Little change in Honduras prison where 362 died

JUTICALPA, Honduras (AP) — On the 14th day of each month, Jesus Garcia joins other relatives to hoist a cardboard coffin and carry it in a macabre procession down a road to the prison where two cousins died with 360 other inmates in the worst prison fire in at least a century.

It’s their way to demand justice in the deaths of Antonio and Franklin Garcia, who were among many left locked in their cells as fire raced through the wooden barracks, and the handful of guards on duty ran for their lives.

“We go to the jail, in a symbolic procession with a casket, to ask for justice, but we get no answers,” Garcia said. “We go to the minister of human rights and she passes it along to the president and he passes it along to the first lady, but then nothing gets done.”

A year after the fire in Comayagua, about 60 miles (100 kilometers) from Tegucigalpa, the investigation remains open and prosecutors have filed no charges. The burned cells and electrical system are still being repaired.

While the government created a new agency told to replace the police in the prisons with specially trained guards, social workers and doctors, the three-person commission that started working last week was given no budget and has no office, according to its director, Agusto Avila.

Even the inmate who was the hero of the fire, finding keys and freeing hundreds of men, was never pardoned as President Porfirio Lobo had promised. Honduran law forbids commuting a murder sentence, so Marco Antonio Bonilla is still serving his time, working in the prison infirmary, where he was awakened that night by the screams of inmates as they were devoured by flames.

“There was no mechanism to extinguish fires, no evacuation plan. The firefighters were not allowed to get there quickly and the guards, instead of acting appropriately, only fired shots in the air, supposedly because that is the established procedure in case of escapes,” said government human rights prosecutor German Enamorado, who led the investigation for the Attorney General’s Office.

Garcia is in a position to know it can happen again. Besides being a relative of the dead, he is the warden of the Juticalpa prison northeast of the capital in rural Olancho state. A fire today in the Juticalpa facility of 500 inmates could cause similar devastation because it doesn’t have running water to fight a blaze, despite the fact it is one of the country’s modern facilities, built in 2007.

Human rights monitors have long criticized Honduras‘ prison system. Most of the 11,000 inmates in the country’s 24 prisons have not yet been found guilty. More than half of the 800 prisoners in Comayagua at the time of the fire were still awaiting trial, according to a Honduran government report sent to the United Nations a year ago.

The Office of Human Rights’ investigation into the disaster found “no evidence of criminality in the origin of the fire,” Enamorado said.

It began with “a flame in one of the cells that spread in a few minutes,” Enamorado said, referring to a report by the Office of Alcohol, Tobacco, Firearms and Explosives, whose agents investigated the cause. “But there was negligence on the part of authorities in charge of prison security, whose actions could have avoided a death toll of this magnitude.”

Despite that finding, the Attorney General’s Office is keeping the case open for lack of evidence, he said, awaiting details including autopsy results, the exact number of inmates in the facility that day, whether there was an evacuation plan and the material of the mattresses that burned.

Three of the 362 victims still have yet to be identified; one as never claimed by relatives and two were burned beyond recognition.

The Legal Forensics Department and the Attorney General’s Office didn’t respond to interview requests to explain the delay.

Relatives of those who died say the government is just trying to avoid blame. “There’s a policy on the part of the attorney general to conduct investigations in an obstructive manner in cases of human rights violations with an objective to keep the responsibility from falling on the state,” said Joaquin Mejia, attorney for the Committee of Relatives of the Victims of Comayagua.

And Honduras’ permanent state of fiscal, political and judicial crisis leaves few resources for improving prisons.

The national budget allocated around $ 15 million to the prison system for 2013. About 85 percent goes to pay salaries for prison officials and guards, according to the Security Department.

Honduran prisons receive the rest of their funding from taxes that inmates pay from the work they do inside. At Comayagua, prisoners grew corn and beans and raised fish and chicken on the 36 acres of farmland surrounding the facility.

Dani Rodriguez, a police inspector, was named director of Comayagua prison on Feb. 15, a day after the fire. He has not been able to change much.

“The state transferred 180,000 lempiras ($ 9,000), and by selling some of the scrap metal after the fire we got 32,000 lempiras ($ 1,500), and the TV show they did for our benefit left us with a huge plastic check which they used for the photo, but we haven’t received the money yet,” Rodriguez said.

As in all Honduran prisons, Rodriguez supplements scant government funds with the taxes he collects from inmates, who run their own businesses from inside. With his inmate population down by half after the fire, so is his budget, about $ 1,000 for food and maintenance.

Garcia knows the difficulties from running the Juticalpa prison.

“We receive water for a couple of hours a day thanks to a neighbor who lets us connect to his tank, but the water is not always clean. Sometimes a fire truck will supply some water as a donation from the mayor’s office,” said Gonzalo de Jesus, the prison administrator who works with Garcia.

Roberto Urquia, who works in the Juticalpa prison infirmary, brings his own water and boils it to make is safe.

“About 25 percent of the inmates have chronic gastrointestinal problems,” he said.

