It cannot be denied that the recent World Cup helped focus on one of the world’s most popular sports. And it cannot also be denied that psychology plays an important part on who is going to be the winner.

During the World Cup, the Algerian team prepared for its matches by watching the legendary movie “The Battle of Algiers.” The movie, which depicts the fight of Algerians against the French ruling their country, perhaps helped them to a reasonable performance during the Cup.

The Brazilian team, which was on the way to what the players thought was a certain victory, particularly after the first goal against the Dutch, saw their hopes crushed after the Dutch tied the game and went on to win it at the end. Here psychology played against the Brazilians.

Psychology also played against the Argentinians, who, led by the legendary Diego Armando Maradona were convinced they were going to be among the finalists. An early goal by the Germans, a couple of minutes after the start of the game, was a factor in their poor performance and the ultimate 4 to 0 defeat of their team.

Thinking about that psychological effect brought to my mind an event that happened years ago. My town’s basketball team had been on a losing streak, and the players’ mood could be said to be underground. Never before in the history of the club had they had such ruinous performances.

The officials at the club were desperate. They talked to the players, they offered them incentives, they threatened to fire them, all to no avail. The team continued losing. This happened until finally one of the officials had a brilliant idea on how to improve the situation. Why not use the services of a psychologist to better the team’s morale?

The one finally chosen was a friend of mine, known to all by the nickname “Rabbit” obviously because of his uncanny resemblance to that animal. My friend was a hardworking but down to earth professional. I knew he was going to do his best to improve the team’s performance.

In effect, during a long holiday the players were called back to work with my friend. He used several techniques to lift the players’ spirits. Movies, music, pep talks, role playing, everything was tried and nothing seemed to work. When the season resumed, the team continued losing every single game. The fans were disappointed and the club officials were furious with my friend.

One day, I was doing errands downtown when I met the Rabbit. I couldn’t help asking him how things were going. “Terrific,” he answered. “Come on, Rabbit,” I told him, “what do you mean, terrific? Your team has continued losing every single game since you became their psychologist.” “That is correct,” he answered, unperturbed, “but now my job is done. Now, when they lose a game, they at least feel good about themselves!”

César Chelala is a writer on human rights and foreign policy issues.

Russia has one of the world’s most serious epidemics of injection drug-use, according to the World Health Organization (WHO) and UNAIDS. It is estimated that Russia has two million injecting drug users (IDUs), 60-70% of whom have HIV-related illnesses. In the past decade, the number of HIV-infected people has increased from an estimated 100,000 to over one million.

Sharing syringes by injecting drug users is the most prevalent cause of HIV transmission in Central Asia and Eastern Europe, where it is responsible for more than 80 percent of all HIV infections.

The Russian authorities have come under strong, widespread criticism for their policies aimed at dealing with the IDU/HIV epidemic. Education to control drug abuse has focused primarily on the promotion of drug abstinence. In addition, officials have relied on criminalization as the main deterrent. That approach has created obstacles to effective addiction treatment and HIV prevention.

Another policy, which has proven effective in other countries, is “harm reduction.” This approach, one dismissed by the Russian authorities, puts prevention of HIV infection and transmission first and features needle exchange programs and treatment with substitute drugs taken orally.

It is estimated that eighty percent of those Russians who are HIV positive became infected by using contaminated needles and syringes. However, despite the proven efficacy of harm reduction strategies in HIV prevention, the Russian authorities have failed to take advantage of them. A 2004 UNAIDS survey found that funding for needle and syringe exchange programs in Russia fell by 29 percent between 2002 and 2004 while the incidence and prevalence of infection and numbers of IDUs was on the rise.

Harm reduction strategies involve providing access to the drug methadone, needle exchange program and addiction counseling. While detoxification is widely available throughout Russia, more comprehensive, longer term treatment remains unavailable in many parts of the country. This failing is critical because research has shown that detoxification by itself is not effective treatment.

Russian law prohibits opiate-substitution therapy (OST) employing oral dosing with methadone or buprenorphine. Use of these drugs, however, has been shown to be the most effective approach for dealing with opiate dependence among IDUs. Although UN agencies strongly support their use in prevention and treatment, these substitute drugs are effectively banned by Russian health and law enforcement officials, despite the fact that OST with them has been shown to reduce HIV prevalence and the risk of HIV transmission. It also has proven to reduce the numbers of IDUs, according to the World Health Organization.

Although it has been proved that appropriate psychosocial counseling is essential for a successful drug addiction treatment, Russian officials also fail to offer such counseling during and after detoxification treatment.

The close relationship between injecting drug use and HIV infection stresses the need for effective drug addiction treatment strategies. As stated by Human Rights Watch, “If Russia doesn’t take steps to address the problems of its drug dependence treatment system it runs the risk of continued and increasing spread of HIV, and even drug resistant HIV strains, due to lack of access by drug users to antiretroviral treatment and their suboptimal adherence due to poor quality drug dependence treatment programs.”

Dr. César Chelala is an international public health consultant and the author of “AIDS: A Modern Epidemic,” a publication of the Pan American Health Organization.

On May 23, 2010, Mordechai Vanunu, whom Amnesty International calls a “prisoner of conscience,” was again sent to prison for a new three-month sentence, accused of violating the terms of his previous release. Previously, he had been in prison for 18 years, and spent the first 11 years in solitary confinement. According to Amnesty International, the restrictions placed on him were not parole, since Vanunu had already served his full term. “They arbitrarily limit his rights to freedom of movement, expression and association and are therefore in breach of international law,” said Amnesty International.

Vanunu is a former Israeli nuclear technician who, in 1986, revealed details of Israel’s nuclear program to the British press. While working as a technician at the Negev Nuclear Research Center, he became increasingly concerned about Israel’s nuclear weapons program and possible Israeli nuclear strategies in case of war. The information he revealed was published by the Sunday Times. In it he estimated that, at the time, Israel had produced more than 100 nuclear warheads.

He was afterwards lured to Italy by a Mossad agent, where he was kidnapped by Israeli operatives. He was transported to Israel where he was tried on charges of treason and espionage, and condemned to 18 years in prison, in a trial conducted behind closed doors.

Although he was released from prison in 2004, he was subject to several restrictions on his speech and movement. He was arrested several times for violating those restrictions. According to Israeli officials, his last prison sentence is the result of his violating the conditions of his 2004 release from prison.

Acknowledgment of possession of nuclear weapons has considerable practical importance for Israel. By denying possession of such weapons, Israel avoids a US legal restriction of funding countries which have a rapid increase of weapons of mass destruction. Presently, Israel receives more than $3 billion a year in military and other aid from Washington.

Although Vanunu is widely reviled in Israel and by many Jews living overseas, he is vastly admired by peace loving people throughout the world. In 1987, he received the Right Livelihood award and in 2001 was given an honorary doctorate by the University of Tromso, in Norway. In 2005, he was awarded the Peace Prize of the Norwegian People.

Daniel Ellbersg has called him “the preeminent hero of the nuclear era.”

Despite his ordeal Vanunu remains defiant. In a poem he wrote entitled “Buried Alive,” in which he compares solitary confinement to living in a grave he wrote, “...Now iron gates, doors, grills, cement in this concrete world solidifying me. Only my mind, my spirit is free- free to remember why I am in prison but not prison for my spirit, they cannot chain my mind.”

Writing in Haaretz, Yossi Melman, its intelligence and military affairs correspondent, stated, “In a proud country that is celebrating its 60th anniversary, which purports to observe the judicial and moral norms of the enlightened world, one might have expected it to take courage and allow Mordechai Vanunu to be free, once and for all.”

Dr. César Chelala is a co-winner of an Overseas Press Club of America award for an article on human rights.

In recent times, China has greatly improved the health status of the majority of its population — while also maintaining a sustained economic expansion. Some of these achievements have been a model for developing countries worldwide. Gains in the health sector, however, are being curtailed by the environmental consequences of the rapid economic expansion of the country. To continue the country’s economic growth — while at the same time protecting people’s health — is one of the main challenges facing Chinese authorities today.

In the last two decades, China has had average economic growth of 9.4%. For the last 50 years, it has also made impressive advances in public health by improving access to health care and tackling infectious diseases with remarkably good results.

The average life expectancy is now 71.8 years, up from 35 in 1949. Immunization coverage is over 95% for those under age one.

From 1960 to 2003, China’s infant mortality rate fell from 150 to 30 per 1,000 live births, and the under-five mortality rate dropped from 225 to 37 per 1,000 live births. Both rates are used as indicators of access to basic health services. At the same time, there has been a sustained increase in the number of community service networks, which provide basic health services to the population.

UNICEF has found that since 1978, the number of health facilities in China has increased by 82% and the number of health staff by 88%. In spite of these improvements, significant challenges for maternal and child health care remain. For example, emergency obstetric and newborn care is deficient, particularly for people living in remote areas. Child mortality rates in remote areas are several times higher than those in urban areas. Also, many poor rural families and migrants in China’s urban areas simply cannot afford health services.

Gains in the health sector are being curtailed by the environmental consequences of the rapid economic expansion of the country. Progress on environmental issues has not been as sustained, particularly the effect of environmental pollution on children. Children's vulnerability to pollution stems from differences in their physiology, growth characteristics and diet.

Vulnerability to environmental hazards is also related to their developmental stage. Children differ from adults in their degree of exposure to those environmental hazards, on how contaminants are absorbed and distributed in the body, and in their capacity to transform and eliminate different chemicals.

Water pollution is a serious environmental concern. Sewage and agricultural wastes contaminate water supplies and provoke a host of waterborne illnesses. In addition, rivers that are used as a source of drinking water are contaminated with heavy metals such as lead, cadmium and arsenic from industrial discharges.

UNICEF reports that China is one of the countries in the world most seriously affected by arsenic contamination. Several studies carried out on the effects of drinking arsenic-contaminated water show serious effects on children’s intelligence and intellectual development.

Toxic compounds in air and water affect the health of children and adults alike. However, because children are still growing and their immune system and detoxification mechanisms are not fully developed, toxic agents have a more serious impact on them than in adults.

Exposure to high levels of lead at an early age, for example, is responsible for children’s low intellectual development. Lead poisoning is probably the most serious chronic environmental illness now affecting children.

Chinese authorities have been trying to limit the damage caused by environmental pollution and have set guidelines in a document entitled "Priority Activities for Sustainable Development." However, despite new policies and regulations, compliance remains low.

It is estimated that 40% of Chinese cities suffer from medium to high levels of air pollution. According to a World Bank assessment, projected health effects of air pollution in urban China by 2020 will include: 600,000 premature deaths in urban areas, 20 million cases of respiratory illness per year, 5.5 million cases of chronic bronchitis and health damages valued at 13% of Chinese GDP.

To overcome the effects of pollution and a contaminated environment, China needs to continue developing energy-efficient technologies and implementing cheap and environmentally responsible transportation systems.

Even more critically, China needs to enforce its own environmental regulations. Its future generations — and future prosperity — are at stake.

Dr. César Chelala, MD, PhD, is an international public health consultant.

On April 9, 1948, 120 fighters from the Irgun and Lehi Zionist paramilitary groups attacked Deir Yassin, near Jerusalem, a Palestinian-Arab village of approximately 600 people. During the assault, around 107 villagers were killed, including women and children. In addition, several villagers were taken prisoner, and were later jeered, spat at, and stoned.

According to most accounts, those villagers lived in peace with their Jewish neighbors from nearby villages. Some of them, from the Givat Shaul Orthodox community just across the valley, tried to help the Deir Yassin villagers during the Irgun-Lehi combined attack. After the attack, the Irgun and Lehi troops began pillaging the houses and corpses, stealing money and jewelery from the survivors, reported the Israeli historian Benny Morris.

“I saw the horrors that the fighters had created. I saw bodies of women and children, who were murdered in their houses in cold blood by gunfire, with no signs of battle and not as the result of blowing up the houses…I have seen a great deal of war, but I never saw a sight like Deir, Yassin,” declared Eliahu Arbel, Operations Officer B of the Haganah’s Etzione Brigade, who arrived at the scene on April 10.

The news of the massacre sparked terror among the Palestinian-Arabs and were an important factor in encouraging them to flee from their towns and villages afraid of the Jewish troop advances. “They ended up expelling people from all of Palestine on the rumor of Deir Yassin,” declared later Mohammad Radwan, a survivor of the massacre.

Haganah and the area two chief rabbis condemned the killings and the Jewish Agency for Israel sent Jordan’s King Abdulla a letter of apology, which the King rebuffed. At the time of the attack Menachem Begin was a leader of the Irgun, although he wasn’t personally involved in it.

On December 4, 1948, Albert Einstein was the most prominent signatory of a letter to the New York Times by a group of Jewish intellectuals on the occasion of Begin’s visit to the United States. Part of the letter reads as follows “…It is inconceivable that those who oppose fascism throughout the world, if correctly informed as to Mr. Begin’s political record and perspectives, could add their names and support to the movement he represents.”

“…The public avowals of Begin’s party [The Freedom Party] are no guide whatever to its actual character. Today they speak of freedom, democracy and anti-imperialism, whereas until recently they openly preached the doctrine of the Fascist state. It is in its actions that the terrorist party betrays its real character; from its past actions we can judge what it may be expected to do in the future.”

“A shocking example was their behavior in the Arab village of Deir Yassin…Most of the Jewish community was horrified at the deed, and the Jewish Agency sent a telegram of apology to King Abdullah of Trans-Jordan. But the terrorists, far from being ashamed of their act, were proud of this massacre, publicized it widely, and invited all the foreign correspondents present in the country to view the heaped corpses and the general havoc at Deir Yassin. The Deir Yassin incident exemplifies the character and actions of the Freedom Party.”

In the Deir Yassin massacre 107 Palestinian-Arabs villagers, including women and children, were killed. Four of the attackers died during the attack. During Operation Cast Lead in Gaza, that took place during the winter of 2008-2009, 1385 Palestinians were killed, among them 762 non-combatants, 107 women and 318 children. 13 Israeli were killed, 10 combatants and 3 Israeli non-combatants, according to B’Tselem, an Israeli human rights organization.

In September 2009, a UN mission headed by Justice Richard Goldstone conducted an investigation of the Israeli offensive and its consequences. The Israeli Government denied him any collaboration to carry out its task, as I heard him personally state this in New York. In his report, Judge Goldstone accused both Palestinian militants and Israeli Defense Forces of war crimes and possible crimes against humanity.

Given that the Israeli forces conducted the Cast Lead Operation attack in clear disproportion of forces and against unarmed civilians, what would Albert Einstein have said about it?

Dr. César Chelala is a co-winner of an Overseas Press Club of America award.

One can fight oppression with violence or one can fight oppression with education. Hema Konsotia, a 32-year-old Indian woman, has chosen the latter. She is helping to change a situation affecting an estimated 165 million Indian Dalits. Also known as “untouchables”, they are a mixed population of numerous caste groups all over South Asia. Although the caste system has been abolished under the Indian constitution, there is still widespread discrimination and prejudice against Dalits, particularly women.

Dalits are frequently denied such basic rights as education, housing, property, freedom of religion, choice of employment and fair treatment before the law. This situation led Indian Prime Minister Manmohan Singh to draw parallels between “untouchability” and apartheid in 2006. As a result of discrimination, Dalits are denied full participation in Hindu social and political life.

In rural India, where caste origins are more apparent and Dalits often remain excluded form local religious activities, many upper caste members believe that Dalits will pollute the temples if they go into them.

Every 20 minutes a crime is committed against Dalits, according to a 2005 government report. Although distressing in itself, this figure probably represents a fraction of all crimes against Dalits, since most of them remain unreported for fear of reprisals from the police or from member of the upper castes.

For several years now, Hema Konsotia has been working to change that situation. She is a union activist and college graduate, leader of Delhi’s sewage workers and their wives. For the last 10 years she has been working to empower them and make them aware of their rights while improving their education through mobile education centers she created in Delhi.

A woman of strong character (when a worker was repeatedly disrespectful to her she held him by his collar and slapped him in the face) she has the unwavering support of her mother, who had been through an abusive marriage herself. “My mother is my secret guru,” she told a reporter. Hema is determined that Dalits, particularly women, will not suffer what women of previous generations did.

And they certainly need her help since a situation of centuries of discrimination has affected theirs and their children’s health and quality of life. For most Dalits, good health care is unaffordable and inaccessible, and generally their experience of health care is limited to emergency care.

The maternal mortality rate is a reflection of accessibility and quality of health services. Prenatal and neonatal care is extremely limited. As a result, complications from pregnancy and childbirth are the leading cause of death among women of reproductive age. Because most Dalit women are poor, their health status is usually worse than statistics suggest.

The maternal mortality rate is 560 deaths per 100,000 live births (that same rate for industrialized countries is 13 per 100,000.) But for every woman who dies during pregnancy and childbirth, approximately 20 more suffer injuries, infections and disabilities that may seriously affect their health. Anemia, which is frequent among poor women, predisposes women to sepsis and hemorrhage during delivery.

Child statistics are equally distressing, since 56 children per thousand who are born alive die before reaching the age of five, a rate that compares with five children per thousand in industrialized countries. In addition, both women and children, particularly among the poor, experience an alarming rate of physical and sexual abuse.

In January of 2007, the UN Committee on the Elimination of Discrimination against Women concluded that Dalit women in India suffer from “deeply rooted structural discrimination.” Proud and determined, Hema Konsotia’s work with Delhi’s poor has already made a difference.

César Chelala is an international public health consultant and a co-winner of an Overseas Press Club of America award for an article on human rights.

George W. Bush is among the five least accomplished U.S. presidents, according to a new survey by the U.S.’s top 238 leading presidential scholars. They have been polled by the Siena College Research Institute’s (SRI) annually for the last 28 years. While president Franklin Delano Roosevelt, who led the country from 1933 until his death in 1945, ranked first in overall accomplishments, former President Bush ranked worst among modern presidents –and the fifth worst in history.

According to the Survey of U.S. Presidents the top five, including Franklin D. Roosevelt, are Theodore Roosevelt, Abraham Lincoln, George Washington and Thomas Jefferson.

The presidential scholars ranked the U.S. Presidents on six personal attributes (background, imagination, integrity, intelligence, luck and willingness to take risks); five forms of ability (compromising, executive, leadership, communication and overall abilities); and eight areas of accomplishment including domestic affairs, economic, working with Congress and their party, appointing supreme court justices and members of the executive branch, avoiding mistakes and foreign policy.

If one analyzes just the Bush administration approach to foreign policy, health care and human rights one may consider among the biggest foreign policy blunders the Iraq and Afghanistan wars. The Bush administration blatantly ignored the advice from Gen. Eric Shinseki, who had estimated that several hundred thousand troops would be required to secure Iraq. Even more seriously, the war against Iraq was based, from the beginning, on false premises.

Vice President Dick Cheney repeatedly stated that Iraq was “the geographic base of the terrorists who have had us under assault for many years, but most especially on 9/11,” in spite of the fact that there was no evidence for such assertion. The bipartisan 9/11 Commission itself found that Iraq had no involvement in the 9/11 attacks and no collaborative operational relationship with Al Qaeda.

Compounding the wrongness of the approach towards Iraq is the right to initiate a preemptive war, flaunting international law. The 2006 updated National Security Strategy of the United States had established that, “….The greater the threat, the greater is the risk of inaction –and the more compelling the case for taking anticipatory action to defend ourselves, even if uncertainty remains as to the time and place of the enemy’s attack. There are few greater threats than a terrorist attack with WMD.”

As was clearly demonstrated not only did the government of Iraq not have any WMD, but at no point it could have been considered a threat to the United States, given the obvious difference in military capability between both countries. This was no impediment for former President Bush and his closest associates to continue using that rationale for the war against that country. That war and the justification for engaging in preemptive wars are among the most serious and damaging foreign policy decisions of the Bush administration.

If one analyzes the Bush presidency regarding its approach to health care one can find a policy of disregard for people’s health and support for corporate interests, which is, after all, only a reflection of the Bush administration decisions on almost all economic matters.

The Bush administration blocked efforts to allow Medicare to negotiate cheaper prescription drugs for seniors thus negatively affecting their health and quality of life, while simultaneously depriving American taxpayers of savings from the very marketplace competition touted by White House economists. The administration also went to court to block lawsuits by patients who had been injured by defective prescription drugs and medical devices. In addition, the General Accounting Office conducted a study that concluded that the Bush administration created illegal, covert propaganda to promote its industry-supported Medicare bill.

The Bush administration record on human rights is dismal. Who can forget the photos of prisoners’ abuse in Abu Ghraib prison in Iraq carried out by the U.S. Army and other U.S. governmental agencies and that have tainted forever the image of the U.S. as a defender of human rights? To compound the magnitude of the abuse, Janis Karpinsky, a commander at Abu Ghraib estimated later that 90% of the detainees in the prison were innocent.

Recently Physicians for Human Rights has uncovered evidence that indicates the Bush administration conducted illegal and unethical human experiments and carried out research on detainees in CIA custody. In addition, medical personnel engaged not only in torture of prisoners but also in the crime of illegal experimentation, activities in clear violation of the Nuremberg Code.

It would be naïve to think that all negative aspects of the Bush administration are the responsibility of former President Bush himself. He obviously is the face for members of his administration and others who were influencing policy decisions. But the ultimate responsibility falls on him. And he is the one that will have to respond to history for his actions.

Dr. César Chelala is a co-winner of an Overseas Press Club of America award.

It is fair to say that the more we love our country the more we want it to be a better, more honorable country. Using this criterion, we can say that few people loved the U.S. as much as former senator Robert Byrd did. And only death could finally silence him.

Nobody was more vocal than Byrd in the opposition to the Iraq war, which he considered a disgraceful course of action that would have negative effects on the country. And he was one of the few to state that opposition as strongly on the Senate floor.

On March 19, 2003, addressing the nation soon after the bombing of Baghdad had begun, former president George W. Bush stated, “The people of the United States and our friends and allies will not live at the mercy of an outlaw regime that threatens the peace with weapons of mass murder. We will meet that threat now, with our Army, Air Force, Navy, Coast Guard and Marines, so that we do to have to meet it later with armies of fire fighters and police and doctors on the streets of our cities.”

Thus was the beginning of one of the most costly wars, both economically, in the number of lives lost and in the U.S. social standing in the world that this country has ever faced. Senator Robert Byrd reacted with predictable horror to this course of action, and was one of the few to vote against the war.

Speaking from the floor of the Senate on the afternoon of March 19, Senator Byrd said, “…today I weep for my country. I have watched the events of recent months with a heavy, heavy heart. No more is the image of America one of strong, yet benevolent peacekeeper. The Image of America has changed. Around the globe, our friends mistrust us, our word is disputed, our intentions are questioned.”

“Instead of reasoning with those with whom we disagree, we demand obedience or threaten recrimination. Instead of isolating Saddam Hussein, we seem to have isolated ourselves. We proclaim a new doctrine of preemption which is understood by few and feared by many. We say that the United States has the right to turn its firepower on any corner of the globe which might be suspect on the war on terrorism. We assert that right without the sanction of any international body. As a result, the world has become a much more dangerous place.”

“We flaunt our superpower status with arrogance. We treat UN Security Council members like ingrates who offend our princely dignity by lifting their heads from the carpet. Valuable alliances are split.”

“After war has ended, the United States will have to rebuild much more than the country of Iraq. We will have to rebuild America’s image around the globe.”

In his address to the nation on the evening of March 19 former president Bush outlined the purpose of invading Iraq, “to disarm Iraq, to free its people, and to defend the world from grave danger.” Earlier that afternoon, on the Senate floor, Senator Byrd had stated, “The case this Administration tries to make to justify its fixation with war is tainted by charges of falsified documents and circumstantial evidence. We cannot convince the world of the necessity of this war for one simple reason. This is a war of choice.”

And while former president Bush and vice-president Dick Cheney insisted on finding lame excuses for the war against Iraq, Senator Byrd said in his speech, “The brutality seen on September 11th and in other terrorists attacks we have witnessed around the globe are the violent and desperate efforts by extremists to stop the daily encroachment of western values upon their cultures. That is what we fight. It is a force not confined to borders. It is a shadowy entity with many faces, many names, and many addresses.”

The Iraq war has proven to be an unrelenting tragedy not only for the hundreds of thousands of Iraqi that were killed but also for the occupying forces soldiers killed and maimed. It is estimated that the total costs of veterans’ health care and disability may be higher than $700 billion. And Senator Byrd has been one of the earliest and strongest voices against this nightmare. His is a heroic voice that could only be silenced by death.

Dr. César Chelala is a co-winner of an Overseas Press Club of America award for an article on human rights.

I still seem to be hearing the Mexican sportscaster shouting in the radio for more than one minute, “Dieguitooooo, Dieguitoooooo, Diego Armando Maradonaaaaaaa!” after the Argentine soccer player scored his second goal against the British during the 1986 World Cup that Argentina won beating West Germany in the final game. He had good reason to shout. Diego Armando Maradona (now Argentina’s coach at the World Cup) had scored his second goal after dribbling six British players (including the goalkeeper) in what is commonly known as “The Goal of the Century.”

Never mind that his first goal during that game was also the most infamous in soccer’s history since it was made striking the ball with his left hand. Maradona was initially evasive about that goal saying that it had been scored “a little with Maradona’s head and a little with the hand of God.” Since then that goal is known as the “Hand of God,” or “la mano de Dios.” Only in 2005 did Maradona acknowledge that he had used his hand on purpose and that he knew the goal was invalid but the goal stood, to the dismay of the British players.

As a special tribute to him, the Mexican officials at the Aztec Stadium where the game took place built a statue of him scoring the second goal and placed it at the entrance to the stadium. That helped ensure that he would always be remembered as one of the greatest players in soccer’s history. In March of 2010, The Times of London chose him as number 1 among The Greatest 10 World Cup players of all time.

For decades Diego Maradona has been the most admired (and for many the most reviled) sportsman in the world. But whether one likes him or not, nobody can deny that he is a unique character in the world of sports. In trips I took to several countries around the world I always found the same reaction after saying that I was an Argentine. Maradona! Maradona! people shouted. It could be a small city in China or a remote town in Africa. Everybody knew Maradona. And now, as the coach for the Argentine team in the South African World Cup, people are still talking about him.

He was an unlikely soccer star, since he is extremely short, although very sturdy. His two strong legs seemed to anchor him to the ground. He could start dribbling his opponents with maniacal speed and dexterity, as he did during the 1986 World Cup. He was a generous player, always sending the ball to a better placed teammate.

But great as his gifts as a player were, so were his personal shortcomings. While playing in Italy for the Napoli team he made it the most successful in its history leading it to winning its only two Italian Championships in 1986/87 and 1989/90 and the Coppa Italia in 1987. At the same time, however, he intensified his cocaine habit for which he was given steep fines and was suspended from soccer for 15 months in 1991. In 1994 he was sent home from the World Cup in the USA for using ephedrine. He retired from soccer in 1997.

He has suffered from serious health problems and gained considerable weight, in addition to continuing use of cocaine. In 2005, a stomach stapling operation helped him overcome his weight problem and after stopping his cocaine addiction he became a popular TV host in Argentina. In 2008, despite his lack of managerial experience, he was named head coach of the Argentine soccer team. Several defeats of the team in international games made many doubt his technical capacity as a coach.

But Maradona continues to be well… just Maradona. He is still his same defiant, arrogant self. Much as I dislike his antics I am still thankful to him. Years ago I was traveling in several Asian countries when I arrived in Bangladesh. After finishing my work there I was at the airport when a customs officer asked me if I had any cash with me. I told him that I had $2,000. The officer then asked me, “Where is the form that you have to fill?” Surprised I responded “What form?”

Upon hearing this, the officer started yelling at me, saying “You damned foreigners are all the same. You come to this country, make money, don’t pay taxes and then just leave, without caring about anything!” Startled, I started mumbling a response when he asked me, “Where are you from?” After I answered “Argentina” he said, obviously overwhelmed, “Oh, Argentina, Maradona, Maradona, just continue, Sir, please, there is no problem, no problem at all!”

César Chelala is a writer on human rights and foreign policy issues.

I can remember my friend’s face when he told me that his daughter had been born with a severe mental disability. “It was as if somebody had pointed a gun to my head,” he told me. For as long as they have been known, mental disabilities (also called mental retardation) have been the cause of profound unhappiness in the parents of children born with them, as well as in the children themselves. But now there is hope.

An experimental drug made by Novartis, a Swiss pharmaceutical firm, has been shown to improve behaviors associated with mental retardation and autism in people affected with fragile X syndrome, the most common inherited cause of these mental disabilities. Although the results have been obtained in a small clinical trial involving only a few dozen patients, this finding offers the possibility that further advances could be obtained in the near future.

If further trials in larger populations produce equally good or better results, they could offer hope in the field of autism research, since between 10 to 15 percent of autism cases result from fragile X syndrome or another kind of genetic defect. Also, even though Novartis tested the drug only in adults, experts believe that it could be even more effective in young children, whose brains still in development are more likely to respond positively to the drug.

It is estimated that as many as one in 35 people in the U.S. are mentally retarded, which amounts to approximately 3% of the population. Also, every five minutes a child is born with mental retardation. The annual cost to the country is over $6 billion in special services and lost wages.

Mentally retarded children have impaired or incomplete mental development, and are limited in their ability to learn and also in their capacity to apply learning. Most of those affected have mild or moderate mental disability and with proper education, training and understanding they can become productive members of society. However, the limitations in cognitive functioning will cause them to learn and develop more slowly than children who are not affected by this condition.

Fragile X syndrome is caused by a genetic mutation in chromosome X in which part of the instructions in the gene are repeated several times. When that section of the gene is repeated 200 or more times, the body shuts off the gene. As a result, the protein that is normally produced by that gene is not produced any longer or if produced is defective. This is what causes the wide variety of symptoms among those afflicted with Fragile X syndrome.

The protein normally produced by chromosome X acts as a sort of coordinator of information among brain synapses (connections between nerve cells), helping to stop or slow down brain signaling at critical intervals. Regulating the flow of information among brain cells is crucial for the brain’s ability to learn and develop normally.

Until recently many researchers believed that the right and perhaps only approach to dealing with mental retardation was rehabilitation, not medication. The improvement in some patients’ behavior after administration of a drug opens a totally new panorama of possibilities. The new studies confirm some previous studies in mice with the fragile X mutation, that show that the drug was able to reduce some abnormalities such as seizures, atypical rates of protein synthesis and other molecular defects. If further authenticated these findings will show that however hard the steel wall of mental retardation is, it can still be broken.

Dr. César Chelala was a researcher in microbial genetics at the Public Health Research Institute of the City of New York.

Predator drones are equipped with large and powerful cameras that beam real-time images to their operators. Last February, a Predator crew operating out of Creech Air Force Base, Nevada, asked for an air strike against three vehicles with males supposed to be insurgents. An OH-58D Kiowa helicopter fired Hellfire missiles and rockets which destroyed the three vehicles. Instead of insurgents, 23 innocent men, women and children were killed and 12 more were seriously injured.

In a scathing report released on May 29, the American military blamed the “inaccurate and unprofessional reporting” by a team of Predator drone operators that led to the strikes. This episode illustrates the serious risks involved in the use of drones, whom many law experts consider violate rules of war. Predator drones are extensively used in Afghanistan and Pakistan, where they track and kill suspected insurgents, sometimes with their own missiles.

A report by the UN Special Rapporteur on extrajudicial, summary or arbitrary executions, Philip Alston, makes a thorough assessment on the effect of drones, whose use has provoked significant controversy.

Drones’ proponents argue that since they have significant surveillance capacity and great precision, they are able to avoid collateral civilian casualties and injuries. They also state that since drones may provide the ability to conduct aerial surveillance and to gather “pattern of life” information, they may allow operators to distinguish between peaceful civilians and those engaged in direct hostilities. The above episode is a clear demonstration of the fallacy of this argument and of the dangers to civilians of using such lethal weapons.

According to the Alston report, the main concern about drones is that they make it easier to kill without any risk to a State’s forces. I believe that an even greater risk is the process of trivializing war, making it thus a deadlier, more dangerous activity since it affects not only those who are target but also those who direct the operation and for whom war becomes no more significant than a video game.

An additional complication to the use of drones is that in many cases international forces are too often uninformed of local practices, or too credulous in interpreting information, to be able to arrive at a reliable understanding of a situation, wrote Michael N. Schmitt, a Professor of International Law at the George C. Marshall European Center for Security Studies, in Germany.

According to Schmitt, precision warfare such as the one carried out by drones intersects (or has the potential to interact) with international humanitarian law in four specific areas: the prohibition of indiscriminate attacks; the principle of proportionality, the requirement to take precautions in attack; and perfidy and other misuses of protected status.

