Kenya hospital imprisons new mothers with no money


NAIROBI, Kenya (AP) — The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he's accused of: detaining mothers who can't pay their bills. Lazarus Omondi says it's the only way he can keep his medical center running.


Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn't let them leave after delivering their babies. The bills the mothers couldn't afford were $60 and $160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.


Now, a New York-based group has filed a lawsuit on the women's behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.


"We hold you and squeeze you until we get what we can get. We must be self-sufficient," Omondi said in an interview in his hospital office. "The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers."


"They stay there until they pay. They must pay," he said of the 350 mothers who give birth each week on average. "If you don't pay the hospital will collapse."


The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi's poorest with hardly anyone to stand up for them.


Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi's slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn't pay the $60 bill, and was held with what she believes was about 60 other women and their infants.


"We were sleeping three to a bed, sometimes four," she said. "They abuse you, they call you names," she said of the hospital staff.


She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor's 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family's 50-square-foot shack, where rent is $18 a month. She says she was released after 20 days after Nairobi's mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.


A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.


"I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me," said Anyoso, a vegetable seller and a single mother with five children who makes $5 on a good day.


Anyoso said she didn't have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.


One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.


Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.


___


Associated Press reporter Tom Odula contributed to this report.


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Epic Journey: Did Moses' Exodus Really Happen?













In the Bible, he is called Moses. In the Koran, he is the prophet Musa.


Religious scholars have long questioned whether of the story of a prophet leading God's chosen people in a great exodus out of Egypt and the freedom it brought them afterwards was real, but the similarities between a pharaoh's ancient hymn and a psalm of David might hold the link to his existence.


Tune in to Part 2 of Christiane Amanpour's ABC News special, "Back to the Beginning," which explores the history of the Bible from Genesis to Jesus, on Friday, Dec. 28 at 9 p.m. ET on ABC.


Christian scripture says Moses was content to grow old with his family in the vast deserted wilderness of Midian, and 40 years passed until the Bible says God spoke to him through the Burning Bush and told him to lead his people, the Israelites, out of Egypt. According to tradition, that miraculous bush can still be seen today enclosed within the ancient walls of St. Catherine's Monastery, located not far from Moses' hometown.


But there was another figure in the ancient world who gave up everything to answer the call from what he believed was the one and only true God.


Archaeologists discovered the remains of the ancient city of Amarna in the 1800s. Egyptologist Rawya Ismail, who has been studying the ruins for years, believes, as other archaeologists do, that Pharaoh Akhenaten built the city as a tribute to Aten, the sun.






G.Sioen/De Agostini/Getty Images











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She said it was a bold and unusual step for the pharaoh to leave the luxurious trappings of palace life in Luxor for the inhospitable landscape of Amarna, but it might have been his only choice as the priests from the existing religious establishment gained power.


"The very powerful Amun-Ra priests that he couldn't stand against gained control of the whole country," Ismail said. "The idea was to find a place that had never been used by any other gods -- to be virgin is what he called it -- so he chose this place."


All over the walls inside the city's beautiful tombs are examples of Akhanaten's radical message of monotheism. There is the Hymn to the Aten, which translates, in part, to: "The earth comes into being by your hand, as you made it. When you dawn, they live. When you set, they die. You yourself are lifetime, one lives by you."


PHOTOS: Christiane Amanpour's Journey 'Back to the Beginning'


Some attribute the writing of the hymn to Akhanaten himself, but it bears a striking resemblance to a passage that can be found in the Hebrew Bible: Psalm 104.


"If you compare the hymns from A to Z, you'll find mirror images to it in many of the holy books," Ismail said. "And if you compare certain parts of it, you'll find it almost exactly -- a typical translation for some of the [psalms] of David."


Psalm 104, written a few hundred years later, references a Lord that ruled over Israel and a passage compares him to the sun.


"You hide your face, they are troubled," part of it reads. "You take away your breath, they die, And return to dust. You send forth your breath, they are created, And you renew the face of the earth."


Like the psalm, the Hymn to Aten extols the virtues of the one true God.


"A lot of people think that [the Hymn to Aten] was the source of the [psalms] of David," Ismail said. "Putting Egypt on the trade route, a lot of people traveled from Egypt and came back to Egypt, it wasn't like a country living in isolation."


