Our World — 10 April 2010

Art Chimes | Washington, DC
09 April 2010

This week on Our World: The amazing world of sand ... the threat of fake medicines ... and the high cost of health care in the U.S.

FREEMAN: "I thought that the American medical system was going to take away my life savings and essentially ruin any prospects I had for a pleasant retirement after the operation."

So he had heart surgery abroad and saved a fortune. Plus how climate change may have driven human evolution, great pictures on our Website of the Week, and more...

I'm Art Chimes. Welcome to VOA's science and technology magazine, "Our World."



Space Shuttle Launches as Program Nears End

The Space Shuttle Discovery blasted into orbit on Monday, carrying seven astronauts and tons of supplies to the International Space Station.

[[ web- put this line in italics ]] Three, two, one, zero. Booster ignition. And liftoff of Discovery, blazing a trail to scientific discoveries aboard Space Station.

Discovery's crew includes four men and three women, including Japanese astronaut Naoko Yamazaki. After docking in orbit, the combined shuttle-space station crew totals 13 people, including, for the first time, four women.

The shuttle's payload includes spare parts ... and equipment for science experiments.

After this mission, there are just three more shuttle flights on the schedule.

What happens after that is still up in the air (so to speak). The Obama administration has cancelled the follow-on Constellation program, which was to return astronauts to the moon. The Space Station will continue to fly for another decade, with astronauts getting there in Russian capsules or commercial spacecraft now being developed.




Counterfeit Drugs Post Growing Public Health Threat

When people get sick, medication is supposed to make them feel better. But that's not the case when the drugs they take are fake. Counterfeit drugs can be ineffective or even deadly, and they are a growing public health problem around the world. Naomi Seck reports.

SECK: More than 100 countries reported incidents of counterfeit drugs in 2008. And according to a prominent science journal, industry insiders say the number of fake drugs on the market is increasing by as much as 25 percent a year. Nature Medicine editor Roxanne Khamsi, who compiled a dozen articles for the journal's global look at the problem, says the results are heartbreaking.

KHAMSI: "In a country the size of Ghana, for example, with 20 million people, we would imagine about 4,000 children dying per year from counterfeit medications for malaria."

SECK: The numbers come from an informal estimate by a World Bank expert, published in the issue. Speaking via Skype, Khamsi says the problem is worst in developing countries. But she says it exists in the developed world as well, where people are turning to the Internet for their prescriptions. She says Internet pharmacies can be less expensive, but it can be harder to know what you are really getting.

KHAMSI: "There are instances we highlighted where people received a drug they'd ordered online in the developed world in the West where it contained rat poison and they died as a result."

TEXT: Khamsi says people around the world are fighting the problem in innovative ways.

In China, lab techs travel the country in specially equipped vans, testing drugs along the way.

In Ghana, a nonprofit organization asked consumers to text an eight-digit code on the medicine box to a free number. If the code — and medication — came from a legitimate source, the customer got a return text telling them so.

But Khamsi says the counterfeiters are just as innovative.

KHAMSI: "It's an arms race. As soon as you figure out a solution like that, then counterfeiters are going to come up with a way to get around it. Just a matter of time.

SECK: Lawmakers are also working to toughen laws against counterfeiters at various points in the supply chain. For instance, India is trying to encourage informants to come forward if they discover fake drugs on the market. And U.S. officials began drafting legislation that would require suppliers to report any problems in the supply chain. But Khamsi says enforcement can be complicated when even the definition of a fake drug is controversial.

KHAMSI: "Is it something that is a substandard drug, that just contains not enough active ingredient? Is it something that is purposefully fraudulent? Is it something that contains something poisonous? Or is it something that might be actually viewed as just a generic drug?"

SECK: Perhaps more worrying is the lack of international resources geared towards enforcement. Interpol, the international police force, created a special unit to fight pharmaceutical crime. They staffed it with two people.

The full review is published in Nature Medicine. I'm Naomi Seck.




