Idlib, Syria and Reyhanli, Turkey – When Khalid Abdel Razek Abu al-Zumar heard that his five-year-old son had been accepted into a programme that would restore his hearing, he rushed to prostrate himself in prayer to thank God.
Aslan, a nattily dressed, smiley little boy, had been hearing impaired his whole life, and now he had a chance to hear his family’s voices and play with other children his age in a whole new way.
“My heart would break whenever kids avoided playing with my kids because they can’t communicate with them in the usual way,” said Khalid, who is 31 years old and a father of five.
Polonnaruwa, Sri Lanka – In the sleepy, verdant village of Ambagaswewa, in the Polonnaruwa district of Sri Lanka’s North Central province, 63-year-old TMH Gamini Sunil Thennakoon’s life is peaceful for the most part. On the brink of retirement, he still spends most days out working his rice paddies but is also content spending his days playing with his grandchildren and chatting with his wife and two daughters. Since boyhood, Thennakoon has farmed rice here across 2 hectares (20,000sqm). A majority-farming nation, agriculture plays a central role in Sri Lanka’s economy and constitutes 21.7 percent of total exports.
But for more than seven years, Thennakoon has been coping with unexplained kidney problems. The symptoms of his condition – abdominal and back pain – are not bad enough to require dialysis yet, but he does take tablets to keep the pain under control.
“I’m not sure what caused the issue, because the rest of my family seems fine,” he says calmly, his granddaughter straddling his lap. She reaches over to swipe at one of the puppies roaming the front porch of their home, where we’re sitting. Ambagaswewa, proliferated by rice paddies, is otherwise a jungle – birdsong twangs through the already humid morning air, luscious vines and creepers on the verge of overtaking farmers’ homes. It’s a peaceful place.
Every month, Thennakoon makes a round trip of more than 30km to a local government hospital for a check-up; during these trips, he has to hire labourers to work in the rice paddies and cover his absence.
Rice farmer Gamini Sunil Thennakoon, 63, pictured with his granddaughter, suffers from unexplained kidney disease [Kang-Chun Chen/Al Jazeera]
Thennakoon is not the only one who has been affected in this way, here.
U Subasinha, a 60-year-old former rice farmer, is one of his neighbours. He has had a particularly hard life. One of his three children has been disabled since birth and, now aged 23, cannot walk. Seventeen years ago, Subasinha’s wife, Kamalavathi, now 54, started experiencing pain and was eventually diagnosed with chronic kidney disease.
Subasinha himself has suffered from acute kidney failure for the past eight years.
He is so frail that he can barely leave his cramped, hot bedroom most days, let alone work. But for the past seven years, he’s been going for dialysis four times a week at a government hospital, more than 25km away.
He has to find the money for the medicine he needs (16,000 rupees or $54) a month for himself and Kamalavathi), and for the hefty transportation costs – upwards of $16 for the round trip of a bumpy, 45-minute tuk-tuk ride each way to the hospital in Polonnaruwa.
None of this is covered by any sort of government-provided healthcare. It’s a huge sum for a household without an income.
The couple says they have no idea what made them sick and they seem surprised at the question. “No one has ever come to ask us this before,” says Kamalavathi.
Kamalavathi, 54, has struggled with kidney pain for the past 17 years [Kang-Chun Cheng/Al Jazeera]
The rise of kidney disease ‘hotspots’
According to statistics from the National Kidney Foundation in the United States, 10 percent of the world’s population is affected by chronic kidney disease and it is the 12th most common cause of death. Millions die annually due to a lack of access to affordable treatment.
Furthermore, according to an analysis by the Global Burden of Disease Study in 2019, chronic kidney disease (CKD) has increased by 40 percent over the past 30 years and is one of the fastest-rising major causes of death. Common precursors to CKD include diabetes and hypertension – diseases increasingly endemic to urbanising populations.
But across rural Sri Lanka, there’s a relatively new phenomenon; “chronic kidney disease of unknown aetiology (cause)” (CKDu). A flurry of scientific research studies has provided no concrete reason as to why as many as 22.9 percent of residents in several “hotspot” areas in the north-central districts of Polonnaruwa and Anuradhapura, plus some neighbouring districts, are suffering from acute kidney damage or failure.
On a national level, 10 to 15 percent of Sri Lankans are impacted by kidney diseases, according to Nishad Jayasundara, who is from a farming community in Sri Lanka and now works as an environmental toxicologist at Duke University in Durham, North Carolina, US, and specifically researches the causes of CKDu.
“[The disease] disproportionately impacts farming communities,” he tells Al Jazeera. “The current estimates indicate that more than 20,000 people [in Sri Lanka] are at end-stage kidney failure, with no alternatives left, while 6 to 10 percent of the population in impacted communities are diagnosed with CDKu.”
