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.




Read more:
As India’s COVID crisis worsens, leaders play the blame game while the poor suffer once again


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.




Read more:
What’s the new coronavirus variant in India and how should it change their COVID response?


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.




Read more:
‘How will we eat’? India’s coronavirus lockdown threatens millions with severe hardship


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.The Conversation

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.

Early exposure to infections doesn’t protect against allergies, but getting into nature might



Katya Shut/Shutterstock

Emily Johnston Flies, University of Tasmania and Philip Weinstein, University of Adelaide

Over the past few decades, allergies and asthma have become common childhood diseases, especially in developed countries. Almost 20% of Australians experience some kind of allergy, whether it’s to food, pollen, dust, housemites, mould or animals.

When people suffer from food allergies, hay fever or asthma, their immune system incorrectly believes the trigger substances are harmful and mounts a defence.

The response can range from mild symptoms, such as sneezing and a blocked nose (in the case of hay fever), to anaphylaxis (from severe food allergies or bee stings) and asthma attacks.




Read more:
What are allergies and why are we getting more of them?


We used to think the rise in allergic conditions was because we weren’t exposed to as many early infections as previous generations. But the science suggests that’s not the case.

However it seems being out in nature, and exposed to diverse (but not disease-causing) bacteria, fungi and other microorganisms may help protect against asthma and allergies.

Remind me, what’s the hygiene hypothesis?

In 1989, researcher David Strachan examined allergy patterns in more than 17,000 children in England. He noticed young siblings in large families were less likely to have hay fever than older siblings or children from small families.

He proposed that these younger siblings were exposed to more childhood illness at a younger age, as more bugs were circulating in these large families and the younger children were less likely to wash their hands and practise good hygiene.

Greater exposure to these childhood infections helped “train” their immune systems not to overreact to harmless things like pollen.

Strachan coined the term “hygiene hypothesis” to explain this phenomenon, and the idea has been appealing to our dirty side ever since.

Yes, it’s a good idea for kids to wash their hands regularly to avoid getting sick.
Wor Sang Jun/Shutterstock

Strachan wasn’t the first to notice exposure to “dirty environments” seemed to prevent allergic disease. A century earlier, in 1873, Charles Blackley noted hay fever was a disease of the “educated class”, and rarely occurred in farmers or people living in less sanitary conditions.

Ditching the hygiene hypothesis

However, Blackley and Strachan were wrong about one important thing: the association between sanitation and allergies is not due to reduced exposure to early childhood infections (or “pathogens”).

Large studies from Denmark, Finland, and the United Kingdom have found no association between the number of viral infections during childhood and allergic disease. In other words, exposure to disease-causing pathogens doesn’t appear to prevent allergies.

In fact, exposure to childhood viral infections, in addition to making a child sick, may contribute to the development of asthma in predisposed children.




Read more:
What causes asthma? What we know, don’t know and suspect


Many researchers now argue the term “hygiene hypothesis” is not only inaccurate but potentially dangerous, because it suggests avoiding infection is a bad thing. It’s not.

Good hygiene practices, such as hand washing, are critical for reducing the spread of infectious and potentially deadly diseases such as influenza and the Wuhan coronavirus.

What about ‘good’ exposure to bacteria?

For healthy immune function, we need exposure to a diverse range of bacteria, fungi and other bugs – known as microbes – in the environment that don’t make us sick.

We need exposure to a range of organisms found in nature.
caseyjadew/Shutterstock



Read more:
Essays on health: microbes aren’t the enemy, they’re a big part of who we are


Within urban environments, recent research shows people who live closer to green, biodiverse ecosystems tend to be healthier, with less high blood pressure and lower rates of diabetes and premature death, among other things.

More specifically, research has found growing up on a farm or near forests, with exposure to more biodiverse ecosystems, reduces the likelihood of developing asthma and other allergies.




Read more:
Children living in green neighbourhoods are less likely to develop asthma


This is potentially because exposure to a diversity of organisms, with a lower proportion of human pathogens, has “trained” the immune system not to overreact to harmless proteins in pollen, peanuts and other allergy triggers.

How can we get more ‘good’ exposure?

We can try to expose children to environments more like the ones in which humans, and our immune systems, evolved.

Most obviously, children need to have exposure to green space. Playing outdoors, having a garden, or living near green space (especially near a diverse range of native flowering plants) is likely to expose them to more diverse microbes and provide greater protection from allergic diseases.

Infants who are breastfed tend to have more diverse gut microbiomes (a larger variety of bacteria, fungi and other microscopic organisms that live in the gut), which makes them less likely to develop allergic diseases in childhood.




