Belize Times March 30, 2014

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THE BELIZE TIMES

Joblessness forces young mother to work at a bar Belize City, March 26, 2014 30 year old mother of two, Nickolette Montes, is more qualified in the medical field than the current Minister of Health, but she has had to settle with working at a nightclub because no jobs are available.

Montes, a high school graduate, said she has applied to over a dozen workplaces for jobs, but they have turned her away either because there is none available or she is better qualified in the medical field.

Montes has worked at the Karl Heusner Memorial Hospital twice, but both times petty political victimization and pressure forced her out.

She now finds herself walking home through the dangerous streets every day in the wee hours of the morning after a day’s work at a Belize City nightclub.

“I am not proud of what I am doing…at my age and with my qualifications I should be settling down, I have two kids and a husband… I shouldn’t have to be drinking at a bar and making friends with strange men every night to survive,” she remarked.

Montes worked at the KHMH from September 2006 to September 2010. She said she worked dutifully in the dietary section up until when she heard strong rumors that the hospital higher-ups were considering firing her. She said that the new administration at the hospital had become hostile towards her, even though none of them complained about her work. She stated that then newly-appointed Chief Executive Officer Francis Gary Longsworth had even threatened to terminate her because she participated in the Carnival celebrations when she had been told not to. Montes said the rule was unfair because it seemed to only apply to her, as others were allowed to take part.

Fearful that once fired from the hospital her chances of ever regaining employment there would expire, she chose to resign.

Montes was fortunate to gain employment at the hospital cafeteria part time from January 6th to March 4th this year. Upon learning that the position was available full time, she submitted an application to fill the post permanently, but her application has evidently been ignored.

She was reliably told that when her superiors saw the names of the two persons who recommended her professionally for the job, they accused her of being a supporter of the People’s United Party and so they refused to give her the job.

The recommenders are two highly respected professionals.

One, a medical professional who

happened to have also been a PUP candidate in the last elections but who worked with her at the KHMH and vouched for her “professionalism and courtesy”, and the other, a Justice of the Peace and Inspector of Police who said that he considered her an educated person with a “humble and honest character that is not involved in any criminal or gang activities”.

Montes said that she feels that despite her proven work ability and experience, she has also not been given a fair chance for the job because one of KHMH’s Human Resource managers handpicked a fam-

ily member for the post.

Montes is disappointed and angry. She said she is neither a supporter of the PUP nor UDP. She said her family is known to be UDP, and her uncle was former UDP politician Samuel Rhaburn.

Montes is mother to a one year old baby girl and a 12 year old son, who tells her he feels ashamed that she works at a bar.

The situation has also strained her relationship with her common-law husband.

“How can I have a future for my kids when I can’t get a good job?” she asked.

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Montes also shared concerns that her interest in a nursing career may be sabotaged by the bad-minded few at the hospital since the course requires students to conduct internship at the KHMH, and it is the same individuals who will have to agree to accept her internship. She has applied to the University of Belize but fears that her efforts to pursue the career are not worthwhile.

Montes is among thousands of young Belizeans unable to find jobs. The latest statistics on joblessness indicate that almost 50% of Belizeans aged 15-30 were unemployed. The Barrow Administration’s Budget debated and passed on Tuesday had no job plan and was devoid of new investments in new industries that could create jobs.

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THE BELIZE TIMES

UDP insults the Judiciary!

Political crony Herbert Panton is new Senior Magistrate?

Belmopan City, March 28, 2014 Very disturbing news has reached the news desk of the BELIZE TIMES. We have learnt that the judicial system is in severe crisis.

The mother load of unconfirmed reports is that UDP extremist Herbert Panton will soon be appointed not any magistrate but a senior magistrate.

This is an unacceptable appointment for many reasons.

Least of which is that a magistrate must not only be impartial but also appear to be impartial.

Panton is associated with the most extreme and blind political follower. The public can remember that he has been the Editor of the vile UDP Newspaper and has hosted the UDP propaganda show Lik Road which spews the most scandalous of biased political talk.