Ismail believes it is possible that the message from the heretic pharaoh has some connection to the story of Moses and the Exodus, as outlined in the Hebrew Bible.




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India gang rape victim dies in Singapore hospital


SINGAPORE/NEW DELHI (Reuters) - An Indian woman whose gang rape in New Delhi triggered violent protests died of her injuries on Saturday in a Singapore hospital, bringing a security lockdown in Delhi and recognition from India's prime minister that social change is needed.


The Indian capital braced for a new wave of protests, closing metro stations and banning vehicles from the city centre district where young activists had converged to demand improved women's rights. The news came in the early hours of the morning in India and there were no signs of protests as morning broke.


The 23-year-old medical student, severely beaten, raped and thrown out of a moving bus in New Delhi two weeks ago, had been flown to Singapore in a critical condition by the Indian government on Thursday for specialist treatment.


"We are very sad to report that the patient passed away peacefully at 4:45 a.m. on Dec 29, 2012 (2045 GMT Friday). Her family and officials from the High Commission (embassy) of India were by her side," Mount Elizabeth Hospital Chief Executive Officer Kelvin Loh said in a statement.


Indian Prime Minister Manmohan Singh said in a statement he was deeply saddened by the death and described the emotions associated with her case as "perfectly understandable reactions from a young India and an India that genuinely desires change.


"It would be a true homage to her memory if we are able to channelize these emotions and energies into a constructive course of action."


Delhi's Chief Minister, Sheila Dikshit, expressed revulsion.


"It is a shameful moment for me not just as a chief minister but also as a citizen of this country," she said.


The woman, who has not been identified, and a male friend were returning home from the cinema by bus on the evening of December 16 when, media reports say, six men on the bus beat them with metal rods and repeatedly raped the woman. The reports say a rod was used in the rape, causing internal injuries. Both were thrown from the bus. The male friend survived the attack.


Singh's government has been battling criticism that it was tone-deaf to the outcry that followed the attack and was heavy handed in its response to the protests in the Indian capital.


Most rapes and other sex crimes in India go unreported and offenders are rarely punished, women's rights activists say. But the brutality of the December 16 assault sparked public outrage and calls for better policing and harsher punishment for rapists.


VEHICLES BARRED FROM DELHI CITY CENTRE


T.C.A. Raghavan, the Indian High Commissioner to Singapore, told reporters hours after the woman's death that a chartered aircraft would fly her body back to India on Saturday, along with members of her family. The woman's body had earlier been loaded into a van at the hospital and driven away.


In New Delhi, the Joint Commissioner of Traffic Police, Satyendra Garg, told NDTV news channel that residents and commuters were advised to avoid the city centre.


The case has received blanket coverage on cable television news channels. Some Indian media have called the woman "Amanat", an Urdu word meaning "treasure".


Talking to reporters earlier on Saturday, Raghavan declined to comment on Indian media reports accusing the government of sending her to Singapore to minimize the possible backlash in the event of her death.


Some Indian medical experts had questioned the decision to airlift the woman to Singapore, calling it a risky maneuver given the seriousness of her injuries. They had said she was already receiving the best possible care in India.


But Dr B.D. Athani, medical superintendent of the New Delhi hospital where she had initially been treated, told Indian television the intention was to give the victim the best chance of surviving in what he described as "an extreme case".


"Her condition was very critical from day one. We had managed what best we could do at our end ... she had to be shifted to a centre with much better facilities."


On Friday, the Singapore hospital had said the woman's condition had taken a turn for the worse. It said she had suffered "significant brain injury". She had already undergone three abdominal operations before arriving in Singapore.


The suspects in the rape - five men aged between 20 and 40, and a juvenile - were arrested within hours of the attack and are in custody. Media reports say they are likely to be formally charged with murder next week.


Commentators and sociologists say the rape tapped into a deep well of frustration many Indians feel over what they see as weak governance and poor leadership on social and economic issues.


Many protesters have complained that Singh's government has done little to curb the abuse of women in the country of 1.2 billion. A global poll by the Thomson Reuters Foundation in June found that India was the worst place to be a woman because of high rates of infanticide, child marriage and slavery.


New Delhi has the highest number of sex crimes among India's major cities, with a rape reported on average every 18 hours, according to police figures. Government data show the number of reported rape cases in the country rose by nearly 17 percent between 2007 and 2011.