Read more:
Gut instinct: how the way you’re born and fed affect your immune system


Having a varied diet that includes fresh and fermented foods can help cultivate a healthy gut microbiome and reduce allergic disease. As can using antibiotics only when necessary, as they kill off good bacteria as well as the bad.

So keep washing your hands, especially in cities and airports, but don’t be afraid of getting a little dirty in biodiverse environments.

This article was co-authored by Chris Skelly, International Programme Director, Healthy Urban Microbiomes Initiative and Head of Programmes (Research and Intelligence), Public Health Dorset.The Conversation

Emily Johnston Flies, Postdoctoral Research Fellow (U.Tasmania), University of Tasmania and Philip Weinstein, Professorial Research Fellow, University of Adelaide

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

1 in 10 patients are infected in hospital, and it’s not always with what you think


Drips and other medical devices were potential sources of infection. But no-one expected to find hospital-acquired pneumonia and urinary tract infections.
from www.shutterstock.com

Philip Russo, Monash University and Brett Mitchell, University of Newcastle

Most people expect hospital treatment to make them better. But for some, a stay in hospital can actually make them sicker. Their wound might get infected after an operation or they might get a blood infection as a result of a medical procedure.

Our study, published today in the international journal Antimicrobial Resistance and Infection Control, found one in ten adult patients in hospital with an acute (short-term) condition had a health care associated infection.

In the first study of its kind in Australia for over 30 years, we also uncovered unexpected infections, like pneumonia and urinary tract infections, as well as high numbers of patients with multi-drug resistant organisms (superbugs).




Read more:
Infections, complications and safety breaches: why patients need better data on how hospitals compare


Why do we need to keep track of infections?

Most of these infections can be prevented. So it is important to know what type of infections they are, how common they are and which patients get them. Once we have this information, we can work out a way to prevent them.

Left unchecked, these infections can make already sick patients sicker, can divert hospital resources unnecessarily, and can kill.

Most hospitals in Australia have ongoing surveillance for specific infections, such as wound and bloodstream infections.

Some states have well coordinated programs like the Victorian program VICNISS, leading to detailed data on health care associated infections. This data is then used to inform hospital strategies on how to prevent infections. However, this type of surveillance method requires extensive resources and does not capture all infections that occur in a hospital.

Instead, we conducted a “point prevalence” survey, which takes a snapshot of the current situation on any given day. This is less resource intensive than ongoing surveillance and it provides valuable information on the distribution and occurrence of all infections in a hospital.




Read more:
Some private hospitals are safer than others, but we don’t know which


In Europe, the European Centre for Disease Prevention and Control co-ordinates national point prevalence studies every four years. These have provided valuable insight into the burden of health care associated infections. They have also been used to track the emergence of multi-drug resistant organisms in Europe. The US, Singapore and many other countries also run them.

Most hospital infections can be prevented.
Santypan/Shutterstock

Unlike most OECD countries, Australia does not have a national health care associated infection surveillance program and does not undertake national point prevalence studies.

The only national data routinely collected relates to bloodstream infections caused by the microorganism Staphylococcus aureus. These infections are serious but rare and only represent a tiny fraction of all infections in hospitals.




Read more:
Golden staph: the deadly bug that wreaks havoc in hospitals


To improve our understanding of health care associated infections across Australia, we used the same study method as the Europeans. Over a four month period in 2018, we visited 19 large hospitals across Australia and collected information on all infections in adult acute inpatients. Four of the hospitals were regional, the others major city hospitals.

What infections did we find?

Of the 2,767 patients we surveyed, we found 363 infections in 273 patients, meaning some patients had more than one infection. The most common infections were wound infections after surgery (surgical site infections), pneumonia and urinary tract infections. These accounted for 64% of all the infections we found.

This is important as most hospitals do not normally look for pneumonia or urinary tract infections and there is no routine statewide or national surveillance for these.

Our findings mean these infections are commonly occurring but undetected. A potential source of information on these types of infections is hospital administrative coding data. However, these codes were mainly designed for billing purposes and have been shown to be unreliable when it comes to identifying infections.




Read more:
We know _why_ bacteria become resistant to antibiotics, but _how_ does this actually happen?


We also found patients with a medical device, such as a large intravenous drip, or urinary catheter (a flexible tube inserted into the bladder to empty it of urine), were more likely to have an infection than those who did not.

Intensive care units treat patients who are gravely unwell and at greater risk of infection. So it was unsurprising to find that 25% of patients in intensive care units had a health care associated infection.

The emergence of multi-drug resistant organisms (superbugs) is a concern worldwide. Previously unknown, our study revealed that 10% of the adult acute inpatients in our study had a multi-drug resistant organism.

What have other studies found?

