Global Health: After Measles Success, Rwanda to Get Rubella Vaccine

Rwanda has been so successful at fighting measles that next month it will be the first country to get donor support to move to the next stage — fighting rubella too.

On March 11, it will hold a nationwide three-day vaccination campaign with a combined measles-rubella vaccine, hoping to reach nearly five million children up to age 14. It will then integrate the dual vaccine into its national health service.

Rwanda can do so “because they’ve done such a good job on measles,” said Christine McNab, a spokeswoman for the Measles and Rubella Initiative, which will provide the vaccine and help pay for the campaign.

Rubella, also called German measles, causes a rash that is very similar to the measles rash, making it hard for health workers to tell the difference.

Rubella is generally mild, even in children, but in pregnant women, it can kill the fetus or cause serious birth defects, including blindness, deafness, mental retardation and chronic heart damage.

Ms. McNab said that Rwanda had proved that it can suppress measles and identify rubella, and it would benefit from the newer, more expensive vaccine.

The dual vaccine costs twice as much — 52 cents a dose at Unicef prices, compared with 24 cents for measles alone. (The MMR vaccine that American children get, which also contains a vaccine against mumps, costs Unicef $1.)

More than 90 percent of Rwandan children now are vaccinated twice against measles, and cases have been near zero since 2007.

The tiny country, which was convulsed by Hutu-Tutsi genocide in 1994, is now leading the way in Africa in delivering medical care to its citizens, Ms. McNab said. Three years ago, it was the first African country to introduce shots against human papilloma virus, or HPV, which causes cervical cancer.

In wealthy countries, measles kills a small number of children — usually those whose parents decline vaccination. But in poor countries, measles is a major killer of malnourished infants. Around the world, the initiative estimates, about 158,000 children die of it each year, or about 430 a day.

Every year, an estimated 112,000 children, mostly in Africa, South Asia and the Pacific islands, are born with handicaps caused by their mothers’ rubella infection.

Thanks in part to the initiative — which until last year was known just as the Measles Initiative — measles deaths among children have declined 71 percent since 2000. The initiative is a partnership of many health agencies, vaccine companies, donors and others, but is led by the American Red Cross, the United Nations Foundation, the Centers for Disease Control and Prevention, Unicef and the World Health Organization.

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Little Clarity in Italian Vote, Aside from Anger

Italians Head to the Polls:
Italians voted Sunday and Monday in a general election that is being closely watched to see whether a clear winner will emerge.

ROME — Italian voters delivered a rousing anti-austerity message and a strong rebuke to the existing political order in national elections on Monday, plunging the country into political paralysis after results failed to produce a clear winner.

Analysts said that the best-case scenario would be shaky coalition government, which would once again expose Italy and the euro zone to turmoil if markets question its commitment to measures that have kept the budget deficit within a tolerable 3 percent of gross domestic product. News of the stalemate sent tremors through the financial world, sending the Dow Jones Industrial Average down more than 200 points.

Although analysts blamed the large protest vote on Italy’s political morass and troubled electoral system, the results were also seen as a rejection of the rapid deficit-reduction strategy set by the European Commission and European Central Bank — from a country too big to fail and too big to bail out.

“No doubt Italy has an imperfect political culture, but this election I think is the logical consequence of pursuing policies that have dramatically worsened the economic and social picture in Italy,” said Simon Tilford, the chief economist of the Center for European Reform, a London research institute.

“People have been warning that if they adhere to this policy there will be a political cost, there will be backlash,” he added. “It couldn’t have taken place in a more pivotal country.”

In an election marked by voter anger and low turnout, the center-left Democratic Party appeared to be leading in the Lower House with 29.6 percent, with 99 percent of the votes counted, and in the Senate with one-third of the votes counted by midnight local time.

But that outcome did not give the Democrats a clear victory because the center-right People of Liberty Party of former Prime Minister Silvio Berlusconi was leading in several populous regions that carry more Senate seats, potentially giving him veto power and raising the prospect of political gridlock.

 Even before the final result, the election was a clear victory for the Five Star Movement of the former comedian Beppe Grillo, which in its first-ever national elections appeared to win about 25 percent of the vote in the Lower House. Italians from both right and left — and the wealthier north and poorer south — were drawn to Mr. Grillo’s opposition to austerity measures and cries to oust the existing political order.

And it was a stinging defeat for the caretaker prime minister, Mario Monti, a newly minted politician whose lackluster civic movement appeared to win around 10 percent in both houses. “Grillo had a devastating success; the rest of the situation is very unclear,” said Stefano Folli, a political columnist for the daily business newspaper Il Sole 24 Ore.

Either the Democratic Party and the People of Liberty Party “will form a grand coalition committed to reforms and changing the electoral law, which would be very difficult, or Italy will be ungovernable,” Mr. Folli added.

Mr. Monti’s caretaker government remains in place with full powers until a new government is formed. Appearing on television on Monday evening, Mr. Monti said he felt “tremendous regret” that during his tenure the political parties were not able to change Italy’s electoral law so as to guarantee more political stability. “It is a great responsibility of the political forces, and one of the reasons for the disaffection and distance from and the revindication of the political class,” he added.

Under Italy’s complex electoral laws, it is extremely hard for any one party to gain a strong ruling majority needed to manage an economy with rising unemployment and a credit crunch, let alone push through structural changes to the ossified economy. Instead, the parties have resisted change to protect their own power bases. 

The results of this election would appear to represent new depths of gridlock, and few experts expected any party to form a governing coalition strong enough to prevail for long. Nicolas Véron, an economist and a senior fellow at Bruegel, a Brussels-based research institute, said that regardless of who ultimately controls the levers of government, “The key question is whether we can have serious structural reform.”

Italy “was a work in progress before the elections,” Mr. Véron added, “and I think investors understand that it will remain a work in progress for some time.”

Gaia Pianigiani contributed reporting from Rome, and Nicola Clark from Paris.

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Afghanistan Order U.S. Troops From Key Province

Bryan Denton for The New York Times

An Afghan soldier and resident of Maidan Wardak Province, which the government has decreed off limits to United States forces.