Linking Human Evolution to Prehistoric Changes in Climate

A fossil discovered in a Siberian mountain cave could supply an important new clue to the origins of modern humans. Writing in the journal Nature, a team of German scientists says DNA evidence taken from a 40,000 year-old pinky finger suggests it belongs to a new subgroup of extinct humans. Meanwhile, a separate study just published by the U.S. National Research Council looks at how the evolution of these prehistoric human ancestors might have been influenced by changes in climate. VOA's Rosanne Skirble has more:


SKIRBLE: Rick Potts tackles the mysteries of human origins for a living. For over 25 years the paleo-anthropologist at the Smithsonian Institution in Washington has led expeditions to East Africa to explore how our early ancestors adapted to changes in landscape and climate.

POTTS: "You walk up a hillside of this eroded region of southern Kenya and you see layer after layer that indicates a huge lake was here, but then the lake is gone. Then there's a volcanic eruption that covered over all the grass. Animals had to move away. Then there's a river that came through that area. The lake is back and then there's a big drought, and so on and on, layer after layer; there are amazing chapters in this story of climate change."

SKIRBLE: Potts says prehistoric climate changes appear to have coincided with milestones in human evolution, such as the emergence of bipedalism — walking on two feet — the development of a larger brain and tool-making skills.

POTTS: "What we were able to investigate is how those tool makers, making stone hand-axes for hundreds of thousands of years, were able to adjust. But then the environmental changes got ramped up, and then the hand axes disappear and we see the technologies that are smaller. We have stone points that were attached to arrows that allowed our direct ancestors, right before the emergence of our own species, to hunt animals and do many more diverse things."

SKIRBLE: That link between climate and human evolution is the subject of the new National Research Council study. Andrew Hill is professor of anthropology at Yale University and part of the team of scientists who contributed to the report. He says efforts to better understand the link between climate and evolution — and to more clearly define those evolutionary adaptations — are limited by gaps in the fossil record.??

HILL: "Any time you find something, it's likely that there's some before that you haven't found yet. And so you're not really dating the origin of these things precisely. That gets better if you find more stuff."

SKIRBLE: Hill says the research team recommends a major new effort to locate additional sites. And he notes that remote sensing devices aboard satellites and unmanned aircraft can help to more precisely target where to excavate.

HILL: "And so you can look for sedimentary rocks as opposed to volcanic rocks, and different kinds of sedimentary rocks like lake beds where there might be something plausible."?

SKIRBLE: Hill says the NRC report also recommends more extensive drilling to extract sediment cores from dry land, lake beds, and ocean floors in regions where humans evolved.

HILL: "In doing that you are also finding more specimens of other kinds of animals and archeology."

SKIRBLE: And, Hill adds, computer-generated climate models using data on temperature, precipitation, and vegetation near human fossils can be a huge help not only in reconstructing past environments, but in understanding the science of climate change in our own era.

HILL: "A very concrete way in which it's useful is that when you are working out models for what will happen in the future, the only way you can really test it is by applying the models to the past where you know what really happened."

SKIRBLE: Over at the Museum of Natural History in Washington, Rick Potts is curator of a new exhibit on human origins. He is also a contributor to the NRC report, which he says recommends new education programs to build on already-strong public interest in the science of human origins.

POTTS: "The idea of being able to trace the emergence of our own species' resilience as the last remaining member of a diverse family tree, and how that evolutionary history interacts with the possibilities of the future, I think is extremely relevant, bringing together these two enormous areas of public curiosity, climate change, and human evolution."

SKIRBLE: Potts says fossil and climate records can bring us a little closer to answering two fundamental question: What does it mean to be human, and how will our resilient species adapt to a future of changing climate?

Rosanne Skirble, VOA News, Washington.





Website of the Week Features 1+ Million Great Photos and Other Images

Time again for our Website of the Week, when we showcase interesting and innovative online destinations.

This time, we crack open the vaults at the Library of Congress to unearth a treasure trove of photographs and other images, from Japanese woodblock prints to century-old color photographs of the Russian empire to pictures documenting 20th century America.

