health care

KAMPALA, Uganda – Ugandan activists are marching to the constitutional court to sue over the deaths of two pregnant women who they say died because they did not pay adequate bribes to government medical workers.

Lawyer Nuur Nakibuuka Musisi said Friday they are also demanding basic services for pregnant women. Government hospitals are supposed to provide free care.

Valente Inziku says nurses refused to treat his wife, who was in labor, even after he gave them the 10,000 shillings (about $4) they asked for. He says in an affidavit that nurses ignored her cries of pain for more than eight hours before she died, late last year. The baby also died.

Friday’s protest follows several opposition-led marches — some of which have turned violent — over government corruption and rising food and fuel costs.


TOPEKA, Kan. — Kansas legislators approved restrictions on private insurance coverage for abortions and adopted a state budget stripping funds from a Planned Parenthood affiliate, capping a string of victories Friday for abortion opponents only four months after sympathetic Gov. Sam Brownback took office.

This year, five major proposals favored by abortion opponents cleared the GOP-dominated Legislature as members heeded a call from Brownback to create “a culture of life.” But Planned Parenthood of Kansas and Mid-Missouri, the target of much of lawmakers’ efforts, confirmed that it is consulting with attorneys over possible legal challenges

“Four or five anti-choice bills, as we would characterize them, is pretty significant,” said Tait Sye, a spokesman for the Planned Parenthood Federation of America. “It would be in the top tier of anti-choice legislatures, which is probably what Brownback wants.”

Brownback, a Republican, is expected to sign the bill sent to him by the state House a mere 15 minutes before lawmakers adjourned their annual session. The House’s early-morning vote was 86-30 in support of a larger bill that included the abortion coverage restrictions. The state Senate had approved it Thursday night, 28-10.

The measure prohibits insurance companies from offering coverage of abortions as part of their general health plans, except when a woman’s life is at risk. If the bill becomes law as expected, starting in July, individuals and employers who want abortion coverage would have to buy supplemental policies that cover only abortion.

Supporters of the bill argue that it will protect employers who oppose abortion rights from having to pay for policies that cover the procedures. The legislation also says that no state or federally administered health-insurance exchange in Kansas established under last year’s federal health care overhaul law can offer coverage for abortions, other than to save a woman’s life.

The $13.8 billion budget approved by legislators, also early Friday, includes a provision diverting about $330,000 in federal family planning funds away from Planned Parenthood of Kansas and Mid-Missouri to public hospitals and health departments. The group’s top executive warned that it will be forced to reduce services dramatically at clinics in Hays and Wichita that don’t perform abortions without affecting one in the Kansas City suburbs that terminates pregnancies.

Brownback already has signed legislation to tighten restrictions on late-term abortions and require doctors to obtain written permission from parents before terminating minors’ pregnancies. Legislators also have sent him a bill to impose new health and safety standards specifically for abortion clinics, which the governor plans to sign Monday.

“Governor Brownback has never been shy about the fact that he’s pro-life,” spokeswoman Sherriene Jones-Sontag said.

Kathy Ostrowski, legislative director for the anti-abortion group Kansans for Life, said the state’s new laws will protect women who seek abortions from dangerous clinics and provide more accurate reporting by doctors about their activities.

“It has obviously been a good session,” Ostrowski said after lawmakers adjourned.

Democratic Govs. Kathleen Sebelius and Mark Parkinson, who held the office before Brownback, blocked most major changes in Kansas abortion laws, vetoing legislation that is becoming law this year.

“There’s clearly a message here that women are dispensable,” said state Rep. Annie Kuether, a Topeka Democrat and one of the Legislature’s shrinking number of abortion rights supporters. “I’m sick and tired of being treated like a second-class citizen.”

The measures in Kansas are part of a wave of anti-abortion legislation across the nation, as abortion opponents have been encouraged by the election of new Republican governors last year and conservative legislators.

The Guttmacher Institute, a research organization supporting abortion rights, says Kansas and Missouri are among seven states now with restrictions on private health insurance coverage of abortion. Also, a dozen states, including Kansas, restrict coverage in health exchanges.

Planned Parenthood officials say moves to strip funds from affiliates are afoot in at least five other states; one in Indiana has filed a lawsuit there.

“Why would we want to continue to give Planned Parenthood tax dollars to ostensibly prevent pregnancy, when they make even more money performing abortions when that ‘prevention’ fails?” said Mary Kay Culp, Kansans for Life’s executive director.

But Brownlie said the Planned Parenthood clinics offer a wide range of services, including thousands of breast exams and tests for sexually transmitted diseases each year. The federal dollars account for about 10 percent of the budget for its Kansas operations, he said.

