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Health City Surgeons Return Toddler’s Heart To Chest Cavity

SINT MAARTEN/CAYMAN ISLANDS - Surgeons at Health City Cayman Islands have made history in the Caribbean after performing life-saving surgery on a child from Nicaragua who was born with his heart outside of his chest cavity.

Health City’s Chief Cardiac Surgeon Dr. Binoy Chattuparambil, also fondly known as Dr. Binoy, said the child, Jeremias, had Pentalogy of Cantrell, an extremely rare and life-threatening congenital disorder found in 5.5-7.9 per million live births. With only 200 reported worldwide, he confirmed that such cases are unheard of by many doctors.

“I have seen (this) only once before, when I was in India and I assisted (on) one case,” he said.

Restoring 10-month-old Jeremias’ heart to its rightful position in his chest cavity, however, was the first time Dr. Chattuparambil led a surgical team for the complex procedure, though he predicted it would be a success.

“This child’s heart was just beneath the skin,” Dr. Chattuparambil explained. “Any trauma…actually even if you press hard, that can kill the baby. So this is a very rare anomaly.” 

The surgical challenges for the six-hour operation were numerous. “We removed the outpouching of the heart and repositioned the heart into the normal location with space constraints and reconstruction of the defects of the pericardium, diaphragm, chest and abdominal wall,” he explained.

The procedure involved many specialists, including plastic surgeon Dr. Javier Mendoza, a pediatric cardiologist, anesthesiologists, intensive care team, physiotherapists and a radiologist, all who carefully charted a plan for Jeremias’ surgery and post-operative management.

Dr. Chandy Abraham, Director of Medical Services and CEO of Health City Cayman Islands, underscored the importance of having multiple medical specialists on staff. “I think one of the important things for an institution like Health City is that we have specialists who combine together to do complex work…so this patient was treated successfully by both the plastic surgeon and the cardiac surgeon and had a successful outcome.”

Dr. Chattuparambil’s initial prediction was accurate: The surgery and recovery were a textbook success.

 “His mother sent me a video last week of the child at home playing – he’s like any other normal child.” Post-operative echocardiograms have shown everything to be fine. “The child will have a normal life now.”

Jeremias’ mother, Marlen Adelina Lopez, had been anxious since her son was born, scared to let him play or even crawl. “I was very scared of him getting hurt. Now, I see everything very different. Now, he is a normal child…he will be able to play, to walk, to crawl, to run like any other child.”

Jeremias’ parents had special words of thanks to Health City and the charities involved in saving their son’s life – Nicaragua’s Bless Back Worldwide and Have a Heart Cayman Islands.

“It’s very hard to have a child in this condition, especially when you don’t have the means to pay for a surgery of this category. So, it’s very important to support these kind of foundations so other kids can get help,” Lopez said. “I cannot express my gratefulness.”

“Everyone here has been very special and very attentive,” said Jeremias’ father, Addylson Alberto Ruiz. “I don’t know what I would do if he wasn’t able to get the services he received at this facility.”

 Lisa Walker, Director of Bless Back Worldwide, who referred the child to Health City Cayman Islands, was effusive in her praise of the facility and its willingness to accept patients from the region. “From our first interaction with Health City, we were amazed at the kindness and professionalism of every staff member we interacted with. We are extremely grateful that your organization extends hope and health to those who do not have access to quality care in their home countries.” She further declared Health City as “a model for excellence in healthcare, (deserving of) a five star rating!”

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UN poised to open summit on world's oceans; outcome will 'call for action' on ocean health

INTERNATIONAL, 2 June 2017 – Warming oceans, depleting sea life and plastic pollution are on the agenda for next week's ocean summit at the United Nations, which will call for urgent action to improve the health of the oceans, while also creating jobs and raising people out of poverty.

“Human activities are having major impacts on the ocean, affecting everything from the viability of marine habitats to the quality and temperature of the water, the health of marine life, and the continued availability of seafood,” the UN organizers said about the event being held 5 to 9 June.

