Cholera outbreak likely to grip Haiti for months - USA Today

A cholera outbreak in earthquake-ravaged Haiti that has killed more than 900 people will continue for at least six months, possibly years, experts say.The outbreak has spread quickly, reaching at least six of Haiti's 10 provinces since it was confirmed Oct. 22, says Donna Eberwine-Villagrán of the Pan American Health Organization. So far, 16,800 people have been hospitalized, but she says the number affected is most likely higher because those who have not gone to a health facility have not been counted.

Her group estimates at least 200,000 people will become ill.

Now that the disease has a foothold, it will be nearly impossible to eradicate without permanent access to clean water, says Jeffrey Withey, a microbiologist with the Wayne State University School of Medicine in Detroit.

A massive earthquake in January left 1.3 million people homeless, many crowded in tent camps without plumbing.

"The outbreak will continue for the foreseeable future," Withey says.

A permanent solution in Haiti is far off, especially since government and relief agencies are overwhelmed trying to save people with the disease, says Sophie Delaunay, executive director of Doctors Without Borders USA.

The bacteria are spread through contaminated food or water. Relief agencies and the government have launched a campaign to teach people to drink only clean water, wash their hands with soap and clean water and dispose of feces properly. Cholera is lethal if untreated. It is relatively easy to treat with rehydration packs of salt or sugar water and antibiotics; even so, Delaunay says, relief agencies do not have enough supplies.

The United Nations Office for the Coordination of Humanitarian Affairs has started a $164 million fundraising effort that includes a proposed $90 million to build permanent distribution systems for clean water.

Complicating the response: riots in several cities Monday by protesters responding to rumors that U.N. peacekeepers from Nepal were to blame for the outbreak. The riots left at least one protester dead and six peacekeepers wounded.

The U.N. Stabilization Mission in Haiti said the protests were linked to the Nov. 28 presidential election.

Robert Quick, an epidemiologist with the Centers for Disease Control and Prevention (CDC) who is in Haiti, says it is likely that the cause of the outbreak will never be known. Global travel and trade make it easy for the bacteria to spread, he says.

The CDC concluded in March that cholera was unlikely to occur in Haiti because the country had not seen an outbreak in at least 50 years.

Afsar Ali, a University of Florida microbiologist who studies cholera in developing countries, was not surprised by the outbreak.

Ali says he went to Haiti in August and saw too many people in crowded, squalid conditions with no access to clean water. He says more surveillance of water sources, particularly in areas outside Port-au-Prince, could have alerted authorities to cholera in the water and an education campaign could have taught people how not to spread the bacteria.

Because the focus was on disaster relief after the quake, he says, "nobody paid attention. Everyone was busy doing other things."

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Bush and Cheney, Together Again at Groundbreaking - New York Times

In their first public appearance together since leaving office, Mr. Bush and Mr. Cheney heaped praise on each other, putting behind them the tension of their final days in the White House when they fought over the president’s refusal to pardon the vice president’s ex-chief of staff. In his new memoir, Mr. Bush wrote that he worried that the fight had fractured their friendship.

Addressing a crowd of 2,500 supporters and Bush administration veterans, Mr. Cheney said the response to Mr. Bush’s book showed that the country had begun to re-evaluate him.

“Two years after you left office, judgments are a little more measured than they were,” Mr. Cheney said. “When times have been tough or the critics have been loud, you’ve always said you had faith in history’s judgment, and history is beginning to come around.”

Mr. Bush responded by hailing his No. 2 and recalling the decision to ask him to be the running mate in 2000. “As I stand here,” Mr. Bush said, “there is no doubt in my mind he was the right pick then, he was a great vice president of the United States and I’m proud to call him friend.”

Until this week, Mr. Bush and Mr. Cheney had seen each other just once in private since President Obama was inaugurated. Mr. Cheney’s attendance was a rare public appearance since his long hospital stay for heart trouble this year. He appeared much thinner in his face and body, more hesitant in his gait, and he used a cane, although he put it aside when it came time to approach the lectern. After the speeches and ceremonial dirt turning, he quickly departed, while other luminaries lingered.

His daughter Liz Cheney said Mr. Cheney, 69, was gaining back his strength. “He lost weight when he was in the hospital this summer, as most people do, but he is feeling great and enjoying working on his book, and hanging out with his grandkids,” she said after the event.