He is known to prance in full red on all major parades in the UDP section of the parade even as a public servant. In full disrespect of the law that governs

public servants and for which many PUPs were fired by this UDP government.

Panton still holds political office within the UDP and their Party structure Panton’s reported appointment is a direct political insult and a rancid attack on the integrity of the judiciary. It comes at a time when the judiciary is being dismantled and compromised. A time when Judges are not getting security of tenure and long sitting magistrates such as Leslie Hamilton and Cathleen Lewis are being unceremoniously sent home.

Panton’s appointment is similar to other political appointments such as the wife of Speaker of the House. His wife who had never been a lawyer in Belize for a single day got a fat job as magistrate in charge of her own court in Independence Village. In fact, the UDP opened a court just for that appointment.

Two independent sources have confirmed to BELIZE TIMES that Panton will be sitting in Belmopan

Magistrates Court. This is sick. Belmopan is the home of the National of Assembly and with the recent protests against the Government, a dangerously obsessive UDP will be sitting as Magistrate to try the cases against the teachers or public servants protesting.

The big bomb is that the appointment of Panton will be in the same court which will be tried in the private prosecution of Elvin Penner. Panton, the UDP extremist, will be in charge of trying his fellow UDP friend, Elvin Penner.

This is in a case where Panton’s political party has done everything to cover up the illegal actions of Penner.

We made contact with the Bar Association who was emphatic that they knew nothing of the appointment and they complained that the posts of magistrates and judges were not being advertised nor were they being informed as to who are appointed so that they could make their input in protecting Belizeans.

We end with excerpts from

07 7 the last case no. 666 of 2010 where it took the Supreme Court to scold the UDP for their interference in the judiciary and the apparent bias that they were contaminating the legal system with: Justice Legal was particularly sharp in his words at paragraph 20 of his judgment where he opined: “An independent judiciary is a judiciary, in relation to its judicial functions, that is free from control of the executive power of the State.

Independence entails that a judge should be free from governmental and political pressure, likely to affect or perceived to affect the judge in the exercise of his judicial functions”.

The test which is applicable in law according to the judgment was whether a well informed observer “would … perceive …that the executive pressure was being put on the judge” and “to that observer, the judge may reasonably be perceived as not independent and impartial”.

Is this a joke?

Remember Barrow said he would start his own UDP Bar Association? Is he creating his own judiciary now?

What has Belize come to and what will the Bar Association do about this?

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THE BELIZE TIMES

2014

Presentation of the 2014/15 Budget for Fiscal Year by

Hon. Francis W. Fonseca Leader of the Opposition

March 24, 2014, Belmopan I rise to make my contribution to the debate on the General Revenue Appropriation Bill for Fiscal year 2014/15.

As always, I am grateful to the people of Freetown for giving me the great honor of representing them in this Honorable House.

I am equally honored and privileged to make my contribution as Leader of the People’s United Party, the Party that fearlessly fought for and won Independence for Belize giving us all our Belizean identity and making it possible for the 31 Members who serve in this Honorable House, to stand as Representatives of the Belizean people.

Those who now sit on the Government benches enjoying the fruits of the selfless, tireless labor of the People’s United Party, we are reminded, belong to a United Democratic Party that rejected Independence, rejected Nationhood, rejected our Belizean identity!!

No wonder then, that they have so cheapened and bastardized our Belizean Nationality with their rampant passport and visa hustling!!

Mr. Speaker, as our Party has done for the last few years, once again this year we held consultations with the Unions, the business community, the churches, student governments, and social organizations, to better inform our contributions to this debate.

Mr. Speaker, in 2014 consultation and dialogue with our social and economic partners is not optional, it is an absolute requirement for true, meaningful development!!

But “dialogue” and “consultation” are not words one associate with this U.D.P. Government.

This is a U.D.P. Government that is disconnected, out of touch and high on themselves. And the budget presented on March 7th by the Hon. Minister of Finance reflects that disconnect and arrogance.