The Ocean Conference, the first ever such summit convened by the UN, will focus on the targets outlined in the 2030 Agenda for Sustainable Development, adopted by Governments in 2015. In particular among the Sustainable Development Goals (SDGs), Goal 14 highlights the need to conserve and sustainably use oceans, seas and marine resources to benefit present and future generations.

“Ocean deterioration has broader implications as it affects poverty eradication, economic growth, sustainable livelihoods and employment, global food security, human health and climate regulation,” the organizers said.

Thousands of people are expected to attend – including heads of State and Government, civil society representatives, business people, as well as actors, and ocean and marine life advocates.

Strong showing likely from Pacific Islands, African coastal States

A big showing is expected from small island developing States, particularly from the Pacific Islands, and from African coastal States, which are on the frontlines of climate change and whose economies are particularly vulnerable to changes in the oceans and marine life.

The current President of the UN General Assembly, Peter Thomson, said he is “very confident” that there is an appetite to take action to aid oceans and marine life.

Mr. Thomson, whose home country, Fiji, is co-hosting the Conference along with Sweden, said people had been “selfish” about their children's and grandchildren's future – but now are more cognizant of the need to sustainably use natural resources.

“Every second breathe you take comes from ocean-produced oxygen. Without a healthy ocean we're in deep trouble; whether it's food, whether it's our climate, we have to have the integrity for the ocean, the source of life,” Mr. Thomson told journalists yesterday in New York.

The main areas of work at The Ocean Conference will be a political call to action, a segment on partnership dialogues and voluntary commitments.

The Secretary-General of The Ocean Conference, Wu Hongbo, who is also the UN Under-Secretary-General for Economic and Social Affairs, said Member States have already hammered out the final text of the conference – which will include 22 specific actions to be taken.

He noted that climate change action taken by the international community is unstoppable, and needs global support: “If you drop a plastic bottle anywhere near your sea, it may end up in some other places. So all these seas and oceans are connected; so regional or individual action seems very weak. We need global solutions to the global challenge.”

NYC's Ocean March

On the eve of the Conference, New York City, which has about 520 miles of coastline, will host the inaugural World Ocean Festival.

New York's festival will feature a first-of-its kind grand “ocean march,” which will be a parade of sailing vessels around lower Manhattan and along 10 nautical miles of Manhattan and Brooklyn waterfront from the Hudson to the East River.

The second main event will be the Ocean Village, which will be set up at Gentry State Park in Long Island City as a “hub for all things ocean,” and will celebrate art, innovation and exhibits on ocean and climate action.

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Green economy is 'the economy of the future,' says UN chief, urging commitment to climate action

INTERNATIONAL, 2 June 2017 – Underscoring the threats posed by climate change – those already apparent, as well as those sure to impact the future of the planet – United Nations Secretary-General António Guterres today urged Governments worldwide to “stay the course” and remain committed to climate action.

“[Climate change] is undeniable,” Secretary-General Guterres told the media at a press encounter in the Russian city of St. Petersburg.

“Those that will be betting on the implementation of the Paris Agreement, on the green economy, will be the ones that have a leading role in the economy of the 21st century,” he said.

Referring to the United States, where President Donald Trump announced yesterday the country's withdrawal from the landmark climate accord, Mr. Guterres added: “In relation to US society, I am deeply convinced that States, cities, the business community, the civil society, will also remain engaged, will bet on the green economy, because the green economy is the good economy, it is the economy of the future.”

The Paris Agreement – agreed in December 2015 and entered into force in November a year later – aims to strengthen the global response to the threat of climate change, in the context of sustainable development and efforts to eradicate poverty.

Also today, UN High Commissioner for Human Rights, Zeid Ra'ad Al Hussein, voiced concern over the US withdrawal from the Agreement.

“The United States' withdrawal from the Paris Agreement is inconsistent with its obligations to those affected by climate change,” said the High Commissioner in a tweet.

