SAN JUAN, Puerto Rico: Hurricane Maria killed nearly 3,000 people in Puerto Rico in the desperate, sweltering months after the storm — almost double the previous government estimate — with the elderly and impoverished hit hardest, according to an independent study ordered by the US territory.
The new estimate of 2,975 dead in the six months after Maria devastated the island in September 2017 and knocked out the entire electrical grid was made by researchers with the Milken Institute School of Public Health at George Washington University. It was released Tuesday.
“We are hopeful that the government will accept this as an official death toll,” said Lynn Goldman, dean of the institute. “A lesson from this is that efforts for assistance and recovery need to focus as much as possible on lower-income areas, on people who are older, who are more vulnerable.”
The finding is almost twice the government’s previous estimate, included in a recent report to Congress, that there were 1,427 more deaths than normal in the three months after the storm.
The George Washington researchers said the official count from the Sept. 20 hurricane was low in part because doctors were not trained in how to classify deaths after a disaster.
The number of deaths from September 2017 to February 2018 was 22 percent higher than the same period in previous years, Goldman said.
The office of Puerto Rico Gov. Ricardo Rossello did not immediately return a message for comment.
The number of dead has political implications for the Trump administration, which was accused of responding half-heartedly to the disaster. Shortly after the storm, when the official death toll stood at 16, President Donald Trump marveled over the small loss of life compared to that of “a real catastrophe like Katrina.”
Hurricane Katrina, which struck New Orleans in 2005, was directly responsible for about 1,200 deaths, according to the National Hurricane Center. That does not include indirect deaths of the sort the George Washington researchers counted in Puerto Rico.
Rep. Nydia Velazquez, a New York Democrat, said the report shows the US government failed the people of Puerto Rico.
“These numbers are only the latest to underscore that the federal response to the hurricanes was disastrously inadequate and, as a result, thousands of our fellow American citizens lost their lives,” she said in a statement.
There is no national standard for how to count disaster-related deaths. While the National Hurricane Center reports only direct deaths, such as those caused by flying debris or drowning, some local governments may include indirect deaths from such things as heart attacks and house fires.
Researchers with George Washington said they counted deaths over the span of six months — a much longer period than usual — because so many people were without power during that time.
“That caused a number of issues,” Goldman said, adding that people were forced to exert themselves physically or were exposed to intense heat without fans or air conditioning. “It’s fairly striking that you have so many households without electricity for so long. That’s unusual in the US after a disaster.”
Puerto Rico’s government released data in June showing increases in several illnesses in 2017 that could have been linked to the storm: Cases of sepsis, a serious bloodstream infection usually caused by bacteria, rose from 708 in 2016 to 835 last year. Deaths from diabetes went from 3,151 to 3,250, and deaths from heart illnesses increased from 5,417 to 5,586.
Bethzaida Rosado said government and health care officials were not prepared for the storm, and she is still angry her 76-year-old mother died because oxygen tanks were not available on the island after the hurricane.
“Do you know what it’s like to see your mother run out of oxygen?” she said. “I don’t wish that on anyone.”
Months ago, the Rossello administration stopped updating its official death toll at 64 and ordered the independent investigation amid suspicions the dead were substantially undercounted.
The first phase of the study cost $305,000. In the second phase, the researchers plan to focus on the causes of death.
The researchers found that the risk of death was 45 percent higher for those living in impoverished communities, and that men older than 65 saw a continuous elevated risk of death.
They also reported that physicians and others told them that Puerto Rico’s government did not notify them about federal guidelines on how to document deaths related to a major disaster.
“Others expressed reluctance to relate deaths to hurricanes due to concern about the subjectivity of this determination and about liability,” the report said.
For the study, the researchers reviewed mortality data, including deaths by age, sex and municipality of residence, from July 2010 to February 2018. They also took into account an 8 percent drop in Puerto Rico’s population in the six months after the storm, when tens of thousands fled because of the damage.
However, they did not share details of the methodology, saying those will be released if the study is published in a scientific journal.
“We did not cherry-pick, I can promise you,” Goldman said. “We used very rigorous methodology.”
