After early success, India’s daily COVID infections have surpassed the US and Brazil. Why?

Rajib Dasgupta, Jawaharlal Nehru University India is in the grip of a massive second wave of COVID-19 infections, surpassing even the United States and Brazil in terms of new daily infections. The current spike came after a brief lull: daily new cases had fallen from 97,000 new cases per day in September 2020 to around 10,000 per day in January 2021. However, from the end of February, daily new cases began to rise sharply again, passing 100,000 a day, and now crossing the 200,000 mark.

Night curfews and weekend lockdowns have been reinstated in some states, such as Maharasthra (including the financial capital Mumbai). Health services and crematoriums are being overwhelmed, COVID test kits are in short supply, and wait times for results are increasing.

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How has the pandemic been spreading?

Residents in slum areas and those without their own household toilet have been worst affected, implying poor sanitation and close living have contributed to the spread.

One word that has dominated discussions about why cases have increased again is laaparavaahee (in Hindi), or “negligence”. The negligence is made out to be the fault of individuals not wearing masks and social distancing, but that is only part of the story.

Negligence can be seen in the near-complete lack of regulation and its implementation wherever regulations did exist across workplaces and other public spaces. Religious, social and political congregations contributed directly through super-spreader events, but this still doesn’t explain the huge rise in cases.

The second wave in India also coincides with the spread of the UK variant. A recent report found 81% of the latest 401 samples sent by the state of Punjab for genome sequencing were found to be the UK variant.

Studies have found this variant might be more capable of evading our immune systems, meaning there’s a greater chance previously infected people could be reinfected and immunised people could be infected.

A new double mutation is also circulating in India, and this too could be contributing to the rise in cases.

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Low fatality rate?

In the first phase of the pandemic, India was lauded for its low COVID death rate (case fatality rate) of about 1.5%. However, The Lancet cautioned about the “dangers of false optimism” in its September 26 editorial on the Indian situation.

In a pandemic situation, the public health approach is usually to attribute a death with complex causes as being caused by the disease in question. In April 2020, the World Health Organization clarified how COVID deaths should be counted:

A death due to COVID-19 is defined for surveillance purposes as a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma)

It is unclear the extent to which the health authorities across the states of India were complying with this.

Many states have set up expert committees to re-examine and verify COVID-19 deaths after coming under criticism that reported death rates were not accurate. Many states made corrections in mortality figures, and the full extent of undercounting is being actively researched.

District-level mortality data, both in the first wave as well as in the current wave, confirm that the global case fatality rate of 3.4% was breached in several districts such as Maharashtra, Punjab and Gujarat. Case fatality rates in some of the worst-affected districts were above 5%, similar to the 5% mortality level in the US.

What are the challenges this time?

A majority of the cases and deaths (81%) are being reported from ten (of 28) states, including Punjab and Maharashtra. Five states (Maharashtra, Chhattisgarh, Karnataka, Uttar Pradesh and Kerala) account for more than 70% of active cases. But the infection seems to have moved out of bigger cities to smaller towns and suburbs with less health infrastructure.

Last year, the government’s pandemic control strategy included government staff from all departments (including non-health departments) contributing to COVID control activities, but these workers have now been moved back to their departments. This is likely to have an effect on testing, tracing and treating COVID cases. And health-care workers now have a vaccine rollout to contend with, as well as caring for the sick.

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What now?

In early March the government declared we were in the endgame of the pandemic in India. But their optimism was clearly premature.

Despite an impressive 100 million-plus immunisations, barely 1% of the country’s population is currently protected with two doses of the vaccine. The India Task Force is worried that monthly vaccine supplies at the current capacity of 70 million to 80 million doses per month would “fall short by half” for the target of 150 million doses per month.

Strict, widespread lockdowns we have seen elsewhere in the world are not appropriate for all parts of India given their effect on the working poor. Until wider vaccination coverage is achieved, local containment measures will have to be strengthened. This includes strict perimeter control to ensure there is no movement of people in or out of zones with local outbreaks, intensive house-to-house surveillance to ensure compliance with stay-at-home orders where they are in place, contact tracing, and widespread testing.

It should go without saying large congregations such as political rallies and religious festivals should not be taking place, and yet they have been.

Strong leadership and decentralised strategies with a focus on local restrictions is what we need until we can get more vaccines into people’s arms.

Rajib Dasgupta, Chairperson, Centre of Social Medicine and Community Health, Jawaharlal Nehru University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Why do some people struggle to make ‘healthy’ decisions, day after day?

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James Kesby, The University of Queensland and Shuichi Suetani, The University of Queensland

To navigate our way through the world, we constantly make choices. While we’ve all made our fair share of regrettable ones, most of us eventually learn from these – and we generally take this ability for granted.

