Philippines orders probe into Sanofi dengue vaccine for 730,000 children

Concepcion Yusop, a national immunization program manager, shows an anti-dengue vaccine Dengvaxia inside a vaccine storage room in Sta. Cruz city, Metro Manila, Philippines December 4, 2017.

By Manolo Serapio Jr and Neil Jerome Morales

MANILA (Reuters) – The Philippines ordered an investigation on Monday into the immunization of more than 730,000 children with a vaccine for dengue that has been suspended following an announcement by French drug company Sanofi  that it could worsen the disease in some cases.

The World Health Organization said it hoped to conduct a full review by year-end of data on the vaccine, commercially known as Dengvaxia. In the meantime, the WHO recommended that it only be used in people who had a prior infection with dengue.

The government of Brazil, where dengue is a significant health challenge, confirmed it already had recommended restricted use of the vaccine but had not suspended it entirely.

Amid mounting public concern, Sanofi explained its “new findings” at a news conference in Manila but did not say why action was not taken after a WHO report in mid-2016 that identified the risk it was now flagging.

A non-governmental organization (NGO) said it had received information that three children who were vaccinated with Dengvaxia in the Philippines had died and a senator said he was aware of two cases.

However, Department of Health Undersecretary Gerardo Bayugo told Reuters the three referred to by the NGO died due to causes not related to the vaccine and Sanofi said no deaths had been reported as a result of the program.

“As far as we know, as far as we are made aware, there are no reported deaths that are related to dengue vaccination,” said Ruby Dizon, medical director at Sanofi Pasteur Philippines.

Last week, the Philippines Department of Health halted the use of Dengvaxia after Sanofi said it must be strictly limited due to evidence it can worsen the disease in people not previously exposed to the infection.

In a statement, Sanofi said the long-term safety evaluation of the vaccines showed significantly fewer hospitalizations due to dengue in vaccinated people over 9 years old compared with those who had not been vaccinated.

Nearly 734,000 children aged 9 and over in the Philippines have received one dose of the vaccine as part of a program that cost 3.5 billion pesos ($69.54 million).

The Department of Justice on Monday ordered the National Bureau of Investigation to look into “the alleged danger to public health … and if evidence so warrants, to file appropriate charges thereon.”

There was no indication that Philippines health officials knew of any risks when they administered the vaccination.

However, the WHO said in a July 2016 research paper that “vaccination may be ineffective or may theoretically even increase the future risk of hospitalized or severe dengue illness in those who are seronegative at the time of first vaccination regardless of age.”

Singapore’s Health Sciences Authority said last week that it flagged risks when Dengvaxia was approved there in October 2016, and was working with Sanofi to strengthen risk warnings on the drug’s packaging.

According to Sanofi in Manila, 19 licences were granted for Dengvaxia, and it was launched in 11 countries, two of which – the Philippines and Brazil – had public vaccination programs.

Brazil’s healthcare regulator Anvisa said in a statement that it now recommends that people who have never been infected with dengue not take the vaccine, which was approved for use in Brazil at the end of 2015.

It was not known whether many people have taken the vaccine, if it was part of any government immunization program or if any illnesses or deaths linked to the drug have been reported to the government.

Anvisa did not immediately respond to a request for comment, nor did the Health Ministry.

A spokesman for Sanofi in Paris was not immediately available for comment. “A SHAMELESS SCAM” A spokesman for Philippines President Rodrigo Duterte said on Sunday the government would hold to account those responsible for the program.

Former Health Secretary Janette Garin, who implemented the program under the administration of then-President Benigno Aquino, said she welcomed the investigation.

“In the event that there will be authorities who will point culpability to me, I am ready to face the consequences,” she told ANC TV. “We implemented it in accordance with WHO guidance and recommendations.”

Presidential spokesman Harry Roque said there had been no reported case of severe dengue infection since the vaccine was administered and urged the public “not to spread information that may cause undue alarm.”

Volunteers Against Crime and Corruption, an NGO, said it was checking a report that three children on the northern island of Luzon had died since being vaccinated in April 2016 but the Department of Health said the deaths were not due to Dengvaxia.

“When we evaluated the clinical records, it was not related to the dengue vaccination,” Bayugo said.

A prominent senator, Richard Gordon, told Reuters he was aware of two deaths – but gave no details – and said approval and procurement for the program was done with “undue haste.”

Dengue is a mosquito-borne tropical disease. Although it is not as serious as malaria, it is spreading rapidly in many parts of the world, killing about 20,000 people a year and infecting hundreds of millions.

While Sanofi’s Dengvaxia is the first-ever approved vaccine for dengue, scientists already recognized it was not perfect and did not protect equally against the four different types of the virus in clinical tests.

A new analysis from six years of clinical data showed Dengvaxia vaccine provides persistent protective benefit against dengue fever in those who had prior infection.

But for those not previously infected by the virus, more cases of severe disease could occur in the long term following vaccination, Sanofi said.

 

(Additional reporting by Karen Lema in Manila, John Geddie in Singapore and Brad Brooks in Sao Paulo and Anthony Boadle in Brasilia; Writing by John Chalmers; Editing by Raju Gopalakrishnan and Bill Trott)

 

Chinese police detain teacher in kindergarten abuse inquiry

BEIJING (Reuters) – Beijing police investigating alleged child abuse at a kindergarten run by RYB Education Inc said on Saturday they had detained a teacher, in the latest scandal to hit China’s booming childcare industry.

Police in the Chaoyang district said it will further investigate claims of abuse after China’s official Xinhua news agency reported this week they were checking allegations that children at the nursery were “reportedly sexually molested, pierced by needles and given unidentified pills”.

Chaoyang district police said in an online posting on Saturday they had detained a 22-year-old teacher, surnamed Liu from the Hebei province adjacent to Beijing.

Police have also arrested another person, also surnamed Liu, for allegedly disrupting social order by spreading false information about the alleged kindergarten abuse, it said in a separate posting.

