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  • Too old to drive? Tips for families of elderly drivers

    California and five other states require physicians to report patients who present a driving hazard, but some experts say healthcare providers are not really knowledgeable about what circumstances would prevent someone from being a safe driver. NBC's Miguel Almaguer reports.

    Tonight on "NBC Nightly News," correspondent Miguel Almaguer reports on what some seniors are doing to stay on the road and how families and doctors struggle to cope with some of our most experienced drivers.

    The Sharp Rehabilitation Adaptive Driving Program in San Diego helps seniors extend their driving years safely.


    For millions of families across the country with aging parents, having that conversation about when to give up driving is oftentimes a difficult one. Everyday 10,000 Americans turn 65. And even though the crash rate for older drivers is actually down from 10 years ago, when there are accidents the chances of a fatality are higher. 

    The AARP is offering an online seminar about how to assess driving skills of the older driver in your life, and how to have a conversation about driving. Click HERE for more information on the seminar. And for tips from the AAA, please click HERE

    CarFit is an educational program that offers older drivers suggestions to improve their safety on the road.


  • Tens of thousands protest in Greece as Angela Merkel says austerity will pay off

    As German Chancellor, Angela Merkel, made her first trip to Greece since 2007, she was greeted by angry demonstrators in the country's capital city. Greeks came out in droves to protest the visit, as many Greeks believe Germany to be a central player behind the austerity measures taken by the debt-stricken country. CNBC's Carolin Roth reports.

    Tens of thousands of angry Greek protesters filled the streets of Athens on Tuesday to greet German Chancellor Angela Merkel, who offered sympathy but no promise of further aid on her first visit since the euro crisis erupted three years ago.

    As police fired tear gas and stun grenades to halt angry crowds chanting anti-austerity slogans and waving swastika flags, Merkel's host, Prime Minister Antonis Samaras, welcomed her as a "friend."

    Blamed by many Greeks for imposing draconian budget cuts in exchange for aid, Merkel reaffirmed Berlin's commitment to keep the debt-crippled Greek state inside Europe's single currency.

    "I have come here today in full knowledge that the period Greece is living through right now is an extremely difficult one for the Greeks and many people are suffering," Merkel said during a joint news conference with Samaras just a few hundred yards from the mayhem on Syntagma Square, outside parliament.

    "Precisely for that reason I want to say that much of the path is already behind us," she added, offering a public display of support to Samaras's three-month-old government on her first visit to Greece since 2007.

    Reuters

    Police try to disperse protesters reacting to the visit of Germany's Chancellor Angela Merkel in Athens on Oct. 9.



    She tried to reassure her hosts that their reforms would eventually pay off, but also made clear that Greece, which has seen its unemployment rate surge to nearly 25 percent and economic output shrink by a fifth, would not solve its problems overnight.

    Angela Merkel greeted warmly by prime minister, but not by Greeks

    Samaras promised to implement economic reforms necessary to restore confidence: "The Greek people are bleeding but are determined to stay in the euro," he said.

    "All of those who made bets that Greece would fail... will lose," Samaras added, according to Spiegel.

    On the other side of the parliament building, tens of thousands of demonstrators defied a ban and gathered to voice their displeasure with the German leader, whom many blame for forcing painful cuts on Greece in exchange for two European Union/International Monetary Fund bailout packages worth more than 200 billion euros ($260 billion).

    Greek police fired teargas and stun grenades when protesters tried to break through a barrier to reach the cordoned-off area where Merkel and Samaras were meeting. Some demonstrators pelted police with rocks, bottles, paint bombs and sticks.

    Four people dressed in World War II-era German military uniforms and riding on a small jeep, waved black-white-and-red swastika flags and stuck their hands out in the Hitler salute. Some protesters carrying banners bearing slogans such as, "No to the Fourth Reich," the BBC reported.  

    Other banners read "Merkel out, Greece is not your colony" and "This is not a European Union, it's slavery."

    Reuters

    Police try to disperse protesters reacting to the visit of Germany's Chancellor Angela Merkel in Athens on Oct. 9.

    Some 6,000 police officers were deployed, including anti-terrorist units and rooftop snipers, to provide security during the six-hour visit. German sites in the Greek capital, including the embassy and the Goethe Institute, were under special protection. This security operation was one of Athens' biggest in a decade, the BBC reported.

    Among the peaceful protesters, teacher Christina Vassilopoulou, 37, told AFP that despite having a doctorate, she only makes 900 euros (about $1,160) a month.

    "We have children that go hungry and most of the parents are unemployed," she told the AFP news agency, the BBC said.

    Constantine Spiliagopoulos, a lawyer who was also taking part in the protests said Merkel was "one of the main reasons that Greece's low income and the working classes of Greece are under attack," according to the BBC.

    "That is why we must make our presence felt, we must shout against these polices and show that we will do everything so that they do not continue," she added.

    Constantinos Siathas was more hopeful, telling The Associated Press: "I think most people, at least those who think and don't act based on feelings or utopian ideas, are pleased and are expecting a lot from Mrs. Merkel's visit."

    Yiannis Bournos, a spokesperson for the leftist Syriza party, criticized Merkel's visit, telling the BBC that Greeks were "frustrated and enraged because they clearly understand that Mrs. Merkel's visit is just a theater play for the political support of a collapsing coalition."

    Aid money "urgently needed"
    After steering clear of Greece for the past five years, Merkel decided to visit now for several reasons.

    She was keen to show support for Samaras, a fellow conservative, as he struggles to impose more cuts on a society fraying at the edges after five years of recession.

    Yannis Behrakis / Reuters

    Demonstrators, dressed as Nazis, wave a swastika flag as they ride in an open-top car in Syntagma Square in Athens to protest against the visit of Germany's Chancellor Angela Merkel, Oct. 9, 2012.

    With a year to go until Germany holds a parliamentary election, Merkel also hoped to neutralize opposition criticism at home that she has neglected Greece and contributed to its woes by insisting on crushing budget cuts.

    After her government flirted earlier this year with the idea of allowing Greece to exit the eurozone, she now appears determined to keep it in, at least until the German election is out of the way.

    IMF: Global economic slowdown is getting worse, US must avoid 'fiscal cliff'

    Greece is in talks with its "troika" of lenders - the European Union, European Central Bank and International Monetary Fund - on the next tranche of a 130 billion euro ($170 billion) loan package, its second bailout since 2010.

    Without the 31.5 billion euro tranche, Greece says it will run out of money by the end of November.

    The European commissioner for economic and monetary affairs, Olli Rehn, said Tuesday that Greece's creditors would not allow the country to go bankrupt, according to the German publication Spiegel. As European Union finance ministers met on Tuesday, Rehn said the next aid package would be granted "at the latest by November."

