In Honor of George Floyd
"Less than a month after testimony began in the trial of Derek Chauvin for George Floyd’s death, at least 64 other people were killed by American law enforcement, with Black and Latino people making up more than half of the dead."
How Privilege and Capital Warped a Movement
By Talmon Joseph Smith, Mr. Smith is an Opinion staff editor, May 25, 2021
Photo from San Francisco rally and march in support of Palestine Saturday, May 15, 2021
Stand with Palestine!
Say NO to apartheid!
Join the global movement in solidarity with the Palestinian people.
A Tribute to the Life, Activism, and Legacy of Ernie Tate
About this Event
We warmly welcome you to join us for a tribute to the life, activism and legacy of Ernie Tate (1934-2021).
Ernie Tate believed capitalism is a cruel and unjust system that has to be changed. Ernie was born in Belfast, Northern Ireland in 1934 and emigrated to Canada in 1955. As a Marxist, union activist and revolutionary, Ernie spent his life working to achieve that in organizing against the war in Vietnam, in union struggles at Toronto Hydro, for protecting universal healthcare and living wages, and much else. Ernie, along with Tariq Ali, was a leading organizer of the Vietnam Solidarity Campaign in Britain, worked for Bertrand Russell’s International War Crimes Tribunal and was a founding member of the International Marxist Group in Britain. In 2014, Ernie published a memoir of his life on the far left in Canada and Great Britain called Revolutionary Activism in the 1950s and 1960s. This two-volume memoir is an important resource for anyone interested in a gritty account of mid-20th century revolutionary movements. It has been a source of information for the 2020-2021 Undercover Policing Inquiry hearings, taking place in England, in which the illegal and immoral activities of police agents in infiltrating the left have been laid bare.
Ernie died on February 5th this year. Please join us to reflect upon and celebrate Ernie’s life, activism and legacy with many of his comrades and friends from around the world, including: Tariq Ali and Phil Hearse (England), Riche Venton (Scotland), Barry Sheppard and Suzanne Weiss (USA), Pam Frache, Judy Rebick, Caroline Egan, Sam Gindin, Bryan Palmer, Rob Fairley, and John Riddell (Canada), and Patrick Bond (South Africa).
The event will be online, on ZOOM. Please register for your free ticket on Eventbrite. A link to the ZOOM room will be sent to you.
Hosted by Socialist Project, Centre for Social Justice, Spring, Resistance, Green Left Weekly, Socialist Viewpoint
Update: Mumia Abu-Jamal is Recovering from Heart Surgery!
Mumia's wife, Wadiya, has spoken to Mumia and reports that he sounded strong. He still needs to be free to get the ongoing medical care he needs and, because he's innocent!
Questions and comments may be sent to: email@example.com
Jeff Bezos has at least $180 Billion!
The Washington State Supreme Court just ruled to allow the right-wing Recall Campaign against Councilmember Kshama Sawant to move forward.
In response, Councilmember Sawant said “This ruling is completely unjust, but we are not surprised. Working people and oppressed communities cannot rely on the capitalist courts for justice anymore than they can on the police.”
“Last summer, all across the country, ordinary people who peacefully protested in multi-racial solidarity against racism and police brutality themselves faced brutal police violence. The police and the political establishment have yet to be held accountable, while in stark contrast, more than 14,000 protestors were arrested.”
“In October, the Washington State Supreme Court unanimously threw out the grassroots recall campaign launched in response to Amazon-backed Mayor Jenny Durkan’s overseeing a violent police crackdown against Seattle protests. Now, this same Supreme Court has unanimously approved the recall against an elected socialist, working-class representative who has unambiguously stood with the Black Lives Matter movement.”
“The recall law in Washington State is inherently undemocratic and well-suited for politicized use against working people’s representatives, because there is no requirement that the charges even be proven true. In effect, the courts have enormous leeway to use recall elections as a mechanism to defend the ruling class and capitalist system. It is no accident that Seattle’s last elected socialist, Anna Louise Strong, was driven out of office by a recall campaign for her links to the labor movement and opposition to World War I.”
The recall effort against Councilmember Sawant explicitly cited her role in Black Lives Matter protests and the Amazon Tax campaign in their articles of recall. In 2019, Kshama was elected for the third time despite a record-breaking influx of corporate money in Seattle elections, including $1.5 million in corporate PAC spending from Amazon, as well as donations from top Amazon executives and numerous wealthy Republican donors directly to Kshama’s opponent.
The Recall Campaign is backed by a host of corporate executives and developers, including billionaire landlord and Trump donor Martin Selig; Jeannie Nordstrom of the billionaire union-busting, retail giant Nordstrom dynasty; Airbnb Chief Financial Officer and former Amazon Vice President Dave Stephenson; Merrill Lynch Senior Vice President Matt Westphal; wealthy Trump donors like Dennis Weibling, Vidur Luthra and Greg Eneil; and plethora of major real-estate players, such as John Stephanus, whose asset management company, Epic, has ranked amongst Seattle’s top 10 landlords for evictions.
Now, because of the Supreme Court’s ruling, the Recall Campaign is able to begin collecting signatures to get a recall election on an upcoming ballot. With the financial backing of the corporate elite, we know the Recall Campaign will have unlimited resources to collect their signatures.
That’s why we need your support to massively expand our Decline-to-Sign campaign and defeat this attack on all working people. The Recall Campaign has already raised $300,000. Can you make a contribution to the Kshama Solidarity Campaign today so that we have the necessary resources to fight back?
Kshama Solidarity Campaign
Copyright © 2021 Kshama Solidarity Campaign, All rights reserved
PLEDGE: Stand with Kshama Sawant Against the Right-Wing Recall!
The right wing and big business are going after Councilmember Sawant because she’s been such a powerful voice for working people – for leading the way on the Amazon Tax, on the $15 minimum wage, and for her role in the Black Lives Matter movement.
Amazon spent millions trying to unseat Kshama last year and failed. Now the Recall Campaign is raising money from corporate executives and rich Republicans to try to overturn that election and all our victories. Their campaign is saying Kshama’s support for Black Lives Matter was promoting “lawlessness” – this is a racist attack on the movement. The right wing will be collecting signatures to get the recall on the ballot; we’re building a Decline-to-Sign movement to keep our voice on the City Council and win COVID relief for working people.
Sign the pledge at:
Paid for by Kshama Solidarity Campaign
PO Box 20611, Seattle, WA 98102
9 minutes 29 seconds
Pass COVID Protection and Debt Relief
Stop the Eviction Cliff!
Forgive Rent and Mortgage Debt!
Millions of Californians have been prevented from working and will not have the income to pay back rent or mortgage debts owed from this pandemic. For renters, on Feb 1st, landlords will be able to start evicting and a month later, they will be able to sue for unpaid rent. Urge your legislator and Gov Newsom to stop all evictions and forgive COVID debts!
The COVID-19 pandemic continues to rock our state, with over 500 people dying from this terrible disease every day. The pandemic is not only ravaging the health of poor, black and brown communities the hardest - it is also disrupting our ability to make ends meet and stay in our homes. Shockingly, homelessness is set to double in California by 2023 due the economic crisis unleashed by COVID-19. 
Housing is healthcare: Without shelter, our very lives are on the line. Until enough of us have been vaccinated, our best weapon against this virus will remain our ability to stay at home.
Will you join me by urging your state senator, assembly member and Governor Gavin Newsom to pass both prevent evictions AND forgive rent debt?
This click-to-call tool makes it simple and easy.
Renters and small landlords know that much more needs to be done to prevent this pandemic from becoming a catastrophic eviction crisis. So far, our elected officials at the state and local level have put together a patchwork of protections that have stopped a bad crisis from getting much worse. But many of these protections expire soon, putting millions of people in danger. We face a tidal wave of evictions unless we act before the end of January.
We can take action to keep families in their homes while guaranteeing relief for small landlords by supporting an extension of eviction protections (AB 15) and providing rent debt relief paired with assistance for struggling landlords (AB 16). Assembly Member David Chiu of San Francisco is leading the charge with these bills as vehicles to get the job done. Again, the needed elements are:
Improve and extend existing protections so that tenants who can’t pay the rent due to COVID-19 do not face eviction
Provide rent forgiveness to lay the groundwork for a just recovery
Help struggling small and non-profit landlords with financial support
Ten months since the country was plunged into its first lockdown, tenants still can’t pay their rent and debt is piling up. This is hurting tenants and small landlords alike. We need a holistic approach that protects Californians in the short-run while forgiving unsustainable debts over the long term. That’s why we’re joining the Housing Now! coalition and Tenants Together on a statewide phone zap to tell our elected leaders to act now.
Will you join me by urging your state senator, assembly member and Governor Gavin Newsom to pass both prevent evictions AND forgive rent debt?
Time is running out. California’s statewide protections will start expiring by the end of this month. Millions face eviction. We have to pass AB 15 before the end of January. And we will not solve the long-term repercussions on the economic health of our communities without passing AB 16.
ASK YOUR ELECTED OFFICIALS TO SAY YES ON AN EVICTION MORATORIUM AND RENT DEBT FORGIVENESS -- AB 15 AND AB16!!!
Let’s do our part in turning the corner on this pandemic. Our fight now will help protect millions of people in California. And when we fight, we win!
Tell the New U.S. Administration - End
Economic Sanctions in the Face of the Global
Take action and sign the petition - click here!
