Posts Tagged ‘Israel grossman attorney Profile’

A History Lesson On The Philippines, Stuffed In A Christmas Chicken

Uncategorized | Posted by Israel Grossman Attorney
Dec 21 2014

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The rellenong manok at La Cocina de Tita Moning, a restaurant in Manila. Chef Suzette Monitnola uses a traditional recipe from the 1930s that belonged to her grandmother.

Aurora Almendral for NPR


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The rellenong manok at La Cocina de Tita Moning, a restaurant in Manila. Chef Suzette Monitnola uses a traditional recipe from the 1930s that belonged to her grandmother.

The rellenong manok at La Cocina de Tita Moning, a restaurant in Manila. Chef Suzette Monitnola uses a traditional recipe from the 1930s that belonged to her grandmother.

Aurora Almendral for NPR

More In This Series

This is part of a series of stories exploring the rich diversity of Christmastime edibles around the world, and the stories behind the food.

Noche buena, the Christmas Eve feast in fervently Catholic Philippines, is deeply steeped in tradition. One of the mainstays of this decadent meal, usually eaten after midnight mass, is rellenong manok (rel-ye-nong ma-nok). It’s a hybrid name: In Spanish, relleno means stuffed, and in Tagalog, manok means chicken.

Rellenong manok is a deboned chicken or capon, filled with a jumble of ingredients that include some combination of minced pork, Edam cheese, chorizo, raisins, pine nuts, canned Vienna sausages, olives, ham, Oxford sausage, hard boiled eggs, and even Spam.

Depending on a family’s adherence to tradition, rellenong manok may be basted with Madeira wine, sprinkled with cinnamon and nutmeg, or washed inside and out with soy sauce and kalamansi, a tiny native Filipino citrus fruit. The chicken is then sewn up and either roasted, or deep fried then braised.

Rellenong manok is a cherished tradition in the Philippines, and is often given as a Christmastime gift, like a nice bottle of wine, a tin of cookies or a fruitcake.

If it seems hard to pin down how this dish got these fillings, it’s because of the complexity of the Philippines’ culture itself. The list of ingredients reads like a map, or a history lesson, of the country’s cultural influences, according to Genevieve Villamora, owner of Bad Saint, a Filipino restaurant slated to open in Washington, D.C. in 2015.

The modern rellenong manok is undoubtedly originally descended from Spain. For 400 years, the Philippines was the Spanish empire’s Asian colony. Spain brought Catholicism to the islands and Filipinos embraced the culinary traditions that came with it.

Spanish pollo relleno is similar to French galantine, but as Filipino culinary historian and author Felice Sta. Maria notes, the Spaniards’ incorporation of dried fruits and nuts comes from the 900 years of Arab influence in Spain. Today, that element of rellenong manok endures as raisins and pine nuts.

Rellenong manok is a labor-intensive dish reserved for special occasions, and through the turn of the 20th century, Filipino families stuck close to Spanish tradition and stuffed their chickens with the rare, imported treats that survived the long ocean voyage from Spain: chorizo, jamón and other preserved meats, olives. Some might also add a hard, round Dutch Edam cheese coated in thick red wax, called queso de bola in the Philippines.

As colonial ties shifted, so did the ingredients for rellenong manok. In 1898, at the end of the Spanish-American War, Spain ceded the last of its colonies, including the Philippines, to the U.S. It became the only official colony of the U.S., and American influence on Filipino culture began to overtake Europe’s.

“The United States considered the Philippines as an additional market for their goods,” Sta. Maria tells The Salt. “And if you look at the products that were imported, all the big American brands were here, and they were bringing in canned meats, canned vegetables which were beginning to compete with these European brands that had already established themselves.”

Seduced by novelty and convenience, Filipinos were eager to try American industrial foods like canned Vienna sausages and Spam. After World War II, with Europe in shambles, and the population living on rations, imports of the European meats that traditionally filled rellenong manok dried up, and Filipinos turned to American processed meats to fill the gap.

Vienna sausage replaced Oxford sausage, and Spam filled in for ham or bacon. Chinese or Filipino sausages stood in for chorizo. Kalamansi replaced hard-to-find lemons.

