Four of the most life-threatening skin conditions and what you should know about them

Some serious skin conditions are more likely to affect those with weaker immune systems.
from http://www.shutterstock.com

William Cranwell, Melbourne Health

This article is part of our series about skin: why we have it, what it does, and what can go wrong. Read other articles in the series here.

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Dermatological emergencies are uncommon, but can cause devastating complications and death if not recognised and treated early. Some skin conditions require treatment in an intensive care unit. Here are some of the most serious skin conditions and what you should know about recognising them.

1. Necrotising fasciitis

Necrotising fasciitis is a severe infection of the skin, the tissue below the skin, and the fascia (fibrous tissue that separates muscles and organs), resulting in tissue death, or necrosis. The infection is rapid, fast-spreading and fatal if not detected and treated early. If not treated with antibiotics and surgery early, toxic shock and organ failure are common.

Necrotising fasciitis may occur in anyone. Previously healthy young people are often affected.

The cause may be one or more bacteria entering the body via an external injury or punctured internal organ. Group A streptococci bacteria, which are the organisms implicated in “strep throat”, are among the most common causes.

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Read more:
Explainer: what causes necrotising fasciitis, the flesh-eating bug?

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Early necrotising fasciitis is easily missed, as similar symptoms are commonly seen in less severe infection. The initial area is painful, red and swollen. This progresses to a dark, blistered, malodorous and blackened area, which is a sign of tissue death. Other symptoms include fever, intense pain, low blood pressure and shock.

The most important risk factors for necrotising fasciitis include diabetes, peripheral vascular disease, trauma, alcohol and intravenous drug use, and use of non-steroidal anti-inflammatory drugs.

Treatment of necrotising fasciitis is immediate hospitalisation, surgical removal of all dead tissue, and intravenous antibiotics. Patients often require intensive care. Management of shock and other complications reduces the risk of death. Use of a hyperbaric chamber (to increase oxygen delivery to the tissue) and immune therapy may also be required.

Around a quarter of people diagnosed with necrotising fasciitis will die, and sepsis occurs in up to 70% of cases.

Most have heard of necrotising fasciitis as the ‘flesh-eating bug’.
DermNet New Zealand

2. Scalded skin syndrome

Staphylococcal scalded skin syndrome is an uncommon major skin infection. It typically affects newborn babies, young children and adults with reduced immune systems or kidney failure. This syndrome is caused by toxins produced by the bacterium Staphylococcus aureus, which is common in throat, ear and eye infections.

Around 15-40% of adults carry Staphylococcus aureus on the skin surface and have no problems. But these adults may inadvertently introduce the bacteria into nurseries or daycare centres. Because young children have weak immunity to specific toxins, they’re at increased risk of scalded skin syndrome.

Scalded skin syndrome is characterised by a red, blistering rash resembling burns. Early symptoms include fever, skin redness and skin tenderness. Other symptoms may include sore throat or conjunctivitis.

Within 24-48 hours, fluid-filled blisters form on the entire body. The blisters may rupture, leaving areas resembling burns. Large areas of the skin peel off and fall away with only minor touch.

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Read more:
Common skin rashes and what to do about them

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Scalded skin syndrome requires hospitalisation for intravenous antibiotics and treatment of the wounds. Ruptured blisters require wound dressings, and the skin surface requires intense care to avoid further damage.

Other treatment includes intravenous fluid and electrolyte maintenance to prevent shock and other complications, paracetamol for pain and fever, and avoidance of severe sepsis. Sepsis is when chemicals released into the bloodstream to fight an infection trigger inflammatory responses throughout the body, which can be life-threatening.

Complications of scalded skin syndrome include severe infection, pneumonia, cellulitis (a bacterial skin infection) and dehydration. Most children treated appropriately recover well and healing is complete within a week.

Staphylococcal scalded skin syndrome is more likely to occur in people with weaker immune systems – such as children.
DermNet New Zealand

3. DRESS syndrome

Standing for “drug reaction with eosinophilia and systemic symptoms,” DRESS syndrome is a severe reaction that affects the skin and internal organs. The patient may have an extensive rash, fever, enlarged lymph nodes and damage to the liver, kidneys, lungs, heart, blood components or pancreas. Symptoms usually start two to eight weeks after the responsible drug has been taken.

The death rate is estimated between 10 and 20%, most often due to liver failure.

The most common drugs responsible include anticonvulsants, antidepressants, non-steroidal anti-inflammatory drugs, antibiotics and sulfa drugs (a type of synthetic antibiotic). The severe reaction is thought to occur due to a pre-existing genetic change in the immune system, a triggering illness (most often a viral infection) and defective breakdown of the drug by the body.

Early diagnosis is essential. The responsible drug must be stopped immediately and patients may require intensive care or burn unit management. More intensive treatment is needed if organs are involved.

DRESS syndrome appears a few weeks after taking a drug the patient is allergic to.
DermNet New Zealand

4. Life-threatening drug reactions

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are variants of a life-threatening reaction that affects the skin and mucous membranes (mouth, eyes, genitals, respiratory or gastrointestinal tracts).

These are unpredictable reactions that leave sufferers critically unwell, with widespread death of the outer skin layer (epidermis), which peels off. The rash generally begins on the trunk and extends to the limbs and face, and there is intense skin pain. Before the rash appears, symptoms include fever, sore throat, runny nose, conjunctivitis and general aches.

It’s almost always caused by medications. The most common medications causing this reaction are anticonvulsants, antibiotics, allopurinol (gout medication), non-steroidal anti-inflammatory drugs and an HIV drug. The reaction usually occurs in the first eight weeks after taking the drug. It’s more likely to happen if the patient has cancer, HIV or specific genes that may play a role.

This reaction can be fatal by causing dehydration and malnutrition, severe infection, respiratory failure, gastrointestinal complications and multi-organ failure.