Indeed, research published by the US government’s National Library of Medicine in 2016 states: “Geographical mapping indicates a relationship between CKDu and agricultural irrigation water sources [in Sri Lanka].”
The fishing docks at Pasikuda beach, Batticaloa, on Sri Lanka’s east coast [Kang-Chun Cheng/Al Jazeera] [Kang-Chun Cheng/Al Jazeera]
A lack of early symptoms
While CKD has identifiable symptoms, such as weight loss and poor appetite, swollen ankles or hands, shortness of breath and itchy skin, early on, CKDu is asymptomatic until the latter stages of the disease, so early detection is nearly impossible, say doctors. By the time a patient receives a diagnosis, the disease is usually untreatable.
Even when symptoms do appear, they usually include back pain, swelling in the arms and legs and “body aches”, not uncommon for farmers and fishermen used to hard manual labour.
Dr S B A M Mujahith is a nephrologist – a doctor who specialises in treating kidney diseases – at Batticaloa Teaching Hospital on Sri Lanka’s eastern coast. He grew up just 50km down the coast from Batticaloa in the town of Nintavur and this played an important role in his career choice: “It was a community investment,” he tells Al Jazeera.
CKDu was first identified as an issue in Sri Lanka in the 1990s. There’s a geographical link, says Mujahith – some parts of the eastern and north-central provinces seemed especially hard hit. Many, like himself, wanted to investigate further and identify the causes.
A World Health Organisation (WHO) team even came to investigate the causes of CKDu in the 2010s, but ultimately the study was inconclusive.
A fisherman brings in part of his catch for the day close to the Negombo fish market on the western coast of Sri Lanka, just north of the capital, Colombo [Kang-Chun Cheng/Al Jazeera]
Mujahith likes to use the term “chronic interstitial nephritis in agricultural communities” (CINAC) since the disease is rather specific to the nation’s agricultural workers. It affects mainly men – most patients live and work in poor agricultural communities and may be exposed to toxic agrochemicals through work, inhalation, and ingesting contaminated water and food, explains Mujahith.
Sri Lanka, a small tropical nation with a population of about 22 million people, is undergoing the fifth year of the worst economic crisis in its history. The result has been limited access to medicine and food which hinders treatment and management of the disease, particularly in remote and under-served places such as Ambagaswewa.
‘Education is key’
Jayasundara, who grew up in a farming village in southern Sri Lanka, is currently working to isolate the factors of CKDu in his research, which examines phenomena such as how agrochemical concentration increases during drought (due to evaporation), or how the economic decline has affected the rest of the country.
Chronic disease in one specific organ of the body – in this case, the kidneys – can be a telltale sign of environmental harm, he says. “Sri Lanka serves as a clear example of how environmental change leads to so many downstream effects that affect people’s lives.”
Fishermen in Kalpitiya, northwestern Sri Lanka, prepare for a day out on the water [Kang-Chun Cheng/Al Jazeera]
The confounding cause of CKDu means it’s difficult to prescribe solutions for villagers, although those with the means are switching from drinking groundwater to filtered water.
Filtered water is not an option for many, however.
“If you’re choosing between food and sending your kids to school, you’re not going to be spending money on filtered drinking water,” says Sumuthuni Sivanandarajah, a marine biologist working at Blue Resources Trust, a marine research and consultancy organisation based in Sri Lanka.
Her work focuses on the self-employed fishing communities along the coasts of Sri Lanka, among whom kidney disease is also on the rise.
Sameera Gunasekara is a research scientist at Theme Institute in Sri Lanka exploring how climate change and diverse environmental exposures affect public health – specifically kidney diseases.
He agrees that the economic crisis has made it harder for people in remote farming and fishing communities to buy water filters. “People know, are conscious that clean water helps,” he explains. “But there’s some misunderstanding. [People] think that chlorinated water, or boiling, will help. That does with bacteria, but not the removal of hazardous materials.” The need for more education in these underserved regions is key, says Gunasekara.
Fishermen in Sri Lanka are prone to severe dehydration as they often take just one meal a day and carry little water with them [Kang-Chun Cheng/Al Jazeera]
Across the afflicted north-central farming provinces, Gunasekara is working to help educate the local population on reducing agrochemical usage, not staying in the sun for a long time, and preventing dehydration.
“Farming and fishing people have a stereotype, they are hard groups to convince,” the researcher continues. To begin with, biomarkers for the initial stages of the disease – back pain and leg swelling – are very subtle; not everyone experiences them. But even those who do experience them may not pay them heed.
“They just take a painkiller and get back to the field – they tend to suffer for a long time without doing proper [kidney] screening.” For many of these households, says Gunasekara, since the father is the only person earning money, the whole family collapses when he falls ill.
