4 Oct 2013 | Africa, Middle East and North Africa, News and features, Sudan
The government of Sudan cut the country off from the internet as protests against the end of fuel subsidies spread.
The release of the annual Freedom on the Net report for the first time includes a chapter on Sudan, authored by Index Award nominees GIRIFNA. This is more than timely, as the country is witnessing a new wave of widespread protests triggered by the Sudanese government’s announcement in late September 2013 that it will lift economic subsidies from fuel and other essential food items.
Based on a survey of 60 countries in Freedom House’s Freedom on the Net 2013, Sudan is categorised as “Not Free” with a score of 63, placing it among the bottom 14 countries in the category. As one of ten sub-Saharan African countries surveyed, Sudan joined Ethiopia as the two “Not Free” countries in the region. Kenya and South Africa were categorised as “Free” and the remaining six – Angola, Malawi, Nigeria, Rwanda, Uganda and Zimbabwe – as “Partly Free”.
Sudan has invested heavily in its telecommunications infrastructure in the last decade, resulting in a steadily increasing internet penetration rate of 21 percent and a mobile penetration rate of 60 percent by the end of 2012, according to the International Telecommunication Union (ITU). It also boasts the cheapest post-paid costs in the Middle East and North Africa in 2012, and healthy market competition amongst four telecommunications providers.
However, these infrastructural and economical advantages are highly reduced against the backdrop of a State that has little respect for freedom of expression, freedom of association, participation and peaceful assembly. The Sudanese regime is amongst the worst globally in terms its obstruction of the access to independent and diverse information both offline and online. A global study on press freedom conducted by Reporters without Borders earlier this year ranks Sudan at 170 out of 179 countries surveyed. This clearly reflects that the violations of freedom of expression impacting the traditional print media are also starting to reflect online.
The Sudan Revolts, the wave of protests triggered by economic austerity plans that hit the country between June and July 2012, was the first time the authorities implemented a large-scale crackdown and detentions of citizens using digital platforms to communicate, connect, coordinate and mobilise. Additionally, the government increased its deployment of a Cyber Jihadist Unit to monitor and hack into Facebook and email accounts of activists. The National Telecommunications Corporation (a government agency) also engages in the censoring and blocking of opposition online news forums and outlets. YouTube, for example, was blocked for two months in late 2012 in response to the “Innocence of Muslims” video.
The attacks on cyber dissidents during Sudan Revolts included the detention of digital activists, such as Usamah Mohammed, for up to two months, the forced exile of Sudan’s most prominent video blogger Nagla’a Sid Ahmad, and the kidnapping and torture of the Darfurian online journalist Somia Hundosa. Moreover, one of the most high profile political detainees from the Nuba Mountains, Jalila Khamis, spent nine months in detention without charges. When she was finally brought to trial in December 2012, the main evidence against her was a YouTube video taken by Sid Ahmad, in which Khamis testified about the shelling of civilians in the Nuba Mountains by the government.
Since September 23 this year, authorities have responded to the new wave of protests with unprecedented violence toward peacefully protesting urban dwellers. More than 200 have been killed in Khartoum and Wad Madani by live bullets fired by riot police, national security agents, and/or state sponsored militias. According to a government statement, 600 citizens have been detained, though activists say that number is much higher. On Wednesday, September 25, the government shut down internet access for 24 hours. When the internet returned, it was much slower, with Facebook inaccessible on mobile phones and YouTube blocked or non-functional due to a very slow broadband connection.
The US sanctions imposed on Omer El Bashir’s regime since 1997 also continue to hinder the free access to the internet and the free flow of information as it limits access to a number of new media tools. This includes limited access to anti virus suites, e-document readers, and rich content multimedia applications that most Sudanese citizens cannot download. The inability to download software security updates makes many users in Sudan vulnerable to malware. Smart phone applications cannot be downloaded or purchased from the iTunes and/or Android stores.