The responsible drug has to be stopped, and treatment (in a burns unit and intensive care unit) includes wound care, fluid management, pain management and prevention of infection. Long-term complications, including scarring, eye, oral, genital, lung disease and mental health disorders, are common. Around a quarter of people with this reaction will die.

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Read more:
The skin is a very important (and our largest) organ: what does it do?

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This reaction to medications is totally unpredictable.
DermNet NZ

William Cranwell, Dermatology Clinical Research Fellow, Melbourne Health

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

These Australian Social Media Reactions To The #SydneySiege Are Perfect

Malaysian Christians Seek to End Restrictions on Malay Bibles

Federation calls for removal of ‘every impediment’ to importing and printing Scripture.

KUALA LUMPUR, Malaysia, April 6 (CDN) — Christian importers of Bibles that Malaysian officials detained are balking at conditions the government has imposed for their release, such as defacement of the sacred books with official stamps.

The Home Ministry stamped the words, “This Good News [Malay] Bible is for use by Christians only” on 5,100 Bibles without consulting the importer, the Bible Society of Malaysia (BSM), which initially refused to collect them as it had neither accepted nor agreed to the conditions. The Home Ministry applied the stamp a day after the government on March 15 issued a release order for the Bibles, which had been detained in Port Klang, 38 kilometers (24 miles) southwest of Kuala Lumpur, since March 20, 2009.

Another 30,000 Bibles detained since Jan. 12 on the island of Borneo remain in port after the Sarawak state Home Ministry told the local chapter of Gideons International that it could collect them if the organization would put the stamp on them. Gideons has thus far declined to do so, and a spokesman said yesterday (April 5) that officials had already defaced the books with the stamp.

The government issued letters of release to both organizations on March 15 under the condition that the books bear the stamp, “Reminder: This Good News [Malay] Bible is for use by Christians only. By order of the Home Minister,” and that the covers must carry a serial number, the official seal of the department and a date.

The Home Ministry’s stamping of the BSM Bibles without the organization’s permission came under fire from the Christian community. In a statement issued on March 17, Bishop Ng Moon Hing, chairman of the Christian Federation of Malaysia (CFM), described the Home Ministry’s action as desecration.

“[The] new conditions imposed on the release of the impounded Bibles … is wholly unacceptable to us,” he added.

Ng described the conditions imposed by the Home Ministry as tantamount to treating the Malay Bible as a “restricted item” and subjecting the word of God to the control of man. In response, Home Minister Hishammuddin Hussein has said the act of stamping and serialization was standard protocol.

 

Government Overtures

In the weeks following the March 15 release order, the government made several attempts to try to appease the Christian community through Idris Jala, a Christian from Sarawak state and a minister in the Prime Minister’s Department.

Idris issued the government’s first statement on March 22, explaining that officials had reduced earlier conditions imposed by the Home Ministry to require only the words, “For Christianity” to be stamped on the covers of the Bible in font type Arial, size 16, in bold.

Idris informed BSM that the Bibles could be collected in their present state or arrangements could be made to have stickers with the words “For Christianity” pasted over the imprint of the stamps made by the Home Ministry officials. In the event that this was not acceptable, the minister pointed out that BSM had the option of having the whole consignment replaced, since the government had received an offer from Christian donors who were prepared to bear the full cost of purchasing new Bibles.

In response, the CFM issued a statement on March 30 saying, “The offer made does address the substantive issues,” and called on the government “to remove every impediment, whether legal or administrative, to the importation, publication, distribution and use of the [Malay Bible] and indeed to protect and defend our right to use the [Malay Bible].”

Bishop Ng, however, left it to the two importers to decide whether to collect the Bibles based on their specific circumstances.

On March 31, BSM collected the mishandled Bibles “to prevent the possibility of further acts of desecration or disrespect.” In a press statement, BSM officials explained that the copies cannot be sold but “will be respectfully preserved as museum pieces and as a heritage for the Christian Church in Malaysia.” The organization also made it clear that it will only accept compensation from the Home Ministry and not from “Christian donors,” a term it viewed suspiciously.

On Saturday (April 2), Idris issued a 10-point statement to try to resolve the impasse. Significantly, this latest overture by the government included the lifting of present restrictions to allow for the local printing and importation of Malay and other indigenous-language Bibles into the country.

In Sarawak and Sabah, there would be no conditions attached to Bibles printed locally or imported. There also would be no prohibitions and restrictions on residents of these two states carrying such Bibles to other states. A significant 64 percent of Malaysian Christians are indigenous people from Sabah and Sarawak states who use the Malay language in their daily life, and having the Bible in the Malay language is considered critical to the practice of their Christian faith.

In the case of West Malaysia, however, in view of its larger Muslim population, the government imposed the condition that the Bibles must have the words “Christian publication” and the sign of the cross printed on the front covers.

 

Christian Response

Most Christians responded to this latest overture with caution. Many remained skeptical, seeing it as a politically motivated move in view of Sarawak state elections on April 16. Nearly half of Sarawak’s population is Christian.

Bolly Lapok, an Anglican priest, told the online news agency Malaysian Insider, “It’s an assurance, but we have been given such assurances before.” BSM General-Secretary the Rev. Simon Wong reportedly expressed the same sentiments, saying the Home Ministry already has a record of breaking its word.

The Rev. Thomas Phillips of the Mar Thoma Church, who is also president of the Malaysian Consultative Council of Buddhism, Christianity, Hinduism, Sikhism and Taoism, questioned the timing of the proposal: “Why, after all these years?”

The youth wing of the Council of Churches rejected the proposal outright, expressing fears that the government was trying to “buy them over” for the Sarawak election, and that it would go back on its word after that.