For some people suffering from illnesses such as schizophrenia and substance use disorder – previously referred to as “substance abuse” – making the right choices can be extremely difficult.

In fact, many mental illnesses feature problems with cognition (thinking and comprehension), including depression and bipolar disorder. Decision-making ability varies in healthy people, too, sometimes as a consequence of differences in genetics.

What’s happening in the brains of these people that puts them on unequal footing to the rest of us?

Even simple decisions are complex

It’s important to note in day-to-day situations, there’s often no distinctly “right” or “wrong” choice to be made. However, some choices do result in healthier or more productive outcomes for us and those around us.

Our brains carry out a suite of complex processes when making decisions. And there are four important factors in each decision we make: value, motivation, action and strategy.

When choosing between two options, say A and B, we first need to understand which choice will be more rewarding, or provide more value. Our personal motivation to attain this reward then acts to bias which option we choose, or whether we make a choice at all.

Understanding what action is required to obtain A, or B, is also important. Combining all this information, we try to understand which strategy will maximise our rewards. And this lets us improve our decision-making ability over time.

There are multiple decision-making processes in the brain that help determine the choices we make.
James P. Kesby

Interrupted connections

We refer to our personal history and past experiences to guide our future choices. But mental disorders often cause problems in the decision-making process.

Research shows people with schizophrenia can have trouble understanding the relationship between their actions and the outcomes. This means they might keep selecting A, even if they know it’s no longer as valuable as B.

They’re also more willing to adopt strategies based on less information, in other words “jump to conclusions”, about outcomes.

Substance use disorder, particularly with stimulants such as methamphetamine or cocaine, often leads to people getting stuck when certain outcomes change.

For example, if we reversed all the street lights so red meant “go” and green meant “stop” without telling anyone, most people would get an initial shock but would eventually alter their behaviour.

People with stimulant dependence, however, would take longer to learn to stop on the green light – even if they kept getting into car accidents. This is because excessive stimulant use impacts regions in the brain that are crucial to adapting to changing environments.

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How the brain decodes each decision

The human brain contains multiple circuits (like pathways) and chemical messengers called “neurotransmitters”. These are responsible for guiding the processes discussed above.

The decision-making circuits commonly associated with schizophrenia and substance use disorder include areas of the “cortex” – the outer part of our brain important for complex thought (especially the frontal lobe) – that “talk” to hub areas such as the “striatum”. The striatum lets us select and then initiate an action to achieve a specific goal.

Different cortical areas are used to compute different processes in the brain. The prefrontal cortex helps us understand when a strategy needed for success changes. So, if we replaced all the traffic lights with sirens, the prefrontal cortex would help us realise this and adjust.

When the anticipated outcome of a choice changes (such as if A was better, but then suddenly B became better), the orbitofrontal cortex helps us identify this. Similarly, the striatum is key for anticipating what an outcome will be and when we will get the reward.

The cortex is the wrinkly layer that covers our brain. The striatum sits underneath the cortex, in the forebrain.
Shutterstock

Dopamine helps make your choices a reality

Extensive research efforts have found the brains of people experiencing schizophrenia function differently in multiple areas. It’s believed this could contribute to decision-making problems.

For the psychotic symptoms observed in schizophrenia (such as hallucinations and delusions), alterations in the neurotransmitter dopamine are important. Dopamine is a chemical in the brain that’s key for anticipating rewards, making decisions and controlling the physical actions necessary to act on our choices.

In our research, we’ve argued increases in dopamine in the striatum may cause problems with how the brain integrates information from the cortex, resulting in decision-making difficulties. However, this may only be the case in some individuals.

Stimulants also cause excessive dopamine release. They can alter the balance between goal-directed behaviours, which are flexible and respond to environmental changes – and habits, which are automatic and hard to break.

Usually, when we learn something new our brain keeps adapting and incorporating new information. But this is slow and cognitively demanding. Substance dependence can accelerate a person’s progression to habitual behaviour, wherein a set strategy or response become ingrained.

This then makes it hard to stop seeking drugs, even if the individual no longer finds them enjoyable.

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How we can we help people make better decisions

Unfortunately, problems with cognitive ability are hard to treat. There are no medications for schizophrenia or stimulant dependence shown to reliably improve cognition. This is a consequence of the human brain’s complexity.

That said, there are ways we can all improve our memory and decision-making, which may also help those with mental illnesses causing cognition problems.

For instance, cognitive remediation therapy is a behavioural approach that trains the brain to respond to certain situations better. For people with schizophrenia, it may improve visual memory and perhaps more complex decision-making.

Not being able to navigate decisions day-to-day is one of the most debilitating aspects of disorders that impact cognition. This leads to difficulties in maintaining work, keeping friends and leading a fulfilling life.