KABUL, Afghanistan — The Afghan government barred elite American forces from operating in a strategic province adjoining Kabul on Sunday, citing complaints that Afghans working for American Special Operations forces had tortured and killed villagers in the area.

The ban was scheduled to take effect in two weeks in the province, Maidan Wardak, which is seen as a crucial area in defending the capital against the Taliban. If enforced, it would effectively exclude the American military’s main source of offensive firepower from the area, which lies southwest of Kabul and is used by the Taliban as a staging ground for attacks on the city.

By announcing the ban, the government signaled its willingness to take a far harder line against abuses linked to foreign troops than it has in the past. The action also reflected a deep distrust of international forces that is now widespread in Afghanistan, and the view held by many Afghans, President Hamid Karzai among them, that the coalition shares responsibility with the Taliban for the violence that continues to afflict the country.

Coalition officials said they were talking to their Afghan counterparts to clarify the ban and the allegations that prompted it. They declined to comment further.

Afghan officials said the measure was taken as a last resort. They said they had tried for weeks to get the coalition to cooperate with an investigation into claims that innocent civilians had been killed, abducted or tortured by Afghans working for American Special Operations forces in Maidan Wardak. But the coalition was not responsive, the officials said.

The officials said that without information from the coalition, they could provide few specifics about who was accused or which units they were working with.

A statement from the presidential palace suggested that abuses may have been committed by American Special Operations troops, and not just by Afghans working alongside them. But in interviews after the announcement, Afghan officials indicated that the Afghans were the main suspects, and that the Americans were seen as enabling the abuses rather than perpetrating them.

Throughout the war, the United States military and the C.I.A. have organized and trained clandestine militias. A number still operate, and remain beyond the knowledge or control of the Afghan government. Aimal Faizi, the spokesman for Mr. Karzai, said it was time for foreign forces to hand over control of the “parallel structures,” as he called them, to the government.

Much of the work done by American Special Operations forces in Afghanistan or anywhere else is highly classified, and information about it is closely guarded. A senior American military officer, for instance, said he did not know whether such forces were based in Maidan Wardak or were based elsewhere and were flown in periodically for missions.

Afghan officials are, for the most part, told even less, and many in the Karzai administration no longer wish to allow Americans to continue “running roughshod all around our country,” said a person who is close to Mr. Karzai.

As additional evidence of that sentiment, the person close to Mr. Karzai, who asked not to be identified because he was discussing internal deliberations, cited an order issued earlier this month by Mr. Karzai sharply curtailing the circumstances in which Afghan forces could call in coalition airstrikes.

That order, however, simply brought Afghan forces into line with the rules that coalition troops have followed since last year. Neither Afghan nor foreign military commanders believe its impact will be far-reaching.

It will probably be harder to assess the effects of the ban decreed on Sunday, and the competing views on the matter illustrate just how far apart Afghan and coalition officials are when it comes to charting a course for the war.

With the withdrawal of American forces picking up pace, most of the coalition’s conventional forces in eastern Afghanistan, including in Maidan Wardak, have shifted into advisory roles. Among coalition troops, offensive operations are increasingly becoming the sole purview of the Special Operations forces.

United States officials, in fact, are planning to rely heavily on the elite troops to continue hunting members of Al Qaeda and other international militants in Afghanistan after the NATO mission here ends in 2014.

Afghans have expressed far less enthusiasm about foreign forces, either conventional or Special Operations troops, continuing to operate in Afghanistan for years to come. “The international forces, they are also factors in insecurity and instability — it’s not only the insurgency,” said Mr. Faizi, the presidential spokesman.

As for concerns that the new ban could reduce pressure on the Taliban, Mr. Faizi said that the Afghan Army and the police would “certainly be able to handle this work.”

Habib Zahori and Sangar Rahimi contributed reporting.

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Johnson wins 2nd Daytona 500; Patrick finishes 8th

DAYTONA BEACH, Fla. (AP) — A big first for Danica Patrick, but an even bigger second for Jimmie Johnson.

Patrick made history up front at the Daytona 500 Sunday, only to see Johnson make a late push ahead of her and reclaim his spot at the top of his sport.

It was the second Daytona 500 victory for Johnson, a five-time NASCAR champion who first won "The Great American Race" in 2006.

"There is no other way to start the season than to win the Daytona 500. I'm a very lucky man to have won it twice," said Johnson, who won in his 400th career start. "I'm very honored to be on that trophy with all the greats that have ever been in our sport."

It comes a year after Johnson completed only one lap in the race because of a wreck that also collected Patrick, and just three months after Johnson lost his bid for a sixth Sprint Cup title to go two years without a championship after winning five straight.

Although he didn't think he needed to send a message to his competitors — "I don't think we went anywhere; anybody in the garage area, they're wise to all that," Johnson said — the win showed the No. 48 team is tired of coming up short after all those years of dominance.

"Definitely a great start for the team. When we were sitting discussing things before the season started, we felt good about the 500," Johnson said, "but we're really excited for everything after the 500. I think it's going to be a very strong year for us."

Patrick is hoping for her own success after a history-making race.

The first woman to win the pole, Patrick also became the first woman to lead the race. She ran inside the top 10 almost the entire race, kept pace with the field and never panicked on the track.

Her only mistakes were on pit road, where she got beat on the race back to the track, and on the final lap, when she was running third but got snookered by the veterans and faded to eighth. That's going to stick with Patrick for some time.

"I would imagine pretty much anyone would be kicking themselves about what they coulda, shoulda have done to give themselves an opportunity to win," she said. "I think that's what I was feeling today, was uncertainty as to how I was going to accomplish that."

There were several multicar crashes, but no one was hurt and none of them approached the magnitude of the wreck that injured more than two dozen fans in the grandstand at the end of the second-tier Nationwide Series race on the same track a day earlier. Daytona International Speedway workers were up until 2 a.m repairing the fence that was damaged in the accident, and track officials offered Sunday morning to move any fans who felt uneasy sitting too close to the track.

Several drivers said the accident and concern for the fans stuck with them overnight and into Sunday morning, and Johnson was quick to send his thoughts from Victory Lane.

"I just want to give a big shout-out to all the fans, and I also want to send my thoughts and prayers out to everybody that was injured in the grandstands," Johnson said.