RYB’s New York-listed shares plunged 38.4 percent on Friday as the scandal sparked outrage among parents and the public.

The second woman, 31, and a Beijing native, was arrested on Thursday, police said.

Parents said their children, some as young as three, gave accounts of a naked adult male conducting purported “medical check-ups” on unclothed students, other media said.

RYB provides early education services in China and at the end of June was operating 80 kindergartens and had franchised an additional 175, covering 130 cities and towns in China.

Meanwhile, Beijing city authorities have urged RYB to remove the head of the kindergarten, Xinhua reported.

The Chaoyang district has launched an investigation into all childcare facilities in its area, the report said.

(Reporting by Shu Zhang and Josephine Mason; Editing by Christian Schmollinger and Clelia Oziel)

North Korean women suffer discrimination, rape, malnutrition: U.N.

Women wearing traditional clothes walk past North Korean soldiers after an opening ceremony for a newly constructed residential complex in Ryomyong street in Pyongyang, North Korea April 13, 2017.

By Stephanie Nebehay

GENEVA (Reuters) – North Korean women are deprived of education and job opportunities and are often subjected to violence at home and sexual assault in the workplace, a U.N. human rights panel said on Monday.

After a regular review of Pyongyang’s record, the U.N. Committee on the Elimination of Discrimination against Women also voiced concern at rape or mistreatment of women in detention especially those repatriated after fleeing abroad.

North Korean women are “under-represented or disadvantaged” in tertiary education, the judiciary, security and police forces and leadership and managerial positions “in all non-traditional areas of work”, the panel of independent experts said.

“The main issue is first of all the lack of information. We have no access to a large part of laws, elements and information on national machinery,” Nicole Ameline, panel member, told Reuters. “We have asked a lot of questions.”

North Korea told the panel on Nov. 8 that it was working to uphold women’s rights and gender equality but that sanctions imposed by major powers over its nuclear and missile programs were taking a toll on vulnerable mothers and children.

Domestic violence is prevalent and there is “very limited awareness” about the issue and a lack of legal services, psycho-social support and shelters available for victims, the panel said.

It said economic sanctions had a disproportionate impact on women. North Korean women suffer “high levels of malnutrition”, with 28 percent of pregnant or lactating women affected, it said.

“We have called on the government to be very, very attentive to the situation of food and nutrition. Because we consider that it is a basic need and that the government has to invest and to assume its responsibilities in this field,” Ameline said.

“Unfortunately I am not sure that the situation will improve very quickly.”

The report found that penalties for rape in North Korea were not commensurate with the severity of the crime, which also often goes unpunished. Legal changes in 2012 lowered the penalties for some forms of rape, including the rape of children, rape by a work supervisor and repeated rape.

This has led to reducing the punishment for forcing “a woman in a subordinate position” to have sexual intercourse from four years to three years, the report said.

It said women trafficked abroad and then returned to North Korea, are reported to be sent to labor training camps or prisons, accused of “illegal border crossing”, and may be exposed to further violations of their rights, including sexual violence by security officials and forced abortions.

 

(Reporting by Stephanie Nebehay; Editing by Robin Pomeroy and Alison Williams)

 

Reuters finds 3,810 U.S. areas with lead poisoning double Flint’s

Reuters finds 3,810 U.S. areas with lead poisoning double Flint’s

By M.B. Pell and Joshua Schneyer

(Reuters) – Since last year, Reuters has obtained neighborhood-level blood lead testing results for 34 states and the District of Columbia. This data allows the public its first hyper-local look at communities where children tested positive for lead exposure in recent years.

While the number of children with high lead levels has plummeted across the U.S. since lead paint and gasoline were phased out in the 1970s and 1980s, many communities remain exposed to the toxic heavy metal, the data show.

In all, Reuters has identified 3,810 neighborhood areas with recently recorded childhood lead poisoning rates at least double those found across Flint, Michigan, during the peak of that city’s water contamination crisis in 2014 and 2015. Some 1,300 of these hotspots had a rate of elevated blood tests at least four times higher than Flint’s.

Reuters defined an elevated result as any test higher than the Centers for Disease Control and Prevention’s current reference number of 5 micrograms per deciliter, the level at which the agency recommends a public health intervention.

The news agency obtained the data, broken down by census tract or zip code, from state health departments or the CDC through records requests. U.S. census tracts are small county subdivisions averaging 4,000 residents. Zip codes have average populations of 7,500.

This newest map reflects additional data obtained this year, and includes some changes to data initially published by Reuters in a map last December.

The map now includes testing data for additional states and cities: Kansas, Georgia, Tennessee, Vermont, North Carolina, New York City and Washington, DC.

The newly identified communities with high rates of elevated childhood lead levels include a historic district in Savannah, Georgia, areas in Rutland, Vermont, near the popular skiing mountain Killington, and a largely Hasidic Jewish area in Brooklyn.

The updated map includes other minor changes. Recently, the CDC provided testing results to correct data it previously released to Reuters for Pennsylvania, Ohio, New Jersey, Virginia and Louisiana. Responding to earlier records requests, the CDC mistakenly released test results for all children under 16, though the news agency requested testing results for children under six – the age group most likely to be affected by lead exposure.

Still, even with the updated CDC data, the number of areas with high rates of elevated lead tests increased or remained about the same in each state.

The map now features zip code level data for Los Angeles County, California, provided by the state’s Department of Public Health. An earlier version featured census tract level results, but reporters discovered the county’s epidemiologist had misclassified some of them. The county has declined to provide corrected data.

(Editing by Ronnie Greene)

Northern California shooting death toll reaches five after wife’s body found

police sirens

By Alex Dobuzinskis

(Reuters) – The death toll in a shooting spree in rural Northern California rose to five after police discovered the body of the gunman’s wife hidden in the couple’s house, an assistant sheriff said on Wednesday.

The body of the wife of the gunman, Kevin Neal, was discovered late on Tuesday, hidden under a hole in the floor, Tehama County Assistant Sheriff Phil Johnston said.