We need more research to understand how different brains make different decisions. Hopefully then we can improve the lives of those living with mental illness.

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James Kesby, UQ Amplify Researcher, The University of Queensland and Shuichi Suetani, Psychiatrist, Queensland Brain Institute, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

You’ve got (less) mail: COVID-19 hands Australia Post a golden opportunity to end daily letter delivery

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Paul Alexander, Curtin University

Australia Post delivered more than 3.3 billion items last financial year. That’s almost 14 million deliveries a day (not counting weekends and public holidays).

Its 2019 annual report itemises the massive logistical network required: 15,037 street post boxes, 4,343 post offices, 461 sorting and distribution facilities, 4,845 delivery vans, 2,600 trucks, six airline freighters, rail assets, and 8,992 motorbikes and electric delivery vehicles.

Letters and parcels move in “waves” to 12.1 million addresses daily. Federally legislated service standards oblige Australia Post to deliver a letter within the country in no more than four days at a fixed rate (currently A$1.10). And to do so every week day to 98% of all delivery points.

Or at least Australia Post did so until late April. That’s when the federal government granted a temporary suspension of the services standards, allowing it to deliver letters every second business day in metropolitan areas.

The rationale was to enable Australia Post to divert resources from letter delivery – the part of its business in decline for at least a decade – to the booming demand for parcel delivery driven by COVID-19.

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In May, with support from the Senate crossbench, the government passed amendments extending the suspension to June 2021.

That move is not universally supported. Unions fear postal workers will lose jobs. Federal opposition leader Anthony Albanese has signalled Labor Party support for a Senate motion to overturn the changes.

These cuts are to jobs, these cuts are to services that are absolutely essential […] In particular, older Australians really rely upon their postal services.

It’s true Australia Post provides an indispensable service. But its revenues tell a story of people relying on postal services less and less.

Lost letters

The decline of the letter business over the past decade has been relentless.

In 2009 Australia Post made a profit before interest and income tax of A$384.5 million. Of this its letter business generated A$52 million. Parcels and logistics made A$187 million. Other business (such as agency services and merchandise) made about A$146 million.

In 2019 its net profit was down to a razor-thin A$41 million. Profit before interest and tax for its non-letters businesses was almost A$259 million. Its letters business lost almost A$192 million.

Australia Post can still make profits delivering letters in major cities and regional centres, where population density is high and distances short. But not in in rural areas, where per-delivery costs skyrocket. Its commercial competitors, meanwhile, can cherry-pick the most lucrative market segments and avoid the loss-making ones.

Parsing parcels

Australia Post has long yearned to be freed from its obligation to deliver letters daily. In 2015 then chief executive Ahmed Fahour declared letter posting “in terminal and structural decline” and that Australia Post “is a parcels company more than a letters company”.

In March, current chief executive Christine Holgate told a Senate estimates committee:

Our most significant challenge is managing the tipping point of that transformation from letters for our delivery network, which is about 70% of our costs, which is actually now in need really of a significant transformation.

The cost of delivering a $1.10 letter is not much less than a $10 parcel. It makes no commercial sense to utilise resources on loss-making activities at the expense of profitable ones.

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But Australia Post is not just another corporation. Profits are not its only measure of success. It is owned by the nation. Its services are essential, particularly to rural communities.

Fingal Post Office, in north-east Tasmania.
Shuttterstock

At this time, a strong case can be made it is a better social service to ensure timely parcel delivery.

In the longer term, the issue for policy makers is whether the social good is best served by keeping Australia Post to its historical obligations, or allowing it to meet burgeoning parcel demand and return a bigger dividend to the federal government to help fund other public services.

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While opinions will vary, the numbers make a compelling case. They show a mail delivery system designed before the advent of the internet doesn’t need to be daily any more – just as the telephone last century helped end the importance of mail being delivered twice a day.

Paul Alexander, Associate Professor, Network analysis, Procurement,Supply Chains, Curtin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Health Check: do we really need to take 10,000 steps a day?

Walking has a variety of health benefits.
From shutterstock.com

Corneel Vandelanotte, CQUniversity Australia; Kerry Mummery, University of Alberta; Mitch Duncan, University of Newcastle, and Wendy Brown, The University of Queensland

Regular walking produces many health benefits, including reducing our risk of heart disease, type 2 diabetes and depression.

Best of all, it’s free, we can do it anywhere and, for most of us, it’s relatively easy to fit into our daily routines.

We often hear 10,000 as the golden number of steps to strive for in a day. But do we really need to take 10,000 steps a day?

Not necessarily. This figure was originally popularised as part of a marketing campaign, and has been subject to some criticism. But if it gets you walking more, it might be a good goal to work towards.

