The Jersey City Medical Center, in Hudson County.

The Health Factory

The Jersey City Medical Center, in Hudson County.

In addition to the surgery building and the maternity hospital, the campus included the nurses' residence (Murdoch Hall), hospital for chest diseases (Pollock), a psychiatric hospital, and an outpatient clinic. The Medical Center's services were free

By STEVEN J. SPEAR
Published: August 29, 2005

TODAY, going to an American hospital seems about as safe as parachuting off a bridge. An estimated 98,000 Americans die each year as a result of medical error, and a nearly equal number succumb to infections they acquire in hospitals. Those rates are unacceptable in the world's most medically advanced country.
This month, President Bush signed a bill intended to reduce the rate of medical errors. The legislation authorizes the creation of ''patient safety organizations'' to which health care providers can report errors and near misses. On the basis of these reports, the organizations will recommend ways to avoid such mistakes. And to reduce disincentives to reporting, the bill prevents information disclosed to these organizations from being used in malpractice lawsuits.


The new legislation is a step in the right direction. It will allow hospitals to study their errors without fear that acknowledging mistakes will lead to reprisals. But within the hospitals themselves lies a far bigger opportunity to reduce the rate of catastrophic medical error, if the hospitals would just follow the example of the world's most successful industrial organizations.

Companies like Toyota, Alcoa and Vanguard differ from one another in the products they produce and the technologies they employ, but they share a management approach that has resulted in a combination of safety, quality, efficiency and responsiveness unmatched by their competitors.

It may seem a stretch to compare a carmaker's, aluminum refiner's, or mutual fund company's operations with a hospital's. But all these companies manage complex processes that require a great deal of problem solving -- and they have something important to teach health care.

Typically, health care workers, like employees in many other industries, tend to work around problems when they encounter them, meeting patients' immediate needs but not resolving the problems' root causes. Therefore, people confront ''the same problem, every day, for years,'' as one nurse phrased it to me. These persistent difficulties manifest themselves as regular inefficiencies within the system, and they occasionally lead to catastrophic mistakes.

What sets the non-health care leaders apart is that as they do their work, they are constantly learning how to do it better. Work is designed to reveal even little problems as they occur-- well before they cause errors or near misses worthy of being reported. Managers respond to these problems immediately, with rapid experiments aimed at generating sustainable fixes, rather than with workarounds that are constantly repeated. The knowledge that results from this process is then shared through collaborative experimentation in which all employees take part.

A number of American hospitals have tried this approach, with promising results. For example, hospitals in the Pittsburgh Regional Healthcare Initiative addressed a recurring predicament in intensive care. Catheters placed directly into veins or arteries, called central lines, are used to deliver medication swiftly to critically ill patients. But a quarter-million patients nationwide who receive this treatment each year suffer bloodstream infections as a result, and of those, 15 percent die. At one Pittsburgh area hospital, mortality was a staggering 40 percent of those infected, and the cost for each infected patient was $25,000 to $80,000. To eliminate these infections, the hospitals taught themselves to find problems and institute small process enhancements at a rate far faster than a national reporting program will most likely allow. Together, these small fixes added up to a significant improvement.

For periods of days or weeks, the Pittsburgh hospitals observed the placement and maintenance of every central line, looking for minor breaks in routine that could create opportunities for infection. Along the way, they found dozens of factors that were potentially suspect. One hospital realized that in its line-maintenance kits, gloves were stored on the bottom, causing nurses to fish through sterile material with bare hands. Other kits had drapes -- sheets that isolate the area on which a nurse or doctor is working -- that were either too small to be effective or so large that patients knocked them out of the way.

Other hospitals discovered that only on certain shifts were there doctors expert in placing the more difficult but least infection-prone type of line. And the shifts that lacked such expertise also lacked simple, reliable ways to signal the experts on other shifts to move lines from high-risk to low-risk locations or to remove them entirely when they returned to work.

By quickly identifying and resolving these small procedural problems, the Pittsburgh hospitals as a group cut their central line infection rates in half, and some hospitals were able to cut their individual infection rates nearly to zero. These hospitals and others used a similar approach to solve other problems, like patient falls and faulty medication administration.

