Diarrhoea, stomach ache and nausea: the many ways COVID-19 can affect your gut



Shutterstock

Vincent Ho, Western Sydney University

Media reports earlier this week described a Queensland nurse with stomach pains who went on to test positive for COVID-19.

Could stomach pains be another symptom of COVID-19? And if you have stomach pains, should you get tested?

Although we might think of COVID-19 as a respiratory disease, we know it involves the gut. In fact SARS-CoV-2, the virus that causes COVID-19, enters our cells by latching onto protein receptors called ACE2. And the greatest numbers of ACE2 receptors are in the cells that line the gut.

COVID-19 patients with gut symptoms are also more likely to develop severe disease. That’s partly because even after the virus has been cleared from the respiratory system, it can persist in the gut of some patients for several days. That leads to a high level of virus and longer-lasting disease.

We also suspect the virus can be transmitted via the faecal-oral route. In other words, the virus can be shed in someone’s poo, and then transmitted to someone else if they handle it and touch their mouth.




Read more:
We don’t know for sure if coronavirus can spread through poo, but it’s possible


What type of gut symptoms are we talking about?

A review of more than 25,000 COVID-19 patients found about 18% had gastrointestinal symptoms. The most common was diarrhoea followed by nausea and vomiting. Abdominal pain was considered rare. In another study only about 2% of COVID-19 patients had abdominal pain.

Some people believe COVID-19 causes abdominal pain through inflammation of the nerves of the gut. This is a similar way to how gastroenteritis (gastro) causes abdominal pain.

Another explanation for the pain is that COVID-19 can lead to a sudden loss of blood supply to abdominal organs, such as the kidneys, resulting in tissue death (infarction).

Are gut symptoms recognised?

The US Centers for Disease Control has added diarrhoea, nausea and vomiting to its list of recognised COVID-19 symptoms.

However, the World Health Organisation still only lists diarrhoea as a gastrointestinal COVID-19 symptom.

In Australia, nausea, diarrhoea and vomiting are listed as other COVID-19 symptoms, alongside the classic ones (which include fever, cough, sore throat and shortness of breath). But abdominal pain is not listed.

Advice about symptoms that warrant testing may vary across states and territories.

How likely is it?

Doctors often use the concept of pre-test probability when working out if someone has a particular disease. This is the chance a person has the disease before we know the test result.

What makes it difficult to determine the pre-test probability for COVID-19 is we don’t know how many people in the community truly have the disease.

We do know, however, COVID-19 in Australia is much less common than in many other countries. This affects the way we view symptoms that aren’t typically associated with COVID-19.

It’s far more common for people’s abdominal pain to be caused by something other than COVID-19. For example, about a quarter of people at some point in their lives are known to suffer from dyspepsia (discomfort or pain in the upper abdomen). But the vast majority of people with dyspepsia do not have COVID-19.

Similarly, irritable bowl syndrome affects about 9% of Australians, and causes diarrhoea. Again, the vast majority of people with irritable bowel syndrome do not have COVID-19.

So how about this latest case?

In the Queensland case, we know the nurse was worried he could have had COVID-19 because he was in close contact with COVID-19 patients.

As he seemed otherwise healthy before developing new abdominal symptoms, and considering he worked on a COVID ward, his pre-test probability was high. Doctors call this a “high index of suspicion” when there is a strong possibility someone may have symptoms due to a disease such as COVID-19.

What does this mean for me?

If you have new gastrointestinal symptoms and you’ve potentially been in contact with someone with COVID-19 or if you also have other classic COVID-19 symptoms (fever, cough, shortness of breath and sore throat) you should definitely get tested.

If you have just gastrointestinal symptoms, you may need to get tested if you’re in a “hotspot” area, or work in a high-risk occupation or industry.

If you have gastrointestinal symptoms alone, without any of these additional risk factors, there is no strong evidence to support testing.




Read more:
8 ways the coronavirus can affect your skin, from COVID toes, to rashes and hair loss


However, if COVID-19 becomes even more common in the community, these symptoms now regarded as uncommon for COVID-19 will become more common.

If you have concerns about any gastrointestinal symptoms, seeing your GP would be sensible. Your GP will provide a balanced assessment based on your medical history and risk profile.




Read more:
4 unusual things we’ve learned about the coronavirus since the start of the pandemic


The Conversation


Vincent Ho, Senior Lecturer and clinical academic gastroenterologist, Western Sydney University

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

What is autoinflammatory disease, the rare immune condition with waves of fever?



from www.shutterstock.com

John Silke, Walter and Eliza Hall Institute and Najoua Lalaoui, Walter and Eliza Hall Institute

Just over 20 years ago, people from three generations of an American family were referred to the National Institutes of Health (NIH) in Washington DC with an unknown disease.

