npr--2020-06-11--New York City EMS Workers Allege Retaliation After Speaking About Pandemic

New York City EMS Workers Allege Retaliation After Speaking About Pandemic A group of New York City emergency medical service workers who gave interviews to the news media , including NPR , are suing the city for allegedly retaliating against them after speaking about their experiences responding to the COVID-19 pandemic .
In a federal lawsuit filed Wednesday with the federal court in Manhattan , four EMS workers allege the city is violating their right to speak on issues of public concern under the First Amendment , as well as their due process rights .
In late April , the @ @ @ @ @ @ @ notifying three paramedics — including Elizabeth Bonilla , who spoke to NPR earlier that month — that they were restricted from treating patients , according to the complaint .
Workers on restricted status are not allowed to receive overtime or work for any other emergency medical services in the city 's 911 system .
The letters , the complaint says , gave no reason why they were put under restrictions .
EMT John Rugen , a union officer of FDNY EMS Local 2507 , was put on restricted status after the fire department @ @ @ @ @ @ @ days , claiming that he violated the FDNY 's social media policy and patient privacy laws without providing any evidence , according to the complaint .
The fire department referred NPR 's request for comment to the city 's law department , which declined to answer questions about why Rugen , Bonilla and the other EMS workers who filed the lawsuit were put on restricted status and if any other workers who have spoken to the media have been restricted .
`` The FDNY respects the First Amendment rights of its employees but @ @ @ @ @ @ @ respect the privacy rights granted under the law to patients receiving emergency medical care , '' Nicholas Paolucci , spokesperson for New York City 's law department , said in an email .
Paolucci also declined to answer NPR 's question about whether the city has received any complaints that the plaintiffs ' interviews disclosed any patient 's protected health information .
`` We do n't litigate these matters in the press , '' Paolucci added .
Terry Meginniss , one of the attorneys representing the EMS workers in the lawsuit , says @ @ @ @ @ @ @ their patients ' privacy is `` absolute hogwash . ''
`` If the fire department is n't really motivated by its interest in stopping the union from publicizing what 's going on in the streets , then it would behoove the fire department to tell these individuals exactly what they think they did wrong and give them a chance to say something because these folks are the heroes of the city , '' Meginniss says .
`` These are the people who go out and treat people , and they have been living @ @ @ @ @ @ @ of the paramedics who filed the lawsuit are union members of Local 2507 , which has been fielding interview requests from journalists during the pandemic to help promote the work of paramedics and EMTs as the union continues contract negotiations with the city .
`` Every agency likes to take pride of itself .
However , EMS is known to be the stepchild of the fire department , '' says Oren Barzilay , the president of Local 2507 who is also among the lawsuit 's plaintiffs .
`` We always get the crumbs @ @ @ @ @ @ @ decided to do this campaign on our own , this is when it became a problem . ''

New York City EMS Workers Allege Retaliation After Speaking About Pandemic
Enlarge this image toggle caption John Minchillo/AP John Minchillo/AP
A group of New York City emergency medical service workers who gave interviews to the news media, including NPR, are suing the city for allegedly retaliating against them after speaking about their experiences responding to the COVID-19 pandemic.
In a federal lawsuit filed Wednesday with the federal court in Manhattan, four EMS workers allege the city is violating their right to speak on issues of public concern under the First Amendment, as well as their due process rights.
In late April, the New York City Fire Department sent letters notifying three paramedics — including Elizabeth Bonilla, who spoke to NPR earlier that month — that they were restricted from treating patients, according to the complaint. Workers on restricted status are not allowed to receive overtime or work for any other emergency medical services in the city's 911 system. The letters, the complaint says, gave no reason why they were put under restrictions.
EMT John Rugen, a union officer of FDNY EMS Local 2507, was put on restricted status after the fire department first suspended him without pay for 30 days, claiming that he violated the FDNY's social media policy and patient privacy laws without providing any evidence, according to the complaint.
The fire department referred NPR's request for comment to the city's law department, which declined to answer questions about why Rugen, Bonilla and the other EMS workers who filed the lawsuit were put on restricted status and if any other workers who have spoken to the media have been restricted.
"The FDNY respects the First Amendment rights of its employees but those rights must be carefully balanced to respect the privacy rights granted under the law to patients receiving emergency medical care," Nicholas Paolucci, spokesperson for New York City's law department, said in an email.
Paolucci also declined to answer NPR's question about whether the city has received any complaints that the plaintiffs' interviews disclosed any patient's protected health information.
"We don't litigate these matters in the press," Paolucci added.
Terry Meginniss, one of the attorneys representing the EMS workers in the lawsuit, says any implication that they have not respected their patients' privacy is "absolute hogwash."
"If the fire department isn't really motivated by its interest in stopping the union from publicizing what's going on in the streets, then it would behoove the fire department to tell these individuals exactly what they think they did wrong and give them a chance to say something because these folks are the heroes of the city," Meginniss says. "These are the people who go out and treat people, and they have been living through incredibly difficult times."
All of the paramedics who filed the lawsuit are union members of Local 2507, which has been fielding interview requests from journalists during the pandemic to help promote the work of paramedics and EMTs as the union continues contract negotiations with the city.
"Every agency likes to take pride of itself. However, EMS is known to be the stepchild of the fire department," says Oren Barzilay, the president of Local 2507 who is also among the lawsuit's plaintiffs. "We always get the crumbs of the pie, so when we decided to do this campaign on our own, this is when it became a problem."


npr--2020-06-11--LA Police Reassigns 7 Officers As It Investigates Complaints Of Excessive Force

LA Police Reassigns 7 Officers As It Investigates Complaints Of Excessive Force The Los Angeles Police Department has reassigned seven officers to nonfield duties as it investigates dozens of complaints of excessive force during recent protests against police brutality .
The department said it has assigned 40 investigators to look into 56 complaint investigations into `` allegations of misconduct , violations of Department policy , and excessive force '' during the protests – of which 28 involve alleged use of force .
`` [ W ] e will look into every complaint thoroughly and hold every officer accountable for their @ @ @ @ @ @ @ in a statement .
Earlier this week , Los Angeles County and city officials announced that thousands of protesters who were arrested over curfew violations or failure to disperse will not be prosecuted .
A reporter for NPR member station KPCC/LAist , Adolfo Guzman-Lopez , said he was among those injured when police started firing rubber bullets .
`` I just got hit by a rubber bullet near the bottom of my throat , '' Guzman-Lopez tweeted on May 31 .
`` I had just interviewed a man with my phone at 3rd @ @ @ @ @ @ @ and shot me in the throat , I saw the bullet bounce onto the street . ''
Other KPCC/LAist reporters reported being `` baton-checked , '' sprayed with tear gas , and fleeing from rubber bullets fired at peaceful crowds by Los Angeles police officers .
A Los Angeles Times review of dozens of instances found that `` demonstrators suffered a range of injuries at the hands of the LAPD , from minor bruising from baton strikes and falls as police skirmish lines advanced , to serious injuries to their genitals and heads @ @ @ @ @ @ @ being launched into crowds , sometimes from close range . ''
Law enforcement agencies have used a range of strategies and weapons amid nationwide protests against police brutality and systemic racism .
As NPR has reported , many police departments have used weapons dubbed `` less lethal , '' but such weapons can cause serious injuries and occasionally death , especially when used at close range .

LA Police Reassigns 7 Officers As It Investigates Complaints Of Excessive Force
Enlarge this image toggle caption Frederic J. Brown/AFP via Getty Images Frederic J. Brown/AFP via Getty Images
Updated at 9:20 p.m. ET
The Los Angeles Police Department has reassigned seven officers to nonfield duties as it investigates dozens of complaints of excessive force during recent protests against police brutality.
The department said it has assigned 40 investigators to look into 56 complaint investigations into "allegations of misconduct, violations of Department policy, and excessive force" during the protests – of which 28 involve alleged use of force.
"[W]e will look into every complaint thoroughly and hold every officer accountable for their actions," Los Angeles police said in a statement.
Earlier this week, Los Angeles County and city officials announced that thousands of protesters who were arrested over curfew violations or failure to disperse will not be prosecuted.
A Los Angeles Times review of dozens of instances found that "demonstrators suffered a range of injuries at the hands of the LAPD, from minor bruising from baton strikes and falls as police skirmish lines advanced, to serious injuries to their genitals and heads from foam and sponge bullets and beanbags being launched into crowds, sometimes from close range."
In Long Beach, Calif., a reporter for NPR member station KPCC/LAist, Adolfo Guzman-Lopez, said he was among those injured when police started firing rubber bullets. "I just got hit by a rubber bullet near the bottom of my throat," Guzman-Lopez tweeted on May 31. "I had just interviewed a man with my phone at 3rd and Pine and a police officer aimed and shot me in the throat, I saw the bullet bounce onto the street."
Other KPCC/LAist reporters reporting in the region said they were "baton-checked," sprayed with tear gas, and fleeing from rubber bullets fired at peaceful crowds by police officers.
Law enforcement agencies have used a range of strategies and weapons amid nationwide protests against police brutality and systemic racism. As NPR has reported, many police departments have used weapons dubbed "less lethal," but such weapons can cause serious injuries and occasionally death, especially when used at close range.