Dale Earnhardt Jr., whose father was killed in this race 12 years ago, was involved in Saturday's accident but refocused and finished second to Johnson, his Hendrick Motorsports teammate.

"Me personally, I was just really waiting to get the news on how everybody was, how all the fans were overnight, just hoping that things were going to improve," Earnhardt said, adding that he "wasn't really ready to proceed until you had some confirmation that things were looking more positive."

The race itself, the debut for NASCAR's new Gen-6 car, was quite similar to all the other Cup races during Speedweeks in that the cars seemed to line up in a single-file parade along the top groove of the track. It made the 55th running of the Daytona 500 relatively uneventful.

When the race was on the line, Johnson took off.

The driver known as "Five-Time" raced past defending NASCAR champion Brad Keselowski on the final restart and pulled out to a sizable lead that nobody challenged over the final six laps.

Johnson and Keselowski went down to the wire last season in their race for the Sprint Cup title, with Johnson faltering in the final two races as Keselowski won his first Cup championship.

Although it was a bit of an upset that stuck with Johnson into the offseason, it gave him no extra motivation when he found himself racing with Keselowski late Sunday for the Daytona 500.

"As far as racing with Brad out there, you really lose sight of who is in what car," Johnson said. "It's just somebody between you and the trophy. It could have been anybody."

Once Johnson cleared Keselowski on the last restart he had a breakaway lead with Greg Biffle and Patrick behind him. But as the field closed in on the checkered flag, Earnhardt finally made his move, just too late and too far behind to get close enough to the lead.

Earnhardt wound up second for the third time in the last four years. But with all the crashes the Hendrick cars have endured in restrictor-plate races — teammate Kasey Kahne was in the first accident Sunday — team owner Rick Hendrick was just fine with the finish.

"We have a hard time finishing these races. Boy, to run 1-2, man, what a day," Hendrick said. Jeff Gordon, who was a contender early, faded late to 20th.

And Johnson considered himself lucky to be the one holding the trophy at the end.

"Man, it's like playing the lottery; everybody's got a ticket," he said. "I've struck out a lot at these tracks, left with torn-up race cars. Today we had a clean day."

Mark Martin was third in a Michael Waltrip Racing Toyota. Keselowski, who overcame two accidents earlier in the race, wound up fourth in Penske Racing's new Ford. Ryan Newman was fifth in a Chevy for Stewart-Haas Racing and was followed by Roush-Fenway Racing's Greg Biffle, who was second on the last lap but was shuffled back with Patrick to finish sixth.

Regan Smith was seventh for Phoenix Racing, while Patrick, Michael McDowell and JJ Yeley rounded out the top 10.

Patrick was clearly disappointed with her finish. When the race was on the line, she was schooled by Earnhardt, who made his last move and blocked any chance she had.

Still, Patrick became the first woman in history to lead laps in the 500 when she passed Michael Waltrip on a restart on Lap 90. She stayed on the point for two laps, then was shuffled back to third. She ended up leading five laps, another groundbreaking moment for Patrick, who as a rookie in 2005 became the first woman to lead the Indianapolis 500 and now is the 13th driver to lead laps in both the Daytona 500 and the Indy 500.

"Dale did a nice job and showed what happens when you plan it out, you drop back and get that momentum. You are able to go to the front," Patrick said. "I think he taught me something. I'm sure I'll watch the race and there will be other scenarios I see that can teach me, too."

Earnhardt was impressed, nonetheless.

"She's going to make a lot of history all year long. It's going to be a lot of fun to watch her progress," said Earnhardt Jr. "Every time I've seen her in a pretty hectic situation, she always really remained calm. She's got a great level head. She's a racer. She knows what's coming. She's smart about her decisions. She knew what to do today as far as track position and not taking risks. I enjoy racing with her."

Johnson, one of three heavyweight drivers who took their young daughters to meet Patrick — "the girl in the bright green car" — after she won the pole in qualifications, tipped his cap, too.

"I didn't think about it being Danica in the car," Johnson said. "It was just another car on the track that was fast. That's a credit to her and the job she's doing."

The field was weakened by an early nine-car accident that knocked out race favorite Kevin Harvick and sentimental favorite Tony Stewart.

Harvick had won two support races coming into the 500 to cement himself as the driver to beat, but the accident sent him home with a 42nd place finish.

Stewart, meanwhile, dropped to 0-for-15 in one of the few races the three-time NASCAR champion has never won.

"If I didn't tell you I was heartbroken and disappointed, I'd be lying to you," Stewart said.

That accident also took former winner Jamie McMurray, his Chip Ganassi Racing teammate Juan Pablo Montoya, and Kasey Kahne out of contention.

The next accident — involving nine cars — came 105 laps later and brought a thankful end to Speedweeks for Carl Edwards. He was caught in his fifth accident since testing last month, and this wreck collected six other Ford drivers.

The field suddenly had six Toyota drivers at the front as Joe Gibbs Racing and Michael Waltrip Racing drivers took control of the race. But JGR's day blew up — literally — when the team was running 1-2-3 with Matt Kenseth, Denny Hamlin and Kyle Busch setting the pace.

Kenseth, who led a race-high 86 laps, went to pit road first with an engine problem, and Busch was right behind him with a blown engine. Busch was already in street clothes watching as Hamlin led the field.

"It's a little devastating when you are running 1-2-3 like that," Busch said.

Hamlin's shot disappeared when he found himself in the wrong lane on the final restart. He tried to hook up with Keselowski to get them back to Johnson, but blamed former teammate Joey Logano for ruining the momentum of the bottom lane.

Hamlin offered a backhanded apology to Keselowski on Twitter, posting that he couldn't get close enough because "your genius teammate was too busy messing up the inside line 1 move at a time."

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The Texas Tribune: Advocates Seek Mental Health Changes, Including Power to Detain

Matt Rainwaters for Texas Monthly

The Sherman grave of Andre Thomas’s victims.

SHERMAN — A worried call from his daughter’s boyfriend sent Paul Boren rushing to her apartment on the morning of March 27, 2004. He drove the eight blocks to her apartment, peering into his neighbors’ yards, searching for Andre Thomas, Laura Boren’s estranged husband.