Precision attacks as carried out by drones may violate international humanitarian law’s tenet of distinction, as stated in Articles 48, 51 and 52 of Additional Protocol I. As indicated by Schmitt, distinction has been cited as a “cardinal” principle of international humanitarian law by the International Court of Justice.

CIA officers are concerned that the use of drones will backfire and may help Al Qaeda and Taliban leaders recruit more militants. “Some of the CIA operators are concerned that, because of its blowback effect, [the drones’ program] is doing more harm than good,” said Jeffrey Addicott, former legal adviser to U.S. Special Forces in an interview with Inter Press Service.

Presently, several countries including China, France, India, Israel, Iran, Russia, Turkey and the United Kingdom either have or are seeking drones with the capability to shoot laser-guided missiles. If the use of these dangerous weapons becomes more frequent, so will the safety of innocent civilians and violations of international humanitarian law.

César Chelala is a co-winner of an Overseas Press Club of America award for an article on human rights.

A friend of mine, a prestigious physician who works the longest hours of anybody I know makes only one exception from her demanding schedule in New York. Once a week, she returns home early to watch a new episode of her favorite soap opera. I cannot think of a more unlikely fan. It goes to show that soap operas appeal across a broad spectrum, from the most intellectually sophisticated to people with little or no formal education.

Increasingly, soap operas, or telenovelas, are being used throughout the world to disseminate messages about health issues such as the need for contraception, domestic violence, HIV/AIDS, nutrition, how to achieve peace between countries in conflict and how to elevate the status of women in developing countries. By identifying themselves with the protagonists’ dreams and problems the viewer establishes an immediate connection with them.

In Colorado, State officials have developed a telenovela called “Crossroads: Without Health, There Is Nothing,” specifically aimed at conveying health messages to the population. One of the producers’ aims was to increase the number of health-insured kids in the State, since almost half of the 150,000 uninsured children were eligible either for Medicaid or the Child Health Plan Plus program. Following airing of the telenovelas, there was a substantial increase in the number of children applying for insurance.

In Niger, Africa, Niger’s Broadcasting Corporation (ORTN) and UNICEF have joined forces and produced a serial drama entitled ‘Soueba’ which focuses on the lives of young people in Niamey, Niger’s capital. By following their journey into adulthood, the program explores the realities of love and sex and the dangers posed by the HIV/AIDS epidemic. “Soueba is more than an entertainment. Our aim with Soueba is to stop the taboo around HIV/AIDS, decrease the stigma towards people living with the disease, encourage positive attitudes and improve prevention behaviors,” declared Director Mahaman Souleymane.

In Ethiopia, the characters in the soap opera Yeken Kignit (“Looking Over One’s Daily Life”) have kept millions of Ethiopians glued to their radios for two and a half years. In the process, they may also have changed their lives. Following both Yeken Kignit and a similar soap opera called Dhimbibba (“Getting the Best Out of Life”) male listeners sought to be tested for HIV at four times the rate of non-listeners, while the demand for contraceptives rose 52 percent among married women who listened to the programs.

In Nicaragua, PATH, an international nonprofit organization based in Seattle, working with a Nicaraguan non-profit group called Puntos de Encuentro (“Meeting Points”) has inserted health-related messages into one of the country’s most popular soap operas. The aim of those messages is to change some cultural assumptions that lead to domestic violence and sexual abuse among adolescent girls and young women.

In Vietnam, the Ministry of Agriculture and several partners used entertainment education concepts to communicate pest management and environmental protection techniques to rice farmers. The soap opera project won several awards for its effectiveness in communicating science to people.

Latin American countries such as Brazil, Argentina, Mexico and Venezuela have become active exporters of these products, which are eagerly watched in countries as far away from Latin America as Russia, Albania, China and several countries from the former Soviet Union.

There may be other advantages to soap operas. I was recently in Albania, a country that had suffered from intense isolation during Enver Hoxha’s regime. While in Tirana, I was running late for a dinner appointment since I couldn’t find the restaurant where the meeting was to take place. I decided to ask a couple of young women who were walking in my opposite direction. Graciously, they told me that it was easier for them to accompany me than to try to explain to me how to go there. They asked me where I was from and when I said that I was from Argentina they said to me in Spanish, “Then we can speak in Spanish!” with flawless Argentine accent. Surprised, I asked them where they had learned to speak it so well. “In the Argentine soap operas, of course,” they answered laughing.

Dr. César Chelala is an international public health consultant and a writer on human rights and foreign policy issues.

One of tango’s best definitions is that of expert Horacio Ferrer, “Tango is music, a dance, a way to see the world, a philosophy, a feeling, a sensitivity, an emotion. It is the mythical dimension of reality, nostalgia, abandonment. It is lovers’ separation, the sadness of lost love, the indifference of the world to pain, the poetry of neighborhoods, the value of friendship…”.

To those themes one should add those tangos that were devoted to a particular street or neighborhood. One of the first tangos dedicated to a street is the one called Caminito (Little Walk), a street located in the neighborhood of La Boca, in Buenos Aires. Although it was created in the decade of the 1920s, Caminito is still one of the most popular tangos of all times.

La Boca is one of the first areas the original Spanish conquerors came to in Buenos Aires. Since the 1880s, Italian immigrants -particularly those from Genoa- who came to Buenos Aires, lived there. That neighborhood was also inhabited by gauchos, creoles and country people. La Boca is now one of Buenos Aires' poorest neighborhoods. Only the street called Caminito, whose houses are now being repainted, retains something of its older allure.

The birth of the tango Caminito is an unlikely story of a musician and a poet, both of them tango experts, and how their friendship with an artist, a painter who gave the name to the street, sparked the creation of that tango. It is also the story of how the street called Caminito became one of the most visited streets in Argentina, an obligatory stop for all tango lovers worldwide.

The creator of Caminito’s music was Juan de Dios Filiberto, a native of La Boca. The writer of the lyrics was the poet Gabino Coria Peñaloza, born in Mendoza, a province in Argentina bordering Chile. And the artist was Benito Quinquela Martín, also a native of La Boca. Quinquela Martín has immortalized that area in a gigantic collection of paintings characterized by their bold colors.

The history of the tango Caminito is still shrouded in mystery. According to some, the name comes from a small road in the town of Olta, in the province of La Rioja. For other tango enthusiasts, the name of the tango is related to the street in La Boca, the neighborhood where the musician Filiberto was born and grew up. Both sides seem to have part of the truth.

The composer Filiberto didn’t achieve his musical expertise very easily. When he was young he worked in different trades. Talking about his musical beginnings he used to say, “When I entered the musical Conservatory I was over twenty-five, and my shoulders were used to the work of the stevedore, blacksmith, metal fitter and caldron maker. My fingers were stiff and clumsy for the keyboard and the fingerboard.” He was, however, passionate about tango and when he became famous he used to say, “My music is many things put together but, overall, it reflects my feelings. In art it is not enough to feel, but to know how to express that feeling.”

He studied violin and music theory in a musical academy in Buenos Aires. Later, Filiberto was given a scholarship to study with a well-known musician, Alberto Williams, and took lessons in counterpoint, piano and guitar. But it was in Teatro Colón, Buenos Aires’ most prestigious classical music theater, where he worked as a technical assistant, where he had a shattering musical experience. In Teatro Colón, Filiberto heard for the first time Beethoven's Ninth Symphony, which opened new musical horizons in his life. “Beethoven,” he used to say, “was my musical God.”

Filiberto frequently walked through one of La Boca’s narrow roads to meet his friends. They were frequently greeted from a window by a young woman living in that area. Some believe that he created the music of Caminito as an homage to that little walk and to that woman. Filiberto later formed his own orchestra, continued composing and his music became known all over the world. Ten years after his death, as a special homage to him, the Juan de Dios Filiberto National Orchestra of Argentine Music was created.

When Filiberto was looking for somebody to put words to his music, the painter Quinquela Martín introduced Peñaloza to him. Quinquela Martín, who called Peñaloza a “crazy poet,” thought that he was the ideal person to put words into Filiberto’s musical compositions. Although Filiberto collaborated with Peñaloza in creating other tangos, none of them surpassed the popularity of Caminito.

At a meeting in a Buenos Aires coffee place, Filiberto told Peñaloza that he had composed the music of a tango inspired in his strolls through an alley in La Boca. After humming a few bars he asked Peñaloza if he would write the lyrics for that tango. Peñaloza responded that he already had something he had written after a love affair in La Rioja and recited it to Filiberto. Filiberto enthusiastically adapted the music to those lyrics and Caminito was born.

Peñaloza’s lyrics were written while visiting La Rioja, a province in Argentina, where he had been stranded by heavy storms in the town of Olta. In that town, Peñaloza met a pretty young school teacher called María and created the lyrics in a rapture of enthusiasm after meeting and falling in love with her. With María, Peñaloza used to take long walks along a narrow dirt road.

Since she went away (Desde que se fué)

she never came back (nunca más volvió)

I will follow her footsteps (seguiré sus pasos)

Little walk, goodbye. (Caminito, adiós).

Caminito was first heard in Buenos Aires at a contest for native songs for the carnival parade of that year, where it won an award. Soon afterwards, it was performed at the Rural Society of Palermo, in Buenos Aires and was later recorded by Carlos Gardel, a tango singer who went onto become a legendary singer from Argentina. Since then, Caminito became one of the three most famous tangos of all time.

Most Argentines can repeat by heart the beginning of the tango’s lyrics,

Caminito that time has erased
(Caminito que el tiempo ha borrado)

and that one day saw us passing by
(que juntos un día nos viste pasar)

I came for the last time
(he venido por última vez)

I came to tell you my woes.
(he venido a contarte mi mal).

Originally, the name of the street Caminito was given by Benito Quinquela Martín, an artist who lived in La Boca and whose vibrantly colored paintings are a historic portrait of life in that area. The story of his life reads like a novel.

In March of 1890, a few weeks old child was left in a Buenos Aires orphanage called Casa de Expósitos under the care of an order of nuns called the Sisters of Charity. The child, who was wrapped in expensive clothes, had with him a handwritten note that said, “This child has been baptized and given the name Benito Juan Martín.” Together with the note there was a shawl with an embroidered flower cut in half. Whoever left the child thought that perhaps it would be possible to reclaim him later by showing the shawl’s other half.

The child stayed with the nuns until he was 6 years old, when he was legally adopted by a poor couple, owners of a modest charcoal business in La Boca. He was lovingly cared for by this couple and forged a unique bond with his adopted mother, a woman with humble origins. His father worked as a stevedore in the nearby port area.

Because he had to help at home, Benito was unable to finish elementary school. When talking about his childhood he said, “I had to leave school before learning the multiplication tables.” When he was 15 years old his adopted father asked him to help him with his work as a stevedore in the port, a work that Benito did for several years. When he was seventeen years old, and while still working at the port, he started taking painting lessons at an academy in La Boca, where he met Filiberto and started a friendship that was to last all their lives.

Benito was part of a group of rowdy youngsters who used to go from house to house playing tangos. Once, when playing at a poor tenement house, they learned that there was a woman seriously ill. They were leaving the place when the sick woman asked them to play a tango. As soon as they finished playing, the woman died. Some of the youngsters felt a sense of guilt that their music had provoked the woman’s death but Filiberto retorted, “If she had to die it is better that she died this way. It must be wonderful to die listening to a tango!”

Benito had taken his adopted father’s name and was now called Benito Quinquela Martín. In the same way that Beethoven’s music had “illuminated” his friend Filiberto, Rodin’s book on art had illuminated Quinquela. He would later remark, “Because my academic studies were rudimentary, I had to rely a lot on intuition and emotion. In those two words I found my best guides and teachers.”

Although at the beginning Quinquela combined both his work as stevedore and charcoal merchant with that of painter, he later decided that he would dedicate himself only to painting for the rest of his life. Most of his paintings reflect harbor scenes and the shipyards in La Boca. They are a song to the working men through the prodigal use of color. It was that characteristic of painting workers that made Mussolini exclaim, after meeting the painter in Italy, “Lei e il mio pittore!” (You are my favorite painter!). When Quinquela asked him why he said so Mussolini responded, “Because you are a painter of the working man.”

One day, unannounced, Quinquela was visited in his precarious studio by Pio Collivadino, who was the Director of the National Academy of Art in Buenos Aires. It was a meeting that would dramatically change Quinquela Martín’s life. Collivadino was instrumental in Quinquela Martín’s showing his work –since the beginning to great critical and popular acclaim- at the Witcomb Gallery and then in the aristocratic Jockey Club, both in Buenos Aires. He later showed his work in Rio de Janeiro, Madrid, Rome –where, in a visit to the Vatican he was received by Pope Pious XI- New York, Havana, Paris, and London.

Received and admired by royalty in the countries he visited, Quinquela Martín became one of the best known Argentine painters. His paintings are now in the most important museums in the world. He also became a philanthropist who donated land to build schools, a children’s clinic, a theater and a museum in La Boca.

When he became famous and was financially comfortable, Quinquela Martín decided to improve the looks of one of the streets in La Boca which had been a pasture ground. Through donations of painting to the people living there, Quinquela helped to keep the tradition of having the houses painted in bright colors.

One of the brightest streets was a little walk, through which both Quinquela Martín and Filiberto used to walk. He decided to call it Caminito, and wrote that name on a piece of wood that was attached to one of the houses. In 1959, that name was officially adopted by the Municipality of Buenos Aires, in a ceremony with fireworks that had as a background the howling of the ship’s foghorns. Quinquela Martín would later say, “I think that we can say with optimism that in La Boca we have won the battle for color.”

In 1971, a street called Caminito was inaugurated in La Rioja, a belated homage to Peñaloza. Today, the other Caminito, the one located in La Boca harbors an independent theater, an open air art gallery where both professionals and aficionados sell their work and where tango enthusiasts dance to the music of tango. The name of Quinquela Martín is now indelibly connected to that street, and to La Boca.

Dr. César Chelala is an international public health consultant and an award winning writer and photographer.

All photos were provided by the author.

This piece was co-written by Alejandro M. Garro and César Chelala.

Baltasar Garzón, a Spanish “investigative magistrate” in charge of triggering the investigation of crimes of national or international significance, is now himself under investigation. Conservative groups accuse Garzón of prevaricato judicial (roughly translated as “abuse of a judge’s power”) for having intentionally bypassed a 1977 amnesty law, opening an investigation on human rights abuses committed during Spain’s civil war. If indicted of that charge, the General Council of the Judiciary may temporarily remove him from office.

For many years, Judge Garzón has engaged in a crusade against Al-Qaeda terrorists, Latin American dictators (including Chilean dictator Augusto Pinochet,) Russian thugs, and powerful Spanish politicians accused of corruption. In addition, he started an investigation of torture claims by former Guantánamo detainees and for crimes committed by Colombia’s FARC rebels.

Garzón pursued those cases under a controversial statute (subsequently repealed) allowing Spanish courts to exercise “universal” jurisdiction over crimes against humanity, regardless of the country where they were perpetrated and the nationality of victims or perpetrators. These high-profile cases brought Judge Garzón powerful enemies all over the world, not to speak of the antagonism he provoked on Spanish government officials and among his own colleagues, many of who see him as an embarrassing self-promoter.

In October 2008, Judge Garzón launched an investigation on the torture, forced disappearances and summary executions perpetrated between 1932 and 1952 under Franco’s dictatorship. Those crimes are allegedly covered by a blanket amnesty enacted by the Spanish Parliament in 1977 (similar to the general amnesties adopted by Argentina, Chile, and several other countries during the 70s and 80s) and a recent “Historical Memory Act” aimed at forgiving and forgetting Spain’s troubled past.

One may legitimately disagree with decisions taken by Judge Garzón. However, in this particular case, he did what he was required to do under international law. Far from abusing his power, Garzón properly applied international conventional and customary law, which preempts Spain’s domestic amnesty to the extent it is aimed at covering massive and systematic human rights abuses. Two supranational tribunals (the European and Inter American Courts of Human Rights), as well as two UN committees (the UN Human Rights Committee and the UN Committee Against Torture) have consistently condemned blanket amnesties which deprive victims of serious human rights abuses of an effective remedy.

Even if the Spanish Supreme Court ultimately decides that Garzón overreached his authority by ignoring the 1977 amnesty law, such decision may be challenged before the European Court of Human Rights, which has held that, in principle, blanket amnesties violate the member states’ duties to investigate systematic and massive violations of human rights. Thus, Judge Garzón had more than plausible reasons for refusing to apply Spain’s amnesty law.

Admittedly, Judge Garzón is a polarizing figure with a penchant for high-profile cases. One may legitimately disagree, from a political standpoint, with his decision to unearth crimes of the past or feel understandably uncomfortable with his showy profile. Yet, while consistently fighting against the powerful of all political persuasions, he has courageously expanded the protective reach of international human rights law, as shown by the precedent established in the Pinochet case.

Whatever personal opinion one may hold on Garzón as an individual and beyond his controversial civil war investigation, the decision to go after him for opening an investigation of Franco’s worst human rights abuses seriously undermines Spain’s credibility in fighting against impunity. More importantly, it ignores that, under international law, Spain’s sovereign decision to forgive and forget its past cannot be adopted at the expense of the victims’ right to justice, truth, and adequate reparations for serious and systematic human rights abuses.

• The authors: Alejandro M. Garro and César Chelala.•

Alejandro M. Garro is Professor of Comparative Law at Columbia University and Senior Research Scholar of the Parker School of Foreign and Comparative Law. César Chelala is a co-winner of an Overseas Press Club of America award.

In spite of some moderate progress in some areas, women’s health needs continue to be unmet in Afghanistan. “Afghanistan is one of the most dangerous places in the world to be pregnant,” states a report on maternal mortality by the Afghan Ministry of Health, UNICEF, and the U.S. Centers for Disease Control and Prevention. This statement is supported by statistics that show that in Afghanistan one woman dies every 27 minutes from a pregnancy-related condition that is preventable, in most cases, with adequate health facilities and medical care.

Other statistics are equally alarming. Afghanistan has the highest infant mortality rate in the world, and the second highest maternal mortality rate, according to U.S. government’s statistics. Hemorrhaging and prolonged or obstructed labor cause the largest number of Afghan maternal deaths, which could be easily prevented by the presence of a trained midwife during childbirth. However, it is estimated that only 14% of women receive skilled medical attention during that time.

The situation is particularly serious in rural areas, where clinics and hospitals may be hours away on foot. To make matters worse, many clinics lack such fundamental supplies as clean water, lighting and other elements for surgery, blood pressure instruments and equipment to test donated blood for HIV contamination.

Travel is complicated by bad weather conditions, lack of security, difficult roads and rough terrain. It is no surprising, then, that the average life expectancy rate for women in Afghanistan is only 44 years.

Women don’t fare better in the educational front. It is estimated that 87 percent of Afghan women are illiterate. Many girls fear going to school for lack of security. Although some aspects of their lives have improved, women are still at a clear disadvantage with men. “Women who try to advocate for their rights in public life are being subject to violence and physical attacks,” said Zia Moballegh, acting country director for the International Centre for Human Rights and Democratic Development.

“Violence targeting women and girls is widespread and deeply rooted in Afghan society,” stated last November Norah Niland, chief UN human rights officer in Afghanistan. Rape, that brutal form of sexual violence, is also a frequent problem. “Our field research finds that rape is under-reported and concealed, and a huge problem in Afghanistan. It affects all parts of the country, all communities and all social groups,” stated Ms. Niland.

It is estimated that one in three Afghan women experience physical, psychological or sexual violence at some point in their lives. Paradoxically, shame is usually attached to the victims, who often find themselves prosecuted for adultery, than to the perpetrators. While adultery is punishable by jail, no provision in the Afghan penal code criminalizes rape.

A sad result of the oppressive atmosphere in their lives is that an increasing number of women in Afghanistan are choosing suicide as a way to escape the violence and abuse in their daily lives, according to a human rights report prepared by Canada’s Foreign Affairs Department. “Self-immolation is being used by increasing numbers of Afghan women to escape their dire circumstances, and women constitute the majority of Afghan suicides,” states de report completed at the end of 2009.

According to the director of a burn unit at a hospital cited in the report, in 2008 more than 80 women tried to commit suicide by setting themselves on fire in the province of Heart. Many among those women died. Last January, two women fled their homes to escape from domestic violence in the Ghor Province in Southwestern Afghanistan. The two women were later arrested; one of them was beaten in public and the other was confined in a sack with a cat, according to Ghor’s Governor.

“I poured fuel over my body and set myself ablaze because I was regularly beaten up by my husband and insulted by my in-laws, said Zarmina, a young woman of 28 told IRIN, a project of the UN Office for the Coordination of Humanitarian Affairs.

The abuses to women throughout the country are a serious call of attention to the government. It shows that it not only needs to enact laws protecting women but make sure that these laws are properly followed. It is one of the Karzai’s government most urgent tasks.

Cesar Chelala, MD, PhD, an international public health consultant, is a co-winner of an Overseas Press Club of America award.

The revelation that the number of opium-addicted Afghan children has reached new highs is a sad unintended consequence of that war. It dramatically illustrates how adult war games can doom generations of children to a miserable life.

A group of researchers hired by the US State Department found staggering levels of opium in Afghan children, some as young as 14 months old, who had been passively exposed by adult drug users in their homes. In 25% of homes where adult addicts lived, children tested showed signs of significant drug exposure, according to the researchers. According to one of the researchers the children exhibit the typical behavior of opium and heroin addicts. If the drug is withdrawn they go through a withdrawal process.

The results of the study should sound an alarm, since not only were opium products found in indoor air samples but also their concentrations were extremely high. This suggests that, as with second-hand cigarette smoke, contaminated indoor air and surfaces pose a serious health risk to women and children’s health.

The extent of health problems in children as a result of such exposure is not known. What is known is that the number of drug users has increased from 920,000 in 2005 to over 1.5 million, according to Zalmai Afzali, the spokesman for the Ministry of Counter-Narcotics (MCN) in Afghanistan. A quarter of those users are thought to be women and children. Afzali stated that Afghanistan could become the world’s top drug-using nation per capita if current trends continue.

According to the UN Office on Drugs and Crime (UNODC) no other country in the world produces as much heroin, opium, and hashish as Afghanistan, a sad distinction for a country already ravaged by war. This may explain why control efforts so far have been concentrated on poppy eradication and interdiction to stem exports with less attention paid to the rising domestic addiction problem, particularly in children.

Both American and Afghan counter narcotic officials have said that such widespread domestic drug addiction is a relatively new problem. Among the factors leading to increased levels of drug use is the high unemployment rate throughout the country, the social upheaval provoked by this war and those that preceded it and the return of refugees from Iran and Pakistan who became addicts while abroad.

Those who are injecting drug users face the additional risk of HIV-infection through the sharing of contaminated syringes. “Drug addiction and HIV/AIDS are, together, Afghanistan’s silent tsunami,” declared Tariq Suliman, director of the Nejat’s rehabilitation center to the UN Office for Humanitarian Affairs. There are about 40 treatment centers for addicts dispersed throughout the country but most are small, poorly staffed and under-resourced.

For the first time ever, an international team including World Health Organization (WHO) officials and experts from Johns Hopkins University and the Medical University of Vienna has joined efforts to design a treatment regime for young children.

The U.S. and its allies have the resources to rapidly expand and adequately fund and resource such treatment and rehabilitation centers throughout the country. Anything less will be yet another serious indictment of an occupation gone astray.

Dr. César Chelala is an international public health consultant and a co-winner of an Overseas Press Club of America award.

Malaria continues to be endemic in the developing world, causing more than 1 million deaths every year, mostly among children living in Sub-Saharan countries.

Because of the failure to develop a truly effective vaccine against malaria, public health intervention remains focused on controlling the mosquito vector of the parasite that causes the disease. And, just as it has for decades, mosquito control relies mainly on the use of the insecticide DDT (dichloro-diphenyl- trichloroethane). While highly effective in controlling the mosquito population, there are serious drawbacks to DDT use.

The good news is that the results of a new project carried out in Mexico and Central America show that the fight against malaria does not have to depend on using DDT. In Mexico and the Central American countries, it is estimated that around 108.7 million people live in areas that are environmentally favorable to transmission of malaria, with 35 percent at high risk of contracting the disease.

The need to continue to rely on DDT to effectively combat malaria has been the subject of a long running discussion. Although DDT spraying has long been successfully used in controlling the mosquito population and the spread of malaria, it easily enters the food chain and persists for many years in the environment. The result is often serious harm to wildlife. In addition, the mosquito population under attack can become resistant to DDT, making necessary the search for alternatives.

Since 2004, a project funded by the U.N. Environmental Program and the Global Environmental Facility has been carried out with the technical support of the Pan American Health Organization in Mexico, Belize, Costa Rica, Guatemala, Honduras, Nicaragua, El Salvador and Panama. It was developed on strategies outlined in the "Roll Back Malaria" approach championed by the World Health Organization.

This project was initially implemented in Mexico and subsequently adopted to local areas in the Central American countries. Critical to its success has been the use of public health measures aimed at controlling mosquito breeding and standing sites, rapid diagnosis and treatment of those affected with malaria and active community participation.

Public health measures against malaria had already shown their effectiveness in Central America. During the construction of the Panama Canal, which had been abandoned by the French in 1889 due to financial scandals and the high number of worker deaths from malaria and yellow fever, thousands of lives were saved thanks to public health measures implemented by Dr. William C. Gorgas of the U.S. Army Medical Corps.

Similar public health measures have been applied in the Mexico/Central America project, including participatory community treatment of larval breeding sites, improvements in housing conditions, periodical clearing of vegetation around houses, and elimination of stagnant water near houses. These actions are complemented by a wide array of educational interventions aimed at information about malaria transmission, and rapid diagnosis and prompt treatment of those affected in the community.

Early detection and treatment is crucial for eliminating the parasite carriers. A key aspect has been the collaboration of voluntary community health workers who are taught to make an early diagnosis in situ and to administer complete courses of treatment not only to those affected but to patients' immediate contacts.

The project was carried out in "demonstration areas" selected for their high levels of malaria transmission. In those areas, the number of malaria cases fell 63 percent from 2004 to 2007. In several demonstration areas I visited in Honduras and Mexico as a consultant for the Pan American Health Organization, malaria had practically been eliminated. Plans are under way to expand the project to other regions where malaria remains a serious threat.

One of the advantages of avoiding DDT (and its toxic effects) is the enormous savings realized from discontinuing its routine use. These savings can now be put to good use against other diseases.

Although DDT can still be used in some countries or regions with extremely high levels of malaria infection, the fact that an effective campaign against malaria can be waged without it, and at much lower cost, raises hopes that this approach can be used as time goes on by a wide range of developing countries in the Americas, Africa and Asia.

Dr. César Chelala is an international public health consultant.

If past experience with authoritarian regimes is any guide, new sanctions on Iran will not succeed in curbing its nuclear power development and will, instead, strengthen the hardliners in government. Much more can be gained by improving the relationship between U.S. and Iranian citizens.

Ahmadinejad’s despotic behavior is not in itself enough to initiate a war against Iran that may have tragic consequences for the region and for the whole world. Despite Ahmadinejad’s rantings against Israel, Iranian leaders know that an attack against that country would be suicidal, unleashing terrible reprisals from Israel and the United States.

There is widespread suspicion that Iran’s possession of a nuclear bomb may initiate an arms race in the Middle East. However, what is now an open secret – Israel’s possession of nuclear weapons- has not ignited such a race. Since threats of punitive action against Iran are not weakening its nuclear ambitions, it is time to try a different approach.

Iranians insist that portraying them as a warmongering nation does not respond to historical precedent. They point out that the U.S. was responsible for overthrowing a constitutionally elected government in their country, and that it supported Saddam Hussein’s invasion of their country while Israel provided arms to Iran. In addition, Iranians claim that the U.S. and other Western countries supplied Saddam Hussein with chemical and biological weapons that caused hundreds of thousands of Iranian civilian deaths.

On April 23, 2010, Republican Congressman Ron Paul stated his opposition to sanctions on Iran stating, “…it feels as if we are back in 2002 all over again: the same falsehoods and distortions used to push the United States into a disastrous and unnecessary one trillion dollar war on Iraq are being trotted out again to lead us to what will likely be an even more disastrous and costly war on Iran….We need to see this for what it is: Propaganda to speed us to war against Iran for the benefit of special interests.”

President Obama has repeatedly stated the danger represented by nuclear weapons falling into terrorists’ hands, thus suggesting the need to curb Iran’s development of a nuclear weapon. However, Pakistan is a far more serious danger in that regard, since it has a very unstable government and Al-Qaeda is already present in that country.

It is a common experience that many times countries behave like people. If a person is threatened and coerced by an infinitely more powerful adversary, the only way for that person to react is to become more fearful and find extreme ways of defending itself against that menace.

Three decades of sanctions against Iran have proved to be ineffective. Why are they going to be effective now, when the Iranian regime is more determined than ever to pursue its own road to nuclear development? Sanctions will also not stop the Iranian regime abuse of its own people. As Dursun Peksen, a political science professor and an expert on economic sanctions has written, “My research into the effect sanctions have on human rights conditions in authoritarian regimes shows that more abuses typically occur with sanctions in place and that the number of abuses is greater when sanctions on those regimes are more extensive.”

According to Abolhassan Bani-Sadr, who was the first president of the Islamic Republic of Iran, foreign governments which want to support the democratic movement in Iran should adopt a policy of active neutrality. As he recently stated, “Sanctions will be counterproductive because the threat of international crisis is the Iranian regime’s only remaining resource for legitimizing its despotic power.”

Also, for sanctions to succeed they have to be part of a broad international effort. In that regard, the possibilities for Russia and China’s support are very slim, since to do so would harm their own considerable economic interests in that country. Iraq’s president has already spoken against sanctions to its Iranian neighbors, Turkey has expressed reluctance to participate on sanctions and Brazilian President Inacio Lula da Silva has stated that isolating Iran is counterproductive.

History has shown that demonizing people only fosters hate between countries. We fear what we know but we fear even more what we don’t know. Parallel to efforts on the diplomatic front, dialogue between both countries should be actively fostered through an exchange of artists, scientists, writers and religious figures. In February of 2008 The New York Philharmonic gave a concert in Pyongyang, North Korea capital, one of the countries belonging to the “axis of evil” according to President Bush’s infelicitous expression. Why cannot it do the same in Tehran?

Iran is an ancient country which has given the world outstanding artists and thinkers. Let’s conduct an active exchange that will benefit both countries and diminish the atmosphere of confrontation and suspicion. Let’s change a paradigm geared for war for one geared for peaceful coexistence. It would be a logical next step in brokering peace in that troubled region.

Their names are Chandrika, Hamida, Amod, Madhuri, Maria or Jenny. And as varied as these children's names are their nationalities: Indian, Bangladeshi, Nepalese, Nicaraguan or North American. What unites them is that they have been made to work as prostitutes and, in the process, have endangered their lives and well-being and seriously compromised their future.

It is estimated that 4 million women and girls worldwide are bought and sold each year either into marriage, prostitution or slavery. Approximately 1 million children enter the sex trade every year. (Although most are girls; boys are also involved.)

As many as 50,000 women and children from Asia, Latin America and Eastern Europe are brought to the United States and forced to work as prostitutes or servants. In the United States during the past two years, the government has prosecuted cases involving hundreds of victims. In other countries where this problem is frequent, the prosecution rate is even lower.

Child sex tourism is worldwide phenomenon, but it is concentrated in Asia and Central and South America. According to UNICEF, 10,000 girls annually enter Thailand from neighboring countries and end up as sex workers. Thailand’s Health System Research Institute reports that children in prostitution make up 40% of prostitutes in Thailand. And between 5,000 and 7,000 Nepali girls are transported across the border to India each year and end up in commercial sex work in Mumbai, Bombay or New Delhi.

Although the greatest number of children working as prostitutes is in Asia, Eastern European children from Eastern European countries, such as Russia, Poland, Romania, Hungary and the Czech Republic, are increasingly vulnerable.

As a social pathological phenomenon, prostitution involving children does not show signs of abating. In many cases, organized groups kidnap children and sell them into prostitution, with border officials and police serving as accomplices.

The U.N. Special Rapporteur on Violence Against Women called attention to the levels of state participation and complicity in the trafficking of women and children across borders. Because of their often undocumented status, language deficiencies and lack of legal protection, kidnapped children are particularly vulnerable in the hands of smugglers or corrupt and heartless government officials.

Commercial sexual exploitation of children is increasing worldwide. There are several reasons. These include increased trade across borders, poverty, unemployment, low status of girls, lack of education (including sex education) of children and their parents, inadequate legislation, lack of or poor law enforcement and the eroticization of children by the media, a phenomenon increasingly seen in industrialized countries.