The study also found that government emergency plans in place when Maria hit were not designed for hurricanes greater than a Category 1. Maria was a Category 4 with 154 mph winds. Damage was estimated at more than $100 billion.
The researchers made several recommendations, including more emergency planning and government training for doctors on filling out death certificates.
They also said the public health system needs to be strengthened, though Goldman said they don’t know yet whether those weaknesses contributed to storm-related deaths.
She added that she has doubts whether Puerto Rico, which is trying to restructure a portion of its more than $70 billion public debt amid a 12-year recession, can adopt any of the recommendations.
“I don’t think they have the resources,” she said. “That is a very critical issue.”
Hurricane Maria killed 3,000 in Puerto Rico: Report
Hurricane Maria killed 3,000 in Puerto Rico: Report
- The researchers found that the risk of death was 45 percent higher for those living in impoverished communities, and that men older than 65 saw a continuous elevated risk of death
US health officials report 1st case of new form of mpox in a traveler
- Mpox is a rare disease caused by infection with a virus that’s in the same family as the one that causes smallpox
NEW YORK: Health officials said Saturday they have confirmed the first US case of a new form of mpox that was first seen in eastern Congo.
The person had traveled to eastern Africa and was treated in Northern California upon return, according to the California Department of Public Health. Symptoms are improving and the risk to the public is low.
The individual was isolating at home and health workers are reaching out to close contacts as a precaution, the state health department said.
Mpox is a rare disease caused by infection with a virus that’s in the same family as the one that causes smallpox. It is endemic in parts of Africa, where people have been infected through bites from rodents or small animals. Milder symptoms can include fever, chills and body aches. In more serious cases, people can develop lesions on the face, hands, chest and genitals.
Earlier this year, scientists reported the emergence of a new form of mpox in Africa that was spread through close contact including through sex. It was widely transmitted in eastern and central Africa. But in cases that were identified in travelers outside of the continent, spread has been very limited, according to the US Centers for Disease Control and Prevention.
More than 3,100 confirmed cases have been reported just since late September, according to the World Health Organization. The vast majority of them have been in three African countries — Burundi, Uganda, and the Democratic Republic of the Congo.
Since then, cases of travelers with the new mpox form have been reported in Germany, India, Kenya, Sweden, Thailand, Zimbabwe, and the United Kingdom.
Health officials earlier this month said the situation in Congo appears to be stabilizing. The Africa CDC has estimated Congo needs at least 3 million mpox vaccines to stop the spread, and another 7 million vaccines for the rest of Africa. The spread is mostly through sexual transmission as well as through close contact among children, pregnant women and other vulnerable groups.
The current outbreak is different from the 2022 global outbreak of mpox where gay and bisexual men made up the vast majority of cases.
Migration agreement violates medical ethics, aid groups say
- Asylum-seekers should be considered at risk of post-traumatic stress disorder, humanitarian organizations say
ROME: More than a dozen humanitarian organizations that provide healthcare to migrants criticized Italy’s migration deal with Albania as violating the code of medical ethics and urged health workers not to cooperate with it.
The deal, the centerpiece of Premier Giorgia Meloni’s crackdown on human trafficking, calls for some male migrants rescued at sea to have their asylum cases processed while they are detained at two holding centers in Albania, a non-EU nation.
Italy, which has long demanded Europe shoulder more of the continent’s migration problem, has held up the deal with Albania as a model for the continent and a strong deterrent to would-be refugees setting out on smugglers’ boats from North Africa for a better life.
However, the five-year deal, budgeted to cost Italy €670 million ($730 million), has run into a series of obstacles and legal challenges that have prevented even a single migrant from being processed in Albania.
FASTFACT
The five-year deal, budgeted to cost Italy $730 million, has run into a series of obstacles and legal challenges that have prevented even a single migrant from being processed in Albania.
First, construction delays prevented the opening of the centers for several months. Then, after the first two batches of 20 men were brought to Albania this month, Italian courts issued rulings that resulted in them being taken to Italy anyway.