To: President Joe Biden, Vice President Kamala Harris and all Members of the U.S. Congress:
We write to you because we are deeply concerned about the impact of U.S. sanctions on many countries that are suffering the dire consequences of COVID-19.
The global COVID-19 pandemic and global economic crash challenge all humanity. Scientific and technological cooperation and global solidarity are desperate needs. Instead, the Trump Administration escalated economic warfare (“sanctions”) against many countries around the globe.
We ask you to begin a new era in U.S. relations with the world by lifting all U.S. economic sanctions.
U.S. economic sanctions impact one-third of the world’s population in 39 countries.
These sanctions block shipments and purchases of essential medicines, testing equipment, PPE, vaccines and even basic food. Sanctions also cause chronic shortages of basic necessities, economic dislocation, chaotic hyperinflation, artificial famines, disease, and poverty, leading to tens of thousands of deaths. It is always the poorest and the weakest – infants, children, the chronically ill and the elderly – who suffer the worst impact of sanctions.
Sanctions are illegal. They are a violation of international law and the United Nations Charter. They are a crime against humanity used, like military intervention, to topple popular governments and movements.
The United States uses its military and economic dominance to pressure governments, institutions and corporations to end all normal trade relations with targeted nations, lest they risk asset seizures and even military action.
The first step toward change must be an end to the U.S.’ policies of economic war. We urge you to end these illegal sanctions on all countries immediately and to reset the U.S.’ relations with the world.
Add your name - Click here to sign the petition:
Resources for Resisting Federal Repression
Since June of 2020, activists have been subjected to an increasingly aggressive crackdown on protests by federal law enforcement. The federal response to the movement for Black Lives has included federal criminal charges for activists, door knocks by federal law enforcement agents, and increased use of federal troops to violently police protests.
The NLG National Office is releasing this resource page for activists who are resisting federal repression. It includes a link to our emergency hotline numbers, as well as our library of Know-Your-Rights materials, our recent federal repression webinar, and a list of some of our recommended resources for activists. We will continue to update this page.
If you are contacted by federal law enforcement you should exercise all of your rights. It is always advisable to speak to an attorney before responding to federal authorities.
State and Local Hotlines
If you have been contacted by the FBI or other federal law enforcement, in one of the following areas, you may be able to get help or information from one of these local NLG hotlines for:
- Portland, Oregon: (833) 680-1312
- San Francisco, California: (415) 285-1041 or firstname.lastname@example.org
- Seattle, Washington: (206) 658-7963
If you are located in an area with no hotline, you can call the following number:
Know Your Rights Materials
The NLG maintains a library of basic Know-Your-Rights guides.
- Know Your Rights During Covid-19
- You Have The Right To Remain Silent: A Know Your Rights Guide for Encounters with Law Enforcement
- Operation Backfire: For Environmental and Animal Rights Activists
WEBINAR: Federal Repression of Activists & Their Lawyers: Legal & Ethical Strategies to Defend Our Movements: presented by NLG-NYC and NLG National Office
We also recommend the following resources:
- Grand Juries: Slideshow
Movement for Black Lives Legal Resources
By Christoph Koettl and Caroline Kim, May 22, 2021
A New York Times review of bodycam footage showing the fatal police shooting of Andrew Brown Jr. in April raises questions about whether officers were in imminent danger when they used lethal force as he drove away to avoid arrest.
The officers have not been charged in the shooting. R. Andrew Womble, the district attorney for North Carolina’s First Judicial District, determined that they were justified in their actions because Mr. Brown was using his car as a “deadly weapon.” He said police body-camera videos “clearly illustrate the officers who used deadly force on Andrew Brown Jr. did so reasonably” and only when their lives were in danger.
Mr. Brown’s family members and their lawyers have described the shooting as an “execution.”
A review of slowed-down bodycam footage by The Times shows that 13 of the 14 gunshots — including the fatal one — were fired as Mr. Brown was driving away from officers, not at them. The footage was presented by the district attorney at a press conference and is from four officers’ cameras.
Sheriff Tommy Wooten II of Pasquotank County said that “while the deputies did not break the law, we all wish things could have gone differently. Much differently.”
Here’s what the videos of the 20-second interaction show.
The police officers arrive in a Pasquotank County Sheriff’s Office pickup truck at Mr. Brown’s house at 8:23 a.m. on Wednesday, April 21, to execute search and arrest warrants. According to the prosecutor, the police team had been briefed that morning that Mr. Brown, 42, had previous convictions and a history of resisting arrest.
Mr. Brown is sitting in his vehicle outside his house after returning from a drive that morning, the prosecutor added. The officers approach him with their weapons drawn, shouting orders at him.
Mr. Brown does not comply with officers’ orders. The situation escalates.
As two officers reach the driver’s-side door, Mr. Brown backs up the vehicle, and grazes but does not injure an officer.
Mr. Brown ignores officers’ repeated commands to stop the car, and lurches the vehicle forward while steering it sharply to the left, putting officers at risk.
The car initially moves toward the same officer who had been grazed moments earlier. This officer does not move away from the vehicle, but takes a step into Mr. Brown’s path. It’s unclear if the officer is trying to obstruct Mr. Brown’s escape, or trying to evade the car.
The officer briefly places his left hand on the hood of the car, and this is when another officer fires a shot that Mr. Womble said “entered the front windshield” of the car and was not fatal. That contradicts a preliminary internal investigation report, which found that no bullet went through the windshield.
The video shows that there is a brief pause in shooting while Mr. Brown steers his car between two officers. At this point, as Mr. Brown accelerates and drives away, three officers fire 13 more shots into the side and rear of Mr. Brown’s car. One of the shots is fatal, hitting Mr. Brown in the back of his head. His car crashes into a tree 50 yards from his home.
In justifying the police's use of lethal force, Mr. Womble said Mr. Brown “drove recklessly and endangered the officers." He also argued that “they could not simply let him go.”
But the legalities around this can get complicated. “The Supreme Court has never authorized the use of deadly force simply because someone is resisting arrest or fleeing,” Paul Butler, a law professor at Georgetown University and former federal prosecutor, said in an interview about the footage. He also said that “sometimes the best policing is to let the suspect go.”
The officers’ actions may have violated their department’s guidelines. The Pasquotank County Sheriff’s Office’s use-of-force policy states that shooting at a moving vehicle is “rarely effective,” and that officers should fire at a moving vehicle only “when the deputy reasonably believes there are no other reasonable means available to avert the imminent threat of the vehicle.”
Seth Stoughton, a law professor and policing expert at the University of South Carolina, questioned the officers’ actions at the time Mr. Brown was speeding away. “Deadly force is only justified while there is an imminent threat of death or great bodily harm,” he said. “Once the vehicle has driven past the officers and they are now to the side of it, or behind it, as it's going away from them, there is no more imminent threat.”
Beyond the shooting of Mr. Brown, the videos show that officers may have placed some of their colleagues and others at risk. In their line of fire was a neighbor’s house and an unmarked white police minivan.
Mr. Womble said that while the white minivan was in the path of the bullets, there was no danger to the officers inside.
Michael Anthony Gordon Sr., whose house was in the line of fire, told The Times that a bullet from the shooting entered his kitchen, and that no one was home at the time. Mr. Womble stated that one shot fired by the police was believed to have ricocheted, and hit the house.
The district attorney’s decision not to press charges closes a state-level criminal case, though a federal civil rights case is ongoing.
Reporting was contributed by Richard Fausset. Produced by Malachy Browne and Jugal Patel.
The Louisiana State Police said Mr. Greene died in 2019 from crashing his S.U.V. during a police chase, but video footage shows troopers shocking, choking and beating him.
By Dan Levin and Michael Levenson, May 21, 2021https://www.nytimes.com/2021/05/21/us/ronald-greene-video-louisiana.html?action=click&module=Top%20Stories&pgtype=Homepage
The death of Ronald Greene after a police chase in Louisiana in 2019 is attracting new scrutiny after the publication of police body camera footage that appears to show a starkly different version of events than the one given by the Louisiana State Police.
Days after The Associated Press published more than two minutes of footage from the encounter, the state police released what it said was all of the related video. A lawyer for the Greene family said the footage had been shown to Mr. Greene’s mother and sister last fall.
The death is under investigation by the F.B.I. and other federal agencies, and Mr. Greene’s family has filed a wrongful-death lawsuit accusing the state police of covering up the cause of his death.
Here’s what we know about the case.
Who was Ronald Greene?
Mr. Greene was a 49-year-old Black man who lived in Monroe, La. He was married, worked as a barber, and had recently gone into remission after battling cancer for two years, according to CNN. He was on his way to meet his wife in Florida when he died shortly after midnight on May 10, 2019.
What was his family told about his death?
The authorities told Mr. Greene’s relatives that he died from injuries he sustained in a crash outside Monroe after he failed to stop immediately for a traffic violation, a lawyer for his family said.
The Associated Press reported, citing the Union Parish coroner, that Mr. Greene’s death was ruled accidental and was attributed to cardiac arrest, and that the coroner’s file made no mention of any struggle with the police.
What does the body camera footage show?
The A.P. obtained body camera footage of the episode and published three excerpts on Wednesday. The footage shows Mr. Greene’s S.U.V. stopped on the side of the road. Troopers are seen opening his vehicle and jolting Mr. Greene with a stun gun, and Mr. Greene is heard to scream “I’m sorry” and “I’m scared.”
