Small acts of kindness ... but it"s not enough for women in refugee camps

In a refugee camp near the Greek city of Thessaloniki, I treated a Kurdish woman in her early twenties for a throat infection. Before she left, the translator asked her if there was anything else we could help her with. She broke down in tears. She had four children who she was struggling to look after and keep clean. She showed us a photograph of her children, just one year ago, well dressed and smiling. This woman was not only tired and desperate, she was ashamed of her living conditions. The food was bad, toilets revolting and she could not properly look after her family.

This refugee crisis is the worst in living memory. The UNHCR currently estimates that there are 65.3 million people displaced from their homes by conflict and persecution globally. Many are women and 41% are children.

Women were deliberately not drinking water so they could avoid a trip to the revolting portable toilets

In times of crisis women bear the brunt. All refugees are marginalised, but the women are particularly vulnerable to exploitation and physical and sexual harm. Many are victims of unimaginable atrocities as they flee their home countries. Pregnant women and those with small children are uniquely vulnerable on the dangerous journey to Europe. Throughout these camps there are widespread reports of gender-based violence.

In the camps women are under extraordinary pressure. Many have young families to provide for. Living in small tents they need to look after their children, feed their families, keep them clean and try to retain some normality with dignity.

Women are hit hardest by poor access to sanitation and water. Washing clothes for large families in a refugee camp becomes an impossible task. Summertime Greece is hot, in the camp where I worked women felt they could not keep clean and were deliberately not drinking water so they could avoid a trip to the revolting portable toilets; just six for a camp housing 600. They were risking dehydration and kidney and urine infections. One woman cried as she described the shame she felt about having to urinate in a bucket inside a tent that she shared with her large family.

Small acts of kindness do not solve the problems but they do give some comfort and dignity. Photograph: Hannah Mitchell

Asides from the issue of sanitation, the toilet area was poorly lit and women felt afraid and unsafe going there at night, with reports of intimidation and fights.

In the rush to respond to the large numbers of refugees arriving, many of the camps have sprung up in previously abandoned warehouses. They were not designed for human habitation. However, provision of clean, well-lit sanitation facilities, which a large number of people can use is not a difficult task and something that could be easily addressed in the camps.

Another recurring theme was that women did not want to be intimate with their partners. Many felt pressured into having sexual relations and there were newly pregnant women in the camps. Women have distinct health needs that can easily be overlooked in the response to acute medical needs. Provision of good maternity care and being pragmatic about access to family planning should be prioritised.

Many of the women had previously assumed the role of carer in their family, and many were deeply upset by their inability to carry out that role in the camps. The UNHCR emphasises that women must be involved specifically with the management and distribution of resources. There was little evidence of this on the ground in the camps. Unfamiliar and unpalatable food was given out. Many of the women complained that by the time it arrived it was hardly edible.

We need to empower women in the camps

Central to the humanitarian response should be empowering these women who have lost everything. Many of the women felt they weren’t being listened to. Here simple, pragmatic things can make a huge difference; volunteers in one of the camps organised distribution of fresh fruit and vegetables, which were needed to cook traditional meals from back home. Another gave out cooking utensils. Many of the women were delighted by this. Another volunteer gave pillows to each of the tents. These small acts of kindness do not solve the problems but they do give some comfort and dignity.

These women see no solution to their problems … They wait with their children for their lives to start again

However, the painful reality is that these women see no solution to their problems within reach. They wait with their children for their lives to start again. They are terrified for their children’s future as they have no access to formal education. One said that a prison sentence would be better than being in the camps, because at least then they would know when they would get to leave.

The responses of local people in the towns hosting the refugees was mainly one of kindness and compassion. The volunteer response, though at times chaotic, shows some of the large amount of goodwill towards refugees in Europe. The response of some of the European countries to the refugees is shameful, especially the failure of the UK to provide a safe haven for the many unaccompanied child refugees.

The world has been slow in its response to the refugee crisis, but this is an issue that will affect us all for many generations. These women have faced the most appalling conditions with the utmost of resilience and dignity. As the refugee crisis slips down the news agenda and out of the public’s mind, these families are going nowhere. If Lebanon, a country with a population of under 5 million can host 1.5 million refugees, then surely the rest of the world can play its part too.

Translation by Nada Sarsour, Amer Sawaf, Mohamad Abou Ras, Mariam Saleh and Mohamad Namo.

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Small acts of kindness ... but it"s not enough for women in refugee camps

Savile told hospital employees he performed sex acts on corpses in Leeds mortuary

Jimmy Savile was explained to have been best pals with the chief mortician of Leeds basic infirmary. Photograph: Ray Tang /Rex

Jimmy Savile advised hospital workers he interfered with patients’ corpses, taking grotesque images and stealing glass eyes for jewellery, above two decades at the mortuary of Leeds general infirmary.