On January 16, Honduras’ Congress approved building a new prison at Comayagua with $ 60 million borrowed from a local bank.

“They had the ability to do such business while the inmates have no water or medication,” said Odalis Najera, commissioner for the National Office to Prevent Torture, an organization created by the U.N. to monitor Honduran prisons. “The situation that each and every one of them is living is equivalent to torture.”

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Who Pays the Highest Price When It Comes to Breast Cancer?

In this, the third in our month-long series on the disparities and inequities of cancer in the U.S. and beyond, we look at the group of American women hardest hit—by far—when it comes to breast cancer.

One in nine women will have breast cancer. The disease is the second-leading cause of death among women in the United States. But no group suffers more from breast cancer than African-American women.

According to the Centers for Disease Control and Prevention (CDC):

•   African-American women have the highest death rate from breast cancer of all races/ethnicities. They are 40 percent more likely to die of the disease than white women.

•   Forty-five percent of black women are found to have breast cancer that has spread beyond the breast (when it has reached a far deadlier stage) compared with 35 percent of white women.

•   After learning that their mammogram is not normal, 20 percent of black women wait or delay seeing a doctor for follow-up more than 60 days. That’s compared to 12 percent of white women. Waiting longer for follow-up care may allow cancer to spread.

Have Cancer but No Insurance? No Problem — You Can Pay With Your Life

•   Only 69 percent of black women start treatment within 30 days of their diagnosis of breast cancer, compared with 83 percent of white women.

•   Overall, breast cancer death rates among U.S. women fell 27 percent from 1990 to 2005, but not at equal rates. In white women, breast cancer mortality declined by 2.5 percent annually, but it declined just 1.4 percent each year for African-American women.

•   Fewer black women receive the surgery, radiation, and hormone treatments they need compared to white women.

Like other types of cancer disparities, the reasons that black women have worse survival rates are numerous. They include poverty, lack of access to care, lack of health insurance, literacy barriers, and unequal treatment by professionals in the healthcare system, according to a March 2002 Institute of Medicine report.

“A lot of the same reasons for disparities that we see in other types of cancers come into play here—less access to care; less access to screening technologies; not receiving the same kinds of treatments and follow-up care,” says Dr. David Wetter, a professor in the department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, at the University of Texas MD Anderson Cancer Center, in Houston.

But there are also differences in the types of breast cancer among various racial and ethnic groups. “African-American and Hispanic women seem to get a more aggressive form of cancer and at a younger age—the ‘triple negative’ breast cancer. It’s a more virulent form of cancer with worse outcomes,” Wetter says. A “triple negative” breast cancer means the cancer cells do not have receptors for the hormones estrogen or progesterone or high levels of the HER2/neu protein. These levels can tell an oncologist how quickly the breast cancer might grow.

One Group Dies From Cancer More Often Than Any Other. Do You Know Who It Is?

The good news is that black women get mammograms about as often as white women, according to the CDC.

Still, everyone—from government to public health departments to doctors to women themselves—need to take more steps to erase breast-cancer disparities affecting black women, experts say. The Affordable Care Act is a good start. Under the new law, women who have no ability to pay can still get a mammogram.

Even better, the National Breast and Cervical Cancer Early Detection Program provides screenings and diagnostic services to low-income, uninsured, and underinsured women. Click on the “Find a Screening Provider” tab on the program’s site to arrange for your mammogram.

Black women should also get regular physical exams and discuss their risk of breast cancer with a health professional. The Agency for Healthcare Research and Quality has a list of questions for women to use to improve communication with a doctor about tests like mammograms.

What more do you think should be done to lower breast cancer rates among African-American women?  

Related Stories on TakePart:

• So You Think Obamacare is Radical? Take a Look at China

• Breast Cancer Innovations

• Confused About Donating to Breast Cancer Causes? Here’s How to Pink Straight

---

Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.

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2 Nigeria journalists charged after polio killings

KANO, Nigeria (AP) — Police in northern Nigeria arrested and charged two radio journalists and a local cleric alleged to have sparked the killings of at least nine women gunned down while trying to administer polio vaccines, officials said Tuesday. Police claimed their on-air comments about a vaccination campaign in the area inflamed the region and caused the attacks.

The allegations against the journalists working for Wazobia FM show the continuing struggle over free speech in Nigeria, a nation that came out of military rule only in 1999 and where simply taking photographs on the street can get a person arrested. Though Nigeria has a rambunctious free press, threats and attacks against journalists remain common and unsolved killings of reporters still haunt the country.

On Friday in Kano, the largest city in Nigeria’s predominantly Muslim north, gunmen in three-wheel taxis attacked women preparing to give the oral-drop vaccines to children, killing at least nine, police said. Witnesses later said they saw at least 12 dead from the attack. No group has claimed responsibility for the attack, though suspicion immediately fell on the sect known as Boko Haram, which is waging a campaign of guerrilla shootings and bombings across northern Nigeria.