Women who do routine jobs such as cleaners are almost six times more likely to die from alcohol abuse than women in better paid roles, according to new government research.

The report by the Office for National Statistics found cleaners, sewing machinists and bar staff face 5.7 times greater risk of fatal liver disease, mental disorders and poisoning than doctors and lawyers.

This was despite richer women downing almost twice as much alcohol, the study finds.

Meanwhile men who worked as van drivers and labourers have a three and a half times bigger threat of meeting a similar fate than than those in higher managerial and professional work.

The new report is the first analysis of the social inequalities in adult alcohol-related mortality in England and Wales in the last decade as measured by the National Statistics Socio-economic Classification (NS-SEC).

A year ago an ONS report found professional and managerial women are downing almost twice as much alcohol as the lower paid.

They are drinking an average of 10.2 units a week – more than a bottle of wine – compared with 6.5 units for manual workers.

Statistician Myer Glickman, whose team compiled the latest findings, said: ‘They are an apparent contradiction but it could be down to a number of factors.

‘One could be there are other things affecting people’s health such as whether they are smokers or have a poorer diet which may make them more vulnerable to the effects of alcohol.

‘Also patterns of drinking may be different, such as binge drinking on particular types or brands of alcohol rather than drinking similar or even greater amounts but over a longer period of time.

‘The greater difference between male and female social groups could also be down to the fact that professional women in general are particularly advantaged when it comes to good health.’

The most alcohol related deaths occurred in males aged between 50 and 54 with routine jobs (52.2 per 100,000). For women it was for those in routine work and age 45 to 49 (42 per 100,000).

For the less advantaged groups, alcohol-related mortality peaked in middle age and then declined, whereas for managers and professionals, the risk of mortality increased steadily the older they got.

The report said this means alcohol-related deaths in the less advantaged groups tend to be younger as well as being more common.

The study also found the number of alcohol-related deaths in England and Wales doubled between 1991 and 2008, rising from 3,415 (6.4 per 100,000 population) in 1991 to 7,344 (12.4 per 100,000) in 2008. But the most recent data in 2009 indicated a drop in alcohol related deaths of 3.3 per cent, to 7,099.

Regionally, the highest mortality rate for men in all occupied classes combined was found in the North West of England (26.9 per 100,000) followed by the North East (23.7), the West Midlands (23.6) and London (21.3).

These areas all had significantly higher mortality rates for all occupied classes combined than England and Wales as a whole, where the figure was 19 per 100,000.

The lowest mortality rate was in the East of England (12.4 per 100,000), half of that seen in the North West. The second lowest was the South West (15.2) followed by the East Midlands and the South East, both 15.5 per 100,000. Similar regional patterns were observed for women, but with lower overall death rates.

Previous survey results have suggested that less advantaged social groups drink less in total than the more advantaged groups.

Therefore the explanation for these inequalities is not a simple one, and may be associated with differences in the detailed patterns of drinking among different groups or with the influence of underlying factors other than alcohol consumption, said the report.

Alcohol-related deaths include only these causes defined as being most directly due to alcohol consumption, such as alcoholic liver disease (accounting for approximately two-thirds of all alcohol-related deaths), fibrosis and cirrhosis of the liver, (18 per cent), mental disorders (9 per cent) and accidental alcohol poisoning (3 per cent).

It does not include other diseases where alcohol has been shown to contribute to the risk of death, such as cancers of the mouth, oesophagus and liver. It also excludes deaths from accidents and violence where alcohol may have played a part.
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The coalition may present itself, like all the main political parties, as pro-family, but it is mothers who have become the “shock absorbers” for the coalition’s cuts in welfare benefits and childcare provision, say critics.

From cuts to maternity grants and child benefits, to closures of Sure Start centres, childcare schemes and after-school clubs, it is women – particularly single mothers on low incomes – who bear the brunt of attempts to reduce the deficit.

The changes will affect women’s incomes and ability to enter the job market, critics say, and put many at risk of poverty. “The disproportionate impact of the cuts on women raises issues of fairness and calls into question the idea of society sharing the weight of national debt reduction,” said Abigail Davies, assistant director of policy and practice at the Chartered Institute of Housing. “Overall the public spending cuts are known to impact disproportionately on single parent families, most of which are headed by women. Cuts to benefits and public spending, coupled with stricter job-seeking expectations for lone parents claiming benefits, will trap some women in an impossible situation.”

Benefit cuts that affect women include reductions in the childcare tax credit, the Sure Start maternity grant, and the health in pregnancy grant, and the freezing of child benefit rates for three years.