The late Top of the Pops presenter had free of charge access to the mortuary from the late 1970s to the mid-1990s, an official investigation has identified, concluding that Savile’s interest in the deceased was “not within accepted boundaries”.

One particular former Broadmoor nurse informed investigators that Savile claimed to have performed intercourse acts on bodies and “mucked about” in the mortuary, posing in pictures with the deceased following placing them in lewd positions.

The former nurse explained: “He [Savile] was saying that they utilised to put the bodies collectively, male and female, and he also mentioned that they took photographs and also that he received involved in some of the photographs … I was a little bit upset due to the fact I had no idea, in people days, of necrophilia. A number of of the Broadmoor individuals would have been diagnosed with that, but I didn’t entirely realize what it meant, and partway by means of I just wandered off.

“[Savile] talked about gamaroosh … It indicates oral sex … that he [Savile], he would go down on them and gamaroosh and muck about.”

Separately, the independent investigation was told that Savile had removed glass eyes from the bodies and employed them as jewellery.

One witness mentioned: “I looked at his hands and he had these gross, large silver rings with bulbous issues and I sort of went, ‘Yes, mm,’ always be polite to your superstar, ‘Yes, Jim.’ And he explained: ‘D’you know what they are? They are glass eyes from dead bodies in Leeds mortuary exactly where I perform and I enjoy functioning there, and I wheel the dead bodies all around at evening and I really like that.’”

Savile was mentioned to have been very best friends with the chief mortician of Leeds standard infirmary, who is now dead, and had regular unsupervised access to the mortuary from the late 70s until the mid-90s.

The investigation, published by the Department of Health, established that Savile had publicly disclosed his interest in the dead, that he was close friends with the chief mortician, and that there was a lack of stringent procedures concerning accessibility to the mortuary till the late 80s at the earliest.

It concluded: “In light of the claims about the glass eye jewellery and Savile’s interference with the bodies of the deceased, it is evident his curiosity in the mortuary was not inside of accepted boundaries.”

A Residence Office pathologist confirmed to the inquiry that it would have been feasible for Savile to pose with the bodies before the rigor mortis stage, a chemical change which brings about a corpse’s limbs to grow to be stiff.

Dr Jennifer Bolton advised the investigators: “A degree of posing would be feasible with some assistance of the body in the pre-rigor mortis phase and by the straightforward laying of one entire body on top of yet another when rigor mortis was fully established.

“It would be possible to manipulate the body to some extent alone by exploiting the results of rigor mortis but it would be far more effortlessly attained if more than one individual was involved.”

• Any individual needing assistance should get in touch with the National Association for People Abused in Childhood (Napac) on 0808 801 0331

Savile told hospital employees he performed sex acts on corpses in Leeds mortuary

A Grieving Mother Acts, Whilst The FDA Dithers

Vaccination is one of the most important advances in public health in current centuries.  Hundreds of vaccines have all but eradicated many of the infectious illness scourges of the past.  But outbreaks of Meningitis B (MenB) — which is caused by serotype B of a bacterium called Neisseria meningitidis, or meningococcus — on at least four college campuses for the duration of the previous eighteen months display that more needs to be completed.

Scientists and drug firms have presently accomplished their component what we need to have now is a lot more responsible government regulation. But simply because FDA is unwilling or unable to give that, the mom of a university-student who died from a swiftly progressive MenB infection has taken matters into her personal hands.  Alicia Stillman, a Michigan mom, has shown the heroism that bureaucrats lack.

The initial portion of the story is federal regulators’ insufficient and piecemeal actions to stem the further spread of the potentially deadly MenB.  More than a dozen students have been contaminated at 4 U.S. colleges, the 1st of whom was Kalamazoo College sophomore Emily Stillman, who died from the infection in February of final 12 months.  Worldwide, there are 20,000-80,000 situations of MenB yearly, with a mortality charge of about 10 %.  Of individuals who survive, about one particular-fifth endure from devastating long lasting disabilities this kind of as brain injury, deafness, or limb reduction.  One University of California Santa Barbara student in last year’s outbreak was a freshman lacrosse player whose feet had to be amputated.

As students, mothers and fathers and university administrators learned to their dismay, there is no accredited MenB vaccine in the United States despite the fact that one known as Bexsero, produced by Novartis, has been authorized by regulators in the European Union, Australia, and Canada, and is available in people nations.  The same vaccine is in clinical trials in the United States, but characteristically, the FDA has slowed the testing and approval process, so officials at the impacted campuses had been forced to appeal to the federal government for unique permission to import and administer it.

Had FDA moved expeditiously and permitted Bexsero to come to market, at least some of the circumstances would probably have been prevented.

Bexsero is not an isolated situation.  FDA regulators react consistently to a distorted set of incentives and disincentives, which usually final results in regulatory delays, higher advancement expenses, and even specific important medicines in no way reaching the American industry.