A few days before the killings, Wazobia FM aired a program in which presenters talked about how one of the station’s journalists had been attacked by local officials and had his equipment confiscated after coming upon a man who refused to allow his children to be vaccinated. The journalists and the cleric on the program apparently discussed the fears people have about the vaccine, which then spread through the city.

Kano state police commissioner Ibrahim Idris ordered the journalists and the cleric be arrested immediately after Friday’s attack.

Initially, Idris said the journalists would face charges of “culpable homicide” over the polio workers’ deaths. Those charges can carry the death penalty. However, at an arraignment hearing Tuesday afternoon, prosecutors brought lesser charges that included conspiracy, inciting a disturbance and obstruction of a public servant. Magistrate Ibrahim Bello ordered a follow-up hearing Thursday.

Onimisi Adaba, operation manager for Wazobia FM and its sister stations, later told The Associated Press that the radio group was “fully aware of the situation.”

“We are presently attending to the matter,” Adaba said. He declined to comment further.

There have long been suspicions about the polio vaccine in northern Nigeria, with people believing the drops would sterilize young girls.

In 2003, a Kano physician heading the Supreme Council for Shariah in Nigeria said the vaccines were “corrupted and tainted by evildoers from America and their Western allies.” That led to hundreds of new infections in children across the north, where beggars on locally made wooden skateboards drag their withered legs back and forth in traffic, begging for alms. The 2003 disease outbreak in Nigeria eventually spread throughout the world, even causing infections in Indonesia.

Today, Nigeria is one of only three countries where polio remains endemic, the others being Afghanistan and Pakistan.

Nigeria came out of a long period of military rule in 1999 and has an unbridled free press, but journalists are often harassed by police and the State Security Service, the nation’s secret police. Local journalists also have been attacked and killed in the oil-rich nation over their reporting. Eighteen journalists have been killed in Nigeria since 1992, according to the Committee to Protect Journalists

Newspapers and radio stations also often hold off paying journalists their salaries for months at a time. That forces reporters to make money from selling advertising to those they cover or through collecting so-called “brown envelope” bribes slipped into briefing materials at news conferences.

Mohamed Keita, an official with the Committee to Protect Journalists in New York, said his organization is investigating the circumstances surrounding the journalists’ prosecution.

“We are troubled by the detentions of journalists insofar as there appears to be no evidence linking their program to the murderous attacks on the polio clinics,” Keita said. “We call on Nigerian authorities to afford the journalists due process under the law.”

___

Associated Press writer Jon Gambrell in Johannesburg contributed to this report.

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CNN’s Sanjay Gupta adds fiction to his workload

LOS ANGELES (AP) — When doctors get called on the carpet by other doctors, it’s productive but not always pretty, as neurosurgeon Sanjay Gupta describes it.

Closed-door meetings in which physicians candidly dissect cases that went awry can verge on “dignified versions of street fights,” said CNN’s globe-trotting correspondent.

He drew on such sessions — commonplace for hospitals, if little publicly known — for his first novel, “Monday Mornings,” and is a writer-producer on a new TNT series based on the 2012 book.

The drama, from veteran producer David E. Kelley (“Boston Legal,” ”The Practice”) and with a heavyweight cast that includes Ving Rhames, Alfred Molina and Bill Irwin, debuts Monday (10 p.m. EST). That’s also the day the show’s fictional Chelsea General Hospital holds its weekly reviews.

In the real world, such meetings to scrutinize complications and mistakes in patient care can lead to new guidelines, Gupta said.

“They can be simple, like never sedate a patient until they’re strapped in on the table,” he said, the outcome of an unrestrained patient having taken a tumble. “Some changes are big, some are small, but they are always important. We are always redefining medicine.”

In the first episode of “Monday Mornings,” brash but dedicated neurosurgeon Dr. Tyler Wilson (Jamie Bamber, “Battlestar Galactica”) is grilled for failing to check a patient’s medical history. Gupta said he learned his own “searing” lesson, about carefully reviewing lab results, without any harm to the patient.

Do the forums ever become a stage for office politics?

“People do jockey for position in these situations,” Gupta replied. “If someone’s at the lectern (under scrutiny), anyone can ask questions, not just the chairperson of the department. So the nature and tone of it can change pretty quickly.”

The most disturbing inquiries involve an apparently reckless M.D. with “a disregard for the person on the operating table or in the hospital,” he said. “You can imagine your own mother or loved in the position of the patient, and those are the most indelible ones of all.”

The meetings make for gripping drama on “Monday Mornings.” But is a show that focuses on medicine’s failures as well as its triumphs potentially a hard sell for audiences?

“ER,” TV’s once-reigning hospital drama, aired a powerful first-season episode in which decisions by Dr. Mark Greene, the caring, steady lead character played by Anthony Edwards, cost a pregnant woman her life. The story line was a rarity on the show that routinely focused on medical heroics.

The key to making the TNT series work is the “likability” of its physicians, said Bill D’Elia, a producer on “Monday Mornings.”

It’s crucial to “understand their motivation, understand how good they are, how much they care. So it’s not black-and-white” when a character blows it, D’Elia said.