In 2013 the U.D.P. gave us 0.7% economic growth, the worst economic performance in some 20 years; a 2013 in which production of all of Belize’s major crops fell significantly, a 2013 in which petroleum production fell by 23%, a 2013 in which the prices of food, healthcare and transportation all increased, a 2013 in which massive foreclosures of homes and businesses continued, a 2013 in which Foreign Direct Investment fell to its lowest levels in the last 15 years, a 2013 in which more and more Belizeans fell into poverty and lost hope in the future.

That is the Belizean U.D.P. reality today Mr. Speaker, and the 2014/15 Budget offers no change of course, no change in direction, no jobs plan, no investment strategy, no plan to reduce cost of living, no

tax reform, no sense of purpose or hope.

Like the Ringmaster at a cheap circus, the Minister of Finance smeared on the make-up and lipstick, sprayed himself from head to toe with some $5 Kush Kush, and for good order, even recited some Shakespeare but no amount of make-up can hide the ugly reality of the Belizean people and no amount of cheap cologne can cover up the smell of this rotten U.D.P.Government. The silence is deafening. No one is listening anymore!! The empty, flowery rhetoric is played out!!

The game is over master!! The Ringmaster is standing all alone on center stage under the big circus tent and his pants are on the ground!!

U try talk pretty Mr. Prime Minister but Belizean people reality ugly bad!!

Mr. Speaker, the Budget for Fiscal year 2014/15 is a “Noodles Budget”. More and more Belizean families forced unto a steady diet of Ramens – pick u flava!! Each flava got wan Minister Name. Shrimp da Barrow. Beef da Montero… Chicken da Boots.

More and more Belizean families crying out “Ends Nah a Meet Mr. P.M.” What World are you living in Sir? Dis da no Gucci, Rolex and TMZ Mr. P.M. Dis da haad time, pain and sorrow Belize in 2014 under the U.D.P.!!

U di say things di get better but the Belizean people from North to South, East to West di say loudly “We no di see it”!!

U di say money di run but the Belizean people di say “We no di feel it”!!

Mr. Speaker, the 2014/15 Budget offers no solutions to the serious economic challenges facing Belize.

With an increasing reliance on tax revenue, it further chokes the private sector out of the real economy.

It offers no measures to improve productivity and competitiveness It offers no policy strategy for lower cost production.

It offers no plan for expanding exports relative to imports.

Mr. Speaker, the P.M. boasts about reducing the Debt to G.D.P. Ratio but here again this is an empty, hollow boast. How can the Debt to G.DP. Ratio be true when it fails to take proper account of monies owed for B.T.L. and B.E.L., fails to account for over $168M in Petro Caribe payables, and fails to account for other contingent liabilities which in 2013 stood at some $100M. Added together this amounts to an additional 1/2Billion in Debt

which is not properly accounted for.

And on the issue of G.D.P. Mr. Speaker, what is more important than G.D.P is G.D.P. per Capita. When one combines a 2013 G.D.P. growth rate of 0.7% with 2.5% population growth, the end result is a Negative -1.8% G.D.P. per Capita growth!

But we should not be shocked that the budget presents us with so much fiction and fantasy, Mr. Speaker.

After all this is a Prime Minister who takes his Economics lessons from Dickens and Wilde, not Sen and Sachs.

So, Mr. Speaker, what does the 2014/15 Budget have to offer?

The P.M. boasts of infrastructure spending. Well after neglecting the country’s infrastructure for 5 years it’s about time you started spending some money.

The problem, Mr. Speaker, is that the infrastructure spending is both inequitable and bogged down by the hustling of a chosen few.

Hundreds of Millions in Belize City to protect U.D.P. Southside political seats while our rural communities and people in Toledo, Stann Creek, Cayo, Orange Walk, and Corozal get crumbs!!

This political madness must end!!

Mr. Speaker, this is a budget that celebrates poverty and dependency.

Once again the P.M. beats his chest and boasts about BOOST and Pantry!!