There are also special social and cultural reasons for children entering into the sex trade in different regions of the world. In many cases, children from industrialized countries enter the sex trade because they are fleeing abusive homes. In countries of Eastern and Southern Africa, children who became orphans as a result of AIDS frequently lack the protection of caregivers and are, therefore, more vulnerable to sexual abuse and exploitation. In South Asia, traditional practices that perpetuate the low status of women and girls in society are at the base of this problem. Children exploited sexually are prone to sexually transmitted diseases and HIV/AIDS. In addition, because of the conditions in which they live, children can become malnourished, and develop feelings of guilt, inadequacy and depression.

Besides the moral and ethical implications, the impact that sexual exploitation has on children's health and future development demands urgent attention. Throughout the world, many individuals and nongovernmental organizations are working intensely for the protection of children's rights. Many times, their work puts them in conflict with governments and powerful interest groups.

Among the U.N. agencies, UNICEF has been particularly active in calling attention to this phenomenon and in addressing the root causes of sexual exploitation by providing economic support to families so that their children will not be at risk of sexual exploitation, by improving access to education -- particularly for girls -- and by becoming a strong advocate for the rights of the child.

The work of such nongovernmental organizations and U.N. agencies should be a complement to governments' actions to solve this problem. Those actions should include preventing sexual exploitation through social mobilization and awareness building, providing social services to exploited children and their families and creating the legal framework and resources for psychosocial counseling and for the appropriate prosecution of perpetrators.

The elimination of the sexual exploitation of children around the world is a daunting task, but one that is achievable is effective programs are put in place. Only when this phenomenon is eliminated will we be able to say that the world's children are exercising their right to a healthy, and peaceful, life.

Dr. Cesar Chelala is an international medical consultant residing in New York.

Puede que sea una sorpresa para muchos, pero don Quijote todavía vive, y en un lugar donde nadie lo imaginaría. Don Quijote vive ahora en Tucumán, mi ciudad natal en el norte de la Argentina.

No viste armadura sino, a pesar de la temperatura, traje y corbata. Probablemente lleve fajos de papeles, algunos de ellos expedientes legales que le permiten perseguir y enfurecer a sus enemigos. Afortunadamente, sus enemigos son los de la civilidad, la decencia y el honor.

Es de estatura mediana, cara alargada con barba corta, nariz aquilina y ojos penetrantes, entre verdes y azules. Son ojos serios y decididos.

Aunque no es abogado, sus conocimientos legales son enciclopédicos y probablemente superiores a los de cualquier letrado, algo que utiliza para perseguir a los pillos. Trabaja como director de una empresa de construcciones, pero —para consternación de su mujer— deja de lado cualquier actividad para seguir su obsesión.

Lo que más lo identifica no es su aspecto físico, sino más bien su devoción por luchar por causas injustas. En español hay una frase maravillosa que lo define totalmente: «defensor de pobres, menores y ausentes».

Sus derrotas no le hacen mella. Protestó vigorosamente cuando el gobierno argentino otorgó una medalla de honor al general Augusto Pinochet, enviando docenas de cartas a las autoridades argentinas.

Sus protestas fueron desoídas y el general Pinochet recibió su condecoración. Presentó entonces una moción especial para prohibirle usar su medalla, alegando que Pinochet había ayudado a los ingleses contra los argentinos durante la guerra de las Malvinas. Su moción fue denegada una vez más.

Cuando Pinochet murió, nuevamente presentó una moción a las autoridades solicitando que la familia devolviera la medalla. La moción fue otra vez denegada. «Este no es el fin de esta historia», me dijo después, mortificado.

Un incidente reciente lo muestra de cuerpo entero. Durante mucho tiempo fue una fuente de irritación para los tucumanos que al lado de la casa de gobierno hubiera un edificio de departamentos de doce pisos cuya pared contigua estaba cubierta con el logo de una empresa internacional de bebidas gaseosas.

Para los tucumanos parecía que la empresa fuera dueña del gobierno de la ciudad. Aunque irritados, los ciudadanos comunes no podían hacer nada.

Vivo en Nueva York y visito a mi familia en Tucumán por lo menos una vez al año. Durante una de mis visitas caminaba con don Quijote cuando vi el logo que abarataba no sólo la casa de gobierno, sino todos los alrededores. No pude evitar comentar a mi amigo que ese enorme logo afeaba la zona.

«No se preocupe», me dijo, «muy pronto ya no estará allí». Me reí descreído.

«¿Quién va a borrarlo?», pregunté. Se dio vuelta y me contestó: «Yo».

Volví a reírme. Afortunadamente, no pareció enojarse por mi reacción. No se lo dije, pero me preguntaba cómo iba a hacer algo que ni los funcionarios del gobierno habían podido hacer: derrotar a una de las empresas internacionales más poderosas del mundo.

En mi siguiente visita a la ciudad ya no estaba el logo. La enorme pared estaba totalmente pintada de blanco. Sorprendido, llamé a mi amigo y le pregunté qué había ocurrido. «¿No le dije que lo borraría?», dijo orgullosamente. Entonces me dio algunos de los detalles de la operación.

Había contactado arquitectos y funcionarios de la municipalidad que estaban de acuerdo con él pero que no habían podido obligar a la empresa a quitarlo. Había intereses muy poderosos detrás del logo que ocupaba el mejor espacio de la ciudad, le explicaron. A pesar de eso, don Quijote presentó varias quejas legales a las autoridades, aunque inútilmente. Siguió luchando sin inmutarse.

Finalmente, después de nueve meses de incansable lucha («fue un parto», me dijo), encontró un resquicio legal y pudo obtener un decreto municipal que obligaba a la empresa a quitar el logo ofensivo.

Después de muchas derrotas, éste era obviamente un importante logro para mi amigo. No pude sino preguntarle, «¿Por qué continúa luchando por todas esas causas perdidas que son tan costosas, le insumen tanta energía, y no le producen ningún beneficio financiero?».

Me miró tristemente y respondió: «Porque si no lo hago, me enfermo».

César Chelala es un médico y escritor argentino, co-ganador del premio Overseas Press Club of America por un artículo sobre derechos humanos.

For people throughout the world, the election of Barak Obama to the U.S. presidency seemed to signal in a new era, that of the end of racism. Indeed, Obama’s election was a momentous occasion and, one would have hoped, a milestone on the road to reconciliation. However, some recent, very ominous events cast a worrisome veil over the democratic process in the United States.

There are many reasons that can explain Obama’s election as President: his penetrating intelligence, a well orchestrated campaign, and a life devoted to public service in which each action was like a brilliant chess move by a master of the game. But there were other factors of equal significance.

Before Obama’s election, not only was the country involved in wars in Iraq and Afghanistan, in what increasingly looks like a quagmire, particularly in the latter country. The economy was in a desperate state, and unemployment and health costs were rising. There was a feeling of widespread malaise in the country believed by many to be the result of an incompetent president manipulated by darker forces, an opinion widely shared throughout the world.

However, after the initial high of Obama’s election, there is now a changed atmosphere in the country. Violence is an inescapable companion to racism. And violence, or violent outbursts racially motivated, are certainly on the increase in the U.S. Threats against President Obama have increased by 400% since President George W. Bush left office, the highest numbers on record.

What makes this situation particularly worrisome is that they come not only from fringe elements in society. Thinly disguised, they also originate from certain political leaders who seem intent on creating an atmosphere of violence and disrespect around the President and the presidency.

How else can one interpret this statement by House Minority Leader John Boehner? “There is a political rebellion going on in America, and what we saw last night was just a glimpse of it,” he stated after last November’s elections. One doesn’t need to be a psychologist or a linguist to understand that such statements stoke the fires of rebellion, and are all the more dangerous when coming from a leader holding one of the most powerful offices in Washington.

As if this weren’t enough, Boehner added, “Clearly it’s been a difficult year. For us it’s been like standing in front of a machine gun--liberal ideas every single week, one after another. I think it really has the American people concerned. They are scared to death,
actually.”

Not to be upstaged, the ineffable Mrs. Palin, vice-presidential candidate of the Republican Party during the last presidential election—and an avid hunter--told her Tea Party supporters at a recent event in Nevada, “Don’t retreat, reload.”

If to these dangerous words--rebellion, machine gun, scared to death, reload--one adds the recent attacks on Democratic legislators during discussion of the health care bill in which they were spat on and threatened with racial and homophobic insults one has the makings of a racially charged –and extremely dangerous- atmosphere in the country.

Although there are other causal factors as well – political, social, economic - there can be no doubt that racism plays an important role.

The country is now facing an increase of 244 percent increase in the number of Patriot groups (militias and other organizations that see the federal government as their enemy) in 2009. At the same time, there has also been an increase in the number of anti-immigration groups throughout the country. These groups grew from 173 in 2008 to 309 in 2009, a rise of nearly 80 percent.

Are we facing a setback after so much work done in the last decades to overcome division and hatred in America? Mr. Doudou Diène, a former United Nations Special Rapporteur on Contemporary forms of racism, racial discrimination, xenophobia and related intolerance, stated after visiting several states in the U.S., “Racism and racial discrimination have profoundly and lastingly marked and structured American society. The U.S. has made decisive progress. However, the historical, cultural and human depth of racism still permeates all dimensions of life and American society.”

Cesar Chelala, a co-winner of an Overseas Press Club of America award, is a contributing editor to The Globalist.

It may come as a surprise to many, but Don Quixote is still alive, and in a most unlikely place. Don Quixote is now living in Tucumán, my hometown in Northern Argentina.

He is not dressed with body armor but rather, despite usually scorching temperatures, with suit and tie. He will probably be carrying bundles of papers, some of them legal sheaves which enable him to persecute and enrage his enemies. Fortunately, his enemies are also those of civility, decency, and honor.

He is of medium height, a narrow face with a short beard, an aquiline nose, and penetrating eyes, a mixture of green and blue. They are serious, determined eyes.

Although he is not a lawyer himself, his legal knowledge is encyclopedic and probably greater than that of any lawyer, something he uses to full advantage when suing miscreants. He works as a director in a construction company but—to his wife’s dismay—he will sideline any activity to pursue his obsessions.

What identifies him most is not his physical aspect. It is rather his devotion to fight for unjust causes. There is a wonderful phrase in Spanish that totally defines him, “Defensor de pobres, menores y ausentes,” (Advocate for the poor, the children, and the absent.)

His defeats leave him undaunted. He strenuously protested when the Argentine government awarded a medal of honor to General Augusto Pinochet, sending dozens of letters to the Argentine authorities.

His appeals were denied and General Pinochet received his decoration. He then made a special motion to forbid him from using his medal, on the grounds that Pinochet had helped the British against the Argentines during the Malvinas/Falkland war. His motion was denied once more.

When Pinochet died, he again presented a motion to the authorities to have Pinochet’s family return his medal. Again that motion was denied. “This is not the end of this story,” he later told me, chagrined.

A recent incident shows him at his best, though. For a long time, it had been a source of irritation to Tucumánians that, on the side of the Government House there was a 12 floor tall apartment building whose wall, contiguous to it, was totally covered with the logo of an international soft drink company.

To Tucumánians, it looked as if that company owned the city government. Although greatly irritated, common citizens were unable to do anything about it.

I live in New York and visit my family in Tucumán at least once a year. During one of my visits I was walking with Don Quixote when I saw the logo cheapening not only the Government House next to it but all the surrounding area. I couldn’t help commenting to my friend how that huge logo belittled the whole area.

“Don’t worry,” he told me, “very soon it will not be there.” I could only laugh in disbelief.

“Who is going to erase it?” I asked. He looked at me and answered, “I will.”

I laughed again. Fortunately, he didn’t seem annoyed by my reaction. I didn’t tell him then but I wondered how he was going to do something that not even government officials had been able to do: Defeat one of the most powerful international companies in the world.

On a later visit to my hometown I no longer saw the logo. The huge wall was totally painted in white. Surprised, I called my friend and asked him what had happened. “Didn’t I tell you that I would erase it?” he said proudly. He then gave me some of the details of the operation.

He had contacted architects and government officials at City Hall who agreed with him but had been unable to force the company to remove it. There were very powerful interests behind the logo which occupied the city’s best space, they explained. In spite of that, Don Quixote presented several legal complaints to the authorities, but to no avail. He still continued his fight, undaunted.

Finally, after nine months of unrelenting struggle (“just like a pregnancy,” he told me) he finally found a legal loophole and was able to obtain a municipal decree ordering the company to expunge the offending logo.

After many defeats, this was clearly a major achievement for my friend. I couldn’t but ask him, “Why do you continue fighting all these mostly lost causes which are so costly, take so much of your energy, and don’t give you any financial gain?”

He looked at me sadly and responded, “Because if I don’t do it, I get sick.”

Dr. César Chelala is an award-winning writer on human rights issues.

Captain Ferguson (not his real name) gets up early in the morning, and has breakfast with his wife and children. At the office, Captain Ferguson sits in front of the computer on and off for almost eight hours every day. At the end of the day he heads back home. Captain Ferguson’s wife is glad to see him back to discuss the events of her day. He does the same, with one omission. By most measures, it has been a beautiful day.

Beautiful, that is, if you don’t consider Captain Ferguson’s omission. While sitting in front of his computer, he was directing unmanned aerial vehicles (UAVs), also known as drones, carrying powerful bombs to land in distant countries. He presumes, but he is not totally sure, that he has hit the right target. After the bombs exploded four suspected terrorists were killed. Four fewer criminals the U.S. will have to deal with.

A later investigation will later reveal that they were not terrorists but rather they were parents and children on a birthday party. As a result of the attack, four adults and eight children were killed, and several more seriously injured.

Captain Ferguson, of course, was unaware of the consequences of his actions. He only thinks that he has a somewhat tedious but rewarding job, since he is an important piece in the fight against terror. Only later he will know the truth, when the outcry of the victims’ relatives cannot be silenced any longer. The predictable apologies will not bring back the dead to life, nor heal those injured.

Let’s compare this made–up scenario with reality.

During the first year of the Obama administration, there were 51 drone attacks, compared to 45 drone attacks during President Bush’s two terms in office, according to The Year of the Drone, a report by the Washington-based New America Foundation. The report also states that the civilian fatality rate has been 32 percent in drone attacks since 2004.

“Drones are currently killing people in Afghanistan, Pakistan, Yemen and Somalia. It should be noted that the United States is not at war with any of those countries, which should mean in a sane world that the killing is illegal under both international law and the US Constitution,” states Philip Girald, a former CIA officer and fellow of the American Conservative Defense Alliance.

Girald’s observation is confirmed by Mary Ellen O’Connell, a Professor of Law at Notre Dame Law School. In a research paper entitled “Unlawful Killing with Combat Drones” Professor O’Connell says, “The CIA’s intention in using drones is to target and kill individual leaders of al-Qaeda or Taliban militant groups. Drones have rarely, if ever, killed just the intended target. By October 2009, the ratio has been about 20 leaders killed for 750-1000 unintended victims. Drones are having a counter-productive impact in Pakistan’s attempt to repress militancy and violence. The use of the drone is, therefore, violating the war-fighting principles of distinction, necessity, proportionality, humanity.”

In the meantime, the U.S. military plans to more than triple its inventory of high-altitude drones capable of 24-hour patrols by 2020. General David Petraeus, head of the U.S. Central Command, which includes both Afghanistan and Iraq, declared in a speech last January, “We can’t get enough drones.”

War, we should sadly acknowledge, is not a Nintendo game. And innocent people’s lives are not expendable. If we don’t admit the tragic dimension of war we will be cursed by its consequences.

Cesar Chelala, a co-winner of an Overseas Press Club of America award, is a contributing editor to The Globalist.

There is not a single factor that accounts for violence against women, but several social and cultural factors have kept women particularly vulnerable to this phenomenon.

What they have in common, however, is that they are manifestations of historically unequal power relations between men and women.

The involvement of men is critical to curb the spread of this injustice. In this case, NGOs have proven to be more effective than government agencies.

The stubborn fact, however, is that in many countries violence against women, especially in the domestic setting, is seen as normal behavior. In that sense, domestic violence exemplifies perverse power relationships.

When this kind of relationship becomes established, people become conditioned to accept violence as a legitimate means of settling conflicts — both within the family and in society at large — thus creating and perpetuating a vicious cycle.

Violence begets violence, and often does irreparable damage to the family and to the social structure.

Women who marry at a young age are more likely to believe that sometimes it is acceptable for a husband to beat his wife, and are more likely to experience domestic violence than women who marry at an older age, according to a UNICEF study. This, among other reasons, is why it is so essential that young girls forced into marriage in Yemen have been able to come forward and request a divorce from the courts in recent months.

Lack of economic resources and the capacity to lead economically independent lives also underscore women’s vulnerability to violence, and the difficulties they face in extricating themselves from a violent relationship. According to some studies, there is a link between rise in violence against women and the destabilization of economic patterns in society.

Although physical violence and sexual violence are easier to see, other forms of violence include emotional abuse, such as verbal humiliation, threats of physical aggression or abandonment, economic blackmail and forced confinement to the home. Many women consider psychological abuse and humiliation even more devastating than physical violence.

What’s more, from a public health perspective, sexual violence increases women's risk of contracting sexually transmitted diseases, including AIDS (through forced sexual relations or the difficulty in persuading men to use condoms), increases the number of unplanned pregnancies, and may lead to various gynecological problems such as chronic pelvic pain and painful intercourse.

The stubborn fact is that in many countries violence against women, especially in the domestic setting, is seen as normal behavior. Even more disturbing, a large proportion of women are beaten while they are pregnant. Comparative studies reveal that pregnant women who are abused have twice the risk of miscarriage and four-times the risk of having low-birth-weight babies than non-battered pregnant women.

In India, a study of maternal deaths carried out in 400 villages and seven hospitals showed that 16% of all deaths during pregnancy were due to domestic violence.

Domestic violence can have devastating consequences on children as well. According to a UNICEF report, as many as 275 million children worldwide are currently exposed to domestic violence. One of the findings of the report is that children who live with domestic violence not only endure the stress of an atmosphere of violence at home but are more likely to become victims of abuse themselves.

It is estimated that 40% of child-abuse victims also have reported domestic violence at home. In addition, children who are exposed to domestic violence are at greater risk for substance abuse, teenage pregnancy and delinquent behavior.

Although doctors and health personnel can greatly help the victims, many times they are not trained to diagnose abuse accurately. And more so, women are often reluctant or afraid to report abuse.

Various cultural, economic and social factors, including shame and fear of retaliation contribute to women's reluctance to report these acts. Legal and criminal systems in many countries also make the process difficult.

Frequently, fear keeps women trapped in abusive relationships. It has been found that almost 80% of all serious gender violence injuries and deaths occur when female victims of violence try to leave a relationship — or after they have left.

As a World Health Organization report states, "The health sector can play a vital role in preventing violence against women, helping to identify abuse early, providing victims with the necessary treatment and referring women to appropriate and informed care. Health services must be places where women feel safe, are treated with respect, are not stigmatized, and where they can receive quality, informed support."

Women who marry at a young age are more likely to believe that sometimes it is acceptable for a husband to beat his wife, and are more likely to experience domestic violence than women who marry at an older age.

Given the difficulties in properly diagnosing abuse or reluctance report it, prevention of violence against women is key.

Prevention may act at three levels: primary prevention stops the problem from happening; secondary prevention stops it from progressing further; and tertiary prevention teaches victims, after the fact, how to avoid its repetition. Studies carried out in industrialized countries show that public health approaches to violence can lower the negative impact of domestic violence.

Governments also have been increasingly responsive to women groups’ demands to deal seriously with this issue. In Bangladesh, new laws make violence against women a punishable offence. Belgium, Peru and Yugoslavia have amended laws to more clearly define sexual harassment. The Dominican Republic, Portugal, Spain, Uruguay and Belgium, among others, have passed laws that increase penalties for domestic abuse. The Kingdoms of Jordan and Morocco have both made strides to protect women’s rights — denouncing so-called honor killings in the former and providing confidential victims’ assistance hotlines in the latter.

In India and Bangladesh a traditional system of local justice called salishe is used to address abuse on a case-by-case basis. For example, when a woman is beaten in Bangladesh, the West Bengali non-governmental organization Shramajibee Mahila Samity sends a female organizer to the village to discuss the situation with the people involved and helps find a solution, which is then formalized in writing by a local committee.

In China, there has been some progress regarding this issue as well, such as placing posters on some roads and in subways stressing the problems that domestic violence represent to society. The All-China Women’s Federation has been playing a significant role in bringing domestic violence into the legislative and policy-making processes.

In February 2007, Mexico’s President Felipe Calderón signed a law passed by the Senate, that requires local and federal authorities to curb violence against women. Mexico’s new law is the first-ever federal measure to combat domestic violence and other abuses against women, although similar measures were already in the books in many cities and states.

Studies carried out in industrialized countries shows that public health approaches to violence can lower the negative impact of domestic violence.

Many governments find it difficult to work with women at the community level, which is where NGOs come into play. This is the case in Jamaica, Malaysia and Mozambique, among others, where these organizations have been particularly active. In Ethiopia, the Association of Women’s Lawyers is actively working against sexual violence and domestic abuse.

The involvement of men is critical to curb the spread of this injustice. In this case also, NGOs have proven to be more effective than government agencies. In Cambodia, Jamaica and the Philippines, NGOs are working effectively with men to support women’s empowerment and rights. The Women’s Centre of the Jamaica Foundation counsels young male parents and trains male peer educators through its program Young Men at Risk.

But more work needs to be done if this pandemic is going to be controlled.

Government and community leaders should spearhead an effort to create a culture of openness and support to help eliminate the stigma associated with violence against women. Laws should be followed up with plans for specific national action.

Domestic violence is a threat to equality and justice that no civilized society should allow to exist.

Dr. Cesar Chelala is an international public health consultant and a co-winner of an Overseas Press Club of America award.

Several years ago, during my first visit to Cuba to attend a health-related meeting I was witness to an unusual event. As friends and I walked into the Bodeguita del Medio, a traditional restaurant famous because of the number of illustrious visitors who had dined there over the years, a young Cuban man was discretely asked to leave. Seeing my friends and myself and realizing we were not Cuban, he began ranting against the restrictions placed on Cubans by their government.

“I have the money to spend here,” he told us. “But they prefer to have foreigners eat here. I am fed up with this regime. Do you see something in that corner?” he asked us. “Yes,” we said, “there is a man standing there.” “You are wrong,” he replied, “he is not a man. That’s a gigantic ear that is listening to everything I am saying to you. But I don’t care; I am so sick and tired of this situation.”

In a few brief minutes, I gained an idea of some of the problems besieging Cuban society: the need for foreign money, the oppressive nature of the regime, and the dissatisfaction of the youth. These impressions were later confirmed during another visit to the island when I headed a U.N. mission to assess the progress of Cuban scientists in developing interferon, an anti-viral substance.

To pinpoint the Cuban government shortcomings, however, is in no way to deny its achievements. During that last visit I had the opportunity of meeting Fidel Castro. Although we didn’t raise any political issues in our conversation, I was able to observe his enormous interest in, and knowledge, about health issues. That interest and knowledge underlie his government’s achievements in two critical areas, health and education. Cuba is in the forefront in both fields when compared to other Latin American countries and in some areas on a par with the United States.

This progress, however, has been hindered by an unnecessary and substantially ineffectual embargo against that country, a situation that has cost the U.S. both in material terms and in prestige among Latin American governments who consider the embargo a violation of a nation’s rights and sovereignty.

There is no doubt that political pressure from the powerful Cuban exile community in Florida has been an important factor in maintaining the embargo. However, the descendants of that immigrant generation have a more nuanced view of the Cuban regime; they have seen the damage cause by the antagonism between both countries and are eager for more amicable relations between them.

While Cubans have always been clear as to their admiration for the American people –which I was able to observe during my visits to the island- the embargo does more to foster hate and mistrust of the U.S. government than of the Cuban government. Moreover, the U.S. has been flying in the face of world opinion on the Cuban issue. If votes in the U.N. General Assembly are a test, no country in the world –with the exception of the United States, Israel and the Marshall Islands- support the embargo.

President Obama has wisely eased restrictions on travel to the island by Cubans and their descendants. He should now strengthen that approach through an intense exchange of scientists, doctors, artists and ordinary citizens between both countries. The effect would be dramatic in neutralizing the atmosphere of antagonism and should lead to a lifting of the embargo.

Trade with the United States now amounts to half a billion dollars a year, a negligible amount equivalent to U.S. trade with Canada on a single day. Should normal relations return, the increase in trade could be substantial. A furthering of this administration’s more open attitude toward the island is in the best interests of both the US and the Cuban people, who have been the ones really hurt by this situation.

Cesar Chelala, MD, PhD, is an international public health consultant and a co-winner of an Overseas Press Club of America award.

That violence against women is considered accepted behavior in many countries does not diminish its seriousness or its negative impact on the physical and mental health of women worldwide. Its persistence throughout the world — despite other obvious social measures of progress — indicates the need to confront it with more effective policies.

Some studies conducted in the United States reveal that each year approximately 4 million women are physically attacked by their husbands or partners.

In every country where reliable studies have been conducted, statistics show that between 10% and 50% of women report that they have been physically abused by an intimate partner during their lifetime.

According to the World Health Organization (WHO) data, the most devastating effect of gender violence worldwide is that violence against women claims almost 1.6 million lives each year — about 3% of deaths of all causes.

Domestic violence, violence that occurs in the home or within the family, is the most common kind of gender violence. It affects women regardless of age, education or socioeconomic status. Its victims are women in developing nations and Western countries alike.

The situation has led public health experts to consider violence against women a global public health issue — one requiring a public health approach.

Worldwide, violence is as common a cause of death and disability among women of reproductive age as cancer — and a greater cause of ill health than traffic accidents and malaria together.

Few precise figures on violence against women exist, but some of the numbers can be shocking.

According to Mexico’s Health Ministry, about one in three women suffer from domestic violence, and it is estimated that over 6,000 women die in Mexico every year as a result. According to a 2006 study of women in Mexico sponsored by the government (Encuesta Nacional sobre la Dinámica de las Relaciones en los Hogares 2006), 43.2% of women over 15 years old have been victims of some form of intra-family violence over the course of their last relationship.

Worldwide, violence is as common a cause of death and disability among women of reproductive age as cancer — and a greater cause of ill health than traffic accidents and malaria together.

Domestic violence is rife in many African countries as well. In Zimbabwe, according to a United Nations report, it accounts for more than six in ten murder cases in court. According to surveys, 42% of women in Kenya and 41% in Uganda reported having been beaten by their partners.

Although some countries such as South Africa have passed women’s rights legislation, the big test — full implementation, with teeth — has not been passed.

In China, according to a national survey, domestic violence occurs in one-third of the country’s 270 million households. A survey by the China Law Institute in Gansu, Hunan and Zhejiang provinces found that one-third of the surveyed families had witnessed family violence — and that 85% of victims were women.

In Japan, as in many other countries, the number of reported cases has increased in recent times. According to some advocates working to end domestic violence, this may signal that victims may be overcoming cultural and social taboos that once forced them into silence. According to the National Police Agency, reported cases reached an all-time high of 20,992 in 2007, mostly women in their 30s.

The changes associated with the transition period in the countries of Central and Eastern Europe and the former Soviet Union — such as increases in poverty, unemployment, income inequality, stress, and alcohol and drug abuse — have led to an increase in violence in those societies, including violence against women.

In Russia, estimates put the annual domestic violence death toll at more than 14,000 women. Natalya Abubikirova, executive director of the Russian Association of Crisis Centers, in a statement to Amnesty International drew a dramatic parallel to capture the scope of the problem: "The number of women dying every year at the hands of their husbands and partners in the Russian Federation is roughly equal to the total number of Soviet soldiers killed in the 10-year war in Afghanistan."

Domestic violence affects women regardless of age, education or socioeconomic status. Its victims are women in developing nations and Western countries alike.

In a study conducted by the Council for Women at Moscow State University, 70% of the women surveyed said that they had been subjected to some form of violence — physical, psychological, sexual or economic — by their husbands. Some 90% of respondents said they had either witnessed scenes of physical violence between their parents when they were children or had experienced this kind of violence in their own marriages.

Research carried out in several Arab countries, shows that at least one out of three women is beaten by her husband. Despite the serious consequences of domestic violence, and the increasing frequency of violence against women, not enough is done by the governments of Arab and Islamic countries to address these issues.

As the United Nations Development Fund for Women (UNIFEM) has stated, "To date, there is no comprehensive and systematic mechanism for collecting reliable data on violence against women in Arab countries."

In many Islamic countries, or in countries with a substantial Muslim majority, passages from the Koran are sometimes used to justify violence against women. Yet many religious experts state that Islam rejects the abuse of women and advocates equality in the rights of women and men.

In many cases, violence against women — including killings — are based more on cultural than religious grounds and are justified by the need to protect a family’s honor.

This pattern of abuse is similar for industrialized countries.

Some studies conducted in the United States reveal that each year approximately 4 million women are physically attacked by their husbands or partners.

According to the WHO’s "World report on violence and health," between 40% and 70% of female murder victims in Australia, Canada, Israel, South Africa, the United Kingdom and the United States were killed by their husbands or boyfriends — often within the context of an ongoing abusive relationship.

In Russia, estimates put the annual domestic violence death toll at more than 14,000 women.

According to a U.S. study, violence against women is responsible for a large proportion of medical visits, and for approximately one-third of emergency room visits. Another study found that in the United States, domestic violence is the most frequent cause of injury in women treated in emergency rooms, more common than motor vehicle accidents and robberies combined.

In the United States, 25% of female psychiatric patients who attempt suicide are victims of domestic violence, as are 85% of women in substance abuse programs. Studies carried out in Pakistan, Australia and the United States show that women victims of domestic violence suffer more depression, anxiety and phobias than women who have not been abused.

As Noeleen Heyzer, former executive director of UNIFEM has stated, "Violence against women devastates people’s lives, fragments communities and prevents countries from developing."

Dr. Cesar Chelala is an international public health consultant and a co-winner of an Overseas Press Club of America award.

The rapid urbanization if our planet, which began in the 19th century, is one of the most notable changes in modern times. While in 1950, 29% of the population lived in cities, that figure is estimated now in 50% and by 2030 that proportion will be 61%. In Africa, urbanization has followed a similar trend: it experienced a rapid shift from 15% in 1950 to 41 percent now. It is estimated that by 2030 54% of the population in that continent will be living in cities. Not only are more people living in cities but the cities themselves are becoming larger and more numerous. This situation poses unique problems related to the provision of water, sanitation and a healthy environment.

There are now 43 cities in Africa with populations of more than 1 million inhabitants. It is expected that by 2015 there will be 70 of them. Because of slow economic growth, lack of effective development policies and limited resources, infrastructure development has not kept up with the increasing needs for shelter and services in growing urban populations. At the same time, urban settlements in the developing countries are growing five times as fast as those in the industrialized countries.

This explosive growth of urban populations has resulted in African cities having overcrowded, informal settlements characterized by inadequate housing and poor infrastructures such as water supplies, sanitation and waste management services. This is the result, in part, of the fact that most cities, both in developed and developing regions are experiencing a polarization of their populations into affluent and poor neighborhoods. Modern trends are towards segregation rather than social integration between rich and poor neighborhoods.

This is the case for many African cities, where local governments have been unable to keep with the pace of change and as a consequence have also been unable to provide dwellers with proper infrastructures related to the provision of water and the collection, transportation, processing and disposal of waste materials.

In developing countries with economies under stress, waste management is a problem that often endangers health and the environment. However, it is a low priority problem for governments often besieged by other problems such as poverty, hunger, children’s malnutrition, water shortages, unemployment and even war. In that regard, fast-growing population, increasing poverty and its effects on living conditions are some of the problems facing cities in the developing world.

Water supply, sanitation and health are closely related issues. Poor hygiene, inadequate management of liquid or solid waste and lack of sanitation facilities are contributing factors in the death of millions of people in the developing world due to diseases that are easily preventable. In addition, people living in un-serviced or poorly serviced areas value the increased convenience and privacy associated with improved sanitation.

For example, lack of sanitation and inadequate disposal or storage of waste near houses can provide habitats for vectors responsible for several infectious diseases such as amebiasis, typhoid fever and diarrheas. Uncontrolled and inadequate landfills, for their part, are a big danger to the environment and a health risk to the population since they may lead to contamination of water and soil. The health risks associated with poor sanitation tend to be higher in densely populated low-income urban areas. At a global level, more than 5 million people die each year from diseases related to inadequate waste disposal systems.

Contamination of water leads to a whole range of diarrheal diseases such as cholera that kills 1.8 million people worldwide. An estimated 90 percent among them are children below five, mainly from developing countries. Most of the burden can be attributed to unsafe drinking water, inadequate sanitation and poor hygiene practices.

