Ban Ki-moon apologizes to Haiti for cholera outbreak

UN chief apologises for the international organisation's part in the 2010 outbreak blamed on Nepalese UN peacekeepers.

The UN chief formally presented a 'new approach' to the cholera epidemic in Haiti [AP]

UN Secretary General Ban Ki-moon has apologised for the first time to the people of Haiti for the international organisation's role in a deadly cholera outbreak that has killed more than 9,300 people and infected more than 800,000.

"On behalf of the United Nations, I want to say very clearly we apologise to the Haitian people," he said three times, in Haitian Creole, French and English, to the UN General Assembly on Thursday.

"We simply did not do enough with regards to the cholera outbreak and its spread in Haiti ... We are profoundly sorry for our role," Ban said.

According to numerous independent experts, cholera was introduced to Haiti by infected Nepalese UN peacekeepers sent to the Caribbean country after the massive 2010 earthquake.

Cholera, a disease that is transmitted through contaminated drinking water and causes acute diarrhoea, is a major challenge in a country with poor sanitary conditions.

The UN reiterated its rejection of claims that it is also legally responsible for the damages from the health emergency.

"We do not change our basic legal position," UN Deputy Secretary General Jan Eliasson told reporters on Thursday.

The UN chief also formally presented the 193-nation General Assembly with a "new approach", a two-pronged programme to help the families of the cholera victims and support the battle against the disease.

The UN hopes the new proposal will raise $400m over two years, but funding for prior UN assistance to Haiti has been slow to arrive.

Aid to victims

Ban urged donors to finance the programme and confirmed on Thursday that two programmes were planned, each costing $200m.

One will strengthen the fight against the epidemic, which resurged after Hurricane Matthew devastated the country in early October, and improve the country's sanitary infrastructure.

Some 72 percent of Haitians have no toilets at home and 42 percent still lack access to drinking water, the UN says.

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Source: ALJAZEERA

Relevant news this week

FREDERIC J. BROWN/AFP/Getty Images

1. Trump starts 'thank you' tour through states he won

President-elect Donald Trump, most of his Cabinet picks in place, kicks off his "Trump USA Thank You Tour 2016" on Thursday with a massive rally at the U.S. Bank Arena in Cincinnati. Earlier in the day, Trump and Vice President-elect Mike Pence, the governor of Indiana, will hold an event in Indianapolis with Carrier Corp, the heating and air-conditioning company that agreed this week to keep at least 800 jobs in Indiana that it had planned to move to Mexico. No details have yet been released on the price of keeping those jobs in Indiana, and hundreds of workers at the plant could still lose their jobs. Trump's victory tour will focus on states where he beat his Democratic rival, Hillary Clinton, in the election. [Politico, The Salt Lake Tribune]

 

2. Colombian Congress approves new peace deal with FARC rebels

Colombia's Congress ratified a revised peace deal with the Revolutionary Armed Forces of Colombia, known by its Spanish acronym FARC, on Wednesday night, marking a major step toward ending five decades of civil war. Voters in October narrowly rejected the first version of the accord, which opponents said was too lenient on the rebels. The new deal exposes more rebels to criminal prosecution, but critics accused President Juan Manuel Santos of ramming the agreement through and sidestepping the will of the people by seeking lawmakers' approval instead of holding another referendum. [USA Today, The New York Times]

 

3. Pelosi reelected as House Democratic leader

Rep. Nancy Pelosi (D-Calif.) won another term as House Democratic leader on Wednesday, surviving a challenge from Rep. Tim Ryan (D-Ohio) in a closed-door vote. Ryan received 63 votes, while Pelosi got almost exactly the two-thirds she predicted, with 134 votes. Although the vote was far from close, it amounted to the largest defection against Pelosi since she took over the party's House leadership in 2002. Still, the victory demonstrated that Pelosi's influence within the party remained solid despite the Republicans' win in the November elections, in which they retained control of the House and Senate and put Donald Trump in the White House. [The Hill, The Associated Press]