To go from working around problems to identifying and solving them required hospital workers to change the way they worked, from the front lines to the senior levels. But the effects were profound. If the rest of the country's hospitals follow that example, the national savings would be measured in tens of thousands of lives and billions of dollars every year.

Copyright 2005 The New York Times Company | Privacy Policy | Home | Search | Corrections | Help | Back to Top

Jersey City, City Hall

Jersey City, City Hall

Designed by architect Lewis Brome, City Hall opened in 1896. It was the political base of the powerful Hudson County Democratic Machine of Frank Hague, John V. Kenny,and former Mayor Thomas J. Whelan

Doctors Join to Promote Electronic Record Keeping

Stewart Cairns for The New York TimesDr.

Eugene Heslin receives computer training from Lori Jesman.

September 19, 2005
Doctors Join to Promote Electronic Record Keeping
By MILT FREUDENHEIM

He is a self-described techie, but that did not help Dr. Eugene P. Heslin harness the wonders of electronic medical records. The technology seemed too complicated and expensive for a small medical group like his six-doctor family practice in rural upstate New York.

"The large groups can afford the software," said Dr. Heslin, a family physician in Saugerties. "For the onesies and twosies, small groups like ours, there is no profit margin."

Now, though, in a collaboration with 500 like-minded doctors, as well as hospitals, insurers and employers in two Hudson Valley counties, Dr. Heslin and his partners are clearing barriers that have made modern information technology inaccessible to the hundreds of thousands of small doctors' offices around the nation.

The Hudson Valley effort is being watched as a potential model by federal and state government and industry officials, who say that up to 60 percent of Americans receive their primary care at small-scale physicians' offices. Unless those small medical practices can adopt the most modern and efficient information technology, millions of Americans may never know the benefits of the most advanced and safest care.

Electronic records, particularly ones that can be shared online by different doctors and hospitals, can improve the quality and safety of patient care by reducing errors that kill tens of thousands of patients each year. That is why, with considerable cheerleading but only modest financial help from Congress and the Bush administration, big organizations like Kaiser Permanente, the Mayo Clinic and many medical centers across the country are spending billions to convert to electronic records.

And last week, in the aftermath of Hurricane Katrina, government and private health care officials were rushing to build an electronic database of prescription drug records for hundreds of thousands of people who lost their records in the storm. Health and Human Services Secretary Mike Leavitt said the chaos wreaked by Katrina "powerfully demonstrated the need for electronic health records."

Also helping propel the electronic revolution are private insurers, Medicare and some employers, which are paying incentives to medical providers that can achieve better efficiency and patient care through improved information management.

But smaller medical practices have typically been ineligible for such bonuses because the doctors lack the computerized records that help them qualify. The hurdles typically include up-front costs as high as $30,000 for each doctor, and the need for support and training.

As a result, fewer than 5 percent of physicians nationally are using a computerized system as part of patient care, said Dr. Thomas J. Handler, a research director at the Gartner market research group. For most doctors who work in groups of five or fewer, the portion is probably 3 percent or less, he said.

To overcome such obstacles, Dr. Heslin and his regional colleagues, who call their cooperative effort the Taconic Health Information Network and Community, are pooling their resources and knowledge.

A Web-based, central database approach means that doctors need little more than a few standard PC's, a high-speed Internet connection and the willingness to pay a monthly subscription fee of $500 to $600, eliminating the initial outlay of tens of thousands of dollars.

The Taconic group, operating in Dutchess and Ulster Counties, received a seed grant of $100,000 from the eHealth Initiative, a national nonprofit organization that is intent on bringing the medical profession into the modern digital era. The organization's affiliated foundation cited the Taconic group in its annual progress report late last month. The Taconic network has also received $1.5 million from the federal Agency for Healthcare Research and Quality, to pay for an evaluation of the system by an independent researcher.

Dr. David J. Brailer, the Bush administration's health information technology coordinator, said that programs like the Taconic network "are obviously out in front of the rest.

"My mantra is to ask, How can we make electronic medical records cheaper and more valuable to the doctor?" Dr. Brailer said. "These are grass-roots efforts that are filling a hole that the federal and state governments cannot respond to."

Under the Taconic system, which is being introduced in phases, doctors can log onto a secure Web site to get prompt laboratory and X-ray and other imaging results for their patients from four local hospitals and two big lab companies. Later this year, the doctors will be able to send prescriptions electronically to participating local drugstores or online pharmacies. The biggest part of the push is to start next year: the introduction of electronic health records accessible online to the patient's doctor and, with the patient's permission, to any other medical provider on the network.