They were ten to 82 years old and had symptoms including monthly episodes of unexplained high fevers (up to 41℃), lasting two to seven days.

They also had painful swollen lymph nodes, enlarged spleens and livers, abdominal pain, mouth ulcers, joint pain, and a patchwork of other symptoms.

The symptoms, which they’d had since shortly after birth, seemed like an inflammatory reaction. However, doctors could not trace the episodes to an infection.




Read more:
Explainer: what is inflammation and how does it cause disease?


We now know these symptoms are typical of autoinflammatory diseases – rare conditions with seemingly unprovoked episodes of fever and inflammation.

Because the inflammatory episodes occur regularly, the diseases are also known as “periodic fever syndromes”. In addition to being painful and debilitating, some of the conditions can damage vital organs, such as the heart and lungs.

What causes autoinflammatory disease?

Autoinflammatory diseases are caused by abnormal activation of the innate immune system, the body’s first-line defence against invading pathogens.

The innate immune system is a hard-wired response that can quickly mobilise to fight foreign invaders. Among its many roles is the release of cytokines.

These are immune messengers critical for alerting and recruiting other cells to the fight, increasing blood circulation and inducing fever. More about cytokines later.

However, in autoinflammatory diseases, invading microbes don’t cause the fever and inflammation. Instead, genetic changes (mutations) lead to the innate immune system being activated for what appears to be no reason, causing uncontrolled inflammation.




Read more:
Explainer: what is the immune system?


Autoinflammatory diseases typically begin in childhood, often from birth, and are lifelong conditions. The genetic mutations can be passed from parents to their children, leading to multiple cases of disease in an extended family.

Autoinflammatory diseases are different from autoimmune diseases, such as multiple sclerosis, which are caused by defects in the adaptive immune system, a different arm of the immune response.




Read more:
Explainer: what are autoimmune diseases?


There are a number of different autoinflammatory diseases, often caused by different genetic mutations.

How do we treat autoinflammatory disease?

Autoinflammatory diseases cannot be cured, and treatment is usually to relieve symptoms during an attack. Patients are often treated with high doses of corticosteroids, a broad-brush approach to suppress the immune system.

Autoinflammatory diseases are also quite rare, which in the past has made it difficult to develop specific treatments.

Because autoinflammatory diseases are typically associated with excess production of cytokines, they are sometimes treated with so-called biologics – antibodies that mop up these excess cytokines.

These are usually antibodies to the cytokines tumour necrosis factor (TNF) or interleukin-1.

However biologics are expensive, and can have significant side-effects.

Without knowing the cause of an inflammatory disease, treatment is a trial and error process; a drug that works for one person may not work for another.

Antibodies against the molecule TNF (above) can be used to treat excess inflammation.
from www.shutterstock.com/StudioMolekuul

Can genetic testing help?

The discovery of mutations in genes causing autoinflammatory diseases has led to the development of genetic tests to help diagnosis.

However, some people with autoinflammatory disease do not have a change in one of the known disease-causing genes.

So our researchers have established the Australian Autoinflammatory Disease Registry to help identify other genetic causes of autoinflammatory diseases.

How we found out about the underlying mechanism

While the NIH researchers were looking for a cause of the American family’s disease, another strand of the story was playing out in Australia.

We were looking at the role of the master cytokine TNF, which controls many aspects of the body’s inflammatory response, and its partner RIPK1.

Usually, the body has many checks and balances to ensure these molecules are tightly controlled.

But we worked with the US scientists who found a critical mutation in the gene coding for RIPK1. We found this mutation, leading to changes in just one amino acid, was enough to supercharge its partner TNF into an elite killer.

This is what triggered the uncontrolled inflammation behind the American family’s disease.

Our team named this condition CRIA syndrome (cleavage-resistant RIPK1-induced autoinflammatory syndrome).

So what does this mean?

Understanding the molecular mechanism by which CRIA syndrome causes inflammation gives us an opportunity to get to the root of the problem, and to offer an alternative to existing treatments.

For this American family, treatment with an agent that inhibits the faulty RIPK1 might be a tailored option.

Lastly, the discovery of CRIA syndrome now confirms RIPK1 can play an important role in regulating inflammation in humans. So it may also play a role in far more common human illnesses, such as colitis (inflammation of the colon), rheumatoid arthritis and the skin condition psoriasis.




Read more:
What is rheumatoid arthritis, the condition tennis champion Caroline Wozniacki lives with?


The Conversation


John Silke, Leader, Infection, Inflammation and Immunity theme, Walter and Eliza Hall Institute and Najoua Lalaoui, Postdoctoral research fellow, Inflammation Division, Walter and Eliza Hall Institute

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

Pakistan: Good News


The link below is to an article reporting on some rare good news from Pakistan.