Expanded coverage of Texas is produced by The Texas Tribune, a nonprofit news organization. To join the conversation about this article, go to texastribune.org.

For more articles on mental health and criminal justice in Texas, as well as a timeline of the Andre Thomas case: texastribune.org

Matt Rainwaters for Texas Monthly

Laura Boren

He drove past the brightly colored slides, swings and bouncy plastic animals in Fairview Park across the street from the apartment where Ms. Boren, 20, and her two children lived. He pulled into a parking spot below and immediately saw that her door was broken. As his heart raced, Mr. Boren, a white-haired giant of a man, bounded up the stairwell, calling out for his daughter.

He found her on the white carpet, smeared with blood, a gaping hole in her chest. Beside her left leg, a one-dollar bill was folded lengthwise, the radiating eye of the pyramid facing up. Mr. Boren knew she was gone.

In a panic, he rushed past the stuffed animals, dolls and plastic toys strewn along the hallway to the bedroom shared by his two grandchildren. The body of 13-month-old Leyha Hughes lay on the floor next to a blood-spattered doll nearly as big as she was.

Andre Boren, 4, lay on his back in his white children’s bed just above Leyha. He looked as if he could have been sleeping — a moment away from revealing the toothy grin that typically spread from one of his round cheeks to the other — except for the massive chest wound that matched the ones his father, Andre Thomas (the boy was also known as Andre Jr.), had inflicted on his mother and his half-sister as he tried to remove their hearts.

“You just can’t believe that it’s real,” said Sherry Boren, Laura Boren’s mother. “You’re hoping that it’s not, that it’s a dream or something, that you’re going to wake up at any minute.”

Mr. Thomas, who confessed to the murders of his wife, their son and her daughter by another man, was convicted in 2005 and sentenced to death at age 21. While awaiting trial in 2004, he gouged out one of his eyes, and in 2008 on death row, he removed the other and ate it.

At least twice in the three weeks before the crime, Mr. Thomas had sought mental health treatment, babbling illogically and threatening to commit suicide. On two occasions, staff members at the medical facilities were so worried that his psychosis made him a threat to himself or others that they sought emergency detention warrants for him.

Despite talk of suicide and bizarre biblical delusions, he was not detained for treatment. Mr. Thomas later told the police that he was convinced that Ms. Boren was the wicked Jezebel from the Bible, that his own son was the Antichrist and that Leyha was involved in an evil conspiracy with them.

He was on a mission from God, he said, to free their hearts of demons.

Hospitals do not have legal authority to detain people who voluntarily enter their facilities in search of mental health care but then decide to leave. It is one of many holes in the state’s nearly 30-year-old mental health code that advocates, police officers and judges say lawmakers need to fix. In a report last year, Texas Appleseed, a nonprofit advocacy organization, called on lawmakers to replace the existing code with one that reflects contemporary mental health needs.

“It was last fully revised in 1985, and clearly the mental health system has changed drastically since then,” said Susan Stone, a lawyer and psychiatrist who led the two-year Texas Appleseed project to study and recommend reforms to the code. Lawmakers have said that although the code may need to be revamped, it will not happen in this year’s legislative session. Such an undertaking requires legislative studies that have not been conducted. But advocates are urging legislators to make a few critical changes that they say could prevent tragedies, including giving hospitals the right to detain someone who is having a mental health crisis.

From the time Mr. Thomas was 10, he had told friends he heard demons in his head instructing him to do bad things. The cacophony drove him to attempt suicide repeatedly as an adolescent, according to court records. He drank and abused drugs to try to quiet the noise.

bgrissom@texastribune.org

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Many Cruise Ship Lack Backup Power Systems, Vexing Regulators

Denis Poroy/Associated Press

The Carnival Splendor cruise ship was towed into San Diego Bay in 2010, after a fire destroyed its electrical systems.

It is becoming a familiar tale: When the cruise ship was towed into port, the endless hours for passengers of sleeping on deck and going without electricity or toilets were finally over.

“It was really hell,” said Bernice Spreckman, who is 77 and lives in Yonkers, N.Y. “I used my life jacket, which was flashing with a little light on it, to find a bathroom it was so dark.”

Ms. Spreckman was not among the 4,200 people aboard the Carnival Triumph who this month endured five days of sewage-soaked carpets and ketchup sandwiches. Her trial at sea came in 2010, on another ship run by Carnival Cruises, called the Splendor, which carried 4,500 passengers.

On both ships, fires broke out below decks, destroying the electrical systems and leaving them helpless. A preliminary Coast Guard inquiry into the Splendor found glaring deficiencies in its firefighting operations, including manuals that called for crew members to “pull” valves that were designed to turn.

But more than two years after the episode, the final report about what happened on the Splendor has yet to appear, a reflection of what critics say is a pattern of international regulatory roulette that governs cruise ship safety.

While the Splendor was based in the United States, the ship was legally registered in Panama, meaning the Panamanian Maritime Authority had the right to lead the investigation. But after the 2010 fire, Panamanian regulators chose to have the Coast Guard take over the inquiry. Then, officials in both countries apparently spent months trading drafts of their reports.

One official in Panama said the authority had completed its review of the Splendor report in October 2012. But a Coast Guard spokeswoman, Lisa Novak, said it still had not “finalized” the report. In the case of the Carnival Triumph, the regulatory scene will shift to the Bahamas, where that ship was registered.

In a recent letter to Coast Guard officials, Senator Jay Rockefeller, Democrat of West Virginia, said that cruise ships seemed to have two separate lives. Only during days near port are they closely monitored.

“Once they are beyond three nautical miles from shore, the world is theirs,” said the letter from Senator Rockefeller, who has headed recent inquiries into cruise ship safety.

Cruise industry officials point out that seaborne vacations are extremely safe and that some 20 million people go on cruises annually, with few problems. The most glaring exception to that record occurred last year when a vessel operated by a subsidiary of Carnival, the Costa Concordia, ran aground off the coast of Italy, resulting in 32 deaths.

In the Triumph’s case, the Coast Guard has said that the ship’s safety equipment failed to contain the blaze. And both the Triumph and the Splendor returned from their aborted voyages without serious injuries to passengers or crew.