According to The A.P., which said it had obtained 46 minutes of video footage from the encounter, one trooper wrestled Mr. Greene to the ground, put him in a chokehold and punched him in the face. Another trooper is seen briefly dragging Mr. Greene by shackles on his ankles as he lay on the ground.
In the clips published by the A.P., covering more than two minutes, Mr. Greene is seen being jolted again with a stun gun while lying handcuffed on the ground.
The A.P. reported that the troopers, who were white, left Mr. Greene lying facedown and moaning for more than nine minutes, as they wiped blood from their hands and faces. “I hope this guy ain’t got AIDS,” one of the troopers is heard to say, adding an expletive.
Video from several minutes later shows Mr. Greene limp, unresponsive and bleeding from his head and face, and he is then seen being loaded onto an ambulance gurney with his arm cuffed to a bedrail, according to The A.P.
In one body camera video that the state police later released, a trooper can be heard saying that he had beat Mr. Greene, using an expletive. “Choked him and everything else, trying to get him under control,” the trooper says.
After Mr. Greene was in handcuffs, the trooper says, he was “still fighting and we were still wrestling with him, trying to hold him down, ’cause he was spitting blood everywhere — and then, all of a sudden, he just went limp.”
“Yeah,” the trooper continues. “I thought he was dead.”
Did the entire footage become public?
The state police had described the release of the footage obtained by The A.P. as “premature” and unauthorized, and a state police spokesman said that the agency could not yet release it because the encounter was the subject of an administrative and criminal investigation.
But on Friday, the state police released what it said was all of the video of the encounter, including a 46-minute clip and additional footage from body and dashboard cameras. Col. Lamar A. Davis, the state police superintendent, said the parts that had been released without official authorization had not been “provided to the public in its full capacity, or context.”
At a news conference announcing the release of the footage, Colonel Davis said the state police had every intention of releasing all required evidence at the right time.
“Any suggestion otherwise is categorically false,” he said, adding, “It’s unfortunate that the path to get here today has taken this long.”
Gov. John Bel Edwards of Louisiana had said that he had arranged for Mr. Greene’s family to view the body camera footage last year, but that he agreed not to publicly release the video until the federal investigation had concluded.
On Friday, Mr. Edwards said in a statement that he strongly supported the release of the video, which was done in consultation with the U.S. attorney’s office and the district attorney. He said the video was “disturbing and difficult to watch.”
What do the police say happened?
Mr. Greene’s family said state troopers initially told them that Mr. Greene died on impact after crashing his vehicle into a tree during the chase, according to The A.P.
A single-page crash report, released later by the state police and reviewed by The A.P., said that troopers tried to stop Mr. Greene for an unspecified traffic violation, but that he refused to pull over and troopers pursued him.
The report says that the chase ended when Mr. Greene’s vehicle crashed; that he was taken into custody after struggling with troopers; and that he became unresponsive and died on the way to a hospital, The A.P. reported. The news agency said the crash report did not mention any use of force by troopers.
The Louisiana State Police later released a statement acknowledging that the troopers did use force in the encounter, and saying the use of force was justified. It did not open an internal investigation until 474 days after Mr. Greene’s death, according to The A.P.
What does the Greene family say happened?
Mr. Greene’s family sued the police for wrongful death in May 2020, arguing that he had died as a result of a struggle with troopers that “left him beaten, bloodied and in cardiac arrest.”
In their lawsuit, Mr. Greene’s relatives said that there was no sign that the front of Mr. Greene’s vehicle had struck anything, and that his airbag had not deployed. Mr. Greene got out of the vehicle uninjured and could “walk, speak and otherwise function in a healthy manner,” according to the lawsuit.
The suit alleges that two troopers pinned Mr. Greene down and shocked him three times with a Taser while he begged them to stop. Emergency medical technicians who were called to the scene found Mr. Greene unresponsive, with several stun-gun barbs stuck in his body, according to the lawsuit. Included in the court papers are photos that circulated online, appearing to show Mr. Greene’s bruised and bloodied face.
The family commissioned an independent autopsy that found severe injuries to Mr. Greene’s head and skull and several wounds to his face, the family’s lawyer said. After examining the damage to Mr. Greene’s vehicle, which was mostly on the rear driver’s side, an accident reconstruction expert concluded that it was inconsistent with a fatal collision, the lawyer said.
In September, federal authorities opened a civil rights investigation into Mr. Greene’s death. The F.B.I., the Civil Rights Division of the Justice Department and the United States Attorney’s Office for the Western District of Louisiana are handling the federal investigation, according to an F.B.I. spokeswoman.
What has happened to the officers involved?
The lawsuit filed by Mr. Greene’s family includes seven defendants, three of whom are not identified by name, according to CNN. The A.P. reported that six troopers were involved in the encounter.
One of the troopers, Kory York, served a 50-hour suspension and returned to active duty, pending the outcome of state and federal investigations, the state police said. He was found to have violated policies regarding the treatment of prisoners in custody and the activation of body-worn and in-car cameras.
Another trooper, Chris Hollingsworth, died in a car crash in September 2020, the state police said. The A.P. reported that Mr. Hollingsworth had been notified hours earlier that he would be fired as a result of an internal police investigation into Mr. Greene’s death.
A third trooper, Dakota DeMoss, who chased Mr. Greene at speeds exceeding 115 miles an hour, according to The A.P., was one of four Louisiana state troopers arrested in February in an unrelated case on charges of using excessive force and deactivating their body cameras while making arrests.
The State Police said Trooper DeMoss had been notified of the agency’s intention to terminate him. He remains on leave pending the outcome of disciplinary proceedings, the State Police said.
Fewer babies’ cries. More abandoned homes. Toward the middle of this century, as deaths start to exceed births, changes will come that are hard to fathom.
By Damien Cave, Emma Bubola and Choe Sang-Hun, May 22, 2021https://www.nytimes.com/2021/05/22/world/global-population-shrinking.html?action=click&module=Spotlight&pgtype=Homepage
All over the world, countries are confronting population stagnation and a fertility bust, a dizzying reversal unmatched in recorded history that will make first-birthday parties a rarer sight than funerals, and empty homes a common eyesore.
Maternity wards are already shutting down in Italy. Ghost cities are appearing in northeastern China. Universities in South Korea can’t find enough students, and in Germany, hundreds of thousands of properties have been razed, with the land turned into parks.
Like an avalanche, the demographic forces — pushing toward more deaths than births — seem to be expanding and accelerating. Though some countries continue to see their populations grow, especially in Africa, fertility rates are falling nearly everywhere else. Demographers now predict that by the latter half of the century or possibly earlier, the global population will enter a sustained decline for the first time.
A planet with fewer people could ease pressure on resources, slow the destructive impact of climate change and reduce household burdens for women. But the census announcements this month from China and the United States, which showed the slowest rates of population growth in decades for both countries, also point to hard-to-fathom adjustments.
The strain of longer lives and low fertility, leading to fewer workers and more retirees, threatens to upend how societies are organized — around the notion that a surplus of young people will drive economies and help pay for the old. It may also require a reconceptualization of family and nation. Imagine entire regions where everyone is 70 or older. Imagine governments laying out huge bonuses for immigrants and mothers with lots of children. Imagine a gig economy filled with grandparents and Super Bowl ads promoting procreation.
“A paradigm shift is necessary,” said Frank Swiaczny, a German demographer who was the chief of population trends and analysis for the United Nations until last year. “Countries need to learn to live with and adapt to decline.”
The ramifications and responses have already begun to appear, especially in East Asia and Europe. From Hungary to China, from Sweden to Japan, governments are struggling to balance the demands of a swelling older cohort with the needs of young people whose most intimate decisions about childbearing are being shaped by factors both positive (more work opportunities for women) and negative (persistent gender inequality and high living costs).
The 20th century presented a very different challenge. The global population saw its greatest increase in known history, from 1.6 billion in 1900 to 6 billion in 2000, as life spans lengthened and infant mortality declined. In some countries — representing about a third of the world’s people — those growth dynamics are still in play. By the end of the century, Nigeria could surpass China in population; across sub-Saharan Africa, families are still having four or five children.
But nearly everywhere else, the era of high fertility is ending. As women have gained more access to education and contraception, and as the anxieties associated with having children continue to intensify, more parents are delaying pregnancy and fewer babies are being born. Even in countries long associated with rapid growth, such as India and Mexico, birthrates are falling toward, or are already below, the replacement rate of 2.1 children per family.
The change may take decades, but once it starts, decline (just like growth) spirals exponentially. With fewer births, fewer girls grow up to have children, and if they have smaller families than their parents did — which is happening in dozens of countries — the drop starts to look like a rock thrown off a cliff.
“It becomes a cyclical mechanism,” said Stuart Gietel Basten, an expert on Asian demographics and a professor of social science and public policy at the Hong Kong University of Science and Technology. “It’s demographic momentum.”
Some countries, like the United States, Australia and Canada, where birthrates hover between 1.5 and 2, have blunted the impact with immigrants. But in Eastern Europe, migration out of the region has compounded depopulation, and in large parts of Asia, the “demographic time bomb” that first became a subject of debate a few decades ago has finally gone off.