    Merkel said the aid payment was "urgently needed" but stopped short of promising that the funds would flow.

    "The troika report will come when it is ready. Being thorough is more important than being quick," Merkel said.

    "We are working hard on this, but we must resolve all the problems," she added. "I think we'll see light at the end of the tunnel."

    "This is an effort that should be seen through, because otherwise it would make the circumstances even more dramatic later on," she added, according to Spiegel.

    Ties between Germany and Greece run deep. Thousands of Greeks came to Germany after World War II as "guest workers" to help rebuild the shattered country and more than 300,000 Greeks currently reside there.

    But the relationship is clouded by atrocities Greeks suffered at the hands of the Nazis. Samaras' own great grandmother killed herself after she watched Nazi tanks rolling down the streets of Athens and the swastika flying over the Acropolis.

    Greek President Karolos Papoulias, whom Merkel also met on Tuesday, fought against the Germans as a teenager, before fleeing to escape persecution by the Greek military dictatorship and finding refuge in Germany.

    The crisis has revived long-dormant animosities, with Greek protesters burning effigies of Merkel in Nazi gear and German media playing up images of lazy Greeks keen for German cash.

    Relations hit a post-war low early this year when Merkel's finance minister, Wolfgang Schaeuble, likened Athens to a "bottomless pit" and proposed imposing a European "Sparkommissar" on Greece to control its finances.

    "The average German voter is irritated at the thought of dispatching more taxes or savings to feckless southerners, yet is desperate for the respect and goodwill to Germany that comes from public displays of magnanimity," said David Marsh, chairman of think tank OMFIF.

    "When Merkel flies to Athens, she's showing she's in charge, and she cares."

    Reuters contributed to this report.

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  • Peace-prize winning girl shot by Taliban to be sent abroad for treatment, Pakistani president says

    After being targeted by the Taliban for speaking out about women's rights, Malala Yousafzai remains in the hospital, recovering from surgery to remove a bullet from her neck. NBC's Amna Nawaz reports.

    Pakistani President Asif Ali Zardari ordered Tuesday that the young Pakistani activist who was seriously injured in a shooting by the Pakistani Taliban be sent abroad for medical treatment, the website for Pakistan's Dawn newspaper reported.

    Malala Yousafzai, a 14-year-old Pakistani activist who won international acclaim for her work promoting peace, and two other young girls were shot and seriously injured Tuesday, police and hospital officials said.

    Local police and hospital officials told NBC News that Malala was shot after leaving her school in the Swat region.

    Official sources told Dawn that the single bullet, which hit Malala's head, had pierced down to her backbone.


    “We have thoroughly examined her, she is in critical condition. The bullet traveled from her head and then lodged in the back shoulder, near the neck,” a doctor told the AFP agency, according to Dawn, requesting anonymity as he was not authorized to speak to media.

    Gunmen hunted down young Malala Yousafzai at her school, shooting her in the head after she dared to criticize the extremists who are ravaging her country. NBC's Amna Nawaz reports.

    “Next three to four days are important for her life. She is in the intensive care unit and semi-conscious, although not on the ventilator,” he added, according to Dawn.

    “In such a condition, she immediately needs a sophisticated surgical procedure, which is not possible in the country,” sources told Dawn.

    Malala was nominated for the International Children's Peace Prize in 2011 for a blog she wrote under a pseudonym for the BBC. She also won the National Peace Prize in Pakistan, was honored with a school named after her, and quickly became an outspoken critic of the Taliban in Pakistan and a public advocate for peace.

    In the blog, she chronicled life in the Swat Valley under the brutal and oppressive rule of the local faction of the Pakistani Taliban, who carried out public floggings, hung dead bodies in the streets, and banned education for girls.

    AFP

    Soldiers take Malala Yousafzai, 14, to an army hospital after a gunman attacked her and two other girls in Peshawar, Pakistan, on Tuesday.

    Obama her 'ideal' leader
    In early 2011, the militants had added Malala to their hit list. 

    "We wanted to kill her as she was pro-West, she was speaking against Taliban and more important she was calling President Obama as her ideal. She was young but was promoting a Western culture in the Pakhtun populated areas," Ihsanullah Ihsan, the spokesman of Tehrik-e-Taliban Pakistan or TTP said Tuesday.

    Veronique De Viguerie / Getty Images, file

    Malala Yousafzai, pictured here at the age of 12 in March 2009, was undergoing surgery after she was shot twice Tuesday.

    The Taliban had made a plan for killing her a year ago but were waiting for an opportunity, he told NBC News.

    Malala was initially treated at the Saidu Sharif Teaching Hospital, in Mingora, the main city of Swat, but was airlifted to a hospital in the larger city of Peshawar.

    'New radicals': Pakistan's Generation Y battles to shape country's future

    A police official, quoting other students who witnessed the shooting, said some people came in a car and stopped in front of the school and then asked them to identify Malala.

    "Since the students already knew about threats to Malala Yousufzai's life, therefore they said they didn't know her," the police officer said.

    Arshad Arbab / EPA

    Images of daily life, political pursuits, religious rites and deadly violence.

    But he said Malala was shot when she came out of the school and got in a school van.

    Americans ignore 'great risks,' travel to Pakistan to protest US drone strikes

    The young girl's stark depictions of daily life in Swat -- as Pakistan’s army carried out a massive military operation against the Taliban in the area -- led her to become the first Pakistani girl nominated for the children's peace prize.

    She began writing the diary for the BBC when she was just 11.

    In one posting on her BBC blog, she wrote: "My younger brother does not like going to school. He cries while going to school and is jubilant coming back home ... He said that whenever he saw someone he got scared that he might be kidnapped. My brother often prays 'O God bring peace to Swat and if not then bring either the U.S. or China here.'"

    A short documentary profiling an 11-year-old Pakistani girl on the last day before the Taliban closed down her school. (By Adam B. Ellick)

     

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  • Deadly crossing: Death toll rises among those desperate for the American Dream

    In a rural Texas county, an increasing number of illegal immigrants are dying before they can complete the journey to what they hoped would be a better life. (Warning: This video contains some footage that may be disturbing for viewers.)

    MISSION, Texas -- In the freezer of a small funeral home nearly 13 miles from the Texas-Mexico border, 22 bodies are stacked on plywood shelves, one on top of the other. 

    The bodies wrapped in white sheets have names, families and official countries of origin -- Honduras, El Salvador, Mexico, sometimes China or Pakistan. The bodies in black shrouds are the remains of the nameless and unclaimed, waiting to be identified.