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Where did 10,000 come from?

The 10,000 steps concept was initially formulated in Japan in the lead-up to the 1964 Tokyo Olympics. There was no real evidence to support this target. Rather, it was a marketing strategy to sell step counters.

There was very little interest in the idea until the turn of the century, when the concept was revisited by Australian health promotion researchers in 2001 to encourage people to be more active.

Based on accumulated evidence, many physical activity guidelines around the world – including the Australian guidelines – recommend a minimum of 150 minutes of moderate intensity physical activity a week. This equates to 30 minutes on most days. A half hour of activity corresponds to about 3,000 to 4,000 dedicated steps at a moderate pace.

In Australia, the average adult accumulates about 7,400 steps a day. So an additional 3,000 to 4,000 steps through dedicated walking will get you to the 10,000 steps target.

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One size doesn’t fit all

Of course, some people accumulate a lot fewer steps per day – for example, older people, those with a chronic disease, and office workers. And others do a lot more: children, runners, and some blue-collar workers. So the 10,000 goal is not suitable for everyone.

Setting a lower individual step goal is fine as long as you try to add about 3,000 to 4,000 steps to your day. This means you will have done your 30 minutes of activity.

People measure their daily steps using a variety of activity trackers.
From shutterstock.com

Studies that examine how the number of daily steps relates to health benefits have mainly been cross-sectional. This means they present a snapshot, and don’t look at how changes in steps affect people’s health over time. Therefore, what we call “reverse causality” may occur. So rather than more steps leading to increased health benefits, being healthier may in fact lead to taking more steps.

Nonetheless, most studies do find taking more steps is associated with better health outcomes.

Several studies have shown improved health outcomes even in participants who take less than 10,000 steps. An Australian study, for example, found people who took more than 5,000 steps a day had a much lower risk of heart disease and stroke than those who took less than 5,000 steps.

Another study found that women who did 5,000 steps a day had a significantly lower risk of being overweight or having high blood pressure than those who did not.

The more the better

Many studies do, however, show a greater number of steps leads to increased health benefits.

An American study from 2010 found a 10% reduction in the occurrence of metabolic syndrome (a collection of conditions that increase your risk of diabetes, heart disease and stroke) for each 1,000-step increase per day.

An Australian study from 2015 demonstrated that each 1,000-step increase per day reduced the risk of dying prematurely of any cause by 6%, with those taking 10,000 or more steps having a 46% lower risk of early death.

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Another Australian study from 2017 showed people with increasingly higher step counts spent less time in hospital.

So the bottom line is the more steps, the better.

Step it up

It’s important to recognise that no public health guideline is entirely appropriate for every person; public health messages are aimed at the population at large.

That being said, we shouldn’t underestimate the power of a simple public health message: 10,000 steps is an easily remembered goal and you can readily measure and assess your progress. You can use an activity tracker, or follow your progress through a program such as 10,000 Steps Australia.

Increasing your activity levels, through increasing your daily step count, is worthwhile; even if 10,000 steps is not the right goal for you. The most important thing is being as active as you can. Striving for 10,000 steps is just one way of doing this.

Corneel Vandelanotte, Professorial Research Fellow: Physical Activity and Health, CQUniversity Australia; Kerry Mummery, Dean, Faculty of Kinesiology, Sport and Recreation, University of Alberta; Mitch Duncan, , University of Newcastle, and Wendy Brown, Professor of Human Movement Studies, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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

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.

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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?

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

If 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.

We asked five experts: do I have to drink eight glasses of water per day?

Eight seems like a lot…
from http://www.shutterstock.com

Alexandra Hansen, The Conversation

Everyone knows humans need water and we can’t survive without it. We’ve all heard we should be aiming for eight glasses, or two litres of water per day.

This target seems pretty steep when you think about how much water that actually is, and don’t we also get some water from the food we eat?

We asked five medical and sports science experts if we really need to drink eight glasses of water per day.

All five experts said no

Here are their detailed responses:

https://cdn.theconversation.com/infographics/248/5569e2081efba668022eb859f9f36a24735d7625/site/index.html

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If you have a “yes or no” health question you’d like posed to Five Experts, email your suggestion to: alexandra.hansen@theconversation.edu.au

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Disclosure statements: Toby Mündel has received research funding from the Gatorade Sport Science Institute and Neurological Foundation of New Zealand, which has included research on hydration.

Alexandra Hansen, Section Editor: Health + Medicine, The Conversation

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

Article: Violence in Iraq Continues

The link below is to an article that reports on the current situation on the ground in Iraq. Violence continues on a daily basis and the country appears just as bad, if not worse, that it was under Saddam Hussein. 

