Port-Au-Prince, Haiti (CNN) — It should be possible to keep an outbreak of cholera out of Haiti’s capital, but the potentially deadly disease remains a major risk, an international aid worker told CNN on Monday.

“I think we’ll be able to contain it fairly well, but it is a risk, it is a major risk,” said Jason Erb, deputy country director for the International Medical Corps.

The fast-moving outbreak has claimed at least 253 lives on the impoverished island nation, which has yet to recover from January’s massive earthquake. Another 3,015 cases have been reported, according to Haiti’s Health Ministry.

Even if the disease can be kept out of the capital, Port-au-Prince, it remains a serious risk in the tent camps that remain home to tens of thousands of earthquake survivors, Erb warned.

“It’s a danger because the camps are so crowded and so unhygienic,” he said on CNN’s “American Morning.”

Aid workers are trying to educate people about the importance of hand-washing and clean water in preventing the spread of cholera, he said.

A small number of cases have been reported in Port-au-Prince, but Erb said they seem to be the result of people carrying the disease from the camps — not from contaminated water in the capital.

And he cautioned against panic.

“You have to have quite a few people to contaminate a body of water,” he said. “It’s not just going to be one or two cases. That’s going to be quite controllable. It’s not good … but it’s not going to lead to a massive outbreak.”

There is “an awful lot of monitoring” for the disease, he said, and “cases generally don’t go unnoticed.”

Five patients in Port-au-Prince were infected north of the city in Artibonite, said Imogen Wall, spokeswoman for the U.N. Office for the Coordination of Humanitarian Affairs in Haiti.

They traveled to the nation’s main city, where health officials discovered them to be infected within the incubation period, she said.

The five have been isolated and are receiving treatment, she said.

Meanwhile, officials are stepping up sanitation efforts and setting up quarantine areas in Port-au-Prince. Authorities are bracing themselves for a possible larger outbreak nationwide.

“I think the only responsible thing we can do at the moment is prepare and plan for the worst-case scenario,” Wall said.

Wall said aid organizations are working on constructing facilities to treat patients and sending more doctors to the affected areas.

“We’re all right for supplies … but we’re short on medical personnel,” she said.

The cholera outbreak comes after recent heavy rains caused the banks of the Artibonite River to overflow and flood the area.

The river was dammed in 1956 to create Lac de Peligre and is Haiti’s dominant drainage system.

On Friday, officials with the U.S. Centers for Disease Control and Prevention and the U.S. Agency for International Development discussed efforts on a containment strategy for the outbreak.

The CDC will send an 11-member team to Haiti over the next few days to find out which antibiotics will be most effective in treating the outbreak.

USAID will provide supplies needed to set up treatment centers.

The group already has 300,000 oral re-hydration kits in position and is distributing water purification kits in affected areas.

Cholera is caused by a bacterial infection of the intestines and, in severe cases, is characterized by diarrhea, vomiting and leg cramps, according to the CDC. In such cases, rapid loss of body fluids can lead to dehydration and shock.

“Without treatment, death can occur within hours,” the agency says.

A person can get cholera by drinking water or eating food contaminated with the bacteria.

During epidemics, the source of the contamination is often the feces of an infected person, and infections can spread rapidly in areas where there is poor sewage treatment and a lack of clean drinking water.

All the reported cases in the Lower Artibonite involve severe diarrhea and vomiting, Wall said.

Ian Rawson, director of Hospital Albert Schweitzer Haiti near Verrettes, said patients began showing choleralike symptoms October 16.

The pace picked up significantly Tuesday and beyond, though he said the situation was under control Friday at his 80-bed facility about 16 miles east of St. Marc.

“So far, we’ve been able to manage it,” Rawson said, noting that new patients were now coming in via pickups about every 10 minutes.

Temperatures in the mid-90s exacerbated the dual concerns about dehydration and people contracting cholera by drinking tainted water.

People with buckets lined roadsides in and around villages, hoping that passers-by might have clean water, said Eric Lotz, Haiti’s national director for the nonprofit Operation Blessing.