Authorities believe Neal, 44, killed his wife on Monday, the day before he went on a rampage at multiple sites around the small community of Rancho Tehama, about 120 miles (193 km) north of Sacramento, killing four other people. Neal also opened fire at an elementary school before he was slain by police.

Johnston said many more people might have been killed if staff at the Rancho Tehama School had not locked Neal out. One child there was shot but survived, and others were hurt by flying glass and other debris from the hail of bullets.

“I really, truly believe that we would have had a horrific bloodbath in that school if that school hadn’t taken the action when they did,” Johnston told a news conference.

School employees locked the doors when they heard gunfire in the distance.

The employees ushered children inside from the playground, according to Sacramento television station KCRA, which cited details from the school district superintendent.

Neal, who was driving a pickup truck, rammed open a school gate, before a custodian leaned out from behind a building and distracted him, according to KCRA. Employees finished locking the doors seconds before Neal walked up and opened fire, the station reported.

Neal, frustrated at not being able to enter the school, drove off and was shot to death on the road by police, Johnston said.

Neal was armed with two rifles he illegally manufactured and two handguns registered to someone else, Johnston said, noting that he was prohibited from having firearms under a court-issued restraining order.

Authorities did not discover Neal’s wife had been killed until Tuesday, after Neal shot his neighbors and drove around Rancho Tehama, killing four adults during a 25-minute shooting spree, Johnston said.

Authorities did not provide a possible motive for the rampage and did not identify those killed, citing the need to notify relatives.

On Wednesday, one adult injured in the shooting was hospitalized in critical condition, and a child and three other adults were in stable condition, Johnston said.

(Reporting by Alex Dobuzinskis in Los Angeles; Editing by Leslie Adler)

Gunman kills four in Northern California shooting spree

By Dan Whitcomb

(Reuters) – A gunman carrying a semi-automatic weapon and two handguns opened fire at multiple locations across a small Northern California community on Tuesday, killing four people before he was slain by police.

At least 10 other people were wounded, including two children at an elementary school near the small town of Corning, about 100 miles (160 km) north of Sacramento, where the suspect was slain, according to police and local media.

“Deeply saddened to hear of the shooting in Northern California, the loss of life, including innocent children,” Vice President Mike Pence said on Twitter. “We commend the effort of courageous law enforcement. We’ll continue to monitor the situation & provide federal support, as we pray for comfort & healing for all impacted.”

Shots were fired at Rancho Tehama Elementary school where some people were injured there but no students or staff members died, Corning Union Elementary School District administrative assistant Jeanine Quist said.

Tehama County Assistant Sheriff Phil Johnston said at a news conference that the shooter, who he did not name, had been armed with a semi-automatic rifle and two handguns.

The Sacramento Bee newspaper, citing multiple law enforcement officials, later identified the suspect as 43-year-old Kevin Janson Neal, a local resident who had been arrested in February in connection with a stabbing.

Johnston did not give a motive for the shooting rampage. The local Redding Record Searchlight newspaper reported that it began when the gunman opened fire at a home and some six other locations shortly after 8 a.m. PST.

A parent, Coy Ferreira, said he was dropping off his daughter at the elementary school when he heard gunfire.

“One of the teachers came running out of the building and told us to all run inside because there was a shooter coming,” Ferreira told Redding, California, television station KRCR.

Ferreira said he heard gunfire for over 20 minutes and that a student in the room was struck.

Area resident Brian Flint told local media his neighbor was the shooter and had stolen his truck.

Enloe Medical Center in Chico, some 40 miles away, received five patients, three of whom were treated and released, hospital spokeswoman Natali Munoz-Moore said.

St. Elizabeth Community Hospital in the community of Red Bluff received two patients, including one who was stabilized and transferred to another facility, spokeswoman Amanda Harter said.

Mercy Medical Center in Redding received three patients, including one who also was transferred elsewhere, Harter said.

(Reporting by Dan Whitcomb in Los Angeles; Additional reporting by Alex Dobuzinskis in Los Angeles and Peter Szekely and Daniel Wallis in New York; Editing by Phil Berlowitz and Lisa Shumaker)

Five dead in California shooting spree that ended at school: local media

police sirens

(Reuters) – Five people died in a shooting spree on Tuesday that ended at a school in a remote area of rural Northern California and some children were among the wounded, according to officials and local media.

Law enforcement officers shot to death the gunman, who was among the five people who died in a series of shootings at seven or more locations, according to Redding, California, newspaper the Record Searchlight.

The shooting spree began at a home and ended at Rancho Tehama School near the town of Corning, the Sacramento television station KCRA reported, citing law enforcement.

The shooter was armed with a semi-automatic rifle and two handguns, Assistant Sheriff Phil Johnston told local media.

A number of students were airlifted for medical care after gunfire at Rancho Tehama School, Johnston said.

Law enforcement did not immediately say what might have motivated the shooter.

Sheriff’s Office officials could not immediately be reached for comment.

Enloe Medical Center in Chico, more than 40 miles (64 km) southeast of the school, received five patients, and three of them were treated and released, hospital spokeswoman Natali Munoz-Moore said by phone. She declined to provide any details on their conditions.

St. Elizabeth Community Hospital in the community of Red Bluff received two patients, including one who was stabilized and transferred to another facility, Amanda Harter, a spokeswoman for the facility, said in an email. Mercy Medical Center in Redding received three patients, including one who also was transferred elsewhere, said Harter, whose company, Dignity Health, runs both hospitals.

Shots were fired at the school and some people were injured at the campus but no students or staff members died, Corning Union Elementary School District administrative assistant Jeanine Quist said by phone. The area is about 120 miles (190 km) north of Sacramento.

California Governor Jerry Brown said in a statement he and his wife were “saddened to hear about today’s violence in Tehama County, which shockingly involved schoolchildren.”

“We offer our condolences to the families who lost loved ones and unite with all Californians in grief,” Brown said.

