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	Protecting health-care workers in the firing line by Priya Shetty The Lancet & agencies   Dec 2013   Several medical associations and non-governmental organisations have launched an initiative to tackle violence against aid workers in conflict zones. Priya Shetty reports.   “In Syria, having a medical kit visible on your car seat can be more dangerous than having a Kalashnikov”, says Bruce Eshaya-Chauvin, medical adviser to the International Committee of the Red Cross (ICRC). “Health-care workers in conflict zones are literally being hunted down.”   Eshaya-Chauvin was talking at an ICRC conference about violence against health-care workers in London, UK, on Dec 3. The ICRC, along with key players in global health such as the World Medical Association (WMA), the British Medical Association (BMA), and Médecins Sans Frontières (MSF), is spearheading a project called Healthcare in Danger to raise awareness of the way that medical workers in war zones are targeted.   The Geneva Conventions and human rights laws to protect sick people during conflict state that all wounded and sick must have access to medical assistance, but this international framework is frequently flouted. For many in the humanitarian community, this situation is reaching a crisis point that requires urgent action both internationally and on the ground.   A 2011 report by the ICRC recorded violent acts in 16 countries and gives some insight into the perpetrators and the victims, and shows how indiscriminate this violence is. The state was responsible for a third of the events, and armed groups for another third. A point worth highlighting, says Eshaya-Chauvin, is that attacks are not just aimed at international humanitarian workers—in many situations, local medical staff bear the brunt of the attacks. Indeed, international non-governmental organisations (NGOs) were affected in 34·5% of attacks, and local health-care workers in 25·6%.   The violence is often brutal. Health-care workers might be beaten severely, kidnapped and tortured, or shot at by snipers. Those seeking health care might be killed on their way to hospitals, and those hospitals themselves might be the target of gunfire and bombing. Armed forces on either side of the conflict regularly block ambulances or destroy medical supplies.   Providing health care in conflict zones is obviously inherently dangerous, but sometimes the level of violence aimed at health-care workers—irrespective of how neutral they are—means that providing humanitarian aid can become untenable. This August, for instance, MSF was forced to pull out of Somalia after 22 years because the extreme security situation meant that the NGO could no longer ensure the safety of their staff. By the time MSF left the country, 16 of its workers had been killed since 1991, and several staff had been attacked.   Whether or not violence against health-care workers is on the rise is debatable. For one thing, data are fairly scarce. A seeming rise in violent attacks could also be due to increased levels of reporting. What is certain is that violence against humanitarian workers in war zones isn"t new, says David Nott, a consultant general surgeon at Chelsea and Westminster hospital in London who has provided emergency care in conflict zones for the past 20 years. The first time he was shot at, in an ambulance in Bosnia in 1993, he “was very shocked. I never knew things like that could happen. It was an eye-opener.”   Then in Darfur, the ambulance he was in was stopped by children wielding AK-47s. “They were very young—about 9 years old—and it would have been impossible to explain to them who we were. They"ve never seen people like us—they think you"re from Mars.” Negotiation being impossible, the doctors got through by stepping on the accelerator and driving as fast as they could.   These anecdotal reports have been crucial in raising awareness, but a key focus now is on gathering comprehensive data. “I know doctors always say they want more data, but in this case it is vital”, says Vivienne Nathanson from the BMA.   Obtaining data during conflicts is problematic at the best of times, but gleaning information about attacks on health-care workers must be done with extreme care because spreading misinformation is a key political tactic. Ensuring data validity, therefore, will be crucial. The ICRC, for example, tries to corroborate any reports with at least one other source. Bruno Jochum, director of MSF Switzerland, told The Lancet that they are starting to document incidents too, relying only on MSF workers for information. So what is behind this violence? Clearly, a key motivation in conflict is to destabilise the opposition. “Medicine is a social service. In war tactics, depriving social services to a population is a military strategy”, says Jochum.   But Eshaya-Chauvin is also convinced that “health care is not as sacred as it once was; people don"t have the same respect for health-care workers or institutions as they once did”. What"s more, this is not just true of conflict-ridden regions, he says, but in countries in Europe and in the USA too, he says. For instance, NHS Protect, which is charged with safeguarding UK public sector health workers, says that physical assaults against health-care workers in the UK have risen from 59 744 in 2011—12 to 63 199 in 2012—13, a rise of 5·8%.   “In Syria, for example, providing medical care to wounded fighters is seen as a partisan act, which attackers use to justify violence against doctors or facilities”, says Jochum.   Another factor that can muddy the perceived neutrality of health care is the increasingly blurred lines between aid workers and the military, in which either the military travel in ambulances or humanitarian workers travel with armed convoys, which inevitably compromises neutrality, says Andre Heller Perache, head of programmes at MSF.   Neutrality is not the privilege of a major international charity, says Perache. “It"s not a function of the size of an NGO as to whether they can stay neutral. When they do accompany armed convoys, it"s often to negotiate themselves safe access”, he says, which can be a dangerous choice.   The medical community does not have an easy task ahead. When soldiers abandon all ethics and think nothing of shooting pregnant women in the stomach, as in recent horrific attacks in Syria, creating a medical safe zone can seem impossible. But health workers in the field have long devised strategies to evade violence, says Donatella Rovera, a senior crisis response investigator for Amnesty International.   In Aleppo, Syria, when field hospitals were being bombed, health workers travelled with medical kits in backpacks. “They would hover around demonstrations. When someone was injured, they would quickly take them away and treat them in residential apartments that would act as hospitals just for an hour or two to avoid detection.” Rovera then noticed armed forces, so intent on discovering these locations, “following the trail of blood up the stairs, to break into every apartment”. This persecution is “extremely common in conflicts”, she says.   Such experiences can be disillusioning, but emergency workers like Nott are clear that “something urgently needs to be done. Enough is enough.” Awareness-raising efforts such as the ICRC"s help by encouraging the humanitarian community to collectively devise strategies to reduce violence.   Training first-responder volunteers in road safety, ethics, and communication and negotiation skills could greatly enhance their safety, according to a 2013 report by the ICRC on violence against ambulances.   In the workshops that the ICRC has run since 2011, a resounding recommendation has been to remind countries why international frameworks to protect humanitarian workers in war zones are in place. When this is forgotten, says Jochum, health care is neglected. “In conflict negotiations, there is very little emphasis on making space for medical work—for instance to evacuate wounded, and having safe areas and ceasefires.” This is why it is vital to have “a good understanding of this issue at the government level”, says Eshaya-Chauvin. “They need to know what is at stake, why medical coordination is important, why ambulances are important, why ensuring neutrality of health-care workers is critical.”   Nathanson agrees: “We are trying to change a lot of political thinking. The problem is that governments in many countries have stopped thinking that health is sufficiently important.”   This international pressure will need to be bolstered by context-specific knowledge gathered by those on the ground. This is likely to be crucial since each conflict is very different, and what works in one might not in another. “For instance”, says Nathanson, “in one country, labelling ambulances with red crosses made them immune from shelling, and in another country close by, those same crosses made them targets. One solution won"t fit all countries.”   Nott is calling on the UN to put protection in place for humanitarian workers. “It"s true that when you put boots on the ground, it becomes military. But it does need a show of force. The UN need to be the protectors.”   The problem with this, says Jochum, is that “in many conflicts, belligerent forces don"t see the UN as neutral. When the UN deploy forces, it is usually in support of a government or a dominant party. So their protection of humanitarian workers can transform the perception of those workers as partisan. It is very clearly what happened in the last years of the war in Afghanistan, for instance.”   A positive sign is that UN agencies such as WHO seem to be taking the problem very seriously. At the London symposium, Rudi Coninx, from WHO"s Policy Practice and Evaluation Unit, said this issue is high on the agenda. “We believe there has been an escalation in violence against health-care workers that is calling on WHO to do more, to say more. We can"t wait for more data before we act. People are being killed today. This is unacceptable.”   http://www.safeguardinghealth.org/ http://www.healthcareindanger.org/ Visit the related web page