The matter is before the EU’s Court of Justice in Luxembourg, which has been asked to rule on whether the men come from countries deemed safe for return. All 20 hail from Bangladesh and Egypt.
On Friday, the nongovernmental organizations released a detailed analysis of the procedures to screen migrants first on Italian naval ships and then in the Albanian centers to determine if they are “vulnerable.” Only men deemed to be not “vulnerable” are to be sent to Albania.
The aid groups said there were no proper facilities or instruments to make such a determination. And regardless, practically everyone who has set off on the dangerous Mediterranean crossing has endured the physical, psychological, or sexual abuse that should disqualify them from Albanian detention, they said.
The migrants should be considered at risk of post-traumatic stress disorder or other severe physical and mental health consequences, they said.
“The Italy-Albania Protocol violates the code of medical ethics and human rights and puts the physical and psychological health of migrants at risk,” the statement said.
The groups criticized the international organizations cooperating with the project, identifying the International Organization of Migration and the Knights of Malta’s Italian rescue corps as being “complicit” in human rights violations.
The Knights of Malta strongly rejected the claim, denying their doctors and nurses were in any way taking part in the “selection” of migrants or where they disembark, and said none had participated in the transfer of migrants to Albania.
In a statement, the Knights said their medical teams had worked on Italian naval vessels rescuing migrants in the Mediterranean since 2008, providing necessary first aid.
They said that work continues today unchanged.
The Knights “are proud of what has been accomplished in more than 15 years with the coast guard saving human lives at sea and has no intention of stopping this activity which often is the difference between life and death,” the group said.
There was no immediate reply to an email sent to the IOM seeking comment.
The Italian government has said the rights of the migrants would be fully guaranteed in the Albanian centers.
The deal has been blessed by European Commission President Ursula von der Leyen as an example of “out-of-box thinking” to tackle the migration issue.
However, human rights groups say it sets a dangerous precedent and violates Italy’s obligations under international law.
The UN refugee agency has agreed to supervise the first three months of the agreement, and one of its teams is conducting an “independent mission” on board the transfer ship to monitor the screening process.
The legal challenges have come despite the small number of people impacted.
Even though the centers were built to house as many as 3,000 migrants a month, just 20 were transferred in the first two separate ship passages, only to be sent to Italy after the Rome courts intervened.
The statement was signed by Doctors Without Borders, Emergency, Sea-Watch, SOS Mediterranee, and other aid groups.
Gabon votes on new constitution hailed by junta as ‘turning point’
- The junta on Saturday extended a night curfew by two hours, bringing it forward to midnight “during the whole electoral process,” according to a decree read on state television
LIBREVILLE: Gabon extended a night curfew as it held a referendum on a new constitution the ruling junta says will mark a new chapter after 55 years of dynastic rule in the African nation.
The estimated 860,000 registered voters have faced an onslaught of calls by authorities on TV, radio, and social media to make their ballot count — whether they choose a green one, meaning “yes,” or a red one for “no.”
With the campaign dominated by official propaganda by the junta that took power in August last year in a coup, local media say voter turnout will be a crucial factor.
Voting began late at several polling stations in the capital, Libreville, with papers still being handed out when the polls opened at 7 a.m. (0600 GMT).
The 2,835 polling stations nationwide are due to remain open until 6 p.m.
The junta on Saturday extended a night curfew by two hours, bringing it forward to midnight “during the whole electoral process,” according to a decree read on state television.
It did not specify when the extended curfew ending at 5 a.m. would remain.
The proposed constitution sets out a vision of a presidency with a maximum of two seven-year terms, no prime minister, and no dynastic transfer of power.
It would also require presidential candidates to be exclusively Gabonese — with at least one Gabon-born parent — and have a Gabonese spouse.
This would eliminate toppled ruler Ali Bongo Ondimba, married to a Frenchwoman, and his children.
His replacement, transitional President Brice Oligui Nguema, declared the referendum a “great step forward” as he cast his vote at a Libreville school.
“All Gabonese are coming to vote in a transparent fashion,” the junta chief told the press, having ditched his general’s uniform for a brown civilian jacket over light-wash jeans.