Mark Foster, a pediatrician in Wappingers Falls, in Dutchess County, has already seen the benefit of his electronic lab-results link. When a boy came in recently with a painful swollen knee, Dr. Foster suspected Lyme disease, which is endemic in the county.

"We tested him, and the next morning I looked online and called his mother and got him on antibiotics," Dr. Foster said. "Within 48 hours, his fever was gone. He's absolutely normal now."

Under the former system of communicating by fax with the laboratory and sorting through the piles of paper that arrive daily, he said, "the kid could have been suffering for two more days."

The Taconic network, along with two other medical alliances - one in Indianapolis, the other in Whatcom County, in Washington State - are "well ahead of the pack," said Janet Marchibroda, the chief executive of the eHealth Initiative.

The Taconic group is negotiating discounts with software and hardware vendors, according to Dr. A. John Blair III, a laparoscopic surgeon who is the organization's chief executive. Dr. Blair is paid by a separate regional doctors' organization that currently donates his time to the Taconic network. The day-to-day work of building and running the system, dealing with vendors and providing technical support to the doctors is performed by a rapidly growing paid staff, now numbering 15 and based in Wappingers Falls.

The key to the system is its secure shared database. "Instead of having dozens of systems in doctors' offices, it is hosted on one facility," Dr. Blair said.

All a participating doctor needs is at least one computer terminal with high-speed access to the Internet, he said, and a router computer for security protection and antivirus software. Some doctors have flat screens in each examining room. Some have wireless tablets or laptops they take from room to room. Most have separate terminals for themselves and their nurses and administrative staffs.

The Taconic network supplies the training for doctors and their staffs and maintains local support centers to troubleshoot the inevitable challenges posed by new software.

"That's what they need, that's why I like this model," said Dr. Handler at the Gartner research group. Without such technical support for small medical practices, "it's hard for them to get over the hurdles," he said.

Much of the Taconic doctors' costs for the system can be offset by payments from insurers and employers like I.B.M. and Verizon that offer bonuses to doctors in their networks who meet quality standards.

I.B.M., which has 60,000 employees in the mid-Hudson Valley region, is enthusiastic about the Taconic group's approach. "You can cut down dramatically on medical errors; you are less likely to be accidentally given a drug you are allergic to," said Dr. Paul Grundy, a medical director at I.B.M. The company will pay doctors who use the electronic prescription system an additional $6 a year for each employee they treat.

MVP Health Care is an insurer in upstate New York that has 100,000 members who receive care from the Taconic physicians. It will pay an additional $18 a year per member to doctors who meet patient satisfaction and service standards, prescribe generic drugs and log onto the Taconic system regularly, said Dr. Jerry Salkowe, an MVP vice president.

Verizon and other big local employers, like the Price Chopper and Hannaford Brothers supermarkets, are talking to MVP and the Taconic network about additional bonuses through the Bridges to Excellence program, a national employer-sponsored experiment in paying doctors for meeting quality goals.

Francois de Brantes, a General Electric health care official who is president of the e-Health Initiative Foundation, says early studies show that computerization can yield some savings for physicians, mainly in productivity, by freeing them to see more patients. "But the majority of savings go to someone else than the physician," he said. The issue is "how to redistribute a portion of those savings back to the physicians."

Bridges to Excellence pays doctors bonuses of $50 a year per insured patient - money that can add up to tens of thousands of dollars for some large groups. The Taconic group intends to make smaller doctors eligible for such bonuses.

"Many health plans are prepared to pay for performance," said Dr. Blair. "The rub is that you have to have the technology in place to garner those incentives. You need to automate the reporting capability."

Copyright 2005 The New York Times Company Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top

Fugitive Wanted in Vegas Heist Surrenders

Heather Catherine Tallchief speaks to members of the press before surrendering to federal authorities in downtown Las Vegas on Thursday Sept. 15, 2005. Tallchief told reporters that she drove the armored truck in a $3.1 million Las Vegas Strip casino armored truck heist in October 1993. (AP Photo/Isaac Brekken)

Fugitive Wanted in Vegas Heist Surrenders By KEN RITTER, Associated Press Writer
Thu Sep 15, 8:22 PM ET

A woman accused in a multimillion-dollar armored car heist on the Las Vegas Strip surrendered to federal authorities Thursday, saying she was tired of more than a decade on the run and wanted her son to have a normal life.

