Day: June 8, 2024

PHOENIX — The season’s first heat wave is already baking the Southwest with triple-digit temperatures as firefighters in Phoenix — America’s hottest big city — employ new tactics in hopes of saving more lives in a county that saw 645 heat-related deaths last year.  

Starting this season, the Phoenix Fire Department is immersing heatstroke victims in ice on the way to area hospitals. The medical technique, known as cold water immersion, is familiar to marathon runners and military service members and has also recently been adopted by Phoenix hospitals as a go-to protocol, said Fire Capt. John Prato.  

Prato demonstrated the method earlier this week outside the emergency department of Valleywise Health Medical Center in Phoenix, packing ice cubes inside an impermeable blue bag around a medical dummy representing a patient. He said the technique could dramatically lower body temperature in minutes.  

“Just last week we had a critical patient that we were able to bring back before we walked through the emergency room doors,” Prato said. “That’s our goal — to improve patient survivability.”  

The heatstroke treatment has made ice and human-sized immersion bags standard equipment on all Phoenix fire department emergency vehicles. It is among measures the city adopted this year as temperatures and their human toll soar ever higher. Phoenix for the first time is also keeping two cooling stations open overnight this season.  

Emergency responders in much of an area stretching from southeast California to central Arizona are preparing for what the National Weather Service said would be “easily their hottest” weather since last September.  

Excessive heat warnings were issued for Wednesday morning through Friday evening for parts of southern Nevada and Arizona, with highs expected to top 110 degrees Fahrenheit (43.3 Celsius) in Las Vegas and Phoenix. The unseasonably hot weather was expected to spread northward and make its way into parts of the Pacific Northwest by the weekend.  

Officials in Maricopa County were stunned earlier this year when final numbers showed 645 heat-related deaths in Arizona’s largest county, a majority of them in Phoenix. The most brutal period was a heat wave with 31 subsequent days of temperatures of 110 degrees Fahrenheit (43.4 Celsius) or higher, which claimed more than 400 lives.  

“We’ve been seeing a severe uptick in the past three years in cases of severe heat illness,” said Dr. Paul Pugsley, medical director of emergency medicine with Valleywise Health. Of those, about 40% do not survive. 

Cooling down patients long before they get to the emergency department could change the equation, he said.  

The technique “is not very widely spread in non-military hospitals in the U.S., nor in the prehospital setting among fire departments or first responders,” Pugsley said. He said part of that may be a longstanding perception that the technique’s use for all cases of heatstroke by first responders or even hospitals was impractical or impossible. 

Pugsley said he was aware of limited use of the technique in some places in California, including Stanford Medical Center in Palo Alto and Community Regional Medical Center in Fresno, and by the San Antonio Fire Department in Texas. 

Banner University Medical Center in Phoenix embraced the protocol last summer, said Dr. Aneesh Narang, assistant medical director of emergency medicine there.  

“This cold water immersion therapy is really the standard of care to treat heatstroke patients,” he said. 

MONTGOMERY, Alabama — Parts of the north side of Montgomery are defined by what it has lost: restaurants, grocery stores and a convenient pharmacy, the latter of which closed five years ago.

People who still live in the historically Black neighborhood of Newtown, like Sharon Harris, are frustrated. She goes to a different location of the same pharmacy chain, which is four miles from her home.

“You have to come back sometimes,” she said, “and then they wait so long to fill the prescription.”

In cities across the U.S., major retail pharmacies have closed hundreds of stores over the past few years and independents can’t always afford to stay open. That can leave residents of color without easy access to a business that provides not only prescriptions but also fundamental public health services like vaccinations, over-the-counter medicines and even food.

Closures create “a situation where there’s not just (a lack of) investment in terms of pharmacy development and expansion, but there’s no incentive to stay in those neighborhoods,” said Dima Qato, a professor of clinical pharmacy at the University of Southern California who has studied pharmacy access.

And an Associated Press analysis of licensing data from 44 states, data from the National Council for Prescription Drug Programs and the American Community Survey shows residents of neighborhoods that are majority Black and Hispanic have fewer pharmacies per capita than people who live in mostly white neighborhoods.

MAC Pharmacy is the only one serving about 20,000 people in a majority Black ZIP code in Cleveland. George Tadross, the part-owner and pharmacy manager, said he is adamant about making things as as easy as possible for his mostly older customers — sometimes by organizing their medications by day for them.

“You have to have a pharmacist to talk to,” he said. “My philosophy in the pharmacy business is you know your doctor, he knows everything about you. You need to know your pharmacist as well (because) the pharmacist is the only one that sees the whole medical treatment plan you have.”

Pharmacists play a role in managing chronic diseases like diabetes and heart-related issues, which Black and Hispanic people are more likely to be diagnosed with.

And when pharmacists or pharmacy technicians reflect their customer base — by speaking the same language or understanding the community — it can be easier to build a strong rapport and trust, said Jasmine Gonzalvo, who teaches at Purdue University’s College of Pharmacy and has researched the needs of Spanish-speaking patients at pharmacies.

She noted that if people don’t feel comfortable asking questions about the medication, then it might mean they don’t take it or don’t take it correctly.

“You don’t get a refill,” Gonzalvo said, “simply because there were barriers in the way of your communicating and feeling safe in that relationship with your pharmacist.”

That’s why Bert’s Pharmacy in Elizabeth, New Jersey, has “Spanish- and English-speaking staff all the time,” said owner and pharmacist Prakash Patel said. His business is located in an ZIP code where nearly 70% of the residents are Hispanic.