Additionally, Sudan has a combination of restrictive laws that work together to impede freedom of expression both off and online, including the 2009 Printed Press Materials Law, and a new Media law that has recently appeared in Parliament, which officials have hinted would for the first include language restricting online content. Additionally, the National Security Act (2010) gives National Intelligence and Security Services the permission to arrest journalists and censor newspapers under the pretext of “national security,”. An IT Crime Law, in effect since 2007 criminalises websites that criticise the government or publishes defamatory materials. All these laws contradict Sudan’s National Interim Constitution, which guarantees the right to freedom of expression, association and assembly.
A version of this article has been published on GIRIFNA’s website. The arabic version of the Freedom on the Net report can be accessed here.
4 Oct 2013 | News and features, United States
ProPublica and This American Life, both which I love, are making some waves for a story highlighting the risks of taking too much acetaminophen (known as paracetamol in the UK). They found that “taken over several days, as little as 25 percent above the maximum dosage – or just two additional extra strength pills a day – has been reported to cause liver damage”.
In a more than 10,000 word piece, they say that over the past decade 1,500 people have died from accidental overdoses of the drug in the US. The story is very critical of “McNeil Consumer Healthcare, the unit of Johnson & Johnson that has built Tylenol [the brand name of the drug in the US] into a billion-dollar brand and the leader in acetaminophen sales”. The story claims that:
McNeil opposed even a modest government campaign to educate the public about acetaminophen’s risks, in part because it would harm Tylenol sales.”
They also criticise the FDA, the US drugs regulator for not taking tougher action, but the agency said:
FDA officials said the agency saw the benefits of keeping acetaminophen widely available as outweighing the “relatively rare” risk of liver damage or death. Some patients cannot tolerate drugs such as ibuprofen, and for them acetaminophen may be the best option, said one agency official.”
I do appreciate that the story gave a bit of context in quoting the figures for accidental deaths of ibuprofen, another non-prescription pain killer. The article says deaths due to ibuprofen overdose are negligible.
Massive coverup? Hardly
But is the fact that acetaminophen can cause liver damage being hidden by an avaricious company with complete disregard for public safety or by an over-stretched US drugs regulator? Hardly. Google “acetaminophen risk”. The first result in the US is WebMD. See risks:
When taken incorrectly, however, acetaminophen can cause liver damage. And your risk of liver damage may be increased if you drink more than three alcoholic drinks every day, take more than the recommended dose (overdose), or if you take any additional drugs that also contain acetaminophen at the same time.”
Read a little further along under the next subhead, How to Use Acetaminophen Safely.
Make sure to use the correct dosage. Don’t take more acetaminophen than directed or take it more often than directed. Taking more than recommended can damage your liver — and won’t provide any more pain relief.”
We’ve got a couple of bottles of acetaminophen that we have bought in the US. One bottle from US pharmacy Walgreens says, “See New Warnings Information”. It has a specific liver damage warning. It has in bold: “Overdose warning: Taking more than the recommended dose (overdose) may cause liver damage.” Both bottles warn not to take with other drugs that contain acetaminophen or if you drink three or more alcoholic drinks per day.
Ok, I thought. Maybe McNeil is trying to protect their brand, Tylenol, as the story says over and over again. I went to the Tylenol site, the official site for McNeil’s acetaminophen brand, and at the bottom of the page, granted not prominently displayed but there, is a link called: Tylenol labeling change.
New Dosing Instructions: Beginning Fall 2011
Acetaminophen, the active ingredient in TYLENOL®, can be found in more than 600 over-the-counter (OTC) and prescription medications, such as TYLENOL®, SUDAFED® Triple Action™, NyQuil®, Percocet® and Vicodin®.* Acetaminophen is safe when used as directed, but when too much is taken (overdose), it can cause liver damage. Some people accidentally exceed the recommended dose when taking multiple products at the same time, often without realizing they contain acetaminophen or by not reading and following the dosing instructions.