Bishop Paul Tan, president of the Catholic Bishops’ Conference of Malaysia, called the proposal an “insidious tactic of ‘divide and rule,’” referring to its different requirements imposed on Malaysians separated by the South China Sea. Dr. Ng Kam Weng, research director at Kairos Research Centre, stressed that the proposal “does not address the root problem of the present crisis, i.e. the Allah issue.”

 

Muslim Reactions

The 10-point proposal has also drawn the ire of Muslim groups, who view it as the government caving in to Christian pressure.

Perak Mufti Harussani Zakaria expressed his disappointment, reportedly saying, “If the government does this, just cancel the law,” in reference to various state Islamic enactments that prohibit the use of the word “Allah” and other so-called Islamic terms that led to the banning of the Malay Bible. Malay Bibles have not been allowed to be printed locally for fear that they will utilize “prohibited” words.

The Muslim Organizations in Defense of Islam (Pembela) threatened to challenge the 10-point proposal in court if it was not reviewed in consultation with Muslim representatives.

On the same day Pembela issued its statement, the government seemed to have retracted its earlier commitment. The Home Minister reportedly said talks on the Malay Bibles were still ongoing despite Idris’ 10-point proposal, which purportedly represents the Cabinet’s decision.

As a result, James Redas Noel of the Gideons said yesterday (April 5) that he was confused by the mixed messages coming from the government and will not make a decision on whether to collect the Bibles until he had consulted church leaders on the matter, according to the Malaysian Insider.

The issue with the Malay Bibles is closely tied to the dispute over use of the word “Allah” by non-Muslims.

In a controversial court ruling on Dec. 31, 2009, judge Lau Bee Lan had allowed The Herald, a Catholic newspaper, to use “Allah” for God in the Malay section of its multilingual newspaper.

The Home Ministry filed an appeal against this decision on Jan. 4, 2010. To date, there is no indication as to when the case will be heard.

Christians make up more than 9 percent of Malaysia’s nearly 28 million people, according to Operation World.

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

Moroccan Islamists Use Facebook to Target Christians

Local Christians sense authorities, extremists and society in collusion against them.

RABAT, Morocco, June 17 (CDN) — Moroccan Christians say Muslim extremists in the country are aiding and encouraging the government to pursue them by exposing and vilifying them on social networking site Facebook.

Facebook user Gardes Maroc Maroc has posted 32 image collages featuring dozens of Christian converts, calling them “hyena evangelists” or “wolves in lamb’s skins” who are trying to “shake the faith of Muslims.” That terminology on the website, which is in Arabic, matches that of Morocco’s anti-proselytizing law, which outlaws efforts to “shake the faith of Muslims.”

The online images depict Christian converts and their families from across the country and include details about their roles and activities in churches, their personal addresses and anecdotal stories attempting to malign them.

“These are some pics of Moroccan convert hyenas,” reads one image.

Since March, the Moroccan government has expelled more than 100 foreign Christians for alleged “proselytizing.” Authorities failed to give Christians deportation orders or enough time to settle their affairs before they left.

Observers have called this a calculated effort to purge the historically moderate Muslim country, known for its progressive policies, of all Christian elements – both foreign and national.

Amid a national media campaign to vilify Christians in Morocco, more than 7,000 Muslim clerics signed a statement denouncing all Christian activities and calling foreign Christians’ aid work “religious terrorism.”

On the Facebook page, Gardes Maroc Maroc makes a particularly strident call to Moroccan authorities to investigate adoptive parents of children from the village of Ain Leuh, 50 miles south of Fez. The user claims that local Christians under orders of “foreign missionaries” were attempting to adopt the children so missionary efforts would not “go in vain.”

On March 8, the Moroccan government expelled 26 Christian foreign staff members and parents working at Village of Hope in Ain Leuh.

Now efforts against national Christians have gained momentum. One image on the Facebook page challenged the Islamic Ministry of Religious Affairs and Endowments, saying, “Evangelist hyenas are deriding your Ministry.” The page with the images claimed that Christians had rented out an apartment belonging to that government ministry.

An entire page was dedicated to a well-known Christian TV personality in the Middle East, Rashid Hmami, and his family. The user also inserted pictures of hyenas next to those of Christians, presumably to indicate their danger to the nation.

 

National Christians Threatened

Moroccan Christians told Compass that authorities had begun harassing them even before the forced deportations of foreigners, and that pressure from officials only intensified in March and April.

Since the deportations started in early March, it seems that authorities, extremists and society as a whole have colluded against them, local Christians said. Dozens of Christians have been called to police stations for interrogation. Many of them have been threatened and verbally abused.

“They mocked our faith,” said one Moroccan Christian who requested anonymity. “They didn’t talk nicely.”  

Authorities interrogated the convert for eight hours and followed him for three weeks in March and April, he said. During interrogation, he added, local police told him they were prepared to throw him in jail and kill him.

Another Moroccan Christian reported that a Muslim had taken him to court because of his Christian activities. Most Moroccan Christians that spoke to Compass said the attitudes of their Muslim relatives had shifted, and many have been kicked out of their homes or chosen to leave “to not create problems” for their families.

Moroccan converts meet in house churches. Some of them have stopped meeting until the pressure subsides.

“The government is testing the reactions,” said Moroccan lawyer Abdel Adghirni of the recent pressure on Christians.

The lawyer, known as one of the strongest defenders of Berber rights in Morocco, said that although the government’s recent reactions seem regressive, they are part of the nation’s societal transformation process.

“The government is trying to dominate,” said Adghirni. “They are defending themselves. They feel the wind of change. All of this is normal for me – like a complex chemistry that activates as different elements come into contact. Things are moving.”

 

Congressional Hearing

In an effort to alert U.S. Congress to the sudden turn against religious tolerance in Morocco, the Tom Lantos Human Rights Commission is holding congressional hearings today on the deportations of foreign Christians from the country.

Earlier today, the National Clergy Council held a press conference at the National Press Club in Washington, D.C., to congratulate the Moroccan government on religious tolerance. Organizers of the congressional hearings said they view the council’s press conference as an effort to counter the hearings.