As is the case with non-TV doctors, Gupta said.

A mistake is made and “you think that’s a bad doctor. You may even think that’s a bad human being, and in some cases you might be right,” he said. “But a lot of times you’re not, and I think showing the rest of the story, how it may continue to get discussed” is illuminating.

Besides writing for “Monday Mornings,” Gupta, 43, makes sure it depicts surgery and the world of medicine accurately.

How Gupta fits the tasks into his already demanding schedule is a medical mystery. As D’Elia said, he never knows if he’s talking to the doctor in Atlanta, where Gupta lives with his family and practices, or in another city, sometimes far-flung, as part of his award-winning work for CNN (which, like TNT, is part of Time Warner subsidiary Turner).

“When I talk to him I have this (mental) picture of him in front of a green screen so he can input wherever he is,” D’Elia said. “He’s as likely to be in Pakistan as New York.”

Since joining CNN in 2001, Gupta has covered events including the quake and tsunami in Japan, Hurricane Katrina and the Gulf of Mexico oil disaster. In 2003, while embedded with a Navy medical unit, he reported from Iraq and Kuwait and acted as a doctor as well as a reporter, performing brain surgeries in a desert operating room.

That same year, he got a spot on People magazine’s list of the “sexiest men alive.”

He anchors the weekend medical affairs program, “Sanjay Gupta MD,” is on the staff and faculty at the Emory University School of Medicine in Atlanta, and is an associate chief of neurosurgery at Grady Memorial Hospital.

In 2009, he was approached for the position of surgeon general in the new Obama administration, a post he says he declined because it would have halted his work as a neurosurgeon. He’s said he’s a supporter of the Affordable Care Act and wants to see it fully implemented to give more Americans coverage.

Gupta learned his work ethic from his parents, who moved from India in the 1960s to work at a Ford plant in Detroit, where he grew up, and is surprised when people ask how he does it all.

“There’s a lot of people who work a lot harder than I do and aren’t known,” he said.

___

Online:

http://www.tntdrama.com

___

Lynn Elber can be reached at lelber(at)ap.org and on Twitter (at)lynnelber.

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UK ‘to avoid triple-dip recession’

12 February 2013 Last updated at 19:22 ET

The UK will avoid falling into a so-called triple-dip recession, according to the business lobby group, the CBI.

The group believes that the UK economy will grow 0.3% in the first quarter of the year.

That comes after the economy shrunk in the last quarter – the first period in what some feared might be another six months of negative growth.

But the CBI now expects the UK to grow 1% in 2013 – less than the 1.4% it previously expected.

“We are beginning to see the return of organic growth, with clear signs that firms offering the right products into the right markets are growing sales and expanding,” said CBI director-general John Cridland.

“Recent business surveys also give grounds for cautious optimism about our forward prospects.”

But he warned that “after the uncertainties of 2012, the fear of external storm clouds lingers”, referring to the eurozone debt crisis and weak global growth.

The business group said that inflation will likely climb during the year but it does not expect a further round of quantitative easing.

The Bank of England has so far pumped £375bn into the financial system, creating money through “asset purchases” of buying government bonds.

Earlier this month, the Organisation for Economic Co-operation and Development (OECD) said the Bank should consider injecting more money into the economy if growth remains weak.

The UK economy bounced back to growth in the third quarter of last year, boosted by the Olympics, after shrinking for the previous nine months. Prior to that, the UK was in recession at the height of the financial crisis in 2008.

If the economy were to also shrink in the first three months of 2013, then the UK would re-enter recession, defined as two consecutive quarters of contraction.

The UK has still not recovered the levels of output seen before 2008.

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Pope’s sudden resignation sends shockwaves through Church

VATICAN CITY (Reuters) – Pope Benedict stunned the Roman Catholic Church including his closest advisers on Monday when he announced he would stand down in the first papal abdication in 700 years, saying he no longer had the mental and physical strength to run the Church through a period of major crisis.

Church officials tried to relay a climate of calm confidence in the running of a 2,000-year-old institution but the decision could lead to one of the most uncertain and unstable periods in centuries for a Church besieged by scandal and defections.

Several popes in the past, including Benedict‘s predecessor John Paul, refrained from stepping down even when severely ill, precisely because of the confusion and division that could be caused by having an “ex-pope” and a reigning pope living at the same time.

This could create a particularly difficult problem if the next pope is a progressive who influences such teachings as the ban on women priests and artificial birth control and its insistence on a celibate priesthood.

The Church has been rocked during Benedict’s nearly eight-year papacy by child sexual abuse crises and Muslim anger after the pope compared Islam to violence. Jews were upset over rehabilitation of a Holocaust denier and there was scandal over the leaking of the pope’s private papers by his personal butler.

In an announcement read to cardinals in Latin, the universal language of the Church, the 85-year-old said: “Well aware of the seriousness of this act, with full freedom I declare that I renounce the ministry of Bishop of Rome, Successor of St Peter …

“As from 28 February 2013, at 20:00 hours (1900 GMT) the See of Rome, the See of St. Peter will be vacant and a conclave to elect the new Supreme Pontiff will have to be convoked by those whose competence it is.”