A parent, Coy Ferreira, said he was dropping off his daughter when he heard gunshots.

“One of the teachers came running out of the building and told us to all run inside because there was a shooter coming,” Ferreira told Redding, California, television station KRCR.

“So we all hurried up and ran and told the students to get in the classrooms.”

Once inside a classroom, Ferreira said he heard gunfire for over 20 minutes and a student in the room was struck.

Brian Flint told local media his neighbor was the shooter and had stolen his truck.

The shooter’s name has not been released.

(Reporting by Alex Dobuzinskis in Los Angeles and Peter Szekely and Daniel Wallis in New York; editing by Frances Kerry and Phil Berlowitz)

Special Report: Lead poisoning lurks in scores of New York areas

Special Report: Lead poisoning lurks in scores of New York areas

By Joshua Schneyer and M.B. Pell

NEW YORK (Reuters) – In public health circles, New York City is known for its long war on lead poisoning.

The city outlawed residential lead paint in 1960, 18 years before a national ban. A 2004 housing law targeted “elimination” of childhood lead poisoning within six years. The city offers free lead testing in housing, vows to fix hazards and bill landlords when necessary, and has seen childhood exposure rates decline year after year.

Yet inspectors didn’t visit the Brooklyn apartment where Barbara Ellis lived until after her twin daughters tested high for lead three years in a row, she said. They found peeling lead paint on doors and windows. The girls required speech and occupational therapy for their developmental delays, common among lead-exposed children.

“Their words and speech are still a little slurred,” Ellis, a subway conductor, said of daughters Kaitlyn and Chasity, now 6. Tired of feuding with their landlord, they found new lodging in Harlem.

The family’s plight is not uncommon.

Areas of high lead exposure risk remain throughout America’s largest and richest city, a Reuters exploration of blood testing data found. In the first examination of its kind, reporters obtained New York childhood blood testing data down to the census tract level – neighborhood areas with some 4,000 residents apiece. In densely populated New York, a tract often covers several square blocks.

While poisoning has nearly been eliminated in many neighborhoods, Reuters identified 69 New York City census tracts where at least 10 percent of small children screened over an 11-year period, from 2005 to 2015, had elevated lead levels.

That is twice the rate found across Flint, Michigan, during the peak of its notorious water contamination crisis in 2014 and 2015, where the Centers for Disease Control and Prevention found 5 percent of children’s tests were high.

The risk areas spanned New York neighborhoods and demographic groups. Peeling old paint is a conspicuous hazard, but reporters tracked other perils hiding in plain sight, from leaded soil and water, to dangerous toys, cosmetics and health supplements.

In 2015, 5,400 city children tested with an elevated blood lead level, 5 micrograms per deciliter or higher, New York’s most recent annual report on lead poisoning showed. More than 800 had levels at least twice that high.

Previously undisclosed data explored by Reuters offers a hyper-local look at neighborhood areas where the city has fallen short of its eradication goal.

“New York’s prevention program is renowned, so the fact it still has pockets like these shows how challenging this issue is on a national scale,” said Patrick MacRoy, a former director of Chicago’s lead poisoning prevention program.

Reuters found:

• A 2004 housing law co-sponsored by Bill de Blasio, now the mayor, targeted scofflaw landlords. But the city isn’t policing two key provisions that require landlords to find and fix hazards, sometimes waiting until children get poisoned before taking action.

• The areas where the most children tested high are in Brooklyn, including neighborhoods with historic brownstones and surging real estate values, where construction and renovation can unleash the toxin. The worst spot – with recent rates nearly triple Flint’s – was in a Hasidic Jewish area with the city’s highest concentration of small children.

• An affluent area near Riverside Park in Manhattan’s Upper West Side has had rates comparable to Flint’s.

• Reporters were able to buy dangerous leaded products in city shops, including children’s jewelry. One item, a cosmetic marketed for use around children’s eyes, tested with levels 4,700 times the U.S. safety standard. It was labeled lead-free.

• Reuters purchased other items subject to New York lead warnings through online giants Amazon and EBay, which later pulled the items from their websites.

• Soil testing in Brooklyn backyards and a park detected lead levels comparable to some sites designated under the federal Superfund toxic-cleanup program.

While exposure rates have dropped citywide – by up to 86 percent since 2005 – the number of children meeting New York’s criteria for lead poisoning, twice the CDC’s elevated threshold, barely budged between 2012 and 2015.

“Unfortunately, nationally and locally, we are beginning to see signs there is a leveling off in what was once a steep downward trend,” said Rebecca Morley, a housing expert who co-authored a recent report calling for more aggressive national lead abatement policies.

In a statement, City Hall spokeswoman Olivia Lapeyrolerie said comparisons between New York and Flint are “alarmist and inaccurate,” given the city’s sharp declines in lead poisoning and aggressive prevention efforts.

But Morley, while crediting the city’s progress, said the data show “extreme pockets of poisoning remain.”

New York is just one of hundreds of American communities struggling with poisoning. In a two-year investigation, Reuters has now documented 3,810 census tracts or zip code areas across 34 U.S. states where recent high childhood lead test rates have been double those found in Flint.

There’s no safe level of lead in a child’s blood. Exposure is linked to brain damage, lower IQ, behavioral disorders, and lifelong health impacts.

Six-year-old twins Kaitlyn and Chasity Ellis, who were exposed to lead in a Brooklyn apartment, pose with their mother Barbara Ellis (R) and grandfather Ruden Ellis in a park in Harlem - where the family now lives - in New York City, U.S. September 20, 2017. REUTERS/Joshua Schneyer

Six-year-old twins Kaitlyn and Chasity Ellis, who were exposed to lead in a Brooklyn apartment, pose with their mother Barbara Ellis (R) and grandfather Ruden Ellis in a park in Harlem – where the family now lives – in New York City, U.S. September 20, 2017. REUTERS/Joshua Schneyer

A QUESTION OF ENFORCEMENT

Seventy percent of New York’s housing stock was built in the 1950s or earlier, when lead was still common in paint. A toddler can be poisoned by swallowing a dime-sized flake of lead paint, or by ingesting paint dust.