Agreement cannot be renegotiated based on the request of a single Party – UNFCCC secretariat

Separately, the secretariat of the UN Framework Convention on Climate Change (UNFCCC) – the international environmental treaty under whose auspices the Paris Agreement was negotiated and agreed – expressed “regret” at the announcement that the US will withdraw from the accord.

In a statement yesterday, the UNFCCC secretariat said that it took note of the announced intention to renegotiate the modalities for the US participation in the Agreement and, in that regard, the secretariat stood ready to engage in dialogue with the US Government regarding the implications of the announcement.

However, it also pointed out that the Agreement – signed by 195 Parties and ratified by 146 countries plus the European Union – “cannot be renegotiated based on the request of a single Party.”

“It enjoys profound credibility, as it was forged by all nations and is supported by a growing wave of business, investors, cities, states, regions and citizens,” added the secretariat, noting that remains committed to continue working with all Governments and partners in their efforts to “fast forward” climate action at global and national levels.

Climate changing because of human activity – Intergovernmental Panel on Climate Change

Also today, the Intergovernmental Panel on Climate Change (IPCC) – the international body for assessing the science related to climate change, which provides a scientific basis for governments at all levels to develop climate related policies – underscored that scientific evidence behind climate change is clear.

“The climate is changing and it is changing because of human activity,” Jonathan Lynn, the head of Communications and Media Relations at IPCC, told journalists at a regular press briefing in Geneva.

“As the last IPCC report put it: 'Without additional mitigation efforts beyond those in place today, and even with adaptation, warming by the end of the 21st century will lead to very high risk of severe, widespread and irreversible impacts',” he added.

At the same briefing, Deon Terblanche, Director of Atmospheric Research and Environment Department at the World Meteorological Organization (WMO), said that while the agency had not run new models overnight, an assumption could be made that in the worst case scenario, temperatures could rise by an additional 0.3 degrees Celsius above the pre-industrial level by the end of the century.

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Thousands given free pass from integration exams after IND mistake

SINT MAARTEN/THE NETHERLANDS – Between 2,000 and 3,000 foreigners have been exempted from taking the Dutch integration exams – although they should have done them – thanks to mistakes at the IND immigration service, reports ANP.

The foreigners have temporary permits to stay and should have taken the Dutch inburgering exams in language and culture because of tighter rules around exemptions from 2015.

But Klaas Dijkhoff, junior security and justice minister, said on Thursday that the IND had failed to apply the more stringent requirements. Regrettably, he added, their residency status cannot now be changed.

Application forms and the IND website have, however, been updated while employees have received written instructions on the rules about who is legitimately exempt. But the PVV said the mess-up was effectively giving “gifts” to foreigners and questioned why it took two years to emerge.

The party called to withdraw these abnormal residency permits. The exams – much discussed in expat circles – involve Dutch proficiency tests, a grilling on the whys and wherefores of Dutch society and the labour market.

People who do not pass within three years can be fined and have their permit to stay rescinded. (DutchNews)

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Message of Prime Minister William Marlin on the start of the 2017 Atlantic Hurricane Season

POND ISLAND - Hurricanes are no fun. Believe me, I speak from personal experience and from having to go through one of the worst hurricanes this island has ever seen some 22 years ago.

On June 1, 1995, as the Atlantic Hurricane Season officially began, nobody could have predicted that St. Maarten would have been hit by a Category 4 monster called Luis.

No one could have stopped it either. And many of us were caught literally with our pants down. We were not prepared physically nor mentally to spend months without running water; without electricity, with schools closed, and supermarkets either looted or razed to the ground.

There was nothing romantic about eating dinner with candle light. There was nothing safe about using blue tarpaulins as roofs.

We have come a long way since those days of anguish and pain.

We have learnt some valuable lessons about hurricane preparedness, but we have, maybe because of the lull in recent years, begun to slip slowly back into complacency and inaction.

The fact that we have not been hit by a major storm in several years does not mean we should let our guards down.