Despite leaving a strong imprint on rellenong manok, Sta. Maria says the American culinary influence in the Philippines is now on the decline. “The U.S. is having such a hard time competing with goods from other countries, plus Filipino companies are making their own versions of American products … tweaking them for the Filipino taste,” she says.

These days, as far as Filipinos are concerned, rellenong manok isn’t an import from Spain, it’s Filipino. Which is why more than 100 years after Spain left the Philippines, the tradition of a Christmastime chicken is still going strong.

“It’s not just comfort [food], it’s your role … to continue these food traditions. It wouldn’t be Christmas without them,” says Sta. Maria, “And this continues over generations for as long as those traditions can market themselves and convince each new generation that it tastes good, it looks good, it’s part of us. You can’t take it away from us. If you take it away from us we’re not us.”

Still, it is just one of several Christmas traditions in the Philippines. Many families eat roast pig and festive sticky rice – to celebrate the rice harvest, a tradition that predates even the Spanish.

Aurora Almendral is a journalist in Manila.

Article source: http://www.npr.org/blogs/thesalt/2014/12/21/371910092/a-history-lesson-on-the-philippines-stuffed-in-a-christmas-chicken?utm_medium=RSS&utm_campaign=world

Obama Calls North Korean Hack ‘Cybervandalism’

Uncategorized | Posted by Israel Grossman Attorney
Dec 21 2014

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Sony Pictures Studios headquarters building is seen in Culver City, Calif., on Friday. President Obama has criticized Sony for cancelling distribution of The Interview following after the studio was hacked by North Korea.

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Sony Pictures Studios headquarters building is seen in Culver City, Calif., on Friday. President Obama has criticized Sony for cancelling distribution of The Interview following after the studio was hacked by North Korea.

Sony Pictures Studios headquarters building is seen in Culver City, Calif., on Friday. President Obama has criticized Sony for cancelling distribution of The Interview following after the studio was hacked by North Korea.

Damian Dovarganes/AP

President Obama tells CNN that he doesn’t consider North Korea’s hack of Sony Pictures an act of war, but instead a case of “cybervandalism.” But, he stands by his criticism of the movie studio for pulling the satirical film The Interview because its plot angers Pyongyang.

“If we set a precedent in which a dictator in another country can disrupt through cyber, a company’s distribution chain or its products, and as a consequence we start censoring ourselves, that’s a problem,” Obama told CNN’s State of the Union this morning.

“And it’s a problem not just for the entertainment industry, it’s a problem for the news industry,” he said. “CNN has done critical stories about North Korea. What happens if in fact there is a breach in CNN’s cyberspace? Are we going to suddenly say, are we not going to report on North Korea?”

The film depicts comedy duo Seth Rogen and James Franco as journalists who score an interview with North Korea’s reclusive leader, Kim Jong Un. In the film, the CIA recruits the pair to assassinate Kim.

The president’s latest remarks on CNN follow a Friday news conference in which called Sony’s decision to cancel the release of The Interview a mistake.

“Sony is a corporation. It suffered significant damage. There were threats against its employees. I’m sympathetic to the concerns that they faced,” Obama said. “Having said all that, yes I think they made a mistake.”

Responding to the president’s initial remarks, Sony Pictures CEO Michael Lynton told NPR that the studio “did not capitulate” to hackers.

“We don’t own movie theaters, and we require movie theater owners to be there for us to distribute our film,” Lynton told NPR’s All Things Considered.

“We very much wanted to keep the picture in release. When the movie theaters decided that they could not put our movie in their theaters, we had no choice at that point but to not have the movie come out on the 25th of December,” he said. “This was not our decision.”

On Saturday, North Korea denied its involvement in the cyberattack against Sony Pictures and said it wanted to help the United States investigate the breach. But the regime also threatened “serious” consequences if Washington declined the offer.

Article source: http://www.npr.org/blogs/thetwo-way/2014/12/21/372271870/obama-calls-north-korean-hack-cybervandalism?utm_medium=RSS&utm_campaign=world

Tunisia, Cradle Of ‘Arab Spring,’ In Historic Presidential Vote

Uncategorized | Posted by Israel Grossman Attorney
Dec 21 2014

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Tunisian voter Dina Ghlisse, 19, displays her finger with the indelible ink mark after voting in La Marsa, on the outskirts of Tunis, on Sunday. More than three years after Tunisia sparked “Arab Spring,” the country is choosing a president.

