Day: June 29, 2024

SAN JUAN, Puerto Rico — Beryl strengthened into a hurricane Saturday as it churned toward the southeast Caribbean, with forecasters warning it was expected to strengthen into a dangerous major hurricane before reaching Barbados late Sunday or early Monday. 

A major hurricane is considered a Category 3 or higher, with winds of at least 178 kph. Beryl is now a Category 1 hurricane. 

A hurricane warning was issued for Barbados, and a hurricane watch was in effect for St. Lucia, Grenada, and St. Vincent and the Grenadines, while a tropical storm watch was issued for Martinique, Dominica and Tobago.  

“It’s astonishing to see a forecast for a major (Category 3+) hurricane in June anywhere in the Atlantic, let alone this far east in the deep tropics. #Beryl organizing in a hurry over the warmest waters ever recorded for late June,” Florida-based hurricane expert Michael Lowry posted on X. 

Beryl’s center is forecast to pass about 45 kilometers (about 28 mi) south of Barbados, said Sabu Best, director of the island’s meteorological services. 

On Saturday, Beryl was about 1,160 kilometers (about 721 mi) east-southeast of Barbados, with maximum sustained winds of 120 kph. It was moving west at 35 kph. 

“Rapid strengthening is now forecast,” the Miami-based National Hurricane Center said. 

Warm waters are fueling Beryl, with ocean heat content in the deep Atlantic the highest on record for this time of year, according to Brian McNoldy, University of Miami tropical meteorology researcher. 

Beryl is the strongest June tropical storm on record that far east in the tropical Atlantic, noted Philip Klotzbach, Colorado State University hurricane researcher. 

“We need to be ready,” Barbadian Prime Minister Mia Mottley said in a public address late Friday. “You and I know when these things happen, it is better to plan for the worst and pray for the best.” 

She noted that thousands of people were in Barbados for the Twenty20 World Cup cricket final in the capital, Bridgetown, on Saturday.  

Some fans, such as Shashank Musku, a 33-year-old physician who lives in Pittsburgh, Pennsylvania, were rushing to change their flights to leave before the storm. 

Musku has never experienced a hurricane: “I don’t plan on being in one, either.” 

Meanwhile, St. Vincent and the Grenadines Prime Minister Ralph Gonsalves said in a public address Saturday that shelters will open Sunday evening as he urged people to prepare. He ordered officials to refuel government vehicles and asked grocery stores and gas stations to stay open later before the storm. 

Beryl is the second named storm in what is predicted to be a busy hurricane season, which runs from June 1 to November 30 in the Atlantic. Earlier this month, Tropical Storm Alberto came ashore in northeast Mexico with heavy rains that resulted in four deaths. 

Mark Spence, manager of a hostel in Barbados, said in a phone interview that he was calm about the approaching storm. 

“It’s the season. You can get a storm any time,” he said. “I’m always prepared. I always have enough food in my house.” 

The National Oceanic and Atmospheric Administration predicts the 2024 hurricane season is likely to be well above average, with between 17 and 25 named storms. The forecast calls for as many as 13 hurricanes and four major hurricanes. 

Beryl is expected to drop up to 15 centimeters (about 6 inches) of rain in Barbados and nearby islands, and a high surf warning of waves up to 4 meters (13 feet) was in effect. A storm surge of up to 2 meters (6.6 feet) is also forecast. 
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ABUJA, Nigeria — Yunusa Bawa spends a lot of time talking about the vaccine for the human papillomavirus that is responsible for nearly all cases of cervical cancer. But on most days, only two or three people allow their daughters to be vaccinated in the rural part of Nigeria where he works.

The challenge in Sabo community, on the outskirts of the capital of Abuja, is the unfounded rumor that the HPV vaccine will later keep young girls from giving birth.

“The rumor is too much,” said Bawa, 42.

As more African countries strive to administer more HPV vaccines, Bawa and other health workers tackle challenges that slow progress, particularly misinformation about the vaccine. The World Health Organization’s Africa office estimates that about 25% of the population still has doubts about it — reflecting concerns seen in some other parts of the world in early campaigns for the vaccine.

A common sexually transmitted virus, HPV can cause cervical cancer, certain other cancers and genital warts. In most cases, the virus doesn’t cause any problems, but some infections persist and eventually lead to cancer.

Across Africa, an average of 190 women died daily from cervical cancer in 2020, accounting for 23% of the deaths globally and making it the leading cancer killer among women in the WHO Africa region of 47 countries. Eighteen of the 20 countries with the highest rate of cervical cancer cases in the world are in Africa. Yet the region’s HPV vaccination rate has been low.

More than half of Africa’s 54 nations – 28 – have introduced the vaccine in their immunization programs, but only five have reached the 90% coverage that the continent hopes to achieve by 2030. Across the region, 33% of young girls have been vaccinated with HPV.

