TIME Ukraine

U.N. Says Nearly 1,000 Killed in Ukraine Since September Truce

A man of the Don battalion Lugansk People's Republic militia on the firing line on the Seversky Donets River on Nov. 18, 2014.
A man of the Don battalion Lugansk People's Republic militia on the firing line on the Seversky Donets River on Nov. 18, 2014. Krasilnikov Stanislav—Corbis

An average of 13 people every day since Sept. 5

Almost 1,000 people have been killed in Ukraine since a truce was signed in September between the Ukrainian government and pro-Russian separatists controlling parts of the restive eastern region, according to a United Nations report.

An average of 13 people have been killed every day since the Sept. 5 cease-fire was brokered between Ukraine and the rebels, equating to at least 957 deaths up to Tuesday, the U.N. human rights group found in the report. At least 4,317 people have been killed in the conflict since April, including the 298 who died when Malaysia Airlines Flight 17 was shot down in July, and thousands of others have been injured. Some 466,000 people have been registered as displaced.

MORE: Cease-Fire in Ukraine Fails and Preparations for War Begin

“Respect for the cease-fire has been sporadic at best,” said Zeid Ra’ad Al Hussein, the U.N.’s top human rights official, in a statement. “All parties need to make a far more whole-hearted effort to resolve this protracted crisis peacefully and in line with international human rights laws and standards.”

[AFP]

TIME World

A CDC Epidemiologist Talks About Life on the Front Lines of the War Against Ebola

Redd, right, with local medical student Francis Abu Bayor.
Redd, right, with local medical student Francis Abu Bayor. Christina Socias—CDC

The CDC's Dr. John Redd spent weeks in Sierra Leone, combatting Ebola. He talks with TIME about the experience

Dr. John Redd, a captain in the U.S. Public Health Service, was sent in September by the Centers for Disease Control and Prevention (CDC) to Sierra Leone, one of the three West African countries most devastated by the Ebola epidemic. The 52-year-old was assigned to Makeni, the capital of the northern district of Bombali (pop. 434,000). After six weeks battling the deadly disease, Redd returned to his home in Santa Fe, N.M., where he described his experience to Time Inc. senior editorial adviser Richard B. Stolley.

 

THE ROLE OF CDC DOCTORS DEPLOYED TO FIGHT EBOLA IS NOT PATIENT CARE. WHY?

I am a medical epidemiologist, and epidemiologists control disease at a population level. I volunteered to go to Sierra Leone with CDC to help control the outbreak and support local efforts to slow it down.

 

WASN’T IT DIFFICULT FOR YOU NOT TO TREAT PATIENTS?

I was treating patients, but not one at a time. That’s public health. I was supporting the system of outbreak control so that there will ultimately be fewer patients to treat.

 

WHAT WAS YOUR GOAL?

To slow down the spread and reduce transmission, because that’s what really controls an outbreak like Ebola. It’s the public health measures that will end the outbreak, not treatment, as important as treatment is.

 

HOW DID YOU PROCEED?

First is case identification or case finding. That means helping local authorities find people in the community as early as possible who have the disease or may have it, moving them into holding centers so they are removed from their community while their labs are pending, and then sending patients who are positive to an ETU, Ebola Treatment Unit. That’s where personnel from Doctors Without Borders, the International Red Cross and other aid organizations work – the part of the Ebola system most people are familiar with.

 

WHAT WAS THE LOCAL MEDICAL INFRASTRUCTURE LIKE?

Though extremely under-resourced by American standards, there is an existing public health surveillance system, just as in the U.S., where we have systems to count cases of diseases like influenza. In Sierra Leone, it had been used for diseases other than Ebola, like malaria and typhoid fever. The country also has an existing clinical medical system, which starts with very small health stations in many villages. In my district there were more than 100 of those, leading all the way to the government hospital in Makeni.

 

WHAT WAS THE EBOLA SITUATION WHILE YOU WERE THERE?