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    For the past few years, the family-owned Elizondo Mortuary and Cremation Service in Mission, Texas, has been taking in the remains of undocumented immigrants found dead in nearby counties after crossing the border from Mexico. This year, however, they had to build an extra freezer. It’s become difficult to keep up with the rising tide of dead coming to them from across the Rio Grande Valley.

    Crossing the U.S.-Mexico border illegally has always been dangerous, but this year heat and drought have made the journey particularly deadly. According to U.S. Customs and Border Protection, this part of the border has seen a sharp rise in both rescues and deaths of people crossing the border illegally. So far in 2012, agents have rescued more than 310 people, and found nearly 150 dead in the Rio Grande Valley -- an increase of more than 200 percent over the last fiscal year. 


     

    This comes as migration across the U.S.-Mexico border has dropped to historic lows, falling nearly 62 percent over the last five years, according to numbers recently released by CBP. But the proportion of deaths to apprehensions is rising -- suggesting that while fewer are crossing, more are dying.

    Marta Iraheta has been hunting for months for word of her missing nephew, Elmer Esau Barahona, who left his native El Salvador in June.

    Ground zero is over 70 miles north of the border, in Brooks County. Last year the remains of about 50 presumed undocumented immigrants were found in the county. This year, the tally has reached about 104, with nearly three months to go.

    The rising number of unclaimed corpses marks a growing crisis for this cash-strapped county of fewer than 7,500 residents. Because Brooks has no coroner, it sends the bodies recovered on its vast cattle ranches to Elizondo in neighboring Hidalgo County. It costs, according to county officials, about $1,500 for each body to be processed. 

    Hannah Rappleye for NBC News

    Ranch land in Brooks County, Texas.

    Both the county and Elizondo also make efforts to identify the remains. In most cases, chances are slim. The mortuary uses physical descriptions and accounts of the clothing worn by missing immigrants to attempt to match bodies, but often there are few clues to work with. The elements and animals often destroy corpses and scatter bones across the desert. While DNA testing could help, neither Brooks County nor Elizondo can afford to order the tests for every unidentified body. 

    Many of the migrants who are found dead in this part of South Texas end up buried in paupers’ graves, remembered only by their gender, case number and the name of the ranch where they died.

    Adaptation
    In September, Marta Iraheta traveled from Houston to Falfurrias, Texas, the seat of Brooks County. She came seeking the remains of her nephew and a friend who disappeared in July as they crossed illegally into the United States.  

    US Customs Commissioner David Aguilar says the Mexican border is "safer than ever," and denies claims that Washington downplays threats there.

    Twenty-year-old Elmer Esau Barahona left his hometown of San Vicente, El Salvador, on June 10th. On June 27th -- his is daughter’s second birthday -- he called his mother to say he had arrived in the border city of McAllen, Texas.

    He told her he and his friend were staying in a stash house, waiting for the smugglers to take them on the next leg of the journey. From the stories Iraheta has pieced together from survivors, her nephew and his friend left McAllen five days later, on the evening of July 2.

    They began the long walk with a group of migrants through desolate private ranch land, skirting the Border Patrol checkpoint in Falfurrias. After a day of walking, his friend, a 17-year-old Salvadoran named Elmer Amilcar Sevallos Martinez, sat down and did not get up again. The rest of the group continued on. 

    Just minutes from the highway where the coyotes -- as the smugglers are known -- were to pick them up, Barahona hurt his knee.

    “The coyote told them they had to leave him there,” said Iraheta, his aunt, who is a naturalized U.S. citizen. “They said he was bad, really bad. He was faint. He remained there, sprawled on the ground.”

    The Rio Grande Valley is one of the most trafficked illegal immigration routes used by people known in Border Patrol parlance as “OTM,” or “other than Mexican.” About 60 percent of those apprehended in this area come from Guatemala, Honduras and El Salvador, as well as countries as distant as China, Afghanistan and Russia.

    “When you look at South Texas on a map and draw a straight line to Central and South America, this is your furthest southern point to cross into the U.S.,” said Enrique Mendiola, assistant chief Border Patrol agent for the Rio Grande Valley.

    But the recent increase in traffic through this corridor is attributable to more than geography.

    Since the mid-1990s, U.S. Customs and Border Protection has clamped down hard on border crossings. The agency has more than doubled in size since 2004, and now has 28,000 agents, nearly half of them in Texas. Fences, sensors, drones, checkpoints and disciplined, coordinated enforcement have choked off routes through urban areas that were once easily crossed.

    Smugglers have adapted by moving into sparsely populated areas like the Sonoran desert in Arizona, and the west Rio Grande Valley.

    Rancher John Ladd tells NBC News about Mexican drug traffickers trespassing on his land, threatening his security.

    “We’re starting to see these crossings more in these particular areas than we have in the past,” said Mendiola.

    With triple-digit temperatures and wide deserts, these uncompromising landscapes are harder to patrol than populous areas on the border’s edge. They are also more dangerous for those crossing into the country.

    “There’s no doubt that the increased vigilance has pushed people into these more hostile areas,” said Raquel Rubio-Goldsmith, a professor of Mexican American Studies and coordinator of Arizona State University’s Binational Migration Institute. “Traditionally, people crossed in urban areas. If you cross into an urban area, you can find a way of making it. If you have to cross through these rural areas, you’re taking a big chance.” 

    Despite the rising danger and cost, people keep coming. Advocates and families say that with few legal avenues into the U.S., migrants feel this is the only way to make a better life.

    Field supervisors have been ordered by Washington officials to downplay the smuggling threats, a former DEA supervisor says – a charge U.S. Customs and Border Protection vehemently denies. NBC's Mark Potter reports.

    “Had they been able to have a good chance of getting a visa, they never would have tried to cross the desert,” she said.

    Lucrative cargo
    U.S. Customs and Border Protection says that Gulf Cartel out of Mexico controls most of the lucrative smuggling routes through this area of the Rio Grande Valley, and uses them to ferry both humans and drugs into the country.

    The Border Patrol has made dismantling these networks a priority. Despite daily apprehensions of individual migrants, Deputy Chief Patrol Agent Woody Lee said the agency’s larger aim is “not focusing on what it is that’s coming across, but how do we take out the infrastructure.”

    “How do we take out the people who are moving the product, or the people, on this side of the border? ” he said. “Those people are within our control.”

    This means the agency, which has jurisdiction up to 100 miles from the border, does much of its work far from the Mexico line, following the smugglers as they forge new tactics and routes.

    Hannah Rappleye for NBC News

    Texas Border Volunteer Ed Aldredge, left, and rancher Mike Vickers. The Texas Border Volunteers, a citizen group based in Brooks County, patrols ranch land for undocumented immigrants.