For the first time in 34 years we have a glimpse of how common health care associated infections are in Australian hospitals. Although the only other previous study was larger, a major strength of our study is that we used the same two trained data collectors to collect the data from all hospitals.

This reduced the potential inconsistency in finding infections that might occur if hospital staff collected their own data. It also minimised the use of hospital resources to undertake the survey.

Importantly though, we did not survey all types of hospitals. It is possible that if the same survey was extended to include children, babies and cancer hospitals, higher rates of infection may be found given the vulnerability of these patients.

What can we do better?

As one of the authors has previously noted, a major gap in Australia’s effort to combat health care associated infections, and the emergence of multi-drug resistance organisms, is the lack of robust national data.

This means we cannot measure the effect of national policy or guidelines despite significant investment.

In the absence of a national surveillance program, we recommend that large-scale point prevalence surveys, including smaller hospitals, specialist hospitals and the private sector be undertaken regularly. Data generated from these studies could then be used to inform and drive national infection prevention initiatives.The Conversation

Philip Russo, Associate Professor, Director Cabrini Monash University Department of Nursing Research, Monash University and Brett Mitchell, Professor of Nursing, University of Newcastle

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

Lao Officials to Expel More Christian Families from Village


Katin chief says previously expelled Christians will be shot if they return.

DUBLIN, November 9 (CDN) — Officials in Katin village, southern Laos have ordered six more Christian families to renounce their faith or face expulsion in early January, advocacy group Human Rights Watch for Lao Religious Freedom (HRWLRF) reported today (Nov. 9).

The Katin chief and the village religious affairs officer, along with local security forces, recently approached the six families with the threat after having expelled 11 Christian families, totaling 48 people, at gunpoint last January. The six families now under threat had become Christians since the January expulsion.

The eviction last January followed months of threats and harassment, including the confiscation of livestock and other property, the detention of 80 men, women and children in a school compound and the death by asphyxiation of a Christian villager. (See http://www.compassdirect.org, “Lao officials Force Christians from Worship at Gunpoint,” Feb. 8.)

Immediately after the expulsion, two more families in Katin village became Christians despite the obvious risk to their personal safety, according to HRWLRF. The village chief allowed them to remain in Katin but warned all villagers that their own homes would be “torn down” if they made contact with the expelled Christians.

In the following months, the expelled villagers suffered from a lack of adequate shelter, food and water, leading to eye and skin infections, diarrhea, dehydration and even the death of one villager. Katin authorities also denied Christian children access to the village school. (See http://www.compassdirect.org, “Christians Expelled from Village Suffer Critical Illnesses,” May 14.)

District officials in early May gave the Christians permission to return to Katin and take rice from their family barns to prevent starvation, said another source on condition of anonymity. Some families then tried to cultivate their rice fields to avoid losing them completely, but the work was extremely difficult as authorities had confiscated their buffaloes, essential to agriculture in Laos.

 

Threat to Shoot

In July, officials from the Saravan provincial headquarters and the Ta-oyl district religious affairs office met with the evicted families in their shelters at the edge of the jungle and encouraged them to return to Katin, HRWLRF said.

The Christians agreed to return under five conditions: that authorities designate a Christian “zone” within Katin to avoid conflict with non-believers; that all forms of persecution end; that their children return to school; that Christians must be granted the right of burial in the village cemetery; and that the village award compensation for six homes destroyed in the January eviction.

When higher-level officials approached Katin leaders with these terms, village officials and local residents rejected them, insisting that they would only allow the Christians to return if they gave up their faith. The higher officials invoked Decree 92, a law guaranteeing the rights of religious minorities, but village heads said they would shoot every Christian who returned to Katin.

Shortly after this discussion took place, a further four families in Katin became Christians, according to HRWLRF.

A communist country, Laos is 1.5 percent Christian and 67 percent Buddhist, with the remainder unspecified. Article 6 and Article 30 of the Lao Constitution guarantee the right of Christians and other religious minorities to practice the religion of their choice without discrimination or penalty.

Report from Compass Direct News

Egyptian Couple Shot by Muslim Extremists Undaunted in Ministry


Left for dead, Christians offer to drop charges if allowed to construct church building.

CAIRO, Egypt, June 9 (CDN) — Rasha Samir was sure her husband, Ephraim Shehata, was dead.

He was covered with blood, had two bullets inside him and was lying facedown in the dust of a dirt road. Samir was lying on top of him doing her best to shelter him from the onslaught of approaching gunmen.

With arms outstretched, the men surrounded Samir and Shehata and pumped off round after round at the couple. Seconds before, Samir could hear her husband mumbling Bible verses. But one bullet had pierced his neck, and now he wasn’t moving. In a blind terror, Samir tried desperately to stop her panicked breathing and convincingly lie still, hoping the gunmen would go away.