An economic crisis and chronic dehydration
Batticaloa on Sri Lanka’s east coast, known for both its aquaculture and agricultural activities, in the form of shrimp farms and rice and fish processing facilities, was the site of a brutal massacre during the nation’s relatively recent, longrunning civil war between the Sinhalese and Tamils. It is also one of the hotspots identified for the prevalence of CKDu, he says.
The civil war was an ethnic conflict that lasted for 26 years, ending in 2009 after killing more than 100,000 civilians and 50,000 soldiers from both the Tamil and Sinhalese sides.
Christy PL Navil, 58, has been working as a fisherman here for 12 years – before that, he worked as a helper on the boats. Along Pasikuda beach near Batticaloa, a landing site where 106 fishermen work each day, Navil fishes for calamari from 5am, not returning until the afternoon.
“Sometimes it’s many fish, sometimes it’s no fish,” he says. On the boat, they bring very little water considering the conditions – just 5 litres for two people to last for more than nine hours in the tropical heat. “The sun is hot, but we are just used to it. Sometimes fishing is busy, we aren’t drinking water or eating,” the fisherman admits. “We want to catch the fish.”
With the economic crisis, many fishermen also have to cut back on food, only taking one meal a day.
A fisherman pushes his boat to shore at the Ullackalie lagoon fish landing site on the east coast of Sri Lanka. Fishermen only take small amounts of water with them and can become dangerously dehydrated in the long hours at sea [Kang-Chun Cheng/Al Jazeera]
The resulting chronic dehydration is a major problem, says Sivanandarajah. She points to a combination of hereditary issues, water sources and pollution, toxins in agrochemicals, anthropogenic factors (for example improper pesticide container disposal), and lifestyle issues as possible CKDu causes.
Some fishermen are accustomed to drinking local “arrack” – a form of liquor – to help manage seasickness, she adds. “This is wearing on the body, the kidneys. And with the rising temperatures, it may not be a root cause, but it’s definitely a stressor.”
The lack of formal fishing collectives or societies, the marine researcher continues, means that little is known about the impact of ocean resource depletion on these self-employed communities – or the subsequent health ramifications.
“Government officials lack the knowledge on how to communicate [with fishermen,] they don’t like being out in the field,” says Sivanandarajah. “Sri Lanka’s fisheries sector depends on politics, what the admin implements. No one knows about the fishermen’s income or situation on the ground. It’s very top down, and no one is actually doing anything with the data.”
Food scarcity is a major issue – particularly during the off-season and especially with the ongoing economic crisis, Sivanandarajah says.
A farmer in Medirigiriya, one of Sri Lanka’s ‘hotspots’ for unexplained kidney disease cases, uses water from his ground well which sources water from very deep below the surface [Kang-Chun Cheng/Al Jazeera]
There is also the high use of tube wells, inserted deep into the ground – deeper than wells – which extract very hard water as they break past phosphorus barriers in the earth which would normally act as a water softener, making the water easier on the human kidneys. “These became popular during the tsunami and monsoon seasons since ground wells are destroyed and contaminated by seawater,” Sivanandarajah explains.
Geological shifts linked to climate change can also increase the likelihood of earthquakes and volcanic eruptions, which in turn heighten the risk of tsunamis, say scientists. It is estimated that by the end of the 21st century, the global mean sea level will rise by at least 0.3 metres given current greenhouse gas emission rates, which would further inundate coastal communities with brackish water.
Crippling debt
Nadaraja Pereatambi, 62, has been working as a fisherman from Pasikuda beach since his youth. Two years ago, he was suffering from unexpected, acute kidney pain, culminating in an emergency operation and a 50-day hospital stay.
The treatment was largely successful – Pereatambi is cautiously back at work on the fishing boats. However, he had little choice but to take a 2 lakh loan (200,000 rupees, nearly $675 – an unthinkable sum for someone who makes as little as $4 a day, depending on the catch) to pay off the hospital bill.
“Six other fishermen working on this beach also have issues with kidneys,” he says. “Most have no money for hospital, even when suffering from kidney stones.”
It could be a water problem, he surmises. In the Pasikuda area, he continues, it is common knowledge that the water quality is poor: there’s too much calcium and fluoride, among other minerals: “It’s all very hard.”
Sirani Silva, 48, a patient with acute kidney damage who attends the District General Hospital in Negombo on Sri Lanka’s west coast for regular treatment, is accompanied by her husband as she is so weak [Kang-Chun Cheng/Al Jazeera]
Outside the government-funded District General Hospital in Negombo along Sri Lanka’s western coast, a little north of the capital city of Colombo, 48-year-old W Sirani Silva is easing into a tuk-tuk that her husband will drive her home in.
Two years ago, she found out she had acute kidney damage – with less than 10 percent function remaining – after experiencing nauseating back and stomach pain.