It’s a stark contrast to most European countries, where both girls and boys have been receiving HPV shots.

Part of why Africa has a high burden of cervical cancer is because of limited access to screening for women, said Emily Kobayashi, head of the HPV Program at the vaccines alliance Gavi.

“The elimination strategy is a long game … but we know that vaccination is the strongest pillar and one of the easiest to implement,” Kobayashi said.

But “it is one thing to introduce the vaccine, but if the vaccine remains in the fridge, it doesn’t prevent cervical cancer,” said Charles Shey Wiysonge, head of the vaccine-preventable diseases program in the WHO’s Africa region. He said information must be provided by people “who are trusted, people who are close to the communities.”

There is a long history of vaccine hesitancy in many African countries that is sometimes linked to a lack of trust in government, as one study published in the Nature science journal in May found, giving room for conspiracy theories and misinformation from social media influencers and religious leaders.

In Zimbabwe, where cervical cancer is the most frequent cancer among women, a group of mostly women known as Village Health Workers have been trained to raise awareness about cervical cancer and the HPV vaccine in rural areas. But they fight a high level of hesitancy among religious sects that discourage followers from modern medicines, asking them to rely instead on prayers and “anointed” water and stones.

The women who eventually agree to be screened for cervical cancer do so in secret, said Zanele Ndlovu, one of the health workers on the outskirts of Bulawayo city.

For a deeply religious country like Zimbabwe, “the spiritual leaders have so much influence that a lot of our time is taken trying to educate people about the safety of vaccines, or that they are not ungodly,” Ndlovu said.

There are also success stories in Africa where authorities have achieved up to a 90% vaccination rate. One example is Ethiopia, which relies heavily on religious leaders, teachers and hotline workers.

In Rwanda, the first African country to implement a national HPV vaccination program in 2011, the coverage rate has reached 90%. Hesitancy is less of an issue due to vigorous awareness work that has relied on school-based campaigns and community outreach programs, said Dr. Theoneste Maniragaba, director of the cancer program at Rwanda Biomedical Center.

Mozambique has deployed school-based programs, a door-to-door approach and mobile outreach for girls in hard-to-reach areas that has helped it reach 80% coverage rate with the first of two doses. In Tanzania, where the HPV vaccine has been in use since at least 2018, authorities in April launched a campaign to target over 5 million girls and further raise coverage, which has reached 79% of girls with the first dose.

One of Africa’s largest HPV vaccination drives targeting girls recently kicked off in Nigeria, which has procured nearly 15 million doses with the help of the U.N. children’s agency. It will target girls ages 9–14 with single doses that the WHO’s African immunization advisory group has said is as effective as the regular two doses.

One challenge is explaining the HPV vaccination to girls ahead of the onset of sexual activity, especially in conservative societies, said Dr. Aisha Mustapha, a gynecologist in northern Kaduna state.

Mustapha has been successfully treated for cervical cancer. She said the experience helps in her meetings with religious leaders and in community outreach programs in Kaduna, where she leads the Medical Women Association of Nigeria.

They try to make the girls feel comfortable and understand why the vaccine is important, she said. That sometimes requires comic books and lots of singing.

“The (cervical) cancer … is no respecter of any identity,” she said. “The vaccine is available, it is free, it is safe and effective.”
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DEIR AL-BALAH, Gaza — Children in sandals trudge through water contaminated with sewage and scale growing mounds of garbage in Gaza’s crowded tent camps for displaced families. People relieve themselves in burlap-covered pits, with nowhere nearby to wash their hands.

In the stifling summer heat, Palestinians say the odor and filth surrounding them is just another inescapable reality of war — like pangs of hunger or sounds of bombing.

The territory’s ability to dispose of garbage, treat sewage and deliver clean water has been virtually decimated by eight brutal months of war between Israel and Hamas. This has made grim living conditions worse and raised health risks for hundreds of thousands of people deprived of adequate shelter, food and medicine, aid groups say.

Hepatitis A cases are on the rise, and doctors fear that as warmer weather arrives, an outbreak of cholera is increasingly likely without dramatic changes to living conditions. The U.N., aid groups and local officials are scrambling to build latrines, repair water lines and bring desalination plants back online.

COGAT, the Israeli military body coordinating humanitarian aid efforts, said it’s engaging in efforts to improve the “hygiene situation.” But relief can’t come soon enough.

“Flies are in our food,” said Adel Dalloul, a 21-year-old whose family settled in a beach tent camp near the central Gaza city of Nuseirat. They wound up there after fleeing the southern city of Rafah, where they landed after leaving their northern Gaza home. “If you try to sleep, flies, insects and cockroaches are all over you.”

More than a million Palestinians had been living in hastily assembled tent camps in Rafah before Israel invaded in May. Since fleeing Rafah, many have taken shelter in even more crowded and unsanitary areas across southern and central Gaza that doctors describe as breeding grounds for disease — especially as temperatures regularly reach 32 degrees Celsius.