"I truly feel this is the right thing to do," Heather Catherine Tallchief, 33, said minutes before turning herself in at a federal courthouse.

Tallchief was 21 and working for an armored car company when authorities say she drove away from the Circus Circus hotel-casino with at least $2.5 million in cash.

Her lawyer, Robert Axelrod, said Thursday there was no doubt Tallchief committed the October 1993 theft, but said she was influenced by her then-boyfriend, Roberto Solis, a manipulative ex-con.

"The evidence of the physical acts are quite overwhelming. But there are mitigating factors," Axelrod said. "He brainwashed her."

Tallchief appeared briefly Thursday before a U.S. magistrate judge, who ordered her held without bond on nine felony charges. A preliminary hearing was scheduled for Sept. 29. If convicted, Tallchief faces at least 30 years in prison.

Tallchief told reporters she and her 10-year-old son have been hiding in Amsterdam, Netherlands, where she and Solis fled after the heist.

A few months after their son was born, Tallchief said she left Solis, now 60, with the cash and has no idea where he is today. Solis remains a fugitive in the case.

Tallchief said she told her son about her intent to surrender, leaving him at school Monday in Amsterdam with some parting words.

"I told him to practice his guitar, have fun at his sporting club, do his homework, and I'll see you soon," Tallchief said, adding that her son will be cared for by friends in Amsterdam.

Court records say Tallchief took a position as a driver and armed guard with Loomis Armored Inc. less than six weeks before the heist.

Joe Parris, an FBI supervisory special agent in Washington, D.C., said Tallchief was a "highly sought" fugitive, but never made the FBI's Top 10 Most Wanted list.

Mark Clark, spokesman for Loomis Armored successor Loomis Fargo & Co. of Houston, said he welcomed Tallchief's surrender, but said the company wants the missing money.

"I don't suppose she turned the money in when she turned herself in," Clark said.

Copyright © 2005 The Associated Press. All rights reserved. The information contained in the AP News report may not be published, broadcast, rewritten or redistributed without the prior written authority of The Associated Press.

Copyright © 2005 Yahoo! Inc. All rights reserved.
Questions or Comments
Privacy Policy -Terms of Service - Copyright/IP Policy - Ad Feedback

Many Women at Elite Colleges Set Career Path to Motherhood

Doug Mills/The New York Times

Emily Lechner, at home in North Potomac, Md., with her mother, Carol, is a student at Yale who plans to become a lawyer, but who says her career will take a back seat once she starts having children.

September 20, 2005
Many Women at Elite Colleges Set Career Path to Motherhood
By LOUISE STORY

Cynthia Liu is precisely the kind of high achiever Yale wants: smart (1510 SAT), disciplined (4.0 grade point average), competitive (finalist in Texas oratory competition), musical (pianist), athletic (runner) and altruistic (hospital volunteer). And at the start of her sophomore year at Yale, Ms. Liu is full of ambition, planning to go to law school.

So will she join the long tradition of famous Ivy League graduates? Not likely. By the time she is 30, this accomplished 19-year-old expects to be a stay-at-home mom.

"My mother's always told me you can't be the best career woman and the best mother at the same time," Ms. Liu said matter-of-factly. "You always have to choose one over the other."

At Yale and other top colleges, women are being groomed to take their place in an ever more diverse professional elite. It is almost taken for granted that, just as they make up half the students at these institutions, they will move into leadership roles on an equal basis with their male classmates.

There is just one problem with this scenario: many of these women say that is not what they want.

Many women at the nation's most elite colleges say they have already decided that they will put aside their careers in favor of raising children. Though some of these students are not planning to have children and some hope to have a family and work full time, many others, like Ms. Liu, say they will happily play a traditional female role, with motherhood their main commitment.

Much attention has been focused on career women who leave the work force to rear children. What seems to be changing is that while many women in college two or three decades ago expected to have full-time careers, their daughters, while still in college, say they have already decided to suspend or end their careers when they have children.

