure to the highly contagious corpses — ran out. Confusion delayed the construction of a new treatment clinic.

Experts say the fumbling cost lives across West Africa.

"There's no question that a better and earlier response from WHO could have resulted in thousands and thousands of fewer deaths than we saw," said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University in New York.

The situation at Kenema hospital last summer was horrific. Blood-drenched patients lay in agony in understaffed wards as the dead cluttered the hallways. Health workers sweltered through grueling shifts despite attacks from locals who threatened to burn the building down, convinced doctors and nurses were spreading the disease deliberately.

Meanwhile WHO was "paralyzed," according to Joseph Fair, an American disease expert who was in Freetown advising the Sierra Leone government. In interviews with AP, he described "death by conference call" as health officials argued about things like whether to order more ambulances and the proper color of body bags.

Two months ago, a WHO-commissioned panel criticized the organization's leadership but did not mention the logistical problems, infighting or other details uncovered by AP. The report called for accountability, but did not name a single person or department responsible for the failures. The evaluation concluded that "WHO was reported to be respected for its technical work in the three (Ebola-affected) countries."

___

"WE ARE AT RISK OF VERY POOR PERCEPTION"

Kenema, a diamond town whose potholed roads turn to red sludge in the rainy season, was a microcosm of the messy response across West Africa as Ebola raged out of control last year. Identified in the West African forest in early 2014, the virus appeared to abate in May before surging back, killing hundreds in Guinea, Sierra Leone and Liberia throughout June and July before belatedly triggering an international emergency in August. Officials estimate the outbreak won't be stopped before the end of 2015.

One of Sierra Leone's largest cities, Kenema's proximity to Guinea's forest region and its decent road link to Freetown made it a key seeding point as the virus spread across the region. It was identified as one of two priority areas in an urgent July 24 message sent by WHO's Chan to her senior staff. "Transportation, PPE (personal protective equipment) and other equipment must (be) provided," she wrote.

That did not quite happen.

Staffers were so strapped for safety gear that nurse Donnell Tholley said they sometimes resorted to ill-fitting gloves to protect their hands and stray plastic packaging instead of heavy-duty footwear.

And then there was the chlorine.

In Kenema, the disinfectant was made from powder kept in 10- or 25- kilogram (20- to 50-pound) drums in the hospital's storeroom. The powder was mixed with water in several stages to make chlorine solution for washing hands and sterilizing surfaces. Many aid organizations in West Africa — like Doctors Without Borders, which had a facility in nearby Kailahun — imported the powder. WHO decided to use chlorine from the government's own supplies in Freetown.

That proved to be a mistake.

By the time Souquet wrote his Aug. 20 email, it was the second time in several days the hospital had been left with defective chlorine.

Drums were repeatedly found with tags ripped off, expiration dates obscured or marked by evidence of tampering. Hospital porter Juma Musa described his horror at opening a batch of chlorine powder in July to find that it had expired more than a year earlier.

While in that case Musa said he stopped the spoiled chlorine from being used, other porters told AP they could not rule out that bad batches slipped through. The problem badly rattled staff at a time when many already were abandoning their posts.

"We were in a war zone and the chlorine was the only thing that was giving us courage to come closer to patients," Musa said.

Kenema Government Hospital, an outdoor campus of aging buildings connected by gravel pathways, had enough problems as it was.

The nurses' station was perilously close to an area where Ebola patients were held, with only a flimsy barrier to separate them. Triage was virtually non-existent, and patients — many of them children — were shuffled to the Ebola ward bearing "slips of paper containing incomprehensible abbreviations or incomplete histories," according to an Aug. 7 status report drafted by Tulane University's John Schieffelin and Shevin Jacob of the University of Washington. Maxon Kobba, a nurse there, said that as many as 20 patients could die in one night.

"Some would cry, 'I want to die! I want to die!' because they were in so much pain," he said.

Walking into the hospital made for "the shock of my life," U.S. health official Austin Demby told Sierra Leone expatriates in an Aug. 16 conference call, a recording of which was obtained by AP. He described seeing dead bodies "just laying all over the place" and a "complete breakdown" in management.