For more visit:
http://www.persecution.org/2013/04/04/christian-on-death-row-for-blasphemy-acquitted-by-pakistani-court/

Church ministry in Syria treads carefully after shut down


The spiritual climate in Syria is a changing one. While Syria’s Christian minority is generally respected, conversions to Christianity from Islam are rare and sometimes met with opposition, reports MNN.

Voice of the Martyrs reports that evangelizing is legal, but visas are not granted for missionary work. And while there is freedom to worship, any activity that could threaten communal harmony is suspect, making it difficult to spread the Gospel.

Despite the challenges, Reach Global in the Middle East and North Africa (MENA) began in 2008. The team working in the area is focused on holistic ministry: meeting physical and emotional needs as well as the spiritual needs of an individual.

They have been working together with churches, national partners, and collaborating with like-minded ministry organizations in order to reach the Syrians with the hope of Christ, and there has been success. A church has been planted.

This June however, the Syrian government closed the doors of that evangelical church. The group is still hoping to meet for worship and Bible study, but they are praying for wisdom and discernment on how to do that and still remain within the law.

Report from the Christian Telegraph

Could I live Without a Car for a Year?


I have already lived without a car for a year – in fact it is now over two years. I had a car accident that almost killed me and the car was written off as a consequence of the accident.

How have I got by? Well during that time I have ‘car pooled’ of sorts – because I haven’t got a car, I have been a passenger in the cars of others. I have also traveled via public transport. I have moved around locally on a bicycle and also walked.

So do I need a car? I would say, probably not. I can get by without one. On the rare occasions that i would like a car, I can rent one. I get on the bus and travel to the rental place (about an hour’s drive away) and rent one for a short time. So that’s how I get by without a car.

China Moves Uyghur Christian Prisoner, Allows Family Visit


Court rejects appeal of 15-year sentence for Alimjan Yimit.

DUBLIN, April 29 (CDN) — Authorities in Xinjiang Province recently moved Uyghur Christian Alimjan Yimit from a prison in Kashgar to a prison in the provincial capital Urumqi and allowed the first visit from family members since his arrest in January 2008, sources told Compass.

Alimjan (Alimujiang Yimiti in Chinese) was noticeably thinner but in good spirits, the family told friends after their brief visit to him in Xinjiang No. 3 prison on April 20, one source told Compass. They were allowed only 15 minutes to speak with Alimjan via telephone through a glass barrier, the source said.

But Alimjan’s lawyers, Li Baiguang and Liu Peifu, were prohibited from meeting with him, despite gaining permission from the Xinjiang Bureau of Prison Management, the China Aid Association (CAA) reported on Saturday (April 24).

Officials have now granted Alimjan’s wife Gulnur (Chinese spelling Gulinuer) and other close family members permission to visit him once a month.

Alimjan and Gulnur pastored a Uyghur ethnic house church in Xinjiang prior to his arrest in January 2008.

Attorney Li told Radio Free Asia earlier this month that while the initial charges against Alimjan were both “instigating separatism” and “leaking state secrets” to foreign organizations, his actual offense was talking to visiting Christians from the United States.

The Kashgar Intermediate Court found Alimjan guilty of “leaking state secrets” on Oct. 27, 2009 and gave him a 15-year sentence. His lawyers appealed the sentence, but the People’s High Court of Xinjiang upheld the original verdict on March 16.

“This decision is illegal and void because it never succeeded in showing how Alimjan supplied state secrets to people overseas,” Li said, according to Radio Free Asia.

“Religion lies at the heart of this case,” fellow legal advocate Li Dunyong, who was effectively disbarred at the end of May 2008 when Chinese authorities turned down an annual application to renew his law license, told Radio Free Asia.

Zhang Kai, another Beijing lawyer who had defended Alimjan, suffered the same fate. (See “China Refuses to Renew Licenses for Human Rights Lawyers,” June 11, 2009.)

Alimjan’s legal team now plans to appeal to the Beijing Supreme Court, according to CAA.

Court Irregularities

Officials initially interrogated Alimjan during his employment by two foreign-owned companies and forbade him to discuss the questioning with anyone. In September 2007 they closed the business he then worked for and accused him of using it as a cover for “preaching Christianity” among the Uyghurs.

Kashgar police then detained Alimjan on Jan. 11, 2008 on charges of endangering state security before formally re-arresting him on Feb. 20, 2008 for allegedly “inciting secession” and “leaking state secrets.”

He was then held for more than a year at the Kashgar Municipal Detention Center without facing trial.