But those successes also underscore what most travelers do not realize when they book cruises: nearly all ships lack backup systems to help them return to port should power fail because to install them would have cost operators more money.

The results are repeated episodes involving dead ships, with all the discomforts and potential dangers such situations can bring. In another case, in late 2012, the Costa Allegra cruise ship, a sister ship of the Concordia, lost power after a fire in the generator room and it had to be towed under guard from its location in the Indian Ocean.

In many ways, passengers aboard boats like the Triumph and Splendor were lucky because their ships were disabled in calm weather, when instead they could have been knocked out during storms, or when they were far out at sea or in pirate-infested waters, experts said.

“Anything that knocks a ship dead in the water is serious,” said Mark Gaouette, a safety expert and former Navy officer.

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The Lede: Reeva Steenkamp, Steve Biko and the Quest for Justice in South Africa

LONDON – The title of the presiding judge 35 years ago was the same, chief magistrate of Pretoria, and the venue for the hearing, a converted synagogue, was not far from the modern courthouse seen on television screens around the world in recent days as Oscar Pistorius, the gold medal-winning Paralympic athlete, fought for bail in the killing of his girlfriend, Reeva Steenkamp.

The case that unfolded in the last weeks of 1977, like the one featuring Mr. Pistorius, centered on a death that captured global attention. Then, too, it was the role of the chief magistrate, a jurist of relatively minor standing in South Africa’s legal system, to weigh whether it was a case of murder or mishap. Then, too, there were constituencies, inside the courtroom and beyond, that clamored passionately for their version of the truth.

The similarities – and dissimilarities – will have pressed in on anyone who was present in the Pretoria courtroom those decades ago, when the proceeding involved was an inquest, and the death that of Steve Biko, a 30-year-old black activist who was a popular youth leader of the anti-apartheid movement. By the miserable manner of his dying, alone, naked, and comatose on the floor of a freezing prison cell, Mr. Biko became, in death still more than in life, a powerful force for an end to South Africa’s institutionalized system of racial repression.

A British television report from South Africa in 1977, eight days after Steve Biko, an anti-apartheid activist, was beaten to death in police custody.

The two cases, of course, will find widely different places on history’s ladder. Mr. Pistorius, awarded bail on Friday after a hearing that was sensational for what it revealed of his actions in shooting Ms. Steenkamp, and for the raw emotions the athlete displayed in the dock, became a global celebrity in recent years for his feats as the Blade Runner, a track star who overcame the disability of being born with no bones in his lower legs.

But for all that it has been a shock to the millions who have seen his running as a parable for triumph in adversity, Mr. Pistorius’s tragedy — and still more, Ms. Steenkamps’s — has been a personal one. Mr. Biko’s death was considered at the time, as it has been ever since, as a watershed in the history of apartheid, a grim milestone among many others along South Africa’s progress towards black majority rule, which many ranked as the most inspiriting event in the peacetime history of the 20th-century when it was finally achieved in 1994.

Still, for a reporter who covered the Biko inquest for the Times as the paper’s South Africa correspondent through the turbulent years of the 1970’s, there were strong resonances in the week’s televised proceedings in Pretoria. Among them was the sheer scale of the media coverage, and the display of how live-by-satellite broadcasting and the digitalization of the print press, with computers, cellphones and Twitter feeds, have globalized the news business.

Oscar Pistorius facing the media during his bail hearing this week in Pretoria.

For the Pistorius hearing, there was a frenzied, tented camp of television crews outside the court, a crush among reporters struggling to get into the hearing, and platoons of studio commentators eager to have their say.

The crush among reporters outside the bail hearing for Oscar Pistorius this week in Pretoria.

On each of the 13 days the Biko inquest was in session, I had no trouble finding myself a seat in the airy courtroom. I took my lunch quietly with members of the Biko family’s legal team, and loitered uneasily during adjournments in an outside passageway, eavesdropping on the policemen who were Mr. Biko’s captors in his final days as they fine-tuned the testimony they were to give in court.

In the Pistorius case, the police again emerged poorly, having, as it seemed, bungled aspects of the forensic investigation in ways that could complicate the prosecution’s case that Ms. Steenkamp’s death was a case of premeditated murder — and having assigned the case to an officer who turned out to be under investigation in a case of attempted murder himself. But nothing in that bungling could compare with the sheer wretchedness of the security police officers in the Biko case, who symbolized, in their brutal and callous treatment of a defenseless man, and in the jesting about it I heard in that courtroom passageway, just how far below human decency apartheid had descended.

There was, too, the extraordinary contrast in the deportment of the magistrates in their rulings in the two cases, and what that said about the different South Africas of then and now. Desmond Nair, presiding at the Pistorius hearing, took more than two hours to review the evidence in the killing of Ms. Steenkamp, swinging back and forth in a meandering — and often bewildering — fashion between the contending accounts of Ms. Steenkamp’s death offered by Mr. Pistorius’s legal counsel and those put forward by the police.

Marthinus J. Prins, the chief magistrate in the Biko inquest, took an abrupt three minutes to deliver his finding, a numbing, 120-word exculpation of the policemen and government doctors who ushered Mr. Biko to his death on the stone-flagged floor of the Pretoria Central Prison. “The court finds the available evidence does not prove the death was brought about by any act or omission involving any offense by any person,” Mr. Prins said, reading hurriedly from a prepared statement before leaving the courtroom and slipping away by a rear door.

In finding that nobody was to blame in the black leader’s death, the magistrate brushed aside testimony suggesting what the policemen and doctors involved acknowledged many years later to have been true, when they petitioned for amnesty under the Truth and Reconciliation Commission process that sought to heal the wounds of apartheid: that Mr. Biko had been beaten in police custody, suffering a severe brain injury that was left untreated until he died.

The utter lack of compassion, and of anything resembling justice, was expressed in the dull-eyed satisfaction of Mr. Prins when I caught up with him an hour or so after the verdict in his vast, dingy office a few blocks from the courtroom.

“To me, it was just another death,” he said, pulling off his spectacles and rubbing his eyes. “It was just a job, like any other.”