 

4. Death toll reaches 7 in eastern Tennessee wildfires

The death toll from wildfires eastern Tennessee rose to seven on Wednesday, with at least 53 other people treated for injuries at hospitals. The fires have engulfed two tourist towns — Gatlinburg and Pigeon Forge — near Great Smoky Mountains National Park. More than 700 homes and businesses have been destroyed, nearly half of them in Gatlinburg. Park Superintendent Cassius Cash said the fire that swept through the park and nearby areas was "likely to be human-caused." The fires, which had burned 16,000 acres by late Wednesday, spread so quickly that many of the thousands forced to evacuate left with only the clothes on their backs. One woman at a shelter said it was like "hell opened up." Rainfall finally arrived in the drought-stricken area, helping firefighters douse the blaze, but brought new threats — mudslides, floods, and tornadoes. [The Washington Post, Los Angeles Times]

 

5. OPEC agrees to first output cut since 2008

OPEC agreed to its first production cut since 2008 on Wednesday, sending oil prices surging by more than 9 percent. The deal came after Saudi Arabia, the world's largest producer, agreed to what Saudi Energy Minister Khalid al-Falih described as "a big hit," shouldering the largest of the 1.2 million barrels a day in cuts. Iran had been resisting cuts, insisting it should be allowed to regain market share it lost under recently lifted Western sanctions. Under a compromise, Iran will be allowed to boost production slightly from its October level. Traders said the oil rally might quickly fizzle, as the cuts won't be enough to end a global glut. [Reuters]

 

6. Veterans head to North Dakota to protect pipeline protesters

Two thousand U.S. military veterans plan to form a human shield around protesters against the Dakota Access oil pipeline project on the edge of the Standing Rock Sioux reservation in North Dakota, protest organizers said Wednesday. The veterans are expected to arrive in time for next week's deadline the federal government has set for the protesters to leave their camp near the construction site. The state this week backed away from a threat to cut off supplies to the camp. Protesters vow to stay and continue rallying for a change in the route of the $3.8 billion pipeline project, which they say threatens the reservation's water supply and sacred Native American sites. [Reuters, The New York Times]

 

7. Officer who fatally shot Keith Lamont Scott won't be charged

A Charlotte, North Carolina, prosecutor said Wednesday that Brentley Vinson, the police officer who fatally shot Keith Lamont Scott in September, will not face charges. Vinson is black, as was Scott. Police said Scott had a handgun when he was shot in a confrontation outside his apartment building, but the killing sparked demonstrations calling for police to release dashboard and body camera footage. Mecklenburg County District Attorney R. Andrew Murray said in a news conference that Vinson's use of deadly force was justified because he feared for his own life and the safety of his fellow officers. [The Charlotte Observer]

 

8. Ohio State attack suspect possibly inspired by al Qaeda, ISIS

The student who injured 11 people at Ohio State University this week might have been inspired by al Qaeda propagandist Anwar al-Awlaki, who was killed in a 2011 drone strike in Yemen, and the Islamic State, investigators said Wednesday. The suspect, Abdul Razak Ali Artan, was shot and killed by a campus police officer shortly after witnesses say he plowed his car into pedestrians, then got out and slashed people with a butcher knife. Angela Byers, the F.B.I. special agent in charge of the agency's Cincinnati office, said investigators have found no evidence anyone else was involved directly in the attack, although ISIS claims Artan was a "soldier" of the extremist group. Awlaki and ISIS both have called on Muslims to launch independent attacks on the U.S. [The New York Times]

 

9. Crew said plane ran out of fuel before Colombia crash

Minutes before a plane crashed in Colombia on Monday, killing 71 people, the pilot reportedly informed air traffic controllers that he had "run out of fuel," The Associated Press reported Wednesday. Bolivian flight attendant Ximena Sanchez, one of six people who survived the crash, told a rescuer the same story. "We ran out of fuel. The airplane turned off." The pilot also said in a leaked recording that he was requesting permission to land because the plane had suffered a "total electric failure." The aircraft crashed about eight miles from the Medellín airport. Investigators still have not said what they believe caused the plane, which was carrying a Brazilian soccer team and journalists, to crash. [The Associated Press, USA Today]