Well life haad and people need help but do not take pride Sir in the fact dat under your Government more and more people have to line-up da politician office fu get pan wan list fu get wan lee bag a groceries or help wit dem bills.

To keep people poor is a Social Injustice!

Where are the jobs so our people can live with pride and dignity!!

Mr. Speaker, there is pride in all work but no sing to wi bout bruk stone pan di street.

Our young graduates need jobs too. Single mothers need jobs. Many young professionals are looking for work. Where are their jobs? Di U.D.P. jobs plan da fu bruk stone…..

And the budget, Mr. Speaker speaks of the “Miracle” of the 5% salary adjustment for our teachers and public officers. Well this adjustment is long overdue and richly deserved by those who have been the subject of utter disrespect and demonization by this U.D.P. Government.

This is no increase, Mr. Speaker, the teachers and public officers are trying to catch up with real inflation.

It is the P.U.P. that gave our teachers and public officers their last true salary increase of 30% over the period 2003 to 2005. 10% each year.

Mr. Speaker, Economic data forms the basis for analysis of the health of a Continued on page 26

For Sale

By Order of the Scotiabank (Belize) Ltd., a company duly registered under the Companies Act, Chapter 250 of the Laws of Belize, Revised Edition, 2000, and having its registered office at Cor. Albert and Bishop Streets, Belize City, Belize, hereby gives notice of its intention to exercise its power of sale as Mortgagee under a Deed of Mortgage made the 18th day of March, 2011 between ADRIANNE SARAVIA of Hope Creek Village, Stann Creek District, Belize of the one part, and Scotiabank (Belize) Ltd., of the other part, and recorded at the Land Titles Unit in Deeds Book Vol. 7 of 2011 at Folios 1517 – 1542, the said Scotiabank (Belize) Ltd. will at the expiration of two months from the date of the first publication of this notice sell the property described in the schedule hereto.

All offers to purchase the said property must be made in writing and full particulars and conditions of sale may be obtained from the said Scotiabank (Belize) Ltd. SCHEDULE ALL THAT piece or parcel of land being Lot No. 109 comprising of 766.202 square metres situate in Hope Creek Village, Stann Creek District, bounded and described as shown by Plan No. 351 of 2010 attached to Minister’s Fiat Grant No. 351 of 2010 and also delineated on Plan No. 2080 Comp. No. 77 TOGETHER with all buildings and erections standing and being thereon.

DATED this 19th day of March, 2014.

MUSA & BALDERAMOS 91 North Front Street Belize City Attorney-at-Law for Scotiabank (Belize) Ltd.

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30 MAR

THE BELIZE TIMES PUP NOTICE Lake Independence Standard Bearer Convention

The People’s United Party Standard Bearer Convention for the Lake Independence Electoral Division is scheduled for Sunday, June 8, 2014.

Application are available from the Constituency Committee Chairperson or the PUP Secretariat, Independence Hall, #3 Queen Street, Belize City.

Completed applications must be filled and returned to the Chairperson and the Secretary General. The non-refundable fee is to be submitted to the Secretariat along with the necessary documentation to complete the application package.

Deadline for submission is Friday March 28, 2014.

PUP NOTICE

Municipal Elections – City of Belmopan The People’s United Party is inviting interested applicants for the upcoming City of Belmopan municipal elections to submit their applications. A Convention is slated for Sunday, June 29th, 2014.

Applications are available from the Constituency Committee Chairperson Mr. Paul Wade or the PUP Secretariat, Independence Hall, #3 Queen Street, Belize City.

Completed applications must be filled and returned to the Chairperson and the Secretary General. The non-refundable fee must be submitted to the Secretariat along with the necessary documentation to complete the application.

Deadline for submission is Tuesday April 15, 2014.

2014

PUP NOTICE Corozal Bay Standard Bearer Convention The People’s United Party Standard Bearer Convention for the Corozal Bay Electoral Division is scheduled for Sunday, March 30, 2014 from 8:00am to 5:00pm at St. Francis Xavier R.C. School.

