Who’s Right? 4 Answers on Sony Hack

Sony hack becomes four-way war of words (+video)
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President Obama, Sony execs, movie stars, and a North Korean official have all weighed in on who’s at fault in the massive computer breach at Sony Pictures Entertainment over the satire ‘The Interview.’
By Brad Knickerbocker, Staff writer DECEMBER 20, 2014
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N. Korea Proposes Joint Probe Over Sony Hacking
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The massive computer breach at Sony Pictures Entertainment over the satire ‘The Interview’ – allegedly the work of North Korean hackers – has become a major war of words over freedom of expression as well as security issues involving the Internet and terrorist threats.

All of this over a goofy Hollywood satire based on a ridiculous premise.

At this point, the sharp rhetoric over the Sony hack and its fallout is coming from four directions: the White House, Sony, Hollywood stars, and North Korea.

“We cannot have a society in which some dictator someplace can start imposing censorship here in the United States,” Obama said. “Because if somebody is able to intimidate folks out of releasing a satirical movie, imagine what they start doing when they see a documentary that they don’t like, or news reports that they don’t like. Or even worse, imagine if producers and distributors and others start engaging in self-censorship because they don’t want to offend the sensibilities of somebody whose sensibilities probably need to be offended.”

Sony Pictures Entertainment CEO Michael Lynton was quick to defend the embattled company.

“We have not caved. We have not given up,” he said on CNN. “We have always had every desire to have the American public see this movie.”

“The unfortunate part is in this instance the President, the press, and the public are mistaken as to what actually happened,” Mr. Lynton said. “When it came to the crucial moment … the movie theaters came to us one by one over the course of a very short period of time. We were completely surprised by it.”

He was referring to announcements this week by five major theater chains that they would not be showing “The Interview” for fear of a 9/11-type terrorist attack as threatened by the hackers now identified by the FBI as connected to the North Korean regime.

Sony said in a statement Friday that its decision to cancel the film’s release was only about Christmas Day.

“After that decision, we immediately began actively surveying alternatives to enable us to release the movie on a different platform,” the studio said. “It is still our hope that anyone who wants to see this movie will get the opportunity to do so.”

That seemed to be a reversal of the earlier statement by a Sony spokeswoman that the company “has no further release plans for the film.”

Hollywood personalities have been quick to weigh in.

In an email to David Corn at Mother Jones, actor and activist Sean Penn said, “By caving to the outside threat, we make our nightmares real.”

“This week, the distributors who wouldn’t show ‘The Interview’ and Sony have sent [Islamic extremists] a commanding invitation,” Penn said. “I believe ISIS will accept the invitation. Pandora’s box is officially open.”

In an interview with the trade site Deadline, fellow actor George Clooney urged Sony to “do whatever you can to get this movie out. Not because everybody has to see the movie, but because I’m not going to be told we can’t see the movie. That’s the most important part.”

Psychiatrist, TV personality, and radio talk show host Carole Lieberman, who’s frequently quoted on film industry figures and issues, wrote that “To cower is to ‘greenlight’ future hack and terrorist attacks.”

“Although making the movie may have been a bad idea, it is an even worse idea to pull the movie from theaters and let the terrorists win!” Dr. Lieberman writes at thecelebritycafe.com. “We are now being seen as a cowering nation and terrorists from North Korea to the Middle East are laughing – and probably spoofing – us.”

In her online op-ed “Hollywood on the Couch,” Lieberman says Sony could release the film on DVD or via the Internet, suggesting that viewers make a donation to a charity or counter-terrorism organization.

Mitt Romney tweeted the same idea, suggesting that film viewers contribute $5 to fight Ebola.

Meanwhile, North Korea denies that it’s behind the cyber attack on Sony – sort of.

“There is not any connection,” U.N. diplomat Kim Song told The Associated Press.

Mr. Song criticized the film but disputed his government hacked Sony and orchestrated the movie’s shutdown: “It defamed the image of our country. It made a mockery of our sovereignty. We reject it. But there is no relation” to the hacking.

