Changing of the Guard: Corrupt Chinese Officials Draw Unusual Publicity

BEIJING — The Chinese have become largely inured to tales of voracious officials stockpiling luxury apartments, $30,000 Swiss watches or enough stolen cash to buy their mistress a Porsche.

But when images of a bulbous-faced Communist Party functionary in southwest China having sex with an 18-year-old girl spread on the Internet late last month, even the most jaded citizens took note — as did the local party watchdogs who ordered his dismissal.

These have been especially nerve-racking times for Chinese officials who cheat, steal and bribe. Since the local bureaucrat, Lei Zhengfu, became an unwilling celebrity here, a succession of others have been publicly exposed. And despite the usual cries of innocence, most have been removed from office while party investigators sort through their bedrooms and bank accounts.

In the weeks since the Communist Party elevated a new slate of top leaders, the state media, often fed by freelance vigilantes, have been serving up a head-spinning collection of scandals.

Highlights include a deputy district official in Shanxi Province who fathered 10 children with four wives; a prefecture chief from Yunnan with an opium habit who managed to accumulate 23 homes, including 6 in Australia; and a Hunan bureaucrat with $19 million in unexplained assets who once gave his young daughter $32,000 in cash for her birthday.

“The anticorruption storm has begun,” People’s Daily, the party mouthpiece, wrote on its Web site this month.

The flurry of revelations suggests that members of China’s new leadership may be more serious than their predecessors about trying to tame the cronyism, bribery and debauchery that afflict state-run companies and local governments, right down to the outwardly dowdy neighborhood committees that oversee sanitation. Efforts began just days after Xi Jinping, the newly appointed Communist Party chief and China’s incoming president, warned that failing to curb corruption could put the party’s grip on power at risk.

“Something has shifted,” said Zhu Ruifeng, a Beijing journalist who has exposed more than a hundred cases of alleged corruption on his Web site, including the lurid exertions of Mr. Lei. “In the past, it might take 10 days for an official involved in a sex scandal to lose his job. This time he was gone in 66 hours.”

The licentiousness of Qi Fang, the public security chief of a small city in the far west, probably deserves a prize for originality. This month, an Internet sleuth revealed that Mr. Qi was maintaining two young sisters as mistresses. The sisters, as luck would have it, had also landed police department jobs and shared an apartment bankrolled by the city.

Mr. Qi lost his post, but not before denying any mischief and correcting one detail of the story: the sisters, contrary to earlier reports, are not twins.

Still, for all the salaciousness associated with the latest scandals, analysts say it is too soon to know whether Mr. Xi and other senior leaders have the stomach to wage a no-holds-barred war on the party’s pervasive corruption.

They point out that most of the recent scandals were uncovered by journalists, anonymous citizens or disgruntled colleagues who posted photographs and other damning allegations on the Internet, forcing the authorities to respond. Also significant is that most of those ousted were relatively minor officials.

The manager of a major Chinese Internet company said the party was effectively abetting the anticorruption free-for-all by declining to pull the plug on the online denunciations. But he said there was an implicit understanding that high-ranking officials were off limits.

“For now it’s spontaneous,” said the manager, who asked that the name of his company be withheld because of the political sensitivities involved. “But we also understand the parameters.”

This month, Luo Changping, deputy managing editor at the enterprising newsmagazine Caijing, published accusations on his microblog about improper business dealings by Liu Tienan, the director of China’s National Energy Administration. The postings, which also included charges that Mr. Liu had fabricated his academic qualifications and had threatened to kill his mistress, have caused something of an earthquake, given that they targeted such a high-level official. Just as astonishing, many say, is that Mr. Luo’s claims remain undeleted by censors despite Mr. Liu’s denials of wrongdoing.

Patrick Zuo contributed research.

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News Analysis: Getting Polio Campaigns Back on Track

How in the world did something as innocuous as the sugary pink polio vaccine turn into a flash point between Islamic militants and Western “crusaders,” flaring into a confrontation so ugly that teenage girls — whose only “offense” is that they are protecting children — are gunned down in the streets?

Nine vaccine workers were killed in Pakistan last week in a terrorist campaign that brought the work of 225,000 vaccinators to a standstill. Suspicion fell immediately on factions of the Pakistani Taliban that have threatened vaccinators in the past, accusing them of being American spies.

Polio eradication officials have promised to regroup and try again. But first they must persuade the killers to stop shooting workers and even guarantee safe passage.

That has been done before, notably in Afghanistan in 2007, when Mullah Muhammad Omar, spiritual head of the Afghan Taliban, signed a letter of protection for vaccination teams. But in Pakistan, the killers may be breakaway groups following no one’s rules.

Vaccination efforts are also under threat in other Muslim regions, although not this violently yet.

In Nigeria, another polio-endemic country, the new Islamic militant group Boko Haram has publicly opposed it, although the only killings that the news media have linked to polio were those of two police officers escorting vaccine workers. Boko Haram has killed police officers on other missions, unrelated to polio vaccinations.

In Mali, extremists took over half of the country in May, declaring an Islamic state. Vaccination is not an issue yet, but Mali had polio cases as recently as mid-2011, and the virus sometimes circulates undetected.

Resistance to polio vaccine springs from a combination of fear, often in marginalized ethnic groups, and brutal historical facts that make that fear seem justified. Unless it is countered, and quickly, the backlash threatens the effort to eradicate polio in the three countries where it remains endemic: Pakistan, Afghanistan and Nigeria.