    The coyotes hustle people across the border into stash houses in towns and cities like McAllen and Mission. From there, they pile them into vans -- the seats torn out to fit more bodies -- and drop them off along the road south of the Falfurrias border checkpoint in Brooks County, the northernmost patrol point in this area.

    Those who pay more walk less, according to the Border Patrol and immigrants who have made the crossing. The going rate varies. A thousand, or a few thousand, just to cross the border. For those from Central America, it may cost more than $5,000 or $7,000. For those from China or Pakistan, some say the cost is as high as $50,000. 

    The terrain the immigrants must cross is brutal. The walk can be dozens of miles through the sandy terrain with nothing -- no water, mountains or hills by which to navigate. During the summer, daytime temperatures reached nearly 110 degrees. The brush fools the unaccustomed. One minute they are tired. The next, their bodies begin to give out.

    People in Falfurrias know what happens on the journey, often better than the migrants themselves. 

    They know how some groups have coyotes as guides across the desert. Others are left on their own, with a cell phone to call the coyote when they arrive. Some use it to call 911 if they are dying. 

    Ranchers and Border Patrol agents have seen evidence of brutality. They will tell you that a pair of women’s panties hung in a tree is a sign that a woman was raped there. The coyotes leave them to mark the conquest.

    They will tell you how the coyotes tell their charges that the walk around the Falfurrias checkpoint is short, that they should aim for those lights.

    “That’s Houston,” some coyotes say to give the migrants hope the trip is nearly done. But that distant glare is merely light over a ranch gate, or the streetlights illuminating Highway 281. Houston is nearly 300 miles away.

    A retired assistant Special Agent DEA and an Ex-US drug czar agree the Mexican border is not secure and Washington is "in denial."

    ‘The depravity of man’
    The photos spread across the desk of Brooks County rancher Mike Vickers show corpses in various states of decomposition. From the pile, the sun-bleached skulls of women peer out from beneath the rotting flesh of young men. Others show immigrants who were found near death by the Border Patrol or Vickers himself -- women huddling underneath trees and men leaning against trucks, dazed by thirst and heat exhaustion.

    All the images were taken on Vickers’ ranch.

    “These bodies are everywhere,” Vickers said. “The bones are everywhere.”

    Vickers, who is also a local veterinarian, spoke of the toll the stream of illegal migration has taken on Brooks County ranchers and their families.

    Desperate for water, migrants break the pumps that provide water to the cattle. They tear down fences. Men have scared Vickers’ wife, Linda, as she rode her horse. And finding the remains, which sometimes end up right in their backyard, wears on him.

    “We see the depravity of man out here,” he added. “It’s altered our way of life.”

    Vickers is the chair of a group called the Texas Border Volunteers. At least once a month, members gather in Brooks County to search private ranch lands for migrants and their remains.

    When they find either, they contact the Border Patrol.

    They carry water, food, cameras and GPS devices on their patrols.

    “We do everything we can to try to rescue them and get them out of a bad situation,” Vickers said. “The heat can fool you. It doesn’t have to get that hot to really make someone walking through that sand get dehydrated real quick and suffer heat stroke.”

    They also bring weapons in case they encounter coyotes, gang members or people carrying expensive cargo, such as drugs.

    On a recent patrol, Vickers and two volunteers wearing military camouflage rolled across deep sand in a four-wheeler, searching for signs of life or death.

    Black buzzards drifted above one of the few hills on the land. To ranchers and cowboys, the buzzards have become a sign not of dying cattle, but of a dying human. “Something’s dead up there,” Vickers said.

    Hannah Rappleye for NBC News

    Texas Border Volunteers Ed Aldredge, left, and Mark Medina patrol a ranch in Brooks County.

    On top of the hill, Mark Medina, 45, and Ed Aldredge, 45, both military veterans, picked their way through trees and cacti, searching for a corpse. They found nothing.

    “It’s like finding a needle in a haystack,” Medina said.

    But evidence of crossers was everywhere. Half-empty water jugs, crushed energy drink cans, socks, and jackets lay discarded under trees or covered in sand.

    The Border Patrol has stepped up efforts to rescue immigrants who find themselves lost, dehydrated or sick. They’ve placed rescue beacons on the ranches, where an immigrant can push a button to alert Border Patrol agents. They’ve posted signs with GPS coordinates across the landscape so immigrants with cell phones can call 911 and give their location.

    They’ve also produced public service announcements, including some in Spanish, imploring people not to cross.

    The message is this: “Don’t put your life in the hands of these ruthless people,” said Border Patrol agent Mendiola. “To them, you’re just a commodity. You’re not a human being. You’re cargo.”

    ‘Are you going to come or go?’
    After 17-year-old Sevallos Martinez fell behind, Barahona continued with the rest of the group to trudge through the private ranch land flanking Highway 281.

    In the morning, Barahona stepped into a hole and injured his right leg. In pain, he could barely walk. A friend he made along the journey took off a brown checked shirt and tied it around Barahona’s knee, over his black jeans, then helped him limp along.

    They were almost to the road when Barahona gave out. His friend helped him over a fence. They were minutes from the pickup point, near enough to hear the highway. There were just two fences left. The coyote said the truck was waiting. People ran for the road.

    “He was yelling. Yelling for people to help him,” Iraheta said. “The coyote told him to stop yelling because people would hear him.”

    The friend who helped Barahona told Iraheta her nephew’s lips went white and he fell. The coyote yelled at the friend. “Are you going to come or go?” He ran to the vehicle.

    On July 5th, the coyote called Barahona’s mother in El Salvador and told her he left Elmer in the desert.

    “And that’s where the tragedy began,” said Iraheta. “I looked for him alive in all of the jails and nothing, so I’ve started to look for him among the dead.”

    ‘On our own’
    Brooks County Chief Deputy Urbino Martinez has a stack of white binders filled with emails, letters, and reports of the missing and the dead. His office, he said, is “overwhelmed” by the deaths.

    With a yearly budget of about $585,000 and only one investigator and five deputies on patrol, the county has neither the staff nor the resources to process the remains. Since they’re not technically a “border county,” Martinez said, it’s been impossible to get federal grants to help.

    “We’re pretty much on our own out here,” he said.

    Brooks County has no medical examiner, so it can’t perform autopsies or extract samples. Instead, deputies send remains first to a funeral home in Falfurrias, and then to Elizondo in Mission, where they can extract samples for DNA testing. 

    Hannah Rappleye for NBC News

    A photo of a young woman with her child in the missing persons file at the Brooks County Sheriff's Office.

    But Brooks County’s responsibility doesn’t end there. The sheriff’s office keeps pages of records. Deputies call consulates. They try to match remains to open missing persons cases.