 

10. Big Mac inventor Jim Delligatti dies at 98

Jim Delligatti, inventor of the McDonald's Big Mac, has died at his home in a Pittsburgh suburb. He was 98. Delligatti first served the now-iconic sandwich — two beef patties, special sauce, lettuce, cheese, pickles, and onions on a three-layer sesame-seed bun — at his Uniontown, Pennsylvania, McDonald's outlet in 1967. The chain started serving it nationwide the following year. Delligatti said he was just improvising his own version of double-decker sandwiches served elsewhere. "I would never have dreamed that my creation would turn into a piece of Americana," he once said, according to McDonald's. [CNN]
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Source: THE WEEK

How neglect and bad decision can kill and make people cry

Colombian authorities say evidence is growing that a plane carrying a Brazilian football team crashed because it ran out of fuel as it tried to land. 

The plane had no fuel on impact, an official said, corroborating audio of the pilot asking to land because of a fuel shortage and electric failure.

The capital Bogota was mentioned on the flight plan as a possible refuelling stop, but the plane did not land there.

The plane plunged into a mountainside near Medellin late on Monday.


Only six of the 81 people on board the plane survived.

"Having been able to do an inspection of all of the remains and parts of the plane, we can affirm clearly that the aircraft did not have fuel at the moment of impact," civil aviation chief Alfredo Bocanegra told a news conference.


Freddy Bonilla, another aviation official, said regulations stipulated that aircraft must have 30 minutes of fuel in reserve to reach an alternative airport in an emergency, but "in this case the plane did not have" it.

"The engines are the electrical source... but without fuel, obviously the electrical source would have been completely lost," he added.

In a leaked tape, the pilot can be heard warning of a "total electric failure" and "lack of fuel". Just before the tape ends, he says he is flying at an altitude of 9,000ft (2,745m).

The plane was carrying the Brazilian football team Chapecoense, who had been due to play a cup final against Atletico Nacional in Medellin on Wednesday evening.

Fans gathered at the Atletico Nacional stadium in Medellin on the evening the match was due to be playe -- copyright Reuters

Refuelling stops

The team flew from Sao Paulo to Santa Cruz on a commercial flight, then switched to the chartered aircraft.

Brazil's O Globo reported that because of a delayed departure, a refuelling stop in Cobija, on the border between Brazil and Bolivia, was abandoned because the airport did not operate at night.

The pilot had the option to refuel in Bogota, but headed straight to Medellin.

"The pilot was the one who took the decision," Gustavo Vargas, a representative of Lamia, which operated the plane, was quoted as saying in Bolivian newspaper Pagina Siete. "He thought the fuel would last."

Approaching Medellin, the pilot asked for permission to land because of fuel problems, without making a formal distress call.

But another plane from airline VivaColombia had priority because it had already reported mechanical problems, the co-pilot of another plane in the air at the time said.

The pilot of the crashed plane is heard asking urgently for directions to the airport before the audio recording ends.

Officials say the plane's "black boxes", which record flight details, will be sent to the UK to be opened by investigators. A full investigation into the crash is expected to take months.


On Wednesday night, when the match had been due to take place, tens of thousands of fans gathered at the Medellin stadium - and at Chapecoense's home ground in Chapeco - to pay tearful tributes.

Many wore white and carried candles as a mark of respect. Chapecoense lost 19 players in the crash. Twenty journalists were also killed.

Of the survivors, Chapecoense said that two players remained in a critical but stable condition, while the club's goalkeeper had had one leg amputated and might still lose his other foot.