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Tunisian voter Dina Ghlisse, 19, displays her finger with the indelible ink mark after voting in La Marsa, on the outskirts of Tunis, on Sunday. More than three years after Tunisia sparked Arab Spring, the country is choosing a president.

Tunisian voter Dina Ghlisse, 19, displays her finger with the indelible ink mark after voting in La Marsa, on the outskirts of Tunis, on Sunday. More than three years after Tunisia sparked “Arab Spring,” the country is choosing a president.

Hassene Dridi/AP

Tunisians are going to the polls today to choose a president in a runoff election that represents a choice between the country’s interim leader, swept to power in the wake of the 2011 Arab Spring revolution, or a candidate with ties to the ousted regime.

An aging Beji Caid Essebsi, who represents the secular-leaning Nidaa Tounes (Tunisia Calls) party and who served under Tunisia’s deposed President Zine El Abidine Ben Ali, is challenging interim leader Moncef Marzouki.

Essebsi’s support comes from the wealthy coastal regions and he has used his experience and the prospect of stability to woo voters. Marzouki, 67, is a human rights activist who was forced into exile during the Ben Ali regime. Marzouki is more popular in the country’s poorer south.

As of 2 p.m. Tunisian time (8 a.m. ET), turnout was reported at 38 percent.

As the BBC notes: “The process is being scrutinised not just by international election observers, but also by thousands of Tunisian observers, who are walking around in blue vests and filling in forms. “

In October, Nidaa Tounes won a resounding victory in parliamentary elections, grabbing 85 seats, or just under 40 percent of the 217-seat assembly.

Article source: http://www.npr.org/blogs/thetwo-way/2014/12/21/372273648/tunisia-cradle-of-arab-spring-in-historic-presidential-vote?utm_medium=RSS&utm_campaign=world

Russia Says It Won’t ‘Cave In’ To New Western Sanctions

Uncategorized | Posted by Israel Grossman Attorney
Dec 20 2014

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Russian President Vladimir Putin speaks in front of the map of the Russian Federation, with Crimea on the left of the map, during his annual news conference in Moscow, Russia, on Thursday. The Kremlin has responded angrily to the latest round of U.S.-EU sanctions over the annexation of Crimea.

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Russian President Vladimir Putin speaks in front of the map of the Russian Federation, with Crimea on the left of the map, during his annual news conference in Moscow, Russia, on Thursday. The Kremlin has responded angrily to the latest round of U.S.-EU sanctions over the annexation of Crimea.

Russian President Vladimir Putin speaks in front of the map of the Russian Federation, with Crimea on the left of the map, during his annual news conference in Moscow, Russia, on Thursday. The Kremlin has responded angrily to the latest round of U.S.-EU sanctions over the annexation of Crimea.

Alexei Druzhinin/AP

Russia, battered by the falling price of oil, its chief export, and a tumbling ruble, lashed out against the U.S. and EU for new sanctions that President Vladimir Putin says already account for “25 to 30 percent” of his country’s eroding currency.

A Foreign Ministry spokesman says today that the Kremlin will not “cave in” to pressure from the West over Moscow’s annexation of Crimea, calling sanctions “collective punishment” on residents of the Black Sea peninsula, who voted in March to join Russia.

President Obama on Friday authorized fresh sanctions that prohibit any new American investment, financing or trade with Crimea. The U.S. move comes a day after similar sanctions were slapped on Russia by the European Union.

“Introducing new unilateral sanctions against the Republic of Crimea and the city of Sebastopol by the USA and European Union is direct evidence that the West has acknowledged that the decision by the Crimeans to rejoin Russia was unanimous and voluntary,” the Russian ministry said in a statement.

“That’s why they chose the ‘punishment’ to be collective,” it added. “It is sad that the countries which call themselves democratic resort to such methods in the 21st century.”

Oil prices have dropped below $60 a barrel from about $115 earlier this year, representing a huge loss in revenue for Moscow, which relies heavily on its petroleum exports.