South Korea’s fertility rate dropped to a record low of 0.92 in 2019 — less than one child per woman, the lowest rate in the developed world. Every month for the past 59 months, the total number of babies born in the country has dropped to a record depth.
That declining birthrate, coupled with a rapid industrialization that has pushed people from rural towns to big cities, has created what can feel like a two-tiered society. While major metropolises like Seoul continue to grow, putting intense pressure on infrastructure and housing, in regional towns it’s easy to find schools shut and abandoned, their playgrounds overgrown with weeds, because there are not enough children.
Expectant mothers in many areas can no longer find obstetricians or postnatal care centers. Universities below the elite level, especially outside Seoul, find it increasingly hard to fill their ranks — the number of 18-year-olds in South Korea has fallen from about 900,000 in 1992 to 500,000 today. To attract students, some schools have offered scholarships and even iPhones.
To goose the birthrate, the government has handed out baby bonuses. It increased child allowances and medical subsidies for fertility treatments and pregnancy. Health officials have showered newborns with gifts of beef, baby clothes and toys. The government is also building kindergartens and day care centers by the hundreds. In Seoul, every bus and subway car has pink seats reserved for pregnant women.
But this month, Deputy Prime Minister Hong Nam-ki admitted that the government — which has spent more than $178 billion over the past 15 years encouraging women to have more babies — was not making enough progress. In many families, the shift feels cultural and permanent.
“My grandparents had six children, and my parents five, because their generations believed in having multiple children,” said Kim Mi-kyung, 38, a stay-at-home parent. “I have only one child. To my and younger generations, all things considered, it just doesn’t pay to have many children.”
Thousands of miles away, in Italy, the sentiment is similar, with a different backdrop.
In Capracotta, a small town in southern Italy, a sign in red letters on an 18th-century stone building looking on to the Apennine Mountains reads “Home of School Kindergarten” — but today, the building is a nursing home.
Residents eat their evening broth on waxed tablecloths in the old theater room.
“There were so many families, so many children,” said Concetta D’Andrea, 93, who was a student and a teacher at the school and is now a resident of the nursing home. “Now there is no one.”
The population in Capracotta has dramatically aged and contracted — from about 5,000 people to 800. The town’s carpentry shops have shut down. The organizers of a soccer tournament struggled to form even one team.
About a half-hour away, in the town of Agnone, the maternity ward closed a decade ago because it had fewer than 500 births a year, the national minimum to stay open. This year, six babies were born in Agnone.
“Once you could hear the babies in the nursery cry, and it was like music,” said Enrica Sciullo, a nurse who used to help with births there and now mostly takes care of older patients. “Now there is silence and a feeling of emptiness.”
In a speech last Friday during a conference on Italy’s birthrate crisis, Pope Francis said the “demographic winter” was still “cold and dark.”
More people in more countries may soon be searching for their own metaphors. Birth projections often shift based on how governments and families respond, but according to projections by an international team of scientists published last year in The Lancet, 183 countries and territories — out of 195 — will have fertility rates below replacement level by 2100.
Their model shows an especially sharp decline for China, with its population expected to fall from 1.41 billion now to about 730 million in 2100. If that happens, the population pyramid would essentially flip. Instead of a base of young workers supporting a narrower band of retirees, China would have as many 85-year-olds as 18-year-olds.
China’s rust belt, in the northeast, saw its population drop by 1.2 percent in the past decade, according to census figures released on Tuesday. In 2016, Heilongjiang Province became the first in the country to have its pension system run out of money. In Hegang, a “ghost city” in the province that has lost almost 10 percent of its population since 2010, homes cost so little that people compare them to cabbage.
Many countries are beginning to accept the need to adapt, not just resist. South Korea is pushing for universities to merge. In Japan, where adult diapers now outsell ones for babies, municipalities have been consolidated as towns age and shrink. In Sweden, some cities have shifted resources from schools to elder care. And almost everywhere, older people are being asked to keep working. Germany, which previously raised its retirement age to 67, is now considering a bump to 69.
Going further than many other nations, Germany has also worked through a program of urban contraction: Demolitions have removed around 330,000 units from the housing stock since 2002.
And if the goal is revival, a few green shoots can be found. After expanding access to affordable child care and paid parental leave, Germany’s fertility rate recently increased to 1.54, up from 1.3 in 2006. Leipzig, which once was shrinking, is now growing again after reducing its housing stock and making itself more attractive with its smaller scale.
“Growth is a challenge, as is decline,” said Mr. Swiaczny, who is now a senior research fellow at the Federal Institute for Population Research in Germany.
Demographers warn against seeing population decline as simply a cause for alarm. Many women are having fewer children because that’s what they want. Smaller populations could lead to higher wages, more equal societies, lower carbon emissions and a higher quality of life for the smaller numbers of children who are born.
But, said Professor Gietel Basten, quoting Casanova: “There is no such thing as destiny. We ourselves shape our lives.”
The challenges ahead are still a cul-de-sac — no country with a serious slowdown in population growth has managed to increase its fertility rate much beyond the minor uptick that Germany accomplished. There is little sign of wage growth in shrinking countries, and there is no guarantee that a smaller population means less stress on the environment.
Many demographers argue that the current moment may look to future historians like a period of transition or gestation, when humans either did or did not figure out how to make the world more hospitable — enough for people to build the families that they want.
Surveys in many countries show that young people would like to be having more children, but face too many obstacles.
Anna Parolini tells a common story. She left her small hometown in northern Italy to find better job opportunities. Now 37, she lives with her boyfriend in Milan and has put her desire to have children on hold.
She is afraid her salary of less than 2,000 euros a month would not be enough for a family, and her parents still live where she grew up.
“I don’t have anyone here who could help me,” she said. “Thinking of having a child now would make me gasp.”
Elsie Chen, Christopher Schuetze and Benjamin Novak contributed reporting.
The country’s military and intelligence commanded the recent assault on Hamas in Gaza from an underground bunker made for high-tech air wars.
By Ronen Bergman, May 22, 2021https://www.nytimes.com/2021/05/22/world/middleeast/israel-fortress-of-zion.html
The Israeli Army’s underground command bunker collects intelligence information from various agencies and uses it to carry out operations. Credit...Dan Balilty for The New York Times
It was a little past midnight on Friday, and Israel’s Supreme Command Post was racing to complete as many strikes as possible in the final hours before a cease-fire with the Palestinian militant group Hamas was to take effect at 2 a.m.
On a wall covered with huge screens, a three-dimensional diagram of a high-rise building with one of its apartments marked in red popped up. On another screen, a live video from the air circled above a building in Gaza that looked a lot like the one in the diagram.
This room is the nerve center of a bunker dubbed the “Fortress of Zion,” a new Israeli Army command post deep underground beneath its headquarters in the heart of Tel Aviv. It is designed to command the kind of high-tech air wars that have supplanted ground invasions fought by tanks and infantry battalions.
The latest conflict with the Palestinians was the first time the sprawling facility was used during wartime. It was also the first time the army allowed foreign journalists inside one of the most fortified and secretive installations in the country — an effort to showcase Israel’s military and technological prowess but also to counter criticism over civilian casualties.
From the bunker, the military oversaw thousands of attacks on the Gaza Strip, most of them from the air, but also from the sea and land. The Israelis say they inflicted serious damage on Hamas, which controls Gaza.
Those attacks also took a high toll on civilians. Of the 248 Palestinians killed, 66 were children, Palestinian officials say. That toll brought an international outcry and pressure on Israel from its close ally, the United States, to end the hostilities. The Israeli assault also caused widespread destruction to buildings and other infrastructure in the already impoverished Gaza Strip, deepening a long-running humanitarian crisis.
A cease-fire continued to hold on Saturday afternoon as Egyptian diplomats tried to mediate a longer-term agreement between Israel and Hamas. There were just a few protests against the Israeli occupation and the war in Gaza, easing fears of a military flare-up.
The first noticeable thing one notices upon entering the bunker is the silence. None of the drama and tragedy of war is apparent, and people appear alert, focused and calm.
The command post is built for operations based heavily on intelligence and carried out from the air or by small groups of special forces. It compiles information from disparate agencies into one database and translates it into operational terms.
It is a place where people are measured by the number of approved targets — warehouses, tunnels or weapons that the military can attack. When a senior officer approves one, it is added to a “Targets Book” that the chief of staff reviews once a month.
Over the last two decades, the “targets” have increasingly been people — like senior Hamas figures.
The military is well aware of the criticism of its tactics, and the loss of innocent lives, which have drawn condemnation from inside and outside the country.
One senior officer, aiming to show that Israel had tried to minimize civilian deaths, points to detailed aerial photographs of an operation that he said had been canceled because its target was a Hamas facility near a Gaza hospital. He said many others had been similarly canceled out of concern for civilian casualties.
The head of the Intelligence Division’s Targets Branch, identified as Lt. Col. S. because the military does not allow the intelligence officers to be named in the news media, said he did not think soldiers became coldhearted by reducing people to “targets.”
Another commander working in the bunker said, however, “You can’t kill someone without something dying in you, too.”
Maj. Gen. Nitzan Alon, a former director of operations for the Israeli military, said he understood that the distance from the battlefield and the treatment of people as “targets” could create indifference to human lives.
“This is part of the commander’s challenge,” he said, to ensure that the operation is effective and “to know that there are human beings at the other end.”