“We want to make sure, too, they understood everything,” Patel said. “We have Spanish-language labels for them, we print all the instructions in Spanish for them.”

In Montgomery, where Harris lives, the city is working on a development plan for the north side. A retail analysis in the plan shows a small pharmacy could generate $1.5 million in sales a year.

“There’s an opportunity there because you have what I call a captive market,” said Bob Gibbs, the director of Gibbs Planning Group, which did the analysis. “People that live in a lot of these neighborhoods have limited access to transportation … and they’re very loyal to local businesses that will treat them with respect.

“They will go out of their way just to go there. And they just don’t like having to drive … two miles to go to a drugstore. That’s unfair.”

Harris, though, doesn’t have much hope a new pharmacy will open.

“I don’t see it,” she said. “As long as they have (that CVS) they think it’s OK. … Everybody is waiting for them to do something on this side.”

DAKAR, Senegal — Russia’s top diplomat pledged help and military assistance while on a whirlwind tour of several countries in Africa’s sub-Saharan region of Sahel this week, as Moscow seeks to grow its influence in the restive, mineral-rich section of the continent.

Russia is emerging as the security partner of choice for a growing number of African governments in the region, displacing traditional allies like France and the United States. Sergey Lavrov, who has made several trips to Africa in recent years, this week stopped in Guinea, the Republic of Congo, Burkina Faso and Chad.

Moscow has aggressively expanded its military cooperation with African nations by using the private security company Wagner and its likely successor, Africa Corps, with Russian mercenaries taking up roles from protecting African leaders to helping states fight extremists.

The Polish Institute of International Affairs said in a study this month that in “creating the Africa Corps, Russia took an assertive approach to expand its military presence in Africa.

Moscow is also seeking political support, or at least neutrality, from many of Africa’s 54 countries over its invasion of Ukraine. African nations make up the largest voting bloc at the United Nations and have been more divided than any other group on General Assembly resolutions criticizing Russia’s actions in Ukraine.

Russia-linked entities also spread disinformation to undermine ties between African states and the West, the Africa Center For Strategic Studies, an academic institution within the U.S. Department of Defense, wrote in a March report. Moscow has been “sponsoring 80 documented campaigns, targeting more than 22 countries,” it said.

Here’s a look at how Russia is expanding its influence in Africa. 

Why are African nations turning to Russia? Russia has taken advantage of political unrest and discontent in coup-hit nations, capitalizing on popular frustration and anger with former colonial power France. Military coups have ousted governments seen close to France and the West and doing little to alleviate grinding poverty, unemployment and other hardships.

Russia offers security assistance without interfering in politics, making it an appealing partner in places like Mali, Niger and Burkina Faso, all ruled by military juntas that seized power in recent years. In return, Moscow seeks access to minerals and other contracts.

Violence linked to extremists allied with al-Qaida and the Islamic State group has been on the rise in Sahel for years, despite efforts by France, the U.S. and other Western allies to help fight the jihadi groups there. In 2013, France launched a near decade long operation in Mali to help fight militants, which expanded to Niger, Burkina Faso and Chad. The operation ended nine years later but the conflict did not, contributing to anger with the West.

The U.S. has further lost its footing with key allies for forcing issues — including democracy or human rights — that many African states see as hypocrisy, given Washington’s close ties to some autocratic leaders elsewhere.

While the West may pressure African coup leaders over democracy and other issues, Russia doesn’t meddle in domestic affairs, Rida Lyammouri, a senior fellow at the Policy Center for the New South, told The Associated Press.

What is Russia’s interest in African countries? Africa is rich in minerals, oil and other resources, which come with political and legal challenges. Its resources are increasingly central to economic and national security, such as cobalt, which is used in electronics like mobile phones, or lithium, which is used in batteries.

Russia has thrived in countries where governance is limited, and has signing mining deals through companies it controls. An EU parliament study showed that Russia secured access to gold and diamonds in the Central African Republic, cobalt in Congo, gold and oil in Sudan, chromite in Madagascar, platinum and diamonds in Zimbabwe, and uranium in Namibia.

The U.S. based non-profit Democracy 21 group said in an analysis last December that Wagner and Russia may have made about $2.5 billion through the African gold trade alone since invading Ukraine in February 2022.

Though Russia is increasingly a partner to African countries in the oil and mining sector, it lags far behind as an overall trading partner. For example, data by the International Monetary shows less than 1% of Africa’s exports go to Russia, compared with 33% to the European Union.

Where do Russian contractors operate in Africa? The first reports of Wagner mercenaries in Africa emerged in late 2017, when the group was deployed to Sudan to provide support to then-President Omar al-Bashir, in exchange for gold mining concessions. Wagner’s presence soon expanded to other African countries.

In 2018, Russian contractors showed up to back powerful commander Khalifa Hifter in eastern Libya who was battling militants. They also helped Hifter in his failed attempt to seize the capital of Tripoli a year later.

In the Central African Republic, Russian mercenaries have been providing security since in 2018 and in return have gained access to some of the country’s gold and diamond mines.

Coups in Mali in 2020 and 2021, in Burkina Faso in 2022 and in Niger in 2023, brought military juntas critical of the West to power. All three eventually ordered French and other Western forces out, and instead turned to Russia for military support.

Niger ordered the U.S. to withdraw its troops and close its multimillion dollar flagship investment in a sprawling military and spy base in Agadez earlier this year, after a meeting with a U.S. delegation ended poorly. The decision has upended U.S. counterinsurgency operations in Africa’s Sahel.

Weeks later, Russian trainers arrived in Niger with new defense equipment.