The Rev. Rob Schenck, who heads the council, has had numerous exchanges with Moroccan Islamic leaders and in early April met with the Moroccan ambassador to the United States.

“I have enjoyed a close friendship of several years with the ambassador,” Schenck stated on his website.

Organizers of the congressional hearings have said they are baffled that the National Clergy Council, and in particular Schenck, would speak so highly of the Moroccan government at a time when it is in such blatant violation of human rights.

“There’s good and bad in every country, but what Morocco has done on the whole to advance religious liberty in that region of the world is extraordinary,” Schenck said in a media statement yesterday on Christian Newswire. “We hope to present a fair and balanced picture of this unusual country.”

Congressman Frank Wolf (R-Va.), co-chairman of the Tom Lantos Human Rights Commission, said that the Moroccan government has deported nearly 50 U.S. citizens.

“In spite of this, the U.S. government has pledged $697.5 million to Morocco over the next five years through the Millennium Challenge Corporation,” he said. Wolf is advocating that the United States withhold the nearly $697.5 million in aid that it has pledged to Morocco.  

“It is inappropriate for American taxpayer money to go to a nation which disregards the rights of American citizens residing in Morocco and forcibly expels Americans without due process of law,” he said.

Among those appearing at the hearing today is Dutch citizen Herman Boonstra, leader of Village of Hope, who was expelled in March. Boonstra and his wife were forced to leave eight adopted children in Morocco. Moroccan authorities have refused re-entry for the couple, as they have for all deported Christian foreigners.

Lawyer Adghirni said he believes Morocco cannot survive and develop economically – and democratically – without national diversity.

“We can’t be free without Christians,” Adghirni said. “The existence of Christians among us is the proof of liberty.”

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 

INDIA: OFFICIALS ON DEFENSIVE AT ‘WATCH LIST’ DESIGNATION

U.S. religious rights panel cites culture of impunity at authorities allowing atrocities.

NEW DELHI, August 18 (Compass Direct News) – Ahead of one-year remembrances of massive anti-Christian violence in the eastern state of Orissa, the U.S. Commission on International Religious Freedom (USCIRF) has put India on its “Watch List” for the country’s violations of religious freedom, evoking strong reactions from the Indian government.

USCIRF Chairman Leonard Leo said in a statement on Wednesday (Aug. 12) that it was “extremely disappointing” that India “has done so little to protect and bring justice to its religious minorities under siege.”

The U.S. panel’s decision was “regrettable,” a spokesperson for India’s Ministry of External Affairs, Vishnu Prakash, said in a statement on Thursday (Aug. 13), after the USCIRF put India on the list due to a “disturbing increase” in violence on minorities and a growing culture of impunity in the country.

Violence erupted in Kandhamal district of the eastern state of Orissa in August-September 2008, killing more than 100 people and burning 4,640 houses, 252 churches and 13 educational institutions, according to rights groups such as the All India Christian Council (AICC), the Global Council of India Christians (GCIC) and the Christian Legal Association (CLA).

“India’s democratic institutions charged with upholding the rule of law, most notably state and central judiciaries and police, have emerged as unwilling or unable to seek redress for victims of the violence,” Leo said. “More must be done to ensure future violence does not occur and that perpetrators are held accountable.”

Disagreeing with the USCIRF report, the foreign ministry’s Prakash said India is a multi-ethnic and multi-religious society. “The Constitution of India guarantees freedom of religion and equality of opportunity to all its citizens, who live and work together in peace and harmony,” he said.

Christians were shocked by the foreign ministry spokesman’s claim that “aberrations, if any, are dealt with promptly within our legal framework, under the watchful eye of an independent judiciary and a vigilant media.”

Attorney Robin Ratnakar David, president of the CLA, told Compass that one year after the violence only six people have been convicted in just two cases of rioting, while several suspects have been acquitted in four such cases despite the formation of fast-track courts.

Dr. John Dayal, secretary general of the AICC, pointed out that the more than 50,000 people who fled to forests or took shelter in refugee camps have not returned home out of fear of Hindu nationalist extremists who demand they either convert to Hinduism or leave their villages.

He said there also had been several “pogroms against Muslims, often sponsored or condoned by the state.”

In 2002, India’s worst-ever anti-Muslim violence occurred in the western state of Gujarat. A compartment of a train, the Sabarmati Express, caught fire – or was set on fire (as claimed by Hindu extremists) – near the Godhra city railway station on Feb. 27. In the fire, 58 Hindu passengers, mainly supporters of the Hindu extremist Vishwa Hindu Parishad (World Hindu Council or VHP), were killed. The VHP and the Bharatiya Janata Party (BJP) claimed it was an attack by Islamic terrorists; the ensuing violence killed more than 2,000 people, mostly Muslims.

Following the anti-Muslim violence, the USCIRF recommended that India be designated a “Country of Particular Concern” (CPC), its list of the world’s worst violators of religious freedom. India was removed from the CPC list in 2005.

Designation on the Watch List means a country requires “close monitoring due to the nature and extent of violations of religious freedom engaged in or tolerated by the government,” according to USCIRF. The other countries on USCIRF’s Watch List are Afghanistan, Belarus, Cuba, Egypt, Indonesia, Laos, the Russian Federation, Somalia, Tajikistan, Turkey, and Venezuela.

CLA attorney David said the August-September 2008 violence in Kandhamal could have been prevented had the administration brought to justice those responsible for previous mayhem in December 2007. The December 2007 violence in Kandhamal killed at least four Christians, burned as many as 730 houses and 95 churches and rendered thousands homeless.

The attacks were launched under the pretext of avenging an alleged attack on a VHP leader, Swami Laxmanananda Saraswati. It was the assassination of Saraswati by Maoists (extreme Marxists) on Aug. 23, 2008 that sparked the second spate of violence in Kandhamal, as Hindu nationalists blamed non-Marxist, local Christians for it.