npr--2020-06-11--Cuomo Says New York City's Columbus Statue Should Stay

Cuomo Says New York City 's Columbus Statue Should Stay New York Gov .
Andrew Cuomo said on Thursday that he did not believe New York City 's prominent statue of Christopher Columbus should be removed and pointed out its importance in the Italian American community .
Cuomo was asked on Thursday at a press conference whether it was time for the statue , which stands above the city 's Columbus Circle subway stop , to go .
`` I understand the feelings about Christopher Columbus and some of his acts , which nobody would support , '' said Cuomo @ @ @ @ @ @ @ `` But the statue has come to represent and signify appreciation for the Italian American contribution to New York .
For that reason , I support it . ''
Discussions about the removal of statues dedicated to the Italian explorer once credited with discovering the Americas have proliferated across the country at the same time that some other controversial monuments — Confederate figures — have been removed .
A statue of Columbus was pulled down and tossed into a lake in Richmond , Va. , and one was beheaded in Boston .
Activists @ @ @ @ @ @ @ Minneapolis , according to Minnesota Public Radio .
One was defaced in Miami , member station WLRN reports .
Honors for Columbus and other European explorers have been reconsidered in light of the harm they did to Native people .
Several states and cities replaced Columbus Day , which is still a federal holiday , with Indigenous Peoples Day .
The statue in question stands at the southwest corner of Central Park in the center of a plaza .
New York City has a prominent Italian American community .
The city holds a @ @ @ @ @ @ @ parade largely held to applaud the contributions of Italian Americans .
It 's also home to the famous Little Italy neighborhood , as well as an Italian American museum .

Cuomo Says New York City's Columbus Statue Should Stay
Enlarge this image toggle caption Bebeto Matthews/AP Bebeto Matthews/AP
New York Gov. Andrew Cuomo said on Thursday that he did not believe New York City's prominent statue of Christopher Columbus should be removed and pointed out its importance in the Italian American community.
Cuomo was asked on Thursday at a press conference whether it was time for the statue, which stands above the city's Columbus Circle subway stop, to go.
"I understand the feelings about Christopher Columbus and some of his acts, which nobody would support," said Cuomo, who is of Italian descent. "But the statue has come to represent and signify appreciation for the Italian American contribution to New York. For that reason, I support it."
Discussions about the removal of statues dedicated to the Italian explorer once credited with discovering the Americas have proliferated across the country at the same time that some other controversial monuments — Confederate figures — have been removed. A statue of Columbus was pulled down and tossed into a lake in Richmond, Va., and one was beheaded in Boston. Activists also toppled one of the statues in Minneapolis, according to Minnesota Public Radio. One was defaced in Miami, member station WLRN reports.
Honors for Columbus and other European explorers have been reconsidered in light of the harm they did to Native people. Several states and cities replaced Columbus Day, which is still a federal holiday, with Indigenous Peoples Day.
The statue in question stands at the southwest corner of Central Park in the center of a plaza.
New York City has a prominent Italian American community. The city holds a big celebration of Columbus Day with a parade largely held to applaud the contributions of Italian Americans. It's also home to the famous Little Italy neighborhood, as well as an Italian American museum.


npr--2020-06-11--Mayor-Elect Of Ferguson, Mo., On Where Her City Stands, After Michael Brown

Mayor-Elect Of Ferguson , Mo.
, On Where Her City Stands , After Michael Brown Ella Jones will be sworn in as mayor of Ferguson , Mo.
, next week , becoming the first black mayor — and the first woman — to lead the city that gained national attention when police killed 18-year-old Michael Brown in 2014 .
The protests that erupted in response helped establish the Black Lives Matter movement of today .
Still , nearly six years after Brown 's death , Jones says the protests against police brutality — this time in response to the death @ @ @ @ @ @ @ the same .
`` I do n't think they feel any different , '' Jones tells NPR 's Mary Louise Kelly on All Things Considered .
The officers who were involved in the shooting of Brown were not indicted .
But his death drew the attention of the federal government and the city entered into a federal consent decree in 2016 that resulted in widespread policing and municipal court reforms .
Jones thinks that despite the work Ferguson has done , her city — which has a population that is two-thirds black — @ @ @ @ @ @ @ discussion around police violence in the U.S. '' Even though we are striving to do better , Ferguson is considered as ground zero , '' she says , `` and anything that happens in the United States , they 're gon na always come back to Ferguson . ''
Jones says Ferguson needs to `` strive toward a better image . ''
`` I 'm not saying we got to forget about Michael Brown .
We 'll never forget that .
That 's a part of our history , it 's here to @ @ @ @ @ @ @ However , we 've got to show people that we are improving . ''
Jones understands the community 's frustration , but says she opposes protesters ' calls to defund the police .
`` I am not for [ defunding the police ] , simply because I have looked at Ferguson police department , I 've looked at the changes that they have made and the changes that they are going to make , '' Jones says .
`` You have to get in , the community has to start working with their @ @ @ @ @ @ @ to start working with their community .
Not to police them , but to protect and to serve them . ''
As the movement to end police brutality continues in the country , Jones urges protesters to pivot their focus to running for elected office .
`` Once you protest and you want results , then I suggest to people , 'Go run for office , ' '' she says .
`` Because when you have a seat at the table , you 're able to make policy . ''
Listen to the @ @ @ @ @ @ @ .
Gustavo Contreras and Justine Kenin produced and edited this story for radio .

Mayor-Elect Of Ferguson, Mo., On Where Her City Stands, After Michael Brown
Enlarge this image toggle caption Jeff Roberson/AP Jeff Roberson/AP
Ella Jones will be sworn in as mayor of Ferguson, Mo., next week, becoming the first black mayor — and the first woman — to lead the city that gained national attention when police killed 18-year-old Michael Brown in 2014.
The protests that erupted in response helped establish the Black Lives Matter movement of today.
Still, nearly six years after Brown's death, Jones says the protests against police brutality — this time in response to the death of George Floyd in Minneapolis — feel the same.
"I don't think they feel any different," Jones tells NPR's Mary Louise Kelly on All Things Considered.
The officers who were involved in the shooting of Brown were not indicted. But his death drew the attention of the federal government and the city entered into a federal consent decree in 2016 that resulted in widespread policing and municipal court reforms.
Jones thinks that despite the work Ferguson has done, her city — which has a population that is two-thirds black — still feels like the center of the discussion around police violence in the U.S.
"Even though we are striving to do better, Ferguson is considered as ground zero," she says, "and anything that happens in the United States, they're gonna always come back to Ferguson."
Jones says Ferguson needs to "strive toward a better image."
"I'm not saying we got to forget about Michael Brown. We'll never forget that. That's a part of our history, it's here to stay," Jones says. "However, we've got to show people that we are improving."
Jones understands the community's frustration, but says she opposes protesters' calls to defund the police.
"I am not for [defunding the police], simply because I have looked at Ferguson police department, I've looked at the changes that they have made and the changes that they are going to make," Jones says. "You have to get in, the community has to start working with their police department and the police department needs to start working with their community. Not to police them, but to protect and to serve them."
As the movement to end police brutality continues in the country, Jones urges protesters to pivot their focus to running for elected office.
"Once you protest and you want results, then I suggest to people, 'Go run for office,'" she says. "Because when you have a seat at the table, you're able to make policy."
Listen to the full interview at the audio link above.
Gustavo Contreras and Justine Kenin produced and edited this story for radio.


npr--2020-06-11--N.C. Health Secretary Warns Of Surge In Cases, Possible Return Of Stay-At-Home Orders

