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Survey: Four Out of Five Nurses Have Gotten No Ebola Training At All

Mother Jones

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A new survey conducted by the National Nurses Union shows US hospitals may not be adequately prepared to handle Ebola patients, should the virus continue to spread. Out of the 2,200 nurses who responded to the union’s questionnaire, 85 percent reported that their hospitals had not provided education on Ebola. 76 percent said their institution had no policy for how to admit and handle patients potentially infected with the virus. More than a third claimed their hospitals didn’t have enough safety supplies, including eye protection and fluid resistant gowns.

The survey results were announced on Sunday, just after the Centers for Disease Control and Prevention confirmed that a health worker in Texas had tested positive for the virus. The CDC’s director, Thomas Frieden cited a “breach of protocol” as the likely reason.

Now—as agency officials scramble to figure out just what that breach was—nurses are pushing back. On Monday, NNU nurses in red shirts rallied in Oakland, Calif. with signs reading, “Stop Blaming Nurses. Stop Ebola.”

“We have been surveying nurses for almost two months about Ebola preparedness,” Charles Idelson, an NNU spokesman, said Monday. “What these survey results clearly indicate is that hospitals are still not doing enough to be properly prepared to respond.”

The CDC has announced plans to deploy an Ebola response team “within hours” at any hospital where an Ebola patient is admitted. At a press conference, Frieden said the agency is responding to calls from hospitals that are underprepared to handle the crisis.

On Monday, Frieden said the the CDC is also working with hospitals to better train health workers on Ebola precautions.”We have to rethink the way we address Ebola infection control,” he said. For example, he said, in some cases health workers may actually be wearing too much protective gear, making it harder to remove and dispose of the material.

The NNU survey showed that, even as the CDC called for more hands-on training, especially on how to properly put on and remove safety equipment, few hospitals have provided it for their employees. Ideslson says most are simply pointing nurses to information on their websites, or linking to CDC information. Staffing is another concern, with 63 percent of nurses reporting that hospital facilities won’t adjust the number of assigned patients per nurse to reflect the additional time required to care for infectious patients.

“We are going to continue to protest the failure of so many of these hospitals to put adequate safety measures in place,” Idelson said; he wouldn’t rule out the potential for healthcare workers to walk out on strike, much as Liberian health care workers have.

The American Hospital Association, an organization that represents nearly 5,000 hospitals nationwide, is now calling on hospitals to bolster their training regimens, turned down my request for an interview, but sent a statement saying, “We strongly encourage all hospitals to conduct employee retraining on how to use personal protective equipment to protect themselves from Ebola and other potentially deadly communicable diseases.”

Even if hospitals are prepared, however, it can be difficult to comply with both patient needs and the social blowback that comes with an Ebola diagnosis. The New York Times reported yesterday that Emory University Hospital in Atlanta, a center that had prepared for an outbreak long before the current crisis began, struggled with the county threatening to stop sewer service, couriers refusing to transport blood samples, and pizza delivery services refusing to come to any part of the hospital. And as my colleague Tim Murphy has reported, Louisiana’s attorney general has said the state, which processes a wide variety of hazardous wastes from around the nation, may take legal action to stop the incinerated belongings of deceased Ebola patient Eric Duncan from coming to one of its landfills.

In his press conference, Frieden warned that such fears are unfounded and counterproductive. “The enemy here is a virus. It’s not a person, it’s not a country, it’s not a place, it’s not a hospital—it’s a virus. It’s a virus that’s tough to fight, but together I’m confident that we will stop it.”

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Survey: Four Out of Five Nurses Have Gotten No Ebola Training At All

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What Is Boko Haram, and Why Do Its Members Kidnap Schoolgirls?

Mother Jones

In mid-April, more than 300 schoolgirls were kidnapped from Chibok boarding school in northern Nigeria by gunmen from the Islamist sect Boko Haram. Three weeks later, most of those girls are still missing. More than a week ago, a group of Nigerians launched the Twitter campaign #BringBackOurGirls, sparking global outrage over the attack. And on Tuesday, Secretary of State John Kerry offered to send a team to help rescue the children. Meanwhile, Nigeria’s nightmare gets worse by the day: On Monday, the leader of the group, which has terrorized the country for years, threatened to sell the girls off as slaves, and on Tuesday, Boko Haram kidnapped another eight girls. But let’s back up a minute. What is Boko Haram, exactly? And why do its members kidnap schoolgirls?