PUP NOTICE Caribbean Shores Standard Bearer Convention The People’s United Party Standard Bearer Convention for the Caribbean Shores Electoral Division is scheduled for Sunday, June 1, 2014.

Application are available from the Constituency Committee Chairperson or the PUP Secretariat, Independence Hall, #3 Queen Street, Belize City.

Completed applications must be filled and returned to the Chairperson and the Secretary General. The non-refundable fee is to be submitted to the Secretariat along with the necessary documentation to complete the application package.

Deadline for submission is Friday March 28, 2014.

PUP NOTICE Belize Rural South Standard Bearer Convention The People’s United Party Standard Bearer Convention for the Belize Rural South Electoral Division is scheduled for Sunday, June 22, 2014.

Application are available from the Constituency Committee Chairperson or the PUP Secretariat, Independence Hall, #3 Queen Street, Belize City.

Completed applications must be filled and returned to the Chairperson and the Secretary General. The non-refundable fee is to be submitted to the Secretariat along with the necessary documentation to complete the application package.

Deadline for submission is Friday March 28, 2014.

PUP NOTICE

Orange Walk North Standard Bearer Convention The People’s United Party Standard Bearer Convention for the Orange Walk North Division is scheduled for June 15, 2014.

Application are available from the Constituency Committee Chairperson or the PUP Secretariat, Independence Hall, #3 Queen Street, Belize City.

Completed applications must be filled and returned to the Chairperson and the Secretary General. The non-refundable fee is to be submitted to the Secretariat along with the necessary documentation to complete the application package.

Deadline for submission is Tuesday April 15, 2014.

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THE BELIZE TIMES

Journeying Back to the Beginning

By Angela Banner-Joseph As we celebrate women’s moI started connecting with my Garifuna roots as a youngster and I made my first visit to the community of Hopkins when I was 3 years old. My father told me that during this visit, I was blessed by a shaman of the community. My Creole grandma, Cecilia Banner, continued my education in the Garifuna culture by traveling with me to Stann Creek—now Dangriga—during the summers to visit my Garifuna great grandmother, Pillara Rivas Avaloy, who lived on Pineapple Road in the center of town.

During these visits I began to learn about my African culture and to embrace the beauty of Garifuna living. I would get up early each morning to watch my great grandmother bake Creole bread or cassava bread on the fire hearth. I enjoyed the smell of the smoke from the fire hearth. Today, each time I travel home, the smell of a distant fire takes my memory back to the wonderful days in Stann Creek.

Another favorite love was the language. I loved the sound of how Great Grandmother communicated in the Garifuna language. I was intrigued by the sound. I did not understand a word, but I was in awe of it. Great Grandmother was always sad that my father never taught us the Garifuna language or Spanish. He had shunned his culture because of the stereotypical backlash of being Garifuna, so he raised us celebrating only our Creole ancestry.

The best part of my visits was listening to the drums and music of my ancestors. I loved the music and all cultural aspects of my heritage, for I am Garinagu. The drums were made from mahogany or mayflower hollowed-out hardwood cylinders, and sheepskins or peccary (wild bush pig) were stretched across the top. I made more visits to Stann Creek until I was 9 and then continued my education by learning all aspects of the culture in the large Garifuna community located in the Bronx, New York, where my grandmother and father lived.

My grandmother, Leonie Avaloy Joseph, or Cookie as she was called, was a member of the Garifuna community that included members from Belize, Guatemala, Honduras, and Nicaragua. She participated in traditional activities like Hunguhungu, a dance similar to the sacred dance of dugu, the Garifuna Feast for our Ancestors, and Chugu, a ritual that connects to our ancestral spirits. She introduced my sister and me to everything spiritual and connected us to our family’s roots.