Dayal said the USCIRF’s latest conclusions could have been avoided if more action had been taken against the perpetrators of last year’s violence.

“The USCRIF action would not have been possible, and India would have been able to rebuff the U.S. scrutiny more effectively, if several thousand Christians were still not in refugee camps, if the killers were still not roaming scot-free and if witnesses, including widows, were not being coerced,” he said.

‘Indifferent’

Shashi Tharoor, India’s Minister of State for External Affairs, told a private news channel that India did not need approbation from outside its borders.

“As far as we are concerned, we are essentially indifferent to how others view the situation,” he said. “In democracy, what matters to us is how we deal with our own internal issues. I don’t think we need any certificates from outside.”

He dismissed the report as meddling in internal affairs even though between June 2002 and February 2007 Tharoor served as under-secretary general for communications and public information for the United Nations, a body representative of international accountability in human rights.

In its annual report, India’s home (interior) ministry had acknowledged that the incidence of communal violence was high. It noted that in 2008, as many as 943 communal incidents (mainly against Muslims and Christians) took place in which 167 persons were killed and 2,354 persons were injured. The figures were up from those of 2007, when there were 761 incidents in which 99 persons were killed and 2,227 persons were injured.

Justifying its decision, the USCIRF report stated that several incidents of communal violence have occurred in various parts of the country resulting in many deaths and mass displacements, particularly of members of the Christian and Muslim minorities, “including major incidents against Christian communities within the 2008-2009 reporting period.”

“Because the government’s response at the state and local levels has been found to be largely inadequate and the national government has failed to take effective measures to ensure the rights of religious minorities in several states, the Commission decided to place India on its Watch List.”

The USCIRF had released its 2009 annual report on religious freedom across the globe on May 1 but put the India report on hold, planning to prepare it after a visit to the country in June. A USCIRF team planned to visit India to speak to the government and others concerning the situation in Kandhamal and Gujarat on June 12, but the Indian embassy in Washington, D.C. did not provide visas in time.

“USCIRF’s India chapter was released this week to mark the one-year anniversary of the start of the anti-Christian violence in Orissa,” Leo pointed out in last week’s statement.

‘Teflon-Coated State’

The AICC’s Dayal seemed pessimistic about a change in the government’s attitude.

“Unfortunately, nothing really impacts the government of India or the government of Indian states,” he said. “The state, and our social conscience, seems Teflon-coated. The patriotic media and political sector dismiss international scrutiny as interference in the internal affairs of India, and a beaten-into-submission section of the leadership of religious minorities assumes silence to be the best form of security and safety.”

Dr. Sajan George, the national convenor of the GCIC, said the report showed that India had become a “super violator” of human rights. The Rev. Dr. Babu Joseph, spokesman for the Catholic Bishops’ Conference of India, said the U.S. panel’s report did not augur well with India’s claim to find a respectable place within the community of nations.

“India as an emerging economic power in the world should also endeavor to better its records of protecting human rights, particularly when it comes to religious freedom of its citizens,” Joseph said.

Joseph told Compass the USCIRF report was “a clear indication of the growing concern of the international community with India’s repeated failure to take decisive and corrective measures to contain religious intolerance.”

Christian leaders generally lauded the report, with Dayal saying, “India’s record on the persecution of minorities and the violation of religious freedom has been a matter of international shame for the nation.”

Report from Compass Direct News 

PAKISTAN: SUSPECTS IN RAPE OF CHRISTIAN GIRL CLEARED

Police in Muslim-majority nation suspected of corruption.

ISTANBUL, April 10 (Compass Direct News) – Police have declared three Pakistani men innocent of raping a 13-year-old Christian girl despite eye witness accounts and medical evidence indicating their guilt.

At a hearing in Nankana Sahib district court on April 3, police from the Pakistani town of Sangla Hill, 64 miles from Lahore, cleared 40-year-old Mohammed Shahbaz, 30-year-old Waqas Sadiq and 25-year-old Yousaf Sadiq of accusations of raping and threatening Ambreen Masih.

Shahbaz was the only suspect to attend the hearing, which was initially called to discuss terms of his pre-arrest bail. But Judge Ijaz Hussan Awan said he couldn’t set terms for bail if police didn’t want to arrest or detain him.

“In Pakistan it has always been like this – the wealthy person can approach the police and change the course of an investigation,” said prosecuting attorney Akbar Durrani. “Regarding Christians, they cannot put any pressure on the police for a fair investigation.”

Ambreen and her family accuse Waqas Sadiq and Yousaf Sadiq of kidnapping her and taking her to their family residence. The Masihs accuse the two men and Shahbaz of repeatedly raping her, releasing her after two hours and threatening to kill her if she informed authorities.

The three men, along with a relative, 25-year-old Zahid Riyasat, allegedly kidnapped her a second time on Feb. 5. When her parents started to worry about her absence, her father, Munir Masih, organized a search party with other local Christians. They found the three suspects at the house of the Sadiqs’ father, raping her at gunpoint, according to a First Instance Report (FIR).

As the search party approached the four suspects, the accused fired warning shots into the air and then ran away, Munir Masih said in the report.

Ambreen then returned home with her family. She said that when the captors originally abducted her, they said, “We will kill your parents if you tell them this.”

On Feb. 6 Masih obtained permission from the judicial magistrate of Sangla Hill for an official medical examination of Ambreen, which established that she had been raped. Her parents sought police to file charges against the three men, but officers responded only after CLAAS prompted them to open a case.

After police declared the three men innocent following their investigation, lawyers representing Masih accused family members of the suspects of bribing police.

“In that village, Christians are nothing for the Muslims, they make them work for them and sometimes make them work without paying them,” said CLAAS field worker Katherine Sapna.