Mr. Prins, who rose to his position through the apartheid bureaucracy, without legal training, appeared at that moment, as he had throughout the inquest, to be disturbingly sincere, yet utterly blinded. Faithful servant of the apartheid system, he had given it the clean bill of health it demanded, and freed the police to continue treating black political detainees as they chose. Among the country’s rulers, the verdict was embraced as a triumphal vindication, while those who chose to see matters more clearly understood it to be a tolling of history’s bell.

Listening to Mr. Nair delivering his ruling in the Pistorius case, there will have been many, in South Africa and abroad, who will have found his monologue on Friday confusing, circular in its argument, and numbingly repetitive. As an exercise in jurisprudence, it was something less than a stellar advertisement for a South African legal system that, at its best, is a match for any in the world, as it was back in 1977.

Sydney Kentridge, lead counsel for the Biko family at the inquest, moved seamlessly to England in the years that followed, and became, by widespread reckoning among his peers, Britain’s most distinguished barrister, still practicing in London now, at 90.

In the 2011 Steve Biko Lecture at the University of Cape Town, Sydney Kentridge spoke about the inquest into his death in 1977.

A host of other South African expatriates who fled apartheid have made outstanding careers as lawyers and judges in Britain, the United States, and elsewhere in the English-speaking world, but many others stayed at home, and continue to serve a court system that has fared rather better, in recent years, than many other institutions in the new South African state.

But even if Mr. Nair, in granting Mr. Pistorius bail, seemed no match in the elegance of his argument for South Africa’s finest legal minds, he nonetheless did South Africa proud. In the chaotic manner of his ruling, which sounded at times like a man grabbing for law books off a shelf, he was, indisputably, doing something that Mr. Prins, all those years before, had not even attempted: looking for ways to steer his course to justice. People will disagree whether Mr. Pistorius deserved the break he got in walking free from that courtroom, but nobody could reasonably contest that what we saw in his case was the working of a legal system that strives for justice, and not to rubber-stamp the imperatives of the state.

This post was revised to make it clear that Sydney Kentridge, the lawyer who represented Steve Biko’s family in 1977 and practiced law well into his 80s, is now 90.

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Fans injured when car sails into fence at Daytona

DAYTONA BEACH, Fla. (AP) — At least 30 NASCAR fans were injured Saturday when a car sailed into the fence at Daytona International Speedway, and large chunks of debris — including a tire — flew into the grandstands. No fatalities were reported from the accident on the last lap of the Nationwide Series race.

The crash began as the field closed in on the finish line, and rookie Kyle Larson's car came upon the wreck and went airborne into the fence that separates the track from the seats.

Large chunks of Larson's car landed in the grandstands, and one of his tires appeared to fly over the fence and land midway up the lower section. The car itself had its entire front end sheared off, with the burning engine wedged through a gaping hole in the fence.

Speedway President Joie Chitwood said 14 fans were treated on site, and 14 others were taken to hospitals. Chitwood didn't give any updates on their conditions.

The number of those transported given by Chitwood was slightly lower than that given by local officials.

Halifax Health spokesman Byron Cogdell said 12 people were transported to Halifax Health Medical Center in Daytona Beach and six others were taken to Halifax Health Medical Center of Port Orange. All were in stable condition, Cogdell said.

Lindsay Rew, a spokeswoman for Florida Hospital Memorial Medical Center, said its Daytona Beach hospital had one fan there who was in good condition. She said three others they had been expecting were diverted to another hospital.

No fatalities were reported at either hospital. Cogdell said two people taken to the Halifax in Daytona Beach arrived in critical condition, and one of those had life-threatening injuries, both were upgraded to stable condition.

The accident happened the day before the Sprint Cup Series season-opening Daytona 500 — NASCAR's version of the Super Bowl. Daytona workers could be seen repairing the large section of fence where Larson hit, as well as the wall that was damaged in the accident.

"First and foremost our thoughts and prayers are with our race fans," Chitwood said. "Following the incident we responded appropriately according to our safety protocols, and had emergency medical personnel at the incident immediately.

"We're in the process of repairing the facility and will be ready to go racing tomorrow."

As emergency workers tended to injured fans and ambulance sirens wailed in the background, a somber Tony Stewart skipped the traditional post-race victory celebration.

Stewart, who won for the 19th time at Daytona and seventh time in the last nine season-opening Nationwide races, was in no mood to celebrate.

"The important thing is what going on on the frontstretch right now," said Stewart, the three-time NASCAR champion. "We've always known, and since racing started, this is a dangerous sport. But it's hard. We assume that risk, but it's hard when the fans get caught up in it.

"So as much as we want to celebrate right now and as much as this is a big deal to us, I'm more worried about the drivers and the fans that are in the stands right now because that was ... I could see it all in my mirror, and it didn't look good from where I was at."

The accident spread into the upper deck and emergency crews treated fans on both levels. There were five stretchers that appeared to be carrying fans out, and a helicopter flew overhead. A forklift was used to pluck Larson's engine out of the fence.

Chitwood waited by steps as emergency workers attended to those in the stands. Across the track, fans pressed against a fence and used binoculars trying to watch. Wrecked cars and busted parts were strewn across the garage.

"It's a violent wreck. Just seeing the carnage on the racetrack, it's truly unbelievable," driver Justin Allgaier said.

It was a chaotic finish to a race that was stopped for nearly 20 minutes five laps from the finish by a 13-car accident that sent driver Michael Annett to a hospital, where his Richard Petty Motorsports team said he would be held overnight with bruising to his chest.

The race resumed with three laps to go, and the final accident occurred with Regan Smith leading as he headed out of the final turn to the checkered flag. He admittedly tried to block Brad Keselowski to preserve the win.

"I tried to throw a block. It's Daytona, you want to go for the win here," Smith said. "I don't know how you can play it any different other than concede second place, and I wasn't willing to do that today. Our job is to put them in position to win, and it was, and it didn't work out."

As the cars began wrecking all around Smith and Keselowski, Stewart slid through for the win, but Larson plowed into Keselowski and his car was sent airborne into the stands. When Larson's car came to a stop, it was missing its entire front end. The 20-year-old, who made his Daytona debut this week, stood apparently stunned, hands on his hips, several feet away from his car, before finally making the mandatory trip to the care center.