Each week, Silva makes the 20km journey twice for dialysis sessions in hospital, and is on the waiting list for a transplant. She is far too sick to take care of the house or her three children but is grateful that they are healthy. Since the onset of her illness, the family has switched to drinking filtered water, but still uses well water for cooking and other household needs.
Since Silva is so weak, her husband, K Usdesangar, 51, accompanies her to every dialysis visit, which means he loses income from working as a tuk-tuk driver – he was previously a fisherman – on those days.
“We have no idea where this comes from,” he says, since Silva had an otherwise clean medical history and never suffered from hypertension or diabetes, the main precursors for most kidney disease patients. “Perhaps, it just comes with the family.”
New report warns people are increasingly at risk in a continent warming twice as fast as the global average.
Europe is increasingly facing bouts of heat so intense that the human body cannot cope, climate monitors have warned.
The continent endured a record number of “extreme heat stress” days in 2023, the European Union’s Copernicus climate monitoring service and the World Meteorological Organization (WMO) said on Monday.
In writing its latest report, Copernicus and the WMO noted last year’s extreme conditions, including a July heatwave that pushed 41 percent of southern Europe into strong, very strong or extreme heat stress – the biggest area of Europe under such conditions in any day on record.
The continent also suffered catastrophic flooding, severe droughts, violent storms and its largest ever forest fires.
“We’re seeing an increasing trend in the number of days with heat stress across Europe and 2023 was no exception, with Europe seeing a record number of days with extreme heat stress,” said Rebecca Emerton, a climate scientist at Copernicus.
For its latest study, Copernicus and WMO used the Universal Thermal Climate Index, which measures the effect of the environment on the human body.
It takes into account not just high temperatures but also humidity, wind speed, sunshine and heat emitted by the surroundings.
The index has 10 different categories of heat and cold stress, with units of degrees Celsius representing a “feels-like” temperature.
Parts of Spain, France, Italy and Greece experienced as many as 10 days of extreme heat stress in 2023, defined as a “feels like” temperature of more than 46 degrees Celsius (115 degrees Farenheit), at which point immediate action must be taken to avoid conditions such as heat stroke.
Extreme heat poses particular risks to people who work outdoors, the elderly, and those with health conditions such as cardiovascular diseases and diabetes.
Parts of Italy recorded 7 percent more deaths than normal last July. A 44-year-old man painting road markings in the northern town of Lodi was among those who died after he collapsed at work.
“We see that there is excess mortality when we see such extreme heatwaves like was the case in 2023,” said Alvaro Silva, a climatologist from WMO.
“This increase in mortality… is affecting [the] big majority of European regions. This is a big concern.”
Red Cross workers check on the welfare of a homeless man during a heatwave in Rome last July [Guglielmo Mangiapane/Reuters]
Heat-related deaths in Europe have soared by about 30 percent in the past 20 years, the report said.
For the world as a whole, last month was the warmest March ever, marking the 10th straight month of historic heat as greenhouse gas emissions, mostly from fossil fuels, continued to push temperatures higher.
The surface temperature of the world’s oceans, which absorb 90 percent of excess heat produced by emissions, also hit a new high, according to Europe’s climate monitoring agency.
In their latest report, scientists warned Europe was warming twice as fast as the global average and that heatwaves were likely to become longer and more powerful in future.
“Current heatwave interventions will soon be insufficient to deal with the expected heat-related health burden,” the report said, noting that Europe’s population was ageing while also becoming increasingly urban.
Mali and Burkina Faso recorded most extreme heat in what scientists called a once-in-a-200-year occurrence.
Human-caused climate change contributed to an unusually intense and lethal hot spell throughout West Africa’s Sahel region in April, according to a study by World Weather Attribution (WWA), an international network of scientists focusing on extreme weather events.
The heatwave caused temperatures in Mali and Burkina Faso to climb to more than 45 degrees Celsius (113 degrees Fahrenheit) between April 1 and April 5, an unusual spike for the season that likely led to numerous deaths, said the study published on Thursday.
The extreme weather also coincided with the Muslim holy month of Ramadan and frequent power cuts, heightening the risk of heat-related casualties.
“Even minimum temperatures, overnight, remained relatively high, making it so that people did not get a break from the heat,” the study added.
‘Human-induced’ climate change
The WWA’s observations and climate models found that “heatwaves with the magnitude observed in March and April 2024 in the region would have been impossible to occur without the global warming of 1.2C to date”, which it linked to “human-induced climate change”.
Although the Sahel is accustomed to bouts of heat during this time of year, the extreme hot spell in April would have been 1.4C cooler “if humans had not warmed the planet by burning fossil fuels” such as coal and other activities such as deforestation.
The study noted that the five days of extreme heat was a once-in-a-200-year event.
But it warned that “these trends will continue with future warming”.
The WWA recommended that countries formulate heat action plans that would warn citizens when extreme temperatures are imminent and offer guidance on how to prevent overheating.