To help encourage appropriate acetaminophen use, the makers of Extra Strength TYLENOL® have implemented new dosing instructions lowering the maximum daily dose for single-ingredient Extra Strength TYLENOL® (acetaminophen) products sold in the U.S. from 8 pills per day (4,000 mg) to 6 pills per day (3,000 mg). The dosing interval has also changed from 2 pills every 4 – 6 hours to 2 pills every 6 hours.“
Emphasis mine. Was McNeil against educating the public because they worried about damaging sales of their flagship brand? It would seem not.
Education Campaign: Get Relief Responsibly™
In addition to the new dosing instructions on the OTC label, the makers of TYLENOL® launched Get Relief Responsibly™, an initiative designed to educate consumers about the appropriate use of OTC and prescription medications, particularly those containing acetaminophen, and the importance of reading and following medication labels. As a part of this initiative, the makers of TYLENOL® have created a new website www.getreliefresponsibly.com. The site includes an interactive Acetaminophen Finder tool to help consumers identify products that contain acetaminophen and build a personal acetaminophen medication list to share with their healthcare provider or pharmacist.”
I don’t know how prominent the campaign was, as I live in the UK. And I thought that maybe they launched this quietly in response to the ProPublica investigation. Nope, the date on the page is autumn 2011. This would be consistent with the “See New Warnings Information” label on our bottle of Walgreen’s Pain Reliever PM. It undermines all the assertions in the investigation that McNeil has resisted efforts to reduce dosages or engage in public education.
Stating the obvious in thousands of words
These are facts hidden in plain view: Don’t take too much acetaminophen, especially with alcohol. Taking more than recommended won’t do you any good, and it could wreck your liver. As a matter of fact, we’re going to recommend taking less of our flagship product.
It took me 30 seconds to find the relevant info on WebMD, and another 30 seconds to quickly scan the Tylenol site. How long did it take ProPublica and This American Life? TWO YEARS AND $750,000.
As an editor, I keep saying to myself: Where’s the story here? The headline, anodyne even by American standards, is “Use Only as Directed”. My response: No shit. I mean, really? If you use a drug above the recommended dosage, there is a risk. If McNeil has ruthlessly tried to cover up the idea that if you take too much of the drug it will wreck your liver, they’re doing a really poor job.
Labelling on US acetaminophen bottles undermine repeated assertions in the investigation that the FDA has resisted calls for clearly labelling about overdose risks, especially with respect to liver damage. It is clearly listed under Warnings, in bold, on both bottles of acetaminophen we have.
Where is the breaking news? Has the FDA covered up the fact that if you take too much of the drug you can die? No, it hasn’t. Easily available information, both online and on the packaging, is clear about the risks of taking an overdose. But the key thing is that if you take too much of anything, even water, it can kill you. In technical terms it’s called LD50, the median lethal dose.
Whist Pro Publica’s piece does remind the reader to be more careful about taking other medications that might have acetaminophen and to more carefully monitor dosage, it isn’t revealing any new information, nor is it exposing a cover-up.
The story includes a clock, counting how long it has been since the FDA created an expert panel to evaluate the safety of over-the-counter pain relievers. The agency has not yet completed its work. This is about as damning as the revelations gets:
From 2001 to 2010, annual acetaminophen-related deaths amounted to about twice the number attributed to all other over-the-counter pain relievers combined, according to the poison control data.
In 2010, only 15 deaths were reported for the entire class of pain relievers, both prescription and over-the-counter, that includes ibuprofen, data from the CDC shows.”
If acetaminophen, at roughly 150 deaths per year, is twice the number of all other over-the-counter and prescription pain relievers combined, then doesn’t this undermine the entire assertion that the there is a pressing need for the FDA to have this expert panel deliver its findings? It doesn’t seem that pain killers as a class of drug are particularly dangerous at all.