    “At times people wonder why we put all this effort into it,” Martinez said. “Because our administration feels like they’re humans. I know they’re trespassing, I know they shouldn’t be in the United States. But they’re on U.S. soil. We have to protect them and we have to make sure that we do what we have to do on our end, regardless of what we have to go through.”

    Martinez said the Sheriff’s Office is deluged by phone calls, emails and in-person visits from desperate families and friends of the missing. But it’s difficult to find and identify someone who has died in the desert, he said, even when the families offer clues.

    “It’s a sad thing sometimes because you just can’t help them and they don’t understand that,” he said. “They’ll call you and say, ‘He’s by this tree, they’re telling me he’s by this tree.’ If the animals get to them, they’re not going to be by that tree. The limbs are going to be everywhere. That’s just the way it is.”

    Like the files at Vickers’ ranch, the binders deputies have assembled contain photographs both of the living and the dead. In some, the victims are smiling with their children, or clutching their husbands or wives. In others, their bodies are sprawled on the sand, staring up at the sky. Paging through the photographs, Martinez wondered aloud what went through their minds as they lay dying in the desert.

    “It’s not worth it,” he said. “They feel like the dream that they hear about, as soon as they get onto U.S. soil, they’re closer to the dream.”

    “But a lot of the time when they’re being walked across,” he added, “that dream is empty.”

    Searching for answers
    In mid-September, Iraheta came to Brooks County carrying photographs of the two Elmers.

    She believed she had identified a man in one of the sheriff’s files as her nephew, but wanted to know for sure. She carried a snapshot of the picture in the sheriff’s file, showing a man prone face down in the brush, a brown-checked shirt tied around his knee. But her discovery had come too late -- the body had already been buried. Now, answers would cost money.

    Iraheta can recite the figures by heart: $900 to exhume the body; $250 to cut the bone for DNA testing. $3,000 for the DNA test; $100 a day to store the body for nearly four weeks until the results come in; $3,000 to $4,800 to send the body home.

    “That means that’s more than $12,000,” said Iraheta. “I can’t afford that. I’m poor.”

    But she is trying to raise the money, for her sister crying in El Salvador, and for Barahona’s daughter.

    “I want his daughter to have a place to carry a flower to,” she said. “I want her to have a place to say, ‘Here is where my father is buried.’”

    Hannah Rappleye for NBC News

    An unidentified immigrant's grave at the Sacred Heart Cemetery in Falfurrias, Texas. When the remains of a migrant cannot be identified they are buried with a marker indicating where their body was found.

    On this trip, she came with a group assembled by Angeles Del Desierto, or Desert Angels, which has for 15 years conducted rescue mission and searched for the dead along the southern border.

    They went to the sheriff’s office, which had nothing more for Iraheta. They spoke to the local funeral home, which could offer little. They went on a mission into the desert, searching for people, alive or dead.

    Finally, with little hope, they drove to Elizondo Mortuary in Mission. Iraheta carried her photographs of the Elmers and the little she knew about where they were last seen, what they wore, and the things they carried.

    The owner of Elizondo looked at Iraheta’s pictures, and went to her files. She stopped at one file of a man found with no face, no hair, no discernable features -- just bones. But the people who found the remains had recovered personal effects: a white rosary and a pair of pants with two pictures tucked in the pockets -- the same pictures Iraheta had been given by the family of 17-year-old Elmer Amilcar Sevallos Martinez, the boy left in the desert a few hours before her nephew.

    “With those two things, we knew that it was him,” said Iraheta.

    The discovery came just in time for Sevallos Martinez’s family. His remains were to have been buried the following day.

    His family had held out hope the teen would be found alive. They only knew that he had been left in the desert. In some stories, he fell. In others, he was exhausted, and stopped to rest under a tree. But maybe he had recovered and begun to walk again.

    Iraheta called a number she had for the boy’s father, a man from El Salvador living in Maryland.

    “I think he was in shock,” said Iraheta. “He asked how we knew it was him. And we told him by the photos that were in his pants pocket.”

    Sevallos Martinez’s remains are being sent to Maryland by the Salvadoran consulate, so his father can examine the photos and rosary. In some cases, the consulate will help with the cost of sending a body home. Even so, the family, like Iraheta, may want a DNA test to know for sure -- if they can afford it.

    Money is the reason the two Elmers risked their lives to make the illegal crossing -- money and a search for a better life. Now it is a seemingly insurmountable obstacle to their families’ efforts to bring them home.

    “You have nothing to give to your children, to help your mother, so you have to take the decision to come here to find a….to try to find a job to send money to the family,” said Iratea. “They paid the high price for the American dream.”

    “We can’t turn back time,” she added. “But I hope that everyone sees that it’s not worth it, that voyage. To give up your life to that desert.”

    NBC News Correspondent Mark Potter contributed to this report.

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  • Is it possible to be too clean? Researchers say yes

    The very tools we use to battle bacteria and viruses may actually end up 'training' our immune systems to attack allergens. NBC's Dr. Nancy Snyderman reports.

    If you’ve been feeling guilty because you can’t keep your house spotless, stop.

    As it turns out, allowing the odd germ to flourish here or there just might be saving your kid from a lifetime of allergies, Dr. Nancy Snyderman explained on "NBC Nightly News with Brian Williams" Monday.

    It seems counterintuitive, but that’s exactly what the so-called "hygiene hypothesis" suggests. You can actually be too clean for your own good.

    Scientists came up with the hypothesis as a way to explain the explosion of allergies and asthma in America’s youth. And what they discovered was intriguing, if a little disconcerting: kids who grow up in less tidy environments end up with a lower risk of developing sensitivities to benign substances, like pollen and dog dander.

    A study released in June added to the growing mound of evidence that the too-clean-for-health hypothesis might be on track. That study, published in the Journal of Allergy and Clinical Immunology, found that Amish children who were raised on farms were less likely to develop allergies and asthma than their peers.

    Why would exposure to dirt and microbes make a kid less sensitive to pollen and the like?

    For one thing, it’s exposure to pathogens that allows the immune system to become fine-tuned as it learns to differentiate between harmful and harmless irritants.

    Beyond this, exposure to certain bacteria gives the immune system's dedicated "fighters" something to do.

    “I believe that the immune system is like an army,” explains Dr. Samuel Friedlander, an allergist at University Hospitals Case Medical Center in Cleveland. “So, if the army doesn’t have something to fight like microbes, it’s going to fight things like allergens in many cases. People [who] live on farms are exposed to more microbes and as a result the immune system tries to fight those bugs and then, in turn, the body doesn’t have to fight allergens.”