(Additional reporting by Ross Colvin and Devidutta Tripathy in New Delhi; Saeed Azhar, Edgar Su and Sanjeev Miglani in Singapore; Editing by Michael Roddy, Ron Popeski and Mark Bendeich)



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US probes HP's Autonomy fraud allegations






WASHINGTON: US authorities are probing allegations by Hewlett-Packard that a British software firm it bought out had fraudulent accounts, the US tech giant said in its annual report released on Thursday.

On November 20, HP reported a writedown of $8.8 billion, including more than $5 billion it attributed to inflated data from Autonomy, acquired by HP in 2011 for more than $10 billion.

The Californian firm demanded US and British authorities investigate Autonomy, saying "accounting improprieties" before the acquisition led to an "overvalued" acquisition price, which forced HP to take the huge writedown in value.

"On November 21, 2012, representatives of the US Department of Justice advised HP that they had opened an investigation relating to Autonomy," HP said, in its report filed with the US Securities and Exchange Commission.

HP said it had also provided information to the UK Serious Fraud Office and the US Securities and Exchange Commission "related to the accounting improprieties, disclosure failures and misrepresentations at Autonomy that occurred prior to and in connection with HP's acquisition of Autonomy."

"HP is cooperating with the three investigating agencies," it said.

HP's call for a probe came in November as it reported a $6.9 billion quarterly loss, of which $5.5 billion was linked to Autonomy and the rest to the slumping value of HP's own share price.

HP said at the time it had launched an internal investigation "after a senior member of Autonomy's leadership team came forward."

As a result, HP said it believed "that Autonomy was substantially overvalued at the time of its acquisition."

- AFP/al



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Varun Gandhi likely to contest Lok Sabha 2014 from Sultanpur

LUCKNOW: Pilibhit MP of the Bharatiya Janata Party Varun Gandhi might contest 2014 Lok Sabha election from Sultanpur-the constituency adjoining Amethi represented by his cousin Congress general secretary Rahul Gandhi. Congress' Sanjay Singh is the sitting MP from Sultanpur.

So far, two things have actually given credence to the speculation that Varun might contest from Sultanpur. A team of around 24 persons from the BJP has visited all five assembly segments falling in the constituency to mobilise youth in favour of Varun's candidature.

Also, there are posters of Varun everywhere that read, 'Naam wahi jo kaam karaye, Sultanpur ka samman badhaye'. During a rally in 2009, Varun had announced that he would, one day, turn Sultanpur into his 'karmabhoomi' (ground of action).

It seems BJP's plan for Uttar Pradesh would be full of surprises this time - from Varun shifting to Sultanpur to Rajnath switching over from his Ghaziabad constituency and Narendra Modi contesting from Lucknow.

Varun told TOI: "Sultanpur has been my father's political ground, so I don't have to start afresh. There is no need for any survey, as I understand the constituency well."

About the team propagating his candidature, Varun said they were locals. On whether he had decided to contest from Sultanpur, Varun said it would not be right to say anything on this count as election was still a year away.

In 1984, former prime minister Rajiv Gandhi and father of Rahul Gandhi was pitted against his sister-in-law and Varun's mother Maneka Gandhi in the election that took place after Indira Gandhi's death, Rajiv won by a huge margin defeating Maneka, who wanted to establish her claim to her late husband Sanjay's legacy.

In 1977, former prime minister Indira Gandhi's son Sanjay Gandhi had contested from Amethi, which was then part of Sultanpur district. Amethi is from where both Sanjay and Rajiv Gandhi started their political careers.

Sanjay's was a debut that didn't happen because of the Emergency. He lost to Ravindra Pratap Singh of the Janata Party by a few thousand votes. However, he bounced back in the '80 elections, defeating Singh this time.

After Sanjay's death, Indira persuaded Rajiv to help her and in June 1981, he entered politics formally getting elected to the Lok Sabha from Amethi. Since then, Amethi has been the battleground for major showdowns.

Yet another showdown, will it be?

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Kenya hospital imprisons new mothers with no money


NAIROBI, Kenya (AP) — The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he's accused of: detaining mothers who can't pay their bills. Lazarus Omondi says it's the only way he can keep his medical center running.


Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn't let them leave after delivering their babies. The bills the mothers couldn't afford were $60 and $160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.


Now, a New York-based group has filed a lawsuit on the women's behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.