It additionally called for strengthening critical infrastructure such as electricity, water, and healthcare systems to adapt to the increasing frequency and intensity of extreme heat.
The length and severity of the extreme heat led to a stark increase in the number of deaths and hospitalisations in Mali and Burkina Faso, the WWA said.
In the Gabriel Toure hospital in Bamako, the capital of Mali, more than 100 deaths were reported between April 1 and 4, compared with 130 deaths for the entire month of March.
A lack of data in the affected countries makes it impossible to precisely estimate the number of heat-related deaths, said the WWA, adding there were likely hundreds, if not thousands, of other heat-related casualties.
The scientists said that rapid urbanisation and loss of green spaces in cities such as Bamako and Ouagadougou, the capital of Burkina Faso, have increased the urban heat island effect, which makes parts of cities significantly warmer than others.
Countries in the Sahel region have had to contend with drought since the 1970s, as well as periods of intense rainfall from the 1990s.
The dwindling availability of water and pasture, compounded by the development of agricultural land, has disrupted the lives of pastoral populations and encouraged the emergence of armed groups that have extended their hold over vast swaths of territory in Mali, Burkina Faso and Niger.
A woman wheeled the corpse of an elderly man into a bank in Brazil, hoping to get a sign-off on a loan. Suspicious, concerned, and confused bank staff in Rio de Janeiro questioned the man’s well-being before calling police, leading to the woman’s arrest on fraud charges.
Study commissioned by England’s health service says hormones should only be prescribed to teens with ‘extreme caution’.
The evidence behind medical intervention for youth questioning their gender is “remarkably weak”, with some doctors abandoning “normal clinical approaches” to prescribe hormones to teens, a landmark review in the United Kingdom has found.
The long-term health effects of masculinising and feminising hormones on teens are “limited and need to be better understood” and such interventions should only be taken with “extreme caution”, the long-awaited review commissioned by England’s National Health Service (NHS) said on Wednesday.
Puberty blockers, which are given to pre-teens to delay puberty, were not found to relieve gender dysphoria or improve “body satisfaction” and evidence about their effects on psychological wellbeing, cognitive development and fertility was insufficient or inconsistent, the review said.
There was also no evidence that puberty blockers “buy time to think”, since the vast majority of young people on them proceed to hormone treatment, according to the review.
Hilary Cass, the paediatrician who led the review, said that while doctors were usually cautious about implementing new research findings in fledgling areas of medicine, “quite the reverse happened in the field of gender care for children”.
“Based on a single Dutch study, which suggested that puberty blockers may improve psychological wellbeing for a narrowly defined group of children with gender incongruence, the practice spread at pace to other countries. This was closely followed by a greater readiness to start masculinising/feminising hormones in midteens, and the extension of this approach to a wider group of adolescents who would not have met the inclusion criteria for the original Dutch Study,” Cass said in a foreword to the report.
“Some practitioners abandoned normal clinical approaches to holistic assessment, which has meant that this group of young people have been exceptionalised compared to other young people with similarly complex presentations. They deserve very much better.”
Cass also expressed concern about the “exceptional” toxicity of the public discussion about transgender and gender-questioning youth.
“I have faced criticism for engaging with groups and individuals who take a social justice approach and advocate for gender affirmation, and have equally been criticised for involving groups and individuals who urge more caution. The knowledge and expertise of experienced clinicians who have reached different conclusions about the best approach to care are sometimes dismissed and invalidated,” Cass said.
“There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour. This must stop.”
Cass said that studies were “exaggerated or misrepresented” on all sides of the debate despite this being an area with “remarkably weak evidence”.
“The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress,” she said.
The NHS commissioned the review in 2020, amid a sharp rise in the number of young people questioning their gender identity and concerns that some minors were being inappropriately identified as transgender.
The NHS last month announced it would no longer prescribe puberty blockers for children and young people outside of clinical research trials.
The UK’s first gender identity clinic for children, operated by the Tavistock and Portman NHS Trust, closed last month after years of criticism that it rushed minors into changing their gender.
Presumptive Republican presidential nominee Donald Trump has said the issue of abortion access should be left up to states to decide, eschewing calls from within his party to support a nationwide ban on the procedure in the United States.
In a video posted on his Truth Social platform on Monday, the former US president said he was “proudly the person responsible” for overturning Roe v Wade, the landmark legal precedent that had guaranteed abortion rights on the national level for decades.
The US Supreme Court, bolstered by a 6-3 conservative majority that included several Trump appointees, overturned Roe v Wade in June 2022. That put the question of abortion access largely in the hands of individual states to decide, though some anti-abortion activists have pushed for a nationwide ban to be implemented.
“The states will determine by vote or legislation, or perhaps both, and whatever they decide must be the law of the land,” Trump said in Monday’s video.
“Many states will be different,” he said, adding that, “At the end of the day, this is all about the will of the people.”