Finally, the gunfire stopped and one of the men spoke. “Let’s go. They’re dead.”

 

‘Break the Hearts’

On the afternoon of Feb. 27, lay pastor Shehata and his wife Samir were ambushed on a desolate street by a group of Islamic gunmen outside the village of Teleda in Upper Egypt.

The attack was meant to “break the hearts of the Christians” in the area, Samir said.

The attackers shot Shehata twice, once in the stomach through the back, and once in the neck. They shot Samir in the arm. Both survived the attack, but Shehata is still in the midst of a difficult recovery. The shooters have since been arrested and are in jail awaiting trial. A trial cannot begin until Shehata has recovered enough to attend court proceedings.

Despite this trauma, being left with debilitating injuries, more than 85,000 Egyptian pounds (US$14,855) in medical bills and possible long-term unemployment, Shehata is willing to drop all criminal charges against his attackers – and avoid what could be a very embarrassing trial for the nation – if the government will stop blocking Shehata from constructing a church building.

Before Shehata was shot, one of the attackers pushed him off his motorcycle and told him he was going to teach him a lesson about “running around” or being an active Christian.

Because of his ministry, the 34-year-old Shehata, a Coptic Orthodox Christian, was arguably the most visible Christian in his community. When he wasn’t working as a lab technician or attending legal classes at a local college, he was going door-to-door among Christians to encourage them in any way he could. He also ran a community center and medical clinic out of a converted two-bedroom apartment. His main goal, he said, was to “help Christians be strong in their faith.”

The center, open now for five years, provided much-needed basic medical services for surrounding residents for free, irrespective of their religion. The center also provided sewing training and a worksite for Christian women so they could gain extra income. Before the center was open in its present location, he ran similar services out of a relative’s apartment.

“We teach them something that can help them with the future, and when they get married they can have some way to work and it will help them get money for their families,” Shehata said.

Additionally, the center was used to teach hygiene and sanitation basics to area residents, a vital service to a community that uses well water that is often polluted or full of diseases. Along with these services, Shehata and his wife ran several development projects, repairing the roofs of shelters for poor people, installing plumbing, toilets and electrical systems. The center also distributed free food to the elderly and the infirm.

The center has been run by donations and nominal fees used to pay the rent for the apartment. Shehata has continued to run the programs as aggressively as he can, but he said that even before the shooting that the center was barely scraping by.

“We have no money to build or improve anything,” he said. “We have a safe, but no money to put in it.”

 

Tense Atmosphere

In the weeks before the shooting, Teleda and the surrounding villages were gripped with fear.

Christians in the community had been receiving death threats by phone after a Muslim man died during an attack on a Christian couple. On Feb. 2, a group of men in nearby Samalout tried to abduct a Coptic woman from a three-wheeled motorcycle her husband was driving. The husband, Zarif Elia, punched one of the attackers in the nose. The Muslim, Basem Abul-Eid, dropped dead on the spot.

Elia was arrested and charged with murder. An autopsy later revealed that the man died of a heart attack, but local Muslims were incensed.

Already in the spotlight for his ministry activities, Shehata heightened his profile when he warned government officials that Christians were going to be attacked, as they had been in Farshout and Nag Hammadi the previous month. He also gave an interview to a human rights activist that was posted on numerous Coptic websites. Because of this, government troops were deployed to the town, and extremists were unable to take revenge on local Christians – but only after almost the
entire Christian community was placed under house arrest.

“They chose me,” Shehata said, “Because they thought I was the one serving everybody, and I was the one who wrote the government telling them that Muslims were going to set fire to the Christian houses because of the death.”

Because of his busy schedule, Shehata and Samir, 27, were only able to spend Fridays and part of every Saturday together in a village in Samalut, where Shehata lives. Every Saturday after seeing Samir, Shehata would drive her back through Teleda to the village where she lives, close to her family. Samalut is a town approximately 105 kilometers (65 miles) south of Cairo.

On the afternoon of Feb. 27, Shehata and his wife were on a motorcycle on a desolate stretch of hard-packed dirt road. Other than a few scattered farming structures, there was nothing near the road but the Nile River on one side, and open fields dotted with palm trees on the other.

Shehata approached a torn-up section of the road and slowed down. A man walked up to the vehicle carrying a big wooden stick and forced him to stop. Shehata asked the man what was wrong, but he only pushed Shehata off the motorcycle and told him, “I’m going to stop you from running around,” Samir recounted.

Shehata asked the man to let Samir go. “Whatever you are going to do, do it to me,” he told the man.

