‘Use this app twice daily’: how digital tools are revolutionising patient care



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New electronic devices are being used by people of all ages to track activity, measure sleep and record nutrition.
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Caleb Ferguson, Western Sydney University; Debra Jackson, University of Technology Sydney, and Louise Hickman, University of Technology Sydney

Imagine you’ve recently had a heart attack.

You’re a lucky survivor. You’ve received high-quality care from nurses and doctors whilst in hospital and you’re now preparing to go home with the support of your family.

The doctors have made it clear that the situation is grim. It’s a case of: change your lifestyle or die. You’ve got to stop smoking, increase your physical activity, eat a healthy balanced diet (whilst reducing your salt), and make sure you take all your medicine as prescribed.




Read more:
Evidence-based medicine is broken: why we need data and technology to fix it


But before you leave the hospital, the cardiology nurse wants to talk to you. There are a few apps you can download on your smartphone that will help you manage your recovery, including the transition from hospital to home and all the health-related behavioural changes necessary to reduce the risk of another heart attack.

Rapid advancements in digital technologies are revolutionising healthcare. The benefits are numerous, but the rate of development is difficult to keep up with. And that’s creating challenges for both healthcare professionals and patients.

What are digital therapeutics?

Digital therapeutics can be defined as any intervention that is digitally delivered and has a therapeutic effect on a patient. They can be used to treat medical conditions in a similar way to drugs or surgery.

Current examples of digital therapeutics include apps for managing medications and cardiovascular health, apps to support mental health and well being, or augmented and virtual reality tools for patient education.

Paper-based letters, health records, prescription charts and education pamphlets are outdated. We can now send emails, enter information into electronic databases and access electronic medication charts.

And patient education is no longer a static, one-way communication. The digital revolution facilitates dynamic and personalised education, and a two-way interaction between patient and therapist.

How do digital therapeutics help?

Digital health care improves overall quality of care, even in cases where a patient lives hundreds of kilometres away from their doctor.

Take diabetes for example. This condition affects 1.7 million Australians. It’s a major risk factor for developing cardiovascular disease and stroke. So it’s important that people with diabetes manage their condition to reduce their risk.

A recent study evaluated a team-based online game, which was delivered by an app to provide diabetes self-management education. The participants who received the app in this trial had meaningful and sustained improvements in their diabetes, as measured by their HbA1c (blood glucose levels).

App based games of this kind hold promise to improve chronic disease outcomes at scale.

New electronic devices are also being used by people of all ages to track activity, measure sleep and record nutrition. This information provides instant and accurate feedback to individuals and their therapists, allowing for adjustments where necessary. The logged information can also be combined into large data sets to reveal patterns over time and inform future treatments.




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Digital therapeutics are spawning a new language within the healthcare industry. “Connected health” reflects the increasingly digital ways clinicians and patients communicate. A few examples include text messaging, telehealth, and video consultations with health professionals.

There is increasing evidence that digitally delivered care (including apps and text message based interventions) can be good for your health and can help you manage chronic conditions, such as diabetes and cardiovascular disease.

But not all health apps are the same

Whilst the digital health revolution is exciting, results of research studies should be carefully interpreted by patients and providers.

Innovation has led to 325,000 mobile health apps available in 2017. This raises significant governance issues relating to patient safety (including data protection) when using digital therapeutics.

A recent review identified that most studies have a relatively short duration of intervention and only reflect short-term follow up with participants. The long-term effect of these new therapeutic interventions remains largely unknown.

The current speed of technological development means the usual safety mechanisms face new ethical and regulatory challenges. Who is doing the prescribing? Who is responsible for the efficacy, storage and accuracy of data? How are these technologies being integrated into existing care systems?

Digital health needs a collaborative approach

Digital health presents seismic disruption to patient care, particularly when new technologies are cheap and readily accessible to patients who might lack the insight required to recognise normality or cause for alarm. Technology can be enabling and empowering for self management, however there’s a lot more needs to be done to link these new technologies into the current health system.

Take the new Apple Watch functionality of heart rate notifications for example. Research like the Apple Heart Study suggests this exciting innovation could lead to significantly improved detection rates of heart rhythm disorders, and enhanced stroke prevention efforts.

But when a patient receives a high heart rate notification, what should they do? Ignore it? Go to a GP? Head straight to the emergency department? And, what is the flow on impact on the health system?




Read more:
Why virtual reality won’t replace cadavers in medical school


Many of these questions remain unanswered suggesting there is an urgent need for research that examines how technology is implemented into existing healthcare systems.