"I'm not for blaming anybody for anything, but WHO could really spend a little bit more time on Kenema," Demby said on the call.

Others complained about WHO leadership, too. When the Red Cross offered to build an Ebola treatment center to deal with the crush of patients in Kenema, it was held up because no one in Sierra Leone's government or WHO could tell them where to build it.

"The instructions keep changing and nobody seems to take leadership," Red Cross official Panu Saaristo said in an Aug. 4 email to WHO's Ian Norton, who acknowledged that the issue was serious.

"We are at risk of very poor perception by the public when we send in IFRC (the Red Cross) then block their ability to care for patients," Norton wrote in a follow-up message sent to colleagues.

The government in Freetown eventually insisted that the Red Cross set up 12 kilometers (8 miles) out of town. Amanda McClelland, a senior Red Cross Ebola advisor in Sierra Leone, argued against the decision.

"I was trying to hold my ground (until) the president of the country called me," she told the AP. "And he said, 'Well, you can build there or you can go home.'"

The Red Cross gave in and spent about a week fighting to clear the rural site with a single bulldozer in the driving rain before an expert said the land was unusable. The clinic was eventually built several miles away and opened in September 2014 — after the outbreak had peaked, McClelland said.

Outside the hospital's main entrance, the health workers who died are memorialized in a large black marble monument etched with their names and the dates of their deaths. Fading fliers with photos and messages of love remain taped to the cement walls in each ward. The toll of the dead became so overwhelming a new cemetery was opened, behind the Red Cross clinic, the graves marked with numbers instead of names.

Sierra Leone has lost more health workers than any other country affected by the virus, recording 221 of 513 overall deaths.

___

"EVEN BUYING BUCKETS WAS DIFFICULT"

Emails reviewed by AP put many of the complaints over WHO leadership at the feet of Jacob Mufunda, the WHO Representative in Sierra Leone. WHO Representatives, known as WRs, are supposed to reinforce poor nations' health systems and prod local officials to action, but AP found little evidence Mufunda did either.

Meetings scheduled to last a single hour routinely stretched to three or even five hours with "lots of endless talk" and "no decision taken," WHO Ebola coordinator Philippe Barboza complained in an Aug. 8 email to Mufunda.

Fair, who was with the U.S. epidemic research firm Metabiota Inc. before working as a government adviser, recalled an interminable conference call in which officials spent "a good 45 minutes discussing the cultural sensitivities of having a black body bag versus a blue or white one." The cultural issues were real — black body bags were seen as sinister — but Fair said he was upset "that we were spending this much time discussing the color of body bags when we don't have any."

Requests to fix critical problems like the hospital's shaky generator regularly went unfulfilled by Mufunda's office, leaving WHO technicians to cover thousands of dollars' worth of expenses out of their own pockets, according to two WHO employees on the ground at the time. They spoke on condition of anonymity because they were not authorized to talk without the U.N. agency's permission.

Lionel Larcin, a Doctors Without Borders water and sanitation expert sent to Kenema in early August, described sitting on the plane to Africa "reading the newspaper about millions of dollars being sent to fight the virus." But when he asked for protective boots, he was shocked to find WHO staffers dipping into their daily allowances to pay for them.

"Even buying buckets was difficult," he said.

A missive from WHO chief Chan obtained by AP laid out the scale of the problem, not just in Kenema but across West Africa. The Aug. 3 email to Mufunda and other senior WHO staffers said logistics experts were receiving only a couple hundred dollars a week to cover $1,000 or even $10,000 worth of expenditures — a problem that had been festering for four months. Chan warned that WHO needed to respond efficiently if it was to retain its leadership.

"I expect all colleagues especially our WRs to facilitate experts and staff to do their field work and not to post barriers because business as usual does not work during crisis."

Mufunda, who was reassigned to run WHO's office in Mozambique shortly thereafter, did not return messages from AP seeking comment.