And no matter what the hurricane experts may forecast, all it takes is one bad storm to hit us or any of our neighboring Caribbean islands for us to feel the devastating effects.

This is why our motto should be like that of the Boys Scouts: to be prepared at all times.

The time to start planning is not June 1st, when the hurricane season officially begins.  In fact, recent history has shown that since 2014, we have been having storm systems forming in the Atlantic prior to June 1st.

This year, for example, the first named storm, Arlene, formed in April! The time for planning, therefore, should be before June 1st.

We tend to think that we have all the time in the world to get ready. The 48-hours advance warning of an approaching hurricane is not enough to stock up, fix our roofs, clear our yards of debris, etc. which are all part of the normal preparedness exercise.

The fact is, if you have not yet begun preparing for the hurricane season, you need to start right now.

All the government agencies charged with disaster preparedness are getting in high gear to make sure that, God forbid, should we have to go through any storm during this season, everything will be in place to mitigate its effects as much as possible.

But like charity, good preparedness begins at home. It is time to check your hurricane preparedness plan, starting with the roof of your house and or business to your personal and family hurricane kit as well as your insurance papers.

While government will do everything it can to assist in the case of disaster, government cannot do it alone.

My advice therefore is that we should all be prepared as best as we can.

I would also like to urge you to pay keen attention to announcements from the Office of Disaster Management and other government agencies and follow their instructions whenever these are issued for your own safety and the safety of others.

The first priority is to avoid any loss of lives. Have a safe hurricane season.

May God spare us from all devastating storms and other natural disasters.

William V. Marlin,

Prime Minister and Minister of General Affairs.

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Act before time runs out, urges UNICEF, as Yemen grapples with ‘unprecedented’ cholera outbreak

INTERNATIONAL, 31 May 2017 – Amid an “unprecedented” increase in suspected cholera cases in war-torn Yemen – where medical facilities are teetering on the edge of collapse – the United Nations Children’s Fund (UNICEF) has stepped up its response but warned that time may be “running out.”

“More and more children die every day in Yemen from preventable causes like malnutrition and cholera,” said Geert Cappelaere, UNICEF Regional Director for the Middle East and North Africa, in a statement yesterday.

“Anyone with a heart for children cannot let the situation continue. Stop the conflict [now],” he urged.

According to the UN agency, more than 65,000 suspected cases of the deadly disease have been reported in the country, of which about 10,000 were reported in the past 72 hours alone.

Some 532 people, including 109 children have succumbed to the disease over the past month. The numbers are feared to rise as more cases are verified.

Responding to the outbreak, UNICEF has sent in three aircrafts carrying over 40 metric tonnes of lifesaving supplies including medicines, oral rehydration salts (ORS), diarrhoea disease kits and intravenous fluids to treat more than 50,000 patients.

It is also helping provide chlorinated drinking water, disinfect wells and set up water filling stations and storage.

But needs continue to increase, with medicines and other vital medical equipment in short supply, said UNICEF.

This latest crisis comes as the country has been reeling under the effects of a conflict, now into its third year, that has rendered water treatment plants barely functional and water sources severely contaminated by sewage and uncollected garbage.

Half of the country’s health facilities aren’t working, and medical staff haven’t been paid for over eight months.

“The situation in Yemen is teetering on the verge of disaster […] over 27 million Yemenis are staring at an unforgiving humanitarian catastrophe. The biggest victims of this man-made tragedy are Yemen’s most vulnerable population – its children,” underscored Meritxell Relaño UNICEF Representative in Yemen.

“The international community needs to support long-term investments in social services like water and sanitation. Otherwise, deadly disease outbreaks will strike again and kill many more.”

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Climate action 'a necessity and an opportunity,' says UN chief, urging world to rally behind Paris accord

INTERNATIONAL, 30 May 2017 – Highlighting the seriousness of the impact of climate change on the planet and its inhabitants, United Nations Secretary-General António Guterres today called for sustained action to meet the global challenge and to ensure a peaceful and sustainable future for all.