Two NYC Police “Assassinated.”

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POLICE AND FIRE
Updates on Fatal Shooting of Two N.Y.P.D. Officers
By ANDY NEWMAN DECEMBER 20, 2014 7:11 PM December 20, 2014 7:11 pm 38

Photo
Police officers arrived at Woodhull Hospital Saturday night, where Officers Liu and Ramos were pronounced dead.
Police officers arrived at Woodhull Hospital Saturday night, where Officers Liu and Ramos were pronounced dead. Credit Kevin Hagen for The New York Times
Updated, 9:51 p.m. Two police officers were fatally shot as they sat in their patrol car in Bedford-Stuyvesant, Brooklyn, on Saturday afternoon. The assailant then killed himself, the police said. Read the full story.

The slain police officers: Rafael Ramos, 40, left, and Wenjian Liu, 32.

Credit New York Police Department

9:58 P.M.Sharpton and Garner Family Denounce Shootings
The Rev. Al Sharpton issued a statement on behalf of the family of Eric Garner deploring the shootings.

“I have spoken to the Garner family and we are outraged by the early reports of the police killed in Brooklyn today,” Mr. Sharpton said. “Any use of the names of Eric Garner and Michael Brown, in connection with any violence or killing of police, is reprehensible and against the pursuit of justice in both cases.”

Mr. Brinsley’s post on Instagram talked of killing two officers to avenge the death of “1 of ours,” presumably referring to Mr. Garner.

“The Garner family and I have always stressed that we do not believe that all police are bad,” Mr. Sharpton said. “In fact we have stressed that most police are not bad.”

The family of Michael Brown, the teenager fatally shot by a police officer in Ferguson, Mo., released a similar statement.

“We reject any kind of violence directed toward members of law enforcement,” Mr. Brown’s family said.

9:53 P.M.Mayor Has Blood on His Hands, Police Union Head Says

The head of the Patrolmen’s Benevolent Association, Patrick Lynch, blamed the mayor for the shootings as he addressed officers outside Woodhull Hospital after the bodies of Officer Liu and Officer Ramos were borne away.

“There is blood on many hands, from those that incited violence under the guise of protest to try to tear down what police officers do every day,” Mr. Lynch said.

“That blood on the hands starts on the steps of city hall in the office of the mayor.”

Now is a time of grieving, Mr. Lynch said. “We’ll mourn for our city and we’ll mourn for our brothers,” he said. “We’ll straighten our shoulders, we’ll stiffen our backs and we’ll wipe our tears.”

But he warned, “When those funerals are over, we’ll raise our heads and those who allowed this to happen will be held accountable.”

Earlier in the evening, police officers turned their backs on Mayor de Blasio when he entered the hospital.

9:42 P.M.A Somber Salute as Ambulances Leave the Hospital

At 9:40 p.m., hundreds of officers lined a driveway at Woodhull Hospital as two N.Y.P.D. ambulances pulled slowly away, with the bodies of the slain officers inside.

In silence, the officers saluted, and the ambulances, followed by a police caravan, turned onto the street and drove away to take the bodies to the medical examiner’s office.

9:09 P.M.Pataki Blames Mayor and Holder for Shootings
Former Gov. George E. Pataki of New York, a Republican, blamed Mayor de Blasio and United States Attorney General Eric H. Holder Jr. for the shootings of the officers.

“Sickened by these barbaric acts,” Mr. Pataki wrote on Twitter, “which sadly are a predictable outcome of divisive anti-cop rhetoric of #ericholder & #mayordiblasio.”

Sickened by these barbaric acts, which sadly are a predictable outcome of divisive anti-cop rhetoric of #ericholder & #mayordiblasio. #NYPD

— George E. Pataki (@GovernorPataki) 21 Dec 14

8:54 P.M.#BlueLivesMatter Hashtag Circulates on Twitter
Saturday evening, supporters of the police lit up Twitter with the hashtag #BlueLivesMatter — an allusion to the #BlackLivesMatter hashtag used by protesters.