Katherine Rake, chief executive of the Family and Parenting Institute, said: “The targeting of family benefits for cutbacks in the last 12 months means women’s incomes have been disproportionately hit. For many women, child benefit was the only source of income they received directly, giving them independence and control over family spending. The coalition’s decision to end universal child benefit was therefore a particularly painful blow.”

There are concerns that single parents – most of whom are women – will also be unfairly affected by housing benefit reform. “This will require some families to move, which is expensive, unsettling, affects [children’s] educational performance, and puts families into less economically successful areas with reduced employment opportunities,” said Davies. “Cuts to tax credits, Sure Start, after-school clubs and so on, create further barriers to employment for single parents.

“The government wants to encourage social mobility and tackle poverty, but these cuts do not create an environment which supports women or enables them to help themselves.”

Despite the government’s commitment to guarantee 15 hours a week free childcare provision, childcare support has been badly hit by local authority spending cuts. These have led to widespread cuts in Sure Start children’s centres and after-school and holiday play schemes. Although many councils have committed themselves to keeping centres open, most have reduced services drastically.

A survey of mothers using Sure Start centres, carried out in February by the Daycare Trust charity, found that 35% felt that the removal or reduction of services would leave them more socially isolated, and 32% felt it would be harder to see their midwife or health visitor.

Rake said there had been some positive policy developments for mothers over the past 12 months, such as proposals for shared postnatal parental leave, and to extend rights to flexible working. She added: “The government must deliver on these proposals if it is to make strides towards a truly family-friendly society.”

AUSTIN — A state health program that helps low-income women get birth control, Pap smears and cancer screenings could cease to exist as some lawmakers try to shore up their anti-abortion credentials.

About 120,000 women are covered monthly by the Women’s Medicaid Health Program, which must be renewed this year to continue. The state provides about $3 million annually to keep the program afloat and gets about $28 million in matching money from the federal government.

The Health and Human Services Commission estimates that, if renewed, the program would save the state about $84 million over the next two years by reducing unwanted pregnancies through contraceptives.

But conservative Republican state lawmakers, who have launched an

effort to cripple funding for abortion providers and “affiliate” organizations that work with them, are pushing a bill that could eliminate the program altogether.

A measure by state Sen. Bob Deuell, R-Greenville, would continue the health program but includes a provision that stipulates that it would cease to exist if organizations such as Planned Parenthood challenge the state in court and win access to funding.

“I think the election shows that a great majority of voters put people in office that do not want money to go to abortion providers or their affiliates,” Deuell said.

Deuell’s bill passed out of the Health and Human Services committee on a 5-1 vote and is headed to the full Senate.

State Sen. José Rodríguez, D-El Paso, cast the only vote against the bill.

Rodríguez said he opposes the bill because it cuts money for Planned Parenthood, which “has a track record and a history of providing services without complaints under the Women’s Health Program.”

By law, state and federal money for the program cannot be used for abortions.

Planned Parenthood provides abortions but has clinics that do not. Those clinics get funding through the program to offer women’s health services such as birth control and cancer screenings.

Rodríguez said his biggest concern with the bill is that if the state loses a lawsuit, the program could be eliminated entirely.

“We should have some kind of fallback position in the event that there is a successful challenge so that this program continues,” he said.

In 2005 the Legislature passed a bill establishing the Women’s Medicaid Health Program with an amendment that barred abortion providers or their affiliates from receiving funding.

Through the program, low-income women can visit a variety of health-care providers and get free health screenings, birth control and gynecological exams.

When the program was being implemented in 2007, lawyers from the Health and Human Services Commission said the exclusion of clinics that are connected in some way to abortion providers would not withstand a legal challenge. They advised the commission’s director to allow organizations such as Planned Parenthood to participate.

Since then, the attorney general has issued an opinion allowing the state to enforce the amendment. The state’s Health and Human Services Commission is now implementing measures that would bar organizations such as Planned Parenthood from receiving the money, officials said.

Planned Parenthood officials said that each year through the program their agency provides birth control and services such as cancer screenings to more than 40,000 women.

Peter Durkin, president and CEO of Planned Parenthood Gulf Coast, said the organization is “prepared to move forward with a lawsuit if that’s what it takes to continue to provide cervical cancer screenings and other health care to the women who depend on our health centers.”

The bill will have to get 21 votes to be heard on the Senate floor. That would require that at least two Democrats support the measure.

Republican lawmakers, as part of their anti-abortion platform, removed funding for women’s health and family planning services in the Texas House budget and have sought to advance similar measures in the Senate.

Height is often used as a proxy for health, because children who get good nutrition and health care tend to grow taller than their forebears.

Now new research shows that the average height of women in 14 African countries is shrinking. And that spells bad news for the future health of those nations.