N.C. Health Secretary Warns Of Surge In Cases , Possible Return Of Stay-At-Home Orders North Carolina is experiencing a surge of COVID-19 cases and hospitalizations during its second phase of reopening , forcing the state 's health director to contend with the idea of a second shutdown .
`` If we need to go back to stay-at-home [ orders ] , we will , '' Mandy Cohen , the secretary of the North Carolina Department of Health and Human Services , told NPR 's Morning Edition on Thursday .
`` I hope we do n't have to .
I think @ @ @ @ @ @ @ we have to get there , but yes , we are concerned . ''
North Carolina became one of the first states to reopen when it lifted several restrictions related to COVID-19 on May 8 .
The second phase of reopening , which began May 22 , lifted the state 's stay-at-home order and allowed certain businesses to open back up or expand operations in a limited capacity .
But one day after the start of phase two , North Carolina reported its largest single-day spike since the start of the pandemic .
@ @ @ @ @ @ @ is again seeing an increase of COVID-19 cases , according to state data , and currently has more people hospitalized for the disease than at any point since the start of the outbreak .
In all , the state has had more than 38,000 confirmed cases and 1,000 deaths .
`` We never got a first surge or a first wave , and that was really good — we were able to use that time to build our capacity to respond , '' Cohen said .
But in the last two weeks , @ @ @ @ @ @ @ have been `` going in the wrong direction . ''
`` In the last week , we 've had four days of more than a thousand new cases in each one of those days , '' Cohen said .
`` And importantly , we are seeing our hospitalizations go up , so more people [ are ] having serious illness .
Now , we know we still have capacity in our health care systems .
And , you know , but this is an early warning sign for us that we really need @ @ @ @ @ @ @ we do n't forget that COVID-19 is with us . ''
The rise in cases comes as the state finds itself in the middle of a precarious political debate : Despite ongoing restrictions on mass gatherings in North Carolina , President Trump said Wednesday he plans to hold a rally in North Carolina , and the state remains , for now at least , the site of the Republican National Convention in August .
`` Our rules still are that we do not want to have any mass gatherings , '' Cohen said @ @ @ @ @ @ @ going back to church have particular legal status , but the virus does n't know that .
So we think those are risks , and we want to make sure folks are getting tested and are taking care of themselves . ''
North Carolina is n't the only state facing an increase in cases : Nearly half of the states were experiencing surges in new daily cases as of Wednesday .
Collectively , the U.S. just surpassed 2 million cases and recorded more than 112,000 deaths .
`` I know folks are weary @ @ @ @ @ @ @ need to stay vigilant , particularly in our state where we never really saw that first increase , '' Cohen said .
`` So this is new for us , and we need to make sure that we can respond . ''

N.C. Health Secretary Warns Of Surge In Cases, Possible Return Of Stay-At-Home Orders
Enlarge this image toggle caption Ethan Hyman/Raleigh News & Observer/Tribune News Service via Getty Images Ethan Hyman/Raleigh News & Observer/Tribune News Service via Getty Images
North Carolina is experiencing a surge of COVID-19 cases and hospitalizations during its second phase of reopening, forcing the state's health director to contend with the idea of a second shutdown.
"If we need to go back to stay-at-home [orders], we will," Mandy Cohen, the secretary of the North Carolina Department of Health and Human Services, told NPR's Morning Edition on Thursday. "I hope we don't have to. I think there are things we can do before we have to get there, but yes, we are concerned."
North Carolina became one of the first states to reopen when it lifted several restrictions related to COVID-19 on May 8.
The second phase of reopening, which began May 22, lifted the state's stay-at-home order and allowed certain businesses to open back up or expand operations in a limited capacity. But one day after the start of phase two, North Carolina reported its largest single-day spike since the start of the pandemic.
Nearly three weeks later, North Carolina is again seeing an increase of COVID-19 cases, according to state data, and currently has more people hospitalized for the disease than at any point since the start of the outbreak. In all, the state has had more than 38,000 confirmed cases and 1,000 deaths.
"We never got a first surge or a first wave, and that was really good — we were able to use that time to build our capacity to respond," Cohen said. But in the last two weeks, she said, the state's numbers have been "going in the wrong direction."
"In the last week, we've had four days of more than a thousand new cases in each one of those days," Cohen said. "And importantly, we are seeing our hospitalizations go up, so more people [are] having serious illness. Now, we know we still have capacity in our health care systems. And, you know, but this is an early warning sign for us that we really need to take seriously and make sure that we don't forget that COVID-19 is with us."
The rise in cases comes as the state finds itself in the middle of a precarious political debate: Despite ongoing restrictions on mass gatherings in North Carolina, President Trump said Wednesday he plans to hold a rally in North Carolina, and the state remains, for now at least, the site of the Republican National Convention in August.
"Our rules still are that we do not want to have any mass gatherings," Cohen said. "Obviously, the protests and going back to church have particular legal status, but the virus doesn't know that. So we think those are risks, and we want to make sure folks are getting tested and are taking care of themselves."
North Carolina isn't the only state facing an increase in cases: Nearly half of the states were experiencing surges in new daily cases as of Wednesday. Collectively, the U.S. just surpassed 2 million cases and recorded more than 112,000 deaths.
"I know folks are weary at this point, but we really need to stay vigilant, particularly in our state where we never really saw that first increase," Cohen said. "So this is new for us, and we need to make sure that we can respond."
Bo Hamby produced this story for radio.


npr--2020-06-11--As New Zealand Police Pledge To Stay Unarmed, Maori Activists Credit U.S. Protests

As New Zealand Police Pledge To Stay Unarmed , Maori Activists Credit U.S .
Protests Although New Zealand is about as far — in miles , at least — as you can get from Minneapolis , protests have erupted there over the killing of George Floyd .
The Indigenous Maori people in particular have pushed back against police use of force , which disproportionately affects them .
At first glance , the context seems quite different .
New Zealand police do n't usually carry firearms .
The reason goes back to the 19th century British aversion to creating a police @ @ @ @ @ @ @ In general , if New Zealand police officers need to use a gun , there is one in a lockbox in their car that they can use with a supervisor 's permission .
But after a white nationalist gunned down 51 people in two mosques last March in Christchurch , New Zealand 's police introduced a pilot program to send heavily armed police teams on patrol in three communities .
One of these communities was around Christchurch .
The other two were far away in counties near the city of Auckland .
The @ @ @ @ @ @ @ respond more quickly to violent crime .
Julia Amua Whaipooti , a Maori lawyer and activist in Wellington , received the police announcement with fear .
Both of the communities near Auckland that were selected for armed patrols had large populations of Maori and Pacific Islanders , another minority community in New Zealand .
Even though the perpetrator of the crime that inspired the pilot program was white , `` it 's predominantly brown communities [ they 're patrolling ] , '' she says .
`` We are on the precipice of heading @ @ @ @ @ @ @ '' Whaipooti and other activists have been fighting the program since its announcement last fall .
They filed a legal claim that it was in breach of the treaty first signed between Maori chiefs and the British crown in 1840 .
Maori and Pacific people make up about 25 % of New Zealand 's population .
But in the last decade , 66 % of people shot by police have been members of the Maori and Pacific Islander communities , according to advocates and news reports .
Maori and Pacific people are also @ @ @ @ @ @ @ than white New Zealanders .
Whaipooti says that the George Floyd protests have resonated with Maori because they 've experienced similar issues of racial bias .
Even the police association has agreed that there has been `` institutional bias '' in how officers interact with Maori .
`` So if we put guns in [ police ] hands as well to interact with us , that 's going to mean lives , '' Whaipooti argues .
New Zealand 's police association defended the program , saying no officer fired a single shot during @ @ @ @ @ @ @ its goal is to protect these communities from violent crime .
But , following George Floyd 's killing , the hashtag # ArmsDownNewZealand trended to No .
1 on Twitter in New Zealand .
When questioned about the movement on national radio , Prime Minister Jacinda Ardern said she opposed the routine arming of police .
Then , this week , New Zealand Police Commissioner Andrew Coster announced he is not extending the pilot program and said he 's committed to keeping New Zealand cops unarmed .
Coster attributed his decision to public @ @ @ @ @ @ @ `` It is clear to me that these response teams do not align with the style of policing that New Zealanders expect , '' he said .
Though Coster did not reference the recent protests over police brutality against people of color , Whaipooti believes that the Arms Down New Zealand campaign might not have succeeded without the U.S. demonstrations .
`` The power and impact of George Floyd , whose life was stolen so violently and so brutally , '' she says , `` I owe a big duty to that man @ @ @ @ @ @ @ lives of Maori people in this country . ''