The children that are affected the most are those living in low-income urban areas. According to UNICEF, Infant Mortality Rates (IMRs) are almost always higher in poor urban areas than the national average and than those in rural areas. A great proportion of this high mortality among the children of the urban poor can be attributed to diseases common in urban areas such as diarrhea, tuberculosis and parasitic diseases (intestinal worms) that are frequently associated with lack of safe water and sanitation. Malnutrition in children is often a complicating factor.

Germs, particularly those present in water, food or on dirty hands are the most frequent cause of sickness worldwide. Although lack of safe water and sanitary facilities are significant problems, they are made even worse by ignorance in the general population, particularly mothers, about the connection between dirt, germs and childhood diarrhea.

Also, experience has shown that provision of clean water by itself only leads to minor health improvements. The most important factor is personal hygiene, with adequate public sanitation and clean water as additional, supporting components. Thus, while each of these factors is important in itself, they are more effective when they are combined. At the same time, hygienic behavior is not possible without a source of safe water and adequate means to dispose of human and other wastes.

Several naturally-occurring and human-made chemical substances present in drinking water can have a serious effect on health, particularly when present above a threshold level. Among chemicals that can be dangerous in high concentrations are fluoride, arsenic, lead, cadmium, mercury, nitrates and pesticides.

All these factors stress the need to carry out policies that ensure the provision of safe water to the population, particularly in marginal areas lacking basic health and social services.

These comments are particularly appropriate when one reflects on the fact that Africa has the lowest water supply and sanitation coverage of any other region in the world. It is estimated that 1 in 3 Africans have no access to improved water or to sanitation facilities. Even more seriously, the number of people lacking those basic services is increasing. Unless actions are taken now, the absolute number of people lacking basic services will increase from 200 million in 2000 to 400 million in 2020. The majority of those lacking basic services live in informal or suburban areas and rural communities.

In the last 2 decades, Benin has reported significant gains in terms of sanitation coverage and better access to drinking water. Thus, improved sanitation coverage increased from 12% in 1990 to 30% in 2006, while the proportion of the population that gained access to an improved water source increased by 37% since 1990.

According to the Mid-term review of Progress in Reaching Objectives in A World Fit for Children, considerable progress has been made in the field of provision of safe drinking water, particularly in rural areas in that country. This was possible thanks to Government funds and important external support, as well as to a decentralization process that transferred some responsibilities to the local authorities.

According to the same document, although there have been improvements in basic sanitation the degree of improvement is still very low. Among the components still needed to improve the situation are financial support as well as hygiene and communication components aimed at provoking behavioral change, particularly hand-washing as a way to eliminate the transmission of infections from fecal matter.

Despite progress, however, many Sub-Saharan countries will find it difficult to reach the Millennium Development Goals (MDGs) set for 2015, particularly the MDG 7 which stipulates to halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation.

This is evident when, according to the German Technical Cooperation (GTZ), “Today, it is becoming more and more evident that, in many Sub-Saharan African countries, official data on MDG progress in the area of water and sanitation do not reflect the real situation in the ground. In urban and presumable also in rural areas, coverage is overestimated which, as a result, means that the gaps to be bridged are underestimated.”

The Sustainable Sanitation Alliance has defined a set of conditions to address shortcoming of previous efforts to improve sanitation. Among those conditions to be addressed are the following:

* Capital-intensive solutions tend to be costly, energy-intensive and inflexible, failing to reach large proportions of the new slum poor.

* Importing sanitation models from the industrialized world and trying to implement centralized ‘one-size-fits-all’ solutions is in many cases neither appropriate nor sustainable. Planning approaches must be adapted to better allow for the planning and implementation of context-specific sanitation systems.

* Among recent innovations in sanitation planning are a more integrated planning approach (strategic sanitation planning), and a greater emphasis on the actual needs and means of the users encompassing close consultation with all stakeholders.

* We need to overcome the lack of integration between the various components of environmental sanitation: excreta, domestic and industrial waste-water, solid waste and storm water which are often run by separate agencies or institutions. Better use of synergies can lead to more sustainable and cost-effective solutions.

* To achieve adequate sanitation it is necessary to convince local authorities, utilities and donors that there should be effective commitment and participation by all stakeholders.

Several of these conditions are also applicable to improving the provision of safe water. In both cases, it is important to provide incentives for good practice. One such incentive could be increased financial aid to municipalities that succeed in implementing effective sanitation and safe water programs.

It is also important to move from implementing strategic planning process in a pilot municipality to disseminating results (through workshops, publications, exchange visits), followed by changes in legislation and procedures as necessary to replicating the process on a wider scale.

According to Hans van Damme, a special adviser to the Water Supply and Sanitation Collaborative Council, the constraints for improvement are neither financial nor technical –they are political, social and managerial. At the same time, local authorities have to empower people through self-reliance and support individuals and families in their efforts. At the same time, water-sector professionals should combine their technical skills with the ability to communicate those they serve.

Better water and sanitation services can improve everybody’s health and well-being, particularly women and children. The seriousness with which we approach this task will be a measure of our commitment for building communities better prepared to face the challenges related to their need for having better access to potable water and adequate sanitation.

- In this blog series, Dr. Cesar Chelala explores the many challenges presented by urbanization, the impact of urban migration, challenges to health, and challenges of providing clean water. - Ed.

Dr. Cesar Chelala is an international public health consultant.

The recent statement by the Justice Department’s Office of Professional Responsibility that the lawyers who wrote the so called “torture memos” exercised “poor judgment” in writing legal opinions related to the use of torture techniques is a disservice to justice. It is a topic that should be properly addressed by a serious inquiry to establish if there were any violations of the law.

According to the Justice Department’s ethics watchdog, lawyers John Yoo and Jay Bybee wrote opinions on the subject that “contained significant flaws.” In addition, investigators found that Yoo had “violated his duty to exercise independent legal judgment and render thorough, objective and candid legal advice.” As for Bybee, they determined that he had “acted in reckless disregard” of ethical obligations for his actions regarding those memos.

However, the report containing these conclusions stated that Yoo and Bybee were not guilty of professional misconduct that might have led to their disbarment. This is a puzzling statement if one considers that Yoo and Bybee’s actions led to serious violations of national and international law.

It is even more puzzling if one considers that a cover letter accompanying the report stated that an earlier version of the report found “professional misconduct” by the two lawyers. David Margolies, a senior career official at the Office of Professional Responsibility in charge of reviewing the report overruled that finding.

“Justice Department lawyers have an obligation to uphold the law, so when they write legal opinions that are designed to provide legal cover for torture, they need to be accountable with more than a slap in the wrist,” stated Andrea Prasow, senior counterterrorism counsel at Human Rights Watch. She added, “Last minute changes in the Justice Department’s findings should not stop state bars from investigating whether these men violated their ethical obligations as lawyers.”

The “torture memos” sought to provide legal cover for US interrogators to use abusive interrogation techniques such as sleep deprivation and waterboarding. This last practice has been prosecuted as a war crime in the United States. In 1947, the US charged a Japanese officer, Yukio Asano, with war crimes for carrying a form of waterboarding on a US civilian. Asano was sentenced to 15 years of hard labor.

After the Sept. 11, 2001, terror attacks, when Taliban and al-Qaeda operatives were captured, CIA interrogators sought authority to use coercive means of interrogation. These methods were then cleared not only at the White House during the Bush administration, but also by the Justice Department, according to the Office of the Director of National Intelligence.

CIA officers used waterboarding at least 83 times against Abu Zubaydah and 183 times against Khalid Shaikh Mohammed, according to a 2005 Justice Department legal memorandum, even though the United States had historically treated waterboarding as torture. “We prosecuted our own soldiers for using it in Vietnam,” said Attorney General Eric H. Holder.

Information obtained from waterboarding may not be reliable because a person under duress may admit to anything. “It is bad interrogation. I mean, you can get anyone to confess to anything if the torture is bad enough,” said former CIA officer Bob Baer.

In December 2008, Robert Muller, Director of the FBI, stated that despite Bush Administration claims that waterboarding has “disrupted a number of attacks, may be dozens of attacks,” he didn’t believe that evidence obtained by the US government through enhanced interrogation techniques such as waterboarding disrupted any attack. Despite numerous and serious abuses, not a single CIA official and only a few military personnel have faced meaningful punishment.

There are widespread demands for the Justice Department to broaden its preliminary investigation of CIA abuses and on the role that Bush administration lawyers played in justifying those abuses. Former Vice President Dick Cheney boasted that he was a big supporter of waterboarding. President Obama stated at the beginning of his term, “I believe waterboarding was torture and it was a mistake.” By conducting a proper inquiry on the matter, his administration can show that it is still adhering to those same beliefs.

Cesar Chelala is a co-winner of an Overseas Press Club of America award for an article on human rights.

A simple procedure is saving thousands of lives. Although it has been known for many years it has not been not widely used. This approach shows how sometimes simple ideas which respond to real needs can have a dramatic impact on people’s lives and health.

The rationale behind the development of this procedure was based on the several steps doctors have to follow when treating people in intensive care units, also known as “critical care”. It is estimated that, on a given day, some ninety thousand people are in intensive care, almost five million a year.

During a typical stay in an intensive care unit, patients undergo several procedures, most of them critical for its survival. Under these circumstances it is most important that some basic and necessary procedures are properly carried out. Failure to do so could result in the death of the patient.

In 2001, Dr. Peter Pronovost, a Professor at the Johns Hopkins University School of Medicine in the Department of Anesthesiology and Critical Care Medicine, began studying hospital-acquired infections. These infections affect 1 in 10 patients, killing 90,000 of them and costing as much as $11 billion each year.

Pronovost began investigating this alarming situation at Johns Hopkins Hospital focusing on bloodstream infections from central venous catheters used in intensive care units (ICUs). He concluded that providing physicians with a chart reminding them of each step in some routine procedures could drastically reduce the number of errors leading to such infections.

Pronovost shortened lengthy guidelines into a simple checklist of five precautionary steps. According to Pronovost doctors should wash their hands with soap; clean the patient’s skin with chlorhexidine antiseptic; put sterile drapes over the entire patient; wear a sterile mask, hat, gown and gloves, and put a sterile dressing over the catheter site.

Although it can be argued that these are very simple procedures, neglecting one or more can lead to disastrous results.

Pronovost initial findings were confirmed two years later in a Michigan study called the Keystone Initiative. The results of this study, published in 2006 in the New England Journal of Medicine, showed that in the first three months of the project the infection rate in Michigan’s ICUs decreased by sixty-six percent. Within the Initiative’s first eighteen months, the authors estimated that 1500 lives and $100 million were saved.

Based on his initial success, Pronovost and his colleagues later developed checklists for other situations in the ICU such as mechanical ventilation. Although he is not the first one to use a checklist to guide procedures, he is the first to be aware of its advantages and exploit its possibilities.

Dr. Atul Gawande, a surgeon at Brigham and Women’s Hospital in Boston and a professor of surgery at Harvard Medical School enthusiastically promoted this approach. Writing in The New Yorker, Gawande stated that Pronovost work had saved more lives than any other laboratory scientist in the last decade.

Working for the World Health Organization, Dr. Gawande brought the checklist idea to several hospitals around the world, with equally startling results. In eight hospitals ranging from a rural hospital in Tanzania to a high-tech university facility in Seattle Dr. Gawande and a team of public health experts applied a version of the checklist to assess if it improved surgical care.

Without adding a piece of equipment or any extra spending, the rate of major post surgical complications dropped by 36 percent in the six months after the checklist was used and deaths fell by 47 percent in all of the eight hospitals studied.

Despite some drawbacks, such as what to do when a patient has several disorders at the same time and its lack of flexibility, as pointed out by Dr. Sandeep Jauhar, author of “Intern: A Doctor’s Initiation,” it is clear that using checklists for some situations can save lives and money in health care. Pronovost’s approach is now being tried in California and in Spain. If the results are equally positive, it will create new standards of health care performance both in the U.S. and at the international level.

Cesar Chelala, MD, PhD, is an international public health consultant.

by Dr. Cesar Chelala (New York) and Dr. Manuel Peña (Lima, Peru)

Poverty cannot be defined solely in terms of lack of income. A person, a family, even a nation is not deemed poor only because of low economic resources. Little or no access to health services, lack of access to safe water and adequate nutrition, illiteracy or low educational level and a distorted perception of rights and needs are also essential components of poverty.

Poverty is one of the most influential factors for ill health, and ill health — in a vicious cycle — can lead to poverty. Education has proven to be a
There is a two-way link between poverty and health. Illness impairs learning ability and quality of life, has a negative impact on productivity, and drains family savings. Poor people are more exposed to environmental risks (poor sanitation, unhealthy food, violence, and natural disasters) and less prepared to cope with them.

Because they are also less informed about the benefits of healthy lifestyles, and have less access to them as well as to quality health care, they are at greater risk of illness and disability.

Close to 1.5bn people in the world live in extreme poverty, a situation which is particularly stark in the developing world, where 80% of them live. Poor people have little or no access to qualified health services and education, and do not participate in the decisions critical to their day-to-day lives.

Those who live in extreme poverty are five times more likely to die before five years of age, and two and a half time times more likely to die between 15 and 59 than those in higher income groups. The same dramatic differences can be found with respect to maternal mortality levels and incidence of preventable diseases. Level of education in relation to health is particularly important among women. In addition, education for women is closely associated with later marriage and smaller family size.

The impact of poverty on health is largely mediated by nutrition and is expressed throughout the life span. However, nutrition and health are only somewhat responsive to mere economic growth.

Increased income alone cannot guarantee better nutrition and health because of the impact of other factors, notably education, environmental hygiene and access to health care services, which cannot necessarily be bought with increased income in the developing world.

Those living in poverty and suffering from malnutrition have an increased propensity to a host of diseases, a lower learning capacity, and an increased exposure and vulnerability to environmental risks. Poor children frequently lack stimuli critical to growth and development.

The unrelenting stresses in the struggle for survival do not allow poor families to fully appreciate the importance of stimulation and nurture, and even if they do the opportunity to provide these stimuli.

Experiences in several countries have demonstrated the power of education to increase the nutritional levels and the health status of the poor. In urban India, for example, it has been found that the mortality rate among the children of educated women is almost half than that of children of uneducated women.

In the Philippines, it has been shown that primary education among mothers reduces the risks of child mortality by half, and secondary education reduces that risk by a factor of three.

Several strategies can be used to improve the access of mothers and children to educational opportunities as a way of improving their health status. At the national level governments, particularly in developing countries, have to establish education — including the education of the parents — as a priority, and provide necessary resources and support.

Interventions should be targeted to vulnerable groups such as those with lower income or with less access to adequate food.

At the international level, lending institutions have to implement debt-reduction policies for those countries willing to provide increased resources for basic education.

Although an important goal is to reduce economic inequity to improve the health status of populations, emphasis on education can provide substantial benefits in the health status of populations even before reducing the economic gap between the rich and the poor.

Dr. Cesar Chelala is a public health consultant for several international organizations. Dr. Manuel Peña is the Pan American Health Organization representative in Peru.

Movements of people whether from rural to urban areas or from one country to another often alter the characteristic epidemiological disease profile, and at the same time new diseases appear or old ones reemerge. Such is the case of HIV/AIDS, tuberculosis, yellow fever, dengue, and Lyme disease.

For example, large-scale migrations to Costa Rica in the 1980s, stemming from conflicts in other Central American countries, produced a palpable increase--especially along border areas--in the prevalence of malaria and other infectious and parasitic diseases. At the same time, urbanization is associated with changes in diet and exercise that increase the prevalence of obesity with increased risks of type II diabetes and cardiovascular disease.

Among migrants, mobility-related risks include poverty, vulnerability to sexual abuse and exploitation, dangerous working conditions and separation from social support networks. Many of these conditions affect the most vulnerable segment of the population: women, children and the elderly.

The reproductive system of pregnant women is especially vulnerable to environmental contaminants. Each step in the reproductive process can be altered by toxic substances in the environment that increase the risk of abortion, birth defects, fetal growth and perinatal death. Many studies have shown that exposing pregnant women to carbon monoxide can damage the health of the fetus. In addition, the developing fetus is susceptible to environmental factors – for example through the mother’s exposure to toxic substances in the workplace.

Children are especially susceptible to disease when they are born and develop in an environment characterized by overcrowding, poor hygiene, excessive noise, and a lack of space for recreation and study. They suffer not only from a hostile physical environment, but from stress and other factors such as violence that such environments create.

The more obvious ill effects of urban life--emotional stress, loss of family structure, congested traffic, noise, environmental pollution-- affect people from all incomes. Many city dwellers take for granted access to basic public services, such as drinking water supply, housing, solid waste disposal, transportation, and health care. For the poor, however, these are either deficient or nonexistent. Instead, those in poverty zones usually receive an extra dose of environmental pollution, since industries tend to cluster in outlying areas where regulations are more lax.

Particularly in cities, motor vehicles are an important source of air pollution. In addition, they can be a significant cause of pedestrian injuries and fatalities. The pollutants that originate from motor vehicles, particularly nitrogen oxides, hydrocarbons, ozone, and particulate matter, account for a substantial proportion of air pollution in cities and serious impact on health.

Lead particles released as a result of gasoline combustion pose a significant potential threat to children, whose behavior and psychological development can be affected. In Mexico City, a city notorious for its air pollution, children are exposed to several million tons of contaminants.

Yet Mexico City's pollution problem is hardly unique; virtually every major city in the Western Hemisphere is fighting the same battle. Residents of Santiago, Chile, are afflicted with a host of chronic respiratory infections caused by large concentrations of particulate pollutants in the atmosphere, whose persistence is, in turn, facilitated by the area's unique topographical and climatic circumstances.

The crowded urban neighborhoods combined with poor sanitary conditions and inadequate waste removal create conditions favorable to the spread of infectious diseases.

The overcrowded housing in the slums expose the urban poor to high rates of infectious diseases such as pneumonia, tuberculosis and diarrhea. As a result, the proportion of children dying from infectious and parasitic diseases in poor households in Africa, Asia and Latin America is several hundred times higher than in households in Western Europe or in the United States.

The environmental, social and economic situation at home is, in turn, influenced by the general social, economic and political situation. The rules, regulations, and laws governing a particular city or country will be a reflection of the priority that the government attaches to providing good services and a healthy environment to the population.

Given the serious effects that urbanization can have on health, it is essential to include health considerations into policy making. Because many of the negative effects are suffered by the poor and minorities, it is equally essential to view the challenges incorporating considerations of social justice and equity. The economic situation is a key determinant in the decision, resolve and capacity of the authorities to tackle environmental problems more effectively.

As Herbert Girardet, an expert on urban sustainability has stated, “If we are to continue to live in cities, indeed if we are to continue to flourish on this planet, we will have to find a viable relationship between cities and the living world –a relationship not parasitic but symbiotic, or mutually supportive.”

- In this blog series, Dr. Cesar Chelala explores the many challenges presented by urbanization, the impact of urban migration, challenges to health, and challenges of providing clean water. - Ed.

Cesar Chelala, MD, PhD, is an international public health consultant and a writer on human rights issues and foreign affairs.

In 2008, the world reached an important milestone: For the first time in history more than half of its human population - 3.3 billion people - were living in urban areas. By 2030, their number is expected to swell to almost five billion. Many of the new urbanites will be poor and their future will depend, to a large extent, on decisions made now.

Rapid urbanization is related in part to population growth and also to migration--both domestic and external--that many countries are experiencing. Frequently, the causes are rural poverty, the search for better social and employment opportunities, or flight from political persecution and violence.

An example of the last situation is the urbanization process in Colombia. Unlike that characteristic of most other Latin American countries the process in Colombia was stimulated, and to some extent defined, by episodes of violence, which occurred principally in rural areas. Since the 1930s, violence has been an inescapable fact of Colombian civilian life.

As families were uprooted and displaced by successive waves of violence, they fled en masse to the country’s main cities, where the majority among them now resides in poverty-stricken marginal areas. As a result of the violence either witnessed or experienced first-hand, many of Colombia’s young generation have internalized the culture of aggression into which they were born.

Colombia's case is certainly not unique. More recently, the rural poor in many other countries throughout the world have been uprooted by violence and forced to flee en masse toward the large urban centers. The recent tragedy in Haiti exemplifies a massive population movement of people from rural areas to the capital city of Port au Prince, where they ended up living in precarious tenements that were destroyed by the earthquakes that cost the lives of over 200,000 people.

Large migrations will intensify as changing climate conditions will lead to abandonment of flooded or arid and inhospitable environments. This will lead to serious health problems both from the various stresses of the migration process and from the civil strife that could be caused by the chaotic movement of people. Every year, climate change causes the death of approximately 300,000 people, and seriously affects 325 million, according to the Global Humanitarian Forum.

A climate refugee is a person who is forced to relocate, either to a new country or to a new location within their country, due to the consequences of global warming. Sometimes, climate refugees are classified as environmental refugees. The number of environmental refugees will reach 150 million over the next 50 years, according to Professor Norman Myers of Oxford University.

In Africa, desertification and its consequences in agricultural production is displacing increasingly large amounts of people. Approximately 10 million people in Africa have been forced to migrate over the last two decades as a consequence of desertification and environmental degradation.

In addition, most people in Africa move into mostly marginal urban areas because of poverty, environmental degradation, political persecution, and religious strife. In addition, food insecurity and lack of basic services in the rural areas encourage people’s migration into the cities, where they all too often end up living in marginal areas.

These marginal areas, known as bidonvilles in French-speaking West Africa, ishish in some Arab countries, kampungs in Indonesia, villas miseria in Argentina, favelas in Brazil, pueblos jóvenes in Peru, and ranchitos in Venezuela, may contain from 30% to 60% of the population of many Third World cities, according to Worldwatch Institute.

Many governments attempt to discourage migration from rural areas to the cities, but these measures are by and large unsuccessful. Since large cities enjoy preferential treatment in terms of infrastructure and industrial development, they serve as magnets for the "have-nots."

Regardless of the big city's allure, many observers now feel that conditions for the ever-growing numbers of urban poor are most likely worse than for their rural counterparts. The true dimensions of this phenomenon remain elusive, according to World Health Organization expert Dr. I. Tabibzadeh, because the poor are either omitted from official statistics or are not considered separately.

Migrations between countries also continue unabated, usually stimulated by similar factors responsible for internal migration. The Latin American country that has produced the greatest number of migrants is Mexico. Among Mexicans living abroad, 99% can be found in the United States, where income opportunities are greater. In the Southern Cone, Argentina is the main destination for migrants from Paraguay, Uruguay, and Bolivia. In Central America and the Caribbean, the U.S. is the most frequent destination, although there are also significant migratory flows from the Dominican Republic to Venezuela and Puerto Rico and from Haiti to the Dominican Republic.

Several European countries have attracted a large number of Africans and many Africans form Sub Saharan countries have migrated to north-African countries. In addition, the traditional pattern of migration within and from Africa is changing. A male-dominated process is becoming increasingly feminized.

Women’s migration is increasingly being affected by the host countries’ family reunification policies. But women are also traveling alone in search of better job and educational opportunities. In many cases, they end up working in low status, low wage jobs and are particularly prone to exploitation and abuse.

Migration within and from Asian countries is not a new phenomenon. The current trends and characteristics of migration in the region have been shaped by the political and economic changes in recent decades. It is estimated that more than six million migrants are working in East and Southeast Asia, one third of whom are in irregular situation. Until the recent economic crisis oil-rich Arab countries have attracted large numbers of Asian workers.

The economic, social and political trends influencing migration will continue for the next few decades. The challenge for governments is to design migration policies that take into account the needs of the migrants as well as those of the host population. Industrialized countries’ economic investments in developing countries as well as more fair trade policies can foster long-term cooperation and ease migration pressures.

- In this blog series, Dr. Cesar Chelala explores the many challenges presented by urbanization, the impact of urban migration, challenges to health, and challenges of providing clean water. - Ed.

Cesar Chelala, MD, PhD, is an international public health consultant and a writer on human rights issues and foreign affairs.

“Did you see this?” My colleague asked me in a hospital in Port-au-Prince, Haiti’s capital, in 2005. Regrettably, I had seen it. She was referring to a dead child covered by a sheet, flies buzzing around the corpse, seemingly abandoned in a hospital hallway. For days afterwards that sight was a recurring nightmare for me. It also was proof of the already desperate state of Haiti’s hospitals.

I went to Haiti twice, first in 1993 as head of a UN mission to determine the effects of the UN embargo on the population, and again in 2005 to assess the Pan American Health Organization’s efforts in the area.

After my first visit we concluded that although the embargo was worsening the status of the population, the greatest damage to Haitians was caused by the ineffectual and corrupt governments that had plagued the history of this suffering island, as well as by the deleterious influence of the colonial powers.

It would not be fair, however, to easily conclude that everything is wrong with Haiti. In my two visits I was impressed by the Haitians’ entrepreneurial spirit, even among the poor, and by their strong desire for progress and better education. I still remember emerging from my privileged Montana Hotel, now totally destroyed, and seeing clean, impeccably dressed children going to school. And I wondered where they were able to get the water for their basic needs.

I also learned that although the country has among the worst health status indicators on the continent and a high prevalence of HIV/AIDS, it also had one of the most effective programs for combating the infection (until the recent disaster.)

I saw what centuries of unregulated deforestation had caused to the country’s environment and how this deforestation would be a critical factor in worsening the negative effects of natural disasters such as the earthquakes the country has recently experienced. As if the Haitian people hadn’t already suffered enough . . .

Like many, I ask myself if there is a future for this country, and what shape that future will have, particularly after the first phase of reconstruction is completed.

I believe that Haiti’s natural and human resources should be the base for a strong new society, one that will right the many wrongs done to the country before. Some have proposed strengthening the country as a manufacturing outpost for industrialized nations, mainly the United States.

Although this point of view is not incorrect, it does not take into account the tremendous intelligence and resourcefulness of Haitians. Although the re-creation of a manufacturing base is important, it is only part of what Haiti needs. What is now necessary is a base for a sustainable future through agricultural renewal, education, a solid infrastructure, further development of tourism through the stimulation of artistic endeavors and, yes, manufacturing.

Haiti has long been a nation of farmers, even though the country has gone through one of the worst deforestation processes of any other country in the Americas. That is why reforestation –as had already been carried out, albeit in a limited way - and creation of a strong agricultural basis are critical. In order to accomplish these goals, Haiti needs other governments to cooperate in rebuilding agriculture in a sustainable, ecological way. But it also needs fair trade policies from industrialized countries, particularly the U.S.

There cannot be a rebirth of the country without a serious massive education effort. A national education plan can be created with input from teachers and administrators from other countries that wish to collaborate. The strides Haiti was making in the fight against HIV/AIDS show that, given appropriate support, the country can respond adequately to its needs. And the same is true for Haiti as a source of artistic creation, closely associated to its tourist potential.

Aside form the obvious rebuilding of houses, roads need to be built to facilitate the easy movement of people and goods throughout the country. It can be a most useful way of employing large number of workers who can stimulate local economies.

Over the years, a brain drain has evacuated top talent from the country. The collaboration of the Haitian diaspora is critical for the rebuilding of the country, a process that can be encouraged through the financing of temporary contracts with Haitian professionals and technicians living overseas. The degree of cooperation of national authorities and international aid organizations will determine the future of this suffering, noble country.

Cesar Chelala, an international public health consultant, is a co-winner of an Overseas Press Club of America award for an article on human rights.

¿Has visto esto? me preguntó mi colega Mariela Cánepa en un hospital en Port-au-Prince, la capital de Haití, en el 2005. Lamentablemente, lo había visto. Se refería a un niño muerto cubierto por una sábana, mientras las moscas zumbaban alrededor del cadáver, al parecer abandonado en un pasillo del hospital. Durante los días posteriores a la visita, esa imagen fue una pesadilla recurrente para mí. También fue una prueba de la situación ya desesperada de los hospitales en este injustamente castigado país.

Fui a Haití en dos oportunidades. La primero en 1993 como jefe de una misión de las Naciones Unidas para determinar los efectos del embargo de las Naciones Unidas sobre la población, y de nuevo en 2005 para evaluar la cooperación de la Organización Panamericana de Salud.

Después de mi primera visita, llegamos a la conclusión de que, aunque el embargo había agravado la situación de la población, el mayor daño a los haitianos fue causado por los gobiernos ineficaces y corruptos que habían plagado la historia de esta isla, así como por la influencia nociva de los potencias coloniales. Esa influencia nociva, particularmente de Francia, tiene efectos aun hoy en día.

Durante mi segunda visita en 2005, tuve oportunidad de experimentar lo que significa vivir en un clima de violencia, que es un factor cotidiano en la vida de este país. Habíamos decidido visitar Cité Soleil, para ver que servicios de salud estaban disponibles a la población. Cité Soleil es un área marginal localizada en el área metropolitana de Port-au-Prince.

Esta zona, donde vivían entonces entre 200.000 y 300.000 personas es una de las áreas más pobres, violentas y peligrosas de nuestro hemisferio, con una gran carencia de servicios básicos a la población. Para dar una idea de su peligrosidad la policía no se atreve a entrar allí.

Aunque la Misión Estabilizadora de las Naciones Unidas (MINUSTAH) está en Haití desde el 2004, siempre intentó, infructuosamente, tener control sobre esa zona, la que mantenía bloqueada con tanques armados. Cuando manifesté mi deseo de visitar esa área, me dijeron que la única forma de hacerlo era en un tanque militar armado.

A mi y a mi colega que me acompañaba en esta misión nos dieron sendos chalecos anti-balas y en un tanque con custodia militar nos acercamos a la zona. Una vez llegados allí, la custodia militar nos informó que no podía garantizar nuestra seguridad y que debíamos esperar por un par de horas en una barraca militar de Naciones Unidas localizada a la entrada de Cité Soleil.

Rodeados de soldados jordanos de Naciones Unidas esperamos un cambio en la situación. Allí pudimos ver de cerca la frustración de estos soldados jordanos al estar en una situación y un país para ellos totalmente desconocidos e incomprensibles. También pude ver su cara de felicidad y sorpresa cuando, utilizando las pocas palabras árabes que recordaba, me dirigí a ellos en ese idioma. Aun esa rudimentaria comunicación fue capaz de romper, transitoriamente, la monotonía en que viven allí estos soldados.

Al cabo de casi 3 horas, el jefe de nuestra custodia regresó y nos dijo que ellos no podían garantizar nuestra seguridad, por lo que tuvimos que regresar sin haber podido visitar esa zona. Un año más tarde, en Enero del 2006, dos de estos soldados jordanos fueron asesinados en Cité Soleil, triste corolario de una situación casi insostenible para ellos.

Cuando el primer terremoto asoló al país el 12 de Enero del 2010, su epicentro estaba localizado apenas afuera de la capital Port-au-Prince. Curiosamente, la mayoría de las casuchas de Cité Soleil resistieron el embate y los Médicos Sin Fronteras fueron capaces de reabrir el hospital localizado en el centro de esa zona. Los miembros de pandillas que escaparon de las prisiones luego de los terremotos están regresando a Cité Soleil, lo que aumenta notablemente la situación de inseguridad en esa zona.

No sería justo, sin embargo, llegar a la conclusión fácil de que todo está mal en Haití. En mis dos visitas, quedé fuertemente impresionado por el espíritu emprendedor de los haitianos, incluso de los pobres, y por su fuerte deseo de progreso y de una mejor educación. Todavía recuerdo que saliendo de mi privilegiada estadía en el Hotel Montana, ahora totalmente destruido, vi a los niños ir a la escuela, impecablemente limpios y bien vestidos. Y me pregunté cómo eran capaces de obtener el agua necesaria para cubrir sus necesidades básicas.

También aprendí que si bien el país tiene uno de los peores indicadores de salud sobre la situación del continente y una alta prevalencia de VIH / SIDA, también tenía uno de los programas más eficaces para combatir la infección (hasta los terremotos recientes que asolaron parte de la isla).

Vi también los efectos que siglos de deforestación no regulada han causado al país y a su medio ambiente, y cómo la deforestación podría explicar el mayor impacto que los desastres naturales han tenido sobre el país. Como si el pueblo haitiano no hubiera sufrido bastante. . .

Como muchos, me pregunto si hay un futuro para este país, y qué forma tendrá ese futuro, sobre todo después que la primera fase de la reconstrucción se haya completado.
Creo que los considerables recursos naturales y humanos que posee el país deben ser la base para una nueva sociedad, que compense los muchos errores causados antes al país.