An injured journalist also remained in critical condition, the club said.
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Source: BBC

Sad day for Brasilian and World Football

RIO DE JANEIRO (AP) — The Brazilian soccer team aboard the plane that crashed in Colombia was gaining respect and support from across Brazil even though it was a small club with a short history.

Chapecoense, founded in 1973, was preparing to play in the Copa Sudamericana final, South America’s second biggest club competition after the Copa Libertadores. The team was flying to Medellin to face Atletico Nacional on Wednesday in the first leg of the final.

Members of the Chapecoense team were among the 81 people on board the chartered aircraft that crashed on its way to Medellin’s international airport. Colombian police said there were some survivors.

“This is a very, very sad day for football,” FIFA President Gianni Infantino said in a statement. “At this difficult time our thoughts are with the victims, their families and friends. FIFA would like to extend its most heartfelt condolences to the fans of Chapecoense, the football community and media organizations concerned in Brazil.”

Chapecoense reached Brazil’s first division in 2014 and was in ninth place ahead of this weekend’s last round of games. On its way to the continental final, the team known as Chape beat major clubs such as Argentina’s San Lorenzo and Independiente.

Chape strikers Bruno Rangel and Kempes, both 34 years old, are among the top scorers in the Brazilian league, with 10 and nine goals, respectively. One of the team’s top players is 35-year-old midfielder Cleber Santana, who played for Atletico Madrid from 2007-10.

Another team leader was defender Helio Hermito Zampier Neto — commonly known as Net.
Among the passengers on the flight was Mario Sergio Pontes de Paiva, a former soccer player who worked as commentator for Fox Sports.

Known as Mario Sergio, he played briefly for Brazil’s national team in the early 1980s and had a long career as a midfielder and coach with many Brazilian clubs. He last coached Brazilian club Internacional in 2009 and Ceara in 2010.

In the wake of the crash, the Brazilian Football Confederation called off the Brazilian Cup final between Gremio and Atletico Mineiro, which set for Wednesday. A new date has not been set.

Chapecoense is based in Chapeco, a city of about 200,000 that is known for its poultry industry and is located about 800 miles (1,300 kilometers) south of Rio de Janeiro.

 

The club, which doesn’t have any players in Brazil’s national team or in the under-20 team, plays its home matches at the 22,000-seat Arena Conda. But it had been scheduled to play the second leg of the Copa Sudamericana final at the Couto Pereira Stadium, a 40,000-seat venue in Curitiba, a city 300 miles (480 kilometers) north of Chapeco.

A group of rival fans, however, became so impressed with Chapecoense’s amazing run in the competition that they started a campaign on social media to move the final to the iconic Maracana Stadium in Rio de Janeiro.

Twitter | @kaka

Kaka on Twitter

Chape had its best season ever in 2016, earning 52 points from 37 matches. On Sunday, the team lost at Palmeiras 1-0, a result which clinched the Brazilian league title for the host team.

The team was due to host fourth-place Atletico Mineiro at the Arena Conda on Sunday and then face Atletico Nacional in the second leg of the Copa Sudamericana final on Tuesday.
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Source: USATODAY

Obama’s final medals and the ‘Michael Jordan of Greatness’

President Barack Obama awards the Presidential Medal of Freedom to National Basketball Association Hall of Fame member and legendary athlete Michael Jordan during a ceremony in the East Room of the White House November 22, 2016 in Washington, DC.(Photo by Chip Somodevilla/Getty Images)

WASHINGTON – In this season of “lasts” in President Barack Obama’s White House, Tuesday marked an extraordinary gathering of 21 people – superstars all– who received Obama’s final batch of Presidential Medals of Freedom.

“We’ve got innovators and artists. Public servants, rabble rousers, athletes, renowned character actors — like the guy from Space Jam,” said Obama, taking an affectionate poke at Chicago Bulls legend Michael Jordan.

“I am the President, he is the Boss,” said Obama, hanging a medal around the neck of rocker Bruce Springsteen, who closed out Obama’s 2008 and 2012 presidential campaign rallies.

