-Caveat Lector-

>From the BBC
http://news.bbc.co.uk/hi/english/world/europe/newsid_450000/450791.stm


> Friday, September 17, 1999 Published at 23:45 GMT 00:45 UK
> <Picture>
> <Picture>
> World: Europe
> <Picture>
> Russian TB threatens the world
> <Picture>
> One in 10 Russian prisoners is thought to have TB
> <Picture>
> By Madrid Correspondent Daniel Schweimler
>
> World experts in the treatment of tuberculosis have warned that the
> disease in Russian prisons is a timebomb waiting to go off.
>
> Speaking in Madrid at the International Conference on Lung Health, they
> said that unless urgent measures are taken to stop what they call "the
> prison TB pump", the incidence of the disease in Russia will keep
> growing and inevitably spread to the rest of the world.
>
> The incidence of tuberculosis in Russia has more than doubled since 1991
> and a quarter of those cases are in Russian prisons.
>
> TB breeding grounds
>
> The conditions in these under-heated, under-resourced, overcrowded
> buildings is ideal for the spread of the disease, which is killing about
> 5,000 prisoners a year.
>
>
> <Picture: [ image: Scientists are testing traditional herbal remedies as
> they search for new cures]>Scientists are testing traditional herbal
> remedies as they search for new cures The head of Russia's prison
> medical service, Colonel Alexander Conets, told delegates that thanks to
> a greater openness in Russian society, they could firstly admit that
> there is a problem and secondly seek help in trying to deal with it.
>
> But 100,000 prisoners are released from Russian jails every year, many
> of them infected with TB.
>
> Lee Reichman from the National Tuberculosis Centre in the United States
> said the problem would not remain confined to Russia. "Tuberculosis is
> an infectious disease, it spreads from person to person," he said.
>
> "So it must spread and it's being incubated in Russian prisons, and
> unless we do something about this incubation, when it gets out it's
> going to be a disaster."
>
> Resistance spells danger
>
> But what is also worrying health experts is the increase of a new form
> of drug resistant TB which has developed because of widespread misuse of
> antibiotics. This new strain of the disease is expensive to treat and is
> also finding a perfect breeding-ground in Russian jails.
>
>
> <Picture: [ image: Cold, crowded and underfunded - Russian prisons
> provide ideal conditions for spreading TB]>Cold, crowded and underfunded
> - Russian prisons provide ideal conditions for spreading TB A number of
> international organisations, with the backing of the World Health
> Organisation (Who), have launched a pilot project in the central Russian
> region of Tomsk to try to deal with this new strain of TB. It is
> expensive and there are fears that funding for the project could be
> misused.
>
> Hopefully the World Bank is going to come in with a major loan, but the
> local problems in Russia - where there's currently chaos and worse -
> will make it difficult to receive the loan or use it properly," said Mr
> Reichman.
>
> According to speakers at the conference, there is no time to lose - the
> accelerating spread in Russian prisons of HIV, the virus that can lead
> to Aids, will they say lead to an explosion of TB among inmates.
>
> The message from the Madrid conference is clear: that as we enter the
> new century, Western countries and international organisations must
> provide the commitment and the financial resources to address public
> health threats on a global scale.


>From the Telegraph (UK)
www.telegraph.co.uk

>
> ISSUE 1576Saturday 18 September 1999
>
> Hearts taken from 11,000 babies
> By Sean O'Neill
>
> HOSPITALS have removed and retained, without parents' consent,
> the hearts of at least 11,000 children who died of cardiac disease in the past
> 40 years.
>
> Large collections of damaged and malformed hearts are stored at major hospitals
> across the country. The organs were removed from the bodies of children during
> post mortem examinations for which consent was given.
>
> But permission was not sought from families to store the hearts for decades to
> carry out medical research. Relatives did not know that they were burying their
> children without their hearts. The largest collection is held at Alder Hey
> Children's Hospital in Liverpool, which has amassed 2,500 hearts since the late
> 1950s.
>
> In London, the Royal Brompton Hospital and Great Ormond Street Children's
> Hospital have catalogued and stored some 2,000 hearts each. There are 1,500 kept
> in Birmingham and a further 1,000 in Leeds. Hospitals in Southampton, Newcastle,
> Manchester and Bristol have retained about 500 each.
>
> The widespread practice of tissue retention came to light following the scandal
> of high death rates in paediatric cardiac surgery at the Bristol Royal
> Infirmary.
>
> Helen Rickard, who uncovered the practice when she discovered that her daughter
> Samantha had been buried without her heart, will give evidence on Monday to the
> public inquiry into events at Bristol. Mrs Rickard, whose 11-month-old daughter
> died in 1992, obtained a coroner's permission for the return of her baby's heart
> four years later.
>
> She said: "I thought I had buried my daughter after the operation but discovered
> she was not completely laid to rest. If I had known Samantha's heart had been
> taken out I would have insisted it was put back before she was buried."
>
> Mrs Rickard thought her case was an isolated one until the United Bristol
> Healthcare Trust admitted last February that it had retained the hearts of 170
> children who died at the Bristol Royal Infirmary between 1976 and 1995. The
> extent of the practice nationally was revealed to the Bristol inquiry by Prof
> Robert Anderson, president elect of the British Paediatric Cardiac Association.
>
> Prof Anderson, who amassed the collection at the Royal Brompton and is now
> responsible for that at Great Ormond Street, said the failure to consult parents
> was a result of "cock up" rather than conspiracy.
>
> He told the inquiry: "I understand the distress that has been caused. I think I
> can speak on behalf of pathologists interested in congenital heart disease
> throughout the country, that none of us were retaining hearts with any intention
> of creating distress.
>
> "None of us would have wanted to do that. It was an act of omission by us not
> realising that appropriate permission had not been granted. Certainly, when the
> whole thing broke, I was surprised that we had not thought of this earlier and
> we should have done.
>
> "I think that the advances we made in surgical treatment, in understanding, in
> diagnosis, in the past 35 years would not have been possible had we not had
> access to this collection."
>
> The Bristol inquiry, chaired by Prof Ian Kennedy, is expected to recommend when
> it reports next year that permission is obtained from families before doctors
> retain organs or tissue.
>
> Bristol Royal Infirmary has already introduced new consent forms explaining why
> doctors might wish to retain organs. The Royal College of Pathologists is
> drawing up guidelines to ensure that parents are kept fully informed.
>
> Micheala Willis, chairman of the Bristol Heart Children Action Group, said any
> parents with concerns should contact the hospitals where their children were
> treated. Mrs Willis, whose son Daniel died after surgery at Bristol, said:
> "People thought the problem was just confined to Bristol, they did not realise
> that hospitals nationwide were retaining organs. It will come as a shock. There
> should be parental consent in all cases. Often, if parents understand the
> reasons organs are retained, there is no problem."
>
> James Wisheart, the surgeon at the centre of the Bristol scandal, has admitted
> not seeking the explicit consent of parents for the removal of hearts from
> children who died. A spokesmen for Alder Hey said its organ retention policy was
> under review and Great Ormond Street said it had used a new consent form since a
> family complained.


A<>E<>R
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