As New Zealand Police Pledge To Stay Unarmed, Maori Activists Credit U.S. Protests
Enlarge this image toggle caption Hannah Peters/Getty Images Hannah Peters/Getty Images
Although New Zealand is about as far — in miles, at least — as you can get from Minneapolis, protests have erupted there over the killing of George Floyd. The Indigenous Maori people in particular have pushed back against police use of force, which disproportionately affects them.
At first glance, the context seems quite different. New Zealand police don't usually carry firearms. The reason goes back to the 19th century British aversion to creating a police force too much like a military. In general, if New Zealand police officers need to use a gun, there is one in a lockbox in their car that they can use with a supervisor's permission.
But after a white nationalist gunned down 51 people in two mosques last March in Christchurch, New Zealand's police introduced a pilot program to send heavily armed police teams on patrol in three communities. One of these communities was around Christchurch. The other two were far away in counties near the city of Auckland. The police said it would enable them to respond more quickly to violent crime.
Julia Amua Whaipooti, a Maori lawyer and activist in Wellington, received the police announcement with fear. Both of the communities near Auckland that were selected for armed patrols had large populations of Maori and Pacific Islanders, another minority community in New Zealand.
Even though the perpetrator of the crime that inspired the pilot program was white, "it's predominantly brown communities [they're patrolling]," she says.
"We are on the precipice of heading towards an Americanization of our policing."
Whaipooti and other activists have been fighting the program since its announcement last fall. They filed a legal claim that it was in breach of the treaty first signed between Maori chiefs and the British crown in 1840.
Maori and Pacific people make up about 25% of New Zealand's population. But in the last decade, 66% of people shot by police have been members of the Maori and Pacific Islander communities, according to advocates and news reports. Maori and Pacific people are also more likely to be tasered and pepper-sprayed than white New Zealanders.
Whaipooti says that the George Floyd protests have resonated with Maori because they've experienced similar issues of racial bias.
Even the police association has agreed that there has been "institutional bias" in how officers interact with Maori.
"So if we put guns in [police] hands as well to interact with us, that's going to mean lives," Whaipooti argues.
New Zealand's police association defended the program, saying no officer fired a single shot during the six-month pilot, and insisting that its goal is to protect these communities from violent crime.
But, following Floyd's killing last month, the hashtag #ArmsDownNZ trended to No. 1 on Twitter in New Zealand. When questioned about the movement on national radio, Prime Minister Jacinda Ardern said she opposed the routine arming of police.
Then, this week, New Zealand Police Commissioner Andrew Coster announced he is not extending the pilot program and said he's committed to keeping New Zealand cops unarmed.
Coster attributed his decision to public feedback and consultation with community groups. "It is clear to me that these response teams do not align with the style of policing that New Zealanders expect," he said.
Though Coster did not reference the recent protests over police brutality against people of color, Whaipooti believes that the Arms Down New Zealand campaign might not have succeeded without the U.S. demonstrations.
"The power and impact of George Floyd, whose life was stolen so violently and so brutally," she says, "I owe a big duty to that man, because that means he has saved lives of Maori people in this country."


npr--2020-06-11--Biden Warns Facebook On Track To Repeat Mistakes Of 2016 Election

Biden Warns Facebook On Track To Repeat Mistakes Of 2016 Election Joe Biden is demanding that Facebook crack down on false information , including from President Trump , adding his voice to escalating criticism over the social network 's hands-off approach to political speech .
`` We saw in 2016 what can happen when social media platforms are left unchecked and allow disinformation to run rampant .
It puts the very integrity of our elections at risk , '' the presumptive Democratic presidential nominee tweeted on Thursday .
`` So far , Facebook has failed to enact any real reforms @ @ @ @ @ @ @ its platform .
Time is running out . ''
Biden is urging his supporters to sign an open letter to Facebook CEO Mark Zuckerberg demanding the company `` fix the problems in Facebook 's platform that pose a threat to free and fair elections . ''
The letter calls on Facebook to reject political ads with false claims , apply its existing rules against threats and voting misinformation to all users , promote trustworthy content and promptly remove false information that goes viral .
Facebook has said it will not fact-check political ads @ @ @ @ @ @ @ of forbidding advertisers from making false claims — because it does not want to regulate political speech .
That policy has been condemned by many critics and stands in contrast to Twitter , which has banned political ads entirely .
The Biden campaign previously clashed with Facebook over an ad from the Trump campaign that contained false allegations about the Democratic candidate 's dealings with Ukraine .
`` There should be a two-week pre-election period during which all political advertisements must be fact-checked before they are permitted to run on Facebook , '' @ @ @ @ @ @ @ salvo against Facebook comes after the social network decided not to remove a post from Trump about the recent protests over police brutality and racism .
`` When the looting starts , the shooting starts , '' the president wrote .
Critics said the post broke Facebook 's rules against inciting violence .
Twitter hid a tweet in which Trump said the same thing behind a warning label , saying it violated its rules against glorifying violence .
Facebook 's stance has sparked a growing backlash from civil rights groups , congressional Democrats @ @ @ @ @ @ @ .
But Zuckerberg has been unmoved , saying he does not believe the post broke Facebook 's rules .
Biden 's letter called for `` clear rules — applied to everyone , including Donald Trump — that prohibit threatening behavior and lies about how to participate in the election . ''
In response to Biden , Facebook said : `` We live in a democracy , where the elected officials decide the rules around campaigns . ''
It noted that while Biden is calling for more fact-checking , Trump recently signed an executive @ @ @ @ @ @ @ protections from online platforms if they fact-check content or engage in other behavior seen as editorial .
`` Just as they have done with broadcast networks — where the US government prohibits rejecting politicians ' campaign ads — the people 's elected representatives should set the rules , and we will follow them , '' Facebook said .
`` There is an election coming in November and we will protect political speech , even when we strongly disagree with it . ''
Editor 's note : Facebook is among NPR 's financial supporters @

Biden Warns Facebook On Track To Repeat Mistakes Of 2016 Election
Enlarge this image toggle caption John J. Kim/Tribune News Service via Getty Images John J. Kim/Tribune News Service via Getty Images
Joe Biden is demanding that Facebook crack down on false information, including from President Trump, adding his voice to escalating criticism over the social network's hands-off approach to political speech.
"We saw in 2016 what can happen when social media platforms are left unchecked and allow disinformation to run rampant. It puts the very integrity of our elections at risk," the presumptive Democratic presidential nominee tweeted on Thursday. "So far, Facebook has failed to enact any real reforms to stop the spread of disinformation on its platform. Time is running out."
Biden is urging his supporters to sign an open letter to Facebook CEO Mark Zuckerberg demanding the company "fix the problems in Facebook's platform that pose a threat to free and fair elections."
The letter calls on Facebook to reject political ads with false claims, apply its existing rules against threats and voting misinformation to all users, promote trustworthy content and promptly remove false information that goes viral.
Facebook has said it will not fact-check political ads — a departure from its usual policy of forbidding advertisers from making false claims — because it does not want to regulate political speech. That policy has been condemned by many critics and stands in contrast to Twitter, which has banned political ads entirely. The Biden campaign previously clashed with Facebook over an ad from the Trump campaign that contained false allegations about the Democratic candidate's dealings with Ukraine.
"There should be a two-week pre-election period during which all political advertisements must be fact-checked before they are permitted to run on Facebook," Biden's letter said.
Biden's salvo against Facebook comes after the social network decided not to remove a post from Trump about the recent protests over police brutality and racism.
"When the looting starts, the shooting starts," the president wrote.
Critics said the post broke Facebook's rules against inciting violence. Twitter hid a tweet in which Trump said the same thing behind a warning label, saying it violated its rules against glorifying violence.
Facebook's stance has sparked a growing backlash from civil rights groups, congressional Democrats and even the company's own employees. But Zuckerberg has been unmoved, saying he does not believe the post broke Facebook's rules.
Biden's letter called for "clear rules — applied to everyone, including Donald Trump — that prohibit threatening behavior and lies about how to participate in the election."
In response to Biden, Facebook said: "We live in a democracy, where the elected officials decide the rules around campaigns."
It noted that while Biden is calling for more fact-checking, Trump recently signed an executive order that attempts to strip long-held legal protections from online platforms if they fact-check content or engage in other behavior seen as editorial.
"Just as they have done with broadcast networks — where the US government prohibits rejecting politicians' campaign ads — the people's elected representatives should set the rules, and we will follow them," Facebook said. "There is an election coming in November and we will protect political speech, even when we strongly disagree with it."
Editor's note: Facebook is among NPR's financial supporters.


npr--2020-06-11--Biden Outlines Plan To Restart Economy, Including Testing Every Worker