After an initial closed hearing in the Kashgar Intermediate Court on May 27, 2008, court officials returned Alimjan’s case to state prosecutors citing lack of evidence. During a second secret hearing in July 2008 the charge of “inciting secession” was dropped. After further investigation the case was returned to court officials for consideration in mid-October 2008.

On Mar. 30, 2009, just one week after a rare prison visit from his lawyer, prison officials transferred Alimjan to a hospital in Kashgar. Alimjan called out to onlookers, “I’m sick. Tell my lawyer to come quickly to see me,” according to a CAA report. Compass sources confirmed that Alimjan had been beaten in prison. (See “Detained Uyghur Christian Taken to Hospital,” April 16, 2009.)

Last October, authorities finally sentenced Alimjan to 15 years in prison for “leaking state secrets” to foreign organizations.

“It is the maximum penalty for this charge … which requires Alimjan’s actions to be defined as having caused irreparable, grave national damage,” Li Dunyong said in a CAA press statement announcing the verdict.

The United Nations Working Group on Arbitrary Detention has ruled the arrest and detention of Alimjan to be arbitrary and in violation of international law, according to CAA.

Report from Compass Direct News 

Christians in Ethiopian Town Hit by Unexpected Attack


Orthodox church members strike two evangelical worship buildings, beat evangelist unconscious.

NAIROBI, Kenya, April 15 (CDN) — Evangelical Christians in an area of Ethiopia unaccustomed to anti-Christian hostility have come under attack from Ethiopian Orthodox Church (EOC) members threatened by their existence, Christian leaders said.

In Olenkomi, about 65 kilometers (40 miles) west of the Ethiopian capital of Addis Ababa, two church buildings were attacked by an EOC mob in Olenkomi town, Oromia Region, on Jan. 27 – leaving one evangelist unconscious and other Christians fearful of Orthodox hostility. Area Christians fear the assailants will not face justice due to the EOC’s powerful presence and impending elections.

A Mekane Yesus Church building was destroyed in the assault, while a Brethren Church structure suffered damages.

Attacks against evangelicals in the area are rare, but recently Christians have come under immense pressure as they face isolation and verbal threats, church leaders said. Located in the West Shoa Zone of Oromia Region, Olenkomi is a small town where most people there and in surrounding areas belong to the EOC. All officials in government are EOC members, and evangelical Christians encounter difficulties obtaining land for church buildings, church leaders said.

The attack followed an accidental fire from liturgical candles that burned an EOC building. EOC members blamed evangelicals, and in the ensuing assault evangelist Abera Ongeremu was so badly beaten the mob left him for dead. Another three Christians also sustained minor injuries.

Ongeremu was visiting from Neqemite, 260 kilometers (161 miles) away. After the mob stoned the Brethren Church, they next targeted Mekane Yesus Church, where Ongeremu was staying in guest quarters. A member of the mob took a Bible from his guest room and told him to burn it.

“How can I burn the book that showed me life?” the shocked Ongeremu asked.

He said that he told the mob that they could do anything they wanted, but he was not going to burn the Holy Bible. The attackers tied his hands and legs together and threw him back into the room, sprinkling diesel on the walls and roof and locking him in before setting it on fire, he said.

“I thought it was my last,” Ongeremu said. “I now understand nothing will happen to you without the will of God. That was not the day God allowed for me to die.”

Some of the assailants argued that Ongeremu should not die by burning, but by beating. Two of them dragged him out of the room and continuously beat him, covering his face in blood. He sustained wounds on his skull and right arm.

“After repeated beatings I lost consciousness,” he said. “I didn’t know how and when they left me. I only recall they argued about how to kill me.”

Premeditated?

Federal police were summoned from Ambo – the nearest town some 50 kilometers (31 miles) away – to disperse the mob, but too late to avert the injuries and damages after their rugged journey of nearly three hours.

Prior to the attacks, according to church leaders, there was no substantial build-up of tension between the two groups, though EOC priests had expressed anger about the expansion of evangelical churches and had questioned why teachers from evangelical backgrounds were prevalent in the high school in Olenkomi.

Most of the teachers at Olenkomi Secondary High School are evangelical Christians, according to church leaders, who said this circumstance was solely coincidental. Although teachers of evangelical faith are prevalent in the school, they are forbidden by law to promote their faith in class.

The EOC members had been constructing a building for a church in Olenkomi, but because of funding shortfalls they revised the plan and built a temporary structure. Evangelical church leaders said EOC priests had seized the land without formal process, but sources said the EOC’s strong presence in the area kept evangelical church officials from protesting brazen construction efforts.

The EOC’s small structure was being used for liturgical purposes.