Rest in Peace to the two NYPD officers who were murdered in the line of duty today, unbelievable how sick people are #BlueLivesMatter

— Gabby Reinold (@GabbyReinold) 21 Dec 14

8:32 P.M.Threat on Instagram
The Instagram threat believed to have been posted by Mr. Brinsley said, “I’m putting wings on pigs today … They take 1 of ours. Let’s take 2 of theirs.”

8:30 P.M.Cuomo and Holder Issue Statements
“This deplorable act of violence is the opposite of what New York is and what New Yorkers believe in,” Gov. Andrew M. Cuomo said in a statement.

“Tonight, we all come together to mourn the loss of these brave souls,” he added.

The U.S. Attorney General, Eric H. Holder, also issued a statement.

“I condemn this afternoon’s senseless shooting of two New York City police officers in the strongest possible terms,” it began. “This was an unspeakable act of barbarism.”

8:23 P.M.Statement Blames Mayor for Shootings
A statement purporting to be from the Patrolmen’s Benevolent Association, the biggest police union, blamed Mr. de Blasio for the shootings.

“The mayor’s hands are literally dripping with our blood because of his words, actions and policies,” read the statement, “and we have, for the first time in a number of years, become a ‘wartime’ police department. We will act accordingly.”

The statement instructed officers to forward it to colleagues, and it spread instantly through the department.

The Sergeants Benevolent Association issued a similar statement on Twitter.

Over the last two weeks, amid nightly protests against the police, union leaders have been sharply critical of Mr. de Blasio for what they have called insufficient support for officers.

The protests started after a Staten Island grand jury declined on Dec. 3 to bring criminal charges against a white police officer in the chokehold death of Eric Garner, an unarmed black man. The protesters have filled the streets chanting Mr. Garner’s dying words — “I Can’t Breathe” — in calling for changes in policing policies.

8:18 P.M.Police Union Says Two Units Must Respond to All Calls
In the wake of the shootings, a statement purporting to be from the Patrolmen’s Benevolent Association, the biggest police union, gave instructions that effective immediately, “At least two units are to respond to every call, no matter the condition or severity, no matter what type of job is pending, or what the opinion of the patrol supervisor happens to be.”

The statement, which circulated among officers, added: “Absolutely NO enforcement action in the form of arrests and or summonses is to be taken unless absolutely necessary and an individual MUST be placed under arrest. These are precautions that were taken in the 1970’s when Police Officers were ambushed and executed on a regular basis.”

8:11 P.M.Maryland Police Warned New York About Threat
Early this morning, Mr. Brinsley shot and wounded his ex-girlfriend in Owings Mills, Md., near Baltimore, the police in Maryland said.

After the Maryland shooting, Mr. Bratton said, Mr. Brinsley posted from Brooklyn on Instagram that he was going to attack police officers and that the posting might be his last.

Mr. Bratton said that Maryland officials had sent a warning notice to the police in New York, but that it arrived just as the officers were shot.

“The tragedy here is that just as the warning was coming in, the murder was occurring,” Mr. Bratton said.

He said there were no indications that Mr. Brinsley was acting in concert with anyone else.

He said that Mr. Brinsley had been living in Georgia and had a girlfriend in Maryland and some connection to Brooklyn.

Mr. Bratton added a sobering statistic: Today is the seventh time since 1972 that policing partners have been murdered together.

7:54 P.M.De Blasio: ‘Our Entire City Was Attacked’
Mayor de Blasio, appearing beside Mr. Bratton, said, “Our city is in mourning.”

“Our hearts are heavy,” the mayor said. “We lost two good men who devoted their lives to protecting all of us.”

He added, “When a police officer is murdered, it tears at the very foundation of our society — it is an attack on all of us.”

He said, “Our entire city was attacked by this heinous individual.”

Mr. de Blasio said that he had met with the officers’ families, including Officer Ramos’s 13-year-old son, who “couldn’t comprehend what had happened to his father.”