Algunos expertos han propuesto fortalecer el país como un puesto de avanzada de fabricación de mercaderías para los países industrializados, principalmente Estados Unidos. Aunque este punto de vista no es incorrecto, sin embargo no tiene en cuenta la gran inteligencia y el ingenio de los haitianos. Aunque la re-creación de una base de fabricación es importante, es sólo parte de lo que Haití necesita. Lo que ahora se necesita es una base para un futuro sostenible a través de la renovación agrícola, la educación, una sólida infraestructura, un mayor desarrollo del turismo, mediante la estimulación de actividades artísticas y, sí, también de fabricación de mercaderías.

Haití ha sido tradicionalmente una nación de agricultores, aunque el país ha pasado por uno de los procesos de deforestación más marcados que cualquier otro país en las Américas. Por ello, la reforestación, como ya se había llevado a cabo, aunque de manera limitada - y la creación de una fuerte base agrícola son pasos críticos. Con el fin de lograr estos objetivos, otros gobiernos deben cooperar en la reconstrucción de la agricultura en forma sostenible, ecológica. Pero también Haití necesita políticas de comercio justo por parte de los países industrializados, en particular los EE.UU.

No puede haber un renacimiento del país sin un esfuerzo serio de educación masiva. Un plan nacional de educación se puede crear con la participación de los maestros y administradores de otros países que deseen colaborar. Los avances que Haití estaba haciendo en la lucha contra el VIH / SIDA indican que, dado el apoyo adecuado, el país puede responder adecuadamente a sus necesidades. Y lo mismo es cierto para Haití como fuente de creación artística, estrechamente asociada a su potencial turístico.

Aparte de la forma obvia de la reconstrucción de casas, se deben construir caminos para facilitar el movimiento fácil de las personas y bienes en todo el país. Esto puede ser una forma más útil de emplear gran número de trabajadores quienes pueden estimular las economías locales.

Con los años, una fuga de cerebros ha evacuado a los mejores talentos del país. La colaboración de la diáspora haitiana es fundamental para la reconstrucción del país, un proceso que puede ser estimulada mediante la financiación de contratos temporales a los profesionales y técnicos haitianos que viven en el extranjero. El grado de cooperación de las autoridades nacionales y organizaciones internacionales de ayuda determinará el futuro de este sufrido y noble país.

El 28 de Enero, un grupo francés de rescate encontró a Darlene Etienne, una joven de 17 años quien, increíblemente, había sobrevivido dos semanas bajo los escombros de un edificio. Sabemos que es difícil que nadie pueda sobrevivir por más de 72 horas sin agua, mucho menos dos largas semanas. Y aunque es posible que Darlene haya tenido acceso a un poco de agua de los restos de un baño ubicado cerca y, según se la oyó murmurar poco después del rescate, tenía con ella restos de una botella de Coca Cola, su sobrevivencia es casi milagrosa. En un periódico veo su cara llena de lágrimas y cubierta de polvo. Son las lágrimas secas de Haití.

César Chelala, consultor internacional de salud pública, es co-ganador del premio Overseas Press Club of América.

If anybody had any doubts about the influence of corporations in the United States political life, a recent Supreme Court ruling should dispel them. In a 5-4 decision, the U.S. Supreme Court decided, reversing itself, to allow unlimited corporate spending on political campaigns. The damage that this ruling will have on the country’s democratic process should not be underestimated.

The influence of money on US politics is not new. Michael Bloomberg, New York’s mayor, was able to run successfully for office three times thanks in part to the personal funds he infused into his political campaign. The impact of this Supreme Court decision is even more drastic, allowing corporations to invest as much money as they want on political campaigns, deciding in fact the outcome of the elections.

As Senator Russell Feingold, democrat from Wisconsin, has pointed out, this ruling “…means that Wall Street banks and firms, having just taken our country into its worst economic collapse since the Great Depression, could spend millions upon millions of dollars on ads directly advocating the defeat of those candidates who want to prevent future economic disaster by imposing new financial service regulations.”

The amount of corporate money influencing the outcome of elections is staggering. During the 2008 election process, Fortune 500 companies reported profits of over $743 billion, while $2 billion were spent by candidates and political parties during that election. Those profits are just part of the story, since the money corporations have in their treasuries are several times higher than that reported amount.

In its ruling, the Court ignored long standing principles that for over two centuries had gained the public’s respect for its decisions, including the principle of stare decisis, compelling the Court not to depart from its own precedents in the absence of exigent circumstances. In a dissenting opinion, Justice John Paul Stevens stated, “I am not an absolutist when it comes to stare decisis, in the campaign finance area or in any other. No one is. But if this principle is to do any meaningful work in supporting the rule of law, it must at least demand a significant justification, beyond the preferences of five Justices, for overturning settled doctrine.”

Until this decision, corporations and unions were banned from spending their treasury funds on broadcast ads, campaign workers or billboards urging the election or defeat of a federal candidate. After World War II, that prohibition was extended to labor unions. The Court’s conservative group stated that the corporations had the same right to free speech as individuals; therefore, the government could not stop corporations from spending money to help their favored candidates.

Justice Anthony M. Kennedy, who wrote the majority opinion and the most moderate voice among conservatives, stated that “The government may not suppress political speech on the basis of the speaker’s corporate identity.” What Justice Kennedy failed to mention is that this decision will be able to tilt the outcome of U.S. elections to corporate interests, including multinational and foreign corporations.

Although the damage to the democratic process caused by five out of the nine Justices may be mitigated (e.g., by shareholders directing corporate boards of directors to pledge not to use company money to influence elections), allowing corporate money to influence the electoral process has gravely undermined our democracy.

Cesar Chelala is a co-winner of an Overseas Press Club of America award.

The chaotic growth of today's cities can no longer be ignored. The great challenge is how to improve the quality of urban life by ensuring harmonious growth. Cities can--and should--learn from the experiences of other cities with similar characteristics. This effort requires not only the participation of urban planners but public health and environmental experts, politicians, and fundamentally, the communities themselves. Only when these actions are carried out will it be possible, perhaps, to reach that almost ideal situation heralded by Hippocrates some 2,600 years ago: a balance between the human organism and its environment.

When observing the chaotic, burgeoning growth of the modern city, the more erudite of urban planners will reminisce wistfully on how different it is from its ancient Greek counterpart, the polis, which Italian architectural historian Leonardo Benevolo once described as "dynamic but stable, in balance with nature, and growing manageably even after reaching large dimensions."

The rapid and uncontrolled sprawl of today's cities breeds anxiety not only among urban planners and architects. Experts in the field of public health are alarmed as well, for the apparent randomness of the urban dynamic is robbing the population of its basic health and well-being through unregulated environmental pollution, shrinking green areas, inadequate housing, overburdened public services, a mushrooming of makeshift settlements on the outskirts lacking in both infrastructure and services, mounting anomie and the sheer numbers of neighbors who do not know neighbors.

Beijing, a city of over 17 million inhabitants, exemplifies this social alienation. Until the early 1980s, the Chinese capital was constructed as a multitude of siheyuans, or one-story complexes built around a common courtyard that were inhabited by three or four families who shared a single kitchen and water spigot. These courtyards were connected by narrow streets called hutongs that formed a grid from north to south and east to west.

This open structure greatly facilitated contact between neighbors, encouraged the sharing of resources, fostered relations between contiguous families, and enabled the elderly to care for children and share with them their passion for songbirds. Because of these characteristics, these almost idyllic structures were described as "collections of small rural villages."

Until the mid-1980s, only a few skyscrapers disrupted the harmony of the landscape. Today that panorama has the look and feel of the ultimate modern city, where, with few exceptions, these "small rural villages" have been supplanted by sterile, towering skyscrapers. This striking change is not limited to external structure; it has also dramatically altered the fabric of human relations.

Physical isolation has led to an increase in crime, destroyed the local sense of solidarity, and contributed to the fragmentation of what were once cohesive family groups. As the distance between home and the workplace has also increased considerably, workers now find themselves devoting what was once valuable family time to exhausting commutes in overcrowded buses or subways.

According to Chen Xitong, a former mayor of Beijing, "the capital is growing increasingly ugly and it is steadily losing its Chinese character. Most of the modern high-rise buildings, with their boring concrete facades, look like dominoes set down in the landscape without plan and without imagination."

This situation, of course, is not limited to China. In many Latin American cities, old colonial mansions of considerable historic and architectural value are being replaced by huge apartment buildings unrelated to the character of the neighborhood. A new kind of war is being waged in cities throughout the world: Esthetics vs Profits.

- In this blog series, Dr. Cesar Chelala explores the many challenges presented by urbanization, the impact of urban migration, challenges to health, and challenges of providing clean water. - Ed.

Cesar Chelala, MD, PhD, is an international public health consultant and a writer on human rights issues and foreign affairs.

It is an unusual story of how a teacher is bringing books, and culture, to the children in a small community in Colombia. And how, through his personal effort, he may be changing a culture characterized by extreme violence into one of peace.

Since the decade of the 1930s violence has been an inescapable component of Colombian society. From 1948 to 1957 the country went through a civil war known as “La Violencia” which left over 250,000 dead, the result of old rivalries between people from the Liberal and Conservative parties. These incidents created the framework for the extreme violence in Colombian society today.

As a consequence of waves of violence and political persecution, whole families left their homes to live in bigger cities. They usually ended up living in the most marginal and poor areas lacking basic health and social services.

In the 1980’s new factors contributed to the perpetuation of this culture of violence in the country. One of the most important was the dissemination of cocaine and the incorporation of youngsters into the drug trade. Other factors were the economic crisis and the proliferation of guerrilla groups whose activities continue today. Colombia thus became one of the most violent countries in the world.

Inevitably, violence affected all activities of civilian life, such as education. According to some estimates, Colombia now has a 20 percent illiteracy rate, which can be much higher in rural areas affected by violence. In addition, functional illiteracy is also high, due in large measure to the lack of reading materials and libraries in those communities.

Ten years ago, a rural teacher, Luis Soriano Boroquez, had what for many was a crazy idea: to bring books to children in the municipal department of Nueva Granada. He had two unusual allies, two donkeys called Alfa and Beto. It is from them that his adventure got his name: he called it “Biblioburro,” or “donkey’s library.”

Every weekend, this elementary school teacher from the co-ed school of La Gloria loads his donkeys with 70 to 120 books (Alfa is the one that carries most of them) and travels distances from three to eleven kilometers each day bringing books, and culture, to rural children. Every trip takes him up to eight hours each day.

The idea for his library, he explained to the New York Times, came to him after he saw the transformative power of reading among children in a very conflictive area in Colombia. His aim is to fight illiteracy and to help children do research for their homework and provide them with reading materials that they don’t have in their village.

As soon as the first child sees him coming he rushes back to call his companions who come and accompany the teacher as in a parade. When the teacher reaches a village he chooses an empty space. There, he displays a makeshift table where some children do their homework while the rest sit in the grass reading and playing.

Initially, Soriano collected the books in his own house, where he lives with his wife Diana and three children, with the books piled up to the ceiling. But given the demand for books among rural children, and with the financial help of Cajamag, a local financing institution, he recently finished building a small library that has almost four thousand books.

What began as a need son became an obligation on his part, then a custom and now, with the construction of the library, it is an institution. “What I want to do,” Soriano explained, “is to teach children their rights, duties and responsibilities. When they get to know them, every child we teach through Biblioburro,” he added, “becomes an informed citizen who can say no to war.”

Although the new library now serves a small community of 200 children, Soriano still continues his outreach activities during weekends. “Doing this is my life commitment,” he declared to Valentina Canavesio, an independent film producer, “I want to be useful to the society I belong.” Soriano feels that his work contributes, in a small but significant way, to bring peace to his beleaguered country.

Watch this video at Ayoka Productions

Cesar Chelala, a co-winner of an Overseas Press Club of America award, is a writer on human rights issues.

It was a chilly morning in Manhattan late in March. I was on my way to a doctor’s office when I was stopped by a middle-aged black man leaning on a stick he was using as a cane. Although he was dressed in suit and tie, his clothes were dirty and wrinkled. There was a discrepancy between his appearance and the precise, elegant manner of his speech.

“Please tell me where the nearest hospital is, aside from this one,” he asked me, pointing to the hospital that was just across the street. I told him that the nearest hospital was Bellevue, a good mile and a half away by bus and subway. Since he was obviously in pain, I suggested that he try this hospital instead.

“They wouldn’t take care of me. They claim that Bellevue is closer to where I live. But it is not close to here, and I cannot walk that far.” He told me that two weeks before he had been hit by a bus. “Yesterday, somebody stole my crutches, and now I am very much in pain.”

I questioned him about his occupation and where he came from. “I am an accountant form Nigeria. But I have had bad luck in this country and want to go back to Nigeria. I would like to save some money to do it, but I spent the money I had because of the accident.”

I thought that he could use a few dollars to pay for the taxi to Bellevue, so I gave him $10 and said good-bye.

“Wait!” he said, “Give me your name and address. I want to pay you back!” “No,” I said, “that’s fine, don’t worry about it.” “But,” he said, evidently surprised, “you are giving me money, just like that?” “Well,” I answered, “I am also a foreigner, and I know how it is to go through a difficult time away from one’s own country.”

As I was leaving not to be late for my appointment, he turned around and looked at me sadly. “My name is William,” he said, “in case we meet again.”

Cesar Chelala is a writer on human rights issues.

Years of war, bad government, corruption and poverty have left Afghanistan with the highest infant mortality rate in the world, according to UNICEF. More than one out of every five children are dead by the time they are five.

The statistics are frightening. More than 60% of all child deaths and disabilities are due to respiratory and intestinal infections, and of such vaccine preventable deaths as measles. Diarrhea kills tens of thousands of children every year. Many also die from severance of breast-feeding before time. An estimated 7.5 million children and adults are at risk from hunger and malnutrition, the latter affecting children's growth in particular.

Some cities, such as Jalalabad, the largest city in eastern Afghanistan located at the junction of the Kabul and Kunar rivers, are high risk areas for polio due in large part to the massive and continuous population movements from and into polio infected areas. In South Asia in 2000, over 40 percent of the confirmed cases of polio occurred in Pakistan and Afghanistan.

Afghanistan is also one of the most heavily mined nations in the world and has one of the highest proportions of disabled people as a result. It is a well-known fact that children are landmines’ most vulnerable victims as they play, go back and forth to school, tend animals or scavenge.

To control the spread of disease, UNICEF and the Department of Public Health in Nangarhar have launched the “Women Courtyard” initiative, aimed at providing local women with information about polio and other vaccine-preventable diseases, as well as such related issues as hygiene and water-borne illnesses. While this is an important initiative, certain popular traditions may well constitute a barrier to its successful conclusion. One such tradition is that babies not leave their homes before the 40th day after birth, a tradition which prevents many newborns from being vaccinated in good time.

To make matters worse, deadly attacks have targeted schools and impeded access to critical health care. According to Daniel Toole, the UNICEF Director for South Asia, “We have had attacks on villages and on schools by both anti-government elements as well as by coalition forces and international troops that have hit civilians”.

Not a single child growing up in Afghanistan today has known peace in his/her lifetime. Deteriorated mental health is one of the consequences of a permanent state of war. A UNICEF study has found that the majority of children under 16 years of age in Kabul suffer from psychological trauma resulting in serious mental health problems including psychiatric disorders and post-traumatic stress syndrome.

Children in Afghanistan are exposed not only to violence related to acts of war but also to violence resulting from accidents, beatings by close relatives or neighbors or seeing close relatives being beaten or executed. As a recent study published in the Lancet has pointed out, “In Afghan children’s lives, everyday violence matters just as much as militarized violence in the recollection of traumatic experiences.”

Daniel Toole, the UNESCO executive, remarked recently at a press briefing in Geneva, “Afghanistan today is without doubt the most dangerous place to be born,” a sad commentary on that beleaguered country.

Cesar Chelala, MD, PhD, is an international public health consultant. He has written extensively on child health issues.

On Human Rights Day it is appropriate to remember one of the towering figures for peace, Dr. Albert Schweitzer. I recall a visit I made to Lambaréné, in Gabon, a couple of years ago. It was there that the famous Dr. Schweitzer had carried out his humanitarian work, saving the lives of thousands of patients with total dedication to their health and well being. His is a lesson that we should listen to today.

I was at Cité Soleil, where a community of lepers still lives, created as a special ward next to the hospital. During my visit, three men were sitting on a bench, one of whom was trying to fix a violin, his hands ravaged by disease. I took out my camera and was ready to take his picture when he told me, “Don’t shoot!”

Startled by his reaction, I asked him why he didn’t want his picture taken. As he continued working on his violin he told me, “You don’t even bother to say hello, you don’t ask for our permission and you want to take our picture?” I apologized, greeted him properly and asked his permission for a photograph. He readily agreed.

That man taught me an important lesson. Although my intention had not been to show him any disrespect, that is what I was essentially doing. I felt I had the right to take his photograph because I thought it was an interesting shot, but I hadn’t respected his right to say no. That he was a leper who had probably encountered much disrespect in the past made my insensitivity even worse.

The man’s assertiveness about his rights and the atmosphere of quiet pride in Cité Soleil, I realized, were no accident. Dr. Schweitzer was remarkable because of his devotion to the needs of those less fortunate. He left a brilliant professional career as a musician and a theologian to become a physician. He then moved to Africa with his wife, built a hospital in Lambaréné from what had been a chicken coop, and devoted his life to treating thousands of patients out of an irrepressible sense of personal duty.

Looking at a herd of hippos in the Ogowe River, close to the hospital, Dr. Schweitzer strengthened his commitment to the need to revere life: “The greatest evil is to destroy life, to injure life, to repress life that is capable of development.”

I couldn’t help comparing Dr. Schweitzer’s approach to life to what is happening in today’s world, when we live in what seems to be a permanent state of war and where the reasons for going to war are becoming more and more irrelevant. To make things even worse, in today’s world many times religion is used as an excuse to destroy, not to improve life.

People today speak of a clash of civilizations, when the real clash is the lack of respect for the other, the lack of dialogue, the lack of effort to understand each other. As the American philosopher Sam Keen says in his poem How to Create an Enemy, “…Trace onto the face of the enemy the greed, hatred, carelessness you dare not claim as your own…”

Today we desperately need people of Dr. Schweitzer’s stature. We need to follow his philosophy, based on an essential respect for life. As he constantly stressed, the progress of civilization is closely linked to a conception of the importance of life. Only those who say yes to life, to the world in which we live, are capable of making civilization progress.

Although the medical work at the hospital continues after his death, his message of peace has been lost in today's world, ravaged by sinister wars and unnecessary loss of life. Standing in his room and feeling the force of his personality, I thought that later generations have betrayed his legacy of peace.

When we look up in horror to the destruction of a country through a war based on false premises, at the decades of conflict between Palestinians and Israelis, at the wars in Afghanistan and Pakistan, we need to remember Dr. Schweitzer’s words in a 1963 letter to President John F. Kennedy, “The goal toward which we should direct our sight from now to the farthest future is that we should not let war decide issues that separate nations, but we should always try to find a pacific solution to them.”

We will reach that understanding only through dialogue with those who think in different ways from us, when we learn to listen to their concerns and fears. Perhaps then Dr. Schweitzer’s guiding principle will become a reality, “I am life that wants to live, surrounded by life that wants to live.”

Dr. Cesar Chelala, a writer on human rights issues, is a co-winner of an Overseas Press Club of America award for an article on human rights.

The HIV/AIDS pandemic is killing teachers at alarming rates in many developing countries, especially in sub-Saharan Africa. As a result, it is delivering devastating blows to the health, future job possibilities and quality of life to students in those countries. These observations are supported by a World Bank study that warns that in some countries AIDS is killing teachers at a faster rate than replacements can be trained.

Why are these teachers so susceptible to HIV/AIDS? Teachers in rural and impoverished areas in developing countries make more money than the general population. They travel more and are more able to afford illicit unions with infected students and other women they meet. In many of these countries, women are taught to be submissive to men, particularly men in positions of authority. Male teachers may feel entitled to exploit this submissiveness from women.

As a consequence of the HIV/AIDS pandemic, there is increased teacher absenteeism and loss of educators, inspectors, planners and management personnel. Although these losses are more evident in sub-Saharan African countries, they occur throughout the developing world. The pandemic affects not only the access to education but the quality and management of education at local, regional and national levels.

According to some statistics, almost 30 percent of teachers in South Africa are HIV positive, a higher infection rate than in the general population. In Ivory Coast, every week, six teachers die of AIDS, according to a 1998 government study, and the number has probably gone up since then. In several places, private spending on educational fees and other expenses fell almost by half in households with someone with AIDS.

In Zambia, two teachers die for every one that graduates from training school. A Grade 4 school (smallest school) in Zambia has an average of five teachers. Statistics from Zambia's ministry of education show that one teacher dies every day from AIDS-related diseases. This is the equivalent of the ministry of education closing down one school per week due to loss of teachers.

According to UNAIDS estimates, the annual per-capita income of half the countries of sub-Saharan Africa is falling by 0.5-1.2 percent and the GDP in the most-affected countries may decline by 8 percent by 2010. Because of its economic impact, AIDS is reversing decades of slow improvement in child survival, life expectancy, educational progress and economic growth.

In many cases, teachers themselves are poorly informed or not informed at all regarding HIV/AIDS prevention. Teachers need to be better educated not only about HIV/AIDS and its transmission, but also on how to become better advocates in the fight against the infection.

Paradoxically, education itself can be a formidable weapon against AIDS. Several studies have shown that infection rates are lower among educated women. In the 1990s, HIV infection rates in Zambia fell by almost 50 percent among educated women, while there was almost no decline in those who hadn't gone to school. In Uganda, infection rates are lower among girls who have attended high school.

It is crucial to introduce life-skills curricula early in primary school, since HIV-prevention activities have been shown to be more effective among youngsters who are not yet sexually active. Among the important components of the life-skills curricula are issues of gender equity, methods to develop healthy lifestyles and healthy reproductive attitudes, and an understanding of when and how to protect oneself from the HIV infection. Life skills should be taught in an environment with other HIV-prevention interventions.

It is also critical to empower women when they are young. This can help them deal better with sexual advances by teachers and other men. In several countries, there is the widespread belief that by having sex with young women, men can be cured of AIDS.

Because of both biological and cultural reasons, girls ages 15 to 24 in Africa are several times more likely than boys of the same age to be infected with HIV. In Africa, almost 60 percent of HIV-infected people are female, and among teenagers infected with HIV, more than 75 percent are girls. Sex education, when combined with improved communication skills, often leads to delayed sexual initiation, to fewer sexual partners and to increased use of condoms.

At the same time, governments have to make provisions to replace the current and estimated future loss of personnel in the education sector. Among those provisions is the need to develop new technologies and alternative and innovative ways of making AIDS education available to children. At stake are not only children's lives, but also the countries' future development.

Dr. Cesar Chelala is an international medical consultant and the author of "AIDS: A Modern Epidemic," a publication of the Pan American Health Organization. He writes extensively on HIV/AIDS issues.

AIDS is increasingly becoming a serious threat to women, particularly in developing countries. According to the World Health Organization (WHO), AIDS-related illness is the leading cause of death and disease among women of reproductive age in low and middle income countries, particularly in Africa.

While in 1985 there were as many HIV infected men as women in sub-Saharan Africa, women’s infection rate has steadily increased and now the number of HIV infected women is larger than HIV infected men. To date, approximately three quarters of all women with HIV live in sub-Saharan Africa.

There are several reasons for this vulnerability. Women and girls are particularly susceptible to be infected due to biological, social, cultural and economic factors. The female genital tract has a greater exposed surface area than the male genital tract, making it more prone to infection with every exposure. Younger women may be even more vulnerable because they are more often victims of coercive or forced sexual relations with men who may already be infected.

Women who are victims of sexual violence are at a higher risk of being exposed to the infection. According to a South African study, women who were dominated or beaten by their partners were much more likely to be infected with HIV than women who were not. Abusive husbands were more likely to be infected with HIV than non-abusive husbands, according to a study in India involving 20,425 couples.

Women’s lower socio-economic status may also lead to high risk behaviors and make them less able to seek information they need to keep themselves safe. Globally, only 38% of young women were able to describe the ways to avoid infection and less likely than men to know that condoms can protect against the HIV infection. Particularly in sub-Saharan Africa, HIV prevalence is generally higher among adolescent girls aged 15-19 than among their male counterparts.

In addition, many young girls enter into sexual relationships with older men who are more sexually experienced, more powerful and are more likely to be infected and thus able to infect them. “We need to help young people develop the skills for mutual consent in sex and marriage and put an end to violence and sexual coercion,” stated Michel Sidibe, Executive Director of UNAIDS.

It has been shown that violence, or even the threat of it, can lead women to avoid HIV prevention, treatment, and care and support services. The problem of violence against women is exacerbated in countries at war, where in many cases rape is used as a “tool of war.” In some cases, women have been intentionally infected with HIV, so as to provoke a “slow death.”

In many societies, women are at an economic disadvantage with regard to men. In sub-Saharan Africa, for example, property is generally owned by men, and even when they are married, women don’t have as many property rights as their husbands. Lack of property also means limited economic stability and, as a result, an increase in the possibility of sexual exploitation and violence.

Major inequalities between men and women in all aspects of living persist in many parts of the world, such as employment and education opportunities and power imbalances within relationships. In those situations, gender roles limit women to positions where they lack the power to protect themselves from physical abuse and from HIV. Gender inequalities prevent women from asserting their rights and controlling the circumstances that increase their vulnerability to infection.

As a response to this situation international development organizations have stepped up their work on the promotion of women’s basic rights. Recognizing and challenging stereotypes and harmful gender roles is crucial to preventing the spread of HIV. It is important to understand, however, that programs that focus on men and the need to change their stereotypical behavior also need to be implemented. Defeating HIV and AIDS is everyone’s responsibility.

Cesar Chelala, MD, PhD, is an international public health consultant and the author of “AIDS: A Modern Epidemic,” a publication of the Pan American Health Organization.

One thing is certain in these uncertain times. The Middle East process, as conducted until now, is dead. New alternatives must be tried to revive it and a unilateral declaration of statehood by Palestinians should be seriously considered.

Such an option wouldn’t have universal support. Hamas has rejected it and, in a rare show of agreement, the U.S. most surely would veto it if presented to the U.N. Security Council. That measure, nonetheless, has the support of some Israelis. A recent newspaper add by Gush Shalom, one of the best known peace groups in Israel reads, “We shall welcome the declaration of the Free State of Palestine.”

What could lead Palestinians to follow such a drastic course? One reason is that, on one of the more contentious issues, the building of settlements, no progress has been achieved. For the past 25 years, every US President has tried to persuade Israel to stop building settlements in Palestinian lands to no avail. And this is just one of the issues separating Israelis and Palestinians.

The position held by the Palestinians is that they have already made important concessions by accepting a state covering only the areas of the West Bank, Gaza and East Jerusalem which are significantly smaller than the territory allocated to the Arab state in UN Resolution 181.

At the time of that resolution, which recommended the division of the British Mandate of Palestine into two provisional states, one Jewish and one Arab, the UN General Assembly also recommended that the City of Jerusalem be administered by the United Nations. This could be one of the options to overcome the present impasse on the status of that city.

Israel most probably would reject a Palestinian declaration of independence as it did in 1978 during the Camp David negotiations between Israel and Egypt when Anwar Sadat, Egypt’s president, proposed the creation of a Palestinian State in the West Bank and Gaza.

There is also an important precedent regarding the status of Jerusalem. At the Annapolis conference of 2007, Israel’s Prime Minister Ehud Olmert made an important proposal. He offered East Jerusalem as the capital of Palestine and 99.3% of the West Bank to the future Palestinian State. His position, however, was strongly criticized by Israel’s right wing political parties.

Ovadia Yosef, the spiritual leader of the Shas party, threatened that his party would leave the government coalition, thus ending the coalition’s majority in the Knesset, if Olmert agreed to divide Jerusalem. Mahmoud Abbas rejected the offer due to the non-inclusion of the Gaza Strip and continuing settlement construction.

A unilateral declaration of statehood is fraught with complications, although it would follow on the steps of Israel’s unilateral declaration of independence on 1948. Israel’s Prime Minister Netanyahu has warned Palestinians that such a declaration would lead to Israeli counter-measures that could include annexation of more of the occupied West Bank, a move that is clearly illegal from the point of view of international law and of the UN Security Council Resolution 465.

In addition, such a move would surely be vetoed by the U.S. at the U.N. Security Council. However, as the noted Israeli journalist Gideon Levy recently stated, “Israel is so much not willing to make peace, someone has to push Israel, and the only actor who can push Israel is the United States.”

By many criteria, a unilateral declaration of statehood by the Palestinians is an expression of desperation. But it is also an act that can give them a much needed sense of belonging to the community of nations. As stated by the late Palestinian poet Mahmoud Darwish,“…we declare our presence as a wound crying in the depths of time and space in spite of the tempests which try to rend our roots from the very earth to which we gave our name.”

Cesar Chelala, a co-winner of an Overseas Press Club of America award, is the foreign correspondent for the Middle East Times International (Australia).

It can be considered one of the most unequal battles in the world today. It pits a group of indigenous people in Ecuador, almost totally devoid of material resources, against one of the most powerful oil corporations in the world.

From 1964 to 1992, Texaco (which later merged with Chevron and now is called Chevron-Texaco) carried oil exploration and exploitation activities in the Ecuador area of the Amazon. However, drilling for oil without adequate safeguards is one of the most destructive industrial activities both for people and for the environment. This danger has been particularly stark in the case of these activities conducted in the forested areas of the Amazon basin.

Accused of polluting significant portions of the Amazon region, Chevron-Texaco is now facing a multibillion-dollar law suit. The outcome of this battle –expected before the end of this year- may demonstrate how far U.S.-based and other multinational companies can be held accountable for their deeds.

Drilling for oil produces several substances and waste products, which are stored in special pits. If these pits are not properly lined, toxic materials can contaminate surrounding areas. Once toxic waste leaks into water basins, rivers and lakes, it kills fish and makes people and livestock ill, at times threatening their very survival.

Oil activities conducted by Chevron-Texaco in the northeast Amazon region in Ecuador have caused significant environmental damage and serious health consequences for the indigenous population. Chevron-Texaco spilled more than 70 billion liters of toxic waste into 900 unlined pits in an area of more than 5,180 square kilometers. This toxic dumping has affected an indigenous community of 30,000 and has led to the loss of 1 million hectares of rain forest. Experts believe this is the worst oil-related contamination on the planet.

The health damage incurred by the indigenous population has been documented in the village of San Carlos, which contains more than 30 oil wells constructed by Chevron-Texaco. One of the first studies on the effects of oil pollution on people's health in that village was carried out by two medical doctors in collaboration with the University of London's Department of Tropical Medicine and Hygiene. The study, called the "Yana Curi" report (yana curi is the local indigenous term for "oil" or "black gold"), found that cancer rates in San Carlos exceed the average by up to 30 times.

For several years the residents of San Carlos had been exposed to more than 3.8 million liters of oil and toxic waste-water dumped by Chevron-Texaco. Exposure occurred through several routes, including absorption through the skin, ingestion of contaminated food and water, and inhalation of oil and related gases.

Additional evidence on the health effects provoked by improper oil-exploitation techniques was provided by Richard Cabrera, an expert appointed by the court. After reviewing all the data in evidence and several health studies Cabrera, along with a team of 14 technical officials concluded that 1,401 excess cancer deaths in the region were due to oil contamination.

It is estimated that the water used by local residents for drinking, bathing and laundering contains nearly 150 times the amounts considered safe for substances such as hydrocarbons. The study also found the risk of cancer of the stomach, liver, bile duct and skin for those living in San Carlos was more than double the average. Chevron-Texaco claims that these results were only preliminary and not worth analyzing.

Chevron-Texaco has used inadequate extraction techniques, in the process spilling waste products into creeks and rivers rather than pumping it back into the ground as is commonly done elsewhere. Because of pipe breakages, the amount of crude pumped into the ground was nearly double the volume spilled into Alaska's Prince William Sound by the Exxon Valdez in 1989.

In November of 1993, a class-action lawsuit on behalf of residents of the rain forest area known as Oriente was launched in a U.S. District Court in New York, close to Chevron-Texaco's world headquarters in Westchester County. Although the plaintiffs wanted the case to be tried in New York, a federal appeals court in New York ruled that it should be conducted in Ecuador. But in an important decision, the court also stated that any judgment against the oil company would be enforced in America. U.S. courts will also reassert jurisdiction if Chevron-Texaco refuses to cooperate with the litigation in Ecuador.

The suit charges that Chevron-Texaco dumped nearly 70 million liters of toxic waste into hundreds of unlined open pits, and from there it seeped into estuaries and rivers from 1964 to 1992, thus exposing residents to carcinogenic pollutants. The plaintiffs want a thorough cleanup of the area, an assessment of the long-term health effects of the contamination and damage compensation, which could total $ 27 billion.