“The shelter-like house has faced fire disaster in various incidents,” said a church leader in Olenkomi. “The materials used to build it, and the curtains they hung on walls exposed the shelter to several fire incidents. The [candle and lantern] lights the priests used for liturgy were causing problems. We heard that a number of times the fire had lit curtains, and the priests stopped before it spread.”

Such a fire broke out on the day of the attack, this time out-pacing the frantic efforts of the priests. The fire consumed curtains inside the house and spread to roofs and walls. To douse it the priests went to a nearby government-owned water tank operated by an evangelical woman. She granted them water, and the structure did not burn entirely.

When they later returned to wash, however, they put their hands inside the tank and sullied the public water source. When the operator objected, the EOC members  spoke derogatorily of her as a “Pente” and began to spread the rumor that she was responsible for the burnt structure, church leaders said.

EOC members quickly formed into groups of various sizes, sources said, and rolled into town chanting, “This is the day to destroy Pentecostals and their churches!” They first went to the Brethren Church, located by the side of a highway that stretches through Olenkomi to western Ethiopia.

“When we first heard stones falling on the roof, we thought the wind was tearing up iron sheets,” said one evangelist. “We also heard a loud noise from outside. It was around 12:30 p.m. I opened the main door to check what was happening. The whole compound was filled by men and women who carried stones and sticks. It was a very scary sight.”

They were stoning the church building, forcing the praying believers to escape through a back door. The assailants continued breaking doors and windows, thinking worshippers were trapped inside.

Local police arrived, the evangelist said, but they failed to disperse the violent mob.

“Despite firing into the air, the officers didn’t do anything serious to stop the mob,” he said. “They later said it is beyond their capacity and would call Federal Police from Ambo town. The anti-riot police arrived two and half hours later, practically after the mob effectively carried out all the destruction.”

Of the attack on Mekane Yesus Church, one church leader said the mob broke in and set fire on everything they found.

“They gathered benches, office chairs and tables, documents, musical instruments, public address system, choir uniforms and other materials and set them on fire,” he said. “They also lit fire to the church building, which reduced it to ashes.”

The mob was not finished. They proceeded to the high school, where they attacked Christian teachers as students rushed to defend them. Church leaders said the targeting of the school was evidence that the attack had been planned before with well-considered aims.

With Ethiopia scheduled to hold parliamentary elections on May 23, government officials don’t want to upset voters by punishing those behind the attacks, church leaders said. It is likely that officials would pressure church leaders from both camps to settle for the sake of stability, but Christians fear that in doing so their complaints will be overlooked.

Some suspects have been identified, but church leaders don’t expect they will be punished.

“It is like hitting a fire ball,” said a church leader from Brethren Church. “When you hit the fire, it would round back to you. It can even burn you. You may also distribute the fire to new places.”

In spite of the violence, evangelical Christians have engaged in “fervent witnessing ministry and prayer,” he said.

“It awakens us to think, pray and unite,” he said. “There is no good in persecution. But God turned it around for the good of us. The persecution was intended to destroy our commitment, but it rather built our faith.”

As election day draws closer, said the leader, EOC priests could easily motivate followers to attack.

“That would be bad times for believers,” he said. “Let’s pray for people in Olenkomi to know the will of God and repent from evil from which they assume to serve God.”

Report from Compass Direct News 

Vietnam’s Temporary Release of Priest Goes against Trend


Government granting leave to Father Ly is said to be tightening control overall.

DUBLIN, March 30 (CDN) — Vietnamese officials have in recent months tightened control over those they regard as dissidents, and the temporary release of Catholic priest Thadeus Nguyen van Ly on March 15 was a rare exception, according to Amnesty International (AI).

Officials on March 15 released Ly, now 63, from prison for one year so that he could receive medical treatment.

An outspoken advocate for religious freedom, Ly was sentenced to eight years in prison in March 2007 for “spreading propaganda” against the state. He had previously received 10- and 15-year sentences on similar charges.

“The release of Father Ly appears to be a one-off, related to his health,” Brittis Edman, Asia researcher for AI, told Compass by phone.

Human rights lawyer Le Thi Cong Nhan was released on March 6 after serving a three years in prison.  Officials have sentenced 16 other “perceived dissidents” since last September.

“Those 16 are people whose names are in the public domain,” Edman added. “There are probably others we’re not aware of.”

Edman confirmed that Ly was recently diagnosed with a brain tumor, although few details are available on the prognosis or the availability of treatment. Fellow priests told the Union of Catholic Asian News (UCAN) that Ly had suffered three strokes in May, September and November of last year, partially paralyzing his right arm and leg and making it difficult for him to walk, write or feed himself.

Following urgent requests from diocesan priests and family members, officials on March 14 granted Ly one year’s reprieve from his jail sentence. On March 15 they transported him by ambulance from Ba Sao prison camp in northern Ha Nam province to a home for retired priests in Hue, central Vietnam.