The man didn’t listen and began hitting Shehata on the leg with the stick. As Shehata stumbled, Samir screamed for the man to leave them alone. The man lifted the stick again, clubbed Shehata once more on the leg and knocked him to the ground. As Shehata struggled to get up, the man took out a pistol, leveled it at Shehata’s back and squeezed the trigger.

Samir started praying and screaming Jesus’ name. The man turned toward her, raised the pistol once more, squeezed off another round, and shot Samir in the arm. Samir looked around and saw a few men running toward her, but her heart sank when she realized they had come not to help them but to join the assault.

Samir jumped on top of Shehata, rolled on to her back and started begging her attackers for their lives, but the men, now four in all, kept firing. Bullets were flying everywhere.

“I was scared. I thought I was going to die and that the angels were going to come and get our spirits,” Samir said. “I started praying, ‘Please God, forgive me, I’m a sinner and I am going to die.’”

Samir decided to play dead. She leaned back toward her husband, closed her eyes, went limp and tried to stop breathing. She said she felt that Shehata was dying underneath her.

“I could hear him saying some of the Scriptures, the one about the righteous thief [saying] ‘Remember me when you enter Paradise,’” she said. “Then a bullet went through his neck, and he stopped saying anything.”

Samir has no way of knowing how much time passed, but eventually the firing stopped. After she heard one of the shooters say, “Let’s go, they’re dead,” moments later she opened her eyes and the men were gone. When she lifted her head, she heard her husband moan.

 

Unlikely Survival

When Shehata arrived at the hospital, his doctors didn’t think he would survive. He had lost a tremendous amount of blood, a bullet had split his kidney in two, and the other bullet was lodged in his neck, leaving him partially paralyzed.

His heartbeat was so faint it couldn’t be detected. He was also riddled with a seemingly limitless supply of bullet fragments throughout his body.

Samir, though seriously injured, had fared much better than Shehata. The bullet went into her arm but otherwise left her uninjured. When she was shot, Samir was wearing a maternity coat. She wasn’t pregnant, but the couple had bought the coat in hopes she soon would be. Samir said she thinks the gunman who shot her thought he had hit her body, instead of just her arm.

The church leadership in Samalut was quickly informed about the shooting and summoned the best doctors they could, who quickly traveled to help Shehata and Samir. By chance, the hospital had a large supply of blood matching Shehata’s blood type because of an elective surgical procedure that was cancelled. The bullets were removed, and his kidney was repaired. The doctors however, were forced to leave many of the bullet fragments in Shehata’s body.

As difficult as it was to piece Shehata’s broken body back together, it paled in comparison with the recovery he had to suffer through. He endured multiple surgeries and was near death several times during his 70 days of hospitalization.

Early on, Shehata was struck with a massive infection. Also, because part of his internal tissue was cut off from its blood supply, it literally started to rot inside him. He began to swell and was in agony.

“I was screaming, and they brought the doctors,” Shehata said. The doctors decided to operate immediately.

When a surgeon removed one of the clamps holding Shehata’s abdomen together, the intense pressure popped off most of the other clamps. Surgeons removed some stomach tissue, part of his colon and more than a liter of infectious liquid.

Shehata could not eat normally and lost 35 kilograms (approximately 77 lbs.). He also couldn’t evacuate his bowels for at least 11 days, his wife said.

Despite the doctors’ best efforts, infections continued to rage through Shehata’s body, accompanied by alarming spikes in body temperature.

Eventually, doctors sent him to a hospital in Cairo, where he spent a week under treatment. A doctor there prescribed a different regimen of antibiotics that successfully fought the infection and returned Shehata’s body temperature to normal.

Shehata is recovering at home now, but he still has a host of medical problems. He has to take a massive amount of painkillers and is essentially bedridden. He cannot walk without assistance, is unable to move the fingers on his left hand and cannot eat solid food. In approximately two months he will undergo yet another surgery that, if all goes well, will allow him to use the bathroom normally.

“Even now I can’t walk properly, and I can’t lift my leg more than 10 or 20 centimeters. I need someone to help me just to pull up my underwear,” Shehata said. “I can move my arm, but I can’t move my fingers.”

Samir does not complain about her condition or that of Shehata. Instead, she sees the fact that she and her husband are even alive as a testament to God’s faithfulness. She said she thinks God allowed them to be struck with the bullets that injured them but pushed away the bullets that would have killed them.

“There were lots of bullets being shot, but they didn’t hit us, only three or four,” she said. “Where are the others?”

Even in the brutal process of recovery, Samir found cause for thanks. In the beginning, Shehata couldn’t move his left arm, but now he can. “Thank God and thank Jesus, it was His blessing to us,” Samir said. “We were kind of dead, now we are alive."