He said his first thought was with the fans.

"I hope all the fans are OK and all the drivers are all right," Larson said. "I took a couple big hits there and saw my engine was gone. Just hope everybody's all right."

He said he was along for the ride in the last-lap accident.

"I was getting pushed from behind, I felt like, and by the time my spotter said lift or go low, it was too late," Larson said. "I was in the wreck and then felt like it was slowing down and I looked like I could see the ground. Had some flames come in the cockpit, but luckily I was all right and could get out of the car quick."

It appeared fans were lined right along the fence when Larson's car sailed up and into it, but Chitwood indicated there was a buffer. He said there would be no changes to the seating before the Daytona 500.

"We don't anticipate moving any of our fans," Chitwood said. "We had our safety protocols in place. Our security maintained a buffer that separates the fans from the fencing area. With the fencing being prepared tonight to our safety protocols, we expect to go racing tomorrow with no changes."

Larson's car appeared to hit where the cross-over gate — a section that can be opened for people to travel back and forth from the infield to the grandstands — is located in the fence. Previous accidents in which drivers hit crossover gates were severe, but the gates were in the wall and not the fence for Mike Harmon's accident at Bristol in 2002 and Michael Waltrip's at the same track in 1990.

Still, NASCAR senior vice president Steve O'Donnell said it would be studied.

"I think we look at this after every incident," O'Donnell said. "We've learned in the past certain protocols put in place today are a result of prior incidents. Again, our initial evaluation is still ongoing. But it's certainly something we'll look at. If we can improve upon it, we'll certainly put that in play as soon as we can."

Larson had been scheduled to race his sprint car later Saturday night in Ocala, Fla., and even seemed restless to get there during the late stages of the Nationwide race. He pulled out of the event following the accident.

"Honestly, the race itself pales in comparison to the injuries sustained by the fans," said Chip Ganassi, the team owner who has Larson in his driver development program. "Our thoughts and prayers go out to all the fans that were injured as a result of the crash. As for Kyle, I am very happy that he is OK."

Keselowski watched a replay of the final accident, and said his first thoughts were with the fans. As for the accident, he agreed he tried to make a winning move and Smith tried to block.

"He felt like that's what he had to do, and that's his right. The chaos comes with it," Keselowski said. "I made the move and he blocked it, and the two of us got together and started the chain events that caused that wreck. First and foremost, just want to make sure everyone in the stands is OK and we're thinking about them."

Keselowski said the incident could cast a pall on the Daytona 500.

"I think until we know exactly the statuses of everyone involved, it's hard to lock yourself into the 500," Keselowski said. "Hopefully, we'll know soon and hopefully everyone's OK. And if that's the case, we'll staring focusing on Sunday."

___

AP Sports Writer Dan Gelston in Daytona Beach and Associated Press writer Jennifer Kay in Miami contributed to this report.

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Off the Dribble: Salley Offers a Healthy Assist

When Carmelo Anthony went on a vegetarian diet a few weeks ago and caused the biggest culinary conundrum in sports since fried chicken and beer had starring roles in the Red Sox clubhouse, John Salley could only shake his head.

Anthony’s diet was blamed for his sluggish play and the Knicks’ 3-4 record during the 15-day fast.

Anthony admitted that his body felt “depleted out there.”

But Salley, the former N.B.A. player, said that if Anthony had eaten a vegetarian diet correctly, he would have felt invigorated and anything but depleted.

And not just for two weeks but for the entire season.

For Salley, many of his salad days in the N.B.A. really were salad days. Particularly kale salad.

Salley, a 6-foot-11 power forward and center, became a vegetarian in January 1991 after he felt he had to make changes in his lifestyle, much like Anthony’s stated desire for “clarity in his life.”

Vegetarians do not eat meat, fish or poultry, but may eat dairy products like cheese, eggs, yogurt or milk.

Salley had read a story about the Celtics’ Robert Parish, whom he had always admired, and his interest in yoga and a red-meat-free diet.

While Parish’s regimen was not total vegetarian, he recently said that it made a difference in his career, helping him withstand the rigors of playing center against behemoths in the paint.

“My diet consisted of chicken, fish, seafood, salad, pasta and organic when possible,” he said. “I had very little sugar and drank a gallon of water every day. I also ate rice and beans, peas, cabbage, mustard, collards greens and assorted nuts. I would always focus on healthy eating. My success depended on my body and I tried to do right by it. ”

His body responded with 20 years of service in his Hall of Fame career. Parish retired at 43.

Salley was striving for similar health and success.

“I was 27, and I felt I had to change my life,” Salley said. “My knees were sore, my joints ached, I had back problems and my cholesterol was 275. ”

When he was with the Pistons, Salley visited a nutritionist in Detroit who advised him to eliminate fried foods and adopt a macrobiotic diet (grains and vegetables).

Salley, invigorated and healthy, had his best season in 1991. A defensive specialist, he had more energy and quickness and averaged a career best 9.5 points a game.

He kept his healthy diet a secret from his burly Bad Boy Piston steak-and-pork-chop teammates, who included Bill Laimbeer, Rick Mahorn and Dennis Rodman.

“I would tell them all the time,” Salley said, “if you go into a steak house it’s not that they have a certain thing inside the dead flesh or they cook it differently. They make it the same way everybody else does. All you’re doing is eating dead food.”

Salley would search out health food restaurants with a few tables or just counter service for his diet staples of quinoa, kale, spinach, stir fried vegetables, brown rice and wheatgrass on the menu.

“It was hard to find places in 1991,” he said. “So many times I would go into restaurants and ask the cook to steam my vegetables and make me the lightest fish.”

But it was worth it.

“I was playing so well it was crazy,” he said.

During his career, Salley, who retired in 2000, won four championships with the Detroit Pistons, the Chicago Bulls and the Los Angeles Lakers.

He now follows a vegan diet, which eliminates all dairy foods in addition to animal products.

“I’m eating raw,” said Salley, 48. “And I make all my food with no sugar, no salt and no oil.”

Salley is familiar with Anthony’s foray into vegetarian living. The Knicks star followed the Daniel Fast based on the book of Daniel in the Bible, which espouses a diet of mainly liquid and vegetables.