What is Boko Haram? Boko Haram is a group of Islamic fundamentalists based in northern Nigeria that has been terrorizing the country since 2009. The group believes Western culture is sinful and wants to return the country to the pre-colonial era of Muslim rule. To that end, Boko Haram has attacked government targets, including military checkpoints, police stations, highways, and schools, as well as churches, mosques, the UN building, and, recently, a bus station in the capital city of Abuja. Over the past five years, Boko Haram has slaughtered roughly 5,000 Nigerians whom the group viewed as pro-government. Here is a map of Boko Haram attacks over the years, via Business Insider:

What gave rise to the group? Boko Haram has roots in the 1970s-era Islamic revival in the region, but was founded in 2002 by a Muslim cleric named Mohammed Yusuf, shortly after Nigeria’s transition from dictatorship to democracy in 1999. The Boko Haram ideology—disseminated through a mosque and Islamic school Yusuf set up—gained traction in post-dictatorship Nigeria because many northern Muslims saw Western-style democracy as a scheme to disenfranchise them; voter turnout is higher in the Christian south than in the Muslim north. Persistent extreme poverty in the region has reinforced the notion that the government, which the group believes has been corrupted by Western values, cares more about enriching itself than helping Nigerians, and it has helped drive Boko Haram recruitment over the years. It’s hard to say how many Nigerians the group counts as members, but the Nigerian security forces claim to have killed thousands of them.

Nigerians have labeled the group Boko Haram, which loosely translated means “Western education is a sin.” But that’s not what Boko Haram calls itself. Its official name is Jama’atu Ahlis Sunna Lidda’awati wal-Jihad, which in Arabic means “People Committed to the Propagation of the Prophet’s Teachings and Jihad.”

Boko Haram is an Islamist terror group. Any links with Al Qaeda? Yep. In many of his sermons, Boko Haram leader Abubakar Shekau pledges allegiance to Al Qaeda. And Boko Haram has reportedly adopted many of Al Qaeda’s terrorist tactics, including suicide bombings. Last year, the Obama administration officially designated Boko Haram a terrorist organization.

Has the group ever attacked Americans? No. But Boko Haram has threatened to attack the United States, which it calls “a prostitute nation of infidels and liars.” And the group has kidnapped Westerners before.

Why did the militants kidnap the schoolgirls? In an effort to scare Nigerians away from Western education, Boko Haram and other militants have attacked 50 schools over the past year, killing more than 100 schoolchildren and 70 teachers. Thousands of students and teachers across the northern part of the country have been forced to flee their schools because of the violence.

This is not the first time Boko Haram has kidnapped girls, either. Just two weeks before the Chibok abduction, 25 young girls were kidnapped by the Islamist militants from the northern town of Konduga. Those girls are likely still being held captive. And Boko Haram abducted handfuls of children last year, as well as Christian women, whom the group converts to Islam and forces into marriage. But the Chibok kidnapping “is the largest number of children abducted in one swoop in the country,” Nnamdi Obasi, a senior Nigeria analyst for the International Crisis Group, told Mother Jones this week.

Some of the girls have reportedly been married off to the militants. On Monday, the leader of Boko Haram threatened in a homemade video to sell some into slavery:

How did the Chibok attack play out? Here is Michelle Faul, of the Associated Press, who interviewed one of the girls who was able to escape:

She says that when the gunmen came to her dormitory, they were sleeping. This is before dawn. These men came in, they had uniforms. They said, “Don’t worry. We’re soldiers here to help you.” And she said it wasn’t until that they were outside and…started setting fire to the school and shouting…”God is great,” that it suddenly dawned on them these were not soldiers. These were Boko Haram.

You can imagine the conditions that they’re in now. They were taken initially to the Sambisa forest, dense forests, humid heat, blocks of malaria-carrying mosquitoes. They’re probably drinking water from rivers and streams that are not clean. We’re told they’re kept on the move. Every couple of days, they’re moving.