Under pressure from international advocacy groups including AI, the government may have granted Ly’s release to ward off potential embarrassment should he die in prison, Edman said.

“He’s a very public figure, and the Vietnamese government is not comfortable with being criticized.”

Religious Rights Campaigner

Ly was first jailed for one year in 1977 when he distributed a Church statement decrying the arrest of Buddhist monks and the treatment of Catholics in Vietnam, according to an AI report.

This was followed in December 1983 by a 10-year sentence served from the time of his arrest in May 1983 until his early release in July 1992. Prior to his arrest, Ly wrote a seven-point document urging officials to cease harassing Christians and announced that he was willing to be martyred for his faith.

In November 1994 Ly issued a “Ten Point Statement on the State of the Catholic Church in the Hue Diocese,” criticizing the lack of adequate training for would-be priests, the state’s interference in church teachings and its appropriation of church property.

He also became an advisory board member of the U.S.-based Committee for Religious Freedom in Vietnam (CRFV), according to AI.

In 1999, authorities objected when Ly coordinated relief projects for flood victims in partnership with CRFV. In November 2000, while U.S. President Bill Clinton and a CRFV delegation were in Vietnam, Ly reissued his ten-point statement and later made further appeals for religious freedom.

The United States Commission on International Religious Freedom in February 2001 invited Ly to address a hearing on Vietnam. Though unable to attend, Ly submitted written testimony stating that the Vietnamese government had “stripped all churches of their independence and freedom” and urging that the U.S. Congress not ratify a long-negotiated U.S.-Vietnam Bilateral Trade Agreement.

State-owned media then accused Ly of inviting “foreign hostile forces to intervene in Vietnam’s internal affairs” and inciting Catholic followers against the state.

Officials in May 2001 seized Ly during a church service and sentenced him to 15 years in prison for allegedly spreading anti-government propaganda. He was released under house arrest in February 2005 but arrested again in February 2007 and sentenced to eight years for organizing a pro-democracy event.

When the government released over 5,000 prisoners to mark Vietnam’s National Day last Sept. 2, Ly was omitted from the list despite vigorous international campaigns for his release. In a state media report quoted by UCAN, Vice Minister of Public Security Le The Tiem declared that the priest was “still in good enough health to serve his sentence.”

Report from Compass Direct News 

European Court Rules Against Turkey’s Religion ID


Designation on identification cards used to discriminate on basis of religion.

ISTANBUL, February 5 (CDN) — A European court on Tuesday (Feb. 2) ordered Turkey to remove the religious affiliation section from citizens’ identification cards, calling the practice a violation of human rights.

Religious minorities and in particular Christian converts in Turkey have faced discrimination because of the mandatory religion declaration on their identification cards, which was enforced until 2006. Since then, citizens are allowed to leave the “Religion” section of their IDs blank.

The ruling by the European Court of Human Rights (ECHR) “is a good thing,” said Zekai Tanyar, president of the Turkish Protestant Alliance, citing prejudices against Christian converts.

“[Religion on the ID] can cost people their jobs,” he said. “It has been known to affect whether they get a job or not, how people look at them, whether they are accepted for a post or an application of some sort. Therefore I think [the ruling] is a good and appropriate thing.”

Tanyar said the same principles would apply in the case of Muslims living in a country that had prejudices against Muslims. For converts in Turkey having to state their religion on their ID cards, “in practice, and in people’s experience, it has been negative.” 

The ECHR ruling came after a Turkish Muslim national filed a petition challenging that his identification card stated his religion as “Alevi” and not Muslim. Alevis practice a form of Shia Islam that is different from that of the Sunni Muslim majority.

The court found in a 6-to-1 vote that any mention of religion on an identity card violated human rights. The country was found to be in violation of the European Convention of Human Rights – to which Turkey is a signatory – specifically Article 9, which deals with freedom of religion and belief; Article 6, which is related to due process; and Article 12, which prohibits discrimination.

The presence of the “religion” box on the Turkish national identification card obliges individuals to disclose, against their will, information concerning an aspect of their personal convictions, the court ruled.

Although the government argued that indication of religion on identity cards did not compel Turks to disclose their religious convictions, the ECHR found that the state was making assessments of the applicant’s faith, thus breaching its duty of neutrality and impartiality.

In a statement on the verdict this week, Turkish Prime Minister Recep Tayyip Erdogan said that the ruling was in line with the government’s intentions.

“I don’t see the ECHR decision as abnormal,” he said, according to Turkish daily Taraf. “It’s not very important if it is removed.” 