Last week, Russia’s central bank boosted its interest rate to a whopping 17 percent from 10.5 percent in a move to stabilize the ruble’s precipitous slide in recent weeks. At one point last week, the Russian currency had lost 19 percent of its value in a single day.

Even so, NPR’s Corey Flintoff, reporting from Moscow earlier this week, said “some people are trying to convert their money into dollars and euros. But of course, that already amounts to a big loss for them. There doesn’t seem to be anything like a panic yet.

“Most people that I did talk with said they’re kind of resigned to waiting it out and seeing what happens,” Corey says.

Article source: http://www.npr.org/blogs/thetwo-way/2014/12/20/372088847/russia-says-it-wont-cave-in-to-new-western-sanctions?utm_medium=RSS&utm_campaign=world

4 Gitmo Prisoners Released For Return To Afghanistan

Uncategorized | Posted by Israel Grossman Attorney
Dec 20 2014

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The entrance to Camp 5 and Camp 6 at the U.S. military’s Guantanamo Bay detention center at Guantanamo Bay Naval Base, Cuba, in a photograph taken earlier this year.

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The entrance to Camp 5 and Camp 6 at the U.S. military's Guantanamo Bay detention center at Guantanamo Bay Naval Base, Cuba, in a photograph taken earlier this year.

The entrance to Camp 5 and Camp 6 at the U.S. military’s Guantanamo Bay detention center at Guantanamo Bay Naval Base, Cuba, in a photograph taken earlier this year.

Ben Fox/AP

Updated at 10:45 a.m. ET

The United States has released four Afghan detainees from the U.S. military prison at Guantanamo Bay, Cuba, who were returned to Afghanistan — the latest in a series of releases of inmates in recent weeks.

Reuters says: “The men were flown to Kabul overnight aboard a U.S. military plane and released to Afghan authorities, the first such transfer of its kind to the war-torn country since 2009, a U.S. official said.”

The four were released at the request of Afghanistan’s new president, Ashraf Ghani, The Associated Press reports.

The AP says:

“Obama administration officials said they worked quickly to fulfill the request from Ghani, in office just three months, to return the four, who had been cleared for transfer as a kind of reconciliation and mark of improved U.S.-Afghan relations.

“There is no requirement that the Afghan government further detain the men, identified as Mohammed Zahir, Shawali Khan, Abdul Ghani and Khi Ali Gul.”

In a Pentagon statement, the U.S. said it is “grateful to the Government of the Islamic Republic of Afghanistan for its willingness to support ongoing U.S. efforts to close the Guantanamo Bay detention facility. The United States coordinated with the Government of the Islamic Republic of Afghanistan to ensure these transfers took place consistent with appropriate security and humane treatment measures.”

Even so, The Washington Post reports: “The United States and Afghanistan have not started serious discussions about repatriating the remaining eight Afghans still held at Guantanamo Bay, said the official, speaking on the condition of anonymity because of the sensitivity of the transfers.

Last month, five Guantanamo detainees, four of them Yemenis, were sent to Georgia and Slovakia. And, earlier this month, the U.S. transferred six inmates to Uruguay. The latest release comes as no real surprise, as it is part of a larger U.S. effort to draw down the inmate population at Guantanamo, which President Obama, in his first campaign for the White House, promised to close.

Carol Rosenberg, who covers Guantanamo for The Miami Herald, tells NPR that Ghani formally requested the four be transferred “because they were at the front of the queue, meaning they were on a list that was approved a long time ago. So, it was easier to get them out than, say, the other eight Afghans are still at Guantanamo.

“In January 2010, the Obama drew up a list of people who would be approved for release,” Rosenberg says. “These four men were on it, along with dozens of others. Many of them had also previously been approved for release during the Bush years.

“What we’re seeing here is the release of people who were informed in 2008, 2009, 2010, that they would be allowed to go under certain circumstances. But, as I think we all know, the process pretty much got stalled by violence in the various countries where some of these people would be going,” she says.