“Housing is a main way that young kids get poisoned,” said Deborah Nagin, director of the city’s lead poisoning prevention program. “It’s very important that lead paint hazards, when we identify them, don’t sit around.”

Nagin’s health department division works closely with New York’s Housing and Preservation Department, HPD, whose 400 inspectors are trained to detect lead perils.

A 2004 housing code, Local Law 1, championed by then City Council member de Blasio, gave HPD broad authority to cite landlords for paint hazards and get them fixed quickly. Since then HPD has issued more than 230,000 lead paint violations to landlords.

But its inspectors aren’t able to visit all older housing in a city with more than 2 million tenant-occupied units. And the law’s explicit goal – elimination of poisoning – remains elusive seven years past its 2010 target date.

Among the reasons: There is little or no city enforcement of two provisions of the law, designed to make private landlords responsible for preventing poisoning.

One requires landlords to conduct annual lead paint inspections in pre-1960 housing units where small children live, fix hazards and keep records. The other requires them to “permanently seal or remove” lead paint from spots like windows and door-frames – so-called friction surfaces, where paint often breaks down – before new tenants move in.

Reporters reviewed the past 12 years of HPD violation records and found the agency hasn’t cited a single landlord for failure to conduct the annual inspections. Only one was cited for failure to remediate friction surfaces between tenants, in 2010.

“If the city’s not going to nail a few people for failing to do this, then no one is going to pay attention to these requirements,” said Matthew Chachere, a lawyer with anti-poverty group Northern Manhattan Improvement Corporation, who helped draft the 2004 law.

Mayor de Blasio declined comment.

Rafael Cestero, a former HPD commissioner under Mayor Michael Bloomberg, said the measures would be hard to enforce. “There has to be some realism in what we expect a government agency to actually do,” Cestero said. The department focuses on paint violations its own inspectors find, he said, often in response to tenant complaints.

CONEY ISLAND KIDS

In a statement, City Hall called its complaint-based enforcement system “highly effective” at reducing poisoning.

Yet it doesn’t always work, leaving some families to fend for themselves until a child gets poisoned, Reuters found.

In a 116-year-old building in Coney Island, Brooklyn, unit 2R’s grimy walls are marked with “LEAD PAINT” stamps next to two children’s beds, where inspectors recently found the toxin.

HPD records show the cramped apartment has 163 outstanding housing code violations.

During a reporter’s recent visit, the power was out and the building’s common areas were scattered with rodent droppings. In an apartment, a gas kitchen oven was jerry-rigged to provide heat.

Back in 2015, when Natalia Rollins moved here from a homeless shelter, the mother of two felt lucky. A city-sponsored voucher program, CITYFEPS, helped place her in a $1,515-a-month apartment and covered much of the rent.

Rollins, 25, soon grew scared for her baby boys. There was peeling old paint, a ceiling cave-in, roach, rodent and bee infestations, buckling floorboards, a broken window.

“I hated living in shelters, but nobody should have to live like this either,” said Rollins, a daycare worker. “The landlord would just ignore my calls. When you’re on a voucher you’re treated differently.”

Rollins says she reported housing concerns through the city’s 311 hotline dozens of times. Inspectors visited, but didn’t initially test for lead.

Two months ago her son Noah, 2, was diagnosed with lead poisoning. After receiving his test result, the city Health Department quickly swooped in and found the apartment rife with paint hazards.

Noah’s language is developing, but Natalia worries about his acute sensitivity to noises and his pica behavior, a tendency to eat non-food items. Natalia, Noah and older brother Randy, who is autistic, are now staying in a Bronx safe house for lead poisoning victims operated by Montefiore Hospital.

Ervin Johnson, Rollins’ Coney Island landlord, said the apartment was in “excellent condition” when she moved in. “If her kid got exposed to lead, it probably came from somewhere else,” he said.

But the city says most poisoned children are exposed at home, and records show Johnson’s building has been on the citywide list of the 200 “most distressed” multi-unit dwellings since 2007. “This landlord has repeatedly failed their duty to safeguard our youngest New Yorkers,” the city said.

Lapeyrolerie said the city is now pressing Johnson to “immediately” address the building’s violations and working to find Rollins another apartment.

Lapses in public housing have also come to light. For years, the city’s public housing authority, NYCHA, failed to conduct required annual lead inspections in older public housing, an ongoing federal investigation found.

“We can and must do better,” NYCHA spokeswoman Ilana Maier said.

Citywide, the rate of screened children showing a high blood test in 2015 was 1.7 percent, below the CDC’s estimated national average of 2.5 percent.

Yet rates can vary wildly. A tract on the well-to-do Upper West Side of Manhattan – adjacent to Riverside Park between 105th and 109th Streets – had rates similar to Flint’s even in recent years. The area features grand old buildings and multi-million dollar apartments, where renovations could put children at risk if lead safety practices aren’t followed.

WILLIAMSBURG WOES

Decades ago, Williamsburg, Brooklyn, was a low-rent and largely industrial area. Today, its spacious lofts and privileged perch across from downtown Manhattan attract the well-heeled.

Working-class residents remain, too, including thousands of Hasidic Jews from the Satmar sect, who have settled in the neighborhood’s southern zone since World War II. With their distinctive dress and traditions, the Hasidim’s orthodox lifestyle strikes a contrast to the hipster glitz encroaching nearby.

Hasidic Williamsburg suffers alarming rates of childhood lead poisoning, ranking as the riskiest spot Reuters found citywide.

Across three southern Williamsburg census tracts, as many as 2,400 children tested at or above the CDC’s current elevated lead threshold between 2005 and 2015. In one, 21 percent of children tested during this period had high lead levels. Rates in the most recent years were lower, but still above Flint’s.