Presumptive Democratic presidential nominee Joe Biden announced on Thursday an expansive plan to restart the economy and protect public health during the ongoing coronavirus pandemic , including federally funded testing for every worker called back on the job , guaranteed paid sick leave for workers affected by COVID-19 and a federally coordinated contact tracing workforce .
`` Trump may have forgotten about the coronavirus , but it has n't forgotten about us , '' Biden said at the front of a horseshoe-shaped table at a community center in West Philadelphia .
`` The failure to respond to the pandemic , @ @ @ @ @ @ @ any effective leadership role . ''
The former vice president , meeting with black community leaders and business owners , said that he would also task the Occupational Safety and Health Administration with enforcing standard workplace safety requirements and that he wants to build out a public health job corps with state , tribal and local officials to conduct robust contact tracing .
The plan includes requirements that businesses tailor workplace arrangements for employees in high-risk groups , funding for small businesses to help rehire employees and steps for reopening schools and day @ @ @ @ @ @ @ the things that need to be done to make sure you are safe , your customers and safe and your employees are safe is , in the meantime paid for by the federal government , '' Biden said , with his mask dangling from his ear as he talked .
`` This is a crisis .
If we do n't do that , it 's going to cost the government a lot more down the road . ''
Congress has passed about $ 3 trillion in coronavirus relief in four measures .
House @ @ @ @ @ @ @ bill , but Senate Republicans have rejected the measure .
Senate Majority Leader Mitch McConnell has said Congress is not ready to consider another hefty aid package .
The Biden campaign declined to offer details on how much its proposals would cost .
Governors and mayors across the country are lifting restrictions and reopening even as COVID-19 cases continue mounting in many states .
An additional 1.5 million people applied for unemployment benefits last week , a number that has fallen slightly as people return to work but indicates the ongoing economic turmoil @ @ @ @ @ @ @ 12 weeks , more than 44 million first-time claims have been filed , and the Federal Reserve projects the unemployment rate will be more than 9 % by the end of the year .
Biden has slowly been resuming in-person campaigning , mostly within driving distance of his home in Wilmington , Del .
This is Biden 's second Philadelphia visit this month .
In a speech there last week , he condemned President Trump 's response to protests outside the White House and across the country over systemic racism and police brutality @ @ @ @ @ @ @ have increasingly propelled Biden outside his basement television studio .
At the beginning of June , Biden met with black faith leaders in Wilmington , his first in-person event in over two months .
Across the country , Trump is also holding an in-person event on Thursday to roll out his own plans to address the converging crises facing the country .
The president is meeting with pastors , law enforcement officials and small business owners at a Dallas church , where the White House says he will discuss plans for a `` @ @ @ @ @ @ @ president is also holding his first in-person fundraiser in months while in Texas .

Biden Outlines Plan To Restart Economy, Including Testing Every Worker
Enlarge this image toggle caption Jim Watson/AFP via Getty Images Jim Watson/AFP via Getty Images
Updated at 6:25 p.m. ET
Presumptive Democratic presidential nominee Joe Biden announced on Thursday an expansive plan to restart the economy and protect public health during the ongoing coronavirus pandemic, including federally funded testing for every worker called back on the job, guaranteed paid sick leave for workers affected by COVID-19 and a federally coordinated contact tracing workforce.
"Trump may have forgotten about the coronavirus, but it hasn't forgotten about us," Biden said at the front of a horseshoe-shaped table at a community center in West Philadelphia. "The failure to respond to the pandemic, I think the federal government has abdicated any effective leadership role."
The former vice president, meeting with black community leaders and business owners, said that he would also task the Occupational Safety and Health Administration with enforcing standard workplace safety requirements and that he wants to build out a public health job corps with state, tribal and local officials to conduct robust contact tracing.
The plan includes requirements that businesses tailor workplace arrangements for employees in high-risk groups, funding for small businesses to help rehire employees and steps for reopening schools and day care centers.
"We need all the things that need to be done to make sure you are safe, your customers and safe and your employees are safe is, in the meantime paid for by the federal government," Biden said, with his mask dangling from his ear as he talked. "This is a crisis. If we don't do that, it's going to cost the government a lot more down the road."
Congress has passed about $3 trillion in coronavirus relief in four measures. House Democrats passed another $3 trillion funding bill, but Senate Republicans have rejected the measure. Senate Majority Leader Mitch McConnell has said Congress is not ready to consider another hefty aid package.
The Biden campaign declined to offer details on how much its proposals would cost.
Governors and mayors across the country are lifting restrictions and reopening even as COVID-19 cases continue mounting in many states. An additional 1.5 million people applied for unemployment benefits last week, a number that has fallen slightly as people return to work but indicates the ongoing economic turmoil the country faces.
Over the last 12 weeks, more than 44 million first-time claims have been filed, and the Federal Reserve projects the unemployment rate will be more than 9% by the end of the year.
Biden has slowly been resuming in-person campaigning, mostly within driving distance of his home in Wilmington, Del. This is Biden's second Philadelphia visit this month. In a speech there last week, he condemned President Trump's response to protests outside the White House and across the country over systemic racism and police brutality.
The protests and loosening stay-at-home orders have increasingly propelled Biden outside his basement television studio. At the beginning of June, Biden met with black faith leaders in Wilmington, his first in-person event in over two months.
Across the country, Trump is also holding an in-person event on Thursday to roll out his own plans to address the converging crises facing the country. The president is meeting with pastors, law enforcement officials and small business owners at a Dallas church, where the White House says he will discuss plans for a "holistic revitalization and recovery." The president is also holding his first in-person fundraiser in months while in Texas.


npr--2020-06-12--Former Defense Secretary Gates: Pushing Away Peaceful Protesters Was 'A Bad Mistake'

Former Defense Secretary Gates : Pushing Away Peaceful Protesters Was ' A Bad Mistake' Former Defense Secretary and CIA chief Robert Gates said Thursday that it was `` misguided '' and `` a bad mistake '' to push away peaceful protesters at St. John 's Church in Washington , D.C. , where they had congregated on June 1 after the death of George Floyd at the hands of Minneapolis police officers .
The area was cleared with chemical irritants before President Trump took a photo with the Bible in front of the church .
Gates , who was secretary of @ @ @ @ @ @ @ Bush and Obama , spoke with NPR about his new book , Exercise of Power : American Failures , Successes , and a New Path Forward in the Post-Cold War World .
In the conversation , he weighed in on President Trump 's response to the protest movement against racial injustice .
He said it 's time to change the names of Confederate bases .
`` There comes a moment when things become possible and people ought to seize a moment when it presents itself , and this is such a moment .
@ @ @ @ @ @ @ Jim Mattis ' statement of criticism of President Trump 's leadership , published on June 4 , saying he agrees with Mattis : `` It 's hard to disagree that this president is a divider . ''
He continued : `` I think that we are in a weaker position in the world today than we were three years ago . ''
Looking to November , Gates said `` I think that what the country needs is somebody who will try to bring us together . ''
He added that despite disagreements on @ @ @ @ @ @ @ Vice President Joe Biden is `` a man of great integrity '' and a `` decent human being . ''
On the use of security forces to clear protesters at St. John 's Church I do n't know whether it was an abuse of presidential power .
It certainly was , in my view , misguided and a bad mistake in terms of pushing away peaceful protesters .
I do agree with my former colleagues ' opposition to the invocation of the Insurrection Act , I think that would have been a mistake @ @ @ @ @ @ @ authority to use it , but it would have been very unwise .
On the military bases named after Confederate officers I see that the president has come out against any change .
I think as I agree with the Secretary of Defense [ Mark ] Esper and the Secretary of the Army Ryan McCarthy , that we should entertain changing the names of those of those military facilities .
It 's always puzzled me we do n't have a Fort Washington or a Fort Ulysses S. Grant or a military facility named @ @ @ @ @ @ @ .
I think what what we see today is a movement to to remove the symbols of the Confederacy that celebrate it as opposed to understanding it and remembering it .
We were involved in two active wars when I was secretary of defense .
... .
I just think there comes a moment in time when things become possible and people ought to seize that moment when it presents itself .
I think this is such a moment .
On whether he agrees with former Secretary of Defense Jim Mattis ' remarks @ @ @ @ @ @ @ 's just a reality that that this president has not seen it as one of his priorities to try and bring people together , either in general or in response to terrible events , whether it 's the pandemic or the response to to George Floyd 's death .
It 's hard to disagree that this president is a divider .
He 's not the only one in American history , but he certainly has taken it , I think , to a level that we have n't seen in quite a long @ @ @ @ @ @ @ , I agree with Jim Mattis .
On whether Trump has the judgment to serve four more years as president Well , I think I think that there 's a distinction to be made between what he says and what he does .
For example , I supported his outreach to Kim Jong Un in North Korea .
Everything else we 've tried for the preceding quarter of a century had not worked .
I supported his challenging of the Chinese .
The Chinese had gotten away with a lot of things for @ @ @ @ @ @ @ are important things , at least in the realm that I 'm familiar with , where I have thought he his initiatives , at least , were the right things to do .
They have n't proved to be particularly successful .
But at the same time , he has weakened our alliances , which I think is a critically important element of American national security .
There are puts and their are takes .
I think that we are in a weaker position in the world today than we were three years @ @ @ @ @ @ @ , I wrote in my book Duty in 2014 , that I thought Joe Biden had been wrong on almost every major foreign policy issue over the preceding 40 years .
I wrote on the same page , though , that I regarded Joe Biden as a man of great integrity , a very decent human being , as somebody that if you had a personal problem or an issue , Joe Biden would be there to help you .
So although I 've got a lot of policy disagreements with the former @ @ @ @ @ @ @ person .
I think that what the country needs is somebody who will try to bring us together .