Article source: http://www.npr.org/blogs/thetwo-way/2014/12/20/372092432/4-gitmo-prisoners-released-for-return-to-afghanistan?utm_medium=RSS&utm_campaign=world

Despite Its Beauty, Cuba Isn’t Quite Ready For Tourists

Uncategorized | Posted by Israel Grossman Attorney
Dec 20 2014

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In 1959, Fidel Castro imposed a law forbidding the import of foreign cars, so many Cubans drive and maintain older models.

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In 1959, Fidel Castro imposed a law forbidding the import of foreign cars, so many Cubans drive and maintain older models.

In 1959, Fidel Castro imposed a law forbidding the import of foreign cars, so many Cubans drive and maintain older models.

Kate Skogen/JetKat Photo

I’ve always had a good time in Cuba. The people are friendly and funny, the rum is smooth, the music intoxicating and the beaches wide, white and soft.

But you’re accompanied everywhere by government minders. They call them responsables. Any Cuban you interview knows your microphone might as well run straight to their government.

If you want to talk to someone with a different view, you have to slip out of your hotel in the middle of the night without your minder — though dissidents say other security people follow you.

Each trip I’ve made as a reporter has revealed a little more of what kind of society Cubans live in. It’s a warm, sunny place, filled with industrious and accomplished people who laugh loudly in public but mutter or whisper under their breath about the government. And the government is everywhere.

In Cuba, the government is the news and the economy. It is the only voice in every broadcast or book. Every neighborhood has a local “Committee for the Defense of the Revolution,” on watch for what they call “counter-revolutionary activities.”

You still sometimes make a human connection with your responsable, and each trip, I’ve left with a light suitcase. Responsables beg — that is not too strong a word — for you to leave them your blue jeans, razor blades, toothpaste, or The Economist magazine, which they cannot get and often try to sell.

Government press people say, each trip, “Return as a tourist. Bring your family,” and I’ve been tempted. Havana is beautiful, caught in a kind of pastel time capsule of a 1940′s sea-breeze skyline and 1950′s Chevies nosing noisily up the street. Havana would be something to see before new Hyatts, Starbucks, or Chase Bank buildings make it look like many other modern cities.

But tourists inhabit a separate Havana. They can spend dollars, eat lobster, and drink wine in beachside restaurants in which Cubans are not permitted. They can watch news from around the world and travel the Internet as Cubans can’t.

And it is startling and sad to see legions of young women lined up behind tourist hotels, hoping, as Yoani Sanchez, the Cuban blogger, has written, to “snag … a tourist to take them to a hotel and offer them, the next morning, a breakfast that comes with milk.”

The largest hotel company in Latin America is the Grupode Tirismo Gaviota. It is owned by the Cuban military. So while I’ve been glad to go to Cuba as a reporter, I can’t bring myself to return as a tourist.

Maybe now, more Americans will get the chance to see Cuba. And I hope they get to know what they’re really seeing.

Article source: http://www.npr.org/2014/12/20/372061961/despite-its-beauty-cuba-isnt-quite-ready-for-tourists?utm_medium=RSS&utm_campaign=world

Cuban-American Congressional Leaders Vow To Fight Obama’s Proposals

Uncategorized | Posted by Israel Grossman Attorney
Dec 19 2014

A day after the president’s announcement that he wants to normalize relations with Cuba, Cuban-American congressional leaders came together in Miami to condemn it as appeasement of a Communist regime.

Article source: http://www.npr.org/2014/12/19/371821086/cuban-american-congressional-leaders-vow-to-fight-obama-s-proposals?utm_medium=RSS&utm_campaign=world

Exchange Of Spies Was Critical To U.S.-Cuba Deal

Uncategorized | Posted by Israel Grossman Attorney
Dec 19 2014

Part of the deal for the return of American Alan Gross from Cuba involved the release of a Cuban man who had served as a spy for the U.S. He’s said to have provided info about Cuban spies in the U.S.

Article source: http://www.npr.org/2014/12/19/371821107/exchange-of-spies-was-critical-to-u-s-cuba-deal?utm_medium=RSS&utm_campaign=world

Thailand Says It Was Unaware Of CIA ‘Black Site’ On Its Soil

Uncategorized | Posted by Israel Grossman Attorney
Dec 19 2014

Abu Zubaydah, an alleged al-Qaida operative who was reportedly subjected to waterboarding at a secret location in Thailand in 2002.