On Lee Avenue, boys wearing black hats and coats stream out of yeshivas, while women shop in kosher markets and kibitz in Yiddish in front of old brownstones, many built around 1900.

“When I saw the numbers I freaked out,” said Rabbi David Niederman, head of the United Jewish Organizations of Williamsburg. “The concentration of old housing and the number of children in them are big factors.”

In Hasidic Williamsburg, around 25 percent of the population is age five or younger, compared to about 6 percent citywide.

In recent years, city health workers homed in on the poisoning cluster. UJO and other groups helped health officials conduct outreach, distributing lead awareness pamphlets in Yiddish, urging clinics to boost screening, and holding meetings for residents and landlords.

As recently as 2015, one area tract had a rate of 13 percent, the highest in the city. It’s too early to tell whether rates have since dropped.

DANGERS ON STORE SHELVES

Newly mobile toddlers are the most common lead victims, but school-aged kids and adults are also vulnerable.

Recent testing at the city’s public schools showed more than 80 percent had at least one water outlet with lead levels above the Environmental Protection Agency’s standard of 15 parts per billion. New York public radio station WNYC mapped those results. Faucets that test high are shut off pending repairs, but leaded water lines remain common in New York buildings.

Consumer products are another concern. This year, lead safety advocate Tamara Rubin documented several varieties of the wildly popular fidget spinner toy that contained lead.

And in New York’s popular bodegas, other dangerously leaded products can be found on shelves.

Reporters bought several products that can be used by children or pregnant women from area shops, ordered others from online vendors, and sent 13 items for testing at an accredited laboratory. Six had lead levels exceeding consumer product safety standards.

In Jackson Heights, Queens, a vibrant cauldron of the city’s diverse immigrant populations, scores of small shops sell toy jewelry.

Two items Reuters had tested, a butterfly hairpiece and a glittery earring and beret set, each had lead content above the 100 parts per million U.S. safety standard for toys. Both were Chinese imports. One was labeled “lead-safe.”

The city health department sometimes conducts sweeps, seizing dangerous products or ordering shops to destroy them. It recently found Mexican lead-glazed pottery and issued a public advisory.

But some shopkeepers aren’t aware of the warnings, or ignore them.

In the southern section of Brooklyn’s Ditmas Park area, more than 500 children tested high for lead from 2005 through 2015. Many families in the area emigrated from Pakistan and Bangladesh.

In New York, children of South Asian descent are found to have especially high blood lead levels more often than other children. Sometimes, the poisoning can be linked to imported products.

A string of bright blue, red and gold tubes containing eyeliner – known as ‘surma,’ ‘kajal’ or ‘kohl’ – can be found in many Ditmas Park shops. The cosmetic is sometimes applied to children and touted to improve eye health.

Two varieties reporters bought, both marked lead-free, had unsafe lead levels.

The label for Hashmi Surmi Special liquid, made in Pakistan, says it contains “0.00 percent” lead. Lab testing showed 4.7 percent lead, or 4,700 times the Food and Drug Administration safety standard for cosmetics.

The Hashmi brand website says its surma eyeliner should be used by little ones “right from their childhood to prevent stress on sight.”

Manufacturer A.Q. & Co acknowledged the product contains a lead compound, but said it’s safe when “used externally.”

Health departments disagree. Across the United States, several have linked use of surma to childhood poisoning cases.

New York City has warned against using or selling these products, and FDA guidance says they are illegal to import.

When reporters returned to the Bisillah Grocery Store where they bought the Hashmi eyeliner, a shopkeeper said he’d stopped sales months ago, after a customer had an “allergic reaction.” Reminded of a far more recent sale to a reporter, he said, “You must have bought one of the last bottles.”

The Hashmi eyeliner was still available in several other shops nearby.

Other products U.S. health departments have warned about were easy to find online for delivery to New York City doorsteps.

Reuters purchased leaded Indian Ayurvedic medicines from vendors on Ebay and Amazon.

One of them, Ovarin, is touted to improve women’s reproductive health. It was shipped from a vendor in India via Amazon.com Marketplace. “A Boon to the Womanhood,” its online marketing said. Lab testing showed it contains enough lead to potentially harm mother and unborn child when taken at the suggested dosage.

Its maker, Ban Lab, didn’t respond to interview requests.

Amazon.com removed the product from its website after hearing from Reuters that it was subject to health warnings.

Another product, Zandu brand Maha Yograj Guggul, indicated for joint pain and other ailments, was purchased from a vendor in New Jersey via Ebay.com and tested high for lead.

Manufacturer Emami Group acknowledged the product contains lead, as required by Indian regulations for certain Ayurvedic formulas. The product should only be taken under a doctor’s supervision, its packaging says.

Ebay said it would prohibit sale of the item. Amazon and Ebay said they continually monitor products for safety concerns.

OVERHEAD, UNDERFOOT

In Queens, the city subway’s Number 7 train rumbles overhead on an elevated track.

Last year, a painters trade union said it discovered that lead paint has been raining down on bustling Queens neighborhoods from the subway’s century-old structures. A Brooklyn federal judge set a hearing for this December to consider whether to declare a public health emergency.

Poisoning risks also lurk underfoot in some city areas, where past industrial or vehicle emissions, trash incineration, and runoff from buildings with old paint have tainted the soil.

On a late summer evening, reporters conducted soil testing with help from researchers along a path in McCarren Park, a popular family destination in Greenpoint, Brooklyn.

Columbia University Environmental Sciences graduate student Franziska Landes has been testing soil around the former industrial neighborhood for months. Among the scores of backyards Landes has tested, most have had at least one reading above the EPA’s 400 parts per million lead safety threshold for areas where children play.

Aiming a futuristic-looking XRF analyzer gun into the soil, Landes quickly found one spot, along a jogging path, whose reading was five times that level.

“Wow, that’s a high one,” Landes said. Several other readings on the same path were lower, but still above the EPA threshold.

Nagin, director of New York’s lead-poisoning program, said her department hasn’t usually prioritized soil risks in an urban environment where children’s access to yards is limited. She recently met with Columbia researchers and is taking a deeper look.