Former Defense Secretary Gates: Pushing Away Peaceful Protesters Was 'A Bad Mistake'
Enlarge this image toggle caption David Hume Kennerly/Getty Images David Hume Kennerly/Getty Images
Former Defense Secretary and CIA chief Robert Gates said Thursday that it was "misguided" and "a bad mistake" to push away peaceful protesters at St. John's Church in Washington, D.C., where they had congregated on June 1 after the death of George Floyd at the hands of Minneapolis police officers.
The area was cleared with chemical irritants before President Trump took a photo with the Bible in front of the church.
Gates, who was secretary of defense from 2006 to 2011 under Presidents George W. Bush and Barack Obama, spoke with NPR about his new book, Exercise of Power: American Failures, Successes, and a New Path Forward in the Post-Cold War World.
In the conversation, he weighed in on Trump's response to the protest movement against racial injustice. He said it's time to change the names of Confederate bases. "There comes a moment when things become possible and people ought to seize a moment when it presents itself, and this is such a moment."
Gates reflected on former Defense Secretary Jim Mattis' statement of criticism of Trump's leadership, published on June 4, saying he agrees with Mattis: "It's hard to disagree that this president is a divider."
He continued: "I think that we are in a weaker position in the world today than we were three years ago."
Looking to November, Gates said "I think that what the country needs is somebody who will try to bring us together." He added that despite disagreements on foreign policy, presidential candidate and former Vice President Joe Biden is "a man of great integrity" and a "decent human being."
Interview Highlights
On the use of security forces to clear protesters at St. John's Church
I don't know whether it was an abuse of presidential power. It certainly was, in my view, misguided and a bad mistake in terms of pushing away peaceful protesters. I do agree with my former colleagues' opposition to the invocation of the Insurrection Act, I think that would have been a mistake. Obviously, the president has the authority to use it, but it would have been very unwise.
On the military bases named after Confederate officers
I see that the president has come out against any change. I agree with the Secretary of Defense [Mark] Esper and the Secretary of the Army Ryan McCarthy, that we should entertain changing the names of those of those military facilities. It's always puzzled me we don't have a Fort Washington or a Fort Ulysses S. Grant or a military facility named for an African-American Medal of Honor recipient. I think what what we see today is a movement to remove the symbols of the Confederacy that celebrate it as opposed to understanding it and remembering it.
We were involved in two active wars when I was secretary of defense. .... I just think there comes a moment in time when things become possible and people ought to seize that moment when it presents itself. I think this is such a moment.
On whether he agrees with former Secretary of Defense Jim Mattis' remarks calling Trump a divider
I think it's just a reality that that this president has not seen it as one of his priorities to try and bring people together, either in general or in response to terrible events, whether it's the pandemic or the response to George Floyd's death. It's hard to disagree that this president is a divider. He's not the only one in American history, but he certainly has taken it, I think, to a level that we haven't seen in quite a long time. So, in that respect, I agree with Jim Mattis.
On whether Trump has the judgment to serve four more years as president
Well, I think I think that there's a distinction to be made between what he says and what he does. For example, I supported his outreach to Kim Jong Un in North Korea. Everything else we've tried for the preceding quarter of a century had not worked. I supported his challenging of the Chinese. The Chinese had gotten away with a lot of things for a lot of years. So there are important things, at least in the realm that I'm familiar with, where I have thought he his initiatives, at least, were the right things to do. They haven't proved to be particularly successful. But at the same time, he has weakened our alliances, which I think is a critically important element of American national security. There are puts and there are takes. I think that we are in a weaker position in the world today than we were three years ago.
On former Vice President Joe Biden's foreign policy record
What I will say is, I wrote in my book Duty in 2014, that I thought Joe Biden had been wrong on almost every major foreign policy issue over the preceding 40 years. I wrote on the same page, though, that I regarded Joe Biden as a man of great integrity, a very decent human being, as somebody that if you had a personal problem or an issue, Joe Biden would be there to help you. So although I've got a lot of policy disagreements with the former vice president, he is a decent person. ... I think that what the country needs is somebody who will try to bring us together.


npr--2020-06-12--Risks Of Home Birth Loom For Women in Rural Africa Amid the Lockdowns