It is critical to recognize that there are two basic kinds of errors that can be manufactured by “gatekeeper” regulators, whose approval is necessary just before a merchandise can be offered — products such as medicines, vaccines, healthcare products and pesticides.  A Sort I error includes permitting one thing bad to come about (i.e. approving a product that turns out to be damaging), even though a Kind II error delays or prevents one thing beneficial (e.g., failing to approve a existence-saving vaccine).

FDA goes to severe lengths to steer clear of Variety I mistakes and the horrible press and public outrage that accompany them.  Variety II errors, even so, are largely invisible – non-occasions that may be identified only to the business creating the merchandise and possibly a few financial analysts who adhere to the sector. Therefore, they price bureaucrats nothing at all.

But excessive threat aversion manifested as Type II errors can be deadly.  An instance is the three-year delay in the approval of misoprostol, a drug for the therapy of gastric bleeding, which is estimated to have expense amongst 8,000 and 15,000 lives per yr.  Because Bexsero fell victim to the identical kind of self-serving bureaucratic threat-aversion as its advancement was slowed by the FDA, far more circumstances of MenB infection might emerge till the time when the drug is permitted on the U.S. market and created broadly available.

This circumstance could have been averted if only FDA had met its prolonged-standing international commitment to pursue “reciprocity” of approvals with specific foreign governments, which would hasten the approval of a drug in the United States after its sanction by a main foreign regulatory authority.  Reciprocity could be achieved, for instance, just by giving the FDA a finite time period of time (say, 60 days) from the date of an EU, Japanese or Canadian approval to display trigger why a product ought to not be accepted.  In the absence of this kind of evidence from the FDA (which would carry the burden of proof), the drug would be accepted instantly.  (Automated approvals would movement in the opposite direction, if FDA were to grant the initial approval.)

Reciprocity of approvals need to have been in area years ago.  Since its inception in 1990, the Global Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) has brought with each other the regulatory authorities and pharmaceutical business of Europe, Japan and the United States in buy “to accomplish better harmonization to make sure that risk-free, powerful, and high top quality medicines are developed and registered in the most resource-efficient manner.”  The ICH’s agenda (supposedly) involves reciprocity of drug approvals between particular governments, but generations of FDA officials have resisted any this kind of “outsourcing” of their responsibilities.  When I asked a senior European regulator about the extent of the U.S. cooperation on this situation, she quipped, “It’s like discussing the Thanksgiving dinner menu with the turkeys.”

In the absence of reciprocity agreements, in purchase to tackle the latest MenB outbreaks in the United States the FDA ought to have granted approval to Bexsero immediately by means of a regulatory pathway called “accelerated approval.”  An instance was FDA’s 2009 licensing of a GlaxoSmithKline vaccine to stop Haemophilus influenzae Kind b infections that can lead to meningitis, pneumonia, extreme swelling in the throat, and infections of the blood, joints, bones and pericardium.

Though the FDA requested a shipment of Bexsero to Princeton University in October of last 12 months, it did not arrive until December, nine months soon after the physical appearance of the initial case there, and it was in no way created available at two campuses – Kalamazoo University and Drexel University – the place cases occurred.  Accelerated approval could have been granted speedily following no a lot more than a demonstration (via laboratory exams on a little variety of recipients who received the vaccine at Princeton) that Bexsero elicited an immune response against MenB.  And in any situation, there was enough clinical data for regulators in the EU, Canada and Australia to approve this vaccine.

Alicia Stillman, Emily’s mother, was not about merely to wallow in grief in excess of her daughter’s death she decided to get action as a memorial tribute to Emily.

I initial grew to become acquainted with Mrs. Stillman when she posted this comment about an post I had written about MenB last December:

Final February, my nineteen year outdated wholesome daughter contracted the B strain whilst away at university.  I was shocked and devastated — I never ever knew when she obtained her vaccination that there was even such as issue as a B strain that was not covered.  She died inside thirty hours of getting into the hospital with a headache.  My daily life has been altered permanently.  I have followed the “compassionate release” of the Bexsero vaccine to people “lucky” Princeton students [to whom the vaccine was produced offered] — and can only hope the rest of us uncover it available soon.  If any of the selection makers at the FDA watched their sweet daughter die this kind of a death, and if individuals selection makers had to go pick a coffin and a headstone for a single of their kids, I have a feeling the decision would be manufactured a small quicker.

 I grieve with Mrs. Stillman and I admire what she did to make her stage: Final weekend, obtaining attracted nationwide consideration, she organized a bus journey for about 4 dozen folks, mainly college-age youngsters, from her property in Michigan to Windsor, Ontario, the place she had organized for the group to be witnessed by a physician, obtain the vaccine and have it administered.

A Grieving Mother Acts, Whilst The FDA Dithers