The U.N. mission in Haiti credited access to clean water and free medical facilities for preventing feared outbreaks of cholera and tuberculosis.

Source (article): CNN

Source (pictures): PRESSTV, ONLINE.WORLDMAG, 101NEWS

SANTIAGO, Chile - A massive magnitude-8.8 earthquake struck Chile early Saturday, killing at least 85 people, triggering a tsunami and damaging buildings more than 200 miles away.

President Michelle Bachelet declared a “state of catastrophe”.

At least 23 aftershocks were reported, including one registering at 6.9 on the Richter scale.

The U.S. Geological Survey said the earthquake struck 56 miles northeast of the city of Concepcion at a depth of 22 miles at 3:34 a.m. (1:34 a.m. ET).

Jessica Sigala, a geophysicist with the USGS told NBC News that the quake released 500 times more energy than the than the one that hit Port-au-Prince, Haiti, on January 12. The quake was felt in Buenos Aires, Argentina, which is located more than 800 miles away.

Tsunami warnings were issued over a wide area, including Hawaii, South America, Australia and New Zealand, Japan, the Philippines, Russia and many Pacific islands.

NBC station KNHL reported that the first tsunami wave was expected to reach Hawaii’s coastline at 11:19 a.m. local time (4:19 p.m. ET). It warned that “urgent action should be taken to protect lives and property.”

Giant wave
Reuters reported that a tsunami caused by the quake caused “serious damage” to Chile’s sparsely populated Juan Fernández Islands. Citing local police, CNN reported that the islands had been hit by a 40-meter (131-foot) wave.

Bachelet, the country’s president, urged people to stay calm. She told Reuters that 85 deaths had been confirmed.

Edmundo Perez Yoma, the interior minister, warned the death toll “will continue rising.”

An Associated Press Television News cameraman said some buildings collapsed in the capital Santiago, which lies about 200 miles north of the epicenter.

In the moments after the quake, people streamed onto the streets of the capital, hugging each other and crying.

Jen Ross, a journalist based in Santiago, told NBC’s TODAY that she felt “three minutes of shaking”.

Broadcaster TVN reported that several hospitals had suffered structural damage and were being evacuated.

‘It’s like the end of the world’
“Never in my life have I experienced a quake like this, it’s like the end of the world,” one man told local television from the city of Temuco, where the quake damaged buildings.

Simon Shalders, who lives in Santiago, told Sky News: “There was a lot of movement. The houses were really shaking, walls were moving backwards and forwards, and doors were swinging open.

“Santiago has got a history of earthquakes and basically there’s not a lot of old construction in Santiago because of these earthquakes.

“The new buildings in Santiago are designed to withstand fairly strong quakes and they probably held up pretty well.”

There were blackouts in parts of Santiago and communications were still down in the area closest to the epicenter.

Santiago resident Leo Perioto told CNN that “windows were wobbling a lot” in his six-story building.

“The whole building was shaking,” he added. “We could feel the walls moving from side to side.”

An earthquake of magnitude 8 or over can cause “tremendous damage,” the USGS said. The quake that devastated Port-au-Prince on January 12 was rated magnitude 7.0.

‘Threat to more distant coasts’
The Pacific Tsunami Warning Center said the Chile quake generated a tsunami that may have been destructive along the coast near the epicenter “and could also be a threat to more distant coasts.”

According to a 2002 census, Concepcion is one of the largest cities in Chile with a population of around 670,000.

In 1960, Chile was hit by the world’s biggest earthquake since records dating back to 1900.

The 9.5 magnitude quake devastated the south-central city of Valdivia, killing 1,655 people and sending a tsunami which battered Easter Island 2,300 miles off Chile’s Pacific seaboard and continued as far as Hawaii, Japan and the Philippines.

No question, the two church-goers from New Jersey had the best intentions in the world when they arrived in Port-au-Prince this week to help victims of Haiti’s killer earthquake.