If Chevron-Texaco is found liable in a fair trial, it will be not only a victory for the environmental movement but also for the thousands of indigenous people whose survival and quality of life have been affected by the careless exploitation of oil on their lands.

Cesar Chelala, M.D., Ph.D., is an international public-health consultant and an award winning writer on human rights issues. He is the foreign correspondent for the Middle East Times International (Australia).

It is impossible to win a war that you cannot define. That seems to be the main lesson to be drawn from Afghanistan, where a so-called victory seems ever more unreachable. It is also the conclusion of several experts on the region, who fear U.S. forces would be mired forever in that unjustly punished country.

Sometimes, people not geared for war can offer insights into a war situation that professional warriors cannot do. In 2001, U.S. writer Philip Caputo offered a unique insight into the Afghan psychology. He had spent a month in Afghanistan with the mujahedeen as a reporter, during the Afghans’ decade-long war with the Soviets.

At some point in the 1980s, he was accompanying a platoon of mujahedeen who were escorting 1,000 refugees into Pakistan. They had to cross a mountain torrent on a very primitive bridge, consisting essentially of two logs laid side by side. In front of him was a 10-year-old boy, separated from his family, his feet swollen from several days of barefoot marching.

When Caputo realized that the boy was terrified thinking that he could fall into the rapids below, he carried him to the other side. With the help of his interpreter he found the father and handed the boy to him. The father, rather than thanking him slapped the boy in the face and poked Caputo in the chest, shouting angrily at him. Caputo was obviously shocked.

He asked his interpreter about the boy father’s reaction and the interpreter explained to him, “He is angry at the boy for not crossing on his own, and angry with you for helping him. Now, he says, his son will expect somebody to help him whenever he runs into difficulties.”

Caputo concludes, “Well, that little boy probably learned. I don’t know what became of him, but in my imagination, I see our troops encountering him: now 31, inured to hardship and accustomed to combat, unafraid of death, with an army of men like him at his side.”

In a few words, Caputo magisterially captured the strength of the Afghan soldier, able to fight with the most primitive weapons against the greatest empires on earth. When these soldiers feel their land usurped by foreign forces, their strength is multiplied. And this is just one of the obstacles confronting U.S. and NATO forces in Afghanistan.

There are increasing doubts that a plain increase in the number of soldiers fighting in Afghanistan can lead to a victory progressively more difficult to define. Matthew Hoh, a former Foreign Service officer and former Marine Corps captain who became the first U.S. official to resign in protest over the Afghan war, declared to the Washington Post, “Upon arriving in Afghanistan and serving in both the East and South (and particularly speaking with local Afghans) I found that the majority of those who were fighting us and the Afghan central government were fighting us because they felt occupied.”

Can an increase in the number of foreign forces subdue a naturally proud and nationalistic people? In an interview with the German magazine Der Spiegel, U.S. National Security adviser Mr. James Jones offered a sobering view. When asked whether he agreed with General Stanley McChrystal, the top U.S. and NATO commander in Afghanistan, that a troop increase was needed he responded, “Generals always ask for more troops….You can keep on putting troops in, and you could have 200,000 troops there and Afghanistan will swallow them up as it has done in the past.”

Afghanistan has been called the graveyard of empires. It should more properly be called the graveyard of illusions.

Dr. Cesar Chelala, the foreign correspondent for the Middle East Times International (Australia), is a co-winner of an Overseas Press Club of America award.

The disastrous effects of the Russian invasion on Napoleon Bonaparte’s army are well known. Less widely known are the reasons for the defeat of the Grand Army. Although Russian resistance, brutal weather and the lack of food and water decimated the French army, new genetic evidence proves that Pediculus humanus, otherwise known as body lice, had a key role in the debacle.

Researchers led by Dr. Didier Raoult unearthed 2 kg of material containing bone fragments, clothing remnants, and segments of body lice from soldiers buried in a mass grave in Vilnius, the capital of Lithuania. Analysis of the material proves that almost one-third of those buried there were affected by louse-born infections such as typhus and trench fever.

Raoult and his colleagues from the University of the Mediterranean, Marseille, France, studied segments of body lice as well as the dental pulp from soldiers’ teeth. The dental pulp revealed DNA from Bartonella quintana and Rickettsia prowazekii, the agents that cause trench fever and epidemic typhus, respectively. When the DNA of such pathogens is present in teeth, the team concluded, it is very likely that the organism was the cause of death.

Typhus fever and typhoid fever are two different entities. While typhoid fever is a water-borne disease caused by a bacillus, typhus fever derives from a class of organisms that are carried by lice and are between a large bacterium and a virus in size. Under epidemic conditions, the typhus mortality rate nears 100 percent.

In 1812, Napoleon marched into Russia with 500,000 soldiers, leading what up to then had been Europe’s largest army. By the time the French army reached Moscow, only 90,000 soldiers out of a central force of more than 300,000 remained.

Conquering Moscow proved to be a Pyrrhic victory, for most of the capital’s citizens had already abandoned the city and set fire to it. There was almost no food, no shelter, and typhus raged among the soldiers. The only option was retreat.

Until recently, it had been assumed that Russia’s brutal winter was one of the main causes of the French soldiers’ deaths. This idea had been buttressed by Napoleon’s report to the Senate on Dec. 20, 1812: “My army has had some losses, but this was due to the premature rigor of the season.” He thus tried to deflect criticism of his bad decisions during the campaign.

One decision that proved particularly costly was to continue the march toward Moscow despite tremendous loss of life during the march and his own generals’ desperate pleas to halt the invasion. Undaunted, Napoleon answered his generals: “The very danger pushes us on to Moscow. The die is cast. Victory will justify and save us.”

In December 1812, the retreating army reached Vilnius with only 7,000 soldiers and 20,000 stragglers. From there they continued their retreat, leaving the sick and wounded in Vilnius. Those who died there were buried in mass graves.

Napoleon’s Grand Army was destroyed during the invasion of Russia. Of the more than 400,000 military deaths, 220,000 can probably be attributed solely to typhus. A great dream had become a great nightmare.

Although historians had assumed that disease played a big part in dooming the invasion of Russia, the investigation by Raoult and his colleagues provides the first solid evidence in support of this belief. The confirmation by a team of medical researchers that typhus transmitted by lice was one of the main reasons for Napoleon’s defeat shows the value of their technique in helping to reinterpret history.

That Europe’s most powerful army was defeated by a humble microbe should be cause for sobering reflection in these troubling times.

Dr. Cesar Chelala is an international public health consultant and the winner of an Overseas Press Club of America award for an article on human rights.

In what can be considered a sad paradox of history, an analysis of the Israel Defense Forces (IDF) actions during Operation Cast Lead in Gaza shows that the IDF violated several of the Nuremberg Principles, as well as the principles of the Geneva Conventions.

The Nuremberg Principles, a set of guidelines established after World War II to try Nazi Party members, were established to determine what constitutes a war crime. The Geneva Conventions consist of four treaties and three additional protocols that establish the standards in international law for humanitarian treatment of the victims of war.

According to Nuremberg Principle I, “Any person who commits an act which constitutes a crime under international law is responsible therefore and liable to punishment.” As detailed in the “Report of the United Nations Fact Finding Mission on the Gaza Conflict,” also known as the “Goldstone Report,” several crimes against unarmed civilians were committed by the IDF during Operation Cast Lead in Gaza.

The UN Mission investigated 11 incidents in which the IDF launched direct attacks against civilians with lethal outcome. The facts in all except one case, states the Mission, indicate no justifiable military objective. According to the report, “From the facts ascertained in all the above cases, the Mission finds that the conduct of the Israeli armed forces constitutes grave breaches of the Fourth Geneva Convention in respect of willful killings and willfully causing great suffering to protected persons and, as such, give rise to individual criminal responsibility. It also finds that the direct targeting and arbitrary killing of Palestinian civilians is a violation of the right to life.”

Both Israeli government and military officials are responsible for the IDF actions during Operation Cast Lead. As Nuremberg Principle III states, “The fact that a person who committed an act which constitutes a crime under international law acted as Head of State or responsible government official does not relive him from responsibility under international law.”

It has been argued that those that were following orders are not guilty of crimes, and the responsibility for those crimes falls on the superior officers. However, Nuremberg Principle IV states that, “The fact that a person acted pursuant to order of his Government or of a superior does not relieve him from responsibility under international law, provided a moral choice was in fact possible to him.”

Nuremberg Principle VI establishes three kinds of crimes punishable as crimes under international law: crimes against peace, war crimes and crimes against humanity. Among crimes against peace are those crimes “involving planning, initiation or waging of a war of aggression or a war in violation of international treaties, agreements or assurances.”

Although the Government of Israel has the duty to defend its citizens, it is clear that Operation Cast Lead was a war of aggression against Gazans, out of any reasonable proportion and aimed at inflicting massive damage on Gaza’s civilian population. According to a study carried out by B’Tselem, an Israeli human rights organization, 1,387 Gazans were killed during operation Cast Lead, a figure that includes 773 civilians and 330 combatants.

Among the war crimes established by Nuremberg Principle VI are the, “…plunder of public or private property, wanton destruction of cities, towns or villages, or devastation not justified by military necessity.” The UN Mission investigated several incidents involving the destruction of industrial infrastructure, food production, water installations, sewage treatment plants and housing. Among the installations destroyed by the IDF was the el-Bader flour mill, the only operating flour mill in Gaza.

As stated in the UN report, “…the Mission finds that there has been a violation of the grave breaches provisions of the Fourth Geneva Convention. Unlawful and wanton destruction which is not justified by military necessity amounts to a war crime. The Mission also finds that the destruction of the mill was carried out to deny sustenance to the civilian population, which is a violation of customary international law and may constitute a war crime. The strike on the flour mill furthermore constitutes a violation of the right to adequate food and means of subsistence.”

The UN Mission also investigated four incidents in which the IDF coerced Palestinian civilian men at gunpoint to take part in house search operations. The men, blindfolded and handcuffed, were forced to enter houses suspected of having combatants, ahead of the Israeli soldiers. “From the facts available to it, the Mission is of the view that some of the actions of the Government of Israel might justify a competent court finding that crimes against humanity have been committed,” states the report.

Israeli Prime Minister Benjamin Netanyahu has stated that Israel will never allow its soldiers and war-time leaders to appear before an international war-crimes tribunal regarding the IDF conduct during the war on Gaza. As stated in the UN Mission report, however, “In the context of increasing unwillingness on the part of Israel to open criminal investigations that comply with international standards, the Mission supports the reliance on universal jurisdiction as an avenue for States to investigate violations of the grave breach provisions of the Geneva Conventions of 1949, prevent impunity and promote international accountability.”

Cesar Chelala, a co-winner of an Overseas Press Club of America award, writes extensively on human rights issues.

It was, according to tradition, an unusual evening at Taller Latinoamericano, a language school (and much more) in uptown Manhattan. Like Sinatra’s many last performances, this one was supposed to be the last performance at the Taller (they had to move, unable to pay the rent) but I know, as many people do, that it won't probably be the last one. The Taller, as it is frequently called, has survived at that same place before.

The Taller is a language school, a meeting place for unusual people eager for company, a showcase of artistic talent for people from all over Latin America, a concert hall, and a dance school. I used to joke that on a given night you could find a lion tamer, a young Japanese woman giving tango lessons, a tango guitar player from Argentina playing Brazilian songs, an obsessive painter of remarkable naïve paintings, many of which cover the Taller walls … an unending list of colorful characters.

Bernardo Palombo, its director, is an unusual talent. A native of Argentina, he is an innovative teacher of Spanish—he frequently illustrates his lessons with guitar music. He is also a talented musician and singer who has performed with leading Latin American and North American artists.

Tango is among the most performed musical styles played and performed at the Taller, so it was fitting that this event—reported to be a farewell party from this location—would only be tango dancing. Although a few dancers were Argentinean, there were many from different Latin American and Asian countries and even a couple from Africa.

While watching some old and graceful dancers, my thoughts went back to Buenos Aires where during my last trip, I had had a singular experience. I was having lunch at a popular restaurant. Concerned about my weight, I was having a small piece of chicken with a salad when I saw, at the table next to mine, an older man, perhaps in his middle seventies, having a hearty lunch. He was a thin man of normal height.

He had started with a heavy bean soup, and now he was having a huge steak with French fries and a salad accompanied by a big bottle of wine. I envied that he could have such a big lunch while I, younger than him, was also much heavier and unable to do the same.

I congratulated him on his good appetite, something not unusual to do in an informal setting in Buenos Aires, where people are much more gregarious than in other big cities.

“Well,” he said to me, “You won’t believe what happened to me.” He continued. “A couple of years ago, I was diagnosed with a rare form of rheumatism which hindered my movements. I was even unable to cross a wide street without being concerned that I would be hit by a car, since I walked that slowly.

“A friend recommended that I start dancing tango, something that I almost never did before. Although I was a bit reluctant at first, I decided to follow my friend’s advice and soon after I started dancing, I realized that I was walking with much less effort. Not only that, the more I danced the better I felt. I had started dancing a couple of nights a week. Then I was dancing every day and feeling younger, better, and losing weight in the process.

“In the beginning, my wife used to accompany me. Soon, however, she lost interest, perhaps because she couldn’t keep my pace. By common agreement, we decided that I would go to live in an apartment at the back of our house so we that could lead independent lives, but still on friendly terms. I am glad we did that because what began as a curiosity became an obsession, but a wonderful one for me.

“After a few months, I had recovered all my ability to move without pain. I also lost several pounds and made many new, wonderful friends. As a result, not only has my rheumatism disappeared, but now I can eat whatever I want without fear of gaining any weight.”

Looking at my plate before he parted, he said, “Start dancing tango, amigo, it will do wonders for you, too.”

As I recalled his advice, the last stanzas of a tango were being played at the Taller...

Dr. Cesar Chelala is a writer on human rights and public health issues.

The growing worldwide demand for resources is threatening the world's environmental health to an unprecedented extent. Increasingly, women are active participants in the defense of the environment and significantly contribute to stop, or even reverse, the degradation of our natural resources.

“Women have always been more environmentally sensitive compared to men because they are mother earth themselves. Any harm to the mother is bound to affect her progeny, and that is why very instinctively she wishes to protect the earth that is everybody’s mother,” stated Notan Kotak, a woman from a tribal group in India. She was commenting on the role of women from pygmy communities in Congo Brazzaville to protect the natural forests in the region.

In addition to unrestricted exploitation of natural resources, unsound agricultural practices have had devastating effects on the environment and on people's health and quality of life. The National Wildlife Federation has found that diseases associated with contaminated water kill between 5 and 12 million people every year, mostly women and children.

Women are considered the primary users of natural resources in developing countries, because they are responsible for gathering food, fuel and fodder. Because in many cases women are home-managers, and economic providers, women are susceptible to health problems and hazards in several environmental situations.

Women, especially when they are pregnant, are particularly susceptible to several environmental risks, particularly those living in rural or marginal suburban areas in developing countries. The reproductive system of pregnant women is especially vulnerable, since every step in the reproductive process can be altered by toxic substances in the environment. It has been proved that several substances may increase the risk of abortion, birth defects, fetal growth retardation, and peri-natal death.

Although for a long time women have been considered passive recipients of aid rather than active participants in development, their role is crucial both to the economies of the developing countries and to the future of the environment. As environmental educators and motivators for change, women are key agents in the processes leading to a more sustainable and healthy development of the planet.

Just over 100 years ago, in 1906 in India, there was a conflict between men and women in a hilly area called Chipko. Women were protesting the massive clearing of forests by men, who wanted to use them for industrial purposes. When their protests went unheard, women from the villages started hugging themselves to the trees to prevent them for being cut down. They not only prevented large forest areas from being destroyed but they initiated what is now called the Chipko movement, which has become a significant historical reference of women’s efforts in favor of the environment.

The more active participation of women in think tanks and in environmental training activities is allowing them to educate both the public and policy makers about the critical link between women, the use of natural resources and the creation and fostering of sustainable development. In that regard, women have more direct access to local environmental issues and how to approach them than men. Women have often had a leadership role in reducing unnecessary use of resources, promoting an environmental ethic, and recycling resources to minimize waste.

There is growing evidence that women in several countries around the world are taking central roles in the grass-roots environmental movement. And there is increasing belief that development and environmental policies that do not involve women in the same footing men as will not be successful in the long run.

Dr. Cesar Chelala is an international medical consultant and the author of the Pan American Health Organization publication ''The Impact of the Environment on Children's Health.''

Antonio Peralta, known to listeners as exageradamente loco, or "extremely crazy," is a well-known radio personality in Argentina where a radio show is heard by 12 million people. But his studio is hardly conventional: He broadcasts from the courtyard of Buenos Aires's largest psychiatric hospital.

On the air with are also colleagues –other patients– who read news headlines and poems, sing tangos and conduct interviews inside and outside Dr. José T. Borda Hospital. That is where Antonio Peralta, a tall man with long hair and a pleasant smile, hosts an innovative program on mental patients' legal rights.

They work for "Radio La Colifata" -- slang for "Loony Radio," and all are patients who do the weekly show as part of their therapy. It is the first radio program in the world to broadcast from inside a psychiatric hospital, according to the Pan American Health Organization.

"Loony Radio" is one of Argentina's most popular radio programs. Broadcast on 58 stations from cold Tierra del Fuego to trendy Buenos Aires it reaches 12 million listeners who tune in for something out of the ordinary.

During its 18-year existence, the show has managed to stay popular, a remarkable achievement in a nation that has undergone profound economic and social changes over the past two decades. "Loony Radio" has been copied elsewhere in Argentina as well as in Uruguay, Chile, Germany and Spain, and it has won several local and international awards, including a special cultural citation from Argentina's National Congress in 1997.

Maria Lopez Geist, a Buenos Aires psychiatrist said, "'Loony Radio' demystifies the idea that a person with a mental health problem cannot have effective participation in society. Most important for the patients themselves, the show offers a unique therapy that provides contact with the world and eliminates their isolation."

The program is the brainchild of Alfredo Olivera. When he started with the program, Olivera was a 23-year-old psychology student making regular visits to the Borda hospital for a research paper. He was struck by how isolated the patients had become during their stay. They often slept 30 to a room and in some cases were denied contact with the outside world for up to 40 years.

“We created a tool to undo the marginality they normally experience,'' said Alfredo Olivera, who began the program as an experiment in 1991. “We try to change the idea many people have that these patients are dangerous people.” I met Olivera and visited La Colifata during one of my frequent trips to Argentina.

When friends at a small community radio station asked to interview him on hospital conditions, Olivera decided to record patients' views and play them on air. The first tapes were such a hit they were picked up by network radio shows.

Now, nobody is having a better time than the patients themselves. And so is Olivera, who now has a Masters in Psychology from the University of Buenos Aires and works as a consultant with non-governmental organizations interested in replicating La Colifata’s example. So far, there have been almost 40 similar experiences in Europe and Latin America based in La Colifata’s experience.

In 2007, La Colifata hosted the “First Global Meeting of Radios Implemented by Mental Health Patients” in Buenos Aires. Both professionals and mental health patients from several countries such as France, Spain, Italy, Sweden, Brazil, Chile, and other Latin American countries attended the meeting. In 2005, Olivera was named “Distinguished Citizen” by the Buenos Aires Legislature.

La Colifata was featured in the movie “Tetro,” directed by Francis Ford Coppola, and has the support of the famous European singer Manu Chao who recently recorded music at the hospital, working together with patients. Although listeners donate food, clothes and other everyday items used by the patients, steady financial support is always a challenge. But Olivera is undaunted by the obstacles. And so is Peralta, who remarked that he is always looking forward to the next program.

"We eagerly wait to help each other," he said, talking about the other patients. "They are my family."

Dr. Cesar Chelala, a frequent contributor to Americas, is an international public health consultant and a writer on human rights issues.

Where Iran is going and what other countries can do to prevent Iran from developing nuclear weapons are timely concerns. Difficult as the situation is now it can also provide an opportunity for reaching a wider, more important goal: a nuclear weapons free zone (NWFZ) in the Middle East.

Talks between Iran and representatives of the U.S., Britain, Germany, France, Russia and China can help develop a consensus regarding Iran’s development of nuclear power. Iran’s eventual production of nuclear weapons and a possible Israeli or US response can precipitate a war of unknown -but certainly terrible- consequences.

In this context, Israel’s concern over Iran’s nuclear program is legitimate, particularly given the avowed antagonism of Iran for the State of Israel. But Iran’s concerns for an Israeli attack can’t be easily dismissed either.

Given this situation, is it possible to redirect talks in a way to avoid such a disastrous alternative? I believe it is. Both Iranian and Israeli concerns about the other party’s use of nuclear weapons –which by many accounts Iran is still years away from developing- could be addressed by the discussion of an old idea: the creation of a Nuclear Weapons Free Zone (NWFZ) in the Middle East.

The call for such a zone in the Middle East was first issued in 1974. That year, the UN General Assembly passed a resolution calling for all countries in the region “to declare that they will refrain from producing, acquiring or in any way possessing nuclear weapons and nuclear explosive devices and from permitting the stationing of nuclear weapons in their territory by any third party.” In following years, the UN General Assembly renewed that call on several occasions.

On September 17, in a non-binding ballot, the International Atomic Energy Agency (IAEA) adopted a resolution (100 to 1 with four abstentions) urging all Middle East nations to forswear atomic bombs. Israel voted no because the resolution retained a clause calling “upon all states in the region to accede” to the Non-Proliferation Treaty (NPT).

The creation of a NWFZ in the Middle East would be to everyone’s advantage. It cannot be denied that a nuclear armed Iran is of concern not only to Israel but also to many of its Arab neighbors since it would dramatically alter the balance of power in the region. Iran’s development of nuclear weapons could start a nuclear arms race in the Middle East that would divert precious resources for economic development into the development of nuclear weapons with serious consequences for peace and stability in the region.

The establishment of nuclear free zones in other parts of the world has been an effective deterrent to preventing nuclear proliferation. Latin America, the South Pacific, Southeast Asia, Africa and Antarctica have all been established as NWFZ. Since the establishment of that status, no country in those regions has sought nuclear weapons capability.

In this context, only the U.S. has the clout to revive the discussions on the creation of the NWFZ in the Middle East. Such a move would be consistent with President Obama’s call for a world free of nuclear weapons, and would eliminate the main threat to peace in the region.

The U.S. could provide security guarantees to both Iran and to Israel. In Iran’s case, the U.S. could reaffirm its adherence to the 1981 Algiers Accord. Among the main provisions of that agreement (brokered by Algiers in 1981 to resolve the Iran hostage crisis) is that the U.S. would not intervene politically or militarily in Iranian internal affairs. The U.S. would also remove its freeze on Iranian assets and trade sanctions on Iran. To Israel, the US could offer additional security guarantees to reaffirm what has been a sustained support for that country’s political and security aims.

Incorporating the NWFZ into discussions with Iran would indicate a paradigm shift towards an effective road to peace in a region of the world where war has already exacted a terrible price.

Dr. Cesar Chelala, a co-winner of an Overseas Press Club of America award, is the foreign correspondent for the Middle East Times International (Australia).

The results of a new HIV vaccine trial in Thailand, although positive since it shows a lowered the rate of infection amongst those vaccinated, should be treated with cautious optimism. It is, nonetheless, excellent news particularly considering that every day 7,000 people worldwide are newly infected with HIV and that in 2007 over two million people died of AIDS according to UNAIDS (The Joint United Nations Programme on HIV/AIDS).

The new AIDS vaccine was tried in 16,000 volunteers aged between 18 and 30 in parts of Thailand and was carried out by the US Army, the Thai Ministry of Public Health, the US National Institute of Allergy and Infectious Diseases and the patent-holders of the two components of the vaccine, Sanofi-Pasteur and Global Solutions for Infectious Diseases.

The vaccine used in this trial was a combination of two vaccines that when tried singly had not cut infection rates. The vaccine combination was based on HIV strains that circulate normally in Thailand. Participants in the study were tested for HIV infection every six months for three years.

The study was carried out in 16,402 volunteers at average risk of HIV infection. Half of the volunteers received the vaccine combination and the other half received a placebo. Both groups received counseling on how to prevent becoming infected with HIV at the beginning of the study and every six months after the start of the study for a total of three and a half years.

Among the participants in the study, new infections occurred in 51 of the 8,197 people given the vaccine, and in 74 of the 8,198 among those who received the placebo. The results indicate that there was a 31% lower risk of infection among those who had received the vaccine.

Although the number of infections in each group under study is relatively small it is statistically significant, as indicated by Dr. Jerome H. Kim, who is the army’s HIV vaccine program. Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, concurred on the importance of the results.

Although those obtained are indeed important results it is still necessary to be cautious about its implications. For example, the RV144, the vaccine tested in Thailand, was designed to combat the most common strain of the HIV circulating in Southeast Asia. Different strains circulate in the U.S., Africa and other countries and there is no indication yet that the vaccine could function in similar ways when confronted with different HIV strains.

In addition, the number of people involved in the study shows the need for larger, more expensive trials. And finally, although the difference among subjects who had received the vaccine and those who hadn’t is statistically significant, it is still relatively small to consider it for use in the immediate future.

hat is really important, however, is that this study shows a positive response on an issue that up until now had not offered any hopes for solution. If the positive results are shown to be constant and even increase under different conditions we can expect to conquer an infection of tremendous medical, human and economic costs to society.

Cesar Chelala, MD, PhD, is an international public health consultant for several UN agencies.

I call them “regulars” because they are always in my neighborhood in downtown Manhattan. They are out of luck people who depend largely on the help of others. By now, the regulars have become almost like friends.

There is Sarge as we call him, a tall, black, heavyset, intelligent man. He was once in the Army (that’s the reason for his nickname) but with time his health began to deteriorate. Sarge walks with some difficulty. He comes and sits on the steps next to my house at least once a week.

He usually prefaces his request for a handout with a question. “Let me pose you a hypothetical question,” he will say. “Do you think that today there is a possibility you may help me with some change, perhaps also something to eat?” Since he has a genial disposition I am happy to comply.

It is not easy, though, to find foods that he will enjoy, since he claims to have some stomach troubles. I rather believe he is a finicky eater, since there is no specific pattern in what he likes. Despite significant differences in his upbringing, he has something in common with former US President George Herbert Walker Bush: they both detest broccoli.

My wife tends to be more generous with the regulars than myself, so it is not surprising that the three of them like her a lot. “I love your wife” Sarge frequently tells me. When he sees a stern look in my face he adds, “Not in the way you do, though, not in the way you do.” We like to tease each other. A couple of weeks ago I told him, “Hey, Sarge, if you win the lottery will you help me out?” Quick as a weasel he retorted, “Don’t worry, man, I already have you in my will….”

The other regular is Roland, an older man, kind, always with a good word. While my wife was recently in Argentina, he asked me about her every day, probably missing her generous presents. He is also a picky eater, although with a very good reason, since he has had several dental problems in recent times. He has the drawn face of a heavy smoker but otherwise he is very properly dressed and speaks with elegance. Regrettably, life has not been kind to him and now he sleeps on the steps of the neighborhood church, after some unpleasant experiences in a municipal shelter where his things were stolen, several times.

I recently saw him being photographed by an Italian tourist. He posed for her and obediently followed her instructions. After she left I asked him who she was and he told me that she was an art student and that she was planning to use the photographs in her student portfolio at an art school. “I hope that she gave you something for your help,” I told him. “I don’t mind,” he said, “she is only a student.” And he added, proudly, “I am sure that she will do a good job.”

Finally there is Joe, another constant presence in the neighborhood. He usually has a paper cup in his hand where he puts the money he collects. Sometimes I think that he collects a lot since I once saw him counting several large bills. He calls everybody “boss” which is a good way of ensuring a sympathetic response from passersby. He is a young, thin man who walks with a limp and always has a crooked hat on. “Boss,” he would say, handing me his paper cup, “do you have any change?” I usually give him a few coins.

Each of the regulars seems to follow a certain schedule. I tend to see Joe in the mornings, Roland from midday on and Sarge in the early evening. Joe’s request for help is so predictable that one day I decided to surprise him. As soon as I saw him approaching, before he would say anything, I dropped a bunch of coins into his cup. He definitely looked surprised. “Boss, what you are doing?” he yelled at me, “This is my coffee!”

Cesar Chelala writes on human rights issues.

The long awaited U.N. report on the conflict in Gaza is strongly critical of both Israel and Palestinian armed groups. Both sides committed war crimes and possible crimes against humanity stated the report that recommends that Israel should start its own credible investigation into the conflict within the next three months.

If Israel refuses to comply with this recommendation, the investigators called on the U.N. Human Rights Council to refer the matter for action by the International Criminal Court prosecutor within six months. Israel, however, doesn’t accept the court’s authority, and calls the council “a body constantly critical of Israel.”

Israeli human rights groups issued a statement in which they call on “the Government of Israel to respond to the substance of the report’s findings and to desist from its current policy of casting doubt upon the credibility of anyone who doesn’t adhere to the establishment’s narrative.”

The U.N. report follows an investigation of the Gaza war by B’Tselem, an Israeli human rights group. More than half of Palestinians killed by the Israel Defense Forces (IDF) during Operation Cast Lead in Gaza were civilians, states B’Tselem. B’Tselem’s assertions, based on exhaustive investigations, should prompt a serious investigation by Israel’s judiciary and, if its denunciations are confirmed, the punishment of those guilty. Israel’s judiciary cannot afford to be complicit in gross human rights violations carried out the Israeli armed forces.

Although the IDF has acknowledged “rare mishaps” in the conduct of the war in Gaza, it has steadfastly denied violating international humanitarian law. B’Tselem’s investigation does not support the IDF’s allegations, and are a serious accusation against the IDF’s actions in Gaza.

According to the IDF, the Gaza Cast Lead operation death toll is 1,166 which includes 709 combatants and 295 civilians, and has refused to release a list of names or any other evidence. B’Tselem’s findings -based on several months of research and visits to the families of the victims- reveal that 1,387 Gazans were killed. That figure includes 773 civilians and 330 combatants.

The IDF claims that the B’Tselem’s figures are based on flawed research, and reliance on figures reported by Palestinian human rights groups. However, the Israeli human rights group’s figures are similar to those reported by Hamas, which claims that more than 1,350 Gaza residents were killed during the operation, most of them civilians. B’Tselem also claims that the IDF withheld information that could have allowed them to cross-check information.

“Behind the statistics lie shocking individual stories. Whole families were killed; parents saw their children shot before their very eyes; relatives watched their loved ones bleed to death; and entire neighborhoods were obliterated,” states B’Tselem. Israeli Defense Minister Ehud Barak, however, denounced the “extensive rumors that have considerably damaged the IDF’s image both at home and abroad.”

“The failure of the IDF and Israeli government to investigate serious allegations of wrongdoing by its soldiers precedes Operation Cast Lead,” states Human Rights Watch. Since 2000 this organization has documented the persistent lack of fair investigations into civilian deaths resulting from the use of lethal force in policing and law enforcement situations, as well as from combat situations in the West Bank and Gaza even when confronted with credible allegations that soldiers deliberately harmed civilians. Israel’s conduct clashes with its obligations under international law.

Following Operation Cast Lead, B’Tselem sent Israel’s Attorney General and the military’s Judge Advocate General 20 cases that raise questions of breach of law. Among those cases is the killing of some 90 Palestinians (half of them minors) that B’Tselem believes didn’t take part in the conflict and Israeli soldiers’ use of civilians as human shields. According to B’Tselem, it has received only one serious response, in which the Judge Advocate General’s Office stated that it had ordered a Military Police investigation into the use of civilians as human shields.

“The extremely heavy civilian casualties and the massive damage to civilian property require serious introspection on the part of Israeli society,” states B’Tselem. And Sara Roy, a senior research scholar at Harvard’s Center for Middle Eastern Studies recently wrote in the Christian Science Monitor, “Israel's victories are pyrrhic and reveal the limits of Israeli power and our own limitations as a people: our inability to live a life without barriers. Are these the boundaries of our rebirth after the Holocaust?”

Cesar Chelala is a co-winner of an Overseas Press Club of America award for an article on human rights. He is also the foreign correspondent for the Middle East Times International (Australia).

I was irritated with my wife. After waiting for several weeks to carve out some free time to go find a new set of night tables (her own night table had collapsed under the weight of books), we were finally on our way when my wife stopped to talk to a stranger near our house. Though the incident happened some months ago, I only understood its import this morning upon reading a poem by Jack Agüeros, a New York poet, which brought that event back to my mind. But I am jumping ahead, so let me backtrack.

I was walking with my wife, Silvia, to the bus stop when a young man passed in front of us. He was of probable East Indian descent, shabbily dressed and talking to himself, the last being not so unusual in and of itself for New York City. But what told me he wasn’t of sound mind was that on that frigid morning he was shoeless, his feet dirty and calloused.