Israel also regularly accuses Hamas of hiding its facilities and weapons inside or near civilian buildings, effectively using civilians as human shields.
During regular times, 300 to 400 soldiers work there around the clock. When Israel decided to launch its air assault on Gaza, thousands from military headquarters above ground joined the bunker. Also present were members of intelligence agencies like the Mossad and Shin Bet, Israel’s domestic intelligence agency, and Foreign Ministry and police representatives.
For 10 days, they commanded operations from the bunker. Most of them scarcely left.
Inside the nerve center, about 70 people were arrayed on different levels so that everyone could see the screens on the wall. Most were in military uniforms and under 25, and those out of uniform were mostly older.
They sat at tables with computers, landline phones or more obscure communication devices. Some of their keyboards fed data into the wall screens — a detailed breakdown of attacks carried out and damage done to Hamas.
Israel estimates that it destroyed 15 to 20 percent of Hamas’s rocket arsenal and some weapons production facilities. It claims to have killed about 200 Hamas operatives and eliminated 30 percent of the tunnels under Gaza used for sheltering militants, housing command systems and moving weaponry around.
The nerve center also had a map with locations of ground forces and military aircraft throughout the Middle East.
In the hours just before cease-fire, it was clear that Israel was eager to deal powerful final blows to Hamas. One screen tracked rocket launches from Gaza and a possible hit on a kibbutz in southern Israel.
At 2 a.m., the commander echoed the chief of staff’s order to cease hostilities. But no one was going home. The post remains on combat alert until Israel determines that the fragile cease-fire will last.
“Fortress of Zion” took 10 years to design and build. Dug deep into the earth, it is protected from a variety of threats, including nuclear attacks. It has enough energy, food and water to function even if its occupants cannot get to ground level for a long time.
It is an extension of an old command post, nicknamed “the pit,” that was expanded several times but was deemed too small and gloomy and had electricity and sanitation problems.
More important, Maj. Gen. Aharon Haliva, the current director of operations for the military, said, “Over the years, the Israel Defense Forces’ needs have changed.”
The huge ground wars of decades gone by gave way to more frequent but smaller operations — known as the “war between the wars.” And that shift meant relying more on technology and a digital network to pool intelligence, General Haliva said.
The bunker is connected via technology to another underground command post for Israel’s political leaders near Jerusalem, the Air Force’s underground headquarters and the Shin Bet’s command center.
The complex includes a gym, a synagogue, a kitchen and dining rooms, and a bedroom for guests with a row of clocks from different parts of the world, Tehran among them. There is also a lounge with food and nonalcoholic drinks — the only spot where soldiers can use their cellphones.
One floor is occupied by the army’s high command, including a private bedroom for the chief of staff with simple furnishings mirrored throughout the bunker.
Various military and intelligence departments feed the nerve center with information and have a representative physically present. The combined operation allows for a large number of strikes in an almost continuous stream.
Some efforts were made to give the windowless bunker a pleasant atmosphere, decorated with pictures of scenic places in the country and a famous quote by Israel’s founding father, David Ben-Gurion, that reads: “In the hands of this army, the security of the people and the homeland will now be entrusted.”
Patrick Kingsley contributed reporting.
Grand jury minutes in the investigation into Daniel Prude’s death reveal the many ways the criminal justice system struggles when prosecuting the police.
By Nicole Hong and Sarah Maslin Nir, May 22, 2021https://www.nytimes.com/2021/05/22/nyregion/daniel-prude-death-letitia-james.html?action=click&module=Well&pgtype=Homepage§ion=New%20York
Her voice heavy with emotion, Letitia James, New York’s attorney general, stepped onto a church dais in Rochester in February to announce that a grand jury had declined to indict the police officers who were involved in the death of a Black man in their custody.
“I’m disappointed — extremely disappointed,” Ms. James said. Her office had presented the jurors with what she called an extensive investigation into the death of the man, Daniel Prude, whom the police pinned face down on the pavement until he lost consciousness.
“We sought a different outcome than the one the grand jury handed us today,” Ms. James said.
But transcripts of the grand jury proceedings, released publicly by a judge last month at Ms. James’s request, tell a more complicated story.
Grand jury proceedings almost always remain secret, and the transcripts of the inquiry into Mr. Prude’s death provide a rare view into the inner workings of the criminal justice system at a pivotal moment in the continuing national debate over police accountability.
In a grand jury proceeding, prosecutors typically present a one-sided case in hopes of securing a criminal indictment. But during the inquiry into Mr. Prude’s death, lawyers from Ms. James’s office chose to present both sides of the case, effectively acting as prosecution and defense and telling the grand jury upfront that its purpose was to investigate the facts, not necessarily to indict.
Some of the witnesses who were called by prosecutors appeared to absolve the officers of wrongdoing. The revelation prompted fierce criticism of Ms. James specifically, and anger more broadly over a legal process that often seems to shield the police from criminal consequences.
The transcripts underscore the crucial role that grand juries play in deciding whether police officers are charged — or more often, not charged — for encounters that turn deadly. The transcripts also illuminate the particular challenges of prosecuting officers, even for a law enforcement official like Ms. James, who campaigned on criminal justice reform and sued the New York Police Department this year over its handling of protests touched off by the killing of George Floyd in Minneapolis.
Only prosecutors may call witnesses during grand jury hearings, and jurors never hear from the defense. In the case involving Mr. Prude’s death, prosecutors from Ms. James’s office called police trainers who testified that the officers who restrained him did not violate protocol with their techniques. The state’s lawyers also presented a California doctor who is known for defending police actions. He said the officers had not caused Mr. Prude’s death.
Another expert witness, a professor from South Carolina, testified that the police had used unreasonable force by failing to roll Mr. Prude onto his back after he stopped resisting. The prosecutors also questioned two officers who were facing potential indictment, asking why they had resorted to hands-on restraint instead of trying to de-escalate the situation or show more compassion.
At least one juror struggled to reconcile the contradictory testimony.
“It seemed like one expert had an opinion that there was no improper anything done,” said a juror whose name was redacted from the transcript. “And then, another expert had an opinion that there was some — something that was not quite properly done, am I correct?”
Prosecutors told the juror it was the jury’s job to decide whom to believe.
The release of the transcripts, just days before Derek Chauvin, a Minneapolis officer, was convicted of murder in Mr. Floyd’s killing, reignited outrage in Rochester, where the revelations surrounding Mr. Prude’s death touched off fiery protests last year. Citing the transcripts, some community leaders accused Ms. James’s office of deliberately presenting a weak case.
Ms. James said in an interview that the investigation was an earnest effort to let the jury reach an independent conclusion.
“It was really critically important that the grand jury engage in an exhaustive and comprehensive analysis of the facts,” she said, adding that the outcome was a result of laws that give police officers broad protections to use deadly force on the job.
“These are incredibly tough cases to investigate and prosecute, but ultimately I respect the grand jury’s decision,” Ms. James said. “All of us continue to be disappointed by the criminal justice system as a whole.”
On Friday, Ms. James proposed legislation that she said would strengthen police accountability. The proposal includes allowing officers to use force only as a last resort, and establishing criminal penalties for officers who violate the guidelines.
Prosecutors in cases where there may be a strong defense, particularly those that involve potential police misconduct, can present all sides to a grand jury; doing so can indicate how trial jurors may react to evidence.
Whether Ms. James’s prosecutors presented the strongest case they could is difficult to determine, said Geoffrey Alpert, the expert from South Carolina who testified before the Rochester grand jury.
“If the purpose of the grand jury is to get an indictment, then no, they could have called different witnesses,” Mr. Alpert said in an interview. “If the purpose of the grand jury was to give jurors several different perspectives, then they did.”
But Michael Schiano, a lawyer for one of the officers, said that to him, it was as if the prosecutors put on a case for the defense.
“Prosecutors put on the case that we would have put on anyway,” Mr. Schiano said. “They put on the witnesses we would have put on if there was a jury trial.”
The transcripts show that two of the three Rochester officers who were facing potential indictment testified before the grand jury. Although the targets of investigations rarely testify, legal experts said it is more common in cases involving the police, particularly where an officer is claiming to have acted in self-defense.
The officers testified that they decided to use force after Mr. Prude did not follow their instructions to stay on the ground.
“We told him to calm down, and he’s telling us he wants to take our firearms,” one of the officers, whose name is redacted in the transcripts, said. “And then we tell him to stay down and he still tries to get up.”
Mr. Prude encountered the Rochester police on March 23, 2020, shortly after he became emotionally unstable and sprinted out of his brother’s home. Fearful for Mr. Prude’s safety, his brother called 911.
Responding officers found Mr. Prude several blocks away. He was naked and spitting and claiming that he had the coronavirus. They put a mesh hood, or spit sock, over his head and handcuffed him, then pressed his head to the pavement until he lost consciousness. Although it was snowing, no one covered his body or helped him when he vomited, body camera footage shows.
Mr. Prude died a week later. The medical examiner determined that his death was caused by factors that included oxygen deprivation and PCP drug intoxication.
Body camera footage showed Mr. Prude becoming more agitated after the officers placed the hood over his head. The officers said they feared contracting the coronavirus.
Karen Friedman Agnifilo, a former high-ranking official in the Manhattan district attorney’s office, defended Ms. James, saying the attorney general was constrained in her ability to prosecute the Rochester officers because of the broad legal protections provided to the police.