    Dr. Richard Gallo puts it a little differently. If you keep your environment too clean – by using too many bacterial soaps and hand sanitizers, for example – then your immune system becomes more sensitized to any irritant that comes its way.

    “It’s a change in your allergic set point,” says Gallo, a professor and chief of dermatology at the University of California, San Diego. “So being too clean can lead you to have a high allergic set point that will overreact to the environment.”

    Does that mean we can all throw out our mop buckets and soap? No, experts say. We still need to keep things clean, just not Bubble Boy antiseptic.

    And there's an interesting side note: Some really intriguing animal studies have shown that you might be able to reset your immune system even after you’ve grown up by exposing yourself to certain types of bacteria.

    “Some very recent studies that have been published in very excellent scientific journals have shown that with the introduction of specific bacteria in laboratory animals, you can completely reset their immune status and their capacity for certain allergic responses,” Gallo says.

    And keep in mind, experts say, that some bacteria are fairly benign.

    “So my advice is that some hygiene is good, too much is bad,” Gallo says. “In many cases you have to use common sense. You’re in a situation where you’re likely to be exposed to pathogens – germs that could cause disease – it’s a better idea to use sanitizers to remove them.

    "But indiscriminate use - overusing hand sanitizers, anti-microbial soaps and so forth - is also going to be doing harm. So you have to balance the two.”

    It’s Healthy Week! Learn the small steps you can take in your life to go healthy and "like" us on Facebook! And then follow up on Twitter at twitter.com/healthyatnbcu 

    More from "Healthy Week" on NBC News:

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  • Important facts about new Alzheimer's drug solanezumab

    An experimental drug called solanezumab has demonstrated the potential to slow cognitive decline in patients with mild cases of Alzheimer's disease. NBC's Robert Bazell reports.

    By Robert Bazell, NBC News correspondent

    For the first time ever an experimental drug named solanezumab is showing great promise of slowing the progression of Alzheimer's disease, a form of dementia affecting 36 million people worldwide and five million in the U.S.

    Here are some important facts about this drug.


    • It is made by Eli Lilly
    • It is NOT on the market now and most likely will not be for years
    • The reason for that time frame is that today’s results came from a revised look at two trials that were declared failures
    • In the revision the drug seemed to help people with mild Alzheimer’s but not more advanced
    • Even with the revision the benefit was relatively small
    • The company is talking to the FDA about approval, but is very unlikely to get it yet
    • It is very likely that  results will need to be repeated in a trial designed for that purpose
    • It is important for research because it show that drugs like it that target a protein called amyloid beta that many scientists believe is the cause of the disease could work
    • It is possible that this or similar drugs will work better if they are given even earlier, but that has to be proved
    • So it is of no benefit to patients now,  but it is still a ray of hope where there has only been scientific darkness

     

  • More weapons in Syria could trigger 'all-out war'

    Reuters

    Turkish soldiers take strategic position at the Akcakale border gate in southern Sanliurfa province on Sunday.

    News Analysis

    SANLIURFA, Turkey – Monday was another day of cross-border violence and rising tension between Syria and Turkey.

    It was also a day when Gov. Mitt Romney pledged that, if elected president, he’d change the course of events here.

    Among other things, he wants to green-light heavy weapons to the Syrian rebels “who share our values” in order to “defeat the tanks, helicopters and fighter jets” of the Bashar Assad regime.

    For its part, the Obama administration says it has refrained from supplying the rebels with weapons out of concern that they could end up in terrorist hands

    Others say escalating the conflict with more weapons isn’t necessarily good news for ordinary Syrians who are struggling to live along the 600-mile border – or for the U.S., given the potential for a larger regional conflagration.

    Romney: Risk of conflict higher in Mideast after Obama policies

    On the border – but not safe
    Mahmoud Soukman is a truck driver who transports goods between Syria and Turkey. Three weeks ago he left his truck and fled with his wife, 9-month-old daughter and the clothes on their backs, moving in with his mother and siblings on a small farm just inside Turkey.

    But they don’t feel safe, on either side of the border.

    Mortars and shells explode ominously, and often in the distance, as Syrian rebels and government troops fight over strategic swaths of Northern Syria in the ongoing civil war. And one mortar did land near the farm house. 


    Meanwhile, the tit-for-tat border skirmishes between Turkey and Syria have already become routine. The Syrian Army landed a mortar again on Monday about 100 yards inside Turkey, with no casualties; and the Turks have been returning artillery fire at imprecise targets inside Syria.

    Andrea Mitchell talks to Ambassador Dennis Ross about the escalating tensions between Syria and Turkey, and what both presidential candidates are saying they'll do about the situation.

    Syrian President Assad’s regime offered a weak apology for the deaths of five Turkish civilians, killed last week by an allegedly errant shell. But Turkish government officials have become increasingly bellicose. On Monday, Prime Minister Recep Tayyip Erdogan warned Turks to prepare for war, if necessary. 

    Also on Monday, Turkish President Abdullah Gul said the "worst-case scenarios" were now playing out in Syria and Turkey would do everything necessary to protect itself.

    "The worst-case scenarios are taking place right now in Syria ... Our government is in constant consultation with the Turkish military. Whatever is needed is being done immediately as you see, and it will continue to be done," Gul said.

    "There will be a change, a transition sooner or later ... It is a must for the international community to take effective action before Syria turns into a bigger wreck and further blood is shed, that is our main wish," he told reporters in Ankara.

    Near Soukman’s farm, we saw Turkish troops and armored personnel carriers beefing up the border, building sand berms that gave the ordinarily bucolic setting a front-line feel.

    Turkey fires on Syria after another Syrian shell hits its terrority

    ‘Very volatile’
    Some Middle East analysts see a potential tinderbox. “The situation is very volatile, very dangerous and has the potential to escalate into all-out war,” warned Professor Fawaz Gerges from the London School of Economics. 

    What could happen if the rebels get the shoulder-held rocket launchers and anti-aircraft weapons they want?

    One likely scenario, say some Middle East experts, is that the Kremlin will loosen its own under-reported restrictions and sell the Syrian government – which Russia considers a client state – the high-tech weapons that Assad has been clamoring for. 

    If that were to happen, some say it has the potential to unleash an arms race – and an all-out war – on Turkey’s doorstep.

    In that case, Gerges believes, just one mistake, one miscalculation, could trigger a regional war - or worse.

    During a campaign speech at the Virginia Military Institute, GOP presidential candidate Mitt Romney outlined his plan for easing tension in the Middle East, as well as his Syria strategy.

    “If Turkey, a NATO member, is fed up and invades Syria, NATO would have no choice but to intervene in Syria. And you can bet that Iran would become involved, and this could quickly turn into a region-wide conflict between Turkey, NATO, Saudi Arabia and Qatar on the one hand, and Iran, Iraq, Hezbollah and Syria on the other.”