Soil researcher Joshua Cheng, a professor at Brooklyn College, said more vigilance is needed. Residents in affected areas should avoid tracking dirt into homes, wash children’s hands often, and place clean topsoil in spots testing high, he said.

“The lead levels found in Brooklyn backyards are often similar to areas where there has been past lead smelting activity,” Cheng said. “They’re comparable to Superfund sites.”

Sarah DuFord, a mother of two, was among the Greenpoint residents who invited reporters into her backyard to test.

One reading was below the EPA threshold, but others were around four times that level.

“This confirms my fears,” she said. Her next step: screening her 2-year-old for lead.

Then and Now – Childhood lead poisoning in New York: http://tmsnrt.rs/2mojaEm

(Additional reporting by Devika Krishna Kumar. Editing by Ronnie Greene)

Exclusive: $6 for 38 days work: Child exploitation rife in Rohingya camps

Azimul Hasan, 10, a Rohingya refugee boy, serves plates at a roadside hotel where he works at Jamtoli, close to Palong Khali camp, near Cox's Bazar, Bangladesh, November 12, 2017.

By Tom Allard and Tommy Wilkes

COX’S BAZAR/KUTUPALONG, Bangladesh (Reuters) – Rohingya refugee children from Myanmar are working punishing hours for paltry pay in Bangladesh, with some suffering beatings and sexual assault, the International Organisation for Migration (IOM) has found.

Independent reporting by Reuters corroborated some of the findings.

The results of a probe by the IOM into exploitation and trafficking in Bangladesh’s refugee camps, which Reuters reviewed on an exclusive basis, also documented accounts of Rohingya girls as young as 11 getting married, and parents saying the unions would provide protection and economic advancement.

About 450,000 children, or 55 percent of the refugee population, live in teeming settlements near the border with Myanmar after fleeing the destruction of villages and alleged murder, looting and rape by security forces and Buddhist mobs.

Afjurul Hoque Tutul, additional superintendent of police in Cox’s Bazar, near where the camps are based, said 11 checkpoints had been set up that would help prevent children from leaving.

“If any Rohingya child is found working, then the owners will be punished,” he said.

Most of the refugees have arrived in the past two and a half months after attacks on about 30 security posts by Rohingya rebels met a ferocious response from Myanmar’s military.

Described by the United Nations human rights commissioner Zeid Ra’ad Al Hussein as a “textbook example of ethnic cleansing”, Myanmar’s government counters that its actions are a proportionate response to attacks by Rohingya “terrorists”.

The IOM’s findings, based on discussions with groups of long-term residents and recent arrivals, and separate interviews by Reuters, show life in the refugee camps is hardly better than it is in Myanmar for Rohingya children.

The IOM said children were targeted by labor agents and encouraged to work by their destitute parents amid widespread malnutrition and poverty in the camps. Education opportunities are limited for children beyond Grade 3.

Azimul Hasan, 10, a Rohingya refugee boy, stands inside a roadside hotel where he works at Jamtoli, close to Palong Khali camp, near Cox's Bazar, Bangladesh, November 12, 2017.

Azimul Hasan, 10, a Rohingya refugee boy, stands inside a roadside hotel where he works at Jamtoli, close to Palong Khali camp, near Cox’s Bazar, Bangladesh, November 12, 2017. REUTERS/Navesh Chitrakar

Rohingya boys and girls as young as seven years old were confirmed working outside the settlements, according to the findings.

Boys work on farms, construction sites and fishing boats, as well as in tea shops and as rickshaw drivers, the IOM and Rohingya residents in the camp reported.

Girls typically work as maids and nannies for Bangladeshi families, either in the nearby resort town of Cox’s Bazar or in Chittagong, Bangladesh’s second-largest city, about 150 km (100 miles) from the camps.

One Rohingya parent, who asked not to be identified because she feared reprisals, told Reuters her 14-year-old daughter had been working in Chittagong as a maid but fled her employers.

When she returned to the camp, she was unable to walk, her mother said, adding that her daughter’s Bangladeshi employers had physically and sexually assaulted her.

“The husband was an alcoholic and he would come to her bedroom at night and rape her. He did it six or seven times,” the mother said. “They gave us no money. Nothing.”

The account could not be independently verified by Reuters but was similar to others recorded by the IOM.

Most interviewees said female Rohingya refugees “experienced sexual harassment, rape and being forced to marry the person who raped her”, the IOM said.

A 12 year old Rohingya girl who worked as domestic help in a house in Bangladesh, looks out the window at an undisclosed location near Cox's Bazar, Bangladesh, November 8, 2017.

A 12 year old Rohingya girl who worked as domestic help in a house in Bangladesh, looks out the window at an undisclosed location near Cox’s Bazar, Bangladesh, November 8, 2017. REUTERS/Mohammad Ponir Hossain

PAID A PITTANCE, IF AT ALL

Across Bangladesh’s refugee settlements, Reuters saw children wandering muddy lanes alone and aimlessly, or sitting listlessly outside tents. Many children begged along roadsides.

The Inter Sector Coordination Group, which oversees UN agencies and charities, said this month it had documented 2,462 unaccompanied and separated children in the camps. The actual number was “likely to be far higher”, it said.

A preliminary survey by the UNHCR and Bangladesh’s Refugee Relief and Repatriation Commission has found that 5 percent of households – or 3,576 families – were headed by a child.

Reuters interviewed seven families who sent their children to work. All reported terrible working conditions, low wages or abuse.

Muhammad Zubair, dressed in a dirty football shirt, his small stature belying his stated age of 12 years old, said he was offered 250 taka per day but ended up with only 500 taka ($6) for 38 days work building roads. His mother said he was 14 years old.

“It was hard work, laying bricks on the road,” he said, squatting in the doorway of his mud hut in the Kutupalong camp. He said he was verbally abused by his employers when he asked for more money and was told to leave. He declined to provide their identities.