His dry wit seemed intact as he took a poke at Mr. Obama’s recent admission that there were no such things as shovel-ready public works projects. Referring to the groundbreaking, he said, “This may be the only shovel-ready project in America.”

Mr. Bush, on the other hand, left his successor unscathed, as he has since leaving Washington.

“I believe the ultimate responsibility of a leader is to not do what is easy or popular but to do what is necessary and right,” Mr. Bush told the crowd. “The decisions of governing are on another president’s desk, and he deserves to make them without criticism from me. But staying out of current affairs and politics does not mean staying out of policy.”

Mr. Bush plans to use a public policy institute that will be housed at the center along with the traditional presidential library and museum to advance four causes he adopted as his own while in office: human freedom, global health, economic growth and education. He has also started a women’s initiative led by his wife, Laura Bush.

“He’s energized,” Andrew H. Card Jr., his first White House chief of staff, said in an interview. “He’s very much at peace. He’s reliving, but he’s not second-guessing. And he’s not opining. This is not a political event.”

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Move to Ban Earmarks Exposes Both Parties to Divisions in Ideology - New York Times

Given how zealously Mr. McConnell has defended the constitutional prerogative of Congress to control the federal purse, his turnabout was also the surest sign yet that the rightward pressure of Tea Party groups, and an antispending sentiment among voters, have begun to influence the way Washington does business.

At the same time, the renewed push against earmarks highlighted a potential conflict between the calls to eliminate the spending items and demands by many Tea Party supporters for greater fidelity to the Constitution. It is the Constitution, after all, that put Congress in charge of deciding how to spend the taxpayers’ money. In pledging not to let individual lawmakers designate federal money for local purposes, the anti-earmark contingent is in effect ceding more power to the executive branch over how taxpayer dollars are spent, presumably not the outcome desired by the new crop of grass-roots conservatives.

“If Congress does not direct any spending,” said Senator Kay Bailey Hutchison, Republican of Texas, who supported the earmark ban, “the president will have 100 percent of the discretion in all federal programs. The failed stimulus is replete with examples of the president’s earmarks that are wasteful.”

The earmark ban is one issue forcing Republicans to navigate among conflicting priorities, like tax cutting and deficit reduction. But it has quickly emerged as a high-profile if somewhat symbolic test of the willingness of Republicans — and some Democrats for that matter — to respond to what they see as a message of the midterm elections.

Both supporters and skeptics of an earmark ban say that it would empower the executive branch, at least initially. While earmarks amount to a trickle in the government’s flood of red ink — slightly more than three-tenths of 1 percent of federal spending — most of that money would still be expended by federal agencies in the absence of earmarks but without specific directions from Congress.

Senator Thad Cochran of Mississippi, the senior Republican on the Appropriations Committee, said, “I remain unconvinced that fiscal prudence is effectively advanced by ceding to the Obama administration our constitutional authority.” But he said he would abide by his colleagues’ wishes .

Some critics of earmarks say the tension between the constitutional and antispending prerogatives is overblown. Representative Jeff Flake, Republican of Arizona, said Congress could easily maintain — and even expand — its purview over spending and still not engage in the earmarking process that has led to corruption scandals and is often viewed as a way to generate campaign contributions.

“This notion that earmarks are an expression of our Article 1 authority, that’s a pretty sad tale,” Mr. Flake said in an interview, referring to the part of the Constitution that gives Congress power of the purse.

He said defenders of earmarks often noted that they accounted for a tiny percentage of federal spending, and Mr. Flake said that was the reason Congress should stop paying so much attention to them.

Instead, he argued, Congress should focus on the vast bulk of the budget that it has already ceded to the administration’s control, and should improve the authorization process by which Congressional committees judge the merit of spending items, the appropriations process in which the money is allocated and subsequent oversight.

Ralph Spampanato, an organizer of the Stark County 9-12 Patriots, in Ohio, said that he supported the idea of an earmark ban and that Congress should exercise its constitutional authority by adopting a budget and demanding that agencies stick to it.

“If they give them the money that’s required to get their basic job done, there won’t be any money leftover to spend,” Mr. Spampanato said.

Mr. Flake said: “We need to reinvigorate the authorization process. The problem with earmarking is you do very little authorizing, a lot of appropriating and very little oversight.”

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