Have any of the girls escaped? Nigerian police report that 53 of the girls have escaped, but 276 remain missing. Here is the AP’s Faul again, explaining how some of the girls managed to flee the terrorists:

The girl I spoke with was able to escape on the first night. She said that they were loaded onto trucks. It was dark. In the dark, some of the girls clung to low-hanging branches overhead. This was an open-back truck. She said she hesitated. And then one of the girls said, “Me, I’m going. If they shoot me, they shoot me, but I don’t know what else they might do to me if I don’t go.” So this girl jumped down, and the girl I spoke to jumped down. She said she ran into the bush, and she said, “I ran and I ran.” And she said, “That’s how I was able to save myself.”

What is the Nigerian government doing to rescue the girls? The Nigerian government claims that it has deployed aerial surveillance over the forest and that it has soldiers on foot searching for the girls. But from the start, Nigerian security forces made a pretty weak effort to find the girls, Mausi Segun, a researcher for Human Rights Watch based in northern Nigeria, told Mother Jones last week. She says the military did not make use of information provided by parents and locals in its rescue efforts. Desperate parents took to the forest themselves to search for their daughters.

Meanwhile, Nigerian President Goodluck Jonathan waited three weeks before publicly acknowledging the abductions and admitting he had no idea where the girls might be. The tepid response by the government has sparked a string of protests in Abuja. (First lady Patience Jonathan recently alleged that women protesting in Abuja against the government’s weak response to the Chibok abductions had fabricated the kidnappings.)

What is the rest of the world doing to help rescue the kidnapped girls? On Tuesday, the Nigerian government accepted a US offer to send a team of military and law enforcement officials to help the search and rescue effort. The United Kingdom will send a similar team. China and France have pledged assistance, too.

In the wake of the kidnapping, the rest of the world was slow on the uptake. Only after Nigerians criticized the international media’s initial indifference to the massive kidnapping did the foreign press start covering the attack. Since then, global outrage has grown by the day. The Twitter hashtag #BringBackOurGirls has been tweeted more than a million times.

How is the Nigerian government fighting the broader Boko Haram insurgency? Jonathan has vowed to defeat Boko Haram, but the insurgency is deadlier now than at any point in the group’s history. In the the first few months of 2014, the Islamist militants have already killed 1,500 people.

As Mother Jones reported last week, one reason the Nigerian government has not been able to stem attacks by the group is that the military does not coordinate with security forces in the countries that border northern Nigeria—including Cameroon, Chad, and Niger—where Boko Haram hides out. And the military’s expenditures are not tracked, so it’s hard to tell how much of the $6 billion a year the country spends on defense actually goes toward fighting Boko Haram.

Human rights advocates charge that Nigerian security forces’ response to the insurgency, which often includes the indiscriminate killing of northern Nigerian men, has aggravated Boko Haram violence.

The United States provides about $1 million a year in aid to the Nigerian military, as well as $3 million in law enforcement assistance. And the US military will soon start training Nigerian special forces to fight Boko Haram.

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What Is Boko Haram, and Why Do Its Members Kidnap Schoolgirls?

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Here’s What People Are Saying About the Big Keystone XL Report

Mother Jones

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The end is in sight for the tumultuous public debate over the Keystone XL pipeline. On Friday, the State Department released its Final Supplemental Environmental Impact Statement for TransCanada Corporation’s controversial pipeline project—and concluded that approving the pipeline to carry oil from Alberta’s tar sands would have little impact on climate change.

The environmental assessment is one of the last major reports awaited by President Obama before he decides whether or not to approve construction of the pipeline. In his June speech on climate change, Obama said he would sanction the pipeline “only if this project does not significantly exacerbate the problem of carbon pollution.” The pipeline requires State Department review because it crosses the international border between the US and Canada.

Obama’s final decision is still weeks away. But reactions to the report are already plentiful—here’s a sampling.

A statement from 350.org, the environmental organization founded by climate change activist Bill McKibben, reads, in part, “The President has already laid out a climate test for Keystone XL, that it can’t significantly increase greenhouse gas emissions. It’s clear that Keystone XL fails that test…the pipeline would pose an astronomical cost to our climate and a huge risk to families along the pipeline route. Keystone XL will fuel the climate crisis, which means more drought, more fires, more extreme weather events, and a more cost to our economy and the environment.”