Risks Of Home Birth Loom For Women in Rural Africa Amid the Lockdowns One of the indirect effects of the Ebola epidemic that tore through West Africa between 2014 and 2016 was the dramatic decline in access to care for pregnancy and childbirth , increasing the risk of injury or death among expectant mothers across the affected zone .
Now experts worry the novel coronavirus could have the same effect in poor countries around the world , worsening a global maternal mortality rate the World Health Organization has described as `` unacceptably high . ''
In a study published in @ @ @ @ @ @ @ researchers at the Johns Hopkins Bloomberg School of Public Health said the spillover effects of Covid-19 could result in an additional 56,700 maternal deaths over the next six months in 118 low- and middle-income countries .
Even in the best of times , these countries account for an estimated 94 percent of the 295,000 maternal deaths recorded annually worldwide , the bulk of them in sub-Saharan Africa .
The leading cause of those deaths is what 's known as postpartum hemorrhage , or excessive blood loss after the birth of a baby .
@ @ @ @ @ @ @ by the fact that , for a variety of reasons , millions of women still deliver at home ( or en route to a health facility ) , many of them with no one else present .
Despite early predictions that the coronavirus would wreak havoc in African countries , many have so far managed to limit its spread , offering lessons for the world .
Still , the United Nations has raised the alarm about the grave threat to women and girls , predicting that reductions in routine health services and access @ @ @ @ @ @ @ unintended pregnancies .
`` Left unchecked , these reductions ... will be more catastrophic for mothers and children than Covid-19 itself , '' wrote Henrietta Fore , executive director of the U.N. Children 's Fund , in a mid-May commentary to the Lancet Global Health .
`` There may likely be a decrease in facility births , '' says Jeffrey Smith , deputy director of maternal and child health at the Bill and Melinda Gates Foundation , which is a funder of NPR and of this blog .
`` That 's what we @ @ @ @ @ @ @ epidemic in Guinea , Liberia and Sierra Leone , '' all places where a woman 's risk of bleeding out in childbirth was already very high .
For Smith , the prospect of a similar situation in the months ahead underscores the importance of a controversial intervention he and colleagues have championed for decades : equipping pregnant women in remote rural areas with a drug they can take to prevent postpartum hemorrhage should they deliver at home .
An inexpensive , widely-available medication , misoprostol reduces blood loss by causing the uterus to @ @ @ @ @ @ @ feed the placenta .
But the drug is also well known for its ability to safely end an early pregnancy , and the controversy has stemmed in large part from concerns about the latter – that impoverished women with little control over their reproductive lives might be tempted to use it for abortion .
Though unsupported by the evidence , these fears have long hampered efforts in some countries to make the drug more widely available , say researchers like Ndola Prata , director of the Bixby Center for Population , Health , @ @ @ @ @ @ @ , Berkeley .
`` A number of governments have started down this path , '' says Prata , whose work helped bring about regulatory approval of misoprostol for the prevention of postpartum hemorrhage in countries across sub-Saharan Africa and southeast Asia .
`` But the extent to which women who need misoprostol have access to it – we 're still very far away .
We 're missing a huge opportunity to save lives . ''
Misoprostol 's story begins in the mid-1980s , when it came on the market under the brand name @ @ @ @ @ @ @ gastric ulcers .
Soon after its introduction , women in Brazil discovered that the cheap , over-the-counter drug could be safely and discreetly used to induce an abortion .
As its popularity grew , physicians there noticed a reduction in the number of women presenting with severe post-abortion complications , and by the mid-1990s , word of misoprostol 's abortifacient qualities had spread across Latin America and beyond .
Meanwhile , scientists were learning of misoprostol 's many other obstetric applications , including the ability to treat a miscarriage by expelling retained tissue @ @ @ @ @ @ @ it comes to the latter , misoprostol is not the gold standard ; WHO instead recommends oxytocin , which studies have shown to be marginally more effective and to have fewer side effects than misoprostol , which can sometimes cause shivering and fever .
But oxytocin suffers from several crucial limitations : the drug can only be administered via injection , must be given by a skilled provider , and requires constant refrigeration .
So it is n't feasible for use in places where electricity is unreliable , skilled care is scarce and @ @ @ @ @ @ @ .
Misoprostol , by comparison , comes in a tablet form that can be stored for years at room temperature and taken with a cup of water .
Those qualities led the United States Agency for International Development to support programs in poor countries promoting its use at the community level .
In 2011 WHO added misoprostol to its Model List of Essential Medicines , recommending it for prevention of postpartum hemorrhage where oxytocin is not available .
The recommendation was a breakthrough for reproductive health groups , who for years had petitioned @ @ @ @ @ @ @ its stamp of approval .
Yet in doing so , WHO stopped short of endorsing misoprostol for `` self-care , '' citing a dearth of large-scale evaluations of its advance distribution to women at risk of giving birth at home .
And Prata and others say that 's had a chilling effect on efforts around the world , leading all but a small handful of countries to curtail their programs or discontinue them altogether .
`` The global community continues to urge the WHO to look at this situation and to consider the @ @ @ @ @ @ @ , who as chief maternal health advisor to USAID 's Maternal and Child Survival Program oversaw pilot studies of advance distribution of misoprostol in more than a dozen countries .
`` There is one person who will 100 % of the time be there for the birth , and that 's the woman herself .
She should be the one holding the drug . ''
For Prata , WHO 's reluctance to endorse advance distribution smacks of paternalism and an inability to appreciate the reality on the ground – a reality she knows @ @ @ @ @ @ @ Angola , she remembers with painful clarity the first patient she lost to postpartum hemorrhage .
It was in the capital , Luanda , in 1987 , at the height of the country 's 27-year civil war , and Prata , then a newly minted physician at the city 's main maternity hospital , had just delivered a healthy baby boy .
`` Everything was fine , '' she recalls .
`` Everyone was happy .
And then the disaster started . ''
Part of the placenta had broken off in the mother @ @ @ @ @ @ @ .
Though Prata and team were able to remove the retained tissue , they could n't stop the bleeding .
`` And this was in a hospital , '' she says .
`` So you can imagine the risks for women who deliver at home . ''
For those women , Prata says , `` making misoprostol available is the least we can do . ''
Opponents counter that the distribution of misoprostol perpetuates a dangerous double standard whereby women in developed countries receive high quality care while women in poor countries are @ @ @ @ @ @ @ alternative .
`` Pregnant women in rural Africa are expected to give birth ... with the false assurance they will deliver safely with misoprostol , '' wrote the authors of a 2011 letter to WHO on behalf of the faith-based health organization Maternal Life International .
`` We believe there are significant dangers in the unregulated use of misoprostol , '' they added , claiming that these dangers have been `` underplayed by misoprostol advocates whose real agenda is ... unregulated medical abortion . ''
In a 2018 application to remove misoprostol from @ @ @ @ @ @ @ Sevcikova and Allyson Pollock , public health researchers at Newcastle University in the United Kingdom , outlined what they describe as `` crucial gaps in clinical evidence , '' arguing that efforts to reduce maternal mortality should focus instead on strengthening health systems .
Where skilled birth attendants are present and oxytocin is available , they wrote , `` oxytocin is more effective in reducing postpartum bleeding . ''
But increasingly , studies indicate that it often is not more effective .
As far back as 1987 , WHO worried that high temperatures @ @ @ @ @ @ @ might compromise certain essential medicines .
A 1993 analysis confirmed those fears , finding a `` widespread problem with the stability of ergometrine , '' then the drug of choice to prevent postpartum hemorrhage .
The report 's authors noted that with oxytocin injection there seemed to be `` less of a problem , '' but that the data were `` too few to draw definitive conclusions . ''
According to a 2016 systematic review of oxytocin quality in low- and middle-income countries , 57 % of oxytocin vials tested in Africa failed @ @ @ @ @ @ @ districts in Ghana found that the quality of oxytocin `` is likely a serious problem , '' and a similar study in five provinces of the Democratic Republic of Congo found evidence of `` widespread product degradation . ''
In March of last year , representatives of WHO , the U.N. Children 's Fund and the U.N. Population Fund issued a joint statement outlining `` urgent actions '' necessary to ensure the availability of quality-assured oxytocin at all assisted births .
`` Like vaccines , when oxytocin is not of sufficient quality or @ @ @ @ @ @ @ chain , the medicine will rapidly degrade and become ineffective , '' they warned , noting that countries with tropical climates are at particular risk for oxytocin failures .
`` Oxytocin is the best for control of postpartum hemorrhage , '' said Momade Bay Usta , president of the Association of Mozambican Obstetricians and Gynecologists , which partnered with the government on a 2009 pilot project in four of the country 's districts .
`` But unfortunately , Mozambique is a warm country with not enough electricity .
So we knew we needed @ @ @ @ @ @ @ when the pilot was getting underway , some in Mozambique 's reproductive health community worried that women with little education might take misoprostol before the baby comes out , which can cause the uterus to rupture .
`` But now we know that 's not true – that if we give women good information , they will use it correctly . ''
And that 's backed up by the data : in a 2013 review of misoprostol distribution programs , Smith and colleagues reported that out of more than 12,000 women who had @ @ @ @ @ @ @ just 7 did so incorrectly and none had an adverse outcome .
Mozambique 's ministry of health has since expanded the pilot to the rest of the country , making the distribution of misoprostol the centerpiece of a national strategy to prevent postpartum hemorrhage at home births – the largest and still one of the only such programs in Africa .
`` The criticism that community-based distribution of misoprostol for postpartum hemorrhage prevention will increase its use for abortion – that is probably true , '' says Angel Foster , a professor of @ @ @ @ @ @ @ and one of the world 's foremost experts on reproductive health in post-conflict settings .
`` And I would argue there 's a real ethical problem with introducing misoprostol for prevention and treatment of postpartum hemorrhage and not talking about the fact that it can be used for abortion care . ''
Foster adds that while researchers probably wo n't be able to conduct the kind of rigorous randomized controlled trials that would allow WHO to recommend misoprostol 's advance distribution , `` the evidence we have really aligns with what we 're @ @ @ @ @ @ @ that this is a drug that has multiple purposes and can save women 's lives . ''
With fears that many African countries could face a prolonged outbreak over several years , Prata says the need for misoprostol has never been more urgent , adding that governments should distribute the drug and contraceptives to all households with a pregnant woman .
`` We have these powerful tools , '' she says , `` but we do n't trust women to take care of themselves .
And now in many places , they 're @ @ @ @ @ @ @ Patrick Adams is a freelance journalist based in Atlanta , Ga. Find him on Twitter @ jpatadams