Seeing his plight, my wife asked him, “Sir, do you need shoes?” The man looked surprised, and mumbled a response which my wife took as a positive answer. Upon hearing that, Silvia said to me, “Just wait a few minutes,” and turned back toward our house.

“What is going on?” I asked myself. “We are very short of time and my wife is going back to pick up some shoes for a man who probably wouldn’t realize if he had shoes on or not.” I was annoyed at her but didn’t have any choice but to wait for her. The man went to sit on a bench nearby. I decided to keep an eye on him, to make sure that he would wait for her and not try to walk away. I tried to engage him in conversation but was unable to. He obviously preferred to continue inhabiting his own world. How my wife was able to reach him escapes me.

Silvia’s trip was taking more time than I had anticipated and, at a moment when I wasn’t paying attention, the man disappeared.

“Well,” I thought, “that will show her that she can’t be a Samaritan all the time. …” I walked up the avenue and down and up a side street, but couldn’t see him.

Finally, frustrated, I retraced my steps and went back home to tell my wife what had happened. Just as I turned a corner, however, I saw her talking to the shoeless man. (He had gone back in the same direction as my wife.) She was handing him a pair of practically new shoes, part of a bunch that we had decided to donate to a homeless shelter.

“Most probably,” I thought, “he will now go and try to sell them.” I was wrong again. My wife’s generous thoughts prevailed over what I believed was my common sense. While sitting waiting for the bus we saw the young man walk by again, proudly wearing his new set of shoes, a smile on his face. It was the man’s pleasure as well as my wife’s unassuming kindness that I recalled upon reading a Jack Agüeros poem months later. In his “Psalm for Distribution,” Agüeros, a Nuyorican poet of the dispossessed, writes:

Lord,
on 8th Street
Between 6th Avenue and
Broadway
In Greenwich Village
There are enough shoe stores
With enough shoes
To make me wonder
Where there are shoeless people
On the earth.

Lord,
You have to fire the Angel
in charge of distribution.

The poem is set a few blocks away from where this incident took place.

César Chelala is an award winning writer on human rights issues.

At a time when we plainly see the negative effects of politics and greed in the life of nations, it is important to remember Pablo Neruda, a Chilean writer whom Gabriel Garcia Marquez called "the greatest poet of the 20th century — in any language." He was an artist who knew very well how to blend politics and poetry in his life.

Neruda was born Ricardo Eliecer Neftali Reyes Basoalto in 1904 and died in 1973. When he was 16, he changed his name to Pablo Neruda, probably after the Czech writer Jan Neruda. He started writing poetry at 10.

I started reading him when I was a medical student in the 1960s, and haven't stopped. How could I? Two of his books — "Twenty Love Poems and a Song of Despair" (written when he was only 20) and "The Captain's Verses" — are intertwined with my first sentimental adventures. Like millions in Latin America — and across the world — once I read Neruda, he became part of my life.

Neruda's political beliefs were behind some of his most powerful poems. For me, he represents the very ideal of the writer as a political man. When he was only 23, the Chilean government made him honorary consul in Burma, Ceylon, Java, Singapore and later Argentina, and the Spanish cities of Barcelona and Madrid. The Spanish Civil War, during which his friend, the great Spanish poet Federico Garcia Lorca, was murdered, had a profound influence on his writing and his political activities.

He joined the Republican movement, first in Spain and then in France. In 1939, he was appointed Chilean consul in Paris, and from there, he coordinated the emigration to Chile of as many as 2,000 Spanish Republicans who had first escaped to France.

In 1943 he returned to Chile, then joined the protest against President Gabriel Gonzalez Videla's repressive actions against striking miners. In 1945, he became a senator and joined the Communist Party. The government soon expelled him, and from 1947 to 1949 he lived in hiding.

In January 1948, Neruda delivered one of the most passionate speeches on Chile's political history: He read out the names of 628 people being detained at Pisagua concentration camp without having been interrogated or formally charged. That speech became known as "Yo Acuso (I accuse)," after French novelist Emile Zola's 1898 denunciation of the French government's treatment of Alfred Dreyfus. In 1949, he fled to Europe.

Neruda's greatest poetic achievements were fueled by his political beliefs. In his epic work "Canto General (General Song)," published in 1950, Neruda celebrates the richness and beauty of Latin America, and the people's struggle for peace and social justice. Part of the work is the poem "Alturas of Macchu Picchu (Heights of Macchu Picchu)," a celebration of pre-Columbian civilization.

He lived in Europe for three years and returned to Chile in 1952, whence he continued traveling extensively overseas. He visited the United States in 1966 and in 1971 was awarded the Nobel Prize in literature, which he received after being stricken with cancer.

When Salvador Allende was elected president of Chile in 1970, he appointed Neruda as Chile's ambassador to France, where he lived from 1970 to 1972. In 1973, he returned to Chile, but in September of that year, Augusto Pinochet, with help from the CIA, overthrew Allende's government.

Neruda's life, I firmly believe, was shattered by Pinochet's coup and Allende's suicide. Neruda died only 12 days later. Shortly before his death, his house was ransacked by a military unit. When he saw the commander of the unit, weapon in hand in his bedroom, Neruda, who could hardly speak, told him, "There is only one dangerous thing for you in this house — poetry."

Officially, Neruda died of leukemia. Most probably, though, this man, the saddest of men after the death of his friend Salvador Allende and the defeat of democracy in Chile, died of a broken heart.

Cesar Chelala is an international public health consultant for several United Nations agencies and co-winner of an Overseas Press Club of America award for an article on human rights.

“Using children in conflict is a heinous crime and destroys the very fabric of society,” the American actress Angelina Jolie declared in The Hague at the trial of Thomas Lubanga. Lubanga is a Congolese militia leader accused of using children, both boys and girls, during the five-year civil war in the Democratic Republic of Congo (DRC).

One of the tragic consequences of war is the forced participation of girls as soldiers. In Sudan, as well as in many other conflicts throughout the world, girls (sometimes as young as 13) are unwilling warriors or soldiers' sexual partners. It has been estimated that between 1990 and 2003, girls have been part of military and paramilitary groups in 55 countries and have participated in armed conflict in 38 of those countries. Presently, more than 120,000 girls are participating in armed conflicts worldwide.

“In war, these little soldiers work by killing and above all by dying. They make up half the victims of recent African wars,” says Eduardo Galeano, the Uruguayan political writer talking about child soldiers. If the fate of both boys and girls is tragic, girl soldiers suffer additional indignities, an issue that remains to be solved.

Jasmine, a 16 year-old young woman with a four month old baby explains the process of incorporating girls into armed groups in the DRC. In a testimony to Amnesty International she declared, “When the mayi-mayi (community-based militia groups in the DRC) attacked my village, we all ran away. In our flight, the soldiers captured all the girls, even the very young. Once with the soldiers, you were forced to marry one of the soldiers. Whether he was as old as your father or young, bad or nice, you had to accept. If you refused, they would kill you. This happened to one of my friends. They would slaughter people like chickens. They wouldn’t even bury the bodies they slaughtered – they would even feed on their flesh. I even saw a girl who refused to be ‘married’ being tortured.”

Although in some cases girls voluntarily become soldiers, in most cases they are abducted and obliged to participate in combat operations, forced into sexual relations with commanders or fellow soldiers or required to perform other duties off the front lines, but equally as abusive, such as planting landmines, acting as spies or carrying heavy loads. As a result of rape and other forms of sexual abuse, they may acquire sexually transmitted infections, including HIV/AIDS, which are particularly frequent among men from both government forces and rebel groups.

A study by the Canadian human rights organization Rights and Democracy found that 30 percent of the girls in three countries studied (Mozambique, Northern Uganda and Sierra Leone) became pregnant during their stay in the armed forces. Many among them were stigmatized because they had been raped and later had serious difficulties in trying to reintegrate into their communities and care for their babies – often unwanted – born of rape.

Why do some girls voluntarily become soldiers in spite of the obvious dangers involved? They may do it because of lack of other options for survival or for the perceived benefit it might provide to them – protection from ill treatment, to escape situations of domestic abuse or in search of food and clothing. Former girl soldiers who have escaped or been released have explained that the lack of opportunities in their future, such as access to education or means of earning a livelihood led them to join without knowing the harsh consequences it would entail. Other girls may do it to seek revenge against armed forces or groups which have attacked their families and communities or to gain a sense of power. In some cases, girls who became "wives" of commanders are sometimes in charge of organizing raids or spying missions on enemy forces.

Sexual violence is a major concern in Darfur, where children as young as six-years-old are raped by soldiers which witnesses identify as belonging to government forces, according to the United Nations. In addition, high incidence of rapes and sexual violence against children continues in Burundi, Central African Republic, Cote D'Ivoire, DRC, Haiti, Chad, Darfur, Uganda and other situations of concern.

Forced recruitment of children and sexual violence against them is not limited to Africa. Children have suffered similar fates in armed conflicts in Nepal, Burma, Colombia, Afghanistan, Iraq and elsewhere. For example, in Sri Lanka, the Liberation Tigers of Tamil Elam (LTTE) recruited thousands of boys and girls into their ranks during the course of past two decades.

Beginning in the mid 2000’s the TMVP, a breakaway faction of the LTTE, also increased its recruitment of children with the alleged complicity of certain elements of the Government Security Forces. Although the LTTE reduced its recruitment of children in 2008, according to UNICEF, during the hostilities in northern Sri Lanka in the first part of 2009, reports of LTTE recruitment of boys and girls resurfaced. Today, top UN officials are calling for an inquiry into atrocities committed by both sides during the 2009 fighting; this must include the use and recruitment of children.

Girls don't have the choice of freely leaving the groups with whom they are associated. Those who try to leave may be recaptured and punished. They thus have to deal with a double threat: recrimination and punishment from the armed group or discrimination and ostracism from the community if they do manage to return home. Some girls who return home pregnant or with a child are made to feel that they bring "dishonor" to the family.

Reintegration into society can be more difficult for girls than for boys, as they generally carry the stigma of having been sexually abused. In addition, girls may be left with some other consequences aside from sexually transmitted infections, such as chronic physical and mental disabilities or the need to look after babies conceived during forced service. The stigma is not limited to the child mothers but also extends to their children who frequently experience the same kind of rejection as their young mothers.

Because the participation of girls in conflict has been largely ignored, there are few programs that address their unique needs related to their demobilization, rehabilitation and reintegration back into society. In many cases, shunned by their families and communities, they end up working as prostitutes or doing menial work when conflicts end. Girl soldiers, despite the disadvantages of having participated in war, in many cases are extremely resilient and have develop special skills that could be used in post-conflict settings for their re-integration into society. When provided the right opportunities, many of these girls have proven themselves to be productive and capable people who can ultimately contribute to pulling their societies out of the cycle of war.

The practice of using girls as soldiers continues unabated. Because of women's perceived role in society, after their participation in armed conflicts they have more limited options than boys, both in terms of marriage and work prospects. Frequently, former girl soldiers state that they want to receive education once they return home so they can become productive members of society. As Julia Freedson, Director of Watchlist on Children and Armed Conflict, an organization working to end violations against children told me in New York, “When provided the right opportunities, many of these girls have proven themselves to be productive and capable people who can ultimately contribute to pulling their societies out of the cycle of war.”

It is important to strengthen monitoring and reporting of forced participation of girls as soldiers, as well as other violations against them. This is needed in order to hold perpetrators accountable and to work towards release of children from fighting forces. Preventive measures are also important to eliminate abuse of girls, such as massive education campaigns calling attention to the phenomenon and its serious consequences. In addition, it is necessary to increase the number of and quality of rehabilitation and reintegration programs that specifically respond to former girl soldiers' needs. These are costly enterprises, but ones that will allow girls to become the framers of their own future.

César Chelala, an international public health consultant, is the author of the Pan American Health Organization publication "Adolescents’ health in the Americas."

As if rigged elections were not enough, the new Iranian government has compounded its breach of the law by the systematic abuse of Iranians taken prisoner after the June 12 presidential election. Nobody in Iran is immune to the government’s brutality. Only a strict following of the law, the punishment of those guilty and the release of those whose only crime was to protest the recent election results will bring the government the international respect it so desperately seeks.

The accounts of prisoners’ abuse by their relatives and on opposition websites have provoked outrage not only among Mr. Mousavi (the opposition candidate) supporters but even among some prominent conservative clerics, some of whom have relatives who have been brutally tortured by the Iranian police.

Recently, the government released 140 prisoners, President Mahmoud Ahmadinejad urged the judiciary to show “Islamic mercy” to the detainees, and Iran’s supreme leader, Ayatollah Ali Khamenei, personally intervened and ordered the closing of a notorious detention center. The government actions can only be described as “cosmetic” gestures aimed more to appease the growing opposition to its tactics than to restore a respect for the law since abuse continues in an unending dragnet of brutality.

The critical point that galvanized and widened the opposition was the case of Mohsen Ruholamini, son of an adviser to the conservative presidential candidate Mohsen Rezai. Mr Ruholamini died in prison after being severely beaten by the Iranian police. His death comes shortly after the death of Neda Agha-Soltan , whose death during a demonstration against the government sparked protests around the globe and made of her an iconic figure in Iran.

Mr. Mousavvi reacted with predictable anger at these abuses. “They cannot turn this nation into a prison of 70 million people,” he said. Senior clerics have joined in the protests, indicating that if the government continues to tolerate such abuses, the future of Iran’s theocracy was in danger.

Torture to prisoners is not new to Iran’s government. In 2007 alone, the UN Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, sent 24 joint communications and one urgent appeal describing human rights abuses. The Iranian authorities denied any allegations of torture and responded that fair trials had been conducted in all cases.

Despite the government denials, the International Campaign for Human Rights in Iran has verified several reports of systematic torture and abuse of opponents after the recent presidential elections. There are also allegations of the rape of prisoners, which are particular serious abuses in a traditional society such as Iran, aimed at humiliating and dehumanizing prisoners. According to this organization, the widespread, planned and systematic nature of these crimes since the June 12 elections could be raising to the level of crimes against humanity under international law.

On August 9, 2009, Gen. Ismail Ahmadi Moghaddam, Iran’s police chief, acknowledged that protesters were beaten by their jailers at Kahrizak detention center, but blamed an outbreak of disease for their deaths. The police chief’s explanation was flatly denied by several conservative clerics. In addition, Iran’s Prosecutor General Ghorban Ali Dorri Najafabadi, called that those responsible for mistreating prisoners be tried and punished.

There have been reports of family members finding “hundreds of corpses” in a Tehran morgue. The police denied them to retrieve the bodies of their relatives unless they certified that the deaths were due to natural causes.

Iranian lawyer and Nobel laureate Shirin Ebadi urged Iran’s government to release those citizens accused of involvement in the country’s post-election unrest, and so did other Nobel laureates such as Archbishop Desmond Tutu, Mairead Maguire and Jody Williams.

If the Iranian government continues to ignore these calls to justice and freedom for those unjustly detained, it will justify the role of “pariah” government among civilized nations that they so strenuously reject.

Cesar Chelala, MD, PhD, a co-winner of an Overseas Press Club of America award, is the foreign correspondent for the Middle East Times International (Australia).

As the health care discussion has gathered momentum in the U.S., there is increasing evidence of the role played by corporations and politicians to hinder provision of adequate health care to the majority of Americans. The result is that the U.S. has one of the worst health care systems among industrialized nations.

Studies carried out by the World Health Organization and the Commonwealth Fund in New York show that the U.S. health care system overall performance ranked 37th among the countries included in their analysis.

The Commonwealth Fund study, released in 2007, entitled “Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care,” found that not only is the U.S. health care system the most expensive in the world, but comes in dead last in almost any measure of performance.

The Commonwealth study compared the health system in the U.S. and that of Australia, Canada, Germany, New Zealand and the United Kingdom. Although the most evident way in which the United States differs from the other countries is in the absence of universal coverage, the U.S. is also last in terms of access, patient safety, efficiency and equity.

Compared to the other countries studied, the U.S. lags behind in the adoption of information technology and other national policies that promote quality improvement. In countries such as New Zealand, Germany and the United Kingdom, up-to-date information systems enhance physicians’ ability to monitor chronic conditions and medication use. At the same time, the U.S. pays a higher percentage of health dollars for administration than any other nation.

The U.S. is behind all industrialized nations in terms of health coverage. Almost 47 million Americans lack health insurance coverage, which represents more people than the entire population of Canada. As pointed out by Wendell Potter, a former health insurance executive, if this number includes all those that are underinsured, that represents more people than those living in the United Kingdom. According to the Children’s Health Fund, 9 million children are uninsured in the U.S., while another 23.7 million –nearly 30 percent of the nation’s children- lack regular access to health care.

There are several ways corporations pressure politicians not to support health care plans that benefit the majority of the population. As Wendell Potter stated during an interview with Bill Moyers, “By running ads, commercials in your home district when you are running for reelection, not contributing to your campaigns again, or contributing to your competitor...”

In addition, Potter described how a Republican strategist suggested the use of phrases such as “government takeover,” “delayed care is denied care,” “consequences of rationing,” “bureaucrats, not doctors prescribing medicine,” which despite being evidently untruthful were faithfully parroted by politicians opposing health care for all.

Through several mechanisms insurance companies deny coverage to people so as to increase their profits. As Potter explained in a testimony to the U.S. Senate Committee on Commerce, Science and Transportation last June, among those mechanisms are ‘rescission’ and ‘dumping’. If a sick policy holder omits a minor illness or a pre-existing condition when applying for coverage the insurance company use this as a justification to cancel (rescind) the policy.

In addition, insurance companies dump those businesses whose employees’ medical claims exceed what insurance underwriters estimated. What makes the situation particularly serious is that once an insurer dumps a business, that business has no other viable options because of widespread industry consolidation.

Lack of coverage seriously affects the health of the uninsured because they receive less preventive care, are diagnosed at a later disease stage, tend to receive less quality care and have higher mortality rates than those insured.

This is a crucial moment to solve one of the most savage inequities conspiring against people’s health and well being in America. Both individuals and businesses, particularly small businesses, are at the mercy of powerful corporations’ interests. Unless those interests are curbed, people’s health will continue to be a victim of corporations’ predatory appetite.

Cesar Chelala, MD, PhD, is a public health consultant for several international agencies.

A new set of revelations by soldiers who participated in the Israel Defense Forces' (IDF) operation in Gaza offers a disturbing picture of the actions carried out in that territory. Testimony regarding their conduct in Gaza by Breaking the Silence, an organization of Israeli soldiers, confirms previous denunciations by human rights organizations and signals that urgent attention must be paid to the economic and medical needs of a repeatedly abused civilian population.

Operation "Cast Lead" was initiated December 27, 2008 and ended January 18, 2009. Over 1400 Palestinians were killed, 900 of them civilians (65%), including 300 hundred children (22%). Extensive areas of Gaza were razed to the ground and thousands of people were left homeless, even months after the operation ended. The economy of Gaza was all but destroyed.

"Much of the destruction was wanton and resulted from direct attacks on civilian objects as well as indiscriminate attacks that failed to distinguish between legitimate military targets and civilian objects. Such attacks violated fundamental provisions of international humanitarian law, notably the prohibition on direct attacks that failed to distinguish between legitimate military targets and civilian objects (the principle of distinction), the prohibition on indiscriminate or disproportionate attacks, and the prohibition on collective punishment," states Amnesty International in its July 2009 report entitled "Operation ‘Cast Lead': 22 days of death and destruction."

Among the tactics used by the Israeli military was the repeated firing of white phosphorus shells over densely populated areas of Gaza. White phosphorus ignites and burns when it enters into contact with oxygen up to 1500 degrees Fahrenheit (816 degrees Celsius) until nothing is left or there is no longer any oxygen. Severe and persistent skin burns can be produced, and even burns on less than 10% of the body can be fatal because of damage to the liver, kidneys and heart.

The IDF claims it only used white phosphorus as a smokescreen. However, if the IDF intended it as such, it had a readily available non-lethal alternative -smoke shells produced by an Israeli company, concluded Human Rights Watch (HRW). In addition, HRW stated that the IDF had deliberately or recklessly used white phosphorus munitions in violation of the laws of war.

There has been a persistent effort by several actors to deny Palestinians in Gaza their basic humanity and needs. "Gaza is an example of a society that has been deliberately reduced to a state of abject destitution, its once productive population transformed into one of aid-dependent paupers. This context is undeniably one of mass suffering, created largely by Israel but with the active complicity of the international community, especially the US and the European Union, and the Palestinian Authority in the West Bank," states American political scientist and scholar Sara Roy, writing for The Harvard Crimson.

Israeli forces frequently obstructed access to medical care and basic humanitarian aid for those Palestinians who were wounded and trapped. In addition, states Amnesty International, "Israeli soldiers used civilians -including children- as "human shields, endangering their lives by forcing them to remain in or near houses which they took over and used as military positions."

Amnesty International reported that hundreds of civilians were killed in attacks carried out using high-precision weapons -air-delivered bombs and missiles, and tank shells. Others, including women and children, were shot at short range even when they were posing no threat to the lives of Israeli soldiers.

An infant aged 6 months, Nancy Sa'di Wakid, was the youngest Palestinian killed in Gaza. She died as a result of inhaled gas from phosphoric bombs dropped by the Israeli army. A poem by Jane Kenyon entitled Sandy Hole is a painful reminder of her untimely death,

The infant's coffin no bigger than a flightbag....
The young father steps backward from the sandy hole,
Eyes wide and dry, his hand over his mouth.
No one dares to come near him, even to touch his sleeve.

"The IDF is one of the world's most moral armies and operates according to the highest moral code," stated at the time Ehud Barak, Israel's Defense Minister. Uri Avnery, a former Israeli soldier and a leading Israeli human rights activist offers an alternative opinion, "Only one conclusion can be drawn from this: from now on, any Israeli decision to start a war in a built-up area is a war crime, and the soldiers who rise up against this crime should be honored. May they be blessed."

César Chelala, MD, PhD, is a co-winner of an Overseas Press Club of America award. He is also the foreign correspondent for Middle East Times International (Australia).

Parallel to the economic revolution in China is a sexual revolution, particularly among youth, which is having far-reaching consequences on their health and quality of life. Since feudal times, sex has been a taboo subject in China. Even today, despite progress in many areas, many Chinese, especially the older generations, consider sex shameful or dirty and refuse to talk about it. Young people's opinions differ greatly from those of their parents. At the same time, boys and girls are becoming sexually mature at a younger age.

An increasing number of Chinese adolescents are engaging in premarital and unprotected sexual activity. As a result, unwanted pregnancies, abortions and sexually transmitted infections, including HIV/AIDS, are on the rise. China is now in the early stages of a major HIV/AIDS epidemic.

It is estimated that more than 240 million people in China are between 15 and 24, and that some 20 million more people enter adolescence every year. Such a significant segment of the population needs to be informed about sexual matters. A survey conducted by the State Family Planning Commission among 7,000 people, ages 15 to 49, found that 89.2 percent of respondents in cities and 74.6 percent in the countryside agreed that high schools should offer sex education courses. Yet, only in recent years have the first textbooks on sex education been published and distributed in schools.

Not only is the rate of underage pregnancies growing, but the age at which adolescents become pregnant is declining. In some hospitals, up to 40 percent of those receiving abortions are unmarried mothers.

Worldwide, an estimated 14 million adolescent girls give birth every year, while about 4.4 million girls have abortions. The 2001 edition of the Almanac of China's Health reports that approximately 10 million induced abortions are performed annually in China -- with 20 to 30 percent done on unmarried young women.

Under Chinese law, a parent or guardian must approve an abortion performed on a girl of 18 or younger. Thus many pregnant girls who fear their family's reaction go to back-street abortionists or quacks that may endanger a girl's life.

Some risk factors increase the probability of adolescent pregnancy, such as familial instability, the adolescent pregnancy of a sister, a mother with a history of adolescent pregnancy, pressure from friends, low socio-economic status, ignorance of one's own physiology and the use of contraception, poor communication with parents and a lack of discussion of sexual problems.

Unwanted pregnancy in adolescents can have devastating effects because it delays or halts an adolescent's personal development. There is loss of autonomy and more dependence on parents. Group relations are interrupted since pregnant adolescents cannot continue their normal activities at school or work.

In addition to abortions following unwanted pregnancies, forced abortions are still practiced in China, despite its having been prohibited by the central government in Beijing, as a way of enforcing the government’s one-child policy.

Education continues to be one of the most powerful ways to teach young how to develop an optimal state of physical and mental health. To be effective, educational materials about sexual issues must be reviewed periodically and their message adapted to the various social and cultural groups they address.

Because sex has been a taboo subject for so long in Chinese society, some parents themselves should be educated not only about sexual topics but also on how to maintain a productive dialogue with their children and how to keep the communication channels open with them.

At the same time, the mass media could help remove the taboo regarding adolescent sexuality by helping to redefine social norms and modifying attitudes. There should be constant discussion among parents, teachers, and health and social workers in programs that involve adolescents’ well being.

Cesar Chelala, M.D., Ph.D., is the author of the Pan American Health Organization publication Health of Adolescents and Youth in the Americas.

The Obama administration should release Guantánamo Bay inmates or try them in a court of law, said Navanethem Pillay, the U.N. High Commissioner for Human Rights. Her statement follows President Obama’s remarks last May indicating that some Guantánamo detainees were too dangerous to be released and might have to be held indefinitely. The High Commissioner’s comments represent the most serious challenge to President Obama’s decision to limit investigation into past abuses and to continue to hold some Guantánamo detainees without trial.

“The Obama administration has taken aggressive action on this issue from day one, upholding our nation’s fundamental values while making the American people safer,” responded Mark Kornblau, a spokesman for the U.S. mission to the United Nations, underscoring the administration stand on human rights. But, according to Ms. Pillay, “There is still much to do before the Guantánamo chapter is truly brought to a close.”

The fate of the Guantánamo detainees is one of the most contentious legal issues facing the Obama administration. In 2003, The International Committee of the Red Cross (ICRC) revealed its concern about the negative psychological impact that indefinite detentions were having on a large number of prisoners at Guantánamo, and on their families.

Although the detainees are entitled to judicial review, only a handful of them have received a hearing on the merits of their case. As Amnesty International has indicated,one year after the US Supreme Court ruled that the detainees were entitled to a prompt habeas corpus hearing to challenge the lawfulness of their detention, only a handful of them have received a hearing on the merits of their challenges. In addition, indefinite detention has continued even when judges have ordered the immediate release of detainees after such hearings.

When President Obama took office on 20 January 2009, there were approximately 245 men held at Guantánamo. Of those, about 200 had habeas corpus petitions pending in District Court. From inauguration day to early April 2009, only one detainee was released from Guantánamo, and the rest remained in indefinite detention at that facility.

The Obama administration has aptly rejected the term “war on terror” for US counterterrorism efforts, and has also stopped the use of the term “enemy combatant” in the Guantánamo detainee litigation process. However, as Amnesty International points out, “…it [the Obama administration] does not yet seem to be rejecting the substance of the insidious global war framework developed by its predecessor and, like the latter, is citing the Authorization for Use of Military Force (AUMF), a broadly worded congressional resolution passed after the attacks of 11 September 2001, as the basis for detentions.

According to the International Covenant on Civil and Political Rights (ICCPR), “Anyone whose rights have been violated must be able to seek effective remedy, including through the courts.” This principle is violated by the continuing delay faced by the Guantánamo detainees in having effective and timely access to judicial review.

Several legal and human rights organizations have seriously questioned the US government decision to keep Guantánamo detainees without charge or trial, and call that each detainee be either charged with a recognizable criminal offense for proper trial in existing federal courts or be immediately released.

As stated by the UN Human Rights Committee in its General Comment 29, Even when confronting situations that threaten the life of the nation, “in order to protect non-derogable rights, the right to take proceedings before a court to enable the court to decide without delay on the lawfulness of detention, must not be diminished.”

As Ms. Pillay has stated, “Signals coming from America reverberate around the world. Sending the right ones is the responsibility of power.” The correct decisions on the fate of the Guantánamo detainees are an important test of the Obama’s administration intention to follow the rule of law in this controversial issue.

Several myths regarding Iran stand in the way of reaching a peaceful relationship with that country. Much of the concern that Iran may attack Israel, if it successfully develops nuclear weapons, rests on the avowed statement by Iranian President Mahmoud Ahmadinejad that “Israel must be wiped off the map.”

However, Juan Cole, a University of Michigan Professor of Modern Middle East and South Asian History stated that, “Ahmadinejad did not say he was going to ‘wipe Israel off the map’ because no such idiom exists in Persian. Instead, he did say ‘He hoped [Israel’s] regime, a Jewish-Zionist state occupying Jerusalem, would collapse.’”

This is consistent with statements by Iran’s foreign minister Manouchehr Mottaki. Speaking at a news conference, he denied that Tehran wanted to see Israel “wiped off the map.” “Nobody can remove a country from the map. How is it possible to remove a country from the map? He was talking about the regime,” Mottaki said.

“There is a huge chasm between the correct and the incorrect translations,” says Shiraz Dossa, a professor of Political Science at St. Francis Xavier University in Nova Scotia, Canada. “The notion that Iran can ‘wipe out’ U.S.-backed, nuclear armed Israel is ludicrous.”

During an interview with ABC’s George Stephanopoulos last April, Ahmadinejad declared that the Islamic Republic of Iran would recognize the State of Israel if the Palestinians signed a two-state peace deal with Israel. Exactly a month later Israel’s Prime Minister Benjamin Netanyahu responded, “If Israel does not eliminate the Iranian threat, no one will.”

It has been stated repeatedly that an aggressive Iranian government represents a danger for the region and for the U.S. Facts, however, do not substantiate such an interpretation. More frequently than not, Iran has been the recipient of aggressive actions, particularly by the U.S.

Iranians cannot forget that it was foreign intervention, particularly by the British and the U.S. that destroyed democracy in Iran, whose consequences they suffer until today. In 1953, actions by the CIA were instrumental in overthrowing the democratically elected government of Iran’s Prime Minister Mohammad Mossadegh.

In 1988, the U.S.S. Vincennes shot down an Iranian civilian airliner over the Strait of Hormuz toward the end of the Iran-Iraq war. Two hundred ninety passengers were killed, including 66 children, ranking it the seventh among the deadliest airliner fatalities. According to the U.S. government, the Vincennes crew misidentified the Iranian Airbus A300 as an attacking F-14 Tomcat fighter.

Although a settlement was reached between Iran and U.S., then Vice-President George H.W. Bush stated, “I will never apologize for the United States of America, ever. I don’t care what it has done. I don’t care what the facts are.” The Vincennes captain received the Legion of Merit, and the crew was awarded Combat Action Ribbons.

The U.S. staunchly supported the Shah of Iran’s regime, despite its brutal repression of the Iranian people. According to Stephen Kinzer, author of All the Shah’s Men: An American Coup And The Roots of Middle East Terror, fears by the Iranians of more U.S. intervention in the internal affairs of their country led to their taking American diplomats as hostages.

During the Iraq/Iran war from 1980 to 1988 the U.S. supported Saddam Hussein, even though Iraq initiated the war and the U.S. had knowledge of his regime’s use of chemical weapons.

Both the U.S. and Israel have repeatedly threatened military action against Tehran, in flagrant violation of the UN Charter whose Article 2 states, “All Members shall refrain in their international relations from the threat or use of force against the territorial integrity or political independence of any state, or in any other manner inconsistent with the purposes of the United Nations.”

Although fear of aggression by Iran has been often cited as a justification for war against that country, an ad hoc group of Israeli academicians and peace activists issued an statement on August 6, 2008 that says, “…it is clear that the main source of the immediate danger of a new, widespread war stems from the policies of the Israeli government and the flow of threats from it, backed by provocative military maneuvers. After serious consideration, we reiterate our position that all the arguments for such an attack are without any security, political or moral justification.”

Iran’s intention to develop nuclear weapons has also been given as a justification for an attack on Iran’s nuclear sites. However, speaking at the World Economic Forum in May of 2008, Dr. Mohammad ElBaradei, a Nobel peace laureate and head of the International Atomic Energy Agency (IAEA) stated, “We haven’t seen indications or any concrete evidence that Iran is building a nuclear weapon and I’ve been saying that consistently for the last five years.”

Developing a civilian nuclear program is Iran’s inalienable right and, if some predictions are true, it may also become a need in the near future. There are indications that Iran’s oil resources are fast depleting and Iran may become a net importer of oil a decade from now, according to the Campaign against Sanctions and Military Intervention in Iran (CASMII).