Larry Schweiger, the president of the National Wildlife Federation, tells the Washington Post:

Regardless of what the EIS says, the Canadians have admitted that the amount of carbon they’re going to be releasing from the tar sands will increase Canada’s total emissions by 38 percent by 2030 instead of reducing emissions when all the science says that’s what we need to do in order to avoid catastrophic climate change.

Cindy Schild, senior manager for refining and oil sands policy at the American Petroleum Institute, told Bloomberg News, “If they can’t show this project is in our national interest, what is? The only thing left is for the president to decide that this project is in our national interest.”

Brian Straessle, a spokesman for API, added, “The president has had five years of inaction on the Keystone XL pipeline. If 2014 is really his ‘year of action,’ he should start by approving Keystone.”

In a statement, Susan Casey-Lefkowitz, the Natural Resources Defense Council’s international program director, said, “This is far from over. Next we must address whether the proposed Keystone XL tar sands pipeline would be in America’s national interest. To that question, there is only one answer: No. The evidence is overwhelming that this project would significantly worsen carbon pollution, endanger our farms, our homes and our fresh water, create few jobs and transport dirty tar sands to the Gulf for export.”

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Here’s What People Are Saying About the Big Keystone XL Report

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Republicans Are Trying to Build a Better Primary

Mother Jones

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Jonathan Bernstein reports on Republican efforts to shorten the primary season:

If all goes according to plan, the result will be votes in the first four (“carve-out”) states — Iowa, New Hampshire, Nevada, South Carolina — in February, followed by votes in rapid succession in March and April, with the primary season finishing up in May. That’s a lot more compressed than the January-to-June schedule of the past few cycles.

….The 2012 cycle, the theory goes, just went on too long, with eventual nominee Mitt Romney taking too many shots from other candidates. My feeling, however, is that the hits Romney took almost certainly didn’t matter for the fall campaign. The real lesson of 2012 that Republicans should worry about is that virtually any crank, no matter how little qualified for president, can have a very good two weeks….It’s essentially the stories of Michele Bachman, Herman Cain, Newt Gingrich, and Rick Santorum in 2012.

By compressing the calendar, you increase the danger that a mediocre or worse candidate could get hot at just the right time and wrap up the nomination before the party has time to stop it….The March crunch could get so momentous that it overwhelms the rest of the schedule. In other words, if crunch time in March takes on the air of a de facto national primary — even one spread out over two or three weeks — it could mean trouble.

I agree that compressing the actual voting might not matter much. These days, primary campaigns start early: we’ll almost certainly have several declared candidates by early 2015 and a full field by the middle of the year. Those guys are going to be out on the trail taking shots for a very long time no matter what. Besides, primary season is almost always effectively over by March or April anyway, even if there are a few Ron Paul-esque stragglers who refuse to concede for PR reasons. It rarely lasts more than 14 or 15 weeks.

So what about Bernstein’s theory that the real problem is beefing up the invisible primary so that fringe candidates are booted out early? I’m not so sure about that either. The clown show of 2012 was truly sui generis, something that’s never really happened before. And I’m not so convinced that any of the fringe folks would have had better odds in a compressed primary season, as he suggests. Sure, they each got hot for a week or two, but they typically got hot in one or two states. I don’t think they could have replicated that performance if they’d been competing in lots of different states at once.

But I could be wrong! Generally speaking, my advice to both parties is simple: Make your primaries as similar to a general election as possible. That would mean, for example, ditching the Iowa caucuses, since the kind of retail politics that win in Iowa are irrelevant to success in November. What you want is a candidate that can raise lots of money; appeal to lots of people; and has a good media presence. That’s what wins general elections these days, and a successful primary season is one that gives the advantage to those qualities. The quaint notion that New Hampshire is a great place to start because it’s a small state and gives everyone a chance is ridiculous. No modern political party should want a process that gives everyone a chance. They should want a process that brutally winnows out the vanity candidates and narrows the field to folks who know how to win on the big stage.

It won’t happen because it would require the parties to play massive hardball with the Iowas and New Hampshires of the world, something they won’t do. But they probably should.

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Republicans Are Trying to Build a Better Primary

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