Still, Samir admits that sometimes her faith waivers. She is facing the possibility that Shehata might not work for some time, if ever. The couple owes the 85,000 Egyptian pounds (US$14,855) in medical bills, and continuing their ministry at the center and in the surrounding villages will be difficult at best.

“I am scared now, more so than during the shooting,” she said. “Ephraim said do not be afraid, it is supposed to make us stronger.”

So Samir prays for strength for her husband to heal and for patience. In the meantime, she said she looks forward to the day when the struggles from the shooting are over and she can look back and see how God used it to shape them.

“There is a great work the Lord is doing in our lives, we may not know what the reason is now, but maybe some day we will,” Samir said.

 

Government Opposition

For the past 10 years, Shehata has tried to erect a church building, or at a minimum a house, that he could use as a dedicated community center. But local Muslims and Egypt’s State Security Investigations (SSI) agency have blocked him every step of the way. He had, until the shooting happened, all but given up on constructing the church building.

On numerous occasions, Shehata has been stopped from holding group prayer meetings after people complained to the SSI. In one incident, a man paid by a land owner to watch a piece of property near the community center complained to the SSI that Shehata was holding prayer meetings at the facility. The SSI made Shehata sign papers stating he wouldn’t hold prayer meetings at the center.

At one time, Shehata had hoped to build a house to use as a community center on property that had been given to him for that purpose. Residents spread a rumor that he was actually erecting a church building, and police massed at the property to prevent him from doing any construction.

There is no church in the town where Shehata lives or in the surrounding villages. Shehata admits he would like to put up a church building on the donated property but says it is impossible, so he doesn’t even try.

In Egypt constructing or even repairing a church building can only be done after a complex government approval process. In effect, it makes it impossible to build a place for Christian worship. By comparison, the construction of mosques is encouraged through a system of subsidies.

“It is not allowed to build a church in Egypt,” Shehata said. “We can’t build a house. We can’t build a community center. And we can’t build a church.”

Because of this, Shehata and his wife organize transportation from surrounding villages to St. Mark’s Cathedral in Samalut for Friday services and sacraments. Because of the lack of transportation options, the congregants are forced to ride in a dozen open-top cattle cars.

“We take them not in proper cars or micro-buses, but trucks – the same trucks we use to move animals,” he said.

The trip is dangerous. A year ago a man fell out of one of the trucks onto the road and died. Shehata said bluntly that Christians are dying in Egypt because the government won’t allow them to construct church buildings.

“I feel upset about the man who died on the way going to church,” he said.

 

Church-for-Charges Swap

The shooters who attacked Shehata and Samir are in jail awaiting trial. The couple has identified each of the men, but even if they hadn’t, finding them for arrest was not a difficult task. The village the attackers came from erupted in celebration when they heard the pastor and his wife were dead.

Shehata now sees the shooting as a horrible incident that can be turned to the good of the believers he serves. He said he finds it particularly frustrating that numerous mosques have sprouted up in his community and surrounding areas during the 10 years he has been prevented from putting up a church building, or even a house. There are two mosques alone on the street of the man who died while being trucked to church services, he said.

Shehata has decided to forgo justice in pursuit of an opportunity to finally construct a church building. He has approached the SSI through church leaders, saying that if he is allowed to construct a church building, then he will take no part in the criminal prosecution of the shooters.

“I have told the security forces through the priests that I will drop the case if they can let us build the church on the piece of land,” he said.

The proposal isn’t without possibilities. His trial has the potential of being internationally embarrassing. It raises questions about fairness in Egyptian society during an upcoming presidential election that will be watched by the world.

Regardless of what happens, Shehata said all he wants is peace and for the rights of Christians to be respected. He said that in Egypt, Christians have less value than the “birds of the air” mentioned in the Bible. According to Luke 12:6, five sparrows sold for two pennies in ancient times.

“We are not to be killed like birds, slaughtered,” he said. “We are human.”

Report from Compass Direct News

Lao Christians Expelled from Village Suffer Critical Illnesses


One dead, two hospitalized; village chief threatens other residents.

DUBLIN, May 14 (CDN) — In spite of assurances of religious rights by officials in March, Lao Christians expelled from a village in Saravan Province in January are suffering from a prolonged lack of adequate food and clean water.

The lack of basic resources has led to diarrhea, dehydration, eye and skin infections, fainting and general weakness for the Christians expelled from Katin village, and one person has died, Human Rights Watch for Lao Religious Freedom (HRWLRF) reported.