Dr. Bruce Aylward, WHO's top Ebola official, disputed that the mistakes uncovered by AP worsened the epidemic. He said swapping posts was common in emergencies and that Mufunda and other WHO representatives in Guinea and Liberia "took the outbreak very, very seriously and were deeply concerned."

"Now, their ability to scale the response and manage the response the way it needed to be done — they may not have had that experience or that expertise," Aylward said.

In addition to struggles with the government, WHO also was wrestling over the reins with Metabiota, the epidemic research company. The San Francisco-based firm had been charged with reinforcing Sierra Leone's response, but emails obtained by AP alleged that the company was instead undermining the U.N. agency's authority by drawing up response plans without WHO's knowledge.

"Since weeks now Metabiota staff are doing their level best to systematically bypass and marginalise (the) WHO role," wrote Barboza, the Ebola coordinator.

Barboza said the relationship with Metabiota was verging on "open conflict," and recommended pulling all epidemiological staff from Kenema. He warned that the feud was holding up 1 million euros in funding from donors skeptical that WHO had control over the situation.

"That comes as a surprise to me," said Metabiota CEO Nathan Wolfe in an interview Friday. "Most of the feedback has been that we worked very well with WHO."

In follow-up emails Saturday, Metabiota said it had looked into the matter and said the conflict was an "individual disagreement between a Metabiota consultant and an individual at the WHO that we resolved."

Reached by AP, Barboza declined to comment on the emails. Fair said he could not comment on the issue, which emerged after he left the company.

The response also was complicated by other problems.

Emails obtained by AP show a WHO data expert accusing Sierra Leonean officials of fiddling with her Ebola figures to make them match their government's count, presumably to avoid having their numbers contradicted by the U.N. One Kenema government lab worker was even accused of accepting bribes in order to fake Ebola test results, a practice that risked sending infected people back into the community.

Then there was the matter of sheer indifference.

Amid a shortage of body bags, Fair said he spent about 12 hours calling numerous government officials in Freetown, in an attempt to guide a shipment of body bags through customs. By 11 p.m., after dozens of calls, he threatened to have the uncooperative airport customs officer fired unless the body bags were released.

Eventually, some 100 bags were piled into a car. In a 4 a.m. email to Barboza, Fair told AP, he begged the police superintendent to let the driver through a checkpoint so the bags could arrive overnight but said the superintendent slept through the driver's calls. Stuck at the checkpoint, the driver napped in his car until he got authorization to leave the following morning.

"This was at a point when we had about 20 bodies lying outside," Fair said. What are patients supposed to think, he asked, when they see "these bodies of people who were very recently next to them in the clinic, outside, with no dignity whatsoever, in the rain?"

___

"DISORGANIZED AND LATE TO THE PARTY"

The problems that hamstrung the Ebola response have prompted soul-searching at WHO and across the public health community. The WHO-commissioned review was one of no fewer than five different inquiries set up to evaluate the world's bungled response.

"WHO does not have a culture of rapid decision-making and tends to adopt a reactive, rather than a proactive, approach to emergencies," WHO's 28-page report said. It went on to say: "There seems to have been a hope that the crisis could be managed by good diplomacy rather than by scaling up emergency action."

WHO has vowed to overhaul its emergency response system, but has not censured any senior officials who oversaw its Ebola efforts. They remain employed by the agency, except for its Africa director, who retired after serving out his term.

Aylward, the WHO official, said he believes fear and resistance from locals were more powerful drivers of the epidemic than any mistakes by WHO or anyone else.

Dr. Brima Kargbo, Sierra Leone's chief medical officer, defended the government's response to the crisis and said that the greatest setbacks were caused by community resistance.

"To me I don't think there is anything different from what we are supposed to do as a government," he said of any lessons learned from the outbreak.

Redlener, the disaster preparedness expert, said he doesn't think things will be much different the next time a global health crisis strikes, namely because the top WHO leaders remain in place.

"We've already seen what the old leadership at WHO has been able to do, so I don't know why we would expect them to be able to right themselves," he said.