The ConversationIf we are to produce useful digital therapeutics for real-world problems, then it is critical that the end-users are engaged in the process. Patients and healthcare professionals will need to work with software developers to design applications that meet the complex healthcare needs of patients.

Caleb Ferguson, Senior Research Fellow, Western Sydney University; Debra Jackson, Professor, University of Technology Sydney, and Louise Hickman, Associate Professor of Nursing, University of Technology Sydney

This article was originally published on The Conversation. Read the original article.

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Why this generation of teens is more likely to care about gun violence


Jean Twenge, San Diego State University

When 17 people were killed at Marjory Stoneman Douglas High School in Parkland, Florida, it was just the latest in a tragic list of mass shootings, many of them at schools.

Then something different happened: Teens began to speak out. The Stoneman Douglas students held a press conference appealing for gun control. Teens in Washington, D.C., organized a protest in front of the White House, with 17 lying on the ground to symbolize the lives lost. More protests organized by teens are planned for the coming months.

Teens weren’t marching in the streets calling for gun control after the Columbine High School massacre in 1999. So why are today’s teens and young adults – whom I’ve dubbed “iGen” in my recent book on this generation – speaking out and taking action?

With mass shootings piling up one after another, this is a unique historical moment. But research shows that iGen is also a unique generation – one that may be especially sensitive to gun violence.

Keep me safe

People usually don’t think of teenagers as risk-averse. But for iGen, it’s been a central tenant of their upbringing and outlook.

During their childhoods, they experienced the rise of the helicopter parent, anti-bullying campaigns and, in some cases, being forced to ride in car seats until age 12.

Their behavior has followed suit. For my book, I conducted analyses of large, multi-decade surveys. I found that today’s teens are less likely to get into physical fights and less likely to get into car accidents than teens just 10 years ago. They’re less likely to say they like doing dangerous things and aren’t as interested in taking risks. Meanwhile, since 2000, rates of teen binge drinking have fallen by half.

With the culture so focused on keeping children safe, many teens seem incredulous that extreme forms of violence against kids can still happen – and yet so many adults are unwilling to address the issue.

“We call on our national and state legislatures to finally act responsibly and reduce the number of these tragic incidents,” said Eleanor Nuechterlein and Whitney Bowen, the teen organizers of the D.C. lie-in. “It’s essential that we all feel safe in our classrooms.”

Treated with kid gloves

In a recent analysis of survey data from 8 million teens since the 1970s, I also found that today’s teens tend to delay a number of “adult” milestones. They’re less likely than their predecessors to have a driver’s license, go out without their parents, date, have sex, and drink alcohol by age 18.

This could mean that, compared to previous generations, they’re more likely to think of themselves as children well into their teen years.

As 17-year-old Stoneman Douglas High School student David Hogg put it, “We’re children. You guys are the adults. You need to take some action.”

Furthermore, as this generation has matured, they’ve witnessed stricter age regulations for young people on everything from buying cigarettes (with the age minimum raised to 21 in several states) to driving (with graduated driving laws).

Politicians and parents have been eager to regulate what young people can and can’t do. And that’s one reason some of the survivors find it difficult to understand why gun purchases aren’t as regulated.

“If people can’t purchase marijuana or alcohol at the age of 18, why should they be given access to guns?” asked Stoneman Douglas High School junior Lyliah Skinner.

She has a point: The shooter, Nikolas Cruz, is 19. Under Florida’s laws, he could legally possess a firearm at age 18. But – because he’s under 21 – he couldn’t buy alcohol.

Libertarianism – with limits

At the same time, iGen teens – like their millennial predecessors – are highly individualistic. They believe the rights of the individual should trump traditional social rules. For example, I found that they’re more supportive of same-sex marriage and legalized marijuana than previous generations were at the same age.

Their political beliefs tend to lean toward libertarianism, a philosophy that favors individual rights over government regulations, including gun regulation. Sure enough, support for protecting gun rights increased among millennials and iGen between 2007 and 2016.

But even a libertarian ideologue would never argue that individual freedom extends to killing others. So perhaps today’s teens are realizing that one person’s loosely regulated gun rights can lead to another person’s death – or the death of 17 of their teachers and classmates.

The teens’ demands could be seen as walking this line: They’re not asking for wholesale prohibitions on all guns. Instead, they’re hoping for reforms supported by most Americans such as restricting the sale of assault weapons and more stringent background checks.