Jordan, who owns the Charlotte Hornets was teary; so was Ellen Degeneres when they got their medals. Obama, pretty tall himself, had to stretch to attach the medal to another NBA giant, Kareem Abdul-Jabbar.

OPINION

Obama kidded a former University of Chicago physicist, Dick Garwin, who helped create the hydrogen bomb – and then worked to reduce the nuclear threat – for also getting a patent on a “mussel washer” for shellfish.

Chicago’s Newton Minow, hugged the president — who he met as a young law student — as his wife, Jo, and three adult daughters beamed. Everyone laughed when Obama had to call Robert DeNiro twice to the podium. Tom Hanks turned towards the announcer to give an approving nod when he said, “Reach for the sky,” with relish, Hank’s signature line from “Toy Story.”



First lady Michelle Obama was in an aisle seat in the front row, sitting next to Vice President Joe Biden. The row included senior adviser Valerie Jarrett, Attorney General Loretta Lynch and former AG Eric Holder. Mrs. Obama’s chief of staff Tina Tchen greeted Secretary of State John Kerry with a hug. National Security Advisor Susan Rice, an early 2008 Obama backer, was in the House.

In a few weeks, they will all be gone.

Donald Trump will be the president.

Obama did not say Trump’s name when he rebuked his divisive campaign and his “make America great again” slogan.

Ending “on a personal note,” Obama said, “it’s useful when you think about this incredible collection of people to realize that this is what makes us the greatest nation on Earth. … Not because of our differences, but because, in our difference, we find something common to share. And what a glorious thing that is. What a great gift that is to America.”

THE MICHAEL JORDAN OF GREATNESS

Jordan, said Obama, a basketball fanatic, is “more than just the best player on the two greatest teams of all time — the Dream Team and the Chicago ’96 Bulls. He’s more than a logo, more than just an Internet meme. More than just a charitable donor or a business owner committed to diversity.

“There is a reason you call someone ‘the Michael Jordan of’ — Michael Jordan of neurosurgery, or the Michael Jordan of rabbis, or the Michael Jordan of outrigger canoeing — and they know what you’re talking about. Because Michael Jordan is the Michael Jordan of greatness. He is the definition of somebody so good at what they do that everybody recognizes them. That’s pretty rare.”

NEWT MINOW AND THE PUBLIC INTEREST

Minow’s ‘vast wasteland’ line from his 1961 speech about television is famous; Obama of course used it. Obama added, the “public interest” has been “the heartbeat” of Minow’s life’s work, “advocating for residents of public housing, advising a governor and Supreme Court justice, cementing presidential debates as our national institution, leading the FCC.

“…As far as I know, he’s the only one of today’s honorees who was present on my first date with Michelle. Imagine our surprise when we saw Newt, one of our bosses that summer, at the movie theater – “Do the Right Thing.” So he’s been vital to my personal interests.’’


COURAGE

Said Obama about Ellen DeGeneres, “It’s easy to forget now, when we’ve come so far, where now marriage is equal under the law — just how much courage was required for Ellen to come out on the most public of stages almost 20 years ago.”

Comedian and talk show host Ellen DeGeneres wipes tears during a Presidential Medal of Freedom presentation ceremony at the White House November 22, 2016 in Washington, DC. (Photo by Alex Wong/Getty Images)

Obama said the NCAA likely banned the dunk because of Kareem Abdul-Jabbar, honored Tuesday for more than hoops: “He stood up for his Muslim faith when it wasn’t easy and it wasn’t popular. … Kareem is one-of-a-kind — an American who illuminates both our most basic freedoms and our highest aspirations.”