Redlener said that while nearly every response to a major emergency is flawed, WHO's level of dysfunction during Ebola was exceptional, noting that the agency wasn't just stretched for cash, as many have suggested.

"By the time WHO got in there, they were disorganized and late to the party," he said. "When WHO failed to provide that leadership, it was demoralizing for the other agencies and for the rest of the world."

___

Cheng and Satter reported from London and Paris. Associated Press writers Jamey Keaten in Geneva and Lisa Leff in San Francisco contributed to this report.

___

Online:

Maria Cheng can be reached at: https://twitter.com/mylcheng

Raphael Satter can be reached at: http://raphae.li

Krista Larson can be reached at: https://twitter.com/klarsonafrica

Lisa Leff can be reached at: https://twitter.com/scoopscout

___

WHO's Ebola emails: —http://apne.ws/1P9KpWt


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"Choose a job you love and you will not have to work a day in your life" (Confucius)

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Luis Miguel Goitizolo

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9/21/2015 4:26:21 PM

Seven members of 'terrifyingly depraved' paedophile gang jailed
Judge tells men who abused babies and young children while hiding behind veil of respectability that their actions were ‘contrary to all humanity’


Friday 11 September 2015Last modified on Saturday 12 September 2015

Seven members of a paedophile gang involved in the rape and abuse of babies and young children have been jailed for a total of 78 years.

The British gang – described as having “tentacles that go round the world” – streamed attacks on the internet which were seen on every continent. The men preyed on the families of the children they targeted, in one case grooming a mother and father before their baby was born.

Members would frequently travel long distances to carry out the attacks together, or would watch the abuse over the internet – sometimes using the dark web – if only one of them had access to a victim. Records of online conversations revealed that members of the gang, who lived across the UK, would offer advice and guidance to others on drugging their young victims.

The seven men, aged between 31 and 51 and including three convicted sex offenders, were brought to justice following an investigation led by the NationalCrime Agency (NCA). They were convicted of 29 child sex abuse offences, including conspiracy to rape and the multiple rape of a child aged under 13.

Passing sentence at Bristol crown court, Judge Julian Lambert said: “In the worst nightmare, from the very deepest recesses of the mind, at the darkest hour of the night, few can have imagined the terrifying depravity which you men admit.

“What you contemplated and what you did involved the most horrific abuse of a baby and very young children. Your thoughts and deeds are beyond human instinct and reason, and are evil beyond rational understanding.

“You men indulged yourselves in some of the most depraved and grossly deviant behaviour imaginable. The depth to which you sank is astounding and highly shocking to all decent people. What you did is contrary to all nature and humanity and you each appear to have a chilling tendency to centre the world on yourselves and your depraved desires without regard for the innocent and vulnerable.

“Your conduct is of deep concern to the public and people are outraged at what you have done. What you did provokes tears in many and makes others feel physically sick. You sought out the darkest materials on the internet and met in cyberspace to discuss your perverted sexual desires. You then planned the most shockingly sordid exploitation of the very young for sexual purposes. Targeting innocent children in that way is utterly abhorrent.”

The men jailed are John Denham, 50, from Wiltshire, Matthew Stansfield, 35, from Hampshire, Adam Toms, 33, from Somerset, Christopher Knight, 35, from Manchester, Robin Hollyson, 31, from Bedfordshire, David Harsley, 51, from Yorkshire, and Matthew Lisk, 33, from Sussex.

Hollyson was jailed for 24 years, Knight for 18 years, Toms for 12 years, Stansfield for 10 years, Denham for eight years, Lisk for four years and Harsley for two years.


Jailed members of the paedophile gang (from left) John Denham, Matthew Stansfield, Matthew Lisk, David Harsley, Robin Hollyson, Christopher Knight and Adam Toms. Photograph: National Crime Agency/PA

Prosecuting, Robert Davies said he would not go into graphic detail in open court about the offences, nor the content of online chat logs, footage and images recovered because they were so disturbing.