Trouble was, that was all they had in a land where food, water, shelter and transportation are at a desperate premium, said Laura Blank, a disaster communications manager on the ground for World Vision, a Christian humanitarian aid group with long ties to the country.

“They seemed very eager and very passionate about helping the people of Haiti, but they didn’t have a ride to get out of the airport,” said Blank, who had to direct the pair to assistance.

More than a week after a magnitude-7 earthquake devastated the country, disaster organizers say they’re seeing the first signs of a problem that can hinder even the most ambitious recovery efforts: good intentions gone wrong.

From volunteer medical teams who show up uninvited, to stateside donors who ship boxes of unusable household goods, misdirected compassion can actually tax scarce resources, costing time, money, energy — and lives, experts say.

“Everyone wants to be a hero. Everyone wants to help,” said Dr. Thomas Kirsch, co-director of the Johns Hopkins Center for Refugee and Disaster Response. “It’s not the way to do it.”

Even a medical crew from his own school — Kirsch declined to identify them — arrived in Haiti so ill-prepared they had to seek sustenance from non-governmental organizations.

“They had no bedding, supplies or food,” he said. “They ended up glomming onto some of the NGOs.”

Volunteers simply show up
What to do with well-meaning volunteers is not a new problem. In every disaster, large numbers of people simply show up to help. A handbook published by California disaster officials estimates organizers can count on 50,000 “convergent” volunteers after any severe earthquake. After the Sept. 11 terror attacks, more than 40,000 unsolicited volunteers arrived at Ground Zero in New York.

In the U.S. and around the world, aid organizations are walking a fine line, trying to encourage skilled professionals who can provide indispensable assistance — and waving off those who might not be

up to the task. At the federal Center for International Disaster Information, a stern note warns the well-intentioned:

“Volunteers without prior disaster relief experience are generally not selected for relief assignments,” it reads. “Most offers of another body to drive trucks, set up tents, and feed children are not accepted.”

It’s an effort to help would-be Samaritans recognize the reality of the situation, said CIDI director Suzanne H. Brooks.

“It’s very romantic in the TV and movies,” she said. “They think it’s flying in for a weekend. They need to think of it in terms of months.”

Those best suited to help are probably already there, experts said. They’re trained crews who not only have experience working in disasters, but also in developing nations, Kirsch said. The best teams also have a command of Haitian Creole and French, if possible.

When teams arrive without those skills and without their own supplies, they drain resources that could better be used for actual victims, said Dr. Kristi L. Koenig, an emergency physician at the University of California, Irvine, who specializes in disaster response.

“Unless you’re part of a team before the disaster happens with a formal mission, you’re going to be part of the problem,” she said.

Even worse, certain volunteers have required emergency intervention themselves, Kirsch noted.

“Most people do quite well, but about 10 percent don’t,” he said. “They end up totally freaking out and having to be evacuated.”

Winter coats and high-heeled shoes?
A different but equally pressing problem is the flood of ill-advised donations that aid agencies already are facing, organizers said. A handful of “Help Haiti” food and clothing drives across the country are inspiring cringes among some workers, said Diana Rothe-Smith, executive director of the National Voluntary Organizations Active in Disaster, a coalition of agencies.

“I would strongly recommend that no donation drives be conducted unless there’s an existing organization on the ground, in Haiti, that has asked for the help,” Rothe-Smith said. “It does pile up very quickly.”

Donations of old clothes, canned goods, water and outdated prescriptions are accumulating, said Brooks. While such items sound useful, they’re actually expensive to sort, to transport and to distribute, she said. Cast-off drugs can be dangerous.

Oftentimes, the household items donated are simply not useful to the disaster victims they’re intended to help.

“I guarantee you someone is going to send a winter coat or high-heeled shoes,” Brooks said.

In fact, after the tsunami in Indonesia in 2004, aid organizers in Sri Lanka were forced to deal with donations of stiletto shoes, expired cans of salmon, evening gowns and even thong panties, according to news reports. In Florida, a truckload of mink coats showed up during the 2004 hurricane season, Rothe-Smith said, a likely tax write-off for a retailer having trouble pushing furs.