The three accused men are part of a wealthy family of land owners in Sangla Hill. Ambreen comes from a poor background and has seven siblings. Her father works as a day laborer, and Ambreen and two of her sisters work as domestic servants.

Attorney Durrani has appealed to the Lahore High Court to put different police officers on the investigation. Although local police declared the three suspects innocent at the April 3 hearing, they did not deny that Ambreen had been raped. But the police did not suggest any other suspects, Durrani told Compass.

Around 60 Christian families live in Sangla Hill, located near the industrial city of Sheikupura, northwest of Lahore.

 

Murdered Christian

Police reluctance to prosecute crimes against Christians in Pakistan also has hampered Samson Joseph, attorney for the family of Adeel Masih, a 19-year-old Pakistani Christian believed to be the victim of an “honor killing” by two Muslims.

On April 1 the Sessions Court in Gujranwala held a hearing in which police declared the suspects innocent.

Masih was found dead in May 2008 in Hafizabad. Police originally declared his death a suicide, but his family and human rights lawyers believe relatives of a 19-year-old Muslim woman, Kiran Irfan, with whom Masih had a one-year relationship, tortured and killed him.

District police arrested her father, Mohammed Irfan, and her uncle, Muhammad Riasat, in July 2008 – two months after Masih’s family went to Gujranwala police, who initially declined to charge Irfan’s family with any crimes and effectively declared them innocent. A high inspector has reopened the case and taken the two suspects into custody.

Sapna of CLAAS said the case has taken its toll on the family of Adeel Masih, whose father is suffering psychological problems from the apparent murder.

Marriage between Christian men and Muslim women is forbidden according to a strict interpretation of sharia (Islamic law), and even social contacts such as these can incite violent reactions in Pakistan, a majority-Muslim nation of 170 million.

Report from Compass Direct News

PAKISTAN: PARTIAL VICTORY SEEN IN RULING ON KIDNAPPED GIRLS

With both minors saying they had converted to Islam, lawyers feared worse.

ISTANBUL, September 15 (Compass Direct News) – Christian human rights lawyers in Pakistan saw a partial legal victory in a judge’s ruling last week that one of two kidnapped girls be returned to her Christian parents. The judge further ruled that her sister be free to choose whether to go with the Muslim man who allegedly forced her to convert and marry him.

Justice Malik Saeed Ejaz ruled on Tuesday (Sept. 9) that 10-year-old Aneela Masih be returned to her parents – an unprecedented legal victory for Christian parents of a girl who supposedly converted to Islam, according to one lawyer – while leaving her sister, 13-year-old Saba Masih, free to choose whether to go with Amjad Ali, a Muslim man who married her after the June 26 kidnapping.

Saba Masih, whose birth certificate indicates that she is now 13 but who testified that she is 17, said she did not want to return to her parents and tried to keep her little sister from returning to them. Their Muslim captors have repeatedly threatened the two girls that their parents would harm them if they returned.

The older sister is not willing to meet with any of the family members or her parents, said Rashid Rehman of the Human Rights Commission of Pakistan.

“It’s normal behavior,” he told Compass. “She was tutored and brainwashed by the family of her husband Ali, and naturally they made up her mind that her parents will hurt her and treat her inhumanely. In fact that will never happen. Her family is really peaceful, and remained so peaceful the whole time the case was heard in high court.”

After more than three hours of heated legal arguments in the Multan branch of Lahore’s High Court, the judge deemed the oldest child sui juris – capable to handle her own affairs – based on her testimony that she is 17 years old and on a Lahore medical board’s ruling that she is between 15 and 17. The medical board may have been pressured to declare Saba Masih as an adult, according to the parents’ lawyers.

Conditions set in the ruling called for the parents not to “interfere” with Aneela Masih’s religious beliefs, that they be allowed to visit Saba Masih and that the groom’s family pay them 100,000 rupees (US$1,316) according to Pakistani marriage tradition.

Raised in a Christian family in the small town of Chowk Munda, the two girls were kidnapped on June 26 while traveling to visit their uncle in Sarwar Shaheed, northwest of Multan. Saba Masih was married to Ali the next day, and the kidnappers filed for custody of the girls on June 28 based on their alleged forced conversion to Islam.

Islamic jurisprudence and Pakistani law do not recognize the forced marriages of minors.

 

‘Pleased with Outcome’

“We are pleased with the outcome,” said Joseph Francis, head of the Center for Legal Aid Assistance and Settlement (CLAAS). He said, however, that the verdict was not complete without the return of Saba Masih to her family.

Francis and two other CLAAS lawyers were present at the Sept. 9 judgment despite repeated threats against their office over the course of the hearings.

CLAAS lawyer Akbar Durrani told Compass that it was the first time in his life that he had seen such a decision. “In my experience they have not given us the custody of minor girls even as young as 9 years old that have been declared Muslim,” said Durrani, who has been practicing law in Pakistan for 18 years. “It is a legal victory.”

As a minor, though, Aneela Masih’s previous declaration that she had converted from Christianity to Islam was not explicitly recognized. Calling the lawyers into his private chamber to present options before ruling, according to the parents’ lawyers, the judge said he would make no mention of the girls’ supposed conversion to Islam.

“This was a very favorable thing for us,” said Durrani. “He said, ‘I’m only going to decide the custody,’ so we decided this is acceptable to us.”

In his private chamber, the judge gave them different options, warning them that if they didn’t cooperate or accept his proposals he would make his own judgment. In the end he said he would hand the little girl to her mother and set the other free.

“Wherever she wants to go she can go,” the judge told the parties. “But if she wants to go with you she can go, and if she wants to go to her husband she can go.”

The girls, their mother and Ali were then invited into the judge’s chamber, where the judge announced the decision to them.

Durrani said that Aneela Masih went to her mother willingly, while her older sister gave a cry and tried to pull the 10-year-old back to her.