Risks Of Home Birth Loom For Women In Rural Africa Amid Lockdowns
Enlarge this image toggle caption Lynsey Addario/Getty Images Lynsey Addario/Getty Images
One of the indirect effects of the Ebola epidemic that tore through West Africa between 2014 and 2016 was the dramatic decline in access to care for pregnancy and childbirth, increasing the risk of injury or death among expectant mothers across the affected zone.
Now experts worry the novel coronavirus could have the same effect in poor countries around the world, worsening a global maternal mortality rate the World Health Organization has described as "unacceptably high."
In a study published in May in the Lancet Global Health, researchers at the Johns Hopkins Bloomberg School of Public Health said the spillover effects of COVID-19 could result in an additional 56,700 maternal deaths over the next six months in 118 low- and middle-income countries.
Even in the best of times, these countries account for an estimated 94% of the 295,000 maternal deaths recorded annually worldwide, the bulk of them in sub-Saharan Africa. The leading cause of those deaths is what's known as postpartum hemorrhage, or excessive blood loss after the birth of a baby. And that's driven in large part by the fact that, for a variety of reasons, millions of women still deliver at home (or en route to a health facility), many of them with no one else present.
Despite early predictions that the coronavirus would wreak havoc in African countries, many have so far managed to limit its spread, offering lessons for the world. Still, the United Nations has raised the alarm about the grave threat to women and girls, predicting that reductions in routine health services and access to contraceptives could result in 7 million unintended pregnancies.
"Left unchecked, these reductions ... will be more catastrophic for mothers and children than COVID-19 itself," wrote Henrietta Fore, executive director of the U.N. Children's Fund, in a mid-May commentary to the Lancet Global Health.
"There may likely be a decrease in facility births," says Jeffrey Smith, deputy director of maternal and child health at the Bill and Melinda Gates Foundation, which is a funder of NPR and of this blog. "That's what we saw at the height of the Ebola epidemic in Guinea, Liberia and Sierra Leone," all places where a woman's risk of bleeding out in childbirth was already very high.
For Smith, the prospect of a similar situation in the months ahead underscores the importance of a controversial intervention he and colleagues have championed for decades: equipping pregnant women in remote rural areas with a drug they can take to prevent postpartum hemorrhage should they deliver at home.
That drug is misoprostol.
An inexpensive, widely available medication, misoprostol reduces blood loss by causing the uterus to contract, compressing the blood vessels that feed the placenta.
But the drug is also well known for its ability to safely end an early pregnancy, and the controversy has stemmed in large part from concerns about the latter — that impoverished women with little control over their reproductive lives might be tempted to use it for abortion.
Though unsupported by the evidence, these fears have long hampered efforts in some countries to make the drug more widely available, say researchers like Ndola Prata, director of the Bixby Center for Population, Health, and Sustainability at the University of California, Berkeley.
"A number of governments have started down this path," says Prata, whose work helped bring about regulatory approval of misoprostol for the prevention of postpartum hemorrhage in countries across sub-Saharan Africa and southeast Asia. "But the extent to which women who need misoprostol have access to it — we're still very far away. We're missing a huge opportunity to save lives."
The history of misoprostol: from ulcers to abortion
Misoprostol's story begins in the mid-1980s, when it came on the market under the brand name Cytotec for the prevention of gastric ulcers.
Soon after its introduction, women in Brazil discovered that the cheap, over-the-counter drug could be safely and discreetly used to induce an abortion. As its popularity grew, physicians there noticed a reduction in the number of women presenting with severe post-abortion complications, and by the mid-1990s, word of misoprostol's abortifacient qualities had spread across Latin America and beyond.
Meanwhile, scientists were learning of misoprostol's many other obstetric applications, including the ability to treat a miscarriage by expelling retained tissue and to prevent postpartum hemorrhage.
When it comes to the latter, misoprostol is not the gold standard; WHO instead recommends oxytocin, which studies have shown to be marginally more effective and to have fewer side effects than misoprostol, which can sometimes cause shivering and fever.
But oxytocin suffers from several crucial limitations: the drug can only be administered via injection, must be given by a skilled provider and requires constant refrigeration. So it isn't feasible for use in places where electricity is unreliable, skilled care is scarce and basic supplies are often out of stock.
Misoprostol, by comparison, comes in a tablet form that can be stored for years at room temperature and taken with a cup of water. Those qualities led the United States Agency for International Development to support programs in poor countries promoting its use at the community level. In 2011 WHO added misoprostol to its Model List of Essential Medicines, recommending it for prevention of postpartum hemorrhage where oxytocin is not available.
The recommendation was a breakthrough for reproductive health groups, who for years had petitioned the health authority to grant the drug its stamp of approval.
Yet in doing so, WHO stopped short of endorsing misoprostol for "self-care," citing a dearth of large-scale evaluations of its advance distribution to women at risk of giving birth at home. And Prata and others say that's had a chilling effect on efforts around the world, leading all but a small handful of countries to curtail their programs or discontinue them altogether.
"The global community continues to urge the WHO to look at this situation and to consider the movement toward self-care," says Smith, who as chief maternal health advisor to USAID's Maternal and Child Survival Program oversaw pilot studies of advance distribution of misoprostol in more than a dozen countries. "There is one person who will 100% of the time be there for the birth, and that's the woman herself. She should be the one holding the drug."
For Prata, WHO's reluctance to endorse advance distribution smacks of paternalism and an inability to appreciate the reality on the ground — a reality she knows all too well.
A native of Angola, she remembers with painful clarity the first patient she lost to postpartum hemorrhage. It was in the capital, Luanda, in 1987, at the height of the country's 27-year civil war, and Prata, then a newly minted physician at the city's main maternity hospital, had just delivered a healthy baby boy.
"Everything was fine," she recalls. "Everyone was happy. And then the disaster started."
Part of the placenta had broken off in the mother's uterus, causing her to hemorrhage. Though Prata and team were able to remove the retained tissue, they couldn't stop the bleeding. "And this was in a hospital," she says. "So you can imagine the risks for women who deliver at home."
For those women, Prata says, "making misoprostol available is the least we can do."
A call for 'urgent actions'
Opponents counter that the distribution of misoprostol perpetuates a dangerous double standard whereby women in developed countries receive high quality care while women in poor countries are left to make do with an inferior alternative.
"Pregnant women in rural Africa are expected to give birth ... with the false assurance they will deliver safely with misoprostol," wrote the authors of a 2011 letter to WHO on behalf of the faith-based health organization Maternal Life International. "We believe there are significant dangers in the unregulated use of misoprostol," they added, claiming that these dangers have been "underplayed by misoprostol advocates whose real agenda is ... unregulated medical abortion."
In a 2018 application to remove misoprostol from WHO's essential medicines list, Petra Sevcikova and Allyson Pollock, public health researchers at Newcastle University in the United Kingdom, outlined what they describe as "crucial gaps in clinical evidence," arguing that efforts to reduce maternal mortality should focus instead on strengthening health systems. Where skilled birth attendants are present and oxytocin is available, they wrote, "oxytocin is more effective in reducing postpartum bleeding."
But increasingly, studies indicate that it often is not more effective.
As far back as 1987, WHO worried that high temperatures during transport and storage in tropical climates might compromise certain essential medicines. A 1993 analysis confirmed those fears, finding a "widespread problem with the stability of ergometrine," then the drug of choice to prevent postpartum hemorrhage.
The report's authors noted that with oxytocin injection there seemed to be "less of a problem," but that the data were "too few to draw definitive conclusions."
Now that problem looms large.
According to a 2016 systematic review of oxytocin quality in low- and middle-income countries, 57% of oxytocin vials tested in Africa failed international specifications. A study in three districts in Ghana found that the quality of oxytocin "is likely a serious problem," and a similar study in five provinces of the Democratic Republic of Congo found evidence of "widespread product degradation."
In March of last year, representatives of WHO, the U.N. Children's Fund and the U.N. Population Fund issued a joint statement outlining "urgent actions" necessary to ensure the availability of quality-assured oxytocin at all assisted births.
"Like vaccines, when oxytocin is not of sufficient quality or when it is not managed in cold chain, the medicine will rapidly degrade and become ineffective," they warned, noting that countries with tropical climates are at particular risk for oxytocin failures.
"Oxytocin is the best for control of postpartum hemorrhage," said Momade Bay Usta, president of the Association of Mozambican Obstetricians and Gynecologists, which partnered with the government on a 2009 pilot project in four of the country's districts. "But unfortunately, Mozambique is a warm country with not enough electricity. So we knew we needed something else."
Usta recalls that when the pilot was getting underway, some in Mozambique's reproductive health community worried that women with little education might take misoprostol before the baby comes out, which can cause the uterus to rupture. "But now we know that's not true — that if we give women good information, they will use it correctly."
And that's backed up by the data: in a 2013 review of misoprostol distribution programs, Smith and colleagues reported that out of more than 12,000 women who had self-administered misoprostol to prevent postpartum hemorrhage, just 7 did so incorrectly and none had an adverse outcome.
Mozambique's ministry of health has since expanded the pilot to the rest of the country, making the distribution of misoprostol the centerpiece of a national strategy to prevent postpartum hemorrhage at home births — the largest and still one of the only such programs in Africa.
"The criticism that community-based distribution of misoprostol for postpartum hemorrhage prevention will increase its use for abortion — that is probably true," says Angel Foster, a professor of global health at the University of Ottawa and one of the world's foremost experts on reproductive health in post-conflict settings. "And I would argue there's a real ethical problem with introducing misoprostol for prevention and treatment of postpartum hemorrhage and not talking about the fact that it can be used for abortion care."
Foster adds that while researchers probably won't be able to conduct the kind of rigorous randomized controlled trials that would allow WHO to recommend misoprostol's advance distribution, "the evidence we have really aligns with what we're seeing on the ground, which is that this is a drug that has multiple purposes and can save women's lives."
With fears that many African countries could face a prolonged outbreak over several years, Prata says the need for misoprostol has never been more urgent, adding that governments should distribute the drug and contraceptives to all households with a pregnant woman. "We have these powerful tools," she says, "but we don't trust women to take care of themselves. And now in many places, they're the only ones who can."
Patrick Adams is a freelance journalist based in Atlanta. Find him on Twitter @jpatadams