When I was 21, I traveled to Stann Creek to reconnect with my great grandmother who lived on Pineapple Road. I thanked the Jenkins family, who hosted me for the night until I could find my great grandmother on a distant street that had lingered in my head since childhood. Many people would have called me Americanized, but I never forgot my Garifuna and Creole ancestry. The following morning, I journeyed back to the beginning. I stopped a few people in the streets to direct me to Pineapple Road. In my mind, I remembered a cozy bar at the corner. On the property were two structures, with the fire hearth in the rear of the house.

As I was traveling to find great grandmother Pillara, I had flashbacks of the food she used to prepare for us, like darasa (green banana tamales) bimecacule (sticky sweet rice), keki (johnny cake),

falumoun (sere lasus), ereba (cassava bread), suti (roast fish), hudutu (pounded green and ripe plantains, to name a few.

She would begin to make some of these dishes in her mortar. I could hear the sound of the pounding as her hand went up and down to grind the items. We would sip fresh juices out of calabash gourds while listening to the stories of my people. Food has always been a big part of our culture. If my memory is correct, most ancestral rites involved the offering of food to the spirits of our ancestors.

I remembered my trips to the local market to buy the food. We stopped at so many vendors to compare prices and to see who caught the best and freshest fish of the day. We would squeeze the fruits and laugh as she told everyone we were her grandchil-

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dren. She taught us how to say, “buiti binafi” (good morning) so we could greet her friends.

Today, I am glad that I preserved the Garifuna culture and language in my heart. I continue the tradition by telling my son, nieces, and nephew of the past. I keep the connection going by bringing them home to Belize and traveling to Dangriga to learn about the cultural traditions of our people; I tell them to not be ashamed about being Garinagu. I hope Great Grandmother Pillara and Grandmother Leonie are looking down from heaven with a smile on their faces that I remained connected to my roots and that I am proud to say I am Garifuna.

Dr. Angela Banner Joseph holds a doctorate degree in Educational Leadership and Change from the Fielding Graduate University

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THE BELIZE TIMES

The full PUP Social Justice Agenda is available at www.pup.org.bz

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Presentation of the 2014/15 Budget for Fiscal Year by

Hon. Francis W. Fonseca Leader of the Opposition

Continued from page 8 country’s economy.

Belize is on the operating table getting emergency surgery. Taiwan is providing oxygen and Venezuela is giving blood.

This budget continues a 6 year pattern of excuses and empty rhetoric.

After 6 years of U.D.P. stewardship, Belize is headed in the wrong direction and fast!!

Unemployment and underemployment continue to devastate our Belizean families wreaking particular destruction on the hopes and aspirations of our youth and women. More than 30,000 Belizeans actively seeking work can’t find a job.

Some 150,000 Belizeans are living on less than $5.50 per day for food under the U.D.P. Fuel costs remain at an all-time high putting a beating on our farmers, commuters, fishermen, taxi operators, tour operators and our businesses.

Mr. Speaker, the World Banks Ease of Doing Business Report for 2014 ranks Belize at 106 of 189 nations surveyed. This is down from 104 in 2013, so we are moving in the wrong direction.

And the same report ranks Belize at 167 of 189 for ease of starting a business.

The Belize economy bogged down in U.D.P. incompetence and corruption!

Remember the empty, cruel boasts of 5,000 new jobs, lower GST, lower cost of living, lower fuel rates, 6% annual growth!! What a sick joke!!

The Belizean economy and people are suffering Mr. Speaker, and no amount of chest beating, self-praise and bleating of pseudo – nationalism can change this harsh, sober reality!!

Six years of increasing U.D.P. arrogance, waste, incompetence and corruption!!

Mr. Speaker, the World Bank estimates that corruption in small developing economies accounts for a 1% to 2% loss in G.D.P. growth annually.

Here in Belize, corruption is eating away at the heart and soul of this U.D.P. Government. Everywhere you turn, everywhere you look there is corruption.

This is why, Mr. Speaker, as we seek to grow and reform the economy, so too, must we seek to reform

the way we are governed.

Governance Reform: 1. Let us enshrine in the Constitution a requirement for a Referendum on any proposed amendment which in any way undercuts or degrades the fundamental rights and freedom of the Belizean People.