Reproductive rights are expected to be a central issue heading into November’s presidential election, which is set to pit Trump against his Democratic Party rival, President Joe Biden.
Biden has made defending access to reproductive healthcare a central plank of his re-election campaign, condemning Trump and Republican Party lawmakers for supporting the end of Roe v Wade.
Conservatives had spent decades trying to overturn the 1973 legal precedent, and several Republican-led US states enacted strict limits on abortion after the Supreme Court’s decision nearly two years ago, in a case known as Dobbs v Jackson Women’s Health Organization.
But abortion has become an Achilles heel for the Republican Party, as polls show abortion bans and restrictions are unpopular and most Americans want to protect access to the procedure.
The Pew Research Center reported in April 2023 — nearly a year after Roe was overturned — that 62 percent of Americans said abortion should be legal in all or most cases, compared with 36 percent who said it should be illegal.
Looking along partisan lines, the survey found that 84 percent of Democrats or Democratic-leaning independents said abortion should be legal in all or most cases, while 40 percent of Republicans or right-leaning independents said the same.
NEW from @JoeBiden on Trump’s abortion comments >>
“Trump is scrambling. He’s worried that since he’s the one responsible for overturning Roe the voters will hold him accountable in 2024. Well, I have news for Donald. They will. pic.twitter.com/PHSIvITw1z
November’s election is expected to be hard fought, and experts say Trump could risk losing votes in critical swing states if he were to come out strongly in favour of a national abortion ban.
Jeanette Hoffman, a Republican political consultant, told the Reuters news agency that “leaving abortion to the states is [Trump’s] way of punting on the issue”.
“Now that the primary is over, there’s nothing to be gained from proposing a national abortion ban, as he’ll lose support from voters in many swing states,” Hoffman said.
Trump’s comments on Monday drew criticism from anti-abortion groups in the US, however.
Marjorie Dannenfelser, president of the anti-abortion group Susan B Anthony Pro-Life America, said the organisation was “deeply disappointed” by Trump’s position.
The Supreme Court’s 2022 decision “clearly allows both states and Congress to act”, she said in a statement. “Saying the issue is ‘back to the states’ cedes the national debate to the Democrats.”
Senator Lindsey Graham, a top Republican and ally of the former president, also said he disagreed with Trump’s stance.
“I will continue to advocate that there should be a national minimum standard limiting abortion at fifteen weeks,” Graham wrote on the social media platform X.
Meanwhile, Biden slammed his predecessor for making “it clear once again today that he is — more than anyone in America — the person responsible for ending Roe v Wade”.
“Trump is scrambling,” Biden said in a statement.
“He’s worried that since he’s the one responsible for overturning Roe the voters will hold him accountable in 2024. Well, I have news for Donald. They will.”
United States President Joe Biden has denounced a Florida Supreme Court decision that allows a six-week ban on abortion to take effect, calling it “outrageous” and “extreme”.
In a statement released on Tuesday, Biden lashed out at Republicans for limiting reproductive rights in Florida and other US states, a key election issue in 2024.
“Florida’s bans — like those put forward by Republican elected officials across the country — are putting the health and lives of millions of women at risk,” he wrote.
The statement comes in response to a series of rulings from Florida’s highest court on Monday, one of which upheld a ban on abortions after 15 weeks of pregnancy.
But that same decision is expected to pave the way for the six-week ban to go into effect, too.
In April of last year, the conservative-dominated Florida state legislature passed the six-week ban to replace the 15-week one, and Governor Ron DeSantis signed it into law.
However, the 15-week ban had been the subject of long-standing legal challenges. The six-week ban’s implementation hinged on whether the 15-week one could withstand the lawsuits it faced.
Prior to the 15-week ban, Florida had allowed abortion through the second trimester of pregnancy, which made it a destination for those seeking the procedure from nearby states with tighter restrictions.
Abortion headed to the ballot box
Monday’s string of decisions from the Florida Supreme Court also tees up another battle over abortion access in the state, set to unfold in the midst of November’s heated general elections.
The justices allowed a measure to be placed on the ballot that would amend the state constitution and protect abortion access “before viability” — up to around 24 weeks of pregnancy.
The ballot measure passed by a vote of four to three and is known as Amendment 4 or the “Amendment to Limit Government Interference with Abortion”.
It calls for the following language be inserted into the Florida constitution, “No law shall prohibit, penalize, delay or restrict abortion before viability or when necessary to protect the patient’s health.”
Biden referenced the ballot measure in his Tuesday statement, reaffirming his commitment to protecting “reproductive freedom in Florida and across the nation”.
“Vice President [Kamala] Harris and I stand with the vast majority of Americans who support a woman’s right to choose, including in Florida, where voters will have the opportunity to make their voices heard in support of a reproductive freedom ballot initiative this November,” he wrote.