In 1988, long before donors began delivering mosquito nets, measles shots, AIDS pills, condoms, deworming drugs and other Western medical goods to the world’s most remote villages, Rotary International dedicated itself to wiping out polio, and trained teams to deliver the vaccine.

But remote villages are often ruled by chiefs or warlords who are suspicious not only of Western modernity, but of their own governments.

The Nigerian government is currently dominated by Christian Yorubas. More than a decade ago, when word came from the capital that all children must swallow pink drops to protect them against paralysis, Muslim Hausas in the far-off north could be forgiven for reacting the way the fundamentalist Americans of the John Birch Society did in the 1960s when the government in far-off Washington decreed that, for the sake of children’s teeth, all drinking water should have fluoride.

The northerners already had grievances. In 1996, the drug company Pfizer tested its new antibiotic, Trovan, during a meningitis outbreak there. Eleven children died. Although Pfizer still says it was not to blame, the trial had irregularities, and last year the company began making payments to victims.

Other rumors also spring from real events.

In Pakistan, resistance to vaccination, low over all, is concentrated in Pashtun territory along the Afghan border and in Pashtun slums in large cities. Pashtuns are the dominant tribe in Afghanistan but a minority in Pakistan among Punjabis, Sindhis, Baluchis and other ethnic groups. Many are Afghan refugees and are often poor and dismissed as medieval and lawless.

Pakistan’s government is friendly with the United States while the Pashtuns’ territory in border areas has been heavily hit by American Taliban-hunting drones, which sometimes kill whole families.

So, when the Central Intelligence Agency admitted sponsoring a hepatitis vaccination campaign as a ruse to get into a compound in Pakistan to confirm that Osama bin Laden was there, and the White House said it had contemplated wiping out the residence with a drone missile, it was not far-fetched for Taliban leaders to assume that other vaccinators worked for the drone pilots.

Even in friendly areas, the vaccine teams have protocols that look plenty suspicious. If a stranger knocked on a door in Brooklyn, asked how many children under age 5 were at home, offered to medicate them, and then scribbled in chalk on the door how many had accepted and how many refused — well, a parent might worry.

In modern medical surveys — though not necessarily on polio campaigns — teams carry GPS devices so they can find houses again. Drones use GPS coordinates.

The warlords of Waziristan made the connection specific, barring all vaccination there until Predator drones disappeared from the skies.

Dr. Bruce Aylward, a Canadian who is chief of polio eradication for the World Health Organization, expressed his frustration at the time, saying, “They know we don’t have any control over drone strikes.”

The campaign went on elsewhere in Pakistan — until last week.

The fight against polio has been hampered by rumors that the vaccine contains pork or the virus that causes AIDS, or is a plot to sterilize Muslim girls. Even the craziest-sounding rumors have roots in reality.

The AIDS rumor is a direct descendant of Edward Hooper’s 1999 book, “The River,” which posited the theory — since discredited — that H.I.V. emerged when an early polio vaccine supposedly grown in chimpanzee kidney cells contaminated with the simian immunodeficiency virus was tested in the Belgian Congo.

The sterilization claim was allegedly first made on a Nigerian radio station by a Muslim doctor upset that he had been passed over for a government job. The “proof” was supposed to be lab tests showing it contained estrogen, a birth control hormone.

The vaccine virus is grown in a broth of live cells; fetal calf cells are typical. They may be treated with a minute amount of a digestive enzyme, trypsin — one source of which is pig pancreas, which could account for the pork rumor.

In theory, a polio eradicator explained, if a good enough lab tested the vaccine used at the time the rumor started, it might have detected estrogen from the calf’s mother, but it would have been far less estrogen than is in mother’s milk, which is not accused of sterilizing anyone. The trypsin is supposed to be washed out.

In any case, polio vaccine is now bought only from Muslim countries like Indonesia, and Muslim scholars have ruled it halal — the Islamic equivalent of kosher.

Reviving the campaign will mean quelling many rumors. It may also require adding other medical “inducements,” like deworming medicine, mosquito nets or vitamin A, whose immediate benefits are usually more obvious.

But changing mind-sets will be a crucial step, said Dr. Aylward, who likened the shootings of the girls to those of the schoolchildren in Newtown, Conn.

More police involvement — what he called a “bunkerized approach” — would not solve either America’s problem or Pakistan’s, he argued. Instead, average citizens in both countries needed to rise up, reject the twisted thinking of the killers and “generate an understanding in the community that this kind of behavior is not acceptable.”

Read More..

News Analysis: Getting Polio Campaigns Back on Track

How in the world did something as innocuous as the sugary pink polio vaccine turn into a flash point between Islamic militants and Western “crusaders,” flaring into a confrontation so ugly that teenage girls — whose only “offense” is that they are protecting children — are gunned down in the streets?

Nine vaccine workers were killed in Pakistan last week in a terrorist campaign that brought the work of 225,000 vaccinators to a standstill. Suspicion fell immediately on factions of the Pakistani Taliban that have threatened vaccinators in the past, accusing them of being American spies.

Polio eradication officials have promised to regroup and try again. But first they must persuade the killers to stop shooting workers and even guarantee safe passage.

That has been done before, notably in Afghanistan in 2007, when Mullah Muhammad Omar, spiritual head of the Afghan Taliban, signed a letter of protection for vaccination teams. But in Pakistan, the killers may be breakaway groups following no one’s rules.