We investigated more than 800 patients with suspected Ebola, and more than half were confirmed with the disease. There were over 100 deaths, but that is probably an underestimate. There’s a delay in reporting deaths from ETUs, and some deaths in rural areas are not reported. By the time I left, the numbers in our district had begun to decrease. But in -areas around Freetown—the capital of Sierra Leone—cases are still on the rise.

 

WHAT WAS YOUR FIRST CONTACT WITH A PERSON WITH EBOLA?

I saw my first patient the day after I arrived, through a window in a holding center in Makeni. We could not go inside. We had three holding centers with a total of 140 beds, with a physical gradation according to patient risk. In the middle of each center were confirmed patients waiting transit to an ETU in another district. They were vomiting, had diarrhea and were very weak. Anyone who treated those patients, mainly nurses from Sierra Leone, needed to be in full protective gear in spite of the heat – near 100ºF – and high humidity. Those nurses were incredibly heroic. There was another section for patients waiting for blood test results, and a third for patients being observed for 21 days after their tests turned out negative. This separation of patients, and the nursing procedures, were all designed to minimize the risk that someone who was negative could get the disease there.

 

WHEN DID YOU WITNESS YOUR FIRST EBOLA DEATH?

It was the same morning. As many as eight people were dying some days.

 

HOW DID THE SURVEILLANCE PROCESS WORK?

We had about 100 college and public health students from Sierra Leone, mostly men, some women, whose classes had been cancelled because of Ebola. For now, school isn’t happening in Sierra Leone. They were the team’s disease detectives. Every morning they would ride their motor bikes out to respond to alerts that a household member was ill or had died. They would call an ambulance to remove the body or take the patient to a holding center. We had only four ambulances, so sometimes we would have to ask patients to walk to the holding center. We had to be very practical about it. Then the surveillance officer would talk to the family about who might have come in contact with the patient. These contacts would be followed for 21 days.

 

WHERE WERE THESE FAMILIES LOCATED?

Mostly in the south of the district, around Makeni. But some were in villages in the rural north. Many did not have electricity, and most did not have running water or flush plumbing. Unfortunately these conditions are conducive to the transmission of Ebola.

 

THESE INVESTIGATORS WERE GOING HOUSE TO HOUSE AND LITERALLY KNOCKING ON DOORS?

That is correct.

 

YOU SEEM TO HAVE GOTTEN CLOSE TO THOSE YOUNG PEOPLE. HAVE YOU STAYED IN TOUCH?

Yes, especially with a med student named Francis Abu Bayor. We worked side by side over there, and we’ve been emailing since. He was the leader of the surveillance team and in charge of our database on all the patients. He was an absolute optimist. His phrase was “challenge.” He would say, “Dr. John, we have a challenge” and that could mean anything from a new Ebola outbreak in a previously unaffected neighborhood to the printer being out of paper. Everything was just a challenge to be overcome.

 

IS HE STILL THERE?

He’s waiting for medical school to reopen. On my last day there, we gave him a stethoscope, which is traditional in medicine. My parents gave me one when I graduated from med school. Getting hold of a stethoscope was pretty convoluted. I ordered it from Amazon.com and had it delivered to a doctor in Atlanta who was coming to Sierra Leone. When he arrived in Freetown, he gave it to another doctor who was staying in my hotel. Then the three of us who had worked with Francis — Brigette Gleason, Tiffany Walker and I — presented it to him. He told me he was so inspired by his connection with CDC that he was going to make his career in public health.

 

WHAT WERE OTHER OBSTACLES YOU HAD TO OVERCOME?

Fuel was a constant problem because the investigators had to travel so far. So I put in a request to the CDC Foundation for fuel money, and it was granted. One of my jobs most afternoons was to take those fuel vouchers to the gas station and fill up the vehicles that were transporting the blood samples. And sometimes I’d fill up the investigators’ motor bikes as well.