POPE DOESN’T FEAR SCHISM

At a news conference, chief Vatican spokesman Father Federico Lombardi said the pope did not fear a possible “schism” in the Church, with Catholics owing allegiances to a past and present pope in case of differences on Church teachings.

The pope, known for his conservative doctrine, stepped up the Church’s opposition to gay marriage, underscored the Church’s resistance to a female priesthood and to embryonic stem cell research.

But Lombardi said Benedict, who is expected to go into isolation for at least a while after his resignation, did not intend to influence the decision of the cardinals who will enter a secret conclave to elect a successor.

A new leader of the world’s 1.2 billion Roman Catholics could be elected as soon as Palm Sunday, on March 24, and be ready to take over by Easter a week later, Lombardi said.

He indicated the complex machinery of the process to elect a new pope would move quickly because the Vatican would not have to wait until after the elaborate funeral services for a pope.

The decision shocked many throughout the world, from ordinary believers, to politicians to world religious leaders.

“This is disconcerting, he is leaving his flock,” said Alessandra Mussolini, a parliamentarian who is granddaughter of Italy’s wartime dictator.

“The pope is not any man. He is the vicar of Christ. He should stay on to the end, go ahead and bear his cross to the end. This is a huge sign of world destabilization that will weaken the Church.”

OWN BROTHER SURPRISED

The announcement even caught the pope’s elder brother Georg Ratzinger, off guard, indicating just how well-kept a secret it was. Ratzinger told reporters in Germany that he had been “very surprised” and added: “He alone can evaluate his physical and emotional strength.”

Lombardi said Benedict would first go to the papal summer residence south of Rome and then move into a cloistered convent inside the Vatican walls. It was not clear if Benedict would have a public life after he resigns.

The last pope to resign willingly was Celestine V in 1294 after reigning for only five months, his resignation was known as “the great refusal” and was condemned by the poet Dante in the “Divine Comedy”. Gregory XII reluctantly abdicated in 1415 to end a dispute with a rival claimant to the papacy.

Lombardi said Benedict’s stepping aside showed “great courage”. He ruled out any specific illness or depression and said the decision was made in the last few months “without outside pressure”.

Joseph Curran, professor of religious studies at Misericordia University in Dallas, Pennsylvania, said the modern medicine prolonging the life of people had posed difficulties for institutions whose leaders usually rule for life.

“His resignation is a tremendous act of humility and generosity,” he said. “A man who lives up a position of authority because he can no longer adequately exercise that authority, and does so for the good of the Church, is setting a wonderful example,” he said.

But Cardinal Stanislaw Dziwisz, secretary to the late Pope John Paul, who suffered through bad health for the last decade of his life, had a thinly veiled criticism of Benedict. John Paul stayed to the end of his life as he believed “you cannot come down from the cross,” Dziwisz told reporters in Poland.

NO HINT OF RESIGNATION

While the pope had slowed down recently – he started using a cane and a wheeled platform to take him up the long aisle in St Peter’s Square – he had given no hint recently that he was mulling such a dramatic decision.

Elected in 2005 to succeed the enormously popular John Paul, Benedict never appeared to feel comfortable in a job he said he never wanted. He had wished to retire to his native Germany to pursue his theological writings, something which he will now do from a convent inside the Vatican.

The resignation means that cardinals from around the world will begin arriving in Rome in March and after preliminary meetings, lock themselves in a secret conclave and elect the new pope from among themselves in votes in the Sistine Chapel.

There has been growing pressure on the Church for the cardinals to shun European contenders and choose a pope from the developing world in order to better reflect parts of the globe where most Catholics live and where the Church is growing.

John Paul was only 58 when he was elected in 1978 – 20 years younger than Benedict when he was elected – and some commentators said the resignation would likely convince the cardinals to elect a younger man.

“MIND AND BODY”

In his announcement, the pope told the cardinals that in order to govern “… both strength of mind and body are necessary, strength which in the last few months, has deteriorated in me to the extent that I have had to recognize my incapacity to adequately fulfil the ministry entrusted to me.”

Before he was elected pope, the former Cardinal Joseph Ratzinger, was known by such critical epithets as “God’s rottweiler” because of his stern stand on theological issues.

After a few months, he showed his mild side but he never drew the kind of adulation that had marked the 27-year papacy of his predecessor John Paul.

The Archbishop of Canterbury, leader of the worldwide Anglican communion at odds with the Vatican over women priests, said he had learned of the pope’s decision with a heavy heart but complete understanding.

German Chancellor Angela Merkel said the pope’s decision must be respected if he feels he is too weak to carry out his duties. British Prime Minister David Cameron said: “He will be missed as a spiritual leader to millions.”

Elected to the papacy on April 19, 2005, Benedict ruled over a slower-paced, more cerebral and less impulsive Vatican.