ZINKHAM:? "The Prints and Photographs Online Catalog is the primary access tool to learn about and explore the picture collections at the Library of Congress. There are descriptions for many millions of pictures and about one and a quarter million have the digitized image right with the catalog record."

Helena Zinkham is acting head of the prints and photographs division at the Library of Congress.

She says the vast collection is more accessible than ever at loc.gov/pictures, thanks to a redesign unveiled this week, with better tools for finding images, plus slide shows and up-to-date sharing tools.

The head of public reference services at the Library of Congress, Barbara Natanson, says the image collections get a lot of use from a broad range of online visitors.

NATANSON:? "A lot of documentary filmmakers. We have people who are publishing books. We have students themselves from every grade level. We have people who are doing family history or genealogy, who may be looking for the sites that are connected to their families, or even members of their families themselves."

And also curious users who just want to browse through more than a million images of art and the art that is real life at the Library of Congress Prints and Photographs Online Catalog, loc.gov/pictures, or get the link from our site, voanews.com.

MUSIC: Patrick Saussios & Alma Sinti — "Rythmes Gitans"

It's Our World, the weekly science and technology magazine from VOA News. I'm Art Chimes in Washington.





The Wonderful World of Sand. Yes, Sand.

We don't often think about some of the minerals and materials that contribute so much to our life.

But this week we do. And the material in question couldn't be more common. Sand. VOA's Adam Phillips reports.

PHILLIPS: Whether at the desert, on the beach, or piled up at a construction site, sand is one of the most visible and ubiquitous substances on earth. But what is sand, where does it come from, how is it formed, and how does it behave? Those are questions that prompted British geologist Michael Welland to write his book-length ode to the stuff: "Sand: the Never Ending Story."

WELLAND: "What I find wonderful about sand is that it seems such an apparently mundane everyday material, and yet the journeys an individual sand grain can take you on, both physically and imaginatively, I found extraordinary. Every single grain is unique."

PHILLIPS: Geologist and physicists long ago decided that what makes sand sand is the size of the individual granular bits, not what they are made of.

WELLAND: "And the reason for that is that that group of sizes of granular materials behave in their own unique way — in terms of the way they make piles of sand, the way they act — when they're flowing in the air or flowing in water — they behave very differently from everything that is smaller — that's silt and mud — and everything that is bigger — that's gravel and pebbles and cobbles and boulders."

PHILLIPS: Welland's abiding fascination with sand and his new book on the topic have just earned him the prestigious John Burroughs Medal for natural history writing. The award was presented this week at New York's Museum of Natural History. Welland notes that sand figures importantly in the beautiful old building's sparkling pink granite fa?ade.

WELLAND: "Well, part of what's sparkling are quartz grains. Now, in a few million years, the granite of the Natural History Museum, exposed to the elements of New York, will begin to rot and disintegrate. As the most frail minerals dissolve, the quartz, which is tough as old boots, will eventually just drop out as a sand grain."

PHILLIPS: Some of those quartz sand grains will be washed away by rainwater into nearby rivers where they will make their way down to the shoreline and the sea. In the desert, sand grains will usually be buffeted and shaped by the wind. Welland notes that, over the eons, each environment will produce a different form of sand grain.?

WELLAND: "Now if you happen to be in the desert and looked at your sand you will find that the grains are quite smooth and rounded. That's because under the force of the wind, these sand grains bang into each other and that force tends to literally knock the rough edges off a grain. If you go to the beach where those grains are being transported by water and therefore the water buffers the impact between grains, it takes a very long time, geologically, so we're talking millions and millions of years to knock the rough edges off."

PHILLIPS: In yet another kind of transformation, grains of coastal sand can get squeezed together by the weight of overlying sediment and become rock themselves -- sandstone.

WELLAND: "Those sand stones can then be churned up back up to the earth's surface and then those sandstones themselves will rot and so the sand grain starts off on a second life journey."