"At the height of the women's movement and shortly thereafter, women were much more firm in their expectation that they could somehow combine full-time work with child rearing," said Cynthia E. Russett, a professor of American history who has taught at Yale since 1967. "The women today are, in effect, turning realistic."

Dr. Russett is among more than a dozen faculty members and administrators at the most exclusive institutions who have been on campus for decades and who said in interviews that they had noticed the changing attitude.

Many students say staying home is not a shocking idea among their friends. Shannon Flynn, an 18-year-old from Guilford, Conn., who is a freshman at Harvard, says many of her girlfriends do not want to work full time.

"Most probably do feel like me, maybe even tending toward wanting to not work at all," said Ms. Flynn, who plans to work part time after having children, though she is torn because she has worked so hard in school.

"Men really aren't put in that position," she said.

Uzezi Abugo, a freshman at the University of Pennsylvania who hopes to become a lawyer, says she, too, wants to be home with her children at least until they are in school.

"I've seen the difference between kids who did have their mother stay at home and kids who didn't, and it's kind of like an obvious difference when you look at it," said Ms. Abugo, whose mother, a nurse, stayed home until Ms. Abugo was in first grade.

While the changing attitudes are difficult to quantify, the shift emerges repeatedly in interviews with Ivy League students, including 138 freshman and senior females at Yale who replied to e-mail questions sent to members of two residential colleges over the last school year.

The interviews found that 85 of the students, or roughly 60 percent, said that when they had children, they planned to cut back on work or stop working entirely. About half of those women said they planned to work part time, and about half wanted to stop work for at least a few years.

Two of the women interviewed said they expected their husbands to stay home with the children while they pursued their careers. Two others said either they or their husbands would stay home, depending on whose career was furthest along.

The women said that pursuing a rigorous college education was worth the time and money because it would help position them to work in meaningful part-time jobs when their children are young or to attain good jobs when their children leave home.

In recent years, elite colleges have emphasized the important roles they expect their alumni - both men and women - to play in society.

For example, earlier this month, Shirley M. Tilghman, the president of Princeton University, welcomed new freshmen, saying: "The goal of a Princeton education is to prepare young men and women to take up positions of leadership in the 21st century. Of course, the word 'leadership' conjures up images of presidents and C.E.O.'s, but I want to stress that my idea of a leader is much broader than that."

She listed education, medicine and engineering as other areas where students could become leaders.

In an e-mail response to a question, Dr. Tilghman added: "There is nothing inconsistent with being a leader and a stay-at-home parent. Some women (and a handful of men) whom I have known who have done this have had a powerful impact on their communities."

Yet the likelihood that so many young women plan to opt out of high-powered careers presents a conundrum.

"It really does raise this question for all of us and for the country: when we work so hard to open academics and other opportunities for women, what kind of return do we expect to get for that?" said Marlyn McGrath Lewis, director of undergraduate admissions at Harvard, who served as dean for coeducation in the late 1970's and early 1980's.

It is a complicated issue and one that most schools have not addressed. The women they are counting on to lead society are likely to marry men who will make enough money to give them a real choice about whether to be full-time mothers, unlike those women who must work out of economic necessity.

It is less than clear what universities should, or could, do about it. For one, a person's expectations at age 18 are less than perfect predictors of their life choices 10 years later. And in any case, admissions officers are not likely to ask applicants whether they plan to become stay-at-home moms.

University officials said that success meant different things to different people and that universities were trying to broaden students' minds, not simply prepare them for jobs.

"What does concern me," said Peter Salovey, the dean of Yale College, "is that so few students seem to be able to think outside the box; so few students seem to be able to imagine a life for themselves that isn't constructed along traditional gender roles."

There is, of course, nothing new about women being more likely than men to stay home to rear children.

According to a 2000 survey of Yale alumni from the classes of 1979, 1984, 1989 and 1994, conducted by the Yale Office of Institutional Research, more men from each of those classes than women said that work was their primary activity - a gap that was small among alumni in their 20's but widened as women moved into their prime child-rearing years. Among the alumni surveyed who had reached their 40's, only 56 percent of the women still worked, compared with 90 percent of the men.

A 2005 study of comparable Yale alumni classes found that the pattern had not changed. Among the alumni who had reached their early 40's, just over half said work was their primary activity, compared with 90 percent of the men. Among the women who had reached their late 40's, some said they had returned to work, but the percentage of women working was still far behind the percentage of men.