CHEERS AND SCANDAL

But while conservatives cheered him for trying to reaffirm traditional Catholic identity, his critics accused him of turning back the clock on reforms by nearly half a century and hurting dialogue with Muslims, Jews and other Christians.

After appearing uncomfortable in the limelight at the start, he began feeling at home with his new job and showed that he intended to be pope in his way.

Despite great reverence for his charismatic, globe-trotting predecessor — whom he put on the fast track to sainthood and whom he beatified in 2011 — aides said he was determined not to change his quiet manner to imitate John Paul‘s style.

A quiet, professorial type who relaxed by playing the piano, he showed the gentle side of a man who was the Vatican’s chief doctrinal enforcer for nearly a quarter of a century.

The first German pope for some 1,000 years and the second non-Italian in a row, he traveled regularly, making about four foreign trips a year, but never managed to draw the oceanic crowds of his predecessor.

The child abuse scandals hounded most of his papacy. He ordered an official inquiry into abuse in Ireland, which led to the resignation of several bishops.

Scandal from a source much closer to home hit in 2012 when the pontiff’s butler, responsible for dressing him and bringing him meals, was found to be the source of leaked documents alleging corruption in the Vatican’s business dealings, causing an international furor.

Benedict confronted his own country’s past when he visited the Nazi death camp at Auschwitz.

Calling himself “a son of Germany”, he prayed and asked why God was silent when 1.5 million victims, most of them Jews, died there during World War Two.

Ratzinger served in the Hitler Youth during World War Two when membership was compulsory. He was never a member of the Nazi party and his family opposed Adolf Hitler’s regime.

(Additional reporting by James Mackenzie, Barry Moody, Cristiano Corvino, Alexandra Hudson in Berlin, and Dagamara Leszkowixa in Poland; editing by Peter Millership, Ralph Boulton, Janet McBride)

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Trump may have trouble collecting on $5 million orangutan bet

NEW YORK (Reuters) – A comedian, a millionaire and an orangutan. It may sound like the beginning of a screwball joke, but Donald Trump isn’t laughing.

The famously outspoken real estate magnate has sued famously outspoken television host Bill Maher, demanding the $ 5 million Maher offered to give to charity if Trump could prove his father is not an orangutan.

But legal experts say Trump is unlikely to get a dime from Maher, the host of the HBO series Real Time With Bill Maher, because his offer was clearly made in jest.

“It’s parody,” said Bryan Sullivan, a Los Angeles entertainment lawyer. “You know Bill Maher is a comedian and a satirist. The offer is so ridiculous.”

Trump, however, has taken the comic at his word.

“Attached hereto is a copy of Mr. Trump’s birth certificate, demonstrating that he is the son of Fred Trump, not an orangutan,” Trump’s lawyer, Scott Balber, wrote to Maher last month.

When Maher did not respond, Trump filed a breach of contract lawsuit last week in Los Angeles Superior Court.

A Maher spokeswoman referred to his show Friday, in which he ridiculed Trump’s lawsuit.

“It’s never a joke when someone reneges on a commitment that benefits worthy charities,” said Michael Cohen, special counsel to Trump, in response. “The tone of Mr. Maher’s diatribe on Friday evening suggests he is far more concerned with the lawsuit than he wants the public to believe.”

Last year, during the presidential campaign, Trump offered to give $ 5 million to charity if President Barack Obama would release his college records. Trump, who flirted with a possible White House run, previously questioned Obama’s citizenship and boasted that he prompted Obama to release his birth certificate.

As a guest on NBC’s The Tonight Show last month, Maher offered to give $ 5 million to charity if Trump could prove he was not the son of an orangutan, since the ape’s orange fur matches the color of Trump’s trademark gravity-defying coiffure.

“He can donate to a charity of his choice,” Maher said. “Hair Club for Men; the Institute for Incorrigible Douchebaggery. Whatever charity.”

Under contract law, a verbal offer can create a contractual obligation. But courts make exceptions for obviously satirical offers.

In a New York federal case, Leonard vs. Pepsico, a man sued the soft drink maker after it refused to honor a TV advertisement “offer” of a fighter jet for redeemable Pepsi Points.

District Judge Kimba Wood in Manhattan said an offer made “evidently in jest” is not a contract and noted the commercial featured a teenager using the jet to get to school.

“This fantasy is, of course, extremely unrealistic,” Wood wrote.

Trump’s lawsuit alleges that Maher’s show is political commentary, not comedy. In a Fox News appearance last week, Trump said he was certain Maher’s offer was not a joke.

“That was venom,” Trump said. “That wasn’t a joke.”

(Reporting by Joseph Ax. Editing by Andre Grenon)

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Need surgery? Good luck getting hospital cost info

CHICAGO (AP) — Want to know how much a hip replacement will cost? Many hospitals won’t be able to tell you, at least not right away — if at all. And if you shop around and find centers that can quote a price, the amounts could vary astronomically, a study found.

Routine hip replacement surgery on a healthy patient without insurance may cost as little as $ 11,000 — or up to nearly $ 126,000.