	Iceland sends four Bank Bosses to Jail by BBC News, ProPublica, agencies   July 2014   Citigroup to Pay $7 Billion for "Egregious Misconduct".   Banking giant Citigroup has sealed a $7 billion deal with the Justice Department over its "egregious misconduct" of selling toxic mortgage-based securities, which contributed to the financial crisis.   The agreement, which ends a federal investigation, includes a $4 billion penalty to the Justice Department, which the Department describes as the largest of its kind, $2.5 billion for relief to struggling homeowners, and $500 million to state attorneys general and the Federal Deposit Insurance Corporation.   "The settlement includes an agreed upon statement of facts that describes how Citigroup made representations to RMBS investors about the quality of the mortgage loans it securitized and sold to investors," a statement from the Justice Department reads. "Contrary to those representations, Citigroup securitized and sold RMBS with underlying mortgage loans that it knew had material defects."   "Despite the fact that Citigroup learned of serious and widespread defects among the increasingly risky loans they were scrutinizing, the bank and its employees concealed these defects," Attorney General Eric H. Holder Jr. said in a statement.   "The bank’s misconduct was egregious," Holder Jr. stated.   "As a result of their assurances that toxic financial products were sound, Citigroup was able to expand its market share and increase profits," he said.   Citigroup was also the recipient of $45 billion in government bailout funds from TARP, though the Congressional Oversight Panel found that adding up all the various bailout funds the bank received brings the total to $476.2 billion in cash and guarantees. That makes it the bank to receive the biggest amount of federal bailout money.   JPMorgan Chase made a similar settlement with the DOJ in November with its fine totaling $13 billion. Following that deal, critics charged that it was no real deterrent for bad behavior by banks because it included no criminal sanctions for individuals; further, the bank could end up ultimately pushing some of the fine onto U.S. taxpayers.   Yet the Citigroup deal is even worse for the public than the JPMorgan Chase deal, Wall Street watchdog organization Better Markets stated Monday, adding that it fails to achieve any real accountability.   "DOJ brags about and wants everyone to focus on the $7 billion settlement dollar amount, but that amount is meaningless without disclosure of the key information about how many hundreds of billions of dollars Citigroup made, how many tens of billions investors lost, how many billions in bonuses were pocketed, which executives were involved and what positions they now have with the bank," Better Markets President and CEO Dennis Kelleher said in a statement.   “Citigroup, the Wall Street bank that received the largest amount of Federal bailouts to prevent its bankruptcy in 2008 (almost $500 billion), was a conveyor belt for toxic securities throughout the world and is now being handed another big bailout by the government: a sweetheart immunity deal and ongoing concealment of how its executives, officers and staff defrauded the American people and almost caused a second Great Depression," Kelleher continued.   “Today’s actions again confirm the indefensible double standard of justice DOJ established of treating Wall Street’s biggest, richest, most politically connected banks more favorably than anyone else," he added.   The Citigroup deal, the New York Times Deal Book reports, "also sets the stage for negotiations between the Justice Department and Bank of America, which had essentially been on hold while Citigroup worked out an agreement."   http://www.bettermarkets.com/reform-news   * Read more on The Rise of Corporate Impunity - Meet the only Wall St. executive prosecuted as a result of the financial crisis, by Jesse Eisinger reporting for ProPublica, see link below.   Dec 12, 2013 (BBC News)   The onetime CEO of Iceland’s Kaupthing bank, one Hreidar Mar Sigurdsson, is going to jail for five and a half years for his part in his firm’s downfall—which also helped his country’s economy bottom out in 2008.   Three other former high-level Kaupthing execs, including ousted board Chairman Sigurdur Einarsson, will join Sigurdsson for shorter stints in prison for aiding in the cover-up of a sham deal with a Qatari financier that sank the firm late that year.   Although the BBC pointed out Thursday that the foursome’s punishment amounts to “the heaviest sentences for financial fraud” in the country’s history, it represents a relatively breezy penalty compared with the mass-scale wreckage that ensued.   Still, it adds up to many more days behind bars than certain of their deserving American counterparts are likely to face. Here’s more from the BBC:   The court gave Olafur Olafsson, one of the majority owners three years and Magnus Gudmundsson the former chief executive of the Luxembourg branch, three and a half years.   None of them were in court for the decision but it is expected that they will appeal.   The four were also made to pay their own legal costs for the case, which amount to millions of pounds.   The special prosecutor, Olafur Hauksson, said the deal had influenced the bank’s share price. He also said the loans provided for the deal were illegal.   Mr Hauksson told the BBC that there was still another, bigger case against Kaupthing Bank ongoing, in which it is accused of market manipulation. It is due to come to court at the end of January. Visit the related web page
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