President Barack Obama (C) pretends to ‘skyhook’ over National Basketball Association all-time leading scorer and social justice advocate Kareem Abdul-Jabbar before awarding him the Presidential Medal of Freedom to during a ceremony in the East Room of the White House November 22, 2016 in Washington, DC.(Photo by Chip Somodevilla/Getty Images)

ALSO HONORED …

Microsoft’s Bill and Melinda Gates; architects Maya Lin and Frank Gehry; Saturday Night Live founder Lorne Michaels; software engine pioneer Margaret Heafield Hamilton; actor Robert Redford; sports announcer Vin Scully, actress Cicely Tyson; educator Eduardo J. Padrón.
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Source: Chicago Suntimes

Russia warships: Kuznetsov battle group 'refuels off North Africa'

Russia's only aircraft carrier, the Admiral Kuznetsov, will join Russian vessels already off the Syrian coast

A group of warships including Russia's only aircraft carrier, the Admiral Kuznetsov, is reportedly refuelling at sea off North Africa en route to Syria. 

Plans for some of the ships to dock at a Spanish port were cancelled after Nato allies voiced concern.

Nato is concerned planes from the carrier could be used to attack civilians in the Syrian city of Aleppo.

President Vladimir Putin also hinted that an aerial bombardment of rebel-held east Aleppo could resume.


Russia and its ally, the Syrian government, had said earlier that they would continue a moratorium on the bombing.

At an international conference in the Russian city of Sochi on Thursday, Mr Putin said other parties to the conflict had not been keeping their promises.

"Where is the disengagement of terrorists from the healthy part of the opposition?" Mr Putin asked.

"So far we have been restrained, and we have not been rude to our partners, but everything has its limits. We could respond."

The Admiral Kuznetsov can carry dozens of fighter bombers and helicopters. It has been sailing for the past week from Russia to the Mediterranean.

The BBC's Jonathan Marcus reports from Brussels that the battle group is currently at anchor off the North African coast and taking on fuel.

The group has two "oilers" (tankers) with it and it is not clear which of the vessels is actually refuelling, he adds.

The Russian embassy in Madrid formally withdrew a request to Spain for refuelling after being approached by the Spanish foreign ministry.

"Given the information which appeared on the possibility that these ships would participate in supporting military action in the Syrian city of Aleppo, the ministry of foreign affairs requested clarification from the embassy of the Russian Federation in Madrid," the Spanish foreign ministry had said on Wednesday in a statement to the BBC.

It added that permission had been granted in September for three Russian ships to dock in the port of Ceuta between 28 October and 2 November. It said such stops for Russian naval vessels had taken place for years in Spanish ports.

Nato had said the final decision on resupply rested with Spain.

"We are concerned and I have expressed that very clearly about the potential use of this battle group to increase Russia's ability and to be a platform for air strikes against Syria," Nato's Secretary-General Jens Stoltenberg told journalists on Tuesday.

The warships came down the Channel

The naval group also includes a nuclear-powered battle cruiser, two anti-submarine warships and four support vessels, probably escorted by submarines.


The battle group is expected to join about 10 other Russian vessels already off the Syrian coast.
Some 2,700 people have been killed or injured since the Russian-backed Syrian offensive started last month, according to activists.

Western leaders have said Russian and Syrian air strikes on Aleppo could amount to war crimes, an accusation rejected by Russia.

About 250,000 civilians who live in Aleppo have been trapped by the fighting. Moscow announced last week a "humanitarian pause" in attacks as part of a plan to allow civilians and fighters to leave the area.
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Source: BBC

Why are so many doctors fleeing Puerto Rico?

In this Oct. 24, 2016 photo, patients wait their turn at one of the Medical Center external clinics in San Juan, Puerto Rico. A steady departure of medical specialists from Puerto Rico has turned into a stampede amid the island's ongoing economic crisis leaving patients with few doctors to take care of their ills. Carlos Giusti -- AP Photo

Read more here: http://www.miamiherald.com/news/article110742012.html#storylink=cpy

SAN JUAN, Puerto Rico -- Wanda Serrano arrived at Puerto Rico's largest public hospital before dawn to take her 17-year-old son to an appointment. Six hours later, they were still in the packed waiting room hoping to see a doctor.