That’s what researchers found after calling hospitals in every state, 122 in all, asking what a healthy 62-year-old woman would have to pay to get an artificial hip. Hospitals were told the made-up patient was the caller’s grandmother, had no insurance but could afford to pay out of pocket — that’s why knowing the cost information ahead of time was so important.

About 15 percent of hospitals did not provide any price estimate, even after a researcher called back as many as five times.

The researchers were able to obtain a complete price estimate including physician fees from close to half the hospitals. But in most cases, that took contacting the hospital and doctor separately.

“Our calls to hospitals were often greeted by uncertainty and confusion,” the researchers wrote. “We were frequently transferred between departments, asked to leave messages that were rarely returned, and told that prices could not be estimated without an office visit.”

Many hospitals “are just completely unprepared” for cost questions, said Jaime Rosenthal, a Washington University student who co-authored the report.

Most hospitals aren’t intentionally hiding costs, they’re just not used to patients asking. That’s particularly true for patients with health insurance who “don’t bother to ask because they know insurance will cover it,” said co-author Dr. Peter Cram, a researcher at the University of Iowa’s medical school.

But he said that’s likely to change as employers increasingly force workers to share more health care costs by paying higher co-payments and deductibles, making patients more motivated to ask about costs.

The study was published online Monday in JAMA Internal Medicine. A California study published last year about surgery to remove an appendix found similar cost disparities.

Commenting on the study, American Hospital Association spokeswoman Marie Watteau said hospitals “have a uniform set of charges. Sharing meaningful information, however, is challenging because hospital care is unique and based on each individual patient’s needs.”

She said states and local hospital associations are the best source for pricing data, and that many states already require or encourage hospitals to report pricing information and make that data available to the public.

U.S. insurance companies typically negotiate to pay less than the billing price. Insured patients’ health plans determine what they pay, while uninsured patients may end up paying the full amount.

The study authors noted that Medicare and other large insurers frequently pay between $ 10,000 and $ 25,000 for hip replacement surgery.

Sean Toohey, a grains broker at the Chicago Board of Trade, had hip replacement surgery last summer at Loyola University Medical Center in Maywood, Ill. An old sports injury had worn out his left hip, causing “horrendous” pain on the job, where he’s on his feet all day filling orders.

Toohey, 54, said his health insurance covered most of the costs, and it didn’t occur to him to ask about price beforehand. He was back at work two weeks later and is pain free. That’s what matters most to him.

“I never really looked or paid attention” to the cost, he said.

He paid about $ 7,900, but wasn’t sure what the total bill amounted to.

The average charge for hip replacement surgery at Loyola is about $ 42,000, before the negotiated insurance rates. The most expensive items on a typical hip replacement bill include about $ 11,000 for the hip implant, said Richard Kudia, Loyola’s vice president of patient financial services

Kudia said some patients do ask in advance about costs of surgery and other medical procedures, and those questions require “a little bit of research” to come up with an average estimate. Costs vary from center to center because “there is no standard pricing among hospitals across the country. Each hospital develops its own pricing depending on its market,” he said.

An editorial accompanying the hip replacement study said “there is no justification” for the huge cost variation the researchers found.

A few online sites provide price comparisons for common medical procedures, but the editorial said that kind of information “is of almost no value” without information on hospital quality.

A proposed federal measure that would have required states to force hospitals to make their charges public failed to advance in Congress last year but could be revived this year, the editorial says.

“It is time we stopped forcing people to buy health care services blindfolded,” the editorial said.

___

Online:

Journal: http://www.jamainternalmed.com

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Wall Street ends flat as investors seek new catalysts

NEW YORK (Reuters) – Stocks ended a quiet session with slight moves on Monday as investors found few reasons to keep pushing shares higher following a six-week advance, though the longer-term trend was still viewed as positive.

The benchmark index is up more 6.4 percent in 2013, putting both the S&P 500 and Dow industrials near multi-year highs. The S&P is less than 4 percent from its all-time intraday high of 1,576.09, hit in October 2007.

“This is still a market that looks terrific, but when you’re up for six weeks in a row, everyone is going to want to take a pause going into the seventh week even if there is no bad news out there,” said Eric Kuby, chief investment officer at North Star Investment Management in Chicago.

Volume was light, with about 4.812 billion shares changing hands on the New York Stock Exchange, the Nasdaq and NYSE MKT, well below the daily average so far this year of about 6.48 billion shares.

Wall Street was modestly lower throughout the session but regained some ground in the final hour of trading as Google Inc rebounded off earlier losses. Shares of the Internet search giant dipped 0.4 percent to $ 782.42, recovering from earlier declines of 1 percent after the company said in a filing former chief executive Eric Schmidt is selling roughly 42 percent of his stake in the company.

Also in the tech space, Apple Inc rose up 1 percent to $ 479.93 after the New York Times reported the iPhone maker was experimenting with the design of a device similar to a wristwatch.

The Federal Reserve’s Vice Chair Janet Yellen, seen as a potential successor to Fed Chairman Ben Bernanke next year, said the Fed is still aggressively stimulating an anemic U.S. economic recovery that has failed to bring rapid progress on employment.