For more visit:
http://www.christiantelegraph.com/issue16903.html

Religious Conversion Worst Form of ‘Intolerance,’ Bhutan PM Says

Propagation of religion is allowable – but not seeking conversions, top politician says.

THIMPHU, Bhutan, April 13 (CDN) — In the Kingdom of Bhutan, where Christianity is still awaiting legal recognition, Christians have the right to proclaim their faith but must not use coercion or claim religious superiority to seek conversions, the country’s prime minister told Compass in an exclusive interview.

“I view conversions very negatively, because conversion is the worst form of intolerance,” Jigmi Yoser Thinley said in his office in the capital of the predominantly Buddhist nation.

Christian leaders in Bhutan have told Compass that they enjoy certain freedoms to practice their faith in private homes, but, because of a prohibition against church buildings and other restrictions, they were not sure if proclamation of their faith – included in international human rights codes – was allowed in Bhutan.

Prime Minister Thinley, who as head of the ruling party is the most influential political chief in the country, said propagation of one’s faith is allowed, but he made it clear that he views attempts to convert others with extreme suspicion.

“The first premise [of seeking conversion] is that you believe that your religion is the right religion, and the religion of the convertee is wrong – what he believes in is wrong, what he practices is wrong, that your religion is superior and that you have this responsibility to promote your way of life, your way of thinking, your way of worship,” Thinley said. “It’s the worst form of intolerance. And it divides families and societies.”

Bhutan’s constitution does not restrict the right to convert or proselytize, but some Non-Governmental Organizations have said the government effectively limits this right by restricting construction of non-Buddhist worship buildings and celebration of some non-Buddhist festivals, according to the U.S. Department of State’s 2010 International Religious Freedom Report.

It adds that Bhutan’s National Security Act (NSA) further limits proclamation of one’s faith by prohibiting “words either spoken or written, or by other means whatsoever, that promote or attempt to promote, on grounds of religion, race, language, caste, or community, or on any other ground whatsoever, feelings of enmity or hatred between different religious, racial, or language groups or castes and communities.” Violation of the NSA is punishable by up to three years’ imprisonment, though whether
any cases have been prosecuted is unknown, according to the State Department report.

Bhutan’s first democratic prime minister after about a century of absolute monarchy, Thinley completed three years in office last Thursday (April 7). While he affirmed that it is allowable for Christians to proclaim their faith – a practice commanded by Christ, with followers agreeing that it is the Holy Spirit, not man, that “converts” people – Thinley made his suspicions about Christians’ motives manifest.

“Any kind of proselytization that involves economic and material incentives [is wrong],” he said. “Many people are being converted on hospital beds in their weakest and most vulnerable moments. And these people are whispering in their ears that ‘there is no hope for you. The only way that you can survive is if you accept this particular religion.’ That is wrong.”

Thinley’s suspicions include the belief that Christians offer material incentives to convert.

“Going to the poor and saying, ‘Look, your religion doesn’t provide for this life, our religion provides for this life as well as the future,’ is wrong. And that is the basis for proselytization.”

Christian pastors in Thimphu told Compass that the perception that Bhutan’s Christians use money to convert the poor was flawed.

The pastors, requesting anonymity, said they prayed for healing of the sick because they felt they were not allowed to preach tenets of Christianity directly. Many of those who experience healing – almost all who are prayed for, they claimed – do read the Bible and then believe in Jesus’ teachings.

Asked if a person can convert if she or he believed in Christianity, the prime minister replied, “[There is] freedom of choice, yes.”

In his interview with Compass, Thinley felt compelled to defend Buddhism against assertions that citizens worship idols.

“To say that, ‘Your religion is wrong, worshiping idols is wrong,’ who worships idols?” he said. “We don’t worship idols. Those are just representations and manifestations that help you to focus.”

Leader of the royalist Druk Phuensum Tshogpa party, Thinley is regarded as a sincere politician who is trusted by Bhutan’s small Christian minority. He became the prime minister in April 2008 following the first democratic election after Bhutan’s fourth king, Jigme Singye Wangchuck, abdicated power in 2006 to pave the way toward democracy.

Until Bhutan became a constitutional monarchy in 2008, the practice of Christianity was believed to be banned in the country. The constitution now grants the right to freedom of thought, conscience and religion to all citizens. It also states that the king is the protector of all religions.

Thus far, the Religious Organisations Act of 2007 has recognized only Buddhist and Hindu organizations. As a result, no church building or Christian bookstore has been allowed in the country, nor can Christians engage in social work. Christianity in Bhutan remains confined to the homes of local believers, where they meet for collective worship on Sundays.

Asked if a Christian federation should be registered by the government to allow Christians to function with legal recognition, Thinley said, “Yes, definitely.”