Vaccination efforts are also under threat in other Muslim regions, although not this violently yet.

In Nigeria, another polio-endemic country, the new Islamic militant group Boko Haram has publicly opposed it, although the only killings that the news media have linked to polio were those of two police officers escorting vaccine workers. Boko Haram has killed police officers on other missions, unrelated to polio vaccinations.

In Mali, extremists took over half of the country in May, declaring an Islamic state. Vaccination is not an issue yet, but Mali had polio cases as recently as mid-2011, and the virus sometimes circulates undetected.

Resistance to polio vaccine springs from a combination of fear, often in marginalized ethnic groups, and brutal historical facts that make that fear seem justified. Unless it is countered, and quickly, the backlash threatens the effort to eradicate polio in the three countries where it remains endemic: Pakistan, Afghanistan and Nigeria.

In 1988, long before donors began delivering mosquito nets, measles shots, AIDS pills, condoms, deworming drugs and other Western medical goods to the world’s most remote villages, Rotary International dedicated itself to wiping out polio, and trained teams to deliver the vaccine.

But remote villages are often ruled by chiefs or warlords who are suspicious not only of Western modernity, but of their own governments.

The Nigerian government is currently dominated by Christian Yorubas. More than a decade ago, when word came from the capital that all children must swallow pink drops to protect them against paralysis, Muslim Hausas in the far-off north could be forgiven for reacting the way the fundamentalist Americans of the John Birch Society did in the 1960s when the government in far-off Washington decreed that, for the sake of children’s teeth, all drinking water should have fluoride.

The northerners already had grievances. In 1996, the drug company Pfizer tested its new antibiotic, Trovan, during a meningitis outbreak there. Eleven children died. Although Pfizer still says it was not to blame, the trial had irregularities, and last year the company began making payments to victims.

Other rumors also spring from real events.

In Pakistan, resistance to vaccination, low over all, is concentrated in Pashtun territory along the Afghan border and in Pashtun slums in large cities. Pashtuns are the dominant tribe in Afghanistan but a minority in Pakistan among Punjabis, Sindhis, Baluchis and other ethnic groups. Many are Afghan refugees and are often poor and dismissed as medieval and lawless.

Pakistan’s government is friendly with the United States while the Pashtuns’ territory in border areas has been heavily hit by American Taliban-hunting drones, which sometimes kill whole families.

So, when the Central Intelligence Agency admitted sponsoring a hepatitis vaccination campaign as a ruse to get into a compound in Pakistan to confirm that Osama bin Laden was there, and the White House said it had contemplated wiping out the residence with a drone missile, it was not far-fetched for Taliban leaders to assume that other vaccinators worked for the drone pilots.

Even in friendly areas, the vaccine teams have protocols that look plenty suspicious. If a stranger knocked on a door in Brooklyn, asked how many children under age 5 were at home, offered to medicate them, and then scribbled in chalk on the door how many had accepted and how many refused — well, a parent might worry.

In modern medical surveys — though not necessarily on polio campaigns — teams carry GPS devices so they can find houses again. Drones use GPS coordinates.

The warlords of Waziristan made the connection specific, barring all vaccination there until Predator drones disappeared from the skies.

Dr. Bruce Aylward, a Canadian who is chief of polio eradication for the World Health Organization, expressed his frustration at the time, saying, “They know we don’t have any control over drone strikes.”

The campaign went on elsewhere in Pakistan — until last week.

The fight against polio has been hampered by rumors that the vaccine contains pork or the virus that causes AIDS, or is a plot to sterilize Muslim girls. Even the craziest-sounding rumors have roots in reality.

The AIDS rumor is a direct descendant of Edward Hooper’s 1999 book, “The River,” which posited the theory — since discredited — that H.I.V. emerged when an early polio vaccine supposedly grown in chimpanzee kidney cells contaminated with the simian immunodeficiency virus was tested in the Belgian Congo.

The sterilization claim was allegedly first made on a Nigerian radio station by a Muslim doctor upset that he had been passed over for a government job. The “proof” was supposed to be lab tests showing it contained estrogen, a birth control hormone.

The vaccine virus is grown in a broth of live cells; fetal calf cells are typical. They may be treated with a minute amount of a digestive enzyme, trypsin — one source of which is pig pancreas, which could account for the pork rumor.

In theory, a polio eradicator explained, if a good enough lab tested the vaccine used at the time the rumor started, it might have detected estrogen from the calf’s mother, but it would have been far less estrogen than is in mother’s milk, which is not accused of sterilizing anyone. The trypsin is supposed to be washed out.

In any case, polio vaccine is now bought only from Muslim countries like Indonesia, and Muslim scholars have ruled it halal — the Islamic equivalent of kosher.

Reviving the campaign will mean quelling many rumors. It may also require adding other medical “inducements,” like deworming medicine, mosquito nets or vitamin A, whose immediate benefits are usually more obvious.

But changing mind-sets will be a crucial step, said Dr. Aylward, who likened the shootings of the girls to those of the schoolchildren in Newtown, Conn.

More police involvement — what he called a “bunkerized approach” — would not solve either America’s problem or Pakistan’s, he argued. Instead, average citizens in both countries needed to rise up, reject the twisted thinking of the killers and “generate an understanding in the community that this kind of behavior is not acceptable.”

Read More..