Oligui has vowed to hand power back to civilians after a two-year transition but has made no secret of his desire to win the presidential election scheduled for August 2025.
Billboards adorned with an image of the general and urging a “yes” vote are everywhere, the Union newspaper commented on Friday, prompting it to ask: “Referendum or presidential campaign?“
Queues of dozens of voters formed in front of the classrooms housing the polling stations at the Lycee Leon M’Ba in Libreville, under the watchful eye of the soldiers charged with ensuring the ballot’s security.
Nathalie Badzoko, a 33-year-old civil servant, said she voted “yes” and had faith in the junta but admitted she had “not read the whole text” and its 173 articles.
Louembe Tchizinga, a 45-year-old taxi driver casting his ballot, echoed her.
Opponents of the proposed text dismiss it as tailor-made for the strongman to remain in power.
“We are creating a dictator who designs the constitution for himself,” lawyer Marlene Fabienne Essola Efountame said.
Bongo ruled for 14 years until he was overthrown moments after being proclaimed the winner in a presidential election, which the army and opposition declared fraudulent.
He took office on the death of his father, Omar, who had ruled with an iron fist for more than 41 years.
The opposition and the military coup leaders accused Ali Bongo’s regime of widespread corruption, bad governance, and embezzlement.
The Interior Ministry says it has done all it can to ensure Saturday’s referendum is transparent, including by inviting international observers — who were not present in the August 2023 presidential election.
“We trust them, and this is a test,” said Mathurin Bengone, a 45-year-old civil servant at the Ministry of Health.
“If our vote isn’t respected, we won’t vote again.”
The ministry said provisional results will be released as soon as possible, with the final ones announced by the constitutional court.
Polls on the outcome have not been released.
However, nearly 87 percent of those asked said they think the country is “heading in the right direction,” according to an Afrobarometer survey among 1,200 respondents published mid-October.
The survey also suggested that unemployment topped the list of concerns, followed by health, roads, insecurity, and a rising cost of living.
More than 46 percent have “great confidence” in Oligui, who would be the favorite if a presidential election were to take place now.
In their final talks, Biden expected to press China’s Xi on North Korea’s ties with Russia
- Saturday’s talks on the sidelines of the annual Asia-Pacific Economic Cooperation summit in Peru come just over two months before Biden leaves office
LIMA: President Joe Biden is expected to use his final meeting with China’s leader, Xi Jinping, to urge him to dissuade North Korea from further deepening its support for Russia’s war on Ukraine.
Saturday’s talks on the sidelines of the annual Asia-Pacific Economic Cooperation summit in Peru come just over two months before Biden leaves office and makes way for Republican President-elect Donald Trump. It will be Biden’s last check-in with Xi — someone the Democrat saw as his most consequential peer on the world stage.
With the final meeting, officials say Biden will be looking for Xi to step up Chinese engagement to prevent an already dangerous moment with North Korea from further escalating.
Biden on Friday, along with South Korean President Yoon Seok Yul and Japan’s Prime Minister Shigeru Ishiba, condemned North Korean leader Kim Jong Un’s decision to send thousands of troops to help Moscow repel Ukrainian forces who have seized territory in Russia’s Kursk border region.
Biden called it “dangerous and destabilizing cooperation.”
White House officials also have expressed frustration with Beijing, which accounts for the vast majority of North Korea’s trade, for not doing more to rein in Pyongyang.
Biden, Yoon and Ishiba spent most of their 50-minute discussion focused on the issue, agreeing it “should not be in Beijing’s interest to have this destabilizing cooperation in the region,” according to a senior administration official who spoke on condition of anonymity to discuss their private conversations.
The North Koreans also have provided Russia with artillery and other munitions, according to US and South Korean intelligence officials. And the US, Japan and South Korea have expressed alarm over Pyongyang’s stepped-up cadence of ballistic missile tests.
Kim ordered testing exercises in the lead-up to this month’s US election and is claiming progress on efforts to build capability to strike the US mainland.
Biden and Xi have much beyond North Korea to discuss, including China’s indirect support for Russia, human rights issues, technology and Taiwan, the self-ruled democracy that Beijing claims as its own. Both presidents started their day at the leaders’ retreat at the APEC summit.