2. Let us appoint the 13th Senator!

3. Let us review the structure, composition and powers of the Public Accounts Committee.

4. Let us review the structure, composition and powers of the Electoral and Boundaries Commission.

5. Let us pass a Freedom of the Press Law to guarantee Free Speech and protect whistle blowers who expose abuse and corruption.

6. Let us appoint an Independent Commission to review Immigration Policy and Laws.

7. Let us review the role and function of the Integrity Commission.

8. Let us work together to formulate and pass fair, reasonable Campaign Finance Laws.

9. Let us heed the cries of the Belizean people and put an end once and for all to the hustling and cronyism that have completely overtaken the Lands Department.

It is time for us to reject the politics based approach to governance embraced by this U.D.P. Government, and more toward the Solution based approach to development of the next P.U.P. Government which is sure to come whenever they dare to call the election.

The P.M. boasts loudly about his Party’s popularity with the Belizean people, but as we know only too well, those who boast loudly do so to hide their fear and uncertainty. If you bad Mr. P.M., call the Elections and you will feel the wrath of the Belizean people’s “quiet rage” in every corner of this beautiful country.

The People’s United Party is Ready!

The Belizean people are Ready!

Call the Elections and put an end to this U.D.P. Nightmare!!

Mr. Speaker, I thank the Belizean people for their support and encouragement and pray God’s Blessings on them, their families and our country!!

Answers for last week’s puzzle

Answers for last week’s puzzle

SUDOKU PUZZLE SOLUTION #58/2014

2014

BRAIN

TEASER

SUDOKU PUZZLE #59/2014

See answers NEXT WEEK

See answers NEXT WEEK

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THE BELIZE TIMES

2014

BELIZE TIMES WEEKLY

SCIENCE & TECH R

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Gunshot victims to be suspended

between life and death

Doctors will try to save the lives of 10 patients with knife or gunshot wounds by placing them in suspended animation, buying time to fix their injuries 26 March 2014 by Helen Thomson NEITHER dead or alive, knifewound or gunshot victims will be cooled down and placed in suspended animation later this month, as a groundbreaking emergency technique is tested out for the first time.

Surgeons are now on call at the UPMC Presbyterian Hospital in Pittsburgh, Pennsylvania, to perform the operation, which will buy doctors time to fix injuries that would otherwise be lethal.

“We are suspending life, but we don’t like to call it suspended animation because it sounds like science fiction,” says Samuel Tisherman, a surgeon at the hospital, who is leading the trial.

“So we call it emergency preservation and resuscitation.”

The technique involves replacing all of a patient’s blood with a cold saline solution, which rapidly cools the body and stops almost all cellular activity. “If a patient comes to us two hours after dying you can’t bring them back to life.

But if they’re dying and you suspend them, you have a chance to bring them back after their structural problems have been fixed,” says surgeon Peter Rhee at the University of Arizona in Tucson, who helped develop the technique.

The benefits of cooling, or induced hypothermia, have been known for decades. At normal body temperature – around 37 °C – cells need a regular oxygen supply to produce energy. When the heart stops beating, blood no longer carries oxygen to cells. Without oxygen the brain can only survive for about 5 minutes before the damage is irreversible.

However, at lower temperatures, cells need less oxygen because all chemical reactions slow down. This explains why people who fall into icy lakes can sometimes be revived more than half an hour after they have stopped breathing.

Just before heart and brain surgery, doctors sometimes lower body temperature using ice packs, and by circulating the blood through an external cooling system. This can give them up to 45 minutes in which to stop blood flow and perform surgery. However, the cooling process takes time and can

No heartbeat, no hope? (Image: A. Reinke/Plainpicture)

only be done with careful planning and preparation.