In the wake of the Stoneman Douglas High School shooting, the teens’ approach to activism – peaceful protest, a focus on safety and calls for incremental gun regulation – are fitting for this generation.

The ConversationPerhaps iGen will lead the way to change.

Jean Twenge, Professor of Psychology, San Diego State University

This article was originally published on The Conversation. Read the original article.

Dastyari saga shows the need for donations reform, and for politicians to take more care


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Labor’s Sam Dastyari has been sacked from his position as deputy Senate whip for his poor judgement.
AAP/Lukas Coch

Tony Walker, La Trobe University

New South Wales senator Sam Dastyari has been appropriately disciplined by Labor leader Bill Shorten for exercising poor judgement in his interactions with a Chinese businessman who is not an Australian citizen.

Dastyari has been sacked from his position as deputy Senate whip. This is his second demotion in little more than a year after having fallen foul of acceptable standards of political conduct.


Read more: Dastyari demoted again – but government demands he leave parliament


On that first occasion – confirmed by the release this week of a tape recording – Dastyari contradicted his own party’s policy that is critical of China’s activities in the South China Sea.

Compounding his difficulties, he had also accepted a A$5,000 donation from the Chinese businessman mentioned above to meet personal legal obligations.

On this latest occasion, it’s alleged that Dastyari went to the businessman’s house and advised him that conversations between the two needed to be conducted beyond the range of their mobile phones so as to avoid eavesdropping by Australia’s intelligence services.

Dastyari insists that he was not passing on classified information, but the very fact he was alerting a foreign businessman to the possibility of his phone being tapped by the security agencies justifies his sacking.

This was an act of stupidity, if not disloyalty, for an elected representative who claims he has nothing to hide.

The episode also calls Shorten’s management into question. Dastyari should not have been returned to a leadership role so quickly after his first display of poor judgement.

After his earlier demotion he spent just five months on the backbench. He should now remain there for a long time.

Need for clarity

In all of this there is a much bigger issue, and one that requires urgent attention. This is especially so given China’s continued rise, and its persistent efforts to influence politics among its neighbours.

As an important regional player, Australia is far from immune from Chinese “money” politics.

What is required as a matter of urgency is legislation that bans all foreign political donations, along with a separate register of lobbyists who are operating on behalf of foreign entities.

The Dastyari episode should have brought home to the government of the day the need for clear-cut protocols to preclude the possibility of foreign money tainting the political process.

Labor and the Greens have proposed legislation that would ban all foreign political donations. The government is now saying – belatedly – that it will advance legislation in the new year to bring this about. No reasonable argument exists to delay this process.

At the same time, government and opposition should prioritise the establishment of a National Integrity Commission – similar to state-based independent commissions against corruption – to bolster public confidence in the political process, now at a low ebb.

In a research paper, the Parliamentary Library points out that Australia is “one of the few countries where donations from foreign interest political parties or candidates is not prohibited”.

In defining “foreign interests”, the International Institute for Democracy and Electoral Assistance includes entities that “contribute directly or indirectly [and who] are governments, corporations, organisations or individuals who are not citizens; that do not reside in the country or have a large share of foreign ownership”.

That wording would seem to be a reasonable model for Australian legislation.

Of English-speaking democracies, only New Zealand allows overseas donations to parties, but these are capped at NZ$1,500.

Foreign influence

The Dastyari episode underscores the need for clear-cut rules to prevent those with links to foreign governments from using money to influence the political process.

The Chinese businessman in question, Huang Xiangmo, recently stepped down as chairman of the Australian Council for the Promotion of the Peaceful Reunification of China (ACPPRC), a front organisation for the United Work Department of the Chinese State.

The billionaire Huang, whose applications for Australian citizenship have been blocked by the Australian Security Intelligence Organisation, has deep connections in China’s ruling Communist Party.

None of this should be viewed as surprising, or necessarily cause for alarm, but what should be regarded as completely unacceptable is the use of money by foreign donors to influence policy in the service of a foreign government.

In Huang’s case, he withdrew a $400,000 funding pledge after Labor’s then-defence spokesman Stephen Conroy sharply criticised China’s territorial encroachments in the South China Sea.

What is required is clarity around foreign political donations. Politics and self-interest should not be allowed to stand in the way of reasonable steps to put in place regulations that ban all such donations.

In the Senate today, in several personal explanations, Dastyari insisted that he had not passed classified information to Huang, and that indeed he had never received briefings about relations with China that would have enabled him to do so.

That may well be the case, but perceptions in this case are fairly devastating.

Questions remain, such as:

  • Why did Dastyari need to go to the Chinese businessman’s house in the first place?