7:49 P.M.Shooter Is Identified as Ismaaiyl Brinsley
Mr. Bratton identified the shooter as Ismaaiyl Brinsley, 28.

At 2:47 p.m., Mr. Bratton said, as the officers sat in their marked police cruiser at the corner of Tompkins and Myrtle Avenues in Bedford-Stuyvesant, Mr. Brinsley walked up to it.

“He took a shooting stance on the passenger side and fired his weapon several times through the front passenger window, striking both officers in the head,” Mr. Bratton said.

“Officer Ramos and Officer Liu never had the opportunity to draw their weapons,” he said. “They may have never even seen the assailant, their murderer.”

Mr. Brinsley then fled to the nearby Myrtle-Willoughby Avenues subway station, where he shot himself in the head on the platform, Mr. Bratton said.

7:40 P.M.Bratton Identifies the Slain Officers
Police Commissioner William J. Bratton identified the slain officers as Wenjian Liu, a seven-year veteran of the force, and Rafael Ramos, 40, an officer since 2012.

“Today two of New York’s finest were shot and killed with no warning, no provocation,” Mr. Bratton, looking deeply shaken, said at Woodhull Hospital in Williamsburg. “They were, quite simply, assassinated — targeted for their uniform and for the responsibility they embraced to keep the people of this city safe.”

7:22 P.M.N.J. Union Says Anti-Police Sentiment Spurred Shootings
The head of the Policeman’s Benevolent Association in New Jersey said that the shooting of the officers was “spurred on by so much recent hatred aimed at officers everywhere.”

“Our society stands safer because of the sacrifices officers make everyday, but the hatred that has grown over the past few weeks in this country has gone unchecked by many elected leaders,” the official, Patrick Colligan, said in a statement posted on Facebook.

Read the full statement.

Today’s shootings come on the heels of New York protests following a Staten Island grand jury’s decision not to charge the white police officer whose chokehold killed an unarmed black man, Eric Garner, and protests nationwide over a grand jury’s decision not indict a white Ferguson, Mo., police officer in the shooting death of an unarmed black teenager, Michael Brown.

7:07 P.M.Attack Comes Amid Tensions Over Policing
The attack on the police officers comes amid a trying time in the city. Since a Staten Island grand jury declined on Dec. 3 to bring criminal charges against a white police officer in the chokehold death of Eric Garner, an unarmed black man, protesters have filled the streets nightly and chanted his dying words — “I Can’t Breathe” — in calling for changes policing policies.

Over the last two weeks, police union leaders have been sharply critical of Mayor Bill de Blasio for what they have called insufficient support for officers. Though the mayor has praised officers’ work repeatedly since the grand jury decision — and throughout his first year in office — he has stressed the rights of protesters to express themselves and spoken of his experience instructing his biracial son, Dante, to “take special care” during any encounters with police officers. Some union leaders suggested the mayor had sent a message that police officers were to be feared.

In recent days, the Patrolmen’s Benevolent Association, the largest police union, has circulated a letter allowing officers to request that the mayor not attend their funerals in the event of a line-of-duty death.

— MATT FLEGENHEIMER

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Raul Castro Reminds Cubans They Are Communists

Further reunification with the United States and Cuba will take lots of diplomacy and down right open politics to make both sides look good for their constituents. The United States must show the 50 years of separation was a success in eventually bringing the 2 sides together while Cuba must insist communism was and is the way to go. Just so no one forgot, President Raul Castro Saturday declared “victory for the Cuban Revolution.” Alternating as both a good cop-bad cop, declaring “We won the war,” then praised President Obama for smartly ending the 50 years of isolation. For “removing obstacles to our relations, the Cuban people are grateful.” The Cuban president chose to avoid promising any human rights improvement, though so many thousands of political prisoners have been jailed for years. Instead he predicted higher salaries are in store for state workers in the coming year. The brother of ailing Fidel said he would travel to Panama for the April Summit of the Americas. The summit is also on President Obama’s calendar, though there is no note that Obama will be meeting with the Cuban leader. That obviously depends on how relations progress over the next 4 months. “The only way to advance is with mutual respect,” said Castro, repeatedly, in today’s speech. The present Cuban leader reminded the world that his brother had for years told the United States to stop interferingin the internal affairs of Cuba. While the United States has millions of its citizens against the any deal the island has many loyal Communist Party members equally unhappy as some angry Republicans, particularly Florida Senator Marco Rubio. Further progress rests on whether the leaders of both countries can still the anger of those strongly opposed to any deal.