 

WAS A SICK PERSON EVER RELUCTANT TO GO TO THE HOLDING CENTER?

Sometimes, at first. I helped in a few cases. We would talk to the head of the household and to the chief of the village. And we talked to the sick person, of course. To make sure I myself was not exposed to Ebola, I never passed over the threshold of a house. I’d ask the person to come out and we would talk from a distance in the street, usually a dirt path or road. Nobody was taken against their will, and I never saw anyone refuse to go. People were quite aware of Ebola because the education they had received had been very effective.

 

HOW DID FAMILIES REACT WHEN THIS HAPPENED?

It could be tragic. In some cases, it was the last time they ever saw their loved one. They would say goodbye in the house, and because they were contacts, they would have to remain there and be monitored for Ebola. Getting information on that patient in the holding center could be very difficult, though the surveillance officers tried. If the person turned out to be positive, he or she would be taken away to a distant treatment unit, where sometimes they died. Those were some very touching situations.

 

ONCE IN THE HOLDING CENTER, WHAT HAPPENED?

Patients with possible Ebola would receive medications for malaria and typhoid fever, intravenous fluids and also oral rehydration solution, which contains water, sugar and salt. And the blood draw would go as quickly as possible. That had to be done in full protective equipment. It’s quite a heroic job for someone to be drawing blood on Ebola patients all day long. Their dedication is hard to imagine. I was there 42 days, which I found very challenging, physically, mentally and emotionally. But the local health workers have been working like that for months.

 

HOW WERE THE BLOOD SAMPLES TESTED?

They had to be driven four to five hours to a CDC run lab in a town called Bo, which would email or telephone me the results. We had more than 800 samples sent for testing while I was there, and our goal was to have no more than 48 hours between someone’s lab test and learning whether they were positive or negative. It’s below 48 hours now, which considering the logistics is a real victory.

 

THEN WHAT?

There were many days when I would go to the holding centers to deliver blood test results to the nurses and help with the disposition of patients. If positive, we would get that person to a treatment center as quickly as possible, but it was three to four hours away. We, the lab and the treatment center were all in different locations. One way to conceptualize this is to imagine someone is suspected of Ebola in Dallas, has to be taken to Fort Worth to draw blood, then the blood is driven to Wichita, Kans., and if positive, the patient is transported from Fort Worth to Little Rock, Ark., for treatment. That is based on the actual drive times in Bombali.

 

HOW WERE THE ROADS?

Mostly dirt. It was the end of the rainy season, which meant that they were often mud. The vehicle carrying the lab samples crashed twice in one week because of road conditions. One of the scariest moments for me was hearing about those two accidents. I worried that there were unsecured blood samples at the site, but they were packed in a strong puncture-resistant container, and the samples were fine and were tested normally.

 

WHAT WAS THE CDC PRESENCE IN YOUR DISTRICT?

About 60 CDC personnel were in Sierra Leone at any one time, and we had seven staying in Makeni and working in Bombali and the adjacent district, Tonkolili. Six were doctors or epidemiologists, and one was a communications specialist because a vast part of outbreak control is educating people. We all stayed in the same hotel, and often ate breakfast and dinner together. Lunch was a PowerBar at our desks. Most everybody worked until midnight or 1 a.m., but one evening we all got together to relax and watch a movie I had on my laptop —Die Hard—and some of the hotel employees watched too. It was a nice diversion. I felt extremely close to the CDC colleagues I was working with.

 

ANY CHANCE TO EXERCISE?

Four or five times a week, I got on the elliptical at the hotel for an hour at the end of the day. It didn’t plug into the wall, didn’t need electricity. So when the power went out, which happened frequently, I kept going in the dark. The other people in the gym would laugh, but exercise is very important to me, both at home and traveling. When the lights were on, I was on my BlackBerry most of the time on the elliptical. That was routine multi-tasking.

 

HOW DID YOU PROTECT YOURSELF FROM EBOLA?