"We hold you and squeeze you until we get what we can get. We must be self-sufficient," Omondi said in an interview in his hospital office. "The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers."


"They stay there until they pay. They must pay," he said of the 350 mothers who give birth each week on average. "If you don't pay the hospital will collapse."


The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi's poorest with hardly anyone to stand up for them.


Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi's slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn't pay the $60 bill, and was held with what she believes was about 60 other women and their infants.


"We were sleeping three to a bed, sometimes four," she said. "They abuse you, they call you names," she said of the hospital staff.


She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor's 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family's 50-square-foot shack, where rent is $18 a month. She says she was released after 20 days after Nairobi's mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.


A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.


"I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me," said Anyoso, a vegetable seller and a single mother with five children who makes $5 on a good day.


Anyoso said she didn't have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.


One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.


Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.


___


Associated Press reporter Tom Odula contributed to this report.


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Gen. 'Stormin' Norman Schwarzkopf Dead at 78













H. Norman Schwarzkopf, the retired general credited with leading U.S.-allied forces to a victory in the first Gulf War, died today at age 78.


The man who Defense Secretary Leon Panetta today called "one of the great military giants of the 20th century" died in Tampa, Fla., where he lived in retirement, the Associated Press reported.


"The men and women of the Department of Defense join me in mourning the loss of General Norman Schwarzkopf, whose 35 years of service in uniform left an indelible imprint on the United States military and on the country," Panetta said in a statement. "My thoughts and prayers are with the Schwarzkopf family in this time of sadness and grief."


Schwarzkopf, called "Stormin' Norman" because of his reportedly explosive temper, led America to two military victories: a small one in Grenada in the 1980s and a big one as de facto commander of allied forces in the Gulf War in 1991.


"'Stormin' Norman' led the coalition forces to victory, ejecting the Iraqi Army from Kuwait and restoring the rightful government," read a statement by former Secretary of State Colin Powell, who was chairman of the Joint Chiefs of Staff during the Gulf War. "His leadership not only inspired his troops, but also inspired the nation."


WATCH: Gen. Norman Schwarzkopf to Saddam Hussein: 'Get Outta Town'


Schwarzkopf's success during that fight, also known as Operation Desert Storm, came under President George H.W. Bush, who through his office today mourned "the loss of a true American patriot and one of the great military leaders of his generation."








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"Gen. Norm Schwarzkopf, to me, epitomized the 'duty, service, country' creed that has defended our freedom and seen this great nation through our most trying international crises," Bush said. "More than that, he was a good and decent man -- and a dear friend."


Bush's office released the statement though the former president, himself, was ill, hospitalized in Texas with a stubborn fever and on a liquids-only diet.


The current White House occupant, President Obama, also memorialized Schwarzkopf, declaring him "an American original" who "stood tall for the country and Army he loved."


The future four-star general was born Aug. 24, 1934, in Trenton, N.J.


Schwarzkopf's father, who shared his name, directed the investigation of the Lindbergh baby kidnapping as head of the New Jersey State Police, later becoming a brigadier general in the U.S. Army.


Schwarzkopf was raised as an army brat in Iran, Switzerland, Germany and Italy, following in his father's footsteps to West Point, earning an engineering degree and being commissioned as a second lieutenant in 1956.


WATCH: Gen. Schwarzkopf's '5 Minutes of Unimportant Questions'


He earned three Silver Stars for bravery during two tours in Vietnam, gaining a reputation as an opinionated, plain-spoken commander with a sharp temper who would risk his own life for his soldiers.


"He had volunteered to go to Vietnam early just so he could get there before the war ended," said former Army Col. William McKinney, who knew Schwarzkopf from their days at West Point, according to ABC News Radio.


In 1983, as a newly-minted general, Schwarzkopf once again led troops into battle in President Reagan's invasion of Granada, a tiny Caribbean island where the White House saw American influence threatened by a Cuban-backed coup.


But he gained most of his fame in Iraq, where he used his 6-foot-3, 240-pound frame and fearsome temper to drive his forces to victory.


"He was known as a soldier's general," said retired Maj. Gen. Donald Shepperd, as he explained the "Stormin' Norman" nickname to ABC News Radio. "In other words, he really liked the troops and was soft on the troops. But boy, on his general officers, his officers, his NCO's, he was very, very tough and he had a real quick temper."