A Christian who went by the single name of Ampheng died suddenly in April while praying for one of two other Christians who were hospitalized with illnesses caused by their living conditions, an HRWLRF spokesman told Compass. The exact cause and date of Ampheng’s death were not immediately known.

Expelled from their village at gunpoint on Jan. 18 for failing to renounce their faith, the 48 Christians were forced to build temporary shelters at the edge of the jungle, about six kilometers (nearly four miles) away from the village.

They have since survived on food found in the jungle and water from a hand-dug well that is unfit for cooking or drinking, sources told HRWLRF.

District officials in early May gave the Christians permission to return to Katin village and take rice from their family rice barns to prevent starvation, said another source on condition of anonymity.

In addition, some of the Christians have returned to tend their family rice fields, fearing that if the fields are completely abandoned they may lose the right to cultivate them next year. Water buffaloes essential for farm work, however, were confiscated in January along with the Christians’ homes and registration papers, according to HRWLRF.

When the Christians interred Ampheng at the local burial ground, district officials fined them for failing to produce the required proof of house registration, according to HRWLRF.

Katin’s village chief recently warned other residents that their personal possessions would be confiscated if they had any contact with the expelled Christians. If any family continued to maintain contact despite repeated warnings, their own homes would be torn down, the chief reportedly said.

Official reactions to the plight of the Christians have been mixed. In March, a delegation of provincial and district officials led by Gov. Khamboon Duangpanya visited the Christians at their jungle site and assured them of their legal right to embrace the faith of their choice and to live anywhere in the district.

Just days earlier, however, the district head, identified only as Bounma, summoned seven of the Christians to his office and said that he would not tolerate the existence of Christianity in areas under his control. (See “Lao Officials Visit Expelled Christians, Give Assurances,” March 19.)

High level officials failed to intervene last July when villagers seized a Christian identified only as Pew and poured rice wine down his throat, killing him by asphyxiation. Village officials later fined Pew’s family for erecting a cross on his grave, and then detained 80 Christians in a school compound, denying them food and pressuring them to renounce their faith.

The heads of 13 families then signed documents renouncing Christianity in order to protect their children, but most resumed attendance at worship meetings within a few months.

Provincial officials did call a meeting in September 2008 asking Katin authorities to respect Lao religious laws and allow the Christians freedom to worship, but their request was ignored.

A communist country, Laos is 1.5 percent Christian and 67 percent Buddhist, with the remainder unspecified. Article 6 and Article 30 of the Lao Constitution guarantees the right of Christians and other religious minorities to practice the religion of their choice without discrimination or penalty.

Report from Compass Direct News 

Two Evangelists in Ethiopia Released from Prison


Judge acquits Christians falsely accused of insulting Ethiopian Orthodox Church.

NAIROBI, Kenya, October 28 (CDN) — The latest in a series of false charges against two Ethiopian evangelists was put to rest on Friday (Oct. 23), and they were released.

A court in Debiretabor, Ethiopia acquitted the two evangelists of insulting the Ethiopian Orthodox Church (EOC) in prison, an accusation made by fellow inmates after the two were jailed on false charges of offering money for people to convert. The charge that the two Christians insulted the EOC was orchestrated by EOC members both inside and outside the prison, according to area church leaders.

Temesgen Alemayehu and Tigist Welde Amanuel had been sentenced to prison for six months on the false charge of offering money to people to convert but successfully appealed the punishment; after a lower court in Amhara state had thrown out their appeal on Sept. 21, the State Supreme Court in Bahir Dar ordered them to be to be released after paying a 500 birr (US$40) fine.

Before they could be released, however, inmates signed a petition raising the second charge against Alemayehu and Amanuel. On this charge of insulting the EOC while in prison, the judge rejected witnesses’ testimony as contradictory and of no value.

“Thank you to those who prayed for us,” Alemayehu said after his release, adding that he was eager to return to ministry.

“The enemy has tried to frustrate us and delay our freedom,” said Amanuel. “But through prayers and God’s intervention, we are now released from prison. We thank those who prayed on our behalf.”

Alemayehu and Amanuel, of Wengel Lealem church in Addis Ababa, had gone to Debiretabor, Amhara state in July to help establish a church.

“Temesgen and Tigist are extremely happy to again reunite with the church,” said a Christian source, adding that the two evangelists would return to Addis Ababa.

On July 22 they had appeared at district court in Debiretabor to hear charges against them that they were offering money and gifts to people to change their religion; Christian sources said witnesses falsely testified to that effect. Members of the EOC produced the false witnesses, the sources said.

Alemayehu and Amanuel were incarcerated for three months and six days.