The ECHR is independent of the European Union, which Turkey seeks to join. The rulings of the ECHR are binding for members of the Council of Europe, of which Turkey is a member, and must be implemented.

A Step in the Right Direction

Human rights lawyers welcomed the decision of the ECHR, saying it is a small step in the direction of democracy and secularism in Turkey.

“It is related to the general freedom of religion in our country,” said human rights lawyer Orhan Kemal Cengiz. “They assume everyone is Muslim and automatically write this on your ID card, so this is a good reminder that, first of all, everyone is not Muslim in this country, and second, that being a Muslim is not an indispensible part of being Turkish.”

The lawyer said the judgment would have positive implications for religious minorities in Turkey who are subject to intolerance from the majority Muslim population. 

In 2000 Turkey’s neighbor Greece, a majority Christian Orthodox country, lifted the religion section from national IDs in order to adhere to European human rights standards and conventions, causing tumult among nationals.

“In Turkey, Greece or whatever European country, racism or intolerance or xenophobia are not rare occurrences if [religion] is written on your card, and if you are a minority group it makes you open to racist, xenophobic or other intolerant behaviors,” said Cengiz. “There might be times that the [religious] declaration might be very dangerous.”

International Implications

It is not yet known what, if any, effect the ECHR decision could have on the rest of the Middle East.

Because of its history, economic power and strategic location, Turkey is seen as a leader in the region. Like Turkey, many Middle Eastern countries have a place for religious affiliation on their identification cards. Unlike Turkey, listing religious affiliation is mandatory in most of these countries and almost impossible to change, even under court order.

According to Human Rights Watch (HRW), religious identification is used as a tool to deny jobs and even basic rights or services to religious minorities in many Middle Eastern countries.

“It’s a serious problem from a human rights point of view,” said Joe Stork, deputy director for the Middle East and North Africa for HRW, an international human rights organization. “It’s especially problematic when that requirement becomes a basis for discrimination.”

Stork said the identification cards shouldn’t have a listing for religion at all. He said the European decision may eventually be used in legal arguments in Middle Eastern courts, but it will be a long time before change is realized.

“It’s not like the Egyptian government is going to wake up in the morning and say, ‘Gee, let’s do that,’” Stork said.

Egypt in particular is notorious for using religion on IDs to systematically discriminate against Coptic Christians and converts to Christianity. While it takes a day to change one’s religion from Christianity to Islam on their ID, the reverse is virtually impossible. 

Report from Compass Direct News 

Violent Death of Girl in Pakistan Spurs Push for Justice


Rare protest by family of tortured child puts spotlight on abuse of Christian working poor.

LAHORE, Pakistan, January 28 (CDN) — A daring protest and a high-profile funeral here on Monday (Jan. 25) for a 12-year-old Christian girl who died from torture and malnourishment has cast a rare spotlight on abuse of the Christian poor in Pakistan.

In an uncommon challenge in the predominantly Muslim nation, the Christian parents of Shazia Bashir Masih protested police unresponsiveness to the alleged violence against their daughter by Muslim attorney Chaudhary Muhammad Naeem and his family and his attempt to buy their silence after her death. The house servant died on Friday (Jan. 22) after working eight months in Naeem’s house.

An initial medical report indicated she died gradually from blows from a blunt instrument, wounds from a sharp-edged weapon, misuse of medicines and malnourishment. Key media highlighted the case on Pakistan’s airwaves, and minority rights groups along with high-ranking Christian politicians have swooped in to help.

Initially police were unresponsive to the family’s efforts to file charges against Muslim attorney Naeem, and on Saturday (Jan. 23) they staged a protest in front of the Punjab Assembly. The power of Naeem, a former president of the Lahore Bar Association, was such that officers at Litton Road police station refused to listen to Shazia’s relatives when they tried to file a complaint to retrieve her three months ago, telling the girl’s relatives, “a case against a lawyer cannot be registered,” her uncle Rafiq Masih told Compass.

Her mother, Nasreen Bibi, told Compass Naeem came to their home on the day Shazia died and offered 30,000 rupees (US$350) to keep the death secret and to pay for burial expenses.

“I refused to accept their offer, and they went they went away hurling death threats,” she said.

Bibi, a widow who subsequently married a 70-year-old blind man, told Compass that hunger and poverty had forced her to send her daughter to work at Naeem’s house for 1,000 rupees per month (US$12) – the family’s only source of income. Two older daughters are married, and she still cares for a 10-year-old daughter and 8-year-old son living at home.

Rafiq Masih said Naeem illegally kept Shazia at his house, forced her to work long hours and summarily refused family requests to see her. Three months ago, Masih said, Naeem allowed him and Shazia’s mother to see her for five minutes, and the girl complained that Naeem and his son were raping her. Shazia also told them that Naeem, his wife and sister-in-law were beating her and threatening to harm her if she tried to escape.