“He felt depleted because you need to find a natural source of vitamin B12,” Salley said.

B12 is not found in any significant amounts in plant food, and a deficiency can cause fatigue, weakness and tingling in the legs.

It can also cause irritability. Anthony said his diet might have caused him to lash out at Kevin Garnett in a game against the Boston Celtics.

“He didn’t take any supplements to help his body,” Salley said. “He did not get his body to heal. It’s like cutting yourself and not putting a Band-Aid on. He just got part of the plan right.”

Salley is working to make sure children get the plan right with food choices. He spreads the word about healthy eating in the community, having lobbied Congress for more vegetarian options in school lunches.

Although Anthony may have struggled to maintain his vegetarian diet, other N.B.A players and athletes have embraced it.

James Jones of the Miami Heat and Anthony’s teammate A’mare Stoudemire are vegetarians.

Baseball’s Prince Fielder, the triathlete Brendan Brazier, the mixed martial artist Mac Danzig, the bodybuilder Derek Tresize and the tennis player Serena Williams are among athletes who are vegans or vegetarians.

Dr. Joel Kahn, a clinical professor of medicine at Wayne State University School of Medicine and medical director of wellness programs, preventive cardiology, and cardiac rehabilitation at Detroit Medical Center, has counseled Salley and other athletes about the benefits of vegan and vegetarian diets.

“A plant-based, whole-food diet low on sugar and gluten is very anti-inflammatory and ideal for rapid recovery from workouts,” he said.

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Major Banks Aid in Payday Loans Banned by States

Major banks have quickly become behind-the-scenes allies of Internet-based payday lenders that offer short-term loans with interest rates sometimes exceeding 500 percent.

With 15 states banning payday loans, a growing number of the lenders have set up online operations in more hospitable states or far-flung locales like Belize, Malta and the West Indies to more easily evade statewide caps on interest rates.

While the banks, which include giants like JPMorgan Chase, Bank of America and Wells Fargo, do not make the loans, they are a critical link for the lenders, enabling the lenders to withdraw payments automatically from borrowers’ bank accounts, even in states where the loans are banned entirely. In some cases, the banks allow lenders to tap checking accounts even after the customers have begged them to stop the withdrawals.

“Without the assistance of the banks in processing and sending electronic funds, these lenders simply couldn’t operate,” said Josh Zinner, co-director of the Neighborhood Economic Development Advocacy Project, which works with community groups in New York.

The banking industry says it is simply serving customers who have authorized the lenders to withdraw money from their accounts. “The industry is not in a position to monitor customer accounts to see where their payments are going,” said Virginia O’Neill, senior counsel with the American Bankers Association.

But state and federal officials are taking aim at the banks’ role at a time when authorities are increasing their efforts to clamp down on payday lending and its practice of providing quick money to borrowers who need cash.

The Federal Deposit Insurance Corporation and the Consumer Financial Protection Bureau are examining banks’ roles in the online loans, according to several people with direct knowledge of the matter. Benjamin M. Lawsky, who heads New York State’s Department of Financial Services, is investigating how banks enable the online lenders to skirt New York law and make loans to residents of the state, where interest rates are capped at 25 percent.

For the banks, it can be a lucrative partnership. At first blush, processing automatic withdrawals hardly seems like a source of profit. But many customers are already on shaky financial footing. The withdrawals often set off a cascade of fees from problems like overdrafts. Roughly 27 percent of payday loan borrowers say that the loans caused them to overdraw their accounts, according to a report released this month by the Pew Charitable Trusts. That fee income is coveted, given that financial regulations limiting fees on debit and credit cards have cost banks billions of dollars.

Some state and federal authorities say the banks’ role in enabling the lenders has frustrated government efforts to shield people from predatory loans — an issue that gained urgency after reckless mortgage lending helped precipitate the 2008 financial crisis.

Lawmakers, led by Senator Jeff Merkley, Democrat of Oregon, introduced a bill in July aimed at reining in the lenders, in part, by forcing them to abide by the laws of the state where the borrower lives, rather than where the lender is. The legislation, pending in Congress, would also allow borrowers to cancel automatic withdrawals more easily. “Technology has taken a lot of these scams online, and it’s time to crack down,” Mr. Merkley said in a statement when the bill was introduced.

While the loans are simple to obtain — some online lenders promise approval in minutes with no credit check — they are tough to get rid of. Customers who want to repay their loan in full typically must contact the online lender at least three days before the next withdrawal. Otherwise, the lender automatically renews the loans at least monthly and withdraws only the interest owed. Under federal law, customers are allowed to stop authorized withdrawals from their account. Still, some borrowers say their banks do not heed requests to stop the loans.

Ivy Brodsky, 37, thought she had figured out a way to stop six payday lenders from taking money from her account when she visited her Chase branch in Brighton Beach in Brooklyn in March to close it. But Chase kept the account open and between April and May, the six Internet lenders tried to withdraw money from Ms. Brodsky’s account 55 times, according to bank records reviewed by The New York Times. Chase charged her $1,523 in fees — a combination of 44 insufficient fund fees, extended overdraft fees and service fees.

For Subrina Baptiste, 33, an educational assistant in Brooklyn, the overdraft fees levied by Chase cannibalized her child support income. She said she applied for a $400 loan from Loanshoponline.com and a $700 loan from Advancemetoday.com in 2011. The loans, with annual interest rates of 730 percent and 584 percent respectively, skirt New York law.

Ms. Baptiste said she asked Chase to revoke the automatic withdrawals in October 2011, but was told that she had to ask the lenders instead. In one month, her bank records show, the lenders tried to take money from her account at least six times. Chase charged her $812 in fees and deducted over $600 from her child-support payments to cover them.

“I don’t understand why my own bank just wouldn’t listen to me,” Ms. Baptiste said, adding that Chase ultimately closed her account last January, three months after she asked.

A spokeswoman for Bank of America said the bank always honored requests to stop automatic withdrawals. Wells Fargo declined to comment. Kristin Lemkau, a spokeswoman for Chase, said: “We are working with the customers to resolve these cases.” Online lenders say they work to abide by state laws.

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