Ways to Keep Moving with Joint Pain

If you suffer from joint pain, exercise may seem like the last thing you want to do, or need to do. But the right exercises performed properly can be a long-lasting way to subdue ankle, knee, hip, or shoulder pain. For some people, the right exercise routine can even help delay or sidestep surgery.

Is joint pain holding you back? Perhaps an achy ankle or sore knee is making it difficult to enjoy a run through your favorite park or even a short walk. Or maybe a throbbing hip or shoulder prevents you from whacking a golf ball or performing simple tasks like carrying a bag of groceries into your home. The exercises in this report can help relieve ankle, knee, hip, or shoulder pain, and help you become more active again, which can help you stay independent long into your later years.

While exercise is great medicine, it only works if you carve out time to do it regularly. And sometimes the hardest part of a workout is getting started. Here are four ways to help you get your dose of physical activity:

Carve out the time. Skip several half-hour TV shows a week or work out while watching. Get up half an hour earlier each day for a morning workout. If big blocks of time aren’t falling into your lap, try 10-minute walks, or half a workout in the morning and half in the evening.
Build activity into your daily routine. Take stairs, not elevators. When commuting, get off the bus or subway a stop or two ahead, or park farther away from your workplace. While on the phone, try a few stretches, pace around, or do simple exercises like lunges, squats, and heel raises. Bike or walk to work. When running errands within a reasonable radius, park your car in one spot and walk to different shops. Replace your desk and desk chair with a standing desk. Try substituting a stability ball for your desk chair a few hours a day. Rake leaves and shovel snow instead of using a leaf blower or snowblower.
Find a workout buddy. Workouts with a friend can be more enjoyable, plus you’re less likely to cancel on the spur of the moment.
Bugged by bad weather or early darkness? Buy equipment necessary for exercising at home, join a gym, try a class in your community, or walk the mall or an indoor athletic track at a local school.
When motivation flags, remind yourself of your goals, plan small rewards, ask a friend to check up on you, or consider working out with a personal trainer.

For more on developing and mastering a plan for joint pain relief, buy The Joint Pain Relief Workout, a Special Health Report from Harvard Medical School.

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Iraqi Kurds Celebrate Major Victory Over ISIS

Iraqi Kurds seize Mt. Sinjar from Islamic State in major victory
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Iraqi Kurdish fighters have broken the Islamic State’s siege on Mount Sinjar in northern Iraq with the help of US-led airstrikes, freeing hundreds from the Yazidi minority who were trapped there for months.
By Michael Holtz, Staff writer DECEMBER 19, 2014

Iraqi Kurdish fighters have broken the Islamic State’s siege on Mount Sinjar in northern Iraq with the help of US-led airstrikes, freeing hundreds of people from the country’s Yazidi minority who were trapped there for months, a senior Kurdish official said Thursday.

The development marks a major victory for the Kurdish fighters, known as peshmerga, and the US-led coalition against the self-described Islamic State (IS). The plight of the Yazidis, in addition to IS attacks across Iraq’s semiautonomous Kurdish region, prompted the United States to begin airstrikes in the country in August.

The liberation of Mount Sinjar was part of a massive offensive peshmerga forces launched earlier this week against IS militants in northern Iraq. The Kurdish fighters recaptured a large swath of territory in the region over the last few days, reports The New York Times.

The Kurdish fighters’ success in opening up a corridor on Mount Sinjar was, according to The Associated Press, an “incremental step” in their push to retake the town of Sinjar at the foothills of the mountain.