Pope Prays for Freedom in China and Peace in Syria

Alessandro Bianchi/Reuters

Pope Benedict XVI blessed the crowd during his "Urbi et Orbi" address fin St. Peter's Square in Vatican.

ROME — Speaking from the balcony of Saint Peter’s Basilica, Pope Benedict XVI called Tuesday for religious freedom in China and peace for the “defenseless” in Syria in his annual Christmas Day message.

“May peace spring up for the people of Syria, deeply wounded and divided by a conflict which does not spare even the defenseless and reaps innocent victims,” Benedict said. “I appeal for an end to the bloodshed, easier access for the relief of refugees and the displaced, and dialogue in the pursuit of a political solution to the conflict.”

Wearing a short red cape lined with snow-white ermine and trimmed with gold embroidery, Benedict smiled as he offered Christmas greetings in 65 languages to thousands of faithful in Saint Peter’s Square. Marching bands from from the Italian armed forces and the Carabinieri police played festive anthems. During Christmas Eve Mass on Monday evening, the 85-year-old pontiff had appeared tired and his voice hoarse, but on Tuesday he appeared more vivacious as he delivered the traditional message, “Urbi et orbi” — to the city and the world.

He also addressed China, where in recent weeks the Vatican has been increasingly at odds with the government over the ordination of bishops, who cannot hold office without approval from the authorities, to the dismay of the Vatican.

“May the King of Peace turn his gaze to the new leaders of the People’s Republic of China for the high task which awaits them,” Benedict said. “I express my hope that, in fulfilling this task, they will esteem the contribution of the religions, in respect for each, in such a way that they can help to build a fraternal society for the benefit of that noble people and of the whole world.”

Aggravating tensions, the Chinese Bishops’ Council, a government entity, stripped Thaddeus Ma Daqin, 45, the auxiliary bishop of Shanghai, of his title this month, according to Catholic Web sites that cited sources in the Chinese church.

The bishop had been under house arrest since he shocked Communist Party officials and his faithful by renouncing his government position during his consecration in July. In recent years, China’s Patriotic Catholic Association, which does not recognize the authority of the pope, has consecrated a number of bishops over the Vatican’s objections, resulting in their excommunication.

On Tuesday, Benedict asked God to give Israelis and Palestinians the “courage to end to long years of conflict and division, and to embark resolutely on the path of negotiation” and called for peace in Egypt, “land where the Redeemer was born.”

The pope also urged “the return of peace in Mali and that of concord in Nigeria, where savage acts of terrorism continue to reap victims, particularly among Christians.” He prayed for “the refugees from the east of the Democratic Republic of Congo,” and for peace to Kenya, “where brutal attacks have struck the civilian population and places of worship.”

On Monday evening, communicating through his new Twitter handle, @Pontifex, Benedict recalled that as a boy he loved his family’s Christmas crèche, and asked his followers what their favorite Christmas traditions were. “The cribs that we built in our home gave me much pleasure,” his message read. “We added figures each year and used moss for decoration.”

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Gun Makers Based in Connecticut Form a Potent Lobby

Gun owners packed a hearing room in the Connecticut capital, vowing to oppose a bill that would require new markers on guns so that they are easier to trace.

One after another, they testified that the technology, called microstamping, was flawed and would increase the cost of guns.

But the witness who commanded the most attention in Hartford that day in 2009 was a representative of one of Connecticut’s major employers: the Colt Manufacturing Company, the gun maker.

The Colt executive, Carlton S. Chen, said the company would seriously consider leaving the state if the bill became law. “You would think that the Connecticut government would be in support of our industry,” Mr. Chen said.

Soon, Connecticut lawmakers shelved the bill; they have declined to take it up since. Now, in the aftermath of the school massacre in Newtown, the lawmakers are formulating new gun-control measures, saying the state must serve as a national model.

But the failed effort to enact the microstamping measure shows how difficult the climate has been for gun control in state capitals. The firearm companies have played an important role in defeating these measures by repeatedly warning that they will close factories and move jobs if new state regulations are approved.

The companies have issued such threats in several states, especially in the Northeast, where gun control is more popular. But their views have particular resonance in Connecticut, a cradle of the American gun industry.

Like manufacturing in Connecticut over all, the state’s gun industry is not as robust as it once was. Still, Connecticut remains the seventh-largest producer of firearms in the country, according to federal data.

Colt, based in Connecticut since the 1800s, employs roughly 900 people in the state. Two other major gun companies, Sturm, Ruger & Company and Mossberg & Sons, are also based in the state. In all, the industry employs about 2,000 people in Connecticut, company officials said.

Gun-control advocates have long viewed Hartford, the capital, as hospitable terrain, because Connecticut is a relatively liberal state and already has more gun restrictions than most. Democrats control both houses of the legislature.

Yet lawmakers in Hartford did more than shelve the microstamping bill in 2009. They also declined to push a bill last year that would have banned high-capacity ammunition magazines — the very accessory used by Adam Lanza to kill 26 people, including 20 children, at Sandy Hook Elementary School in Newtown.

In several states, the gun companies have enlisted unions that represent gun workers, mindful that Democratic lawmakers who might otherwise back gun control also have close ties to labor.

In Connecticut, the United Automobile Workers, which represents Colt workers, has testified against restrictions. The union’s arguments were bolstered last year when Marlin Firearms, a leading manufacturer of rifles, closed a factory in Connecticut that employed more than 200 people. Marlin cited economic pressures, not gun regulation, for the decision, but representatives of the gun industry have said the combination of the two factors could spur others to move.