A 2001 survey of Harvard Business School graduates found that 31 percent of the women from the classes of 1981, 1985 and 1991 who answered the survey worked only part time or on contract, and another 31 percent did not work at all, levels strikingly similar to the percentages of the Yale students interviewed who predicted they would stay at home or work part time in their 30's and 40's.

What seems new is that while many of their mothers expected to have hard-charging careers, then scaled back their professional plans only after having children, the women of this generation expect their careers to take second place to child rearing.

"It never occurred to me," Rebecca W. Bushnell, dean of the School of Arts and Sciences at the University of Pennsylvania, said about working versus raising children. "Thirty years ago when I was heading out, I guess I was just taking it one step at a time."

Dr. Bushnell said young women today, in contrast, are thinking and talking about part-time or flexible work options for when they have children. "People have a heightened awareness of trying to get the right balance between work and family."

Sarah Currie, a senior at Harvard, said many of the men in her American Family class last fall approved of women's plans to stay home with their children.

"A lot of the guys were like, 'I think that's really great,' " Ms. Currie said. "One of the guys was like, 'I think that's sexy.' Staying at home with your children isn't as polarizing of an issue as I envision it is for women who are in their 30's now."

For most of the young women who responded to e-mail questions, a major factor shaping their attitudes seemed to be their experience with their own mothers, about three out of five of whom did not work at all, took several years off or worked only part time.

"My stepmom's very proud of my choice because it makes her feel more valuable," said Kellie Zesch, a Texan who graduated from the University of North Carolina two years ago and who said that once she had children, she intended to stay home for at least five years and then consider working part time. "It justified it to her, that I don't look down on her for not having a career."

Similarly, students who are committed to full-time careers, without breaks, also cited their mothers as influences. Laura Sullivan, a sophomore at Yale who wants to be a lawyer, called her mother's choice to work full time the "greatest gift."

"She showed me what it meant to be an amazing mother and maintain a career," Ms. Sullivan said.

Some of these women's mothers, who said they did not think about these issues so early in their lives, said they were surprised to hear that their college-age daughters had already formed their plans.

Emily Lechner, one of Ms. Liu's roommates, hopes to stay home a few years, then work part time as a lawyer once her children are in school.

Her mother, Carol, who once thought she would have a full-time career but gave it up when her children were born, was pleasantly surprised to hear that. "I do have this bias that the parents can do it best," she said. "I see a lot of women in their 30's who have full-time nannies, and I just question if their kids are getting the best."

For many feminists, it may come as a shock to hear how unbothered many young women at the nation's top schools are by the strictures of traditional roles.

"They are still thinking of this as a private issue; they're accepting it," said Laura Wexler, a professor of American studies and women's and gender studies at Yale. "Women have been given full-time working career opportunities and encouragement with no social changes to support it.

"I really believed 25 years ago," Dr. Wexler added, "that this would be solved by now."

Angie Ku, another of Ms. Liu's roommates who had a stay-at-home mom, talks nonchalantly about attending law or business school, having perhaps a 10-year career and then staying home with her children.

"Parents have such an influence on their children," Ms. Ku said. "I want to have that influence. Me!"

She said she did not mind if that limited her career potential.

"I'll have a career until I have two kids," she said. "It doesn't necessarily matter how far you get. It's kind of like the experience: I have tried what I wanted to do."

Ms. Ku added that she did not think it was a problem that women usually do most of the work raising kids.

"I accept things how they are," she said. "I don't mind the status quo. I don't see why I have to go against it."

After all, she added, those roles got her where she is.

"It worked so well for me," she said, "and I don't see in my life why it wouldn't work."

Copyright 2005 The New York Times Company Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top

To laugh often and much; to win the respect of intelligent people and the affection of children; to earn the appreciation of honest critics and endure the betrayal of false friends; to appreciate beauty, to find the best in others; to leave the world a little better; whether by a healthy child, a garden patch or a redeemed social condition; to know even one life has breathed easier because you have lived." - Ralph Waldo Emerson

Rita Strengthens to Hurricane as Gulf Coast Watches and Waits

NOAA

The position of Hurricane Rita at 10:15 a.m. ET, according to the National Hurricane Center.