“The stench in Gaza is enough to make you kind of immediately nauseous,” said Sam Rose, a director at the U.N. agency for Palestinian refugees.

Conditions are exacting an emotional toll, too.

Anwar al-Hurkali, who lives with his family in a tent camp in the central Gazan city of Deir al-Balah, said he can’t sleep for fear of scorpions and rodents. He doesn’t let his children leave their tent, he said, worrying they’ll get sick from pollution and mosquitoes.

“We cannot stand the smell of sewage,” he said. “It is killing us.”

Basic services breakdown

The U.N. estimates nearly 70% of Gaza’s water and sanitation plants have been destroyed or damaged by Israel’s heavy bombardment. That includes all five of the territory’s wastewater treatment facilities, plus water desalination plants, sewage pumping stations, wells and reservoirs.

The employees who once managed municipal water and waste systems have been displaced, and some killed, officials say. This month, an Israeli strike in Gaza City killed five government employees repairing water wells, the city said.

Despite staffing shortages and damaged equipment, some desalination plants and sewage pumps are working, but they’re hampered by lack of fuel, aid workers say.

A U.N. assessment of two Deir al-Balah tent camps found in early June that people’s daily water consumption — including drinking, washing and cooking — averaged under 2 liters, far lower than the recommended 15 liters a day.

COGAT said it’s coordinating with the UN to repair sewage facilities and Gaza’s water system. Israel has opened three water lines “pumping millions of liters daily” into Gaza, it said.

But people often wait hours in line to collect potable water from delivery trucks, hauling back to their families whatever they can carry. The scarcity means families often wash with dirty water.

This week, Dalloul said, he lined up for water from a vendor. “We discovered that it was salty, polluted, and full of germs. We found worms in the water. I had been drinking from it,” he said. “I had gastrointestinal problems and diarrhea, and my stomach hurts until this moment.”

The World Health Organization declared an outbreak of hepatitis A that, as of early June, had led to 81,700 reported cases of jaundice — a common symptom. The disease spreads primarily when uninfected people consume water or food contaminated with fecal matter.

Because wastewater treatment plants have shut down, untreated sewage is seeping into the ground or being pumped into the Mediterranean Sea, where tides move north toward Israel.

“If there are bad water conditions and polluted groundwater in Gaza, then this is an issue for Israel,” said Rose, of the U.N. agency for Palestinian refugees. “It has in the past prompted actions by Israel to try and ameliorate the situation.”

COGAT said it’s working on “improving waste management processes” and examining proposals to establish new dumps and allow more garbage trucks into Gaza.

Where can garbage go?

Standing barefoot on a street in the Nuseirat refugee camp, 62-year-old Abu Shadi Afana compared the pile of garbage next to him to a “waterfall.” He said trucks continue to dump rubbish even though families live in tents nearby.

“There is no one to provide us with a tent, food, or drink, and on top of all of this, we live in garbage?” Afana said. Trash attracts bugs he’s never seen before in Gaza — small insects that stick to his skin. When he lies down, he said, he feels like they’re “eating his face.”

There are few other places for the garbage to go. When Israel’s military took control of a 1-kilometer buffer zone along its border with Gaza, two main landfills east of the cities of Khan Younis and Gaza City became off-limits.

In their absence, informal landfills have developed. Displaced Palestinians running out of areas to shelter say they’ve had little choice but to pitch tents near trash piles.

Satellite images from Planet Labs analyzed by The Associated Press show that an informal landfill in Khan Younis that sprung up after October 7 appears to have doubled in length since January. Since the Rafah evacuation, a tent city has sprung up around the landfill, with Palestinians living between piles of garbage.

Cholera fears

Doctors in Gaza fear cholera may be on the horizon.

“The crowded conditions, the lack of water, the heat, the poor sanitation — these are the preconditions of cholera,” said Joanne Perry, a doctor working in southern Gaza with Doctors Without Borders.

Most patients have illnesses or infections caused by poor sanitation, she said. Scabies, gastrointestinal illnesses and rashes are common. More than 485,000 diarrhea cases have been reported since the war’s start, WHO says.

“When we go to the hospital to ask for medicine for diarrhea, they tell us it is not available, and I go to buy it outside the hospital,” al-Hurkali said. “But where do I get the money?”

COGAT says it’s coordinating delivery of vaccines and medical supplies and is in daily contact with Gaza health officials. COGAT is “unaware of any authentic, verified report of unusual illnesses other than viral illnesses,” it said.

With efforts stalled to broker a cease-fire between Israel and Hamas, Dalloul says he’s lost hope that help is on the way.

“I am 21 years old. I am supposed to start my life,” he said. “Now I just live in front of the garbage.” 
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