State law significantly restricts the ability of corporations to make political donations in Connecticut. Employees of Connecticut gun companies have contributed several thousand dollars in total in recent years to state candidates, mostly Republicans, according to an analysis of state records.

Financially, the gun companies and their employees in Connecticut have exerted influence by donating to national groups, especially the National Rifle Association, which have in turn helped Connecticut gun rights groups, according to interviews and financial records.

But it appears that in Hartford, the companies are relying largely on economic arguments.

Their strategy has been led by the industry’s trade group, the National Shooting Sports Foundation, which happens to have its national headquarters in Newtown, a few miles from the site of the shootings.

When Connecticut lawmakers held a hearing in 2011 on the measure to ban high-capacity ammunition magazines, the director of government regulations for the foundation, Jake McGuigan, opened his testimony with some statistics.

Mr. McGuigan told lawmakers that the state’s gun companies contributed $1.3 billion to the Connecticut economy, through their own operations and those of their suppliers.

“Each year, they get courted by other firearm-friendly states, like Idaho, Virginia, North Carolina,” Mr. McGuigan said. He later added, “It’s not an idle threat.”

The federation and Colt have declined to comment on gun-control legislation since the school killings.

“Our hearts go out to our fellow Connecticut residents who have suffered such unimaginable loss,” Colt said in a statement. “We do not believe it is appropriate to make further public statements at this very emotional time.”

Gun-control advocates in Hartford said the gun companies’ strategy was shrewd because it allowed Democratic lawmakers to oppose new regulations while proclaiming that they had not bowed to the National Rifle Association.

Michael Moss and Griff Palmer contributed reporting.

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The New Old Age Blog: Fudging the Facts, for Peace of Mind

Lou, my beloved grandfather, lived almost 101 years and obsessively worried every single day of his adult life — probably because his adult life began before it should have. As a child in Russia, he watched helplessly as his mother and sister were killed during a vicious pogrom in their village.

Lou (I called him Zadie) made his way to America, and immediately began imagining the worst about his fate, and his family’s fate, in his new country. I believe Zadie lived as long as he did because he was afraid of what would happen to his children, grandchildren, and great-grandchildren if he wasn’t here to protect them.

When I was a third-year medical student in New York City, he called from Denver very early one morning, waking me and my roommates. He had been listening to his transistor radio on one of his many sleepless nights of worry, and had heard that a Staten Island Ferry boat had crashed, injuring numerous passengers.

There were more than seven million people in the city, and Zadie called at 4 a.m. to make sure I wasn’t one of those injured. It was from him we learned the importance of telling white lies and omitting certain truths with our elderly parents and grandparents.

Before accusing me of infantilizing and patronizing my older family members, hear me out. Anxiety disorders can be debilitating for the elderly. A comprehensive review of the subject found 10 to14 percent of those 65 and older meet the criteria for these diagnoses, a significantly higher figure than for the more widely recognized depression syndromes in the same demographic.

Indeed, depression and anxiety disorders often occur together. Anxiety disorders are underdiagnosed in the elderly, largely because the symptoms are often assumed to be just another manifestation of aging. Additionally, the clinical assessment of the elderly for anxiety is more complicated than for younger patients because the signs may differ from those classically described in the diagnostic manuals.

A large national study showed an increased incidence of general anxiety disorder beginning after age 55, and the National Alliance on Mental Illness notes that, like depression, obsessive-compulsive disorder tends to worsen in old age. Factors contributing to the prevalence and severity of anxiety disorders in the elderly include a host of concomitant medical problems that interact with anxiety in a complicated way.

From the review article cited earlier:

The co-morbidity between medical illness and anxiety disorders poses difficulties for…diagnosis and detection of anxiety. Researchers have suggested that older adults may be more likely to attribute physical symptoms related to anxiety to medical issues… In turn, many physical conditions, such as cardiovascular disease, respiratory disease, hyperthyroidism, and pulmonary and vestibular difficulties, can mimic the symptoms of anxiety…making it difficult to establish the underlying cause…

Furthermore, the symptoms that result from medical illnesses may produce fearful bodily sensations that may result in the subsequent development of anxiety disorders.

As an example, more than 40 percent of patients with Parkinson’s disease meet the criteria for an anxiety disorder. Dementia is also associated with anxiety in a bidirectional way — anxiety can accelerate cognitive decline, which in turn can increase symptoms of anxiety. Added to this morass are the side effects, which can include anxiety, of many medications taken by older patients.

The elderly clearly are an at-risk population for anxiety disorders. Which brings us back to white lies. Zadie’s well-earned anxieties, obsessions and worries accelerated greatly as he got older, and we realized they could largely be prevented if we simply didn’t share the complete truth with him all the time. This became known in our family as the Zadie Filter.

When we took our children to the mountains, we told him we were headed to Colorado Springs; he’d been to Colorado Springs many times and knew it was a flat highway drive from Denver. No high mountain passes or narrow roads without guardrails.

When he begged my sons to become doctors so they would serve behind the front lines in the event they were drafted (this was long after the military draft ended, which was still not reassuring enough for Zadie), they so promised. When our daughter started driving, Zadie warned her it wasn’t safe for a girl to drive alone in case she had car trouble; she promised she would always have company in the car.

Zadie died when his great-grandchildren were still teenagers, and so he never had to know that the boys didn’t go into medicine and that his great-granddaughter drives alone.