PHILLIPS: Sand grains tend to group together in families according to mineral type, density shape and weight. The relative proportion of these groupings in any one area of beach is unique, so sand can even be used as forensic evidence in criminal investigations.

Welland says sand has so many other uses, the modern world utterly depends on the stuff.

WELLAND: "We wouldn't have any glass. We wouldn't have any concrete. We would not have a cell phone that worked or a computer that worked — or it'd have to work in a completely different way. Much of the world's jewelry would disappear.

PHILLIPS: In his book "Sand: The Never Ending Story," Michael Welland says that sand's beauty and diversity are every bit as compelling as its science. He advises skeptics to bring a magnifying glass next time they go to the beach. Welland predicts that like the mystic British poet William Blake, you'll see a world in a grain of sand.

Adam Phillips, VOA News, New York.



US Medical Tourists Beat High Cost of Health Care

And finally today ... With passage of America's Health Care Reform Bill, more Americans will have access to affordable health insurance. But they have yet to see lower costs for medical treatment. So a small but growing number of Americans are going abroad for surgery or for other medical procedures. Jan Sluizer takes a look at the growing medical tourism industry.

SLUIZER: John Freeman took a gamble a few years ago. The 62-year-old retired computer analyst dropped his health care insurance because the high monthly premiums and a huge deductible were eating up his retirement savings. He hoped he would not need major medical care until he turned 65 and qualified for the government's Medicare insurance program.

But last year, he had a heart attack. He was told surgery in his home town of Reno, Nevada, would cost close to $120,000. Freeman felt he had two choices: use up all his savings or die.

FREEMAN: "I thought that the American medical system was going to take away my life savings and essentially ruin any prospects I had for a pleasant retirement after the operation."

SLUIZER: So he did what hundreds of thousands of Americans do each year — go abroad for surgery. After some research, Freeman decided to have his operation done at the Anadolu Medical Center in a suburb of Istanbul, Turkey. The price: just 15 percent of what it would have cost in Reno: $18,000, all-inclusive, except for airfare.

Acknowledging that Medical Tourism is a growing industry because of lower medical costs overseas, both the American Medical Association and the American College of Surgeons issued statements that encourage patients to seek out the treatment that best suits their needs. However, both organizations also warn patients to make sure they choose certified doctors and surgeons at health care institutions that have met high standards of accreditation.

John Freeman took that advice seriously when he researched Anadolu Medical Center.

FREEMAN: "When I first looked at the website, there's a logo that says 'Affiliated with Johns Hopkins University,' and I think that really helped my comfort zone, so to speak, for this, because I knew there was an affiliation with a well-known American hospital. I knew my doctor was in meetings with American doctors about things like heart surgery techniques."

SLUIZER: Americans began going abroad for cosmetic surgery such as facelifts, breast implants and reductions, and tummy tucks in the 1980s and '90s. Today, common medical procedures pursued overseas include cardiac surgery, knee and hip replacements, liver transplants, and dental work.

But medical tourism is not for everyone. Prospective patients must be fit for travel, the cost must make economic sense, the length of stay should be relatively short, and follow-up care must be predictable and fairly brief.

That is the challenge John Freeman faces — aftercare. Now that he's back home, his doctor wants him to take some expensive post-operation tests. But, still without insurance and feeling okay, Freeman says he doesn't want to spend the money.

That attitude concerns neurosurgeon and Harvard educator, Dr. Teo Forcht Dagi, who oversaw the writing of the statement on medical tourism for the American College of Surgeons. Dagi stresses that overseas medical treatment is not for routine or on-going health problems.

DAGI: "What you get may be cost, but what you give up may be the on-going relationship, the communication, the follow-up care, and things, traditionally, American patients have held very dear."

SLUIZER: Medical industry observers expect an exponential increase in medical travelers, as continuing costly health care at home drives more Americans to seek services overseas from the growing medical tourism industry.

For VOA News, I'm Jan Sluizer in San Francisco.



MUSIC: "Our World" theme

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