The Dow Jones industrial average <.dji> was down 21.81 points, or 0.16 percent, at 13,971.16. The Standard & Poor’s 500 Index <.spx> was down 0.92 points, or 0.06 percent, at 1,517.01. The Nasdaq Composite Index <.ixic> was down 1.87 points, or 0.06 percent, at 3,192.00.</.ixic></.spx></.dji>

Upbeat U.S. and Chinese data last week helped the S&P 500 extend its weekly winning streak to six. The index gained about 8 percent over that period.

Equities have been strong performers lately and many investors have used any declines in the market as opportunities to buy.

“Everyone wants to buy on a dip in this market, but if you’re on the sidelines right now, the decline we’re seeing today just isn’t the kind you would jump in on,” Kuby said.

President Barack Obama will describe his plan for spurring the economy in his State of the Union address on Tuesday. He is expected to offer proposals for investment in infrastructure, manufacturing, clean energy and education.

Opposition has grown to the $ 24.4 billion buyout of Dell Inc , the No. 3 personal computer maker, as three of the largest investors joined Southeastern Asset Management on Friday in raising objections. Dell said in a regulatory filing it had considered many strategic options before opting to go private in a buyout led by Chief Executive Michael Dell.

Dell shares hovered near $ 13.65, the buyout offer price.

Regeneron Pharmaceuticals Inc shares rose 2.7 percent at $ 170.35 after it said longtime drug development partner Sanofi plans to boost its stake.

Moody’s Corp was one of the strongest percentage gainers on the S&P 500, rising 4.9 percent to $ 45.49. Last week the stock plunged 22 percent after the U.S. government launched a civil lawsuit against the company. The sell-off marked the stock’s worst week since October 2008.

About 53 percent of stocks traded on the New York Stock Exchange closed lower while slightly more Nasdaq-listed stocks closed in negative territory.

(Editing by Nick Zieminski)

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Islamists attack Malian troops in Gao

GAO, Mali (AP) — Black-robed Islamic extremists armed with AK-47 automatic rifles snuck into the city of Gao in canoes Sunday to launch a surprise attack on the Malian army in the most populous city in northern Mali, two weeks after French and Malian troops ousted the jihadists.

The combat started at about 2 p.m. in downtown Gao and the fighting was continuing as night fell. Later the sound of gunfire was replaced by the clattering of French military helicopters overhead.

The attack in Gao shows the Islamic fighters, many of them well-armed and with combat experience, are determined and daring and it foreshadows a protracted campaign by France and other nations to restore government control in this vast Saharan nation in northwest Africa.

The Islamic radicals fought against the Malian army throughout the afternoon and were seen roaming the streets and on rooftops in the center of Gao, which has a population of 90,000. Gunfire echoed across the city.

Families hid in their homes. One family handed plastic cups of water through the locked iron gate to others hiding on their patio. Piles of onions lay unattended where market women fled when the Islamists arrived. There were no signs of civilian casualties.

The fighting appeared to center near the police headquarters, where Malian soldiers with rocket propelled grenades traded fire with the combatants believed to be from the Movement for Oneness and Jihad in West Africa, or MUJAO. The only sound in the city was gunfire and the bleating of goats. Soldiers were positioned at every corner in the neighborhood of mud-walled buildings.

Ever since French forces took Gao on Jan. 26, the Islamic rebels had clashed with security forces on the city’s outskirts. This was the first time they succeeded in entering the strategic city.

The Islamic fighters used canoes to cross the Niger River to penetrate Gao, according to French Gen. Bernard Barera, who cited Malian officials.

The Islamic radicals had already tried to spread violence into Gao. On Saturday night, a suicide bomber detonated himself at a checkpoint at the entrance to the city, killing himself and injuring one Malian soldier. An earlier suicide bomber on a motorcycle also blew himself up at the same security spot on Friday, killing only himself.

Besides Gao, French and Malian forces have also retaken the fabled city of Timbuktu and other northern towns, pushing the Islamic extremists back into the desert, where they pose a constant threat to Malian and allied forces. But the Islamic fighters made strategic retreats and are dug into desert hideouts, from where they are expected to continue challenging the control of the cities by French, Malian and allied forces. Several African nations have contributed troops to battle the extremists, who imposed their harsh version of Islamic Shariah law when they controlled the northern cities.

The armed Islamic fighters seized the northern half of Mali in April 2012, sending poorly disciplined and equipped Malian forces retreating in disarray. France launched its military intervention in its former colony on Jan. 11 when the Islamic radicals, many of whom had fought for ex-Libyan leader Moammar Gadhafi, began encroaching on the south, threatening the capital Bamako which lies deep in southern Mali, 1,200 kilometers (750 miles) from Gao.

France has said that it wants to hand over responsibility to the Malian military and other African nations who have contributed troops and has raised with the United Nations Security Council the possibility of establishing a U.N. peacekeeping operation in Mali.

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