They would have been released after their sentences were reduced to the fines, but on Oct. 7 the district prosecutor claimed they would not appear for the next court date, and the judge decided to keep them in prison. Church leaders in Debiretabor said Alemayehu was suffering from kidney infections and had sought permission to get treatment, but prison officials refused.

Debiretabor is the seat for the south Gondar Zone administration in Amhara state. As in the rest of Amhara, Debiretabor’s population is predominantly EOC with hostile attitudes towards evangelicals.

The two Christians’ arrests stemmed from a July 19 incident in which passersby began to question them as they were preaching on a roadside. Christian sources said a heated argument led to a group attack on the two evangelists, wounding Alemayehu. Amanuel sustained minor injuries, the sources said .

Christian sources said a group within the EOC called “Mahibere Kidusan” (“Fellowship of Saints”) had incited members to attack the two evangelists as they were proclaiming Christ. The increasingly powerful group’s purpose is to counter all reform movements within the EOC and shield the denomination from outside threats.

In some cases, the sources said, EOC priests have urged attacks against Christians, and government authorities influenced by Mahibere Kidusan have infringed on Christians’ rights.

Report from Compass Direct News 

Jailed Evangelists in Ethiopia Win Appeal but Remain in Prison


Ethiopian Orthodox Church members said to orchestrate new charge of ‘insulting’ church.

NAIROBI, Kenya, October 8 (CDN) — Two Christians in Ethiopia who had been sentenced to six months of prison on false charges of offering money to people to convert have successfully appealed their sentence, only to be kept in prison on a new charge.

After a lower court in Amhara state threw out their appeal on Sept. 21, the State Supreme Court in Bahir Dar last week ordered Temesgen Alemayehu and Tigist Welde Amanuel to be released after paying a 500 birr (US$40) fine each, Christian sources said. But the two Ethiopian evangelists are still in prison awaiting the result of a new charge that fellow inmates filed for allegedly insulting the Ethiopian Orthodox Church (EOC) while in prison.

Alemayehu and Amanuel, of Wengel Lealem church in Addis Ababa, had gone to Debiretabor, Amhara state in July to help establish a church. On July 22 they appeared at district court in Debiretabor to hear charges against them that they were offering money and gifts to people to change their religion; Christian sources said witnesses falsely testified to that effect.

Members of the EOC produced the false witnesses, the sources said. Alemayehu stated that his only sin was telling of his faith in Christ to interested persons and that he had a constitutional right to do so, but the judge sentenced him and Amanuel to six months of prison.

An appeal they filed at the high court in Debiretabor was thrown out, forcing them to appeal to a higher court (see “Prison Terms Upheld for Two Christians in Ethiopia,” Sept. 25).

Last week, the sources said, the regional State Supreme Court accepted their appeal, reducing the sentence to the fine and ordering their release after they paid it; the guilty verdict, however, remained.

Yesterday, as the evangelists were appearing before the court in Debiretabor regarding the decision of the Supreme Court in Bahir Dar, a new charge was brought against them, Christian sources said: Inmates had signed a petition asking the district prosecutor to prosecute them for insulting the EOC while in prison.

Church leaders in Debiretabor believe that the charge was orchestrated by EOC members both inside and outside the prison.

The judge set Oct. 14 for the two Christians to appear in court to answer to the new charge. At yesterday’s hearing the district prosecutor opposed the release of the two evangelists, claiming they would not appear for the next court date. The judge decided to keep them in prison at least until the Oct. 14 hearing.

The maneuver shattered the two Christians’ hopes of being released, church leaders said.

“We are asking for the continuation of prayers,” said one church leader who requested anonymity for security reasons. “We are thinking of reporting to the State’s Supreme Court in Bahir Dar and see what would be the next move.”

Church leaders in Debiretabor said the condition of the imprisoned Christians is worsening. Alemayehu was said to be suffering from kidney infections and sought permission to get treatment, but prison officials refused.

Debiretabor is the seat for the south Gondar Zone administration in Amhara state. As in the rest of Amhara, Debiretabor’s population is predominantly EOC with hostile attitudes towards evangelicals.

The two Christians’ arrests stemmed from a July 19 incident in which passersby began to question them as they were preaching on a roadside. Christian sources said a heated argument led to a group attack on the two evangelists, wounding Alemayehu. Amanuel sustained minor injuries, the sources said.

Christian sources said a group within the EOC called “Mahibere Kidusan” (“Fellowship of Saints”) had incited members to attack the two evangelists as they were proclaiming Christ. The increasingly powerful group’s purpose is to counter all reform movements within the EOC and shield the denomination from outside threats.

In some cases, the sources said, EOC priests have urged attacks against Christians, and government authorities influenced by Mahibere Kidusan have infringed on Christians’ rights.

Report from Compass Direct News