    Luckily, this nightmare scenario can be avoided. In fact, both Russia and NATO (read: the U.S.) are using their considerable influence over Syria and Turkey, respectively, to keep tempers in check.

    But Turkey is already bristling with almost 100,000 hungry Syrian refugees in camps on its border. And Assad is well aware that Turkey is largely spearheading the rebels’ fight against his regime, supplying their weapons and hosting the military wing of the opposition. 

    If a Syrian warplane were taken down by well-armed rebels and crashed into a Turkish village on the border, killing dozens, the incident could be the match that ignites a conflagration. 

    “You have the potential not only for a region-wide war, but also for international conflict as well,” said Gerges.

    Machine guns operated by motorcycle brakes? Get a glimpse at the rebels fighting against Assad's forces in Syria's mountainous Jabal al-Zawiya area.

    Who are the Syrian rebels?

    Political calculation
    President Barack Obama has maintained that arming the rebels is a red line beyond which chaos could unfold, leaving the risk of an over-militarized Syria with a power vacuum – a kind of Libya on steroids.

    There is also the added danger of “rogue rebels” – both al-Qaida and affiliated militants have already joined the rebels’ ranks – getting their hands on sophisticated weapons and turning them on us.

    At least in his public statements, Romney doesn’t appear too concerned about either happening. Instead, he seems more focused on a victory by freedom-fighters over an evil Syrian regime. His camp says that more powerful and deadly weapons will be a game changer.  

    From his precarious perch overlooking the border, Soukman, the refugee truck-driver, sees only dark days ahead.

    “There’s no food or water in our village. You can die from hunger,” he said. “If the fighting doesn’t calm down, maybe we’ll be here for years.”

    Jim Maceda is an NBC News Correspondent based in London currently on assignment on the Turkish-Syrian border. Reuters contributed to this report.

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  • Fungal meningitis deaths now at 11; 119 cases confirmed

    The number of known patients has grown to more than 105 with eight deaths after tainted steroid injections were linked to a fast-growing meningitis outbreak. NBC's Tom Costello reports.

    The number of people infected with a rare type of meningitis tied to contaminated steroid injections has climbed to 119, federal health officials said Tuesday. Eleven people have died. 

    The drugs were given starting May 21, much earlier than previously suspected, officials with the Centers for Disease Control and Prevention said. Infections and deaths have been reported in nine states. As many as 13,000 patients may have been exposed to the potentially contaminated drugs recalled from a Massachusetts compounding pharmacy, officials added. 

    Cases have been identified in 10 states and health officials fear the numbers will continue to rise as doctors check patients for the symptoms. Doctors and patients alike may not know to look for the unusual infection, which can take weeks to develop after an injection.

    New Jersey has now reported its first meningitis case that may be linked to the contaminated injections. Tennessee continues to log the most victims, with 35 cases and four deaths. In Virginia, 23 cases have been confirmed, with one death. Michigan has reported 21 cases and two deaths, while Maryland has reported five cases and one death. 

    Other affected states include Florida, with four cases; Indiana with 11 cases; Minnesota with three cases, North Carolina with two cases and Ohio with one case, officials said. 

    The drug in question is called methylprednisolone acetate and is used mostly to treat older patients for lower back pain.

    The contaminated drugs have been traced to the New England Compounding Center, a single compounding pharmacy. The pharmacy has closed voluntarily, relinquished its state license and recalled its products, which include steroids, painkillers and dozens of other drugs. At least one sealed vial of drug has been found to have fungus growing in it, the Food and Drug Administration said. The FDA does not regulate pharmacies like the one in Massachusetts but can be called in when contamination is suspected.

    Compounding pharmacies usually make drugs to order, and the steroids suspected of causing the infections did not contain preservatives that can keep fungi and bacteria from growing.

    The pharmacy sent products to clinics in California, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, Nevada, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia, Texas, and West Virginia, the CDC says.

    The patients appear to have had contaminated drugs injected directly into their spinal fluid. CDC says the clinics do not appear to be to blame. The CDC said it has found fungus, including Aspergillus and Exserohilum, in specimens from nine patients.

    In Tennessee, health workers contacted 66 patients who may have been infected, in some cases going door-to-door to inform them of the risk and to answer questions, state officials said. 

    Meningitis is an inflammation of the protective membranes covering the brain and spinal cord. Bacteria or viruses are the usual cause, but meningitis can also be caused by fungi and parasites. "In addition to typical meningitis symptoms, like headache, fever, nausea, and stiffness of the neck, people with fungal meningitis may also experience confusion, dizziness, and discomfort from bright lights. Patients might just have one or two of these symptoms," CDC said.

    Related stories:


  • NBC's Kerry Sanders answers questions about Chavez re-election in Venezuela's elections

    In Venezuela, Hugo Chavez won another 6-year term as president of the oil-rich nation with official results showing the socialist leader garnering 54 percent of the vote. NBC's Kerry Sanders reports.

    CARACAS, Venezuela – President Hugo Chavez scored a comfortable election victory and vowed to deepen his self-styled socialist revolution after a bitterly fought race against a youthful rival who has galvanized Venezuela's opposition.

    The state governor who lost Sunday's presidential vote, Henrique Capriles, accepted defeat as Chavez swept to a 10-point victory margin, the smallest yet for him a presidential race. Chavez won 55 percent of the vote against 45 percent for Capriles with more than 90 percent of the vote counted.

    Venezuela's Hugo Chavez wins 3rd term

    NBC News’ Kerry Sanders is in Caracas reporting on the elections. Earlier today he answered reader questions about Chavez re-election. 

    Click on the link below to replay the informative chat. 

    Photoblog: Chavez wields Bolivar sword at victory rally

     

  • Friendly fire killed Border Patrol agent, sources tell NBC News

    Sources have told NBC news that the shooting at the Mexico border near Naco, Ariz., that killed border patrol agent Nicolas Ivie and wounded two others involved friendly fire. NBC's Mark Potter reports.

    Updated at 7:30 p.m. ET: Investigators are preparing to announce that the death of Border Patrol Agent Nicholas Ivie in Arizona earlier this week was the result of friendly fire -- accidental gunfire from another agent who responded to the same scene, state and federal officials told NBC News on Friday.

    The conclusion is based on an analysis of the ballistics, the lack of evidence of other criminals in the area at the time, and other factors, the sources said.

    The FBI released a statement later on Friday confirming that preliminary evidence showed friendly fire was to blame in the shootings.