When someone reaches an emergency department with a traumatic gunshot injury or stab wound, slow cooling isn’t an option. Often their heart has stopped beating due to extreme blood loss, giving doctors only minutes to stop the bleeding and restart the heart. Even if the bleeding can be stopped, it’s not like filling up an empty gas tank. Resuscitation exposes the body to a sudden onslaught of oxygen, which can cause tissues to release chemicals that damage cells and cause fatal “reperfusion” injuries.

Finding ways to cool the body until it reaches a state of suspended animation – where people are not alive but not yet dead – could give doctors more time in an emergency.

The technique was first demonstrated in pigs in 2002 by Hasan Alam at the University of Michigan Hospital in Ann Arbor, and his colleagues. The animals were sedated and a massive haemorrhage induced, to mimic the effect of multiple gunshot wounds. Their blood was drained and replaced by either a cold potassium or saline solution, rapidly cooling the body to around 10 °C. After the injuries were treated, the animals were gradually warmed up as the solution was replaced with blood.

Vital signs The pig’s heart usually started beating again by itself, although some pigs

needed a jumpstart. There was no effect on physical or cognitive function.

“After we did those experiments, the definition of ‘dead’ changed,” says Rhee. “Every day at work I declare people dead.

They have no signs of life, no heartbeat, no brain activity. I sign a piece of paper knowing in my heart that they are not actually dead.

I could, right then and there, suspend them. But I have to put them in a body bag. It’s frustrating to know there’s a solution.”

That solution will be put to the test in humans for the first time. A final meeting this week will ensure that a team of doctors is fully prepared to try it. Then all they have to do is wait for the right patient to arrive.

That person will have suffered a cardiac arrest after a traumatic injury, and will not have responded to attempts to start their heart. When this happens, every member of Tisherman’s team will be paged. “The patient will probably have already lost about 50 per cent of their blood and their chest will be open,” he says.

The team sees one of these cases each month. Their chance of survival is less than 7 per cent.

The first step is to flush cold saline through the heart and up to the brain – the areas most vulnerable to low oxygen. To do this, the lower region of their heart must be clamped and a catheter placed into the aorta – the largest artery in the body – to carry the saline. The clamp is later removed so the saline can be artificially pumped around the whole body. It takes about 15 minutes for the patient’s temperature to drop to 10 °C. At this point they will have no blood in their body, no breathing, and no brain activity. They will be clinically dead.

In this state, almost no metabolic reactions happen in the body, so cells can survive without oxygen. Instead, they may be producing energy through what’s called

anaerobic glycolysis. At normal body temperatures this can sustain cells for about 2 minutes. At low temperatures, however, glycolysis rates are so low that cells can survive for hours. The patient will be disconnected from all machinery and taken to an operating room where surgeons have up to 2 hours to fix the injury. The saline is then replaced with blood. If the heart does not restart by itself, as it did in the pig trial, the patient is resuscitated. The new blood will heat the body slowly, which should help prevent any reperfusion injuries.

The technique will be tested on 10 people, and the outcome compared with another 10 who met the criteria but who weren’t treated this way because the team wasn’t on hand. The technique will be refined then tested on another 10, says Tisherman, until there are enough results to analyse.

“We’ve always assumed that you can’t bring back the dead. But it’s a matter of when you pickle the cells,” says Rhee.

Getting this technique into hospitals hasn’t been easy. Because the trial will happen during a medical emergency, neither the patient nor their family can give consent. The trial can only go ahead because the US Food and Drug Administration considers it to be exempt from informed consent. That’s because it will involve people whose injuries are likely to be fatal and there is no alternative treatment. The team had to have discussions with groups in the community and place adverts in newspapers describing the trial. People can opt out online. So far, nobody has.

Tisherman says he eventually hopes to extend the technique to other conditions.

For now, suspended animation is limited to a few hours. But that’s not to say that more lengthy suspension isn’t possible (see “Will human hibernation ever happen”).

“We’re trying to save lives, not pack people off to Mars,” says Tisherman. “Can we go longer than a few hours with no blood flow? I don’t know. Maybe years from now someone will have figured out how to do it, but it will certainly take time.”

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THE BELIZE TIMES

30 MAR

2014