The compassion behind some donations is understandable — and laudable, she added. People see dire images on television or in news reports and they want to help.

“It seems to make logical sense to go through your own cupboard and gather those items,” Rothe-Smith said.

The reality, however, is that inappropriate donations actually do more harm than good.

“If you buy a can of peas and it costs 59 cents, it’ll cost about $80 to get it where it needs to go,” Rothe-Smith said.

Mathematics of donation favor cash
Many agencies try to motivate donors with the mathematics of the situation. Jeff Nene, a spokesman for Convoy of Hope, a Springfield, Mo., agency that feeds 11,000 children a day in Haiti, urges cash donations that allow his group to buy in bulk from large suppliers and retailers.

“When people give $1, it translates into $7 in the field,” he said. “If they spend $5 for bottled water, that’s nice and it makes them feel good, but probably it costs us more than $5 to send it. If they give us $5, we can get $35 worth of water.”

That’s a sentiment echoed by virtually every aid agency.

“I would really say at this point, honestly, right now, money is the best thing to give,” Rothe-Smith said.

Donors can find vetted agencies helping in Haiti on sites such as Charity Navigator.

Still, trying to direct the flood of compassion can be tricky, Nene acknowledged.

“Some people get a little miffed by it. They think they’re trying to help and when you don’t receive it in that attitude and spirit, they get upset,” he said.

“You just have to tread lightly. You don’t want to crush people when they’re so willing to help.”

Source (article): MSNBC

Source (picture): MSNBC

LOS ANGELES (AP) — The Los Angeles County coroner has ruled Michael Jackson’s death a homicide and a combination of drugs was the cause, a law enforcement official told The Associated Press, a finding that makes it more likely criminal charges will be filed against the doctor who was with the pop star when he died.

Forensic tests found the powerful anesthetic propofol acted together with at least two sedatives to cause Jackson’s death June 25 in his rented Los Angeles mansion, according to the official, who spoke on condition of anonymity because the findings have not been publicly released.

Dr. Conrad Murray, a Las Vegas cardiologist who became Jackson’s personal physician weeks before his death, is the target of a manslaughter investigation by the Los Angeles Police Department. A designation of homicide means that Jackson died at the hands of another, but does not necessarily mean a crime was committed.

A search warrant affidavit unsealed Monday in Houston includes a detailed account of what Murray told investigators.

According to the document, Murray said he’d been treating Jackson for insomnia for about six weeks with 50 milligrams of propofol every night via an intravenous drip. But he said he feared Jackson was forming an addiction to the anesthetic, which is normally used in hospitals only, and was attempting to wean his patient by lowering the dose to 25 milligrams and adding the sedatives lorazepam and midazolam.

That combination succeeded in helping Jackson sleep two days prior to his death, so the next day, Murray told detectives he cut off the propofol — and Jackson fell asleep with just the two sedatives.

Then around 1:30 a.m. on June 25, starting with a 10-milligram tab of Valium, Murray said he tried a series of drugs instead of propofol to make Jackson sleep. The injections included two milligrams of lorazepam around 2 a.m., two milligrams of midazolam around 3 a.m., and repeats of each at 5 a.m. and 7:30 a.m. respectively.

But they didn’t work.

Murray told detectives that around 10:40 a.m. he gave in to Jackson’s “repeated demands/requests” for propofol, which the singer referred to as his “milk.” He administered 25 milligrams of the white-colored liquid, — a relatively small dose — and finally, Jackson fell asleep.

Murray remained with the sedated Jackson for about 10 minutes, then left for the bathroom. No more than two minutes later, he returned — and found Jackson had stopped breathing.

“There’s no surprise there” that death could result from such a combination, said Dr. David Zvara, anesthesia chairman at the University of North Carolina at Chapel Hill.