“The minor resisted for a fraction of a second to go to the mother,” Durrani said. “The little girl was under pressure; every time she was instructed by her elder sister not to talk to her mother.”

Her mother hugged her, and the lawyer said the little girl seemed very comfortable in her lap. There her mother tried to remove the veil from her daughter to look at her, but she resisted. Outside the courtroom, however, Aneela Masih removed the veil herself and later accepted food and drink. The girls had been fasting during Ramadan.

The lawyers said it was clear from the 10-year-old girl’s reactions that she was confused from the ordeal.

 

Supreme Court Question

Lawyers for the parents are weighing the options and feasibility of getting the oldest daughter back through the Supreme Court.

On Friday (Sept. 12), the girls’ uncle, Khalid Raheel, who has spearheaded the efforts to get them back, told CLAAS lawyers that Aneela was readjusting into her life at home. Raheel asked the family lawyers that they continue to try to get Saba back.

Rehman said he does not think the case would stand in the Supreme Court. “She willingly said, ‘I don’t want to go with my parents,’” he said.

Durrani and Francis, however, said they would continue to fight for her. “We’ll go to the Supreme Court for Saba,” said Francis.

“We will try getting the statement of Aneela and then will re-open the case,” said Durrani, adding that Aneela Masih had told her family, “Please get her back from that place.”

Rehman told Compass in a phone interview that Saba Masih’s statement that she is 17, her supposed embrace of Islam and her marriage by consent will make getting her back very difficult.

“She has admitted the marriage at the court and produced the marriage papers and has claimed that she’s over 16, so it was very difficult for us to prove our case that she’s a minor girl… because it is denied by Saba herself,” said Rehman.

He explained that the only way to secure the oldest daughter’s return to her family would be by proving she is a minor, something virtually impossible at this point because of her testimony. The court has refused to admit her birth certificate as evidence.

Saba Masih still refuses to communicate with her parents.

 

‘Frightened, Small Girl’

In court last week, both sisters sat in hijab dress fully veiled next to a policewoman from the Dar Ul Rahman women’s shelter, where the two girls had stayed since a July 29 hearing.

Their mother tried to talk to them and show them photos. Durrani said that Aneela Masih was responsive to her mother, but her older sister would pull her away, forbidding her from talking to her.

The judge had ruled that the girls stay at the shelter in order to think of their alleged conversion to Islam away from external pressures. Lawyers for the parents said that while in the shelter the girls were continually harassed and threatened that their family would not take them back.

Aneela Masih stated to the lawyers and her parents after the court decision that Ali’s family and their captors told them that everyone was Muslim – the lawyers, the judge, society – and that their parents could not take them back.

Knowing the attention the case of the two girls had attracted, Durrani said, the judge left the case till last. Yet the courtroom, he said, was full of “those who had kidnapped the girls, their supporters, the Islamic fanatics; all these were present in the court and interested in the hearing of the case.”

From the outset at last week’s hearing, the judge wanted to ask Aneela Masih questions about Islam to extract a statement on which he could rule on her custody. Durrani and colleague Justin Gill fought against the lawyer and the judge, arguing that as the 10-year-old was a minor, her statement on faith could not be valid and that she must be returned to her mother.

“We concentrated our efforts on Aneela, that at least we should have some relief to get her back and then we can fight in the Supreme Court if we wish to go for any other thing,” he said, referring to the older sister’s case.

The judge had decided to postpone the verdict till this Thursday (Sept. 18) and place the girls back in the Dar Ul Rahman shelter, where their mother could visit them for two hours every day. But the CLAAS lawyers said they feared waiting would only work against their case in the long run, making it more difficult to gain custody of the younger sister if both were exposed to more harassment and possible brainwashing.

“Even if she is a Muslim and has changed her religion, according to Islam a mother is the best custodian of the child,” Durrani said he and Gill argued.

Rehman said that Aneela Masih seemed frightened and, according to information he had obtained, the girl was afraid of her abductors and her own family even while in the shelter.

“She was a frightened, small girl,” he said. “They told her that if she returned to her parents she’d be treated unkindly.”

 

Threats, Car Chase

On Sept. 8, the day before the hearing, while traveling together from Lahore to Multan, the three lawyers for the Christian parents – Francis, Durrani and Gill – received threatening calls from the supporters of the girls’ kidnappers.

That night while, on their way back from dinner to a bishop’s house where they were staying in Multan, the CLAAS team was approached by armed men on motorcycles who threatened them, warning them to not go to the judgment hearing the next day.

“They said, ‘You should not be in court or you will be responsible for the consequences,’” said Durrani.

When nearby police saw the scene and approached, the armed men left the scene.

“We were afraid, but we knew we had to go,” Durrani said.

After the hearing, while traveling back to Lahore, Durrani said that Muslim fanatics chased them for about 100 kilometers (62 miles).

“Then we went to another city and got to the highway from another shortcut,” he said.

Durrani said the lawyers have many cases like this, causing them concern for their own safety.

“It is not the first time we get threats, but by the grace of God, and by the refuge of our Holy Ghost we are safe,” he said. “Every time we know the prayers of our church and other Christians are with us, which is why we are able to get the victory for our Lord.”

Report from Compass Direct News

EGYPT: ONE CONVERT’S NEVER-ENDING STRUGGLE

Snares abound as Christian seeks to protect wife, baby and future faithful.

ISTANBUL, September 12 (Compass Direct News) – Egypt’s most famous convert to Christianity is a prisoner of his own home, hiding for his life.

After Mohammed Ahmed Hegazy, 25, became the first Muslim-born Egyptian to file a case a year ago for his identification card to reflect his newfound faith, his face has been shown on TV channels and newspapers. Anywhere he goes, he might be recognized by fanatical Islamists bent on killing him – besides his own family members, who also want him dead.