“Until that law changes, this will keep happening over and over again,” Ms. Friedman Agnifilo said.
Prosecutors in Minnesota did not have to rely on a grand jury to charge Mr. Chauvin. Their counterparts in about half of all states, including New York, can only bring felony charges after convincing grand jurors that there is probable cause that crime was committed, a fairly routine exercise. When the defendant is a police officer, the outcome is less certain.
About 1,000 people a year in the United States die in encounters with law enforcement officers, but few are ever charged with murder or manslaughter for deaths in the line of duty. Of those that are, only a third are convicted.
Six years ago, after a Staten Island grand jury failed to indict the officer involved in the death of Eric Garner, an unarmed Black man who was placed in a police chokehold, Gov. Andrew M. Cuomo established a special unit in the attorney general’s office to prosecute such cases. The idea was to remove such prosecutions from local district attorneys, who often work closely with the police.
But in the 43 investigations that unit has investigated since then, only three officers have been charged, according to the attorney general’s office. About a quarter of the investigations remain active.
Mr. Prude’s family did not see how he died until the summer. The video became public in September after their lawyers demanded that city officials release the body camera footage. Revelations of an apparent cover-up led to the firing of Rochester’s police chief and the suspension of the seven officers involved.
Ms. James brought the case before a grand jury shortly after that.
The transcripts revealed Ms. James’s selection of an important expert witness: Gary Vilke, a San Diego doctor who is typically hired by the police to defend them. (All witnesses’ names were redacted in the transcript, but some were easily identifiable.)
Dr. Vilke testified that the weight of the officers pressing on Mr. Prude’s back and legs did not impair his breathing, the transcript showed, leading him to conclude that the officers had not contributed to Mr. Prude’s death.
In an interview last month with a local Minneapolis television station, Dr. Vilke said it was “doubtful” that Mr. Chauvin had caused Mr. Floyd’s death.
Peter Neufeld, a civil rights lawyer who has sued police officers, said it was “incomprehensible” that prosecutors chose Dr. Vilke, whom he described as a reliable defender of police.
“You’re unfairly undermining your case before you get started,” Mr. Neufeld said.
Dr. Vilke did not respond to multiple requests for comment.
Ms. James said that Dr. Vilke had offered his expert opinion and did not tell the grand jury how to vote. She added, however, that his comments about Mr. Chauvin, which came after the case involving Mr. Prude concluded, were troubling and would “factor into any selection moving forward.”
After the grand jury decided not to charge the Rochester officers with homicide, Ms. James met privately with local Black faith leaders.
The Rev. Myra Brown, the pastor of Spiritus Christi Church, said she confronted Ms. James there about her office’s failure to obtain an indictment. Ms. James said it was her office’s ethical obligation to lay out all the facts, Ms. Brown said.
To people like Ms. Brown, Ms. James’s words of extreme disappointment ring hollow now.
“Clearly she wasn’t disappointed enough to send in any real scholarship presenting an airtight case to at least get us an indictment,” Ms. Brown said, “and at least get the Prude family their day in court.”
Kyra and Kami never got a simple test that could have protected them. Their story exemplifies the failure to care for people with the disease, most of whom are Black.
By Gina Kolata, Photographs by Ilana Panich-Linsman, Published May 23, 2021,Updated May 24, 2021https://www.nytimes.com/2021/05/23/health/sickle-cell-black-children.html?action=click&module=Top%20Stories&pgtype=Homepage
SAN ANTONIO — It was 4 a.m. on a Sunday when Dana Jones heard an ominous sound, barely audible over the whirring of box fans, like someone struggling to breathe. She ran down the hall and found her daughter Kyra, age 12, lying on her back, gasping for air. Terrified, she called 911.
A police officer, the first to arrive, dashed into Kyra’s bedroom, threw the slender girl over his shoulder and laid her on a leather sofa in the living room. He asked her mother, an oral surgery technician, to give her CPR.
Kyra’s lips were ice-cold. An ambulance whisked the girl to Methodist Children’s Hospital, where staff members swarmed her and put her into a medically induced coma.
Kyra, who has sickle cell, had suffered a devastating stroke — her second — a common complication of this inherited disease, which afflicts 100,000 Americans, most of them Black. She most likely would never have had the strokes if she had been given an annual screening test and treatment proven more than two decades earlier to prevent nine out of 10 strokes in children with the disease and recommended by the National Institutes of Health. But like countless other children with sickle cell, she was never screened.
This is a paradoxical moment for people who have this painful, deadly disease. For the first time, gene therapies that have advanced through clinical trials offer the real possibility of a cure.
But Dr. Francis Collins, director of the National Institutes of Health, said the lack of attention paid to sickle cell historically “is one more reflection of the fact that we do not have equity in our country.”
Some doctors and researchers believe the national reckoning on race sparked by the pandemic’s devastating impact on people of color, and the Biden administration’s pledge of a broad assault on racial inequities in American medical care, could make this a singular moment for advancing the fight against sickle cell.
Even so, Kyra’s strokes are a striking case study of the broad national failure to provide even the most basic treatments to people with sickle cell. Faulty care and sluggish research are symptoms of what sickle cell specialists say is the deplorable legacy of neglect of Americans with the disease.
A third as many Americans have cystic fibrosis, a genetic disease that is of comparable seriousness to sickle cell but that primarily affects white children, yet it gets “seven to 11 times the research funding per patient, which results in disparate rates of development of medications,” according to a recent opinion piece in The New England Journal of Medicine. Only four medications are approved by federal regulators for sickle call, and 15 for cystic fibrosis.
The screening test for strokes in children with sickle cell has been proven for decades, as has the treatment if it detects markers for stroke risk.
“It’s such a simple, painless and harmless test,” said Dr. Robert Adams, the neurologist whose study, published in The New England Journal of Medicine in 1998, proved the effectiveness of a scan of the head known as Transcranial Doppler ultrasound and blood transfusions for those at high risk for strokes. “It’s not rocket science.”
The National Institutes of Health issued a statement in 2002 recommending that children with sickle cell get screened every year. Then, in 2014, a consensus panel of experts convened by the National Institutes of Health issued guidelines repeating the advice.
But the message often did not get through, said Dr. Peter Lane, director of the sickle cell disease program at Children’s Healthcare of Atlanta and a pediatrics professor at Emory University. “There’s often a gap between the development of improved treatments and delivery of those treatments to the patients who need them.”
With sickle cell, he said, the gap is even bigger. “A big part of the challenge of sickle cell is that it impacts predominantly disadvantaged folks,” he said.
Kyra’s mother has learned, to her eternal regret, about the system’s failings. Ms. Jones said she was shocked when a new doctor told her about the screening test that could have prevented disabling strokes that struck both of her daughters, Kyra, who turns 16 this weekend, and Kami, now 17.
Kyra’s strokes, in 2015 and 2017, severely damaged her brain and caused a learning disability that meant she had to repeat sixth grade and years later still needed a tutor to shadow her in school. Her mother said that no one informed her until recently about the ultrasound test that was offered by a hospital just a 45-minute drive from their home — and that could have helped prevent the damage to both girls.
She still feels guilt and anger. She tosses in bed at night thinking, “What if?” How could the girls’ original doctor not have mentioned it?
“I took everything he said as Bible,” she said.
Researchers have repeatedly found that many children with the disease do not get the test or do not get it annually, as recommended. A new study, based on a survey of the largest group of children with sickle cell to date and recently published in The Journal of Pediatric Hematology/Oncology, again documented the dire situation.
Dr. Julie Kanter, a hematologist at the University of Alabama at Birmingham and director of the university’s adult sickle cell clinic, reviewed medical records of 5,347 children at 28 medical centers large and small, including academic sites as well as smaller medical centers. Only 30 to 75 percent of the children had gotten the recommended screening, depending on the center. On average, just 48.4 percent got the ultrasound. The rates were independent of the medical center’s size or academic affiliation.
“The rate is terrible, actually worse than we thought it would be,” Dr. Kanter said.
The researchers surveyed parents and caregivers and learned that some doctors failed to tell parents about the screenings. Some parents, even if told, had not understood their critical importance. (Dr. Kanter wants to rename the test “stroke screen” rather than Transcranial Doppler ultrasound so its purpose is clearer.) Some medical centers with special sickle cell clinics failed to consistently follow up with families who missed appointments.
There were also logistical obstacles. Sometimes medical centers offering the test were far from the homes of children with the disease. Some parents had trouble getting time off from work to take their children for testing. And the centers that did the tests were sometimes out of a family’s insurance network.
Ultrasound screens aren’t the only needed medical care inconsistently given to children with sickle cell. Hydroxyurea, an inexpensive generic drug, around since the 1980s, can reduce the risk of irreversible damage to organs and the brain. But it is woefully underused. Guidelines from the National Institutes of Health published in 2014 say all children and adolescents should take it, as should adults with three or more pain crises in a year or other serious complications.
A recent survey funded by the National Institutes of Health of 2,200 sickle cell patients from eight sites found that just 48 percent of patients were taking hydroxyurea regularly. Interviews with doctors who did not prescribe the drug revealed that many were unfamiliar with it while others were afraid hydroxyurea, which is also a cancer treatment at much higher doses, might cause cancer, although at the lower sickle cell dose it does not.