The most important thing was no touching. No shaking hands, no hugging. It was a massive societal change. I’d never been to Sierra Leone before, but I’d heard that the people are affectionate and physical. It was really something to live in that reality where you never touch another person — except a couple of times when I inadvertently bumped into someone at a meeting. Also, before being posted, we were trained at CDC in Atlanta in the use of personal protective equipment which all of us carried in backpacks at all times. Fortunately I never needed to put mine on.

 

DID YOU EVER GET SICK OVER THERE?

I got mild food poisoning after a weekend trip to CDC headquarters in Freetown. At first, I didn’t know what it was, but I followed all our established procedures. I isolated myself in my hotel room for 24 hours. We had a supply of MREs [meals ready to eat] so I didn’t have to leave. I checked my temperature and reported it to my supervisor so a decision could be made as to how to handle it, depending upon the symptoms, and if needed, discussions with Atlanta. My symptoms went away quickly, and I never had a fever. It wasn’t Ebola.

 

WHAT WERE BURIALS LIKE?

Every person who died, no matter what the circumstances were, was supposed to be tested for Ebola with a cheek swab and then buried safely. The body was quickly placed in a body bag, which was sprayed with chlorine by a protected burial team. Then it was taken to a new and separate communal cemetery especially set aside for this purpose. To the burial teams’ great credit, they were extremely respectful. Families could not say goodbye at a funeral and could not be at the burial, but could wait nearby. And after the ground was also sprayed with disinfectant, loved ones could leave small memorials and markers there. Seeing that cemetery was one of the most moving experiences of my entire life.

 

THESE WERE HIGHLY EMOTIONAL MOMENTS. DID YOU EVER FIND YOURSELF IN TEARS?

I did cry a couple of times, but only in the evenings at the hotel, not in public. I think most of the CDC workers cried at one time or another. All of the CDC people supported one another a great deal, because everyone realized how stressful it was. So I never felt alone. I felt emotional very frequently, and tears were close, but the days were so busy and long that I was able for the most part to keep my attention on the matters at hand.

 

DID YOU FINALLY GET ACCUSTOMED TO THE DANGER?

I never felt personally threatened, but of course my risk was not zero. To keep it at zero, I would have had to stay home. We were all accepting some level of risk. But it was more the constant psychological cost of having to worry about it, of never touching people, maintaining distance, having to stay disconnected from potential patients. It was like a blanket over all our activities. On a human level, it was very difficult, many hours a day, seven days a week, and it was frequently very sad.

 

WHAT WAS THE FEELING ABOUT AMERICANS THERE?

I didn’t feel a negative vibe even once. People said thank you routinely. It was really touching. When I spoke to the young men and women we were working with, I would emphasize that we were brothers and sisters in the fight against Ebola. We were all on the same team. I think that’s the way everyone felt.

 

HOW DID YOUR OWN FAMILY FEEL ABOUT YOUR ASSIGNMENT?

They were very supportive. My wife, Bernie, actually encouraged me to go to Sierra Leone. She is a physician herself and understood both the gravity of the situation and the contribution I could make to it. Most deployments are for 29 days, and when the CDC asked me to stay longer, she said it sounded like a good idea. We kept in touch mostly by email, but I bought a local phone card and we talked a couple times each week. The connection wasn’t bad. I was able to see my daughters at college on Skype from time to time. It helped that they didn’t seem worried. When we talked or e-mailed, I tended to emphasize the positive aspects of what we were doing and minimized the sad things I’d seen.

 

NOW THAT YOU’RE BACK HOME, ARE YOU IN QUARANTINE?

Technically, I was not. I was in a category that’s called low risk, but not zero risk for 21 days. I had to report on my temperatures twice a day to both the state of New Mexico and CDC. I wasn’t supposed to go to work, but Sandia National Laboratories was very supportive and understanding. I am detailed there by CDC as an epidemiologist on their International Biological Threat Reduction team. I could leave home briefly to buy food or something like that, but my wife was happy to take care of those things. I was told to report any illness or symptoms immediately. It ended November 19, and I’m fine.