Writing in the Jerusalem Post, Douglas Bloomfield quotes Keith Weissman, the former Iran expert at the American Israel Public Affairs Committee (AIPAC) as saying that although Israel’s worries about Iran getting a nuclear weapon are understandable, the Iranian leaders “are not fanatics and they are not suicidal. They know that Israel could make Iran glow for many years.”

As President Barack Obama has repeatedly stated, diplomacy should be pursued in dealing with the Iranian government. Such an approach should include security assurances to the Iranian government that it will not be attacked and putting a stop to US efforts to undermine that country’s leadership. A linguistic equivalent to the Gulf of Tonkin incident should not be the excuse for attacking Iran and unleashing chaos in the region, if not in the whole world.

Cesar Chelala, a foreign correspondent for the Middle East Times International (Australia), writes extensively on human rights issues.

"We are going to smash your hands to pulp like the Chileans did to Victor Jara." Those were the words of the torturers in a Uruguayan prison spoken to my friend Miguel Angel Estrella, a pianist from Argentina. They were referring to the fate of the imprisoned Chilean singer and guitarist Victor Jara, whose hands were destroyed so that he would never play the guitar again. Jara, a fervent opponent of the Pinochet regime, was brutally tortured and later machine-gunned to death following the coup that brought Pinochet to power in 1973.

Estrella was being held in Uruguay's Libertad prison, accused of being a guerrilla from Argentina fighting the Argentine military regime. Unable to prove the charges against him, and given the unprecedented international pressure, the Uruguayan government released him in 1978 after having kidnapped him at the end of 1977.

Estrella was luckier than most of those imprisoned by the South American military. Although tortured and held for a long time in isolation, Estrella eventually recovered, leads a brilliant career as a musician, and is now Argentina's ambassador to UNESCO.

One of those who trained the Uruguayan torturers was an American operative, Daniel (Dan) Mitrione, who was later captured and killed by Uruguayan guerrillas. According to A.J. Langguth, a former New York Times bureau chief in Saigon, Mitrione was among the U.S. advisers who taught torture to the Brazilian police.

Mitrione's method for the application of torture was carefully orchestrated. Langguth reports that the method was described in detail in a book by Manuel Hevia "Cosculluela," a Cuban double agent who worked for the CIA, "Passport 11333, Eight Years with the CIA."

This is Mitrione's voice: "When you receive a subject, the first thing to do is to determine his physical state, his degree of resistance, through a medical examination. A premature death means a failure by the technician. Another important thing to know is exactly how far you can go given the political situation and the personality of the prisoner. It is very important to know beforehand whether we have the luxury of letting the subject die . . . before all else, you must be efficient. You must cause only the damage that is strictly necessary, not a bit more. We must control our tempers in any case. You have to act with the efficiency and cleanliness of a surgeon and with the perfection of an artist . . ."

In Uruguay, Mitrione was the head of the Office of Public Safety, a U.S. government agency established in 1957 by U.S. President Dwight D. Eisenhower to train foreign police forces. At Mitrione's funeral, Ron Ziegler, the Nixon administration's spokesman, stated that Mitrione's "devoted service to the cause of peaceful progress in an orderly world will remain as an example for free men everywhere." Thanks to former U.S. Sen. James Abourezk's efforts, the policy advisory program was abolished in 1974.

Mitrione's case was far from unique. Through the School of the Americas, thousands of military and police officers from Latin America were trained in repressive methods, including torture. On Nov. 16, 1989, six Jesuit priests, a coworker and her teenage daughter were massacred in El Salvador. I knew one of those killed, Ignacio Martin-Baro, vice rector of the Central American University. He was the closest I have ever been to a saint.

A U.S. Congressional Task Force concluded that those responsible for their deaths were trained at the U.S. Army School of the Americas at Fort Benning, Georgia.

Human beings make culture. And we also make torture, that bastard child of culture. It is up to us to change this situation. When running for president, Barack Obama stated, referring to the Iraq war, "It is not enough to get out of Iraq; we have to get out of the mind-set that led us into Iraq."

A similar assertion could be made about torture. It is not enough to say that torture will not be practiced any longer by the U.S. We need to get out of the mind-set that made torture possible in the first place.

Cesar Chelala, a writer on human rights issues, is a cowinner of an Overseas Press Club of America award for an article on human rights.

For over two decades several projects have been carried out between conflicting sides in several regions around the world that have improved public health as a common denominator in the search for peace. Although these initiatives will not by themselves achieve peace, they have become significant points of contact between conflicting parties. They have benefited thousands of people and increased understanding between them, and showed that sustained cooperation can be achieved despite violent disputes and a hostile political atmosphere.

The recent talks between President Barack Obama and Israel’s Prime Minister Benjamin Netanyahu underscore the importance of promoting peace efforts at all levels between Israelis and Palestinians. For example, since its founding in 1988, the Association of Israeli-Palestinian Physicians for Human Rights brought together Israeli and Palestinian health professionals. Following the signing of the Oslo agreement in 1993, a new set of players –aside from NGOs and human rights groups- came into action between 1993 and 1997, focusing their activities on developing and providing health services to the Palestinian people.

In 1995, following an invitation of the late King Hussein of Jordan to officials at the Canada International Scientific Exchange Program (CISEPO), several actions were carried out to foster collaboration between Arab and Israeli doctors. The high incidence of hearing loss shared by Jordanians and Israelis was the basis of a project to provide auditory tests and improve hearing among infants.

Since then, there have been many scholarly exchanges between Canada, Israel and Jordan, many Israeli-Palestinian publications were created, and several scientific symposiums have been carried out. To date, more than 145,000 infants have been screened and treated for hearing loss and their hearing has considerably improved. In addition, the program has expanded to youth health promotion, maternal nutrition and management of infectious diseases.

In December of 2004, the first issue of the magazine bridges was launched under the auspices of the World Health Organization (WHO.) The magazine has contributions from both Israeli and Palestinian health experts, and is another example of the value of building bridges of understanding between Israelis and Palestinians.

Under the leadership of Dr. Mary-Claire King, who identified the first breast-cancer gene, scientists from Tel Aviv, Bethlehem and Seattle teamed up to find the cause of deafness, and have found several genes responsible for hearing loss. They were able to do that despite the obstacles posed by the shutting down of university facilities, blocked shipments and other inconveniences.

Those are just a few examples of what up to now is a very active collaboration between Palestinian and Israeli doctors and health workers. Despite their obvious value, these activities are not universally supported. In 2005, medical and health service providers and members of research and training institutions working in the Occupied Palestinian Territory strongly objected to what they consider is strong pressure to enter into Palestinian-Israeli cooperation in the health area.

According to them, a political agenda is the driving force in what they consider is a forced cooperation between Israelis and Palestinians. In addition, they don’t think that Israeli-Palestinian collaboration in the academic, scientific and professional spheres can truly contribute to reconciliation as long as justice for Palestinians has not been achieved.

Although there is some validity to their position peace will not be achieved overnight. It is only through some incremental steps that reconciliation between both peoples will take place. As former Prime Minister Yitzhak Rabin stated when awarding a UNESCO peace prize, “Peace will be built slowly, day by day, through modest deeds and countless spontaneous details. It will be built, step by step, by people.”

There is no better way to do it than through collaboration in the public health area on issues of common interest. The better health of thousands of women, men and children is a living testimony of the effectiveness of such approach. In a region plagued by lack of confidence and trust, health is the best antidote to war.

Dr. Cesar Chelala is an international public health consultant and a co-winner of an Overseas Press Club of America award.

The Nuremberg Principles, a set of guidelines established after World War II to try Nazi party members, were developed to determine what constitutes a war crime. The principles could also be applied today, when judging the conditions that led to the Iraq war and in the process to the deaths of hundreds of thousands of people, many of them children, and to the devastation of a country’s infrastructure.

In January of 2003, a group of U.S law professors warned President George W. Bush that he and senior officials of his government could be prosecuted for war crimes if military tactics violated international humanitarian law. The group, led by the New York-based Center for Constitutional Rights, sent similar warnings to British Prime Minister Tony Blair and to Canadian Prime Minister Jean Chretien.

Although Washington is not part of the International Criminal Court (ICC), U.S. officials could be prosecuted in other countries under the Geneva Convention, indicated Michael Ratner, president of the Center for Constitutional Rights. Ratner likened the situation to the attempted prosecution by a Spanish magistrate, Baltazar Garzón, of the Chilean military dictator Augusto Pinochet, who was held under house arrest in London.

Both former President George W. Bush and senior officials in his government could be tried for being responsible for torture and other war crimes under the Geneva Conventions. In addition, should Nuremberg principles be followed by an investigating tribunal, former President Bush and other senior officials in his administration could also be tried for violation of fundamental Nuremberg principles. In 2007, Luis Moreno-Ocampo, the ICC’s chief prosecutor, told The Sunday Telegraph that he could envisage a scenario in which both British Prime Minister Tony Blair and then President George W. Bush could face charges at The Hague.

Perhaps one of the most serious breaches of international law by the Bush administration is the doctrine of “preventive war.” In the case of the Iraq war, it was carried out without authorization from the U.N. Security Council in violation of the U.N. Charter, which forbids armed aggression and violations of the sovereignty of any state by any other state, except in immediate self-defense.

As stated in the U.S. Constitution, international treaties agreed to by the United States are part of the “supreme law of the land.” “Launching a war of aggression is a crime and no political or economic situation can justify it,” stated Justice Jackson, the Chief U.S. Nuremberg Tribunal Prosecutor. And Benjamin Ferencz, also a former chief prosecutor of the Nuremberg Trials declared, “a prime facie case can be made that the United States is guilty of the supreme crime against humanity, that being an illegal war of aggression against a sovereign nation.”

The conduct and the consequences of the Iraq war are part of the Crimes against Peace and War crimes stated in Nuremberg Principle VI which defines as crimes against peace, (i) Planning, preparation, initiation or waging of a war of aggression or a war in violation of international treaties, agreements or assurances; (ii) Participation in a common plan or conspiracy for the accomplishment of any of the acts mentioned under (i).

In the section on war crimes, Nuremberg Principle VI includes, “…murder or ill-treatment of prisoners of war or persons on the seas, killing of hostages, plunder of public or private property.” The criminal abuse of prisoners in U.S. military prisons in Iraq, Afghanistan and Guantánamo are clear evidence of ill-treatment and even murder of prisoners. According to the organization Human Rights First, at least 100 detainees have died while in the hands of U.S. officials in the global “war on terror,” eight of whom were tortured to death.

As for the plunder of public or private property, there is evidence that even before the war started, members of the Bush administration had already drawn plans to privatize and sell Iraqi property, particularly oil.

Although there are obvious hindrances to trying a former US president and his associates, such a trial is fully justified by legal precedents, in particular the Nuremberg Principles, as well as by the extent of human lives lost and the breach of international law it has produced.

Cesar Chelala, a co-winner of an Overseas Press Club of America award, writes extensively on human rights issues.

According to the U.S. Census Bureau, by 2010 sub-Saharan Africa will have suffered 71 million deaths from AIDS. By comparison, the bubonic plague of the Middle Ages killed some 30 million people. These are staggering figures, particularly if one considers that deaths from AIDS are only one of the problems affecting African women and children.
Experts at the United Nations warn that most sub-Saharan countries will be unable to reach the Millennium health goals related for 2015, particularly those related to improved health for mothers and children.

Solving Africans' health and development problems need more than statements of good intention, promises of aid (often empty) or movie stars' adoption of African children. Yet, many diseases affecting children and adults can be addressed with minimum resources if they are used strategically.

Childhood malnutrition is a critical issue. Almost 60 percent of deaths of children under 5 in developing countries are due to malnutrition and its effects — such as greater mortality from infectious diseases. Malnourished children are up to 12 times more likely to die from easily preventable infectious diseases (such as measles, malaria, diarrhea and pneumonia) than are well-nourished children.

It is estimated that African women are 10 to 100 times more likely to die during pregnancy and childbirth than women in industrialized countries. Most of these deaths and disabilities are caused by delays in recognizing complications, difficulties in reaching a medical facility and lack of adequate medical care. Skilled health workers are vital in addressing these challenges but their numbers are pitifully low.

Malaria, HIV/AIDS and tuberculosis continue to be major threats facing both children and adults. Recent experiences in Africa and Latin America show that malaria can be controlled without use of DDT, an important new approach to dealing with this disease. It can be done through rapid-case detection and drug treatment, as well as through prevention efforts at a community level emphasizing the use of insecticide-impregnated bed nets, sanitation measures to eliminate vector breeding sites and use of chemical substitutes for spraying houses.

Recent studies have shown that HIV treatment is "failing" in many African countries. The rates of failure vary depending on the program and the country under consideration. Treatment failure in many patients is due to their starting to take medication too late in the course of the infection. Other patients have problems in accessing the drugs, either because they are too poor or live too far away from the health center providing the medication.

Throughout Africa, the stigma associated with HIV/AIDS is one of the main barriers in dealing successfully with that infection, both in terms of prevention and treatment.
Education, public health campaigns and the active participation of members of the clergy have contributed in many areas to overcoming the stigma but much remains to be done and progress is slow.

HIV/AIDS has also had a significant though rarely discussed effect on the education sector. In sub-Saharan Africa, the HIV/AIDS pandemic is killing teachers at a rate faster than replacements can be trained. Another effect of the pandemic is teacher absenteeism, loss of educators, planners and management personnel. It is estimated that close to 30 percent of South Africa's teachers are HIV positive, a higher rate than among the general population.

According to statistics from Zambia's education ministry, every day one teacher dies from an AIDS-related disease. This is the equivalent of the closure of one school per week due to loss of teachers.

In Africa's rural areas, not only are health services and infrastructure inadequate but there also is a lack of properly trained medical personnel. To compound the problem, there is an exodus of trained personnel to higher paying jobs in industrialized countries.

It is estimated that there are more Malawian physicians in Manchester, England, than in Malawi a country of 12 million people with only 100 doctors and 2,000 nurses. Over 15 percent of Malawi's population is HIV-positive. Many of its health-care workers are infected with the disease or have died of AIDS.

According to the World Health Organization, 23,000 health-care workers leave Africa annually. Equally serious is the distribution of health-care workers within the countries themselves. They tend to remain in urban areas.

“In 25 years, Africa will be empty of brains,” warned in 2005 Dr. Lalla Ben Barka of the UN Economic Commission for Africa (ECA) reflecting his concern over Africa’s exodus of human capital. It is estimated that over 300,000 professionals reside outside Africa.

Solving the problem of poverty and the resulting malnutrition and disease it engenders requires three distinct steps: developing efficient and effective health-care systems; increasing access of the poor to adequate health care; and redirecting resources from acute care hospitals using high-tech equipment to investment in low-tech, but effective, community-based primary and preventive care.

Health problems in Africa cannot be considered in isolation — and are not only the responsibility of Africans themselves. Foreign technical and financial assistance is required. Aid must bypass corrupt governments and find ways to help people directly, for example through nongovernmental and U.N. organizations with a proven record of effectiveness. Aid can strengthen civil society and community-based organizations, which are the basis of a democratic society.

To bring hope to a continent ravaged by poverty and disease, effective and urgent action is required. It is available and it can be done.

Dr. Cesar Chelala, an international public health consultant, has conducted health-related missions in several African countries. He is a co winner of an Overseas Press Club of America award.

On April 16, Cándido Conde Pumpido, Spain’s attorney general, said that he wouldn’t recommend going ahead with a probe of six former US officials over allegations that they gave legal support for conducting torture at Guantánamo Bay prison in Cuba. Conde Pumpido’s justification was that the claims are “fraudulent” since the officials didn’t carry out the torture themselves, and if anybody, those accused should be the material authors of the crime.

Spain prosecutor’s decision not to endorse the indictment of the six Bush officials accused of complicity in torture of detainees only delays -but doesn’t stop- their eventual indictment. If the U.S. decides not to try those officials, another country more respectful of its international obligations will do so.

The case involves former US Attorney-General Alberto Gonzales; ex-Undersecretary of Defense Douglas Feith; former Vice President Dick Cheney’s chief of staff David Addington; former Justice Department officials John Yoo and Jay S. Bybee and Pentagon lawyer William J. Haynes II.

Although Mr. Pumpido wants to avoid the indictment used for political ends, it is possible that his refusal may instead convert it into a hot political issue, particularly since judge Baltazar Garzón was the one requesting a course of action. Judge Garzón had successfully prosecuted ex-Chilean dictator Augusto Pinochet in the 1990s in Great Britain. Pinochet was held in England under house arrest for several months before being sent back to Chile.

Pinochet was held in England under the universal jurisdiction principle, which establishes that every country has the ability to bring to justice the perpetrators of grave crimes, no matter where those crimes were committed, and regardless of the nationality of the perpetrators or their victims.

The Geneva Conventions and the Convention against Torture place a legally binding obligation on states that have ratified them to exercise the universal jurisdiction principle over persons accused of grave transgressions of those conventions. If the country where these transgressions have occurred doesn’t bring them to justice, it should extradite them to a country that will. Universal jurisdiction complements, but doesn’t override national prosecutions. Since the US has ratified the Convention Against Torture, it has the legal obligation to prosecute or extradite those who commit or are complicit in torture.

Several countries have already used the principle of universal jurisdiction to try those guilty of serious crimes. The US itself has used this principle before. Last January, a US court convicted Chuckie Taylor, son of the former Liberian president Charles Taylor, for torture carried out in Liberia and sentenced him to 97 years in prison.

The torture policies of the Bush administration will no longer be followed under President Obama’s executive orders. However, the Justice Department has also indicated that it would not prosecute those who used harsh interrogation techniques sanctioned in advance by the Justice Department.

Both President Obama and Attorney General Eric H. Holder have indicated their desire to move forward and not to reignite past issues that could provoke partisan rancor. This policy, however, carry the risks that if those accused of serious crimes are not properly prosecuted, those same actions may be used in future administrations. Although President Obama and Attorney General Eric H. Holder are clear about their intention not to prosecute those that carried out interrogation abuses, they are less clear about the policy towards those that created the framework that facilitated those abuses.

Failure to prosecute those who created the legal framework for torture will hinder any future efforts to totally eliminate those cruel, unlawful acts from the conduct of modern societies.

Cesar Chelala, a writer on human rights issues, is a co-winner of an Overseas Press Club of America award for an article on human rights.

President Obama’s visit to Turkey highlights one of that country’s most difficult foreign policy issues: the lasting controversy over Turkey’s role in the killing of hundreds of thousands of Armenians. President Obama aptly praised Turkey’s recent efforts to solve this long lasting problem.

In 1915, as the Ottoman Empire was in its death throes, almost 1,000,000 Armenians were massacred, and many others were forced into exile from their land. The circumstances that led to this ordeal are still under spirited discussions.

The result of these events is Armenians hatred for the Turks, almost a century after the devastating events of 1915 which Armenians consider genocide. During a trip to Armenia I was once again reminded of man's inhumanity to man. I also found myself face-to-face once again with the power of memory and of hate.

Can this hatred be overcome so that a productive relationship between the two countries can be brought about? It is obviously too late to bring those responsible to justice. However, it should be possible to reach a level of understanding and cooperation between the two societies.

I spoke with Professor Mira Antonyan, director of the Fund for Armenian Relief, about the effects of those events on Armenians today. “The only thing that unites us now is our resentment against the Turks for the events of the past” she told me. That feeling was shared by her husband and a friend of both, who regularly trade with Turkish businessmen. “Being Armenian means having sad memories," she added.

I told them that I felt Armenians were in a quagmire, unable to move forward because of the tremendous weight of past events. "Perhaps you are right," Mira's husband answered, "but genocide is a very heavy burden on our shoulders. We cannot just forget what happened. We cannot erase our memory."

I believe that there is a generational divide on the question. The older generation—those over 50—insist on the need for an apology from the Turkish government for the assassination of Armenians. The younger generations, without rejecting the facts of history, feel the need to overcome the negative effects of those memories. They believe that such visceral attachment to the past is self-defeating.

Kamilla Petrosyan, an Armenian psychiatrist in her late 30s, told me how her 4-year-old son arrived home one day from kindergarten frightened to death on learning that day about the 1915 massacres. "We have to stop this culture of victimization," she said, "otherwise we will never be able to move forward."

Something similar happens in Turkey. Arman Artuc, editor of the HyeTert news portal in Istanbul, told me recently, "Almost everybody living in Turkey grew up with stories (beginning with primary school textbooks, newspapers and other media) of how cruel Armenians have been to Turks during and after WWI using a language of hatred and insults. Only recently commissions were established to change the textbooks and remove such language"

These and other events demonstrate that the Turks too are beginning to show signs of the need to move forward. A number of Turkish intellectuals, including last year's winner of the Noble Prize for literature, Orhan Pamuk, have made public statements to that effect. Turkish President Abdullah Gul has been quite forceful on the need and mutual convenience to have better relations between both countries and has called for the formation of a joint commission of Turkish and American scholars to assess past events.

The creation of a commission of both Turkish and Armenian historians under the auspices of the United Nations and with representatives from the International Court of Justice at The Hague is an important and necessary step. The task of such commission would be to analyze historical documents that will shed definitive light on the events of the past.

A change of paradigm that will allow us to move away from a culture of violence is desperately needed. We should take advantage of the present situation to create an irreversible motion towards mutual understanding through the implementation of a wide range of peace building measures that will create a strong foundation for cooperation.

Some important steps have already been taken. In July 2008, Armenian president Serzh Sarkisian invited Turkish president Abdullah Gul to visit Armenia. The visit, which took place in September 2008, was the first-ever visit of a Turkish head of state to Armenia. This event was followed by high level talks among officials from both countries.

Richard Giragosian, Director of the Armenian Centre for National and International Studies (ACNIS) in Yerevan wrote recently that a changing relationship can result in a “win-win” situation for both countries. For Armenia, it offers new economic opportunities and a much-needed foreign policy success. For Turkey, it will result in improved status vis-à-vis the European Union and the U.S.

The importance of an agreement for peace and cooperation between Turkey and Armenia goes beyond their borders. In a world wired for war, it can show that peace and understanding between peoples burdened by the past is still possible, and create a psychological momentum for peace that would allow reaching similar agreements in other parts of the world.

It is only by constructing bridges of understanding—particularly working with young people, still untainted by the weight of the past—that we will be able to change the present paradigm of violence and war for one of collaboration and peace.

Dr. Cesar Chelala is the co-author of "Missing or Dead in Argentina: The Desperate Search for Thousands of Abducted Victims," a New York Times Magazine cover story, for which he shared an Overseas Press Club of America award. Dr. Chelala is the foreign correspondent for the Middle East Times International (Australia).

Among the many urgent tasks facing the Obama administration one of the most pressing is to restore good relations with Latin America and the Caribbean, damaged by eight years of neglect. A measure that could have far-reaching consequences and notably improve the U.S.’ battered image in the continent would be to return Guantánamo to the Cuban people.

Improving the relationship with Latin America and the Caribbean by giving back Guantánamo to Cuba is pertinent now. This action will strengthen the effects of the Obama administration’s decision to eliminate certain travel restrictions and obstacles to remittances to Cuba and, particularly, its intention to close the Guantánamo facility.

Guantánamo has a convoluted history. Initially, the U.S. government obtained a 99-year lease on the 45 square mile area beginning in 1903. The resulting Cuban-American Treaty established, among other things, that for the purposes of operating naval and coaling stations in Guantánamo, the U.S. had “complete jurisdiction and control” of the area. However, it was also recognized that the Republic of Cuba retained ultimate sovereignty of that area.

In 1934, a new treaty reaffirmed most of the lease conditions, increased the lease payment to the equivalent of $3,085 in U.S. dollars per year, and made the lease permanent unless both governments agreed to end it or the U.S. decided to abandon the area. In the confusion of the early days of the Cuban revolution Castro’s government cashed the first check but left the remaining checks uncashed. Since these checks were made out to the ‘Treasurer General of the Republic’, a position that ceased to exist after the revolution, they are technically invalid.

The U.S. has maintained that the cashing of the first check indicates acceptance of the lease conditions. However, at the time of the new treaty, the U.S. sent a fleet of warships to Cuba to strengthen its position. Thus, a counter argument is that the lease conditions were imposed on Cuba under duress and are render void under modern international law.

The U.S. has used the argument of Cuban sovereignty when denying basic guarantees of the U.S. Constitution to the detainees at Guantánamo by indicating that federal jurisdiction doesn’t apply to them. If the Cuban government indeed has sovereignty over Guantánamo then its claims over the area are legally binding, and the U.S. is obligated to return Guantánamo to Cuba.

Since 1959, the Cuban government has informed the U.S. government that it wants to terminate the lease on Guantánamo. The U.S. has consistently refused this request on the grounds that it requires agreement by both parties. Alfred-Maurice de Zayas, an American lawyer and professor of international law at the Geneva School of Diplomacy and International Relations has indicated, that article 52 of the Vienna Convention on the Law of Treaties states, “A treaty is void if its conclusion has been procured by the threat or use of force in violation of the principles of international law embodied in the Charter of the United Nations.” He also said that the conditions under which the treaty was imposed on the Cuban National Assembly, particularly as a pre-condition to limited Cuban independence, left Cuba no other choice than to yield to pressure.

A treaty can also be void by virtue of material breach of its provisions, as indicated in article 60 of the Vienna Convention on the Law of Treaties. According to the original terms of the lease agreement, the Guantánamo Bay territory could only be used for coaling and naval purposes. However, the use of the Guantánamo facility as an internment camp for Haitian and Cuban refugees or, even more ominously, as a torture center by the U.S. military, indicates a significant breach of that agreement fully justifying its immediate termination.

President Jimmy Carter courageously returned the Panama Canal to the Panamanians, thus setting an important precedent. President Carter did what was legally right, and lifted U.S. prestige not only among Panamanians but throughout the hemisphere.

Returning Guantánamo to the Cubans will allow the U.S. to close one of the most tragic chapters of its legal and moral history. And it will compensate Cubans for the miseries they have had to endure for decades because of Washington’s misguided policies.

Although rape as a weapon of war has existed for as long as war itself, it continues taking a heavy toll on women's lives in today's conflicts around the world. A high proportion of the women who are victims of rape end up infected with sexually transmitted diseases and infections, including HIV.

Since most of the countries experiencing an almost perpetual state of internal strife lack medicines and basic health-care services, becoming HIV-infected is virtually a death sentence. Given the wide use of rape as a weapon of war in some countries, especially those experiencing ethnic or tribal conflicts, and the high rates of HIV infection among warring factions, rape is rapidly becoming genocidal.

Rape happens on a wide scale in the Democratic Republic of Congo (DRC), Uganda and Sudan. In the DRC, where more than 3 million people have been displaced by war, rape victims are counted in the tens of thousands. According to some estimates, up to 60 percent of combatants in the DRC are HIV-infected.

In Uganda, soldiers from the Lord's Resistance Army have raped and mutilated women in their struggle to replace a secular government in the country. Despite the cessation of hostilities the situation in the country remains grim. “The horrific violence committed during the many years of conflict in northern Uganda continues to aggravate discrimination against women and girls in the area today,” stated Godfrey Odongo, Amnesty International’s researcher in Kampala.

Rape was widespread in Rwanda. According to the group Women's Equity in Access to Care and Treatment, 67 percent of rape survivors in Rwanda are HIV-infected. As Anne-Christine d'Adesky, executive director of Women's Equity in Access to Care and Treatment stated, "Rape is an engine of HIV infection."

While rape in Rwanda has stopped, it continues in Sudan and the DRC, where human-rights activists say girls as young as 3 years old have been raped with knives, sticks and guns. In the DRC, gang rape has become so common that thousands of women suffer from vaginal fistulas, which leave them unable to control bodily functions and lead to lifelong debilitating health problems.

Rape as a way of humiliating women, their families and their communities is frequently conducted in public, in front of husbands and children. It is, in essence, a brutal way to show or maintain dominance over the women and their families.

A report by Amnesty International, "Darfur: Rape as a Weapon of War: Sexual Violence and Its Consequences," called attention to the phenomenon in Sudan. According to the Amnesty report, there is a pattern of systematic and brutal attacks against civilians in the Darfur states of Sudan by a government-sponsored militia called the Janjaweed and by the government army. The attacks are the Sudanese government's response to attacks by two main insurgent groups founded in 2003.

The confrontation in Sudan has led to the displacement of over 1.2 million people, most of whom have become internally displaced. The rest have taken refuge in neighboring countries. That these acts have the acquiescence of the government is evidenced by the fact that no member of either the Janjaweed or the armed forces has been charged with rape or other human-rights violations.

There are many other consequences of rape aside from the obvious physical and psychological violence of the act and the high risk of HIV. Many women get pregnant after being raped. In many cases women raped are killed afterward by their attackers. Among those that survive a high proportion are forced to become sex slaves.

Many men view the rape of their wives as a form of humiliation not only against them but also against the ethnic, tribal or religious group they belong to. This may cause husbands and communities to reject women victims and even their children. The women, having endured the brutality of the rape itself and its physical and psychological consequences, then find themselves denied their most basic human rights.

Even when pregnancy does not occur, men in patriarchal societies still may reject their wives, mothers or daughters after they have been raped. Lepa Mladjenovic, a Serbian psychotherapist and antiwar activist, says rape renders a woman "homeless in her own body."

Given the scale of abuses against civilians in Sudan, including the rape of children as young as 8 and women as old as 80, Amnesty International is calling for an international commission of inquiry. Such a commission should be supported by the United Nations and leading Western democracies. Difficult as this problem is, only rapid action and widespread political support will offer the possibility of diminishing its barbaric impact.

by Cesar Chelala and Alejandro Garro

Eric H. Holder Jr., the new U.S. Attorney General, has unambiguously stated his intention to end one of the most shameful episodes in U.S. legal history: “I can assure the American people that Guantánamo will be closed,” he announced at his confirmation hearings in Washington. Effective closure, however, calls for reflection as to the lessons to be drawn from this sad chapter in our constitutional history.

In 2006, Congress passed the Military Commissions Act (MCA), in effect approving the military tribunals established by President George W. Bush and denying the writ of habeas corpus to the Guantánamo detainees. Diverting the prosecution of terrorists to ad hoc martial courts was and remains a sad mistake. The constitutionality of these military commissions, despite congressional authorization, remains unclear. Indeed, bypassing the regularly constituted federal courts has not resulted in security gains with respect to terrorism. In a clear break with the Bush administration’s policies, Mr. Holder has declared that the system of military commissions does not guarantee the rights of due process for detainees. Lesson #1: the Military Commissions Act is far from indispensable and has no place in trials of civilians.

In June 2008, in a closely divided decision, the Supreme Court ruled that, despite congressional authorization, even prisoners unilaterally labeled as “enemy combatants” by the executive branch are entitled to challenge their detention through habeas corpus, a decision yet to be applied for hundreds of Guantánamo detainees. While stressing that the country is still in a state of war, Mr. Holder warned against the “false choice” between upholding civil liberties and protecting national security. Lesson #2: the United States has every right to detain those who pose a threat to its citizens and soldiers but those detained must have the right to challenge the legality of their detention before a federal court.

In November 2008, in the course of the military commission case against Afghan national Mohammed Jawad, army judge Col. Stephen Henley threw out a confession extracted under torture, confirming what legal experts have long maintained: coerced confessions are inherently unreliable and, even when reliable, taint the judicial process which must be exemplary in every respect. During his confirmation hearings, the new U.S. Attorney General left no doubt that water boarding used by U.S. operatives against Guantánamo detainees, constitutes torture. Lesson #3: the government has every right to search for valuable intelligence concerning the intentions and tactics of suspected terrorists, but torture must never be condoned as a valid method of extracting information, not even under the guise of self-protection or for the sake of lives.

The rationale behind the “enemy combatant policy” is to incapacitate suspected terrorists by holding them indefinitely, incommunicado and without charge, for the duration of the so-called “war on terror”. The act of circumventing the most basic guarantees against arbitrary detention affects not only the suspects but everyone else, hurting innocent bystanders caught in the crossfire and ultimately undermining the morale of those fighting terrorism. The detention of dangerous enemies is lawful and makes us safer, but not if the cost is the loss of democratic principles and human dignity. Lesson #4: whatever the challenges posed by the terrorist threat, unilaterally labeling individuals as enemy combatants and detaining them indefinitely and incommunicado by executive order is unacceptable practice.

The abuses prisoners have been subjected to at Guantánamo underscore the need to balance executive discretion with access to legal counsel and meaningful judicial review by federal courts. With Eric H. Holder’s confirmation as U.S. Attorney General, we may look forward to significant improvement in accommodating the “war on terror” with the rule of law, which the executive branch has a primary duty to uphold.

Cesar Chelala is a co-winner of an Overseas Press Club of America award for an article on human rights. Alejandro M. Garro is Professor of Comparative Law at Columbia University, New York.