Zubair then took a job in a tea shop for a month, putting in two shifts per day from 6am to past midnight, broken by a four-hour rest period in the afternoon.

He said he wasn’t allowed to leave the shop and was only permitted to speak to his parents by phone once.

“When I wasn’t paid, I escaped,” he said. “I was frightened because I thought the owner, the master, would come here with other people and take me again.”

 

FORCED MARRIAGE

Many parents also pressure their daughters to marry early, for protection and for financial stability, according to the IOM findings. Some child brides are as young as 11, the IOM said.

But many women only became “second wives,” the IOM said. Second wives are frequently divorced quickly and “abandoned without any further economic support”.

Kateryna Ardanyan, an IOM anti-trafficking specialist, said exploitation had become “normalized” in the camps.

“Human traffickers usually adapt faster to the situation than any other response mechanism can. It’s very important we try to do prevention.” Ardanyan said.

“Funding dedicated to protecting Rohingya men, women and children from exploitation and abuse is urgently needed.”

 

(Reporting by Tom Allard and Tommy Wilkes; Editing by Philip McClellan)

 

In grieving Texas town, faith sustains those left behind

A member of the media walks inside the First Baptist Church of Sutherland Springs where 26 people were killed one week ago, as the church opens to the public as a memorial to those killed, in Sutherland Springs, Texas, U.S. November 12, 2017.

By Tim Reid

SUTHERLAND SPRINGS, Texas (Reuters) – Joe Holcombe and his wife, Claryce, lost eight members of their family in the Texas church shooting last Sunday, including their son, grandchildren, a pregnant granddaughter-in-law and a great- granddaughter who was still a toddler. But they are serene.

Chairs and roses mark where worshipers were found dead at the First Baptist Church of Sutherland Springs where 26 people were killed one week ago, as the church opens to the public as a memorial to those killed, in Sutherland Springs, Texas, U.S. November 12, 2017.

Chairs and roses mark where worshipers were found dead at the First Baptist Church of Sutherland Springs where 26 people were killed one week ago, as the church opens to the public as a memorial to those killed, in Sutherland Springs, Texas, U.S. November 12, 2017. REUTERS/Rick Wilking

“It’s just not a problem to us,” said Holcombe, 86, adding that he and 84-year-old Claryce believe their dead family members are now alive again in heaven.

“We know exactly where the family is, and it’s not going to be long until we’ll both be there,” he said. “And we’re really sort of looking forward to it.”

Chairs and roses show where Joann and Brooke Ward and others were found dead at the First Baptist Church of Sutherland Springs where 26 people were killed one week ago, as the church opens to the public as a memorial to those killed, in Sutherland Springs, Texas, U.S. November 12, 2017.

Chairs and roses show where Joann and Brooke Ward and others were found dead at the First Baptist Church of Sutherland Springs where 26 people were killed one week ago, as the church opens to the public as a memorial to those killed, in Sutherland Springs, Texas, U.S. November 12, 2017. REUTERS/Rick Wilking

The Holcombes were upbeat and full of good humor during a telephone interview, and they are not an exception in this deeply evangelical part of Texas.

What is so striking about relatives and friends of the 26 victims of the church shooting in tiny Sutherland Springs is that they all believe good will come from this act of evil and that their loved ones are now safe for eternity, and breathing again, with God.

Psychologists say such deep faith can help families deal with such a ghastly event. Even so, they warn that leaning too heavily on one’s religious beliefs can stunt the natural grieving period and result in post-traumatic stress later.

A cross with a crown of thorns and a Bible open to the book of Proverbs are seen at the First Baptist Church of Sutherland Springs where 26 people were killed one week ago, as the church opens to the public as a memorial to those killed, in Sutherland Springs, Texas, U.S. November 12, 2017.

A cross with a crown of thorns and a Bible open to the book of Proverbs are seen at the First Baptist Church of Sutherland Springs where 26 people were killed one week ago, as the church opens to the public as a memorial to those killed, in Sutherland Springs, Texas, U.S. November 12, 2017. REUTERS/Rick Wilking

“I can see potentially it could be some form of denial, a delayed traumatic reaction, and if you don’t have some kind of negative feelings, it can catch up with you,” said clinical psychologist and trauma expert Bethany Brand.

Gina Hassan, a psychologist in northern California, said Sutherland Spring’s faith was invaluable in the wake of the shooting, “but if it’s relied upon in a rigid way, then it’s going to be a problem down the line and come back to bite you later on.”

Local veterinarian George Hill, a relative of the Holcombes, said an evangelical belief in Christ was the only way to deal with such a tragedy.

“We haven’t lost hope,” he said. “They are not gone. They are just gone ahead. And we know we’ll see them again.”

He expressed faith that evil would not prevail. “It looks like evil won, but it didn’t,” he said. “Good is going to win.”

Pastor Mike Clements of the First Baptist Church in Floresville, a small city 14 miles from Sutherland Springs, is officiating over the funeral services for the extended Holcombe family on Wednesday.

The dead include Bryan Holcombe, Joe and Claryce Holcombe’s son, and his wife Karla. Their son Danny Holcombe was killed as well, along with his 18-month-old daughter, Noah. Crystal Holcombe, who was 18 weeks pregnant, was Bryan and Karla Holcombe’s daughter-in-law.

Also shot and killed were Emily, Megan and Greg Hill, three children from Crystal’s first marriage, which had ended with her husband’s death.

Under Texas law, Crystal’s unborn child is also being counted as a victim, making a death toll of nine for the family.

People in Sutherland Springs are truly grieving, Clements said. But evangelicals accept Christ into their lives in a very real way, and because of that, their faith is incredibly liberating, especially at a time of such great tragedy.

Most fundamentally, he said, they believe people who have accepted Christ will go to heaven.

“It doesn’t get any better than this,” Clements said over lunch near his church. “There is nothing better than heaven when you are a believer.”

 

(Editing by Frank McGurty and Lisa Von Ahn)