  • What did he need to tell Huang out of range of their mobile phones?

  • Who leaked the information about the encounter to Fairfax Media?

  • Was it leaked by a government agency for political purposes?

The point is this story has, potentially, some way to run, and may yet result in unexpected further developments.

What the whole unfortunate episode demonstrates is that public officials need to avoid carelessness in their interactions with anyone who might represent a foreign government. This is especially so in the case of a country whose methods of doing business politically are not aligned with those of Australia.

Finally, in his interactions with Huang, Dastyari may have served his interests better if he had familiarised himself with the example of the former Labor national secretary during the Gough Whitlam era.

David Combe served in the contentious period between 1973 and 1981, during which, it is alleged, he had sought financial assistance from Iraq for Labor’s losing 1975 election campaign. That support did not materialise, but revelations that it had been canvassed at all severely embarrassed Labor.


Read more: What is soft power? Hint: it’s not footing Sam Dastyari’s bills


After he relinquished his role as national secretary, Combe developed a lobbying business and in the process was befriended by a Soviet embassy official in Canberra whom it later emerged was a KGB agent.

In 1983, Prime Minister Bob Hawke expelled the Soviet official. A cloud descended on Combe, who was later found by the Hope royal xommission not to have compromised Australia’s security.

The ConversationHowever, if there is a lesson in the Combe and Dastyari episodes it is that those in positions of public trust cannot be too careful in the company they keep.

Tony Walker, Adjunct Professor, School of Communications, La Trobe University

This article was originally published on The Conversation. Read the original article.

Why reforming health care is integral for our economy



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Healthcare is becoming increasingly important in a services-led economy.
Shutterstock

Michael Woods, University of Technology Sydney

Australia’s productivity growth has been stagnant for over a decade and, according to a new report, our health policies and programs could be partly to blame. Released today, the Productivity Commission report also highlights how the health-care sector (among others) could play a starring role in improving productivity.

The commission has offered a short list of thematic directions for reform. In health these include eliminating low-value services that have uncertain clinical impacts, changing the way services are delivered to focus more on the patient, and moving away from a community pharmacy model to more automatic dispensing in a greater range of more convenient locations.

The underlying message is that productivity growth is essential if Australia is to expand its economy, generate opportunities for real income growth and raise community living standards.

But as a Productivity Commission discussion paper released last November noted, there is a justified global anxiety that growth in productivity — and in income and well-being, which are inextricably linked to it over the longer term — has slowed or stopped. Across the OECD, growth in GDP per hour worked was lower in the decade to 2016 than in any decade from 1950.

The commission notes that labour productivity has been rising, but that has more to do with greater capital investment than more efficient workforce practices.

The report also highlights a change in thought about productivity. The emphasis has shifted from the need to produce goods more cheaply to improving our human capital – the knowledge, skills and work practices of our community – and delivering more efficient and effective health, education and related services.

The change recognises that Australia is now predominantly a service economy, that health care is a significant economic service, and that the productivity of our workforce, including its health, needs to underpin our economic growth.

The health sector is big and still growing

The health sector is a big part of our economy and still growing as a proportion of our overall economy. By 2016, according to the OECD, it accounted for 9.6% of our total gross domestic product.

This is similar to that of New Zealand and the United Kingdom, less than Canada and far less than the United States – which is an international outlier at over 17% of its total domestic output. Add aged care and disability services, and the commission puts the figure at 13% of Australia’s GDP.

We continue to spend ever more on health, in real (inflation-adjusted) terms, both as taxpayers and as consumers. But are we getting good value for our money? An inefficient health system, wrongly priced services and poorly designed system incentives all drag on the cost of health care and on the productivity of a very large sector of the economy.

A decade ago, the health-care and social-assistance sector employed nearly 1.07 million people. This was a little less than retailing (1.21 million) and a little more than manufacturing (1.03 million). The health sector employed 10.3% of the Australian workforce.

Fast forward to 2017 and retail employment has stayed relatively stable at 1.26 million and manufacturing has declined to 0.9 million. In contrast, health care and social assistance has risen to 1.64 million – 13.3% of total employment.

Any opportunity to increase the efficiency of the health workforce will translate directly to greater labour productivity for the economy as a whole. And its effectiveness can be improved, in part by education and training, which improves the skills of our doctors, nurses, allied health workers and others to work collaboratively to deliver patient-centred care. This is the subject of an independent review for the COAG Health Council by this article’s author.