The country’s agency regulating religious organizations under the 2007 act, locally known as the Chhoedey Lhentshog, is expected to make a decision on whether it could register a Christian federation representing all Christians. The authority is looking into provisions in the law to see if there is a scope for a non-Buddhist and non-Hindu organization to be registered. (See http://www.compassdirect.com, “Official Recognition Eludes Christian Groups in Bhutan,” Feb. 1.)

On whether the Religious Organisations Act could be amended if it is determined that it does not allow legal recognition of a Christian federation, the prime minister said, “If the majority view and support prevails in the country, the law will change.”

Thinley added that he was partially raised as a Christian.

“I am part Christian, too,” he said. “I read the Bible, occasionally of course. I come from a traditional [Christian] school and attended church every day except for Saturdays for nine years.”

A tiny nation in the Himalayas between India and China, Bhutan has a population of 708,484 people, of which roughly 75 percent are Buddhist, according to Operation World. Christians are estimated to be between 6,000 to nearly 15,000 (the latter figure would put Christians at more than 2 percent of the population), mostly from the south. Hindus, mainly ethnic Nepalese, constitute around 22 percent of the population and have a majority in the south.

 

Religious ‘Competition’

Bhutan’s opposition leader, Lyonpo Tshering Togbay, was equally disapproving of religious conversion.

“I am for propagation of spiritual values or anything that allows people to be good human beings,” he told Compass. “[But] we cannot have competition among religions in Bhutan.”

He said, however, that Christians must be given rights equal to those of Hindus and Buddhists.

“Our constitution guarantees the right to freedom of practice – full stop, no conditions,” he said. “But now, as a small nation state, there are some realities. Christianity is a lot more evangelistic than Hinduism or Buddhism.”

Togbay said there are Christians who are tolerant and compassionate of other peoples, cultures and religions, but “there are Christians also who go through life on war footing to save every soul. That’s their calling, and it’s good for them, except that in Bhutan we do not have the numbers to accommodate such zeal.”

Being a small nation between India and China, Bhutan’s perceived geopolitical vulnerability leads authorities to seek to pre-empt any religious, social or political unrest. With no economic or military might, Bhutan seeks to assert and celebrate its sovereignty through its distinctive culture, which is based on Buddhism, authorities say.

Togbay voiced his concern on perceived threats to Bhutan’s Buddhist culture.

“I studied in a Christian school, and I have lived in the West, and I have been approached by the Jehovah’s Witness – in a subway, in an elevator, in a restaurant in the U.S. and Switzerland. I am not saying they are bad. But I would be a fool if I was not concerned about that in Bhutan,” he said. “There are other things I am personally concerned about. Religions in Bhutan must live in harmony. Too often I have come across people who seek a convert, pointing to statues of our deities and saying
that idol worship is evil worship. That is not good for the security of our country, the harmony of our country and the pursuit of happiness.”

The premise of the Chhoedey Lhentshog, the agency regulating religious organizations, he said, “is that all the different schools of Buddhism and all the different religions see eye to eye with mutual respect and mutual understanding. If that objective is not met, it does not make sense to be part of that.”

It remains unclear what the legal rights of Christians are, as there is no interaction between the Christians and the government. Christian sources in Bhutan said they were open to dialogue with the government in order to remove “misunderstandings” and “distrust.”

“Thankfully, our political leadership is sincere and trustworthy,” said one Christian leader.

Asserting that Christians enjoy the right to worship in Bhutan, Prime Minister Thinley said authorities have not interfered with any worship services.

“There are more Christian activities taking place on a daily basis than Hindu and Buddhist activities,” he added.

Report from Compass Direct News
http://www.compassdirect.org

Turkey Arrests 20 Allegedly Linked to Malatya Murders

Suspects in Ergenekon network long sought in homicide case to be questioned.

ISTANBUL, March 18 (CDN) — In simultaneous operations in nine different provinces of Turkey, authorities yesterday arrested 20 people suspected of playing a role in the murder of three Christians in Malatya in 2007, according to local news reports.

Zekeriya Oz, chief prosecutor overseeing the investigation into a clandestine network known as Ergenekon allegedly aimed at destabilizing the government, ordered the arrests based on information that linked the suspects to both the network and to the Malatya murders, Turkish press reported after Istanbul Chief of Police Chief Huseyin Capkin announced the sweep at a press conference yesterday.

“This was an operation related to the Malatya Zirve publishing house murders,” Capkin said, according to online news agency Malatya Guncel. “They were just arrested. This is connected to the Zirve publishing house. That’s the framework.”

Those apprehended include Ruhi Abat, a Muslim theology professor from Malatya Inonu University, Mehmet Ulger, a retired commander of the Malatya Gendarmerie in service at the time of the murders, and other members of the military. Oz will question the suspects in Istanbul, according to reports.