PHOTOS: In Memoriam: People We Lost in 2012


Gruff and direct, Schwarzkopf said during the Gulf War that his goal was to win the war as quickly as possible and with a focused objective: getting Iraq out of Kuwait.






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North Korea's China trade nearly triples in 4 years






SEOUL: North Korea's trade with China has nearly tripled since 2007, according to data published by South Korea, underlining the isolated state's deepening dependence on its only major ally.

Bilateral trade jumped from $1.97 billion in 2007 to $5.6 billion last year, Statistics Korea said, with North Korean exports accounting for $2.44 billion against imports from China of $3.16 billion.

Statistics Korea releases the annual data based on figures from trade and economic organisations at home and abroad. The North does not report economic data.

Trade with China as of last year accounted for 70.1 percent of the North's entire trade of $8.0 billion, up from 41.7 percent in 2007.

During the same period, trade with South Korea -- the North's second-biggest partner -- fell from $1.79 billion to $1.71 billion.

Cross-border relations have been on ice since outgoing President Lee Myung-Bak, known for his hawkish stance towards the communist North, took office in 2008.

Lee suspended humanitarian aid to the North in 2010 and tied any resumption to progress on resolving the issue of Pyongyang's nuclear programme.

Inter-Korea commerce, which accounted for 38 percent of the North's total trade in 2007, was down to 21 percent last year.

Apparently fearful of the consequences of North Korea collapsing, China has pumped in fuel and aid to its neighbour for years.

The nuclear-armed North is subject to international sanctions imposed after its nuclear tests in 2006 and 2009, and those may be tightened or expanded following its successful long-range rocket launch earlier this month.

Pyongyang said the launch was a purely scientific mission, but most of the world condemned it as a disguised ballistic missile test that violated existing UN resolutions.

- AFP/al



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Gulvez thought NCC would help him become a cop

NEW DELHI: By the time Gulvez Ahmad reached the final year of his B Com Honours course, he had changed his mind. He had joined the NCC in school thinking it would boost his chances in a career in policing . But when his father, Kafeel Ahmad, saw him off on December 21, he was looking forward finishing college and joining an MBA programme . Ahmad was one of the five students from the Delhi unit of the National Cadet Corps who drowned in the Periyar at Kochi on Wednesday . The others are Dilshad Alam, Tabish Baqri, Mohammad Zeeshan and Hemanth Kumar.

"He was called Hafiz," says Ahmad's uncle, Faheemuddin, "It means one who has learnt the Quran by heart. He was austere like a maulavi" But Ahmad, a student of Shaheed Bhagat Singh College , was a sharp one as well. Neighbours say he brought home awards and shields, was the "brightest of them all" and was expected to shine more. The news reached his home in Old Govindpura before his father, an embroiderer , did. "He was so young. I even accompanied to the railway station the day he left," says an inconsolable Kafeel Ahmad. Of the 96 cadets attending the trekking camp in Kochi, 53 were from Delhi.

"We've been trying to talk to him on the phone since morning but somebody would disconnect. In the evening, his mobile was switched off," says Dilshad Alam's mother. Dilshad's family was told that two of the five kids had slipped into the river and the other three had been trying to rescue them. "Dilshad could not swim," says his sister Ayesha Jabeen. He, along with Tabish and Zeeshan were engineering students at Jamia Millia Islamia University . Tabish and Zeeshan, were from Uttar Pradesh; Dilshad's family, is based close to the university , in Zakir Nagar. Alam's mother always checked on him when he went out on trips and this was his first one out of the state with the NCC. His father, Khursheed Alam, doesn't hold a steady job and is away most of the time. There was a lot riding on Dilshad's engineering degree.

Baqri came to Delhi from Amroha in Uttar Pradesh three years ago. His younger brother Danish - Baqri was one of six siblings - is concerned about the arrival of his body. "He called us four to five days ago to tell us he is leaving for the trip. My parents are devastated . They have fallen silent," says Danish. They heard of the tragedy on Wednesday evening. Mohammad Zeeshan, another engineering student at Jamia, was from Uttar Pradesh too. The only school student among the casualties was Hemanth Kumar, a student of Government Boys Senior Secondary School at GBlock , Kalkaji.

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Predicting who's at risk for violence isn't easy


CHICAGO (AP) — It happened after Columbine, Virginia Tech, Aurora, Colo., and now Sandy Hook: People figure there surely were signs of impending violence. But experts say predicting who will be the next mass shooter is virtually impossible — partly because as commonplace as these calamities seem, they are relatively rare crimes.