 

WHAT DID YOU LEARN IN SIERRA LEONE?

As a physician, I learned how quickly someone can get terribly sick from Ebola and die. As a medical epidemiologist, I saw that the public health efforts to which CDC is contributing are going to be what eventually ends this outbreak. As a human being, I learned how hard working, brave and heroic my Sierra Leonean colleagues were. At no time did I feel that what I was doing was futile. Ultimately, what I really learned about Ebola is that it is controllable.

 

WOULD YOU GO BACK?

Without question.

TIME Culture

Fraternity Group Under Investigation for Rape Comments

Delta Kappa Epsilon's alumni include George W Bush and Theodore Roosevelt

A fraternity of American students in Britain is under investigation after the minutes of their meetings revealed members making a series of jokes about rape and sexual assault.

The University of Edinburgh has appointed a senior member of staff to investigate the chapter of the American fraternity Delta Kappa Epsilon (DKE).

Minutes from DKE fraternity meetings were leaked to Edinburgh’s student newspaper, which reported them on Tuesday.

During a meeting in March, which listed “Feminists” as an agenda item, a member of the fraternity suggested organizing a game of paintball between the fraternity and the university feminist society, FemSoc, to “calm the waters,” according to the report. The proposal was vetoed but the proposer asked, “How are we going to rape them?”A second student responded: “Let’s go to Montenegro, for a raping trip.”

The fraternity was established in Edinburgh as the first U.K. branch of the historic American society, which counts several U.S. presidents, including George W Bush and Theodore Roosevelt, among its alumni. DKE is no stranger to controversy. It was founded at Yale University in 1844 but is now currently suspended there following an initiation ritual in October 2010 where its members shouted sexist slogans, including “No means yes!”

Edinburgh’s DKE “colony” was officially chartered by the American organization less than a week before the minutes were leaked. However, it is not affiliated with Edinburgh University itself and is independent.

The student newspaper also reported allegations that fraternity members joked about offering to walk drunk women home after nights out and taking advantage of them.

The leaked minutes from Edinburgh’s DKE chapter have been met with widespread condemnation on campus. Vice-President of Edinburgh University Students’ Association Eve Livingston immediately issued a statement calling the comments in the leaked minutes “unacceptable” and in breach of university policy against sexual harassment and “lad banter.”

In a statement via Facebook, the feminist society also strongly condemned the DKE’s behavior as “abhorrent” and said “the fact that this type of behaviour is acceptable to a group of students, and that it was even recorded in official minutes, is a clear example of how rampant sexism and misogyny exists in our everyday surroundings.” The society urged Edinburgh University to take disciplinary action.

Speaking to Huffington Post, an Edinburgh University spokesman said: “We are treating this matter extremely seriously.”

Edinburgh’s DKE chapter did not respond to TIME’s requests for comment.

TIME North Korea

Russia Says North Korea Is Ready to Resume Nuclear Talks

(MOSCOW) — North Korea says it’s ready to resume international talks on its nuclear program, Russia’s foreign minister said Thursday as Moscow sought to raise its profile in the international standoff over Pyongyang’s nuclear and missile programs.

Foreign Minister Sergey Lavrov spoke after meeting with Choe Ryong Hae, a special envoy for North Korean leader Kim Jong Un, who earlier this week gave Russian President Vladimir Putin a letter from Kim.

North Korea has wanted to resume talks for a long time, but the U.S. Japan and South Korea say it needs to honor its previous commitments first to shut down its nuclear programs.

Lavrov said Kim’s letter confirmed a desire to expand bilateral ties and “cooperate on settling the problems that still remain on the Korean Peninsula.”

He said Pyongyang is ready to restart the six-way nuclear talks involving both Koreas, as well as the United States, China, Japan and Russia. The negotiations on dismantling Pyongyang’s nuclear program have broken up over Pyongyang holding nuclear and missile tests.