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Thailand’s prime minister says his government had no knowledge of a secret location inside the country where the CIA is said to have waterboarded top al-Qaida operatives in 2002.

Prime Minister Prayut Chan-ocha was responding to the so-called “torture report” released by the Senate Intelligence Committee earlier this month that detailed the treatment of terrorism suspects at secret locations — black sites— around the world.

One such center, known by the CIA code-named “Cat’s Eye,” was reportedly in Thailand. It is where Abu Zubaydah, an alleged al-Qaida facilitator, and another alleged al-Qaida figure, Abd al-Rahim al-Nashiri, are believed to have been subjected to waterboarding and other techniques in an effort to extract information about terrorist activities. Other such sites were reportedly established by the Central Intelligence Agency in Afghanistan, Poland, Romania and Lithuania.

“The U.S. did not tell us anything. We didn’t know where it was hidden,” Prayut, an army general who seized power in Thailand in May, told reporters in the capital, according to The Bangkok Post.

“We didn’t have to take responsibility because they were already handed over,” Prayuth said.

The Bangkok Post says:

“Gen Prayut had previously denied that Thailand hosted clandestine torture facilities for the US.

“Returning from South Korea last Friday, Gen Prayut acknowledged the release of the explosive Senate report, which listed Thailand among the countries used by the CIA for the detention and torture of suspected terrorists.

“But he said the claims made within the public portion of the massive report were false, and the Foreign Ministry would explain that Thailand was not involved in the CIA’s actions.”

The Washington Post reports that after Abu Zubaydah was captured in Pakistan and handed over to the U.S., the CIA rejected placing him in U.S. military custody, settling instead “on a location in Thailand that would become the agency’s first black site.”

Once there, the alleged al-Qaida operative “was kept in a coffin-sized box for hundreds of hours and waterboarded until he ‘became completely unresponsive, with bubbles rising through is open, full mouth,’” the newspaper said, quoting from the 528-page Senate report that is itself a declassified version of a classified study that exceeds 6,000 pages.

However, the Washington Post says:

“Almost immediately, there were tensions with the Thai government. The day after Abu Zubaida arrived, Thai officials began placing new conditions on their acquiescence, demanding access to U.S. intelligence that officials familiar with the Senate report said had nothing to do with terrorism. The Thai officials who had approved the CIA plan were suddenly replaced by others who objected to the deal and demanded that it be closed ‘within three weeks.’

“CIA lobbying got Thai officials to relent, but by November [2002], the location had leaked. The New York Times refrained from publishing the Thai connection, but “the fact that it had the information, combined with previous media interest, resulted in the decision to close [the site].”

Article source: http://www.npr.org/blogs/thetwo-way/2014/12/19/371865080/thailand-says-it-was-unaware-of-cia-black-site-on-its-soil?utm_medium=RSS&utm_campaign=world

Pakistan Keeps On Vaccinating Despite Tough Terrain And Terror Threat

Uncategorized | Posted by Israel Grossman Attorney
Dec 18 2014

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A Pakistani health worker administers a polio vaccine to a child during a campaign in the northern city of Rawalpindi.

FAROOQ NAEEM/AFP/Getty Images


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A Pakistani health worker administers a polio vaccine to a child during a campaign in the northern city of Rawalpindi.

A Pakistani health worker administers a polio vaccine to a child during a campaign in the northern city of Rawalpindi.

FAROOQ NAEEM/AFP/Getty Images

Between the rugged terrain and the constant terrorist threats, vaccinating Pakistani children against common diseases hasn’t been easy. Mountains make it hard — at times even impossible — for vaccinators to reach people in the north. In the south, health workers have to use four-wheelers and camels to travel through Pakistan’s harsh deserts.

The Taliban also stands in the way. Since 2012, the Taliban has gunned down at least 60 health workers and policemen who were guarding them. The attack this week on a school in Peshawar that killed at least 140 children and teachers is a reminder how the group can wreak havoc with the country’s sense of security.

Still, Pakistan has been making strides in vaccinating children. In 2013, the country saw between 60 and 85 percent immunization coverage against diseases like measles, tuberculosis, polio and meningitis. In 1980, the rate was almost zero.