September 20, 2005
Rita Strengthens to Hurricane as Gulf Coast Watches and Waits
By TIMOTHY WILLIAMS
and CORNELIA DEAN

BATON ROUGE, La., Sept. 20 - Hurricane Rita beat a path toward the west today with strong rain and winds that are expected to batter Florida's southern coast and the Keys and potentially pose a new threat to the weary Gulf Coast.

The center of the hurricane, which strengthened from tropical storm status this morning, was about 75 miles southeast of Key West, Fla., and about 100 miles northeast of Havana, the National Hurricane Center said.

The approach of the storm has prompted evacuations in Key West and other coastal towns, and residents of Texas and Louisiana are warily tracking the storm's progress.

The hurricane center said the storm had reached category 1 strength as it gathered force some 75 to 100 miles east-southeast of Key West. Maximum sustained winds were near 85 miles per hour, the center said, and the strongest winds associated with the eye wall of the hurricane are expected to impact portions of the Florida Keys directly.

Forecasters say that if the storm follows its predicted course, it will strike west of New Orleans - somewhere in southwest Louisiana or along the Texas coast - as early as Friday evening. But even if it does miss New Orleans, its accompanying rainstorms, even if they amount to only a few inches, could cause significant flooding in a city where some neighborhoods have never dried out and the levees have not been fully repaired, officials said.

Rainfall levels could reach 8 inches in some of the string of islands or even up to 12 inches in parts of Cuba and the Florida Keys. The Keys and parts of Miami-Dade County in Florida were under a voluntary evacuation order.

The storm is expected to strengthen once it crosses into the Gulf of Mexico. Hurricanes draw strength from warm surface water, so it is not unusual for a relatively weak Atlantic storm to roar to life as it crosses the warmer Gulf, where water temperatures have been unusually high all summer, said Abby Sallenger of the United States Geological Survey. This happened just over three weeks ago, when Hurricane Katrina, then a Category 1 storm, cut through southern Florida and strengthened to a Category 5 in the gulf.

The Army Corps of Engineers said it was preparing for a second round of severe weather as Tropical Storm Rita approached the Gulf of Mexico, ordering additional sandbags and re-distributing pumps and other equipment to prepare for a possible emergency response.

When Rita approached the Florida Keys on Monday with sustained winds of about 70 miles an hour, emergency officials ordered partial evacuations as far north as Broward County, even though the mainland was not expected to bear the storm's brunt. About 40,000 residents of the lower Keys were ordered to evacuate, and the normally carefree spirit of Key West was strikingly subdued. "We went to bed Friday not worrying about this and woke up Sunday worrying about it," said Raymond Archer, the port director in Key West, on Monday. "This is fresh and real in people's minds."

Mayor Jimmy Weekley spent Monday urging even stubborn long-timers to leave, and thousands of cars chugged north on Route 1.

"I still have people coming up to me and saying they are staying," said Mr. Weekley. "I'm telling them to re-think their position."

Texas, which provided major sanctuary to victims of Hurricane Katrina, went on heightened alert Monday.

The island city of Galveston, which was all but obliterated 105 years ago in a hurricane that claimed up to 12,000 lives, activated its emergency management plan. Mayor Lyda Ann Thomas said that if the storm continued on its projected course, she would order a voluntary evacuation to begin at 2 p.m. today.

Those without cars will be offered space on 88 school buses to four Red Cross shelters in Huntsville, Tex. Nearly 1,200 members of the Texas National Guard have been recalled from relief operations in Louisiana for return to their home bases.

In Louisiana, Gov. Kathleen Babineaux Blanco said coastal residents in the southwest should prepare to evacuate now.

"Even if it doesn't strike the Louisiana coast directly, I want to remind our citizens that we are on the east side of the hurricane," Governor Blanco said. "We are still in a very dangerous place."

Mark Smith, spokesman for the Louisiana Office of Homeland Security and Emergency, said that if the hurricane shifted closer to New Orleans, devastating flooding could follow. "If there's another event, we're concerned the levees that are being repaired would fail," Mr. Smith said.

Timothy Williams reported from Baton Rouge, La., for this article and Cornelia Dean from New York. Reporting was contributed by Christine Hauser in New York; Tim O'Hara in Key West, Fla.; Abby Goodnough in Miami; Ralph Blumenthal in Houston; and John Schwartz in Baton Rouge.