“All those drugs act in synergy with each other,” Zvara said. Adding propofol on top of all the other sedatives “tipped the balance.”

Besides the propofol and two sedatives, the coroner’s toxicology report found other substances in Jackson’s system but they were not believed to have been a factor in the singer’s death, the official told the AP.

When he died, Jackson was skinny but not overly emaciated, and his body had bed sores, the official said. The singer is believed to have developed bed sores in the months following his 2005 acquittal of child molestation charges, when he went into seclusion and spent long stretches in bed.

Murray has spoken to police and last week released a video saying he “told the truth and I have faith the truth will prevail.” Murray did not say anything about the drugs he gave to Jackson. Murray’s attorney, Edward Chernoff, had no immediate comment but has previously said Murray never administered anything that “should have” killed Jackson.

A call to the coroner’s office was not returned Monday.

Jackson’s family released a statement Monday, saying it has “full confidence” in the legal process and the efforts of investigators. It concludes: “The family looks forward to the day that justice can be served.”

The 25 milligrams of propofol Murray told police he gave Jackson the day he died “is not a whopping amount,” said Lee Cantrell, director of the San Diego division of the California Poison Control System. But by combining propofol with a cocktail of the other sedatives, known as benzodiazepines, it “may have been the trigger that pushed him over the edge,” Cantrell said.

Cantrell said it’s perplexing that someone would give various benzodiazepines if one was found not to be effective.

“This is horrible polypharmacy,” he said, referring to the interaction between the various drugs. “No one will treat an insomniac like this.”

The affidavit says Murray told investigators he didn’t order or buy any propofol and had found about eight bottles of it in Jackson’s home along with numerous other medications. But investigators served a search warrant Aug. 11 at a Las Vegas pharmacy and uncovered evidence showing Murray legally purchased from the store the propofol he gave Jackson the day he died.

Murray didn’t tell paramedics or doctors at UCLA hospital where Jackson was rushed June 25 about any drugs he administered other than lorazepam and flumazenil, according to the affidavit. The document says it was only during a subsequent interview with Los Angeles Police detectives that Murray gave a more full accounting of the events leading up to the 911 call.

The coroner’s office has not publicly released its autopsy findings, citing a request from police detectives to withhold results until their investigation is complete.

Homicide, or “death at the hands of another,” is one of several possible findings in a coroner’s death investigation. The designation does not necessarily mean a crime was committed though it is a useful starting point for prosecutors, said Dr. Michael Baden, the former chief medical examiner in New York City and a forensics expert involved in many high-profile murder cases.

“It is an easier prosecution when the medical examiner calls it a homicide,” said Baden, who is not involved in the Jackson investigation.

Source (article): MSN

Source (picture): ARTIEWAYNE

A Jacksonville promotions company plans to sell a doll as a tribute to slain toddler Caylee Marie Anthony.

The Inspirational Caylee Sunshine Doll will go on sale Tuesday for $29.99.

The blonde-haired, 18-inch doll wears jeans and a T-shirt depicting a sun and the phrase: “CAYLEE SUNSHINE.” The song “You Are My Sunshine” plays when her belly button is pushed.

Jaime Salcedo, president of Showbiz Promotions, said he is not selling a doll that looks exactly like Caylee because it would be too morbid and difficult for the public.

Instead, he said, they want to honor and respect Caylee’s life by bringing awareness to her case.

“We want it to be a tribute,” he said.

Salcedo said this is the first product his promotions company will sell that is inspired by the victim of a crime.

Salcedo said he plans to donate a portion of the proceeds to charity — though he does not have an organization lined up yet.

Salcedo said he’s waiting to hear back from several organizations, including the National Center for Missing & Exploited Children. He is considering donating $3 for every doll sold.

Asked about whether it’s appropriate for his company profit on Caylee’s death, Salcedo said he is anticipating critics.

“I think that that is going to come up,” he said.

Salcedo said the public does not understand what it costs to make the doll, ship it, import it, and his company’s expenses.

SOURCE: ORLANDO SENTINEL