Enraged, Naeem promptly asked him and Shazia’s mother to leave, Masih said.

“We tried to bring Shazia with us back home,” he said, “but Naeem flatly refused to let Shazia go, and he cruelly and inhumanely grabbed her hair and dragged her inside the house. He returned to threaten us with dire consequences if we tried to file a case against him for keeping Shazia at his home as a bonded laborer.”

Masih and Bibi then went to the Litton Road police station to try to get Naeem to release Shazia, and it was then that duty officers deliberately offered the misinformation that a case could not be made against a lawyer, they said.

A Muslim neighbor of Naeem, Shaukat Ali Agha, told Compass that Naeem tortured Shazia.

“Often that little girl’s cries for mercy could be heard from the residence of the lawyer during the dead of night,” Agha said. “And whenever Shazia requested some food, she got thrashed badly by his wife, son and sister-in-law. One day Shazia was viciously beaten when, forced by starvation, she could not resist picking up a small piece of sugar cane from the lawn of Naeem’s residence to chew.”

As Shazia’s condition deteriorated, Naeem released her to the family and they took her to Jinnah Hospital Lahore on Jan. 19. After fighting for her life there for three days, she succumbed to her injuries and critically malnourished condition, her mother said.

Doctors at the hospital told Compass they found 18 wounds on her body: 13 from a blunt instrument, and five from a “sharp-edged weapon.”

A high-ranking investigating official told Compass that Naeem had given contrary statements under questioning. The police official said that Naeem initially stated that Shazia had fallen down some stairs and died. The police official, who spoke on condition of anonymity, said Naeem quickly changed his statement, saying she had stolen food from the refrigerator and therefore was beaten. The official added that Naeem also said Shazia was insane, disobedient and stubborn, and “therefore she had gotten thrashed and died.”

Doctors at Mayo Hospital Morgue have taken blood and tissue samples from Shazia’s liver, stomach and kidneys and sent them to the Chief Chemical Examiner’s Forensic Lab in Islamabad to determine the official causes of death, officials said.

Family Beaten in Court

On Saturday (Jan. 23) Shazia’s family, along with many other Christians and Muslims, protested outside the Punjab Assembly for three hours, according to rights groups. Key television channels covered police inaction in the face of the violent death, and several high-profile politicians pledged their support, including Pakistani President Asif Ali Zardari. He promised to give the family 500,000 rupees (US$5,835) after Pakistani Minister of Minorities Affairs Shahbaz Bhatti announced a gift of the same amount to compensate the family.

Only after this public pressure did police file a First Information Report, and Naeem and six others, including family members, were arrested earlier this week. Chief Minister of Punjab Shahbaz Sharif reportedly visited the family, promising justice.

The Lahore High Court took up the case on Tuesday (Jan. 26) and ordered police to conclude investigations within 14 days, but none of the high-level action seemed to matter at a hearing that day at District and Sessions Court Lahore, at which Naeem and his accusers were present. As routinely happens in cases where Christians in Pakistan accuse Muslims of wrongdoing, Compass observed as Naeem’s lawyers chanted slogans against Shazia’s family, threatened them and beat them – including Bibi and her blind husband – driving them from the courtroom.

Compass witnessed the Muslim attorneys yelling chants against local media and Christianity, as well. Naeem was neither handcuffed nor escorted by Defense A-Division Police, though he has been charged with murder.

At Shazia’s funeral on Monday at Sacred Heart Cathedral Church, Bishop of Lahore Diocese the Rt. Rev. Alexander John Malik officiated as eminent Christian politicians, human rights activists, Christian clergymen and many others gathered to pay their respects amid heavy police contingents.

After the funeral, her body was taken to her home in the Sammanabad slum of Arriya Nagar, where a throng of neighbors and Christian mourners gathered, chanting for justice. Shazia’s coffin was then taken to Miani Sahib Christian Cemetery, where she was buried amid cries and tears.

Present at the burial ceremonies were Provincial Minister of Punjab for Minorities Affairs Kamran Michael, Federal Minister for Minorities Affairs Bhatti, Christian members of Punjab Parliament Tahir Naveed Chaudhary and Khalil Tahir Sindhu, Bishop Albert Javed, Bishop Samuel Azariah, National Director of the Center for Legal Aid Assistance and Settlement Joseph Francis and other Christian leaders.

In a joint statement issued that day in Lahore, Catholic Archbishop Lawrence John Saldanha and Peter Jacob, executive secretary of the National Council for Justice and Peace, said that Shazia’s death was not an isolated incident, but that violence against the more than 10 million child laborers in the country is commonplace.

Report from Compass Direct News