Still, a combination of risk factors in troubled kids or adults including drug use and easy access to guns can increase the likelihood of violence, experts say.


But warning signs "only become crystal clear in the aftermath, said James Alan Fox, a Northeastern University criminology professor who has studied and written about mass killings.


"They're yellow flags. They only become red flags once the blood is spilled," he said.


Whether 20-year-old Adam Lanza, who used his mother's guns to kill her and then 20 children and six adults at their Connecticut school, made any hints about his plans isn't publicly known.


Fox said that sometimes, in the days, weeks or months preceding their crimes, mass murderers voice threats, or hints, either verbally or in writing, things like "'don't come to school tomorrow,'" or "'they're going to be sorry for mistreating me.'" Some prepare by target practicing, and plan their clothing "as well as their arsenal." (Police said Lanza went to shooting ranges with his mother in the past but not in the last six months.)


Although words might indicate a grudge, they don't necessarily mean violence will follow. And, of course, most who threaten never act, Fox said.


Even so, experts say threats of violence from troubled teens and young adults should be taken seriously and parents should attempt to get them a mental health evaluation and treatment if needed.


"In general, the police are unlikely to be able to do anything unless and until a crime has been committed," said Dr. Paul Appelbaum, a Columbia University professor of psychiatry, medicine and law. "Calling the police to confront a troubled teen has often led to tragedy."


The American Academy of Child & Adolescent Psychiatry says violent behavior should not be dismissed as "just a phase they're going through."


In a guidelines for families, the academy lists several risk factors for violence, including:


—Previous violent or aggressive behavior


—Being a victim of physical or sexual abuse


—Guns in the home


—Use of drugs or alcohol


—Brain damage from a head injury


Those with several of these risk factors should be evaluated by a mental health expert if they also show certain behaviors, including intense anger, frequent temper outbursts, extreme irritability or impulsiveness, the academy says. They may be more likely than others to become violent, although that doesn't mean they're at risk for the kind of violence that happened in Newtown, Conn.


Lanza, the Connecticut shooter, was socially withdrawn and awkward, and has been said to have had Asperger's disorder, a mild form of autism that has no clear connection with violence.


Autism experts and advocacy groups have complained that Asperger's is being unfairly blamed for the shootings, and say people with the disorder are much more likely to be victims of bullying and violence by others.


According to a research review published this year in Annals of General Psychiatry, most people with Asperger's who commit violent crimes have serious, often undiagnosed mental problems. That includes bipolar disorder, depression and personality disorders. It's not publicly known if Lanza had any of these, which in severe cases can include delusions and other psychotic symptoms.


Young adulthood is when psychotic illnesses typically emerge, and Appelbaum said there are several signs that a troubled teen or young adult might be heading in that direction: isolating themselves from friends and peers, spending long periods alone in their rooms, plummeting grades if they're still in school and expressing disturbing thoughts or fears that others are trying to hurt them.


Appelbaum said the most agonizing calls he gets are from parents whose children are descending into severe mental illness but who deny they are sick and refuse to go for treatment.


And in the case of adults, forcing them into treatment is difficult and dependent on laws that vary by state.


All states have laws that allow some form of court-ordered treatment, typically in a hospital for people considered a danger to themselves or others. Connecticut is among a handful with no option for court-ordered treatment in a less restrictive community setting, said Kristina Ragosta, an attorney with the Treatment Advocacy Center, a national group that advocates better access to mental health treatment.


Lanza's medical records haven't been publicly disclosed and authorities haven't said if it is known what type of treatment his family may have sought for him. Lanza killed himself at the school.


Jennifer Hoff of Mission Viejo, Calif. has a 19-year-old bipolar son who has had hallucinations, delusions and violent behavior for years. When he was younger and threatened to harm himself, she'd call 911 and leave the door unlocked for paramedics, who'd take him to a hospital for inpatient mental care.


Now that he's an adult, she said he has refused medication, left home, and authorities have indicated he can't be forced into treatment unless he harms himself — or commits a violent crime and is imprisoned. Hoff thinks prison is where he's headed — he's in jail, charged in an unarmed bank robbery.


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Online:


American Academy of Child & Adolescent Psychiatry: http://www.aacap.org


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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner


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