Back to acetaminophen, in 2010, the last year the article has figures for fatal accidental acetaminophen poisoning, 166 Americans died. The CDC reported that 2,468,435 Americans died that year. The number who died from acetaminophen poisoning is 0.007 percent of total deaths in the entire country. Tragic? Yes. Common? Hardly. Ibruprofen deaths are negligible, especially compared with the 32,788 Americans who died in road traffic accidents. Journalists are incredibly poor at communicating relative risk, and this over-the-top investigation only serves to reinforce that. What pressing public health crisis has been identified at a cost of $750,000?
I don’t mean to dismiss the suffering of the nearly 150 people who died or of their friends and loved ones, and I think that this story is worth reporting, but in the right terms. For stories like this, I can even see the need to remind people every few years, just to drive home the point that taking too much acetaminophen is risky, especially if you drink a lot. However, I don’t think this story comes even close to rising to the standard of a two-year investigation costing hundreds of thousands of dollars.
Opportunity costs
Peter Osnos at The Atlantic praises the story and asks who will pay for expensive, investigative coverage. The piece seems to be equating the cost with impact. To me, as I said in a comment on the piece, this is not a piece for which we should be getting out our “yay investigative journalism” pom-poms. It proves that investigative journalism can be expensive, yes, but is it going to have an impact? This story will have no more impact than a run-of-the-mill public service piece that could have been bashed out in an afternoon.
Not all investigations lead to publication, and I know that some investigations take time to develop, but I cannot see why this story took two years and three-quarters of a million dollars to reveal information that can be found with a quick search online. As a journalist and editor, I have to ask what is the opportunity cost? The opportunity cost is:
The cost of an alternative that must be forgone in order to pursue a certain action. Put another way, the benefits you could have received by taking an alternative action.”
In this era of scarce resources, it is even more important to ask what opportunities are foregone because resources are deploying elsewhere. It’s Econ 101, but it is an incredibly important question that we need to ask. Two years and three-quarters of a million dollars is a huge investment. It’s the kind of resource that most journalists would give their spare kidney for, but if we’re going to sink that kind of time and precious coin into a story, that story better be worth it.
When I started this post, I thought this was simply about an overly expensive investigation. It took me almost no time at all to undermine the core elements of this story with basic online research. McNeil, if they trying to bully the FDA into inaction, appear to have failed. If a minimal bit of online research calls into question key elements of this story, there are even bigger problems than the excessive cost and time.
UPDATE: I did originally post this under the headline “30 seconds to debunk”, which in retrospect is a bit harsh. ProPublica has meticulously documented their points to the point where I think they completely diluted the impact of the piece. If as a journalist, you want to draw attention to the dangers of the drug, the piece should have been much, much shorter, highlighted the low margin for error in taking more than the recommended dose, especially with alcohol and been done with it. The story has problems, and one of the biggest is that it is incredibly self-indulgent. It fails the most basic commandment of a good piece of journalism: Get to the point.
This article was originally posted on 4 Oct 2013 at Strange Attractor and is reproduced here by permission.
4 Oct 2013 | Africa, News and features, Uganda
A scene from a music video by Ugandan singer Nnabbi Omukazi.
Ugandan artists have for a long time been able to read the public mood in the country and have taken note of it in their plays and songs.
nder the military dictatorship of Idi Amin, a few brave artists expressed themselves through music and drama. Plays that were critical of the Amin regime were written and performed. Several of the authors were killed or forced into exile.
During the early years of President Yoweri Museveni’s National Resistance Movement (NRM) government, musicians, choreographers and playwrights promoted the new government through their works for bringing back stability after the overthrow of Obote and Lutwa regimes. The general public was full of praises for the new regime and artists tapped into that feeling.
However, as the early optimism waned, many artists became more critical. These artists have been censored, paid off or even deported, delivering big blows to artistic freedom of expression in Uganda in the process.
Nnabbi Omukazi composed a song in which she claimed to have had a dream where a dead politician told her that she did not die from cocaine, but that she had been poisoned.