Mr. Barzani said the corridor enables Kurdish fighters to gain direct access to the Yazidis on the mountain and to provide them with humanitarian support.

“All those Yazidis that were trapped on the mountain are now free,” Barzani said, according to Reuters.

The siege began in August when IS forces surrounded the mountain and the tens of thousands of people from the Yazidi religious minority who sought refuge there. The brutal assault sparked Obama into action, leading him to launch airstrikes and humanitarian airdrops.

Stranded and at risk of being slaughtered, many Yazidis were eventually airlifted to safety or fled on foot to Syria. CNN reports that only a few hundred Yazidis were left on the mountain.

In addition to supporting peshmerga troops on the ground in Iraq, US airstrikes have also killed three IS leaders in recent weeks, the Pentagon confirmed Thursday.

“It is disruptive to their planning and command and control,” Gen. Martin Dempsey, chairman of the Joint Chiefs of Staff, told the Wall Street Journal. “These are high-value targets, senior leadership.”

While the US-led air campaign in Iraq remains a joint effort with coalition forces, the US military appears to be largely going it alone in Syria. A Reuters investigation found that nearly 97 percent of the strikes in Syria this month have been carried out by the US alone.

That accentuates a shift that began shortly after the start of the campaign in late September, when U.S. allies carried out 38 percent of the strikes. The percentage quickly dropped to around 8 percent in October and 9 percent in November, according to Reuters calculations based on the data.

U.S. officials are keen to prevent the coalition from fraying over concerns about the air campaign’s direction. Some allies have long worried the air strikes might unintentionally bolster Syrian President Bashar al-Assad by striking a common enemy, sources said. Others in the region are also saying privately that the U.S.-led campaign against Sunni extremists needs to do more to help Sunni Muslims.

GMO Labeling CAN’T be Stopped!

Policy and Action from Consumer Reports

Help us fight for your rights in the New Year

Despite spending $20 million in just one state, Monsanto and Big Food couldn’t crush GMO labeling efforts. Give your tax-deductible year-end donation, and help us keep up the momentum for your right to know in the New Year!

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Dear Bill Deane,

When corporate interests spend $20 million just to stop one state from labeling GMO foods, you have to figure we are on to something.

And when all that money couldn’t crush the GMO labeling movement in Oregon – it lost by only 837 votes out of more than 1.5 million cast – you have to know that together we will beat Monsanto, DuPont and others trying to keep you from knowing what you’re eating.

Today, your year-end donation to Consumers Union will make sure we keep fighting for your rights in the New Year. Whether it’s labeling genetically engineered food, or stopping a conglomerate like Comcast from controlling your Internet experience, we are here for you and no else.

Give your $100.00 tax-deductible donation now, and together we will take them all on!

Oregon’s razor-thin recount vote on GMO labeling – less than a .05 percent difference after tons of money was spent to bury it– shows that we are truly gaining momentum in this epic fight.

Consumers in dozens of other states are now demanding their local lawmakers pass bills requiring GMO labeling. Vermont is headed to the courts to defend its groundbreaking labeling bill. And the battle heads to Washington, D.C. and the new Congress, where industry lobbyists are plotting an all-out assault to block states from labeling GMOs.

Your year-end donation will help us to be ready for this fight and others. As a true consumer-led organization that takes no money or advertising from corporate interests, we count on you to help us stand up for what’s fair and for what’s safe.

Your tax-deductible gift now will make sure we are there fighting for you in the New Year!

Thank you for your incredible support. Your actions show corporate America this is still a nation where people still join together to fight for a fair, just and safe marketplace, and that no amount of money can defeat us.

Sincerely,
Chris Meyer, Consumers Union
Policy and Action from Consumer Reports

New Travel System Invites a New Sexual Attacks

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By MIKE ISAAC DECEMBER 18, 2014 1:13 PM December 18, 2014 1:13 pm 32

Prosecutors in Cambridge, Mass., yesterday charged an Uber driver with sexually assaulting a woman seeking a ride, the latest in a series of attacks on people who use the ride-hailing service.