The actual productivity of the health workforce, unfortunately, is notoriously hard to measure. This is due in no small part to the lack of market forces and to wage costs that are often negotiated between unions and their employers – the governments.

The Productivity Commission’s forthcoming report on improving markets and competition in health and other human services will hopefully offer useful guidance on what reforms are needed in some of these sectors.

Workforce health is an important part of our human capital

A third role for a more efficient and effective health sector is to contribute to improving the health of the workforce overall. Education and health are recognised as the two most significant building blocks of human capital. Making the most of our human capital is a central message of the OECD’s research on productivity.

There is also ample evidence, including in the new Productivity Commission report, that poor health leads to poor labour market outcomes. A 2013 study into disadvantage in Australia concluded that people with long-term health conditions are likely to experience deep and persistent disadvantage, but, equally, disadvantage can lead to poor health.

Back to the future

The challenge remains to reform the health system, and its workforce in particular, so that practitioners, administrators and others have the skills, knowledge and professional attributes to meet the emerging health-care needs of our community.

As the Australian Institute of Health and Welfare points out in its latest review of Australia’s health, the community’s burden of disease is changing. There is now a greater need for longer-term integrated care to deliver services for those with chronic diseases, the elderly, those with dementia, disability and poor mental health, and to provide services to those in rural areas and remote communities.

The message in this latest report is welcome, but unfortunately it is not entirely new. A Productivity Commission report over a decade ago made the point that Australia’s growth potential will depend increasingly on making the best use of our human capital.

One of the aspirations at that time was for an agreed agenda of integrated health services reform within a national framework. It was seen as a way of adding much-needed impetus to overcoming long-standing structural problems that prevented the health-care system from performing to its potential.

The ConversationLittle progress has been made since then. Hence this report is important in reinforcing the message that the next big gains in productivity will need to come from reforming the delivery of health and education. Let’s hope the call for a shared agenda of reforms is taken up more actively than experience to date might suggest.

Michael Woods, Professor of Health Economics, University of Technology Sydney

This article was originally published on The Conversation. Read the original article.

Pakistani Muslims Beat Elderly Christian Couple Unconscious


80-year-old’s bones broken after he refused prostitute that four men offered.

SARGODHA, Pakistan, October 21 (CDN) — An 80-year-old Christian in southern Punjab Province said Muslims beat him and his 75-year-old wife, breaking his arms and legs and her skull, because he refused a prostitute they had offered him.

From his hospital bed in Vehari, Emmanuel Masih told Compass by telephone that two powerful Muslim land owners in the area, brothers Muhammad Malik Jutt and Muhammad Khaliq Jutt, accompanied by two other unidentified men, brought a prostitute to his house on Oct. 8. Targeting him as a Christian on the premise that he would not have the social status to fight back legally, the men ordered him to have sex with the woman at his residence in village 489-EB, he said.

“I turned down the order of the Muslim land owners, which provoked the ire of those four Muslim men,” Masih said in a frail voice. District Headquarters Hospital (DHQ) Vehari officials confirmed that he suffered broken hip, arm and leg bones in the subsequent attack.

His wife, Inayatan Bibi, said she was cleaning the courtyard of her home when she heard the four furious men brutally striking Masih in her house.

“I tried to intervene to stop them and pleaded for mercy, and they also thrashed me with clubs and small pieces of iron rods,” she said by telephone.

The couple was initially rushed to Tehsil Headquarters Hospital Burewala in critical condition, but doctors there turned them away at the behest of the Jutt brothers, according to the couple’s attorney, Rani Berkat. Burewala hospital officials confirmed the denial of medical care.

Taken to the hospital in Vehari, Inayatan Bibi was treated for a fractured skull. The beatings had left both her and her husband unconscious.

Berkat said the Muslim assailants initially intimidated Fateh Shah police into refraining from filing charges against them. After intervention by Berkat and Albert Patras, director of human rights group Social Environment Protection, police reluctantly registered a case against the Jutt brothers and two unidentified accomplices for attempted murder and “assisting to devise a crime.” The First Information Report (FIR) number is 281/10.

Station House Officer Mirza Muhammad Jamil of the Fateh Shah police station declined to speak with Compass about the case. Berkat said Jamil told her that the suspects would be apprehended and that justice would be served.

Berkat added, however, that police appeared to be taking little action on the case, and that therefore she had filed an application in the Vehari District and Sessions Court for a judge to direct Fateh Shah police to add charges of ransacking to the FIR.

Doctors at DHQ Vehari said the couple’s lives were no longer in danger, but that they would be kept under observation.