My mother, Zadie’s daughter, inherited his anxieties, and as she has entered her mid-80s her symptoms have also markedly increased. On the other side of the family, my mother-in-law’s issues with anxiety began with her Parkinson’s disease and have worsened as her neurological condition has progressed.

With our mothers, we also rely on the Zadie Filter. Our white lies and omissions reduce their worries — which is not to say we can protect them from all triggers (they still read the newspaper and watch the nightly news), but even a bit of relief for them is relief for us as well.

Our parents live for the most part on fixed incomes, so when we’re able to cover some of their expenses without their knowing, we do so, and they worry a little less about their bills. All it takes is a little white lie: “The apartment manager waived your heating bill this month because you’ve been such a good long-term tenant,” or, “Of course I used your credit card when I paid for your medicines.”

My mother accidentally found out that our son broke his finger (playing flag football during finals week!) when a well-intentioned friend asked her how her grandson was doing after his injury. She was upset we hadn’t told her — but only for a few moments, until we explained that it had happened a week before, that he was all splinted up and was in no pain. All of which was 100 percent true, and she didn’t lose a minute of sleep worrying about it.

Last week, after pressing our law student son (he of the broken finger) about a school transcript issue I’ve been worried about for him, he assured me it had been taken care of. Our daughter in grad school goes into bars only when she’s with a large group of friends, and our college son is the designated driver for all of his fraternity functions.

And so it begins.

---

Dr. Harley A. Rotbart is professor and vice chairman of pediatrics at the University of Colorado School of Medicine and the author of “No Regrets Parenting.”

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The New Old Age Blog: Fudging the Facts, for Peace of Mind

Lou, my beloved grandfather, lived almost 101 years and obsessively worried every single day of his adult life — probably because his adult life began before it should have. As a child in Russia, he watched helplessly as his mother and sister were killed during a vicious pogrom in their village.

Lou (I called him Zadie) made his way to America, and immediately began imagining the worst about his fate, and his family’s fate, in his new country. I believe Zadie lived as long as he did because he was afraid of what would happen to his children, grandchildren, and great-grandchildren if he wasn’t here to protect them.

When I was a third-year medical student in New York City, he called from Denver very early one morning, waking me and my roommates. He had been listening to his transistor radio on one of his many sleepless nights of worry, and had heard that a Staten Island Ferry boat had crashed, injuring numerous passengers.

There were more than seven million people in the city, and Zadie called at 4 a.m. to make sure I wasn’t one of those injured. It was from him we learned the importance of telling white lies and omitting certain truths with our elderly parents and grandparents.

Before accusing me of infantilizing and patronizing my older family members, hear me out. Anxiety disorders can be debilitating for the elderly. A comprehensive review of the subject found 10 to14 percent of those 65 and older meet the criteria for these diagnoses, a significantly higher figure than for the more widely recognized depression syndromes in the same demographic.

Indeed, depression and anxiety disorders often occur together. Anxiety disorders are underdiagnosed in the elderly, largely because the symptoms are often assumed to be just another manifestation of aging. Additionally, the clinical assessment of the elderly for anxiety is more complicated than for younger patients because the signs may differ from those classically described in the diagnostic manuals.

A large national study showed an increased incidence of general anxiety disorder beginning after age 55, and the National Alliance on Mental Illness notes that, like depression, obsessive-compulsive disorder tends to worsen in old age. Factors contributing to the prevalence and severity of anxiety disorders in the elderly include a host of concomitant medical problems that interact with anxiety in a complicated way.

From the review article cited earlier:

The co-morbidity between medical illness and anxiety disorders poses difficulties for…diagnosis and detection of anxiety. Researchers have suggested that older adults may be more likely to attribute physical symptoms related to anxiety to medical issues… In turn, many physical conditions, such as cardiovascular disease, respiratory disease, hyperthyroidism, and pulmonary and vestibular difficulties, can mimic the symptoms of anxiety…making it difficult to establish the underlying cause…

Furthermore, the symptoms that result from medical illnesses may produce fearful bodily sensations that may result in the subsequent development of anxiety disorders.

As an example, more than 40 percent of patients with Parkinson’s disease meet the criteria for an anxiety disorder. Dementia is also associated with anxiety in a bidirectional way — anxiety can accelerate cognitive decline, which in turn can increase symptoms of anxiety. Added to this morass are the side effects, which can include anxiety, of many medications taken by older patients.

The elderly clearly are an at-risk population for anxiety disorders. Which brings us back to white lies. Zadie’s well-earned anxieties, obsessions and worries accelerated greatly as he got older, and we realized they could largely be prevented if we simply didn’t share the complete truth with him all the time. This became known in our family as the Zadie Filter.

When we took our children to the mountains, we told him we were headed to Colorado Springs; he’d been to Colorado Springs many times and knew it was a flat highway drive from Denver. No high mountain passes or narrow roads without guardrails.

When he begged my sons to become doctors so they would serve behind the front lines in the event they were drafted (this was long after the military draft ended, which was still not reassuring enough for Zadie), they so promised. When our daughter started driving, Zadie warned her it wasn’t safe for a girl to drive alone in case she had car trouble; she promised she would always have company in the car.

Zadie died when his great-grandchildren were still teenagers, and so he never had to know that the boys didn’t go into medicine and that his great-granddaughter drives alone.