“The effects of climate change are dangerous and they are accelerating,” Secretary-General Guterres told a gathering of students, business leaders and academics at the New York University Stern School of Business.

“It is absolutely essential that the world implements the Paris Agreement [on climate change] – and that we fulfil that duty with increased ambition,” he underscored, recalling the ground breaking agreement that entered into force last November.

The Agreement calls on countries to combat climate change and to accelerate and intensify the actions and investments needed for a sustainable low carbon future, and to adapt to the increasing impacts of climate change.

It also aims to strengthen the ability of countries to deal with the impacts of climate change and calls for scaled up financial flows, a new technology framework and an enhanced capacity-building framework to support action by developing countries and the most vulnerable countries in line with their own national objectives.

Science 'is beyond doubt'

Underlining that science behind climate change “is beyond doubt,” Mr. Guterres said:

“As the Intergovernmental Panel on Climate Change put it: 'Human influence on the climate system is clear. The more we disrupt our climate, the more we risk severe, pervasive and irreversible impacts,'” he said, recalling that global temperatures have been rising, year after year, and that that last year was the hottest on record.

Furthermore, there are fears that the melt of sea ice and glaciers due to rising temperatures will have deep and far reaching impact: droughts and dry spells will last longer, while natural disasters like floods and hurricanes will be even more destructive.

Impacts of these catastrophic events, Mr. Guterres noted, would be felt in all corners of the world and in all sectors of the economy.

Informing of his intention to convene a dedicated climate summit in 2019 to reach the critical first review of implementation of the Paris Agreement, the UN chief called on all, including those who might hold divergent perspectives on climate change to engage with him on the way forward.

Green business is good business

He also pointed to the opportunities that climate action can provide, such as through the creation of jobs and increased economic growth. It is thus, not surprising, that many private corporations, including major oil and gas companies have adopted climate action.

“They know that green business is good business. It is not just the right thing to do, it is the smart thing to do,” he highlighted.

Five-point action plan

Laying out a five-point action plan to mobilize the world for climate action, the UN chief underscored that he will intensify political engagement with countries to increase efforts to limit temperature rise to well below 2 degree-Celsius and as close as possible to 1.5 degree-Celsius, the first point.

He also said that he would engage more with Governments and major actors, including the coal, oil and gas industries, to accelerate the global transition to sustainable energy, and committed stronger support by the entire UN development system to Governments as they strive to meet climate commitments and achieve the 2030 Agenda for Sustainable Development and the Sustainable Development Goals (SDGs), especially at the country level.

“That is where true change will be achieved,” he said.

The UN chief also said that he will work to with UN Member States mobilize national and international resources for adaptation, resilience, and the implementation of national climate action plans, and called for new and strengthened partnerships, including with the private sector and through North-South, South-South and triangular cooperation.

Further in his remarks, the Secretary-General cautioned that failure to act on combatting climate change would in turn harm the countries themselves for their inaction.

“Those who fail to bet on the green economy will be living in a grey future [but] those who embrace green technologies will set the gold standard for economic leadership in the twenty-first century.”

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DR Congo approves Ebola vaccine to counter outbreak; UN-trained volunteers to educate local populations

INTERNATIONAL, 30 May 2017 – To contain the latest outbreak of the Ebola virus in the Democratic Republic of Congo (DRC), the United Nations Children’s Fund (UNICEF) provided technical support to 145 volunteers of the Congolese Red Cross and community health workers to deliver lifesaving information to local populations in remote areas along the Central African Republic border.

“Working in close collaboration with health workers and communities was the best way to inform the public quickly about protection measures against Ebola, and to prevent propagation of the disease,” said Christophe Boulierac, UNICEF spokesperson, during a regular briefing in Geneva.

Under the coordination of national health authorities, and in collaboration with the World Health Organization (WHO), UNICEF trained on how to chlorinate water and disinfect homes to avoid the spread of the disease, as well as on the importance of hand washing and ways to adapt local burial practices to reduce contamination risks.