“We’ve seen the death of children occurring even 10 years ago cut down by half because of the vaccines,” says Dr. Dure Akram, a retired professor of pediatrics at Dow Medical University in the Pakistani city of Karachi. Akram, 66, now serves as the honorary chairman of Health Education and Literacy Program, a nongovernmental organization providing primary health care in Karachi.

Akram stopped by NPR to talk about the successes — and challenges — of routine immunization programs in Pakistan.

Will the recent Taliban attack on a school in Peshawar have any effect on the immunization program?

I do not think that this would affect the routine immunization or the polio campaign because we understand that this is retaliation by the Taliban against the army. I hope that it would not in any way compromise the routine the immunization activities going on there.

But in the past the Taliban has made it impossible for health care workers to carry out regular immunization drives. In places such as North Waziristan for instance. Is that still a problem?

That is a very difficult area. Since June of 2012 nobody was allowed to get in there to give vaccination. So that area became a pocket of disease and illnesses of children that could have been easily prevented. This was a political move on part of the Taliban. Presently in the last 6 months, the military has opened it up [and allowed vaccinators in to Taliban controlled areas], But there are still pockets where [the military has] not reached.

Over time, how have vaccines changed Pakistan?

Let me give you a bit of historical perspective. When I was growing up, we just had the smallpox vaccine. Sometimes when there were epidemics of typhoid, there was a typhoid vaccine. Other than that we grew up totally exposed to common childhood infections. So we did not even dream that one day our children would be protected against common infections [like] pneumonia, diarrhea and measles. With GAVI’s (The Global Alliance for Vaccines and Immunisations) help, our immunization program got accelerated and we could procure vaccines that were not accessible because of the price.

During my lifetime as a teacher, I saw diseases disappear. I saw outbreaks of measles disappear. I have seen isolation wards where we used to keep cases of tetanus closing down. A couple weeks ago, I was visiting my old hospital where I used to teach and we were taking rounds in the ward. The professor there — who used to be my student — asked me to look into a case that she thought may be diphtheria. She said, “I have not seen diphtheria in my life.” But I had [seen it] growing up. So this is a very visible impact of the vaccines.

Which vaccine would you say had the greatest impact in Pakistan?

As of now, the measles vaccine because measles decreases the immunity of children. It kind of eats up the vitamin A, which is a major micronutrient that protects against infections. So we used to see outbreaks of measles followed by outbreaks of tuberculosis, vitamin A deficiency and blindness. We definitely are still seeing measles outbreaks but these are in pockets, whereas we used to see outbreaks running throughout the country.

Hopefully [in the future], the most important vaccine to decrease mortality in children would be the pneumococcal and rotavirus vaccines, which would decrease the two major killers of children under 5 in Pakistan. Pneumococcal vaccine was introduced just over a year and a half ago, and the rotavirus vaccine will be introduced next year.

What are the challenges of vaccinating children in Pakistan?

We have a population that is scattered, they’re in areas where there are no roads, especially in the deserts and mountains. We have a poverty level [of] 45 to 50 percent, and they do not have easy access to health care facilities. In addition, we’ve had disasters: the earthquake in 2005 [and] the floods in 2010 and 2011, which displaced over a million people [and] caused epidemics of diarrhea, pneumonia and various infections. Then we have manmade disasters like terrorism, which plagues us almost every week. We’re always in fear as to where it’s going to hit us next.

It seems like health problems in Pakistan are intertwined with insecurity. For instance, the places in Pakistan’s largest city, Karachi, where you still have major disease outbreaks are often the same places that are insecure.

You’re right. In cities like Peshawar — a bustling metropolis — and in Karachi, which is the industrial hub, there are pockets where even now we cannot go to immunize or to give health care because of the fear of insurgents attacking us. But that does not apply to the major part of the country; it applies to isolated pockets in the north of Pakistan and in Karachi.

Article source: http://www.npr.org/blogs/goatsandsoda/2014/12/18/371479086/pakistan-keeps-on-vaccinating-despite-tough-terrain-and-terror-threat?utm_medium=RSS&utm_campaign=world