Copyright 2005 The New York Times Company Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top

Lining Up to Be Raped?

Fred R. Conrad/The New YorK Times
Nicholas D. Kristof

September 20, 2005
Lining Up to Be Raped?
By NICHOLAS D. KRISTOF

Our close ally President Pervez Musharraf of Pakistan visited the U.S. last week and fretted aloud about a surprising problem: The "easiest way" for Pakistani women to make money is to get raped, he said, so they're lining up to be raped and thus making him look bad.

That's right. He's nuts.

"You must understand the environment in Pakistan," The Washington Post quoted him as saying. "This has become a moneymaking concern. A lot of people say if you want to go abroad and get a visa for Canada or citizenship and be a millionaire, get yourself raped."

That comment got Mr. Musharraf in hot water. So over the weekend, Mr. Musharraf denied that he had ever said any such thing - noting that if he had, he would have been "stupid."

True.

The Washington Post reviewed its tapes and reported that it had quoted him correctly. It also added an additional quote from the same interview, in which Mr. Musharraf spoke of rape as an avenue to riches: "It is the easiest way of doing it. Every second person now wants to."

Sexual violence has become a sensitive issue for Mr. Musharraf because of the pioneering work of women like Mukhtaran Bibi, whom a tribal council sentenced to be gang-raped as a way to punish her brother - and who then used her compensation money to start schools and launch a nationwide anti-rape campaign. After I wrote about her last year, Times readers sent her a total of $160,000, which she is using to start an ambulance service, operate schools and campaign for women's rights.

Fearing that Ms. Mukhtaran's anti-rape campaign would make his country look bad, General Musharraf barred her from traveling to the U.S. to attend a conference. When she protested to me and others, the government kidnapped her to keep her from complaining, releasing her only after Condi Rice raised the issue with the Pakistani government.

Then in July and August, I wrote about Dr. Shazia Khalid, a Pakistani physician whom the authorities drugged, put in a mental hospital, threatened to kill and finally exiled to keep her from recounting her rape.

The latest victim to come forward is Sonia Naz, a 23-year-old woman whose husband disappeared. Desperate, she went to the National Assembly building in Islamabad to see if she could get help. Then, she says, the police arrested her and repeatedly stripped her, raped her and beat her.

Embarrassed by these revelations, Mr. Musharraf held a conference in Pakistan this month on women's issues. He wore a necktie with blue and pink, which he said could reflect cooperation between men and women - and then he denounced Dr. Shazia.

Here in New York on Saturday, General Musharraf held a meeting with an invited audience to show himself off as a sensitive man. The meeting started awkwardly when he tried to demonstrate his feminist credentials by saying he opposed violence against women because it's unchivalrous toward the weaker sex. Then, in response to skeptical questions, Mr. Musharraf lost his temper, shouting at audience members and threatening to "get" anyone who exposed Pakistan's problems to the world.

"He totally lost it," said Yasmeen Hassan, a Pakistani lawyer in New York who was present. "It's so unbecoming of a president to get into shouting matches, and to say, 'I'm going to get you.' "

Meanwhile, activists in Pakistan say that the government is stepping up its harassment of women's groups. I tried to phone Ms. Mukhtaran yesterday, but the government seemed to be blocking international calls to her line. Finally I was able to interview her by a circuitous route. She said that all her mail is now intercepted and that the government had just transferred away two senior police officials who had supervised her bodyguards and tried to protect her.

"I feel insecure and controlled," she said.

The irony is that while he's a nitwit on social issues, General Musharraf has proved himself to be a good economic manager, and the 7 percent growth rates generated by his reforms will help undermine fundamentalism and sexual violence in the long run. During his visit, Mr. Musharraf pressed for a free-trade area between the U.S. and Pakistan, and that's a great idea to promote Pakistan's development.

So let's give Mr. Musharraf a free-trade deal - but only on the condition that he clamp down not on Pakistani women fighting against rape, but on Osama bin Laden.

****
For more information on Mukhtaran Bibi, Shazia Khalid and other rape victims from Pakistan, visit www.4anaa.org or www.equalitynow.org.

Copyright 2005 The New York Times Company Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top