Encouraging people to visit their local health centre in case of illness during the epidemic, the DRC Government decided to make the health services available free of charge in the affected health zone of Likati.

In addition, a European Union-funded flight helped UNICEF send supplies and medicines to health facilities in the Likati area.

“It was a very hard-to-reach area and teams could only access it by motorcycle and on foot. This limited propagation of the disease, but also presented an additional challenge for bringing in medical supplies,” Mr. Boulierac elaborated.

“As of 29 May, there were 19 Ebola cases, out of which two were laboratory-confirmed, four were probable and 13 suspected,” said WHO spokesperson Christian Lindmeier. “Out of those 19 cases, there were four deaths, out of which only one was laboratory-confirmed and one was probable.”

He also stated that as of that same time, there were still 294 contacts under follow-up, and as many cases had already been dismissed, it was important to look into various other options.

“A number of diseases could be responsible, such as hepatitis B, hepatitis C, hepatitis E, yellow fever, shigella, typhoid, dengue, and salmonella. Individual cases in the different villages could have different pathogens,” he explained.

Asked about vaccination, Mr. Lindmeier said the protocol for the possible ring vaccination had been formally approved by the national regulatory authorities and the DRC Government with Médecins Sans Frontières (MSF) along with WHO support.

He added that other partners were working on detailed readiness planning for experimental vaccine use, to deploy as soon as possible, if needed.

The international vaccine deployment and cold chain shipment to DRC was not advised at this point, as there were only two confirmed Ebola cases and no new cases had been seen for a while now, he pointed out.

“There is no automatic trigger point for the ring vaccination, but the moment there would be a new case it would be looked at very carefully,” he said.

The authorities, MSF and WHO and partners were in constant contact on this.

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Three killed as car plunges into canal near Lelystad

SINT MAARTEN/THE NETHERLANDS – Three people have been killed in an accident on the A6 between Lelystad and Almere when a car plunged into a canal. All three people in the car were killed.

Police have not yet commented on the identity of the dead but have appealed for witnesses to come forward. Police were alerted to the incident around 9am when witnesses reported something was in the water.

It is unclear, as yet, how the accident happened. Two lanes of the A6 heading for Almere were closed while the investigation got underway.

In another fatal accident on Monday, a 37-year-old woman was killed when a lorry crashed into the cargo bike she was riding in the centre of Breda. Her daughter, thought to be aged about four, was unharmed, police said. (DutchNews)

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Edith Schippers hands over cabinet talks to new chief negotiator

SINT MAARTEN/THE NETHERLANDS – Efforts to form a new Dutch cabinet took a new turn on Monday when Edith Schippers, who has led the talks so far, said she wanted to hand the job over to a new negotiator.

Schippers, who said on Friday that a minority cabinet is looming, says Herman Tjeenk Willink, a Labour party stalwart and former chairman of the Council of State advisory panel should take over and lead the discussions from now on.

Tjeenk Willink (75) helped negotiate previous cabinets in 1994, 1999 and 2010. He is also a friend of the former queen Beatrix and one of her closest advisors. In her final report, handed over to parliament on Monday, Schippers said there were objections to every potential coalition and that this meant she had completed her task.

Tjeenk Willink, who has said he is willing to take on the job, must start by asking different combinations of parties to the negotiating table immediately, the former health minister said.

The results of the election have created a complicated situation, Schippers said. ‘The result demands a formation process which will take time. Parties have to take a step towards the others because there are wide differences in policy.’

Standpoints

However, Schippers refused to talk of deadlock. ‘Standpoints have been taken but they could change in the next phase,’ she said. The Netherlands has been without a government since March 15 when the general election was held.

Two attempts to form a new government have failed so far. The VVD emerged as the biggest party with 33 seats, followed by the anti-immigration PVV on 20, and CDA and D66 on 19.

The big parties have all ruled out working together with Geert Wilders’ PVV unless he takes back discriminatory comments about Moroccans. (DutchNews)

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