Biden faces a tight campaign for re-election this November, as he is expected to run against former Republican President Donald Trump in a rematch of their 2020 race.
Florida was once considered a swing state, with Republicans and Democrats competing neck and neck in key races. But in recent years, Florida has swung rightwards, with Trump winning the state over Biden in 2020.
The last time Florida had a Democratic governor, for instance, was in 1999, nearly a quarter century ago.
Still, experts see the question of abortion access as weighing in Democrats’ favour. The Pew Research Center found that 56 percent of adults in Florida believed abortion should be “legal in all/most cases”.
Another poll (PDF), published last November by the University of North Florida Public Opinion Research Lab, found that 62 percent of survey participants planned to vote for the constitutional amendment protecting abortion access, if it were to appear on the ballot.
A ‘blueprint’ for the US
Florida is the third most populous state in the US, and as such, it carries significant weight in the Electoral College, the system the country uses to determine who wins its presidential elections.
The state is entitled to 30 Electoral College votes, out of a total of 538.
It is also considered a bellwether for trends in legislation nationwide, with Governor DeSantis calling Florida a “blueprint for America’s revival” in a recent book.
But abortion providers and groups like the American Civil Liberties Union (ACLU) and the Center for Reproductive Rights quickly filed complaints to prevent it from being implemented.
However, in June 2022, within months of the bill’s passage, the US Supreme Court overturned Roe v Wade, the 1973 decision that upheld the federal right to an abortion for nearly a half a century.
That placed the question of abortion rights in the hands of the states, creating a shifting patchwork of restrictions across the country.
Plaintiffs in the case before the Florida Supreme Court this week argued that the 15-week abortion ban violated the state constitution’s privacy protections, but the justices rebuffed that argument in a six-to-one vote.
Privacy protections had also been the basis for the now-defunct Roe precedent at the federal level. The decision to overturn Roe featured heavily in the Florida court’s decision on Monday.
“The US Supreme Court abandoned Roe’s position that the right to abortion was grounded in any sort of privacy right,” the justices wrote.
“This demonstrates the tenuous connection between ‘privacy’ and ‘abortion’ — an issue that, unlike other privacy matters, directly implicates the interests of both developing human life and the pregnant woman.”
The ACLU of Florida responded to the decision by calling on voters to turn out for the November election.
“These strict bans have and will continue to lead to multiple tragedies as patients are unable to receive needed care after the arbitrary deadline,” it wrote in a statement.
“In the face of a six-week abortion ban, Floridians now have the chance to assert their will at the ballot box, shaping a Florida that is free from government interference in abortion.”
New York – In the early 1990s, a mysterious illness began to spread rapidly among villagers across several provinces in central China.
At the time, HIV/AIDS had already emerged in other parts of the world, including Europe and the United States, where cases were transmitted mostly through sexual contact. In China, however, people were infected after selling their blood and plasma or receiving transfusions contaminated in the trade.
Over the following decade, as many as 300,000 people in Henan province, the epicentre of the trade, were infected – a scandal exposed by local retired gynaecologist Dr Gao Yaojie.
Long before eye doctor Li Wenliang sounded the alarm on COVID-19 and succumbed to the virus in early 2020, Dr Gao was China’s best-known whistleblower. Her decision to expose the source of China’s AIDS epidemic made her an exile for the last 14 years of her life. She died last December at the age of 95 in New York.
Despite official erasure (Baidubake, China’s Wikipedia equivalent, says Gao settled overseas on a visiting fellowship), Chinese netizens mourned Gao’s death on the same Weibo “wailing wall” page where they commemorated Li.
Gao’s descent from national prominence to relentless official persecution exposed just how ruthless Beijing could be, even at a time when it was seen as opening up to the world.
“All she wanted was the freedom to speak out, to tell the whole world the truth behind China’s AIDS epidemic and to keep a record for history,” said former journalist Lin Shiyu, who edited most of the books Gao published while in exile in the US. “That was why she fled China.”
As the yet-unsolved origin of the COVID-19 pandemic shows, the secrecy Beijing enforces has repercussions for the rest of the world. Across the globe, more than 7 million people have died from the “mysterious virus” that first emerged in Wuhan in late 2019, according to the latest figures from the World Health Organization.
Gao did not set out to be an activist, much less a whistleblower. She became alarmed when she started to see patients in Henan province with tumours that she knew were common symptoms of AIDS. Few had been tested for HIV, let alone diagnosed, until Gao insisted.
“As a doctor I couldn’t turn a blind eye; I had a responsibility to do all I could to prevent this epidemic from spreading. However, at the time, I was unaware of the unfathomable forces underlying the widespread transmission of HIV,” Gao wrote in her 2008 memoir, The Soul of Gao Yaojie. “Had I known, I might not have been able to muster the courage.”