Another recent study, of Medicaid patients in North Carolina, found that only 32 percent of 2,790 Medicaid patients with sickle cell even had a prescription for hydroxyurea and just 31 percent of those patients took the drug regularly.
“To have teenage patients who never heard the word hydroxyurea — that’s preposterous,” said Dr. Patrick McGann, a sickle cell specialist at Cincinnati Children’s Hospital who puts all his patients on the drug.
In sharp contrast, chronic diseases whose patients are predominantly white, including type 1 diabetes and cystic fibrosis, are typically assigned to a nurse case manager who keeps in touch and manages the multiple medical appointments needed to prevent complications.
In sickle cell, said Dr. Michael DeBaun, a sickle cell specialist at Vanderbilt University, “the model of medical care is often reactionary to medical problems.”
The burden falls on parents to navigate the nation’s complicated, fragmented health care system.
‘Where’s the responsibility here?’
The idea for the stroke screening test occurred to Dr. Adams 30 years ago when he was a young neurology faculty member at the Medical College of Georgia in Augusta. One night, a 3-year-old boy with sickle cell was admitted to the hospital with a massive stroke that had destroyed most of his brain. The toddler’s red blood cells, shaped like sickles instead of disks, had gotten stuck in blood vessels to his brain, injuring their fragile linings and blocking blood flow.
“I tried to explain to this mother why her beautiful son had had this terrible stroke,” Dr. Adams said. “I tried to prepare her for what I knew was the eventuality — he had no chance to survive.”
Dr. Adams thought of how he would have felt if this tragedy had struck his own son, Christopher, who was then 9. That night, he determined to find a way to prevent such strokes.
He hypothesized that Transcranial Doppler ultrasound, or TCD, could detect children at high risk before they had strokes. The ultrasound test could measure the rate of blood flow into the brain and detect blood vessels that were partly obstructed by sickle cell. Then blood transfusions might prevent the strokes in the endangered children.
The N.I.H. tested his idea with a study that began in 1994. Children whose ultrasounds indicated high risk were randomly assigned to have transfusions or not.
The study was abruptly stopped in 1997, ahead of schedule, because children at risk who got transfusions had an annual stroke rate of less than 1 percent. Those who did not get transfusions had a 10 percent per year chance of having a stroke. Sickle cell experts were elated.
But decades later, Dr. Adams, now a distinguished professor of neurology at the Medical University of South Carolina, is alarmed that the health care system has failed to consistently use this knowledge that could have prevented so much suffering.
Hospitals must make a concerted effort to reach families with children who have sickle cell, he said.
“Where’s the responsibility here?” he asked.
“My BMW dealer knows when I am due for an oil change,” he said. Surely, he said, clinic staffs can be just as vigilant in contacting families.
“If you know who your patients are,” he said, “you have to keep track of them.”
Life with sickle cell
Ms. Jones and her former husband, the girls’ father, both carried the mutated hemoglobin gene that causes sickle cell if a child inherits it from both parents. Both their daughters were born with the disease.
Their symptoms began when they were babies, screaming in fierce pain when the distorted cells got caught in blood vessels.
When Kami was 2 years old, Ms. Jones found a caring hematologist, Dr. Mahendra Patel. But Ms. Jones said he never told her about the screening test to detect whether her daughters were at risk for strokes.
The girls’ new doctor, Dr. Melissa Frei-Jones, a pediatric hematologist at the University of Texas Health Science Center at San Antonio, confirmed that the girls had never gotten the test, and Methodist Hospital, where Dr. Patel practiced, confirmed that it did not offer the test.
Dr. Patel declined repeated requests for interviews through his office assistant, who said that the girls were no longer his patients and that he did not have time to discuss their care, including whether he ever mentioned the TCD test.
Kyra had her first stroke at age 10 on a steamy night in 2015 as she watched a basketball game with her mother and sister. She had been complaining for weeks of headaches, but that night, the pain was so bad that she screamed in agony.
Ms. Jones rushed her to the hospital. As Kyra slept that night, her mother tapped her. Kyra opened her eyes, but Ms. Jones recalled, “she looked through me like I wasn’t there.”
Terrified, Ms. Jones ran into the hall and cornered a nurse, begging for help. The nurse called a code blue, a life-threatening emergency. Medical personnel rushed into the room, pushing Ms. Jones aside.
Doctors at the hospital put Kyra in a medically induced coma for a week and a half to allow her brain to heal.
When she woke, Ms. Jones was at her bedside. Kyra looked up and said, “Hi, Mommy.”
Ms. Jones wept in relief.
But Kyra had large gaps in her memory. Her reading level had plummeted. She had forgotten how to tell time.
“I couldn’t remember anything,” Kyra said. “Like math. I didn’t even know what 1+1 is. I didn’t know how to divide.”
And she was unable to walk. She stayed in the hospital for a month, working with a physical therapist, progressing from using a walker to wobbly steps on her own.
With determination and special tutoring, she managed — barely — to get through fifth grade, but sixth grade defeated her. She had to repeat it.
Two years later when she was 12, Kyra had her second stroke deep in the middle of that night when her mother heard her gasping for breath.
Kyra, still struggles in school, with a learning disability so severe that — before Covid forced her to do remote schooling — she had a tutor who shadowed her and helped in her classes. She also had two special study periods a day with a teaching assistant standing by to help with schoolwork
A year older than the other students in her grade, Kyra said she found it hard to fit in.
During a tutoring session on a Friday afternoon last year, a chatty girl sitting across the table from Kyra told her, “I have come to the conclusion that I am not smart enough to do eighth-grade science.”
“Neither am I, in all honesty,” Kyra replied. “But I refuse to give up.”
If it weren’t for the medical staff at Methodist Hospital, where Kami and Kyra have long received care, Ms. Jones might never have learned about the TCD ultrasound test. One day in 2019 a doctor there handed Ms. Jones a Post-it note with Dr. Frei-Jones’s name and phone number on it.
At their appointment, Dr. Frei-Jones ordered M.R.I. scans of the girls’ brains to look for stroke damage. Kami’s showed little white spots in her frontal lobes, signs of a silent stroke that had destroyed brain cells. The results explained why she has trouble with organization. She uses every planning tool available to compensate for her losses, including lists and color coding with highlighters.
Kyra, too, had those white spots on her frontal lobes, but she also had big areas toward the back of her brain where tissue had been destroyed by her strokes.
A year ago, Dr. Frei-Jones showed Kyra’s brain scan to Kyra and her mother.
Seeing it, Ms. Jones said, her eyes welled with tears. Kyra was shocked and silent.
Dr. Frei-Jones told Kyra that it was this brain damage that explained why she struggled in school and why, at times, she was unable to find the words to say what she meant.
Dr. Frei-Jones advised — and Kyra agreed — that she should have transfusions every three weeks to reduce her stroke risk and that Kami should have them too.
Transfusions are a major commitment — an all-day ordeal. The girls have to miss school and Ms. Jones misses work. Kyra and Kami both feel tired and slightly ill after getting one.
Ms. Jones is so terrified they will have another stroke that she sleeps with a baby monitor in the girls’ room so she can hear if anything goes wrong in the night.
She knows, to her everlasting regret, that if she had been seeing Dr. Frei-Jones from the start, her daughters would most likely never have had the strokes that damaged their brains.
“I believe that wholeheartedly,” she said. “If things had been handled differently, their strokes could have been prevented.”
By Charles M. Blow, Opinion Columnist, May 23, 2021
“You can’t argue that the cops who kill are just a few bad apples when it is the whole tree that is shading the truth.”https://www.nytimes.com/2021/05/23/opinion/ronald-greene-video.html?action=click&module=Opinion&pgtype=Homepage
A demonstration was held for Ronald Greene, who died in police custody in Louisiana in 2019, at the March on Washington in 2020. Credit...Pool photo by Michael M. Santiago/Getty Images
Interstate-20 in Louisiana links so many of the places that formed me.
It runs through Shreveport, where I was born and the place where I met my ex-wife and we had our wedding.
About 30 miles east, it runs along the southern edge of Minden, where my mother took us to buy school clothes each year — the same city where one of my brothers now lives and where he teaches at the high school.
Approximately 15 miles east of Minden, I-20 passes about a mile north of the flyspeck town where I grew up, Gibsland, named after an enslaver named Gibbs. Much of the land had been his plantation. Literally, Gibbs’s land.
Eight miles east of Gibsland, the highway scrapes across the top of Arcadia. It was our parish seat, the place with the closest library, the place where I saw my first movie and the place where I acquired my driver’s license.
Fifteen miles east of Arcadia, I-20 passes through the northern edge of Grambling, home to Grambling State University, where I went to college, studied mass communications and became co-editor of the Gramblinite, the school’s newspaper.
About 35 miles east of Grambling, the highway bisects the city of Monroe, where my friends and I often went to parties while we were in college, and where my nephew lived with his mother.
All these cities and towns are majority Black and their administration, including policing, reflect that to some degree. These spaces always felt special to me, at least in the relationship between municipal power and the people.
But between those safe spaces, along Interstate-20, the Louisiana State Police reigned. We called the officers state troopers. The feeling they gave, at least to me, was not one of safety.
All of this is why the killing of Ronald Greene in 2019, and the recently released video from one trooper’s body camera footage of the arrest, obtained by The Associated Press, that is discordant with the official police report of the incident, has been so resonant for me.
It was in the city of Monroe that Greene, a 49-year-old Black man, encountered the troopers. Greene was a barber, as is one of my brothers.