My mother, Zadie’s daughter, inherited his anxieties, and as she has entered her mid-80s her symptoms have also markedly increased. On the other side of the family, my mother-in-law’s issues with anxiety began with her Parkinson’s disease and have worsened as her neurological condition has progressed.

With our mothers, we also rely on the Zadie Filter. Our white lies and omissions reduce their worries — which is not to say we can protect them from all triggers (they still read the newspaper and watch the nightly news), but even a bit of relief for them is relief for us as well.

Our parents live for the most part on fixed incomes, so when we’re able to cover some of their expenses without their knowing, we do so, and they worry a little less about their bills. All it takes is a little white lie: “The apartment manager waived your heating bill this month because you’ve been such a good long-term tenant,” or, “Of course I used your credit card when I paid for your medicines.”

My mother accidentally found out that our son broke his finger (playing flag football during finals week!) when a well-intentioned friend asked her how her grandson was doing after his injury. She was upset we hadn’t told her — but only for a few moments, until we explained that it had happened a week before, that he was all splinted up and was in no pain. All of which was 100 percent true, and she didn’t lose a minute of sleep worrying about it.

Last week, after pressing our law student son (he of the broken finger) about a school transcript issue I’ve been worried about for him, he assured me it had been taken care of. Our daughter in grad school goes into bars only when she’s with a large group of friends, and our college son is the designated driver for all of his fraternity functions.

And so it begins.

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Dr. Harley A. Rotbart is professor and vice chairman of pediatrics at the University of Colorado School of Medicine and the author of “No Regrets Parenting.”

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Gadgetwise Blog: Q&A: Finding a Simplified Smartphone

Are there any smartphones designed for the eager-to-learn, but still-on-training-wheels senior citizen?

With the right amount of help and training, many people — regardless of age — can learn the basics of smartphone operation. To help make things easier for those who do not have a lot of experience or patience with modern gadgetry, some manufacturers are making smartphones specifically designed to be easier to use.

Such products include the Pantech Flex, an Android smartphone that offers an optional Easy Experience interface with larger text and home screen shortcut buttons. GreatCall, which makes the big-buttoned Jitterbug flip phone, now has a touch-screen smartphone, the Jitterbug Touch.

The Doro PhoneEasy 740, another simplified Android handset with a large touch screen and a keyboard, is scheduled for introduction in the United States next spring. The CNET site has an early review of the PhoneEasy 740.

If a bigger screen is the most desired feature, standard smartphones like Samsung’s Galaxy Note line, which has a 5.3-inch display and can be used with a stylus, may be easier to use than a smartphone with a smaller screen. Apple’s iPhone 5 model features a more petite four-inch screen, but Apple offers free workshops for new users at its Apple Stores in most major cities.

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In Aiding Quake-Battered Haiti, Lofty Hopes and Hard Truths

Damon Winter/The New York Times

Vegetable vendors worked recently amid rubble in Port-au-Prince, three years after an earthquake devastated the city. More Photos »

PORT-AU-PRINCE, Haiti — A few days after the Jan. 10, 2010, earthquake, Reginald Boulos opened the gates of his destroyed car dealership to some 14,000 displaced people who settled on the expansive property. Seven months later, eager to rebuild his business, he paid the families $400 each to leave Camp Boulos and return to their devastated neighborhoods.

At the time, Dr. Boulos, a physician and business magnate, was much maligned for what was portrayed as bribing the homeless to participate in their own eviction. But eventually, desperate to rid public plazas of squalid camps, the Haitian government and the international authorities adopted his approach themselves: “return cash grants” have become the primary resettlement tool.

This represents a marked deflation of the lofty ambitions that followed the disaster, when the world aspired not only to repair Haiti but to remake it completely. The new pragmatism signals an acknowledgment that despite billions of dollars spent — and billions more allocated for Haiti but unspent — rebuilding has barely begun and 357,785 Haitians still languish in 496 tent camps.

“When you look at things, you say, ‘Hell, almost three years later, where is the reconstruction?’ ” said Michèle Pierre-Louis, a former prime minister of Haiti. “If you ask what went right and what went wrong, the answer is, most everything went wrong. There needs to be some accountability for all that money.”

An analysis of all that money — at least $7.5 billion disbursed so far — helps explain why such a seeming bounty is not more palpable here in the eviscerated capital city, where the world’s chief accomplishment is to have finally cleared away most of the rubble.

More than half of the money has gone to relief aid, which saves lives and alleviates misery but carries high costs and leaves no permanent footprint — tents shred; emergency food and water gets consumed; short-term jobs expire; transitional shelters, clinics and schools are not built to last.

Of the rest, only a portion went to earthquake reconstruction strictly defined. Instead, much of the so-called recovery aid was devoted to costly current programs, like highway building and H.I.V. prevention, and to new projects far outside the disaster zone, like an industrial park in the north and a teaching hospital in the central plateau.

Meanwhile, just a sliver of the total disbursement — $215 million — has been allocated to the most obvious and pressing need: safe, permanent housing. By comparison, an estimated minimum of $1.2 billion has been eaten up by short-term solutions — the tent camps, temporary shelters and cash grants that pay a year’s rent.

“Housing is difficult and messy, and donors have shied away from it,” said Josef Leitmann, manager of the Haiti Reconstruction Fund.

Benefactors and Dysfunction

Beyond the numbers, the sluggish reconstruction has been the latest dispiriting chapter in the chronically dysfunctional relationship between Haiti and its benefactors.