Report from Compass Direct News

Muslim Mob Attacks Christians in Gujrat, Pakistan


Dozens beaten, shot at, left for dead since Sept. 8.

SARGODHA, Pakistan, September 27 (CDN) — A mob of Muslim extremists on Thursday (Sept. 23) shot at and beat dozens of Christians, including one cleared of “blasphemy” charges, in Punjab Province’s Gujrat district, Christian leaders said.

The attack on Tariq Gill, exonerated of charges of blaspheming the Quran on Sept. 3, 2009, and on his father Murad Gill, his mother and the other Christian residents was the latest of more than 10 such assaults on the Christian colony of Mohalla Kalupura, Gujrat city, since Sept. 8, the Rev. Suleman Nasri Khan and Bishop Shamas Pervaiz told Compass.

About 40 Islamists – some shooting Kalashnikovs and pistols at homes and individuals on the street, others brandishing axes and clubs – beat some of the Christians so badly that they left them for dead, Pastor Khan said. So far, 10 families have been targeted for the attacks.

On Thursday (Sept. 23) the assailants ripped the clothing off of Gill’s mother and dragged her nude through the streets, Pastor Khan said.

Among the Christians attacked on Thursday (Sept. 23) were Rashid Masih and his family, he said. The critically injured Masih and his family members, Gill and his parents, and the other injured Christians were initially rushed to Aziz Bhatti hospital in Gujrat, Pastor Khan said, and then transferred to Abdullah Hospital in nearby Lalla Musa to receive more advanced care.

“The injured Christians were under the observation of able doctors at Abdullah Hospital in Lalla Musa,” Pastor Khan told Compass by telephone.

Bishop Pervaiz, central vice chairman of the Pakistan Interfaith Peace Council, said the mob was led by two members of the National Assembly, Meer Anjum and Farasat Dar, at the behest of a powerful member of the Punjab Assembly named Sheikh Islam. The three Muslim politicians were not immediately available for comment, but the Gujrat superintendent of police investigations, identified only as Hafeez, told Christian leaders they were respectable legislators who were innocent.

Also asserting that the three Muslim politicians were behind the violence, Pastor Khan said the assailants have vowed to mount an attack on Mohalla Kalupura similar to the Islamist assault on Gojra in 2009. On Aug. 1, 2009, an Islamic mob acting on a false rumor of blaspheming the Quran and whipped into frenzy by local imams attacked the Christian colony in Gojra, burning at least seven Christians to death, injuring 19 others, looting more than 100 houses and setting fire to 50 of them. The dead included women and children.

Bishop Pervaiz said the attackers in Gujrat have threatened to kill him, Pastor Khan and Bishop Yashua John and continue to roam the streets of Mohalla Kalupura looking for Christian residents to kill.

The Lorry Adda police station house officer (SHO), inspector Riaz Qaddar, has stated publicly that “no stone would be left unturned” to apprehend the gunmen, but the Christian leaders said he has refused to act.

“The SHO flatly denied indicting the Muslim mob and especially the Muslim legislators,” said Pastor Khan, chairman of Power of God’s Healing Ministry International Pakistan and national coordinator of Jesus’ Victory Gospel Assembly of Pakistan.

Bishop Pervaiz said that besides the Christian accused of blasphemy, the attacks also may have been sparked by the election victory last year of an area Christian – who was slain a few days after taking office. Yaqoob Masih won the Tehsil Municipal Authority Gujrat election by a landslide, and a few days after he took office on Dec. 15, 2009, Muslim candidates running for the same office killed him, Bishop Pervaiz said.

He added that Lorry Adda police did not register a murder case at that time.  

In the blasphemy case, Tariq Gill was falsely charged on Aug. 15, 2009 under Section 295-B of Pakistan’s blasphemy laws for desecrating the Quran, but due to the intervention of Christian leaders, influential Muslim elders and police, he was exonerated of all allegations on Sept. 3, 2009, said Bishop Pervaiz, who is also chairman of the Council of Bishops and head of the National Churches in Pakistan.

“Muslim legislators Meer Anjum, Sheikh Islam and Farasat Dar had resentment against Murad Gill’s family over this blasphemy row as well,” said Bishop Pervaiz, “and now through these assaults, which are becoming more frequent and massive, emboldened Muslims have found a way to vent their fury.”

The Christian leaders said they approached District Police Officer Afzaal Kausar about the attacks, and he sent the application for charges to Hafeez, the superintendent of police investigation in Gujrat.