    "While it is important to emphasize that the FBI's investigation is actively continuing, there are strong preliminary indications that the death of United States Border Patrol Agent Nicholas J. Ivie and the injury to a second agent was the result of an accidental shooting incident involving only the agents," said James L. Turgal Jr., FBI spokesman, in a statement to NBC News. "At the appropriate time further information will be provided, but while the investigation continues it would be inappropriate to comment any further at this time."

    The incident involving Ivie and two other agents occurred Tuesday in a rugged area about five miles north of the US-Mexico border near Bisbee, Ariz. The agents had responded to an alarm from a sensor that tracks illegal movement along the border.

    Gary M. Williams / AP

    Christy Ivie, center, wife of Nicholas Ivie, holds back tears as she is surrounded by her father, Tracy Morris, and mother, DeAnn Morris, left, and her sister, Jan Cloward, and brother, Travis Morris, right, during a news conference on Tuesday.

    Ivie was killed. A second agent was wounded and was released from the hospital after undergoing surgery. The third agent was unharmed.

    State and federal officials said immediately after the incident that the shootings were committed by armed criminals.  And since then, Mexican authorities have said they arrested two men in Agua Prieta, northern Sonora state, a few miles from where the shooting occurred.

    Pete Williams is NBC News' chief justice correspondent.

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  • NBC's Kerry Sanders answers questions about the Venezuela elections

    Venezuelan President Hugo Chavez faces the toughest election of his 14-year rule on Sunday in an election pitting him against Henrique Capriles.

    Chavez, 58, is looking to win another six-year term to consolidate his self-styled socialist revolution in the oil nation.

    Chavez faces fierce opposition as election looms

    Capriles, a 40-year-old state governor, is his fresh-faced opponent promising jobs, less crime and an end to cronyism.

    What are Chavez’s chances of victory? Will the elections be free and fair? How will the outcome affect U.S.- Venezuela relations? What about the price of gas in the U.S.? 

    NBC News’ Kerry Sanders is in Caracas reporting on Sunday’s election. He answered reader questions about the elections earlier today.

    Click to replay the informative chat below. 

    Venezuelan elections: Face-off between the showman and the lawyer

  • Seven deaths reported in growing meningitis outbreak; second fungus found

    Updated, Oct. 6: Federal health officials have widened their recall of drugs suspected of giving people an unusual type of meningitis that has so far killed seven, and identified two different types of fungus they believe are infecting people.

    At least 64 cases in nine states have been diagnosed with meningitis linked to the contaminated drugs, the Centers for Disease Control and Prevention reported Saturday.

    Health experts expect more cases will be reported and are asking anyone who had a recent steroid injection for lower back pain to be on the lookout for headaches, stiff necks, unsteadiness and other classic symptoms of meningitis.

    “All patients who may have received these medications need to be tracked down immediately. Patients can find the names of the clinics that used these medications on the CDC website,” said CDC's Dr. Benjamin Park, medical officer for the fungal diseases branch. “It is possible that if patients with infection are identified soon and put on appropriate antifungal therapy, lives may be saved.”

    Tennessee state health officials said four more people had been diagnosed there since Thursday, bringing that state’s total cases to 29, with three deaths. Michigan is the latest to report cases, with four there. People with suspected fungal meningitis have been diagnosed in Tennessee, Virginia, Maryland, Florida, North Carolina, Michigan and Indiana.

    The drug is question is called methylprednisone and is used mostly to treat older patients for lower back pain. All the cases so far have been traced to a single pharmacy in Massachusetts that makes the drugs to order. The pharmacy has closed, surrendered its license and recalled its products, Food and Drug Administration officials said. But they said hundreds of people could have been injected with contaminated steroids and possibly other products. The pharmacy could have shipped products to all 50 states.

    CDC listed the 75 clinics known to have received shipments of methylprednisolone from the pharmacy.

    Tennessee Health Commissioner Dr. John Dreyzehner said the clinics that treated the patients are not to blame. “Our continuing investigation found no lapses in process at the clinics,” Dreyzehner told reporters Friday. “Evidence indicates these clinics and clinicans had no way of knowing about the contamination.”

    "Fungus has been identified in specimens obtained from 9 patients, including Aspergillus and Exserohilum," CDC said. Both types of fungus are found in back yards --  Exserohilum can cause leaf spot but it's also been linked to skin and sinus infections. Aspergillus causes lung infections in cancer, HIV and other patients with suppressed immune systems.

    Some kind of fungal contaminant has been found in at least one vial of drugs made by the pharmacy. Fungi can grow in drugs that are not stored properly, especially those without preservatives, like those made by the compounding pharmacy.

    Meningitis is an inflammation of the spinal cord, usually caused by bacteria or viruses. It can be very serious and symptoms include headache, fever, often a stiff neck and balance problems. Fungi and parasites can also cause this inflammation and in this case the common mold aspergillus is suspected.

    Fungal infections are tricky to treat. Antifungal drugs including voriconazole and amphotericin can be used to treat the infections.

    "Currently, we think that this type of meningitis is quite severe as we have been describing here. The antifungal treatment for this is intravenous antifungal treatment and requires initial hospitalization. But the duration of antifungal therapy could be prolonged, possibly on the order of months," Park said.

    To be especially careful, health officials have widened their warning to anyone who got a steroid injection in the spine between July 1 and September 28 this year. “Infected patients have presented approximately 1 to 4 weeks following their injection with a variety of symptoms, including fever, new or worsening headache, nausea, and new neurological deficit (consistent with deep brain stroke),” the FDA said in a statement on its website.

    “Some of these patients’ symptoms were very mild in nature.”

    The FDA says there will be no shortage of methylprednisone. “There are FDA approved versions of methylprednisolone acetate injection on the market, available with or without preservatives,” it said.

    “Although all cases detected to date occurred after injections with products from these three lots, out of an abundance of caution, CDC and FDA recommend that healthcare professionals cease use of any product produced by the New England Compounding Center until further information is available,” the FDA added. Among the other drugs from the pharmacy being recalled are three steroid drugs -- betamethasone, a steroid usually given in creams or as a spray, dexamethasone and triamcinolone; two local anesthetics called lidocaine and bupivicaine; the blood pressure drug clonidine; and saline.

    Compounding pharmacies are not regulated as closely as drug manufacturers, and their products are not subject to FDA approval.

    Centers for Disease Control and Prevention

    List of healthcare facilities that received large amounts of methylprednisolone acetate (PF) recalled from New England Compounding Center on Sept, 26, 2012.

    The meningitis outbreak tied to steroid epidurals has killed five people so far, and originated from a specialty pharmacy in Massachusetts. NBC's Brian Williams reports.

    Related stories:

     

  • Bald is beautiful