After the earthquake, with good will and money pouring into Haiti, international officials were determined to use the disaster as a catalyst for transforming not only the intractably poor country but the world’s ineffectual strategies for helping it.

Bill Clinton, the United Nations special envoy for Haiti, invoked the “build back better” mantra he had imported from his similar role in South Asia after the tsunami. And Secretary of State Hillary Rodham Clinton cautioned donors to stop working around the government and instead work with it, and to stop financing “a scattered array of well-meaning projects” rather than making “deeper, long-term investments.”

But an examination by The New York Times shows that such post-disaster idealism came to be undercut by the enormousness of the task, the weakness and volatility of the Haitian government, the continuation of aid business as usual and the limited effectiveness of the now-defunct recovery commission that had Mr. Clinton as co-chairman.

André Paultre and Damon Winter contributed reporting.

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Genetic Gamble : Drugs Aim to Make Several Types of Cancer Self-Destruct

C.J. Gunther for The New York Times

Dr. Donald Bergstrom is a cancer specialist at Sanofi, one of three companies working on a drug to restore a tendency of damaged cells to self-destruct.

For the first time ever, three pharmaceutical companies are poised to test whether new drugs can work against a wide range of cancers independently of where they originated — breast, prostate, liver, lung. The drugs go after an aberration involving a cancer gene fundamental to tumor growth. Many scientists see this as the beginning of a new genetic age in cancer research.

Great uncertainties remain, but such drugs could mean new treatments for rare, neglected cancers, as well as common ones. Merck, Roche and Sanofi are racing to develop their own versions of a drug they hope will restore a mechanism that normally makes badly damaged cells self-destruct and could potentially be used against half of all cancers.

No pharmaceutical company has ever conducted a major clinical trial of a drug in patients who have many different kinds of cancer, researchers and federal regulators say. “This is a taste of the future in cancer drug development,” said Dr. Otis Webb Brawley, the chief medical and scientific officer of the American Cancer Society. “I expect the organ from which the cancer came from will be less important in the future and the molecular target more important,” he added.

And this has major implications for cancer philanthropy, experts say. Advocacy groups should shift from fund-raising for particular cancers to pushing for research aimed at many kinds of cancer at once, Dr. Brawley said. John Walter, the chief executive officer of the Leukemia and Lymphoma Society, concurred, saying that by pooling forces “our strength can be leveraged.”

At the heart of this search for new cancer drugs are patients like Joe Bellino, who was a post office clerk until his cancer made him too sick to work. Seven years ago, he went into the hospital for hernia surgery, only to learn he had liposarcoma, a rare cancer of fat cells. A large tumor was wrapped around a cord that connects the testicle to the abdomen. “I was shocked,” he said in an interview this summer.

Companies have long ignored liposarcoma, seeing no market for drugs to treat a cancer that strikes so few. But it is ideal for testing Sanofi’s drug because the tumors nearly always have the exact genetic problem the drug was meant to attack — a fusion of two large proteins. If the drug works, it should bring these raging cancers to a halt. Then Sanofi would test the drug on a broad range of cancers with a similar genetic alteration. But if the drug fails against liposarcoma, Sanofi will reluctantly admit defeat.

“For us, this is a go/no-go situation,” said Laurent Debussche, a Sanofi scientist who leads the company’s research on the drug.

The genetic alteration the drug targets has tantalized researchers for decades. Normal healthy cells have a mechanism that tells them to die if their DNA is too badly damaged to repair. Cancer cells have grotesquely damaged DNA, so ordinarily they would self-destruct. A protein known as p53 that Dr. Gary Gilliland of Merck calls the cell’s angel of death normally sets things in motion. But cancer cells disable p53, either directly, with a mutation, or indirectly, by attaching the p53 protein to another cellular protein that blocks it. The dream of cancer researchers has long been to reanimate p53 in cancer cells so they will die on their own.

The p53 story began in earnest about 20 years ago. Excitement ran so high that, in 1993, Science magazine anointed it Molecule of the Year and put it on the cover. An editorial held out the possibility of “a cure of a terrible killer in the not too distant future.”

Companies began chasing a drug to restore p53 in cells where it was disabled by mutations. But while scientists know how to block genes, they have not figured out how to add or restore them. Researchers tried gene therapy, adding good copies of the p53 gene to cancer cells. That did not work.

Then, instead of going after mutated p53 genes, they went after half of cancers that used the alternative route to disable p53, blocking it by attaching it to a protein known as MDM2. When the two proteins stick together, the p53 protein no longer functions. Maybe, researchers thought, they could find a molecule to wedge itself between the two proteins and pry them apart.

The problem was that both proteins are huge and cling tightly to each other. Drug molecules are typically tiny. How could they find one that could separate these two bruisers, like a referee at a boxing match?

In 1996, researchers at Roche noticed a small pocket between the behemoths where a tiny molecule might slip in and pry them apart. It took six years, but Roche found such a molecule and named it Nutlin because the lab was in Nutley, N.J.

But Nutlins did not work as drugs because they were not absorbed into the body.

Roche, Merck and Sanofi persevered, testing thousands of molecules.

At Sanofi, the stubborn scientist leading the way, Dr. Debussche, maintained an obsession with p53 for two decades. Finally, in 2009, his team, together with Shaomeng Wang at the University of Michigan and a biotech company, Ascenta Therapeutics, found a promising compound.

The company tested the drug by pumping it each day into the stomachs of mice with sarcoma.

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