A baby, aged between three and seven months at the time of the abuse, and two boys aged around four have been identified as victims but another 21 children have been the subject of safeguarding measures in relation to the investigation. Davies said the impact on the victims and their families was “profound and long-lasting”.

Hollyson – who was previously known as Robin Fallick – Stansfield and Harsley are convicted sex offenders while Denham, who changed his name from Benjamin Harrop, was once a youth football coach.

The gang hid behind a veil of respectability, with careers and families, to habitually target children under the age of five in Yorkshire and the south-east and south-west.

The NCA, which led the investigation, said the men met after discussing their sexual interests in young children on legitimate social media and adult sex sites. The gang was described as “incredibly skilled” at grooming victims’ families, even striking up relationships with pregnant women to abuse their babies.

Graham Gardner, deputy director of investigations at the NCA, said: “They don’t stand out as monsters, but they are monsters in disguise. This is serious organised crime at its worst. The men involved in this group actively targeted families to facilitate the sexual abuse of their children, toddlers and babies. The depravity of these men appeared to know no bounds and is without doubt as vile as we have seen.”

The NCA launched its investigation, codenamed Operation Voicer, last September after Toms contacted police and admitted he had abused a child. Their inquiries led to the unmasking of the ring operating across the UK, which had links to other paedophiles across the world. In the weeks that followed, the other six members were arrested and the further two victims were identified.

Police combed the suspects’ electronic communications and established that contact between them began on adult online sex forums, which are publicly accessible and legal to use. Investigators recovered Skype chat logs that recorded conversations between the men, which police described as disgusting and abhorrent.

The exchanges – which were never meant to have been discovered as the men went to great lengths to destroy their online activities – included references to “nep”, a term investigators had not come across before. It is a shortening of “nepiophile”,a person sexually attracted to babies and toddlers. There were also references to controlled drugs and over-the-counter medicines, with members of the ring openly discussing what dosages were needed to drug children of different ages.

Police said an “incredible” amount of planning went into gaining access to victims.

Ian Glover, senior investigating officer, said: “We’ve encountered grooming where the family have been groomed prior to birth of the baby. They go in that early with the sole intention of abusing that baby once it’s born.”

Extensive planning went into enabling the abuse to be screened over the internet to co-conspirators and other paedophiles around the world.

Members of the gang established a way to broadcast their activities without transferring files in a way that could be easily traced, instead using a video conferencing site to stream their abuse, the court heard.

Images of abuse relating to the case are believed to have been seen on every continent and police have circulated evidence about other suspected paedophiles to authorities in Europe, South America and Australia. There was no business element to the activities, with no evidence of any payment being received.

The family of one victim said: “We would like to thank police, the National Crime Agency and all the other law enforcement agencies involved for their support and handling of what has been a very traumatic and distressing experience for us. No family ever wants to find that their child has been the victim of abuse, nor would they ever knowingly put their child at risk. As a family we now need to mend – seeing the perpetrators being brought to justice is the first step.”

A spokesman for the NSPCC said: “Targeting children for sexual abuse before they are even born is completely and utterly beyond the pale. Revulsion isn’t strong enough to describe the feeling this gang’s crimes have evoked.

“When they are released from prison the authorities must ensure they never have the opportunity to pose a threat to any other child. And those babies, toddlers and families affected by this deeply disturbing abuse must get all the support they need to rebuild their lives.

“Fortunately this group of deviants has been caught. But it shows that there is still a long way to go for technology companies and social media networks who work with police to identify and prevent these crimes.”

The NCA said 26 people had been arrested so far in connection with the ongoing investigation. Of those, six were in positions of trust – three teachers, two charity or fundraiser workers and one who was employed by a local authority. More arrests and charges are expected in the UK and abroad.