They had gone to San Juan's Centro Medico to see one of the many kinds of specialists the teen needs for treatment of a genetic disease called tuberous sclerosis, which can cause tumors to grow on his brain, kidneys and other organs. But specialized medical expertise is increasingly difficult to find in the economically troubled U.S. island territory.



Six hours in a waiting room is no longer the exception, but the norm. A pediatric neurologist recently told Serrano that her son, Cedrik, needed to wait 10 months for an appointment.

"I live terrified every single day," Serrano said one recent morning as she clutched his medical records and peered anxiously down a fluorescent-lit hallway for a nurse or doctor. "You feel powerless. You can't do anything except wait for that date to arrive."

Doctors have gradually left Puerto Rico during a decade-long recession that has gripped the island and driven more than 200,000 people to the U.S. mainland seeking better opportunities.

Now, the steady departure of pediatricians, surgeons, orthopedists, neurologists and others has become a stampede as the economy shows no sign of improving and financial problems in the territorial health insurance program make it nearly impossible for doctors to stay in business.

Up to 700 doctors are expected to leave Puerto Rico this year, double the number from two years ago, said Dr. Victor Ramos, president of the island's Association of Surgeons. The territory's number of doctors has dropped from 14,000 to 9,000 in the past decade, the majority leaving for higher salaries and lower living costs on the U.S. mainland.

The island of 3.5 million people now has only two pediatric urologists, one orthopedist specializing in ankle and feet, one pediatric cardiologist, and a handful of geneticists and endocrinologists. It can take a year to see a specialist, Ramos said.

"People are waiting much longer for appointments, including one that could be a matter of life or death because there is simply no room," he said.

Dr. Hiram Luigi, an orthopedic surgeon, said he has to realign the bones of patients a couple of times each month because they did not see a specialist in time.

"I have spent 30 years in orthopedics, and I have never seen something like this," Luigi said.
The lack of specialists has adversely affected patients, whose health conditions often worsen before a doctor sees them.

Many people like Serrano have moved to the U.S. specifically to get medical care. "I'm searching for quality of life," she said.

Puerto Rico's financial woes are largely to blame. The government is behind on insurance payments as it scrambles to make payments on debts that have ballooned in recent years to nearly $70 billion. Doctors not only struggle with delayed reimbursements for services but receive less money through the government's Medicare and Medicaid programs as well as private health insurance than they would for the same services on the U.S. mainland.

Many specialists no longer accept patients with Medicaid, which covers roughly half of Puerto Rico's population. The great majority of patients like Serrano's son now seek specialists at Puerto Rico's largest public hospital, lining up as early as 1 a.m. daily for medical care.

"It's truly the final stop for many people," said Edgar Colon, dean of the University of Puerto Rico's School of Medicine. "We can't keep up."

The hospital is buckling under a surge of patients as it operates with a dwindling budget, unable to buy certain medical supplies like it used to when the government could still borrow money.

Jorge Vidal, president-elect of Puerto Rico's Radiology Association, said he cannot perform some procedures because he can't obtain two types of specialized needles.

"There's a very simple reason they haven't bought them," he said. "They cost $300."

Such problems pushed pediatrician Dr. Hector Nieves to move to Florida in February 2015. In his new office, the answering machine offers same-day appointments.

"I don't regret leaving," Nieves said. "Puerto Rico's problems are much bigger than people think."
Those who have stayed say it will only get worse.


More than 20 percent of the island population is 60 years and older, and that percentage is expected to spike as not only doctors but all types of Puerto Ricans leave for the U.S. mainland.

Serrano and her son will move soon to Orlando to join her husband, who found a job there. She is optimistic about finding specialists to provide the checkups her son needs every six months.

"I'm leaving in peace," she said. "I feel like I've been born again."
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By DANICA COTO  

Associated Press

Read more here: http://www.miamiherald.com/news/article110742012.html#storylink=cpy