Researchers at the Harvard School of Public Health looked at the heights of women ages 25 to 49 in 54 countries who had been measured between 1994 and 2008, and compared that to the heights of women in 1945.

They found that women in 14 African countries lost stature, while women in 21 countries stayed the same. In 19 other nations, including Bangladesh and Kazakhstan, women gained stature. The results were reported in the online journal PLosONE.

The changes in average height were almost always associated with income: Poor women lost height, while more affluent women grew taller. The women in the top 20 percent in income gained height in all countries, and were almost 2 centimeters taller on average than the poorest women in their countries. Women in Guatemala showed the biggest height difference between rich and poor, with an almost 8-centimeter gap.

Even though there’s been a big drop in infant mortality in the time covered by this survey, the stagnation and decline in height “suggest little improvement, and perhaps deterioration, in early childhood living conditions,” according to the study authors.

That’s true not just in Africa.

Through most of American history, Americans have been the tallest people on the planet. Credit that to abundant food and fewer diseases than in the crowded cities of Europe. But Americans’ height plateaued in the 1960s; the Dutch are now the tallest population on Earth. And a 2010 study by economist John Komlos found that African-American women in the United States have actually lost height, starting with those born in 1975.

Since a population’s height usually predicts health, wealth and life expectancy, a loss of height is troubling, the kind of thing usually seen only in times of famine or war, Komlos says.

Porn performer Derrick Burts, 24, learned he was HIV-positive in October after getting tested for sexually transmitted diseases at a healthcare clinic in the San Fernando Valley that serves the adult film industry.

Video: Watch the interview

Burts’ positive test result Oct. 9 came a little more than a month after he had last tested HIV-negative at the same clinic, the Adult Industry Medical Healthcare Foundation, known as AIM. In the weeks in between, he worked on both gay and straight porn sets in California and Florida.

Burts, who performed in straight films as “Cameron Reid” and gay films as “Derek Chambers,” spoke publicly about his diagnosis for the first time Tuesday in an interview with The Times at the AIDS Healthcare Foundation offices in Hollywood. He is scheduled to speak at a 10 a.m. Wednesday news conference.

He sought help from the foundation, which has long been critical of the straight porn industry’s testing protocol and failure to require condom use, after becoming disappointed in his follow-up care at Sherman Oaks-based AIM.

Burts said he now wants to speak out to warn others that the work he was doing was “very dangerous.”

“What they tell you in porn is, ‘You’re not going to make any money if you wear a condom, you know, viewers don’t want to see that,’ ” he told The Times, “so I didn’t even know you had an option to wear a condom. I had never seen a condom on a straight set in my entire life.”

The gay and straight porn industries take different approaches to stemming the spread of sexually transmitted diseases. Gay porn producers typically require condom use, but not HIV testing. In the San Fernando Valley-based straight porn industry, regular tests are required of workers, but condom use is rare.

Burts said that after getting his test results he gave AIM clinic staff the names of about a dozen performers he had worked with in the previous weeks in both gay and straight productions in California and Florida.

AIM officials said last month that no one on their quarantine list had tested HIV-positive. It was not clear whether the list included all the performers named by Burts since he worked out of state and on gay productions.

AIM officials could not immediately be reached for comment Tuesday night. One attorney for the clinic was traveling outside the U.S., according to an e-mail from him earlier in the day.

The clinic has drawn criticism from AIDS activists and state officials who say clinic officials have failed to promptly report HIV and other sexually transmitted diseases.

In 2004, a male porn star, Darren James, contracted HIV and spread the virus to three female performers before it was detected. The outbreak shut down porn production for a month.

James, who has also become a proponent of condom use on porn sets, told The Times last year that he felt he had received poor follow-up care from AIM clinic officials. He spoke about his experiences after a female performer tested HIV-positive. After her diagnosis no other cases were detected among performers and clinic officials said she had rarely worked in the industry

In recent weeks, state workplace safety officials have been considering whether to mandate condom use and additional testing for porn performers.

Last month, AIM officials said the most recent testing “affirms the efficacy of AIM Healthcare Foundation’s testing protocols, as voluntarily implemented by the adult entertainment industry,” adding that “it is regrettable but inevitable that people continue to acquire the HIV virus in their personal life.”

Burts said Tuesday that clinic officials told him they had traced his infection to another performer, who he said they described as a “known positive.”

He called AIM’s statement “completely false.” “There is no possible way. The only person I had sex with in my personal life was my girlfriend.”

His girlfriend, who accompanied him to the interview Tuesday, is also an adult film performer and was among the performers whose names he gave AIM, Burts said. She is HIV-negative, he said.