(the guardian)

"Choose a job you love and you will not have to work a day in your life" (Confucius)

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Luis Miguel Goitizolo

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9/21/2015 4:51:01 PM

Karzai calls al-Qaida a 'myth' and denies 9/11 attacks were plotted in Afghanistan
On the eve of the anniversary of the 2001 attacks, the former president of Afghanistan expressed doubt that the terrorist group was responsible

Thursday 10 September 2015

Hamid Karzai, the former president of Afghanistan, has questioned the existence of al-Qaida, and denied that the 9/11 terror attacks which killed nearly 3,000 people were planned in Afghanistan.

On the eve of the anniversary of the 2001 attacks, Karzai, who left office last year after 12 years, used an interview with al Jazeera to express his doubt that the terrorist group led by the late Osama bin Laden was responsible for the operation which prompted the invasion of Afghanistan.

“I don’t know if al-Qaida existed and I don’t know if they exist,” said Karzai. “I have not seen them and I’ve not had any report about them, any report that would indicate that al-Qaida is operating in Afghanistan. It is for me a myth […] For us, they don’t exist.”

Karzai, who had a poor relationship with successive leaders in Pakistan, also claimed in the interview that Islamic State fighters in Afghanistan are “definitely” members of “Pakistani militias”.

The former politician, who was the chosen candidate of the US to take over a new administration in the wake of the collapse of the Taliban regime in Afghanistan following the 2001 war, clashed repeatedly with Washington during his rule.

Appearing on Al Jazeera English’s new weekly show, UpFront, Karzai declared as “fact” that 9/11 was not plotted in Afghanistan, despite overwhelming proof that Bin Laden and close associates such as Khaled Sheikh Mohammed organised the operation while based in camps or houses in the east and south of the country between 1999 and 2001.

In the interview on Thursday, the former president said he had “never come across” al-Qaida.

When asked if he agreed that al-Qaida in Afghanistan had been behind the 9/11 attacks in New York and Washington DC, Karzai replied: “I can tell you for a fact that the operation was neither conducted from Afghanistan, nor were the Afghan people responsible for that.”

Bin Laden claimed responsibility for the attacks on several occasions, and videoed testaments of participants in the attacks were recorded in Kandahar, where the men trained in al-Qaida camps.

Bin Laden arrived in Afghanistan in 1996, flying from Sudan where he had been living in exile since 1991. He was based first in hills south of the eastern city of Jalalabad before moving south to Kandahar, the spiritual and administrative headquarters of the Taliban.

Many witnesses have described Bin Laden’s movements in Afghanistan during 2001, while vast quantities of al-Qaida-related material was recovered from training camps across Afghanistan by journalists, soldiers and spies.

Only last month an audio tape surfaced including a segment of a speech made in Afghanistan by Bin Laden in the summer of 2001 in which he promises a significant operation in the US soon.

Al-Qaida has since been largely eclipsed by its own offshoot, the Islamic State, which has established a small but growing presence in Afghanistan.

Most analysts and security officials believe the group’s affiliate in Afghanistan is largely composed of disaffected members of the Taliban, but Karzai dismissed any Afghan connection with the group and pointed the finger at neighbouring Pakistan.

“[The Islamic State] … has no ground [in Afghanistan] at all. There is no element, there is no medium, for them to grow, or to rise, or to strengthen,” he said.

“Those who are working in the name of [the Islamic State inside Afghanistan] are definitely Pakistani militia forces,” he added. “Some of them have been captured and ID cards found on them, […] And they are very well supplied. That we know for a fact.”

In recent months, Karzai has repeatedly been accused of attempting to undermine his successor, Ashraf Ghani, but in the interview, he ruled out an attempt to return to the Afghan presidency.

A daring and bloody operation involving US special forces and the CIA put Karzai back in Afghanistan in the last weeks of the 2001 war and then into power as a supposed consensus candidate.

As the Taliban regime crumbled, Karzai was seen as a the man of the hour. He was the head of a major tribe, of Pashtun ethnicity like around 40% of his compatriots, but moderate, educated and pro-western. Educated in India, with credentials as a “freedom fighter” during the war against the Soviets of the 1980s, he enthused officials in Washington, Kabul and London.