Police also raided the guesthouse of the Izmir Gendarmerie, seizing computers and documents. News sources listed Malatya, Siirt, Mugla, Mersin and Izmir as some of the cities in which authorities conducted raids and arrests.

A plaintiff attorney in the Malatya murder case, Orhan Kemal Cengiz, told Compass that the names on the list of those arrested were suspects he and his colleagues have been trying to convince the Malatya prosecutor to pursue since the court received a tip in May 2008.

“They are all the usual suspects,” Cengiz said. “All their names were mentioned in the first informant letter. Unfortunately, despite all our efforts, we couldn’t find anyone to investigate these allegations.”

The letter was the first of many informant letters the Malatya court has received since it started hearing the case on Nov. 22, 2007. Penned by someone who identified himself by the pseudonym “Ali Arslan” but unsigned, the letter claimed that Ulger incited Emre Gunaydin, one of the suspects, to carry out the murders and that he communicated with Gunaydin through Abat and two gendarmerie officers, reported Turkish English daily Today’s Zaman.

Cengiz said that, though it was the duty of the Malatya prosecutor to pursue leads in the informant letter, the prosecutor deferred the investigation to the military court, which in turn refused to investigate, claiming that the name on the letter was fake and the letter was not signed.

“It was like a joke,” Cengiz said.

On April 18, 2007, two Turkish Christians, Necati Aydin and Ugur Yuksel, and German Christian Tilmann Geske, were bound, tortured and then murdered at the office of Zirve Publishing Co., a Christian publishing house in Malatya. The suspects, Salih Guler, Cuma Ozdemir, Hamit Ceker, and Abuzer Yildirim, were arrested while trying to escape the scene of the crime, as was alleged ringleader Gunaydin.

From the beginning of the court hearings, plaintiff lawyers have brought evidence to the court showing the five young suspects were connected to a wider plot to kill the three Christians as well as other key Christian leaders across Turkey. Known as the Cage Plan, the plot is believed to be part of the alleged Ergenekon “deep state” operation to destabilize the government.

The Cage Plan centers on a compact disc found in 2009 in the house of a retired naval officer. The plan, to be carried out by 41 naval officers, termed as “operations” the Malatya killings, the 2006 assassination of Catholic priest Andrea Santoro and the 2007 slaying of Hrant Dink, Armenian editor-in-chief of the weekly Agos.

Cengiz told Compass that new evidence in the Ergenekon case might have convinced Oz to pursue those detained yesterday, and he called the move “a very big step” in shedding light on the Malatya case. He and colleague Erdal Dogan said their efforts – especially a request they sent to Oz on Jan. 18, 2010 asking him to investigate the allegations that Ergenekon members were behind the Malatya murders – surely helped to move the process along.

“I believe our efforts had a very big influence on this,” Cengiz said. “We submitted a petition and requested this from Oz last year. He is acting with the Malatya prosecutor on this.”

At the request of the Istanbul Chief Prosecutor’s Office, the Istanbul Police Department prepared a report last year revealing links between the Malatya murders and Ergenekon, according to Today’s Zaman. According to the report, Sevgi Erenerol, spokesperson for a bogus ultranationalist association known as the Turkish Orthodox Church, described foreign missionary activity as “spying” and “provoking.”

“A piece of evidence in the report was a conference on missionary activity given by Sevgi Erenerol … at the General Staff’s Strategic Research and Study Center,” reported Today’s Zaman.

Erenerol was arrested in connection with Ergenekon in 2008. Her suspected links with those thought to have masterminded the Zirve murders may have influenced yesterday’s arrests, Today’s Zaman reported.

She is also believed to be one of the key people behind false accusations against two members of Turkey’s Protestant Church, Hakan Tastan and Turan Topal, who were arrested in October 2006 for insulting Turkishness and Islam because they openly shared their faith.

After four years of legal battle, a judge finally acquitted the two Christians of insulting Turkey and its people by spreading Christianity, but not without slapping them with a hefty fine for a spurious charge. The two men are in the process of appealing the fine.

The Turkish Constitution grants all citizens the right to speak about their faith.

Plaintiff attorneys in the Malatya murders case said they believe yesterday’s arrests bring them closer to their requests that the Malatya murders case file be joined to that of the Ergenekon trial.

“From now on, we can predict it is very possible that our case will be sent to Istanbul soon and that these two cases will be merged,” said Cengiz.

The next Malatya hearing is scheduled for April 29.

Report from Compass Direct News
http://www.compassdirect.org

Christians in Turkey Face Harassment; Murder Trial Stalls

Departure of presiding judge in Malatya case could further delay justice, attorneys fear.