Soon enough, she discovered that the plasma trade – especially prevalent in rural areas where impoverished villagers needed to supplement their income – had become a vector for transmission. Once Beijing banned most imported blood products, part of its attempt to frame the virus as having a “foreign” origin, pharmaceutical firms ratcheted up domestic demand, making the problem worse.
Even the Chinese Red Cross and its People’s Liberation Army-run hospitals got into the booming blood business. Local officials who stood to profit told villagers that selling plasma was also great for their health. Many were infected with HIV because dirty needles were routinely reused to draw blood.
Half of the 3,000 villagers in one county in Henan province made ends meet with the blood money at the time; 800 developed AIDS, Gao noted in her memoir.
‘Officially controlled process’
As much as Gao’s fight to expose the source of transmissions and to staunch the blood trade rankled local officials, the central government recognised her efforts. When provincial officials put her under house arrest in 2007, the health minister intervened so Gao could travel to the US to receive an award.
Gao, with fellow campaigners Xie Lihua (left), founder and editor of Rural Women Knowing All magazine and secretary-general of Beijing’s Development Center for Rural Women, and Wang Xingjuan, founder of a non-governmental women’s research institute, as they were recognised in the US for their work in 2007 [Yuri Gripas/Reuters]
Even though “whistleblowing” is translated literally into Chinese, the idea is not new, and the right to report wrongdoings was protected in the first constitution of the People’s Republic of China (PRC) of 1954. This stated that “all the PRC citizens had the right to make oral or written reports of any power abuses to the authorities”, according to political scientist Ting Gong in her 2000 paper titled Whistleblowing: what does it mean in China?
But that right has limits.
“In China, whistleblowing is an officially controlled process,” Gong noted.
The tide soon turned on Gao and others. Dr Wan Yanhai, a health official-turned-advocate, was detained in 2002 after distributing a secret government document on 170 AIDS-related deaths.
As with COVID-19, in the case of AIDS, “the impulse to cover up is ideological: Beijing deems its communist system the best in the world and brooks no fault”, Wan told Al Jazeera in February from New York after being barred from returning home to China since 2010. That was the year Wan defied officials’ warnings and attended the Nobel Peace Prize ceremony in Oslo to honour Liu Xiaobo, the Chinese dissident scholar who eventually died in prison in 2017.
For Gao, accolades worldwide and foreign media coverage of her work only gave Chinese officials further cause to rein her in.
After her book tour to Hong Kong in 2008, officials stepped up their surveillance and even cut her off from her family members. Several months later, Gao escaped with only a blood pressure meter and a floppy disk containing details and photos of patients.
At 81, Gao was the oldest dissident ever to have fled China. Barely one month after her death, prominent economist Mao Yushi set a new record. Mao, whose liberal think tank known for advocating market reforms was shut down by officials, shared pictures on social media of his 95th birthday celebrations in Vancouver, Canada, not long after he fled China.
Gao kept writing books into her last days.
“She was used to running around to tend to her patients. She felt useless merely writing on a notepad,” said Lin. Yet, Gao never took her final years in exile for granted.
“The US is no paradise,” wrote Gao, but she added: “Had I never left [China], I wouldn’t have lived past 90.”
Government orders review of approval system for health products in response to supplement-related illnesses.
Health officials in Japan have raided a factory belonging to Kobayashi Pharmaceutical after the drugmaker reported a fifth death possibly linked to its dietary supplements advertised as helping to lower cholesterol.
On Saturday, officials from the ministries of health, labour and welfare as well as local authorities inspected the facility in the city of Osaka that had made the supplements containing an ingredient called red yeast rice, or “beni koji”.
Kobayashi said on Friday that five people had died and 114 people were being treated in hospitals after taking the products. Japan’s Ministry of Health says the supplements are responsible for the deaths and illnesses, and warned that the number of those affected could increase.
The company has said that little is known about the exact cause of the illnesses, which include kidney failure. An investigation into the products is under way in cooperation with government health authorities.
A Japanese pharma company has recalled health supplements containing an ingredient called red yeast rice after deaths and hospitalisations [Reuters]
Reports of health problems surfaced in 2023, although “beni koji” has been used in various products for years.
“Beni koji” contains Monascus purpureus, a red mould that is also used as a red colouring in some foods.
The products were recalled on March 22, two months after the company received official medical reports about the problem. The company’s president, Akihiro Kobayashi, has apologised for not acting sooner.
The supplements could be bought at pharmacies without a prescription. Kobayashi said about a million packages were sold over the past three fiscal years. It also sold “beni koji” to other manufacturers, and some products were exported to countries like China and Taiwan.
The government has ordered a review of the approval system for health products in response to the supplement-related illnesses. A report is due in May.
A Chinese consumers association on Friday urged consumers to stop usage, saying it was concerned about the risk of Kobayashi products, state media reported.
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