“But he did not bother to watch the video we shot of the attack and shrugged off the matter,” Pastor Khan said.

He said that Hafeez told them that Anjum, Dar and Islam were respectable legislators, “and without any investigation declared them innocent.”

This afternoon Pastor Khan led a protest at the Islamabad National Press Club. He said more than 250 Christian protestors reached Islamabad despite an attempt by Inspector Qaddar of Lorry Adda police station to arrest them before they left the area.

“But the invisible hand of Almighty God helped us, and we safely made it to Islamabad,” Pastor Khan said. “Although the government has clamped a ban on all sorts of processions and demonstrations, we successfully staged the sit-in before National Press Club Islamabad.”

Saying he regretted that the demonstration had drawn little attention, he added that the protestors would remain in front of the building tonight demanding justice. The pastor said tomorrow (Sept. 28) they would protest in front of the Islamabad Parliament House.

Report from Compass Direct News

Motive for Aid Worker Killings in Afghanistan Still Uncertain


Taliban takes responsibility, but medical organization unsure of killers’ identity.

ISTANBUL, August 12 (CDN) — The killing of a team of eye medics, including eight Christian aid workers, in a remote area of Afghanistan last week was likely the work of opportunistic gunmen whose motives are not yet clear, the head of the medical organization said today.

On Friday (Aug. 6), 10 medical workers were found shot dead next to their bullet-ridden Land Rovers. The team of two Afghan helpers and eight Christian foreigners worked for the International Assistance Mission (IAM). They were on their way back to Kabul after having provided medical care to Afghans in one of the country’s remotest areas.

Afghan authorities have not been conclusive about who is responsible for the deaths nor the motivation behind the killings. In initial statements last week the commissioner of Badakhshan, where the killings took place, said it was an act of robbers. In the following days, the Taliban took responsibility for the deaths.

The Associated Press reported that a Taliban spokesman said they had killed them because they were spies and “preaching Christianity.” Another Taliban statement claimed that they were carrying Dari-language Bibles, according to the news agency. Initially the attack was reported as a robbery, which IAM Executive Director Dirk Frans said was not true.

“There are all these conflicting reports, and basically our conclusion is that none of them are true,” Frans told Compass. “This was an opportunistic attack where fighters had been displaced from a neighboring district, and they just happened to know about the team. I think this was an opportunistic chance for them to get some attention.”

A new wave of tribal insurgents seeking territory, mineral wealth and smuggling routes has arisen that, taken together, far outnumber Taliban rebels, according to recent U.S. intelligence reports.

Frans added that he is expecting more clarity as authorities continue their investigations.

He has denied the allegation that the members of their medical team were proselytizing.

“IAM is a Christian organization – we have never hidden this,” Frans told journalists in Kabul on Monday (Aug. 9). “Indeed, we are registered as such with the Afghan government. Our faith motivates and inspires us – but we do not proselytize. We abide by the laws of Afghanistan.”

IAM has been registered as a non-profit Christian organization in Afghanistan since 1966.

Dr. Abdullah Abdullah, a former political candidate, dismissed the Taliban’s claims that team members were proselytizing or spying, according to the BBC.

“These were dedicated people,” Abdullah said according to the BBC report. “Tom Little used to work in Afghanistan with his heart – he dedicated half of his life to service the people of Afghanistan.”

Abdullah had trained as an eye surgeon under Tom Little, 62, an optometrist who led the team that was killed last week. Little and his family had lived in Afghanistan for more than 30 years with IAM providing eye care.

IAM has provided eye care and medical help in Afghanistan since 1966. In the last 44 years, Frans estimates they have provided eye care to more than 5 million Afghans.

Frans said he doesn’t think that Christian aid workers are particularly targeted, since every day there are many Afghan casualties, and the insurgents themselves realize they need the relief efforts.

“We feel that large parts of the population are very much in favor of what we do,” he said. “The people I met were shocked [by the murders]; they knew the members of the eye care team, and they were shocked that selfless individuals who are going out of their way to actually help the Afghan people … they are devastated.”

The team had set up a temporary medical and eye-treatment camp in the area of Nuristan for two and a half weeks, despite heavy rains and flooding affecting the area that borders with Pakistan.

Nuristan communities had invited the IAM medical team. Afghans of the area travelled from the surrounding areas to receive treatment in the pouring rain, said Little’s wife in a CNN interview earlier this week, as she recalled a conversation with her husband days before he was shot.

Little called his wife twice a day and told her that even though it was pouring “sheets of rain,” hundreds of drenched people were gathering from the surrounding areas desperate to get medical treatment.