Alejandro Done, the 46-year-old driver, is accused of picking up a young woman in Boston on Dec. 6 while presenting himself as the driver who had been summoned through a ride-sharing service. He then drove to a secluded location, prosecutors say, where he beat and sexually assaulted the woman, whose name the officials have not disclosed. Mr. Done is charged with rape, assault to rape, kidnapping, and two counts of assault and battery.

The authorities said Mr. Done had posed as the driver when he picked up the woman, but it is unclear whether Mr. Done used information from the Uber application to aim at the woman.

“Every day people are engaging car services for their transportation needs, and placing their trust in them for their personal safety and security,” Marian Ryan, the Middlesex County district attorney, said in a statement. “While these services are a convenience, and often a necessity of modern urban living, we urge everyone to take precautions to ensure they are as safe as possible.”

The incident comes as Uber reexamines its safety and driver screening policies. Over the last year, other Uber drivers in the Delhi region of India, San Francisco, Florida and Chicago have faced various charges of assault on passengers.

On Wednesday, Uber said it planned to invest in more comprehensive screening technologies to vet drivers, including biometric and voice identification techniques. Uber said it would also set up emergency response teams in its offices around the world, in order to assist passengers and the authorities in case of an emergency.

“This is a despicable crime and our thoughts and prayers are with the victim during her recovery,” said Kaitlin Durkosh, an Uber spokeswoman. “Uber has been working closely with law enforcement and will continue to do everything we can to assist their investigation.”

Uber Pledges to Strengthen Background Checks for Drivers

The Cuban Paradox: Poor But Free Medical Care for All

Cuba perhaps best known for vintage cars, cigars, and communists, Cuba is also distinguished by something far more enticing to the students and staff of the Harvard School of Public Health–its health care system. The Cuban government assumes full fiscal and administrative responsibility for the health care needs of all its citizens, providing free preventive, curative, and rehabilitation services. This National Health System, as it’s called, is an international success story and, for the last three years, a small group from the School has made its way down to this sunny island nation to learn more about what makes it tick. “It’s good for people to see another system,” says Richard Cash, senior lecturer in the School’s Department of Population and International Health. “Seeing for yourself is far more important and to see what Cuba does with limited resources and to contrast it with our system and other systems is valuable. Everyone that has gone to Cuba has come away clearly educated by the process.”

This March, Cash was joined in this educational experience by 12 MPH students. Roberta Gianfortoni, director for professional education at the School, has organized the trip since its inception and coordinated this year’s excursion with Medical Education in Cooperation with Cuba (MEDICC), a non-profit organization that specializes in offering elective experiences in Cuba to US and Canadian students in the health and medical sciences. The School’s contingent traveled under a special license granted to the MEDICC. Over an eight-day stay in the Cuban capital of Havana, the group visited institutions such as the Ministry of Public Health, maternity hospitals, schools of medicine and public health, AIDS sanatoria, and community health clinics. “The objective is to look at an alternative system,” says Gianfortoni. “It’s an interesting model to study. Our students are going to go to both developed and underdeveloped countries so it’s interesting to consider how Cuba’s concepts and methods can translate to other parts of the world.”

Socio-economic development is typically measured by health indicators such as infant mortality and life expectancy at birth. However, in Cuba, a nation beset by severely limited resources and political tensions both internal and external, these health markers are essentially the same as those in the United States and other parts of the industrialized world. Cuba also boasts the highest rate of public health service in Latin America and has one of the highest physician-to-population ratios in the world. Alone remarkable for a developing country, these feats are even more extraordinary considering the context of a US embargo that’s been in effect since 1961. Because its access to traditional sources of financing is seriously hindered by the sanctions, which until rec- ently included all food and medicine, Cuba has received little foreign and humanitarian aid to maintain the vitality of its national programs. And herein lies the paradox of Cuba’s health care system: because Cuba has so few resources, prevention has become the only affordable means of keeping its population healthy.