ISTANBUL, March 15 (CDN) — Though the horrific scale of the 2007 Malatya murders has not been repeated in Turkey’s Protestant church, a recent report shows harassment continues to be a daily problem for the country’s Christians and churches.

Discrimination, slander and attacks against churches were among the examples of ongoing harassment that the Turkish Association of Protestant Churches (TEK) recorded in 2010.

In an eight-page report published earlier this year, TEK’s Committee for Religious Freedom and Legal Affairs outlined problems Protestants face. Turkish laws and “negative attitudes of civil servants” continue to make it nearly impossible for non-Muslims to establish places of worship, the committee reported. Three churches faced legal problems last year regarding their buildings, according to the report.

Missionary activities are still considered a national threat despite the existence of Turkish laws guaranteeing citizens the freedom to propagate and teach their faith, and children are victims of discrimination at school, according to the report. Though the Religious Education General Directorate for Higher Education and Training Committee allows non-Muslim students to stay out of religious classes, parents have reported cases in which they were not able to take their children out of such
courses.

“After four years [since the Malatya murders], Turkey’s religious freedoms have not improved as desired,” said attorney Erdal Dogan. “Christians, Alevis [a Shiite sub-community] and people of other beliefs are still not protected by law. And people of other faiths apart from Muslims have no legal status. Since racism is still prevalent in the context of freedom, discrimination in its turn has become a fact of life.”   

About a third of Turks are estimated to be Alevis.

Turkey rose to 30th place in Open Doors’ 2011 World Watch List of nations in which persecution against Christians takes place, up from 35th place the previous year. The Christian support organization cited deteriorating conditions as the secular country applied some laws in discriminatory ways against Christians.

TEK estimates that there are up to 3,500 Protestant Christians in Turkey.

 

Malatya Trial Stalled

In the trial of the five primary suspects in the murder of three Christians in Malatya, plaintiff attorneys fear the departure of one of the three judges to a Supreme Court of Appeals post in Ankara could further stall the nearly four-year-old case.

The loss of Judge Eray Gurtekin, who had presided over the case since it began on Nov. 22, 2007, could threaten to set back the progress of the court that has been examining links between the killers and alleged masterminds, according to Dogan, a plaintiff attorney in the case. Gurtekin was appointed as a judge in the Supreme Court of Appeals in Turkey’s capital Ankara last month.

“In a three-member panel [of judges], the change of one is not really helpful,” said Dogan, “because just as the previous presiding judge had started to understand and pay close attention to the case file, a new judge came in his place. I hope he will catch on quickly.”

The new judge joined the Malatya hearings panel this month, and Dogan said there could be more changes in the panel.

The 12th Istanbul High Criminal Court is expected to hear the testimony of another witness on March 29, and the court is trying to locate two more witnesses in order to shed light on the Malatya murders.

On April 18, 2007, two Turkish Christians, Necati Aydin and Ugur Yuksel, and German Christian Tilmann Geske, were bound, tortured and then murdered at the office of Zirve Publishing Co., a Christian publishing house in Malatya. The suspects, Salih Guler, Cuma Ozdemir, Hamit Ceker, and Abuzer Yildirim, were arrested while trying to escape the scene of the crime, as was alleged ringleader Emre Gunaydin.

From the beginning of the court hearings, prosecuting lawyers have brought evidence to the court showing the five young suspects were connected to a wider plot to kill the three Christians as well as other key Christian leaders across Turkey. Known as the Cage Plan, the plot is believed to be part of the alleged Ergenekon “deep state” operation to destabilize the government.

The Cage Plan centers on a compact disc found in 2009 in the house of a retired naval officer. The plan, to be carried out by 41 naval officers, termed as “operations” the Malatya killings, the 2006 assassination of Catholic priest Andrea Santoro and the 2007 slaying of Hrant Dink, Armenian editor-in-chief of the weekly Agos.

Questioned by the judges, Varol Bulent Aral – suspected of being one of the people who planned the murders and linked the killers to the masterminds – said he wanted the court to find out who was supporting the Zirve Publishing Co. He added a cryptic remark to Tilmann Geske’s widow, Suzanne Geske, who continues to live in Malatya with her three children and regularly attends the murder hearings.

“I want to ask Suzanne, what business does a German have here?”

The judges finally threw Aral out of the courtroom for contempt of court when he told the judges: “You are in the clouds!”

Prosecuting lawyers still hope judges will join the Malatya case files to the Cage Plan case, which is being tried at an Istanbul court.

The threat of violence against Christians continues. Last week Turkish news sources reported that Istanbul police arrested two suspects, ages 17 and 18, accused of plotting to assassinate a priest on the European side of the city. The Istanbul Public Prosecutor’s Office is examining their case.

Report from Compass Direct News
http://www.compassdirect.org