 

The Long Path Home

The team left Nuristan following a difficult path north into Badakhshan that was considered safer than others for reaching Kabul. Frans said the trek took two days in harsh weather, and the team had to cross a mountain range that was 5,000 meters high.

“South of Nuristan there is a road that leads into the valley where we had been asked to come and treat the eye patients, and a very easy route would have been through the city of Jalalabad and then up north to Parun, where we had planned the eye camp,” Frans told Compass. “However, that area of Nuristan is very unsafe.”

When the team ended their trek and boarded their vehicles, the armed group attacked them and killed all but one Afghan member of the team. Authorities and IAM believe the team members were killed between Aug. 4 and 5. Frans said he last spoke with Little on Aug. 4.

IAM plans eye camps in remote areas every two years due to the difficulty of preparing for the work and putting a team together that is qualified and can endure the harsh travel conditions, he said.

“We have actually lost our capacity to do camps like this in remote areas because we lost two of our veteran people as well as others we were training to take over these kinds of trips,” Frans said.

The team of experts who lost their lives was composed of two Afghan Muslims, Mahram Ali and another identified only as Jawed; British citizen Karen Woo, German Daniela Beyer, and U.S. citizens Little, Cheryl Beckett, Brian Carderelli, Tom Grams, Glenn Lapp and Dan Terry.

“I know that the foreign workers of IAM were all committed Christians, and they felt this was the place where they needed to live out their life in practice by working with and for people who have very little access to anything we would call normal facilities,” said Frans. “The others were motivated by humanitarian motives. All of them in fact were one way or another committed to the Afghan people.”

The two Afghans were buried earlier this week. Little and Terry, who both had lived in the war-torn country for decades, will be buried in Afghanistan.

Despite the brutal murders, Frans said that as long as the Afghans and their government continue to welcome them, IAM will stay.

“We are here for the people, and as long as they want us to be here and the government in power gives us the opportunity to work here, we are their guests and we’ll stay, God willing,” he said.

 

Memorial

On Sunday (Aug. 8), at his home church in Loudonville, New York, Dr. Tom Hale, a medical relief worker himself, praised the courage and sacrifice of the eight Christians who dedicated their lives to helping Afghans.

“Though this loss has been enormous, I want to state my conviction that this loss is not senseless; it is not a waste,” said Hale. “Remember this: those eight martyrs in Afghanistan did not lose their lives, they gave up their lives.”

Days before the team was found dead, Little’s wife wrote about their family’s motivation to stay in Afghanistan through “miserable” times. Libby Little described how in the 1970s during a citizens’ uprising they chose not to take shelter with other foreigners but to remain in their neighborhood.

“As the fighting worsened and streets were abandoned, our neighbors fed us fresh bread and sweet milk,” she wrote. “Some took turns guarding our gate, motioning angry mobs to ‘pass by’ our home. When the fighting ended, they referred to us as ‘the people who stayed.’

“May the fruitful door of opportunity to embrace suffering in service, or at least embrace those who are suffering, remain open for the sake of God’s kingdom,” she concluded.

 

Concern for Afghan Christians

Afghanistan’s population is estimated at 28 million. Among them are very few Christians. Afghan converts are not accepted by the predominantly Muslim society. In recent months experts have expressed concern over political threats against local Christians.

At the end of May, private Afghan TV station Noorin showed images of Afghan Christians being baptized and praying. Within days the subject of Afghans leaving Islam for Christianity became national news and ignited a heated debate in the Parliament and Senate. The government conducted formal investigations into activities of Christian aid agencies. In June IAM successfully passed an inspection by the Afghan Ministry of Economy.

In early June the deputy secretary of the Afghan Parliament, Abdul Sattar Khawasi, called for the execution of converts, according to Agence France-Presse (AFP).

“Those Afghans that appeared on this video film should be executed in public,” he said, according to the AFP. “The house should order the attorney general and the NDS (intelligence agency) to arrest these Afghans and execute them.”

Small protests against Christians ensued in Kabul and other towns, and two foreign aid groups were accused of proselytizing and their activities were suspended, news sources reported.

A source working with the Afghan church who requested anonymity said she was concerned that the murders of IAM workers last week might negatively affect Afghan Christians and Christian aid workers.

“The deaths have the potential to shake the local and foreign Christians and deeply intimidate them even further,” said the source. “Let’s pray that it will be an impact that strengthens the church there but that might take awhile.”

Report from Compass Direct News