In the last eight months, since an Egyptian court closed his case in a Jan. 29 court ruling that declared it was against Islamic law for a Muslim to leave Islam, Hegazy has had to move five times with his wife and baby daughter.

“The verdict for my case was discriminatory [on the part] of the judge,” Hegazy told Compass in an interview last month. The judge based his decision on Islamic law, which says one can convert “up” in the Muslim hierarchy of religions – from Judaism and Christianity to Islam – but not vice versa.

But months after the final court decision, even after the issue is fizzing out in the media, Hegazy said that his life is in danger – as is that of every convert in Egypt.

 

Living on the Run

“The most difficult thing for me is that the lives of my wife and daughter are in danger all the time,” Hegazy said.

In one instance a year ago, he and his family barely escaped alive. Last October, he received a phone call from a friend who told him that one of his own lawyers had given authorities his address. His friend told him he might have to move in the next few days and to be careful.

“I had a feeling we should move,” said Hegazy, explaining that he listens for God’s voice on such decisions. “So we moved immediately, and the next night the fundamentalists came to attack us.”

A group of Islamists camped around his former house for days. They also set fire to the apartment of Hegazy’s next-door neighbor, killing her. He said the neighbor, whose name was withheld for the security of her relatives, was the best friend of his wife and had helped them in their ordeal.

“The church denied that she was killed, and it was never reported publicly,” he said.

The convert’s hope is that one day he can get his family out of the country, but without passports that is a remote possibility. Passports are issued in the hometown of the citizen.

Both Hegazy and his wife are well-known and unwelcome in their hometowns.

His wife would need to go to El-Minya to apply for a passport, he said, “and as soon as she goes there she will be killed. Even if it’s not family, others will do it, so I can’t take that risk.”

Hegazy’s father has also filed to gain custody of his baby granddaughter so that she is raised Muslim. He has also given authorities false information, such as asserting that Hegazy hasn’t served his military service, and has publicly said that if his son doesn’t recant his faith he will kill him.

“Many lawyers volunteered to file a case against me,” he said.

 

Persecuted Converts

Hegazy risked venturing out of his house on a hot afternoon in August to speak to Compass. At a restaurant, he looked over his shoulder nervously to make sure he wasn’t followed.

What the convert-turned-political activist really wanted to talk about was the situation of thousands of converts in his country who suffer discrimination by the state, family and even local churches, he said, because the country’s constitution is based on sharia (Islamic law).

“The most important thing is to show how converts are persecuted and how they are suffering in Egypt,” said Hegazy. “I want to clarify this because converts are persecuted by society and the church and their families.”

Hegazy minces no words when it comes to what he calls the inability of the church to stand up to the forces of government and Islamic society in order to defend the rights of converts.

“The church in Egypt is impotent and cowardly,” he said, noting church leaders who do not stand up for religious rights and claim they do not evangelize and baptize converts. He cited Coptic Bishop Bishoy, who said that his church is against “proselytizing” and spreading the gospel and that the Coptic Church is not doing it. Coptic churches in Egypt – Catholic and evangelical – publicly claim they do not baptize converts, each blaming the other for doing so, while priests and pastors are known to baptize in secret so as not to provoke violent reactions from Islamists and the government.

“The priest that baptized me refused to see me for a whole year,” said Hegazy. “Not one priest is standing up to say, ‘I baptize converts.’”

Hegazy said that reactions like this leave converts feeling marginalized.

“You have to understand that the church is treating converts as second-class citizens. The only heroic thing they could do was baptize me secretly,” said Hegazy, who had to fight to get a baptismal certificate, as do so many other converts. “Can you imagine how a convert feels? Should we accuse converts of being discriminatory or sectarian if they want to establish their own church?”

Converts, Hegazy said, are attacked on all fronts of Egyptian society. “The government is Islamic, the society is Islamic, and the church is weak,” he said. “Converts are stuck between all of these, between the jaws of the government and society.”

 

A Little Help

Hegazy and other religious rights activists believe that individual cases such as his or that of Maher El-Gohary, filed last month, alone cannot gain legal rights for converts who wish to become officially Christian and accepted in society.

“I don’t believe my case is going to be resolved,” said Hegazy. “I’m not pessimistic, but if we are dealing with a personal case we can’t achieve anything. Instead we have to talk about the broad issue and discuss conversion as a big case, because there are so many believers persecuted.”

As have other activists, Hegazy said that if Egyptian converts living overseas and in Egypt were to file a joint case they would have more leverage. But they need greater support from human rights groups, which are not pushing enough for convert cases, he said.

“I can’t understand how we have so many human rights organizations, and Christian ones, and no one is taking any action,” he said.

Hegazy suggested that human rights organizations should publicly advocate a law that supports freedom of conversion, including committees to monitor developments. If such a law were in place, he said, the Egyptian government would stop using Muslim fundamentalist reactions as an excuse to avoid enforcing justice.

“This way the government can’t say, ‘We don’t [change religion on identification cards] because of fundamentalism, it will upset our society,’ because there will be a law in place,” he said.

Additionally, he said, converts must also fight against lack of action by human rights organizations.

“The problem is we’re struggling with the church, the society, our families,” he said. “So we don’t need an extra struggle with human rights organizations.”

 

Waiting

Hegazy and his lawyer are still waiting for a court date for his appeal. They applied for it in February.

“Every week we go to the court to find out when the appeal date is set for,” said Hegazy’s lawyer, Gamal Eid of the Arabic Network for Human Rights Information.

At a recent court visit they were told to come back in October, leading them to believe that perhaps they will get a court date that month.

Hegazy said he is ready to fight his case to the end. Already, he said, his case has made one gain for Egypt’s converts: the recognition that there are such persons as “converts,” and they are in the public debate.

“Nowadays, the word ‘convert’ is being used in the media here – never before!” said Hegazy. “That’s progress.”  

Report from Compass Direct News