According to a crash report reviewed by The Associated Press, troopers attempted to pull him over for an unspecified traffic violation, but he “refused to stop” and “a pursuit ensued.”
This is how The A.P. reported the conclusion of the single-page police report released by the State Police, which said the chase ended when Greene crashed his vehicle:
“‘Greene was taken into custody after resisting arrest and a struggle with troopers,’ the report says, adding that he ‘became unresponsive’ and died on the way to a hospital. The report doesn’t describe any use of force by troopers.” (The Louisiana State Police later claimed that the troopers did use force and that it was justified.)
The video, however, shows the troopers — all white, by the way — jolting Greene with a stun gun, forcing him to the ground, putting him in a choke hold and punching him in the face. On the video, you can also hear Greene saying, “I’m sorry” and “I’m scared.”
As The A.P. reported about the video:
Instead of rendering aid, the troopers leave the heavyset man unattended, facedown and moaning for more than nine minutes, as they use sanitizer wipes to wash blood off their hands and faces. “I hope this guy ain’t got [expletive] AIDS,” one of the troopers can be heard saying. After a several-minute stretch in which Greene is not seen on camera, he appears again, limp, unresponsive and bleeding from his head and face. He is then loaded onto an ambulance gurney, his arm cuffed to the bedrail.
Everything about this case is wrong. It is true that fleeing the police isn’t smart or legal, but it is also true that doing so shouldn’t be a death sentence.
Furthermore, the police report, which would have been the only official accounting of Greene’s death if this video hadn’t come to light, is a damning false accounting of events, one that is in line with other false accountings that have been refuted by video in high-profile police killings.
Black people distrust the police because things like this teach Black people to distrust the police. This is not paranoia; it is practicality.
Others in the policing structure no doubt also saw this footage in the intervening two years since Greene was killed, and no one apparently said anything. You can’t argue that the cops who kill are just a few bad apples when it is the whole tree that is shading the truth.
Part of the problem is a lack of diversity. As The Advocate newspaper reported in 2018, although 32 percent of Louisiana’s population was Black at the time, only 16 percent of state troopers were. On Saturday, The Advocate reported about the Troop F, the Monroe-based division at the center of the Greene case:
“Of the 66 Troop F members, just six are Black, records show. The area they patrol is about 40 percent African-American. The Troop F roster is 86 percent White and 9 percent Black.”
The connective tissue between these majority Black cities and towns that dot I-20 in northern Louisiana is being patrolled and policed by an overwhelmingly white force unattached and unresponsive to them.
What could possibly go wrong?
8) How Privilege and Capital Warped a Movement
By Talmon Joseph Smith, Mr. Smith is an Opinion staff editor, May 25, 2021https://www.nytimes.com/2021/05/22/opinion/george-floyd-duante-wright-police-race-class.html?action=click&module=Opinion&pgtype=Homepage
By Basma Ghalayini. Ms. Ghalayini is a translator and editor from Gaza, May 24, 2021https://www.nytimes.com/2021/05/24/opinion/israel-hamas-gaza-ceasefire.html?referringSource=articleShare
When I was 9 years old, I was shot by the Israel Defense Forces. Most people I grew up with in Gaza have a story like this: a near miss, a face-to-face confrontation with a fatal bombing, a massacre. Mine is nothing special.
It was 1992, during the first intifada, and I was coming home from the afternoon shift at an overcrowded school for refugees. In those days, there were regular scenes of defiance and confrontation outside the school entrance, between the Israeli militarized vehicles doing their rounds and the kids from the secondary school nearby. To my 9-year-old self, the clashes were a huge inconvenience.
My favorite show, the American soap opera “The Bold and the Beautiful,” started 10 minutes after my last class, on Israel Channel 2. I looked forward to it all day, to watching it before my father, who wholly disapproved, returned home from his clinic.
I had to cross the street to get home. That day was a typical school day: Israeli jeeps on my right, classmates on my left. Barricades had been set up, tires were on fire, thick black smoke filled the air. Gunshots would burst out frequently. I waited for what felt like a reasonably long lull and then I ran across. I heard the bang at the same time that I felt a burning sensation in my calf. I blacked out with the image of Ridge and Brooke, the main protagonists of the show, finally reuniting.
A neighbor took me to the hospital. Thankfully the injury wasn’t severe: A glancing shot, a mere flesh wound. But the pain was immense for weeks. I never did get to see that episode.
Now it’s 2021, and I’ve been living in Britain for 12 years, happily married with two young children. I was, and am, a lucky one. Luckier than lucky. Waking each morning for most of the last two weeks to scroll through the latest lists of the dead and swipe through pictures of my old neighborhood, school, university buildings and the places of my childhood destroyed, I asked myself: What’s so hard for people to understand? Home is a universal concept, isn’t it? You only have one home, and it’s precious. So why are some people still rotely saying that the situation in Gaza is complicated, or that it’s about religion? For many of us, it’s neither of these things.
And it’s not about Hamas either.
President Biden’s announcement about the cease-fire on Friday emphasized the diplomatic efforts conducted with Israel, the Palestinian Authority in the West Bank and Egypt, as mediator. He said that Gaza would be rebuilt with international help and that “we will do this in full partnership with the Palestinian Authority — not Hamas, the Authority — in a manner that does not permit Hamas to restock its arsenal.” But by pointedly excluding Hamas, the Biden administration only perpetuates the myth that Hamas is the central problem.
Hamas was democratically elected — in elections foisted upon Gaza by the Bush administration in 2006 with the blithe assumption that the mainstream secular party Fatah would win, led by the United States’ proxy hard man there, Mohammed Dahlan. Years of corruption — not to mention torture and human rights abuses — meant that many Gazans had lost faith in Fatah by then and weren’t prepared to vote the way Washington wanted them to. Hamas had been a militant Islamic resistance movement, born in the late 1980s, partly from Israel’s occupation of Gaza, and since it was a highly religious party, many of us assumed that at least it would be less corrupt.
Unfortunately, we don’t get elections every four years in Gaza, and Hamas’s victory was something that Gazans soon learned to regret. Critics of the government regularly are beaten, sometimes half to death, and freedoms are restricted. But we haven’t had a chance to vote Hamas out of power; 2006 was the last election we had.
Which is perfect for the Israelis. Hamas, with its iron grip and rocket attacks, is the ideal hook on which to hang all blame. Its popularity has declined since 2006, though that has been buoyed lately — but that, too, actually is irrelevant. What Palestinians think of Hamas has nothing to do with what they think of the right to a legitimate resistance. And most of us believe in the latter. Who wouldn’t in our position?
We knew that the rickety rockets shot from Gaza were all that the Israel Defense Forces and Prime Minister Benjamin Netanyahu needed to redirect public attention on Israeli self-defense and away from the harms inflicted on Palestinians. This isn’t Hamas’s first rodeo. And the provocation that started all this, the expulsion of Palestinians from their homes in East Jerusalem, wasn’t just a provocation. It was an attack on the very last stand of everything Palestinians have ever fought for: home.
Hundreds of thousands of Palestinians live in refugee camps, many elsewhere in the Middle East, often forgoing citizenship rights in that second country and passing on their statelessness to their children and grandchildren in the name of one thing. Home. No elected Palestinian government at this point is going to forget that and simply roll over just because some wannabe international peacemaker wants them to, for their career-boosting photo op in the Rose Garden. That’s been done already.
If any party other than Hamas were in power in Gaza right now, it might have tried to lobby for international support for the Palestinians of East Jerusalem a few days or weeks longer before launching rockets on Israel. But seeing its fellow countrymen and women made homeless, time and time again, would ultimately have forced the hand of even a non-Hamas government in Gaza, either drawing it into the fight or making it so unpopular for not getting involved that it’d be forced out of power. That’s why to focus on Hamas is to miss the point, and to reinforce the myth that the conflict is, in some fundamental manner, about the group. The conflict is about the Israeli occupation.
To focus on Hamas is also to sanitize the conflict, and in that way become complicit in it. It allows people to express sympathy for ordinary Palestinians while blaming a few people at the top of the Palestinian leadership. But the right to self-defense against Israel’s continued aggression belongs to all Palestinians; legitimate resistance cannot be a right only for those Palestinians who believe exclusively in nonviolent self-defense — not in the face of the violence we endure. We, Palestinians, are in this together.
For others to pretend that Israel is waging a war against Hamas, rather than against all Palestinians, is what allows the kinds of attacks and crimes of recent days to be repeated every few years.
And now, if the cease-fire does hold, the spectacular violence of the last two weeks will slip out of the news cycle as Palestinians go back to suffering, largely out of view, the slow-motion violence of Israel’s continued oppression — its blockade of Gaza, its militarization of the West Bank, more evictions of Palestinians.
As kids, one of our favorite games was “shuhada’a.” It was a bit like “doctors and nurses,” in that one kid had to just lie there, doing nothing. But “shuhada’a” means “martyrs,” and in our game, one of us would lie perfectly still in a pretend coffin while the others carried it around chanting “Filistin Hurra” (Free Palestine).
What do you expect from a people who are shot at as kids and given only a prison, or a camp, to live in as adults, instead of their home? It’s not complicated.
Basma Ghalayini is a translator from the Arabic and the editor of “Palestine +100: Stories From a Century After the Nakba.”