“I find Cuba’s system to be very inspiring because it is so public health focused,” says Tracy Rabin, who has made the Cuba trip twice. She traveled the first time as a student in the Department of Immunology and Infectious Diseases; this year she participated as a research associate and program manager for the Program on Ethical Issues in International Health Research in the Department of Population and International Health. Her impressions are not an illusion: despite the economic difficulties of recent years, spending on public health in Cuba has increased steadily, which reflects the political will to maintain successes achieved in this area. An August 1960 law established the Ministry of Public Health as the highest authority responsible for health care. The same year, the Rural Social Medical Service was created, allowing Cuba to place doctors and nurses in the country’s remotest areas to bring medical attention to inhabitants there.
Economic constraints have also forced the Cuban health system to get creative when it comes to solving health problems. Cuba does a lot of work with alternative and herbal medicines, which can be more accessible and affordable to a broader population. A testament to their resourcefulness: they recycle magnets from ballistic missiles for their electromagnetic therapy. Cuba is also internationally recognized for its innovative National Immuniza-tion Program, begun in the ’60s, through which vaccination is integrated into primary care services and depends on active community participation. And the health care system is aggressive in terms of intervention. Since doctors live in the community, if patients skip appointments it’s only a matter of hours before the doctor is knocking at their door. “There is a certain kind of caring there that we lose out on in the United States,” observes Ella Oong, who just finished up her MPH.

“For me the Cuban system reinforces a commitment to community health,” notes Rabin. “It’s nice to see that a lot of these public health theories can work in a medical context–there isn’t necessarily a division between medicine and public health; there’s an effective way for the two to come together. The more that health professionals are educated about different systems the better the US system will be.” Rabin, who plans to go to medical school and study emergency medicine, also hopes to integrate the two. “The emergency room is often the first place that people go for treatment for a wide range of health problems–everything from mental health to domestic violence to infectious diseases,” she says. “I think that Cuba would be a prime place to visit for someone with a strong commitment to public health and to viewing patients as both individuals and members of a community and other groups.”

A functional blend of public health and medicine, Cuba’s commendable health care system is nevertheless a product of a socialist revolution–so whether its methods can be feasibly applied to the United States remains an open question. What does the School’s contingent bring back to their homeland from its weeklong visit? “Well, the students salsa more,” quips Cash, popping a Latin-music CD into his computer. “But seriously, it hits people differently. Some students are impressed by the use of traditional medicine; others are impressed with the immunization programs. And many are conflicted about the AIDS programs.” One of the most controversial of Cuban health programs has been the sanatorium-based care for AIDS, which originally obligated all HIV-positive patients to live out the rest of their lives in these small clinic-based communities. Today, an outpatient option is offered to those who qualify, but many patients don’t take advantage of it because they are often ensured better care in the sanatoria. “Really, what we have is a conflict of ideology–the conflict between personal freedom and public health,” notes Cash. “What works for Cuba may not work for us.”

But everyone on the trip wished that they had a little more time to find out. Ella Oong and Todd Reid, who is studying for his master’s in epidemiology, said they wanted to stay a bit longer to conduct case studies and evaluate how the integration of various practices work. For example, the recent dengue outbreak and eradication campaign would have been perfect models to study Cuba’s comprehensive health care system. Oong, who just graduated this year, won’t return to Cuba with the School. Reid, however, will revisit next year. He is already learning Spanish in preparation for the trip, which will be extended to a three-week excursion. “There’s nothing that replaces the actual experience of being in the midst of the population,” says Reid. “You can read all you want, but I readily understood the importance of being immersed in a different culture. You get so much more just talking to people. You connect with them. You find out what you share.”

Chelsea Merz

This blog is dedicated to bringing back the commitment of professional journalism. As a former network news editor, major market news director and anchor, BILL DEANE gives you the inside story often missed by media more interested in Hollywood gossip. OUR MISSING NEWS gets into the WHY of the day's significant events.