“Pyongyang is ready for the resumption of the six-party talks without any preconditions,” Lavrov said.

Without naming any country, Lavrov also warned against a military buildup in the region “along the bloc lines,” an apparent hint at military cooperation between Washington and Seoul.

Russia’s ties with the communist North soured after the 1991 Soviet collapse, but have improved under Putin’s watch. Moscow has previously sought to help mediate the nuclear standoff, but its diplomatic efforts have had little visible effect.

Lavrov also said Pyongyang is considering a Russian project to build a gas pipeline and a power line to South Korea via its territory.

State-controlled Russian Railways has modernized a North Korean cargo terminal and conducted a pilot project shipping Russian coal to South Korea, Lavrov said. Russia is also considering linking its Trans-Siberian railway with the Trans-Korean railway, he added.

TIME leadership

Melinda Gates on How Women Limit Their Opportunities

Melinda Gates, co-chair of the Gates Foundation, former Microsoft executive and spouse of the Uber-nerd has turned her attention to the issue of women and girls. Her purview is mostly the world’s poorest, but she had some things to say about how even educated and affluent women hold themselves back.

“They doubt themselves,” Melinda told TIME during this week’s 10 Questions interview. “Women don’t tend to see themselves as ready for the next role, as they ought to.” Gates, who recently raised $2.3 billion (that’s with a B) at the London Family Planning Summit, said that at first she didn’t want to head up the drive to make contraceptive choices available to women in developing countries. “I wasn’t sure I was the right person,” she said. “I kept looking for somebody else to lead the effort.”

But she noted that good managers can provide a simple workaround for this problem, simply by making sure to give the women a little nudge to throw their hats in the ring. “I think it’s up to the managers—men or women— to reach down and pull those women up and say, “No, you are ready for that promotion,” or, “You’re at least as qualified as the men.”

In the interview Gates also spoke about what she’s doing to make sure her kids handle their great wealth (including how they allocate their pocket money) and how she refocused her life after turning 50. Subscribers can read the interview here.

TIME sweden

Julian Assange’s Appeal is Rejected by Swedish Court

Julian Assange
WikiLeaks founder Julian Assange speaks to the media inside the Ecuadorean embassy in London on June 14, 2013. Anthony Devlin—AFP/Getty Images

Assange still faces extradition to Sweden if he leaves London's Ecuadorian embassy

The Swedish Court of Appeal has upheld an arrest warrant against the Australian Wikileaks founder, Julian Assange, who is wanted for questioning regarding allegations of sexual assault and rape in Sweden.

Assange, who denies the allegations, has sought asylum in the Ecuadorian embassy in London for more than two years in order to avoid extradition. A Swedish prosecutor first issued an arrest warrant for Assange in 2010 but Assange had appealed for this order to be revoked.

The Court explained its reasoning in upholding the detention order in a statement, saying that “Julian Assange is suspected of crimes of a relatively serious nature.”

“There is a great risk that he will flee and thereby evade legal proceedings if the detention order is set aside,” the court argued, but also noted that Sweden’s investigation into Assange remains deadlocked.

[Guardian]

TIME Israel

Israel to Destroy Homes of Synagogue Attackers

(JERUSALEM) — The family of two Palestinian assailants who carried out a deadly assault on a Jerusalem synagogue this week says police have ordered the demolition of their homes.

Said Abu Jamal, a cousin of the men, said their families in east Jerusalem received demolition orders from Israeli police on Thursday.

Police say Ghassan and Oday Abu Jamal burst into a crowded synagogue on Tuesday morning, killing four worshippers and a Druze Arab policeman with meat cleavers and gunfire before they were shot dead.

It was the bloodiest attack in a recent wave of violence by Palestinian assailants that has killed 11 people.

Prime Minister Benjamin Netanyahu has ordered authorities to destroy the homes of the attackers’ families — a punitive measure that has drawn criticism in the past.

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