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It was believed to be about Cerinah Nebanda, a young, vocal and critical member of parliament who died early this year. The government quickly told the public it was from a cocaine overdose, but her family and some members of parliament were not convinced by this explanation. They decided to hire a pathologist to take body samples of the deceased to South Africa to ascertain the cause of death. The pathologist was intercepted by security en-route to the airport and detained, which compounded the family’s suspicion that the MP had been poisoned because of her critical stance on several government positions. For composing that song, Police interrogated Nnabbi, and her song was banned from the airwaves.
Another artist, Matthias Walukagga, composed the song Tuli bakoowu (We are tired) in which he indirectly hints at the president’s overstay in power. In one verse, the artist asks; “When will the old man also declare that he is tired.” This song was banned on airwaves, but people still buy the CD’s and play it.
One of the biggest Ugandan artists, Bobi Wine aka “Ghetto President” wrote a song criticizing the way small traders in Kampala were being mistreated by the city authorities. In his song Tugambire ku Jennifer (Tell Jennifer to stop harassing us) Bobi attacks Jennifer Musisi, the Executive Director of Kampala Capital City Authority, for not caring about the plight of the poor and only protecting the interests of the rich. Responding to Bobi’s song, Musisi first dismissed it as one without consequence. However, when she realised the pressure the song was creating from the poor city dwellers, she invited Bobi to ceasefire talks. He also walked away with a fat contract to promote city activities starting with the Kampala Carnival 2013, taking place on 6 October 2013.
Patronage does not stop with politicians, it extends to almost all spheres of Ugandan society. Several other performing artists have been given fat contracts from State House (the President’s residence) to work for the presidency in different areas. In fact today, one will see a bus full of artists going to State House on invitation from the President to discuss “issues of national importance.”
Richard Kaweesa and Isaac Rucibigango, both smart and intelligent performing artists composed the song “You want another Rap”, which President Museveni used to woo young voters in the 2011 elections. This song went viral on social media and it worked in the president’s favor. The two artists were handsomely paid by the presidency. Again in 2012 when Uganda was marking 50 years of independence, Kaweesa was given another deal from State House to compose the Jubilee song. This earned him a reported 600 million shillings (US Dollars 235,300).
The same trend can be seen with comedians, as several have specialised in imitating big politicians. Segujja Museveni has perfected the art of mimicking President Museveni and has on several occasions been invited to perform for him. At his first performance before the president, he laughed so hard he had to wipe away tears. It was the first time the nation saw the president have such a hearty laugh. Since then, Segujja’s career has been on a meteoric rise.
As for dramatic artists; they are still reluctant to freely express themselves because of the potential consequences. However, they keep on making references to the political, economical and social spheres of Uganda in their plays. One artist that did this was British-born theatre producer David Cecil. He was deported from Uganda in February 2013 after being accused of staging a play promoting homosexuality. This was at a time when the government of Uganda was up in arms against anyone who seemed not to have a problem with homosexuality.
Most artists have decided to play it safe by keeping away from controversial issues, mainly political, that affect society. Sarah Zawedde, a musician says that the biggest threats to artistic freedom in Uganda are from the cultural, religious and political spheres.
3 Oct 2013 | News and features
Natalya Gorbanevskaya (b 1936) was active in the Russian dissident movement of the late 1960s and early 1970s. That movement provided the impetus and inspiration for the founding of Index on Censorship. After facing severe oppression in Russia, including being deemed committed to a psychiatric hosptial (a common punishment for dissidents), Gorbanevskaya fled to Paris, where she now lives.
Index published 14 of her poems, smuggled out of the Soviet Union, in our very first issue in 1972. This is one of them.
Turn the sky over,
lower it into the sea,
the silent into the voiceless.
Help the sea to rise,
lift the sea into the sky,
sea-blue into sky-blue,
height and depth
bring into balance.
Balance yourself and the world,
the world and the ladybird,
the wavelet and the wave
that drags you under to the bottom.
And go down to the bottom, softly
banging the moist doors behind you.
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