There’s also much uncertainty about what lies ahead in the US-China relationship under Trump, who campaigned promising to levy 60 percent tariffs on Chinese imports.
Already, many American companies, including Nike and eyewear retailer Warby Parker, have been diversifying their sourcing away from China. Shoe brand Steve Madden says it plans to cut imports from China by as much as 45 percent next year.
“When Xi meets with Biden, part of his audience is not solely the White House or the US government,” said Victor Cha, an analyst at the Center for Strategic and International Studies in Washington. “It’s about American CEOs and continued US investment or trying to renew US investment in China and get rid of the perception that there’s a hostile business environment in China.”
White House national security adviser Jake Sullivan said Biden administration officials will advise the Trump team that managing the intense competition with Beijing will likely be the most significant foreign policy challenge they will face.
Administration officials are concerned that tensions between China and Taiwan could devolve into all-out war if there is a miscalculation by either side, with catastrophic consequences for the world.
Sullivan said the Trump administration will have to deal with the Chinese military’s frequent harassment of its regional neighbors.
Skirmishes between the Philippine and Chinese coast guards in the disputed South China Sea have become a persistent problem. Chinese coast guard ships also regularly approach disputed Japanese-controlled East China Sea islands near Taiwan.
Ishiba met with Xi on Friday. Afterward, the Japanese prime minister said he told Xi he was “extremely concerned about the situation in the East China Sea and escalating activity of the People’s Liberation Army.”
The White House worked for months to arrange Saturday’s meeting between Xi and Biden, something the Democrat badly wanted to do before leaving office in January.
Sullivan traveled to Beijing in late August to meet with his Chinese counterpart and also sat down with Xi. Beijing agreed to the meeting earlier this week.
It’s a big moment for Biden as he wraps up more than 50 years in politics. He saw his relationship with Xi as among the most consequential on the international stage and put much effort into cultivating that relationship.
Biden and Xi first got to know each other on travels across the US and China when both were vice presidents, interactions that both have said left a lasting impression.
But the last four years have presented a steady stream of difficult moments.
The FBI this week offered new details of a federal investigation into Chinese government efforts to hack into US telecommunications networks. The initial findings have revealed a “broad and significant” cyberespionage campaign aimed at stealing information from Americans who work in government and politics.
US intelligence officials also have assessed China has surged sales to Russia of machine tools, microelectronics and other technology that Moscow is using to produce missiles, tanks, aircraft and other weaponry for use in its war against Ukraine.
And tensions flared last year after Biden ordered the shooting down of a Chinese spy balloon that traversed the United States.
Abkhazia leader says ready to resign if protesters vacate parliament
- Rare protests have erupted in recent days in the republic, nestled between the Caucasus mountains and the Black Sea, over an economic deal with Moscow
- “I am ready to call elections, to resign.. and stand in elections. Let the people say who they will support,” the leader of the separatist republic Aslan Bzhania said
MOSCOW: The president of the Moscow-backed breakaway Georgian republic of Abkhazia announced Saturday that he is ready to resign after protesters stormed the regional parliament, opposing an investment deal with Russia.
Rare protests have erupted in recent days in the republic, nestled between the Caucasus mountains and the Black Sea, over an economic deal with Moscow.
Abkhazia is recognized by most of the world as Georgian territory, but has been under de-facto Russian control since a brief 2008 war between Moscow and Tbilisi.
“I am ready to call elections, to resign.. and stand in elections. Let the people say who they will support,” the leader of the separatist republic Aslan Bzhania said.
He said his condition was that the protesters who entered parliament and a presidential administration building next door should vacate the premises.
“Those who took over the presidential administration should leave,” he said.
The tiny territory, known for its natural beauty, has been thrown into turmoil over concerns that a proposed investment deal with Moscow could see apartment complexes mushroom in the region.
Protesters have been blocking roads in the main city of Sukhumi for several days this week.
Russia on Friday advised its citizens not to travel to Abkhazia, a traditional holiday destination for Russians.