But Karzai quickly proved himself independent and contrarian, not hesitating to launch vitriolic attacks on his backers when they were responsible for civilian casualties during the bitter war against insurgents in the decade that followed or criticise broad western policies.

Officials from the US, the UK, Nato and the UN all repeatedly criticised Karzai for failing to crack down on rampant corruption and the booming narcotics trade in Afghanistan.

By 2009, according to Robert Gates, the former US defence secretary, Washington was so keen to oust the Afghan president that officials connived in delaying an Afghan presidential election and then tried to manipulate the outcome in a“clumsy and failed putsch”.

(the guardian)

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9/21/2015 5:21:59 PM

Cancer patients may need better prep for chemo side-effects


Chemotherapy side-effects are often misunderstood;study


Thomson Reuters Posted: Sep 18, 2015 11:09 AM ET Last Updated: Sep 18, 2015 11:09 AM ET

Cancer patients need to be prepared for serious side effects from chemotherapy, and hospitalization is one that happens much more often in the real world than in drug trials, according to a new study.

Researchers found that people with advanced lung cancer receiving chemotherapy in real-world settings were almost eight times more likely to be hospitalized during treatment than those participating in clinical trials, which are highly controlled and regulated.

nurse

Patients are often unprepared for the side-effects of chemotherapy according to a new study (Matt Rourke/The Associated Press)

What's more, very few clinical trials even report how often participants are hospitalized during the research, the study authors found.

"Clinical trials should be routinely reporting their hospitalization rates so we know what to expect," said senior author Dr. Monika Krzyzanowska, a medical oncologist at the Princess Margaret Cancer Center in Toronto, Canada.

Krzyzanowska and her colleagues write in JAMA Oncology that the number of times a person goes to the hospital with treatment complications is important to the patient and to the hospital.

A patient's quality of life may suffer if they are hospitalized, and a hospital's reputation or reimbursement may suffer if its patients are repeatedly hospitalized.

"I think that [hospitalization is] actually much more common than we ever anticipated," Krzyzanowska said.

For the new study, the researchers looked at data on how many times patients with lung cancer were hospitalized while receiving chemotherapy.

They searched medical databases and found five clinical trials with a total of 3,962 people that specified how many hospitalizations occurred, and compared them to five studies with 8,624 people receiving chemotherapy in real-world settings.

Overall, 51 per cent of the real-world patients were hospitalized during their treatments, compared to 16 per cent of those in clinical trials.

Some of the research looked at factors related to the risk of hospitalization like the type of chemotherapy used and hospital performance measures, but results varied from study to study.

Based on the data, Krzyzanowska told Reuters Health that she can't say with confidence which factors may be tied to an increased risk of being hospitalized.

But, she said, high hospitalizations are likely to be found among people with other types of cancers and for those on other types of treatments.

Clinical trial vs. real-world patients

"I think this is unfortunately a common phenomenon across disease site and treatment regimen," Krzyzanowska said.

The researchers suggest several possible explanations for the differences in hospitalization rates.

First, the patients in highly selective clinical trials are different from real-world patients, who are likely to have other conditions in addition to cancer. In this study, people receiving chemotherapy in real-world settings were also older, on average, than those in clinical trials.

Another possibility is that unlike people in the real world, complications or side effects among those in closely monitored clinical trials are treated before they lead to hospitalizations.

Knowing how much time patients may spend in hospitals during chemotherapy might help them and their doctors in deciding which treatment is right, Krzyzanowska said.

"I think the low-hanging fruit is that clinical trials should start reporting hospitalizations," she said of the findings.

With that kind of data, the researchers suggest, scientists can calculate the risk of hospitalization per month of chemotherapy and ultimately provide that to patients.

Krzyzanowska also said she'd like to look at what factors drive hospitalizations among cancer patients receiving chemotherapy.

"I definitely think there is a substantial portion of people whose symptoms can be managed earlier so they don't end up in the hospital," she said.

If people are concerned about their quality of life during treatment, Krzyzanowska said, they should ask their oncologist about the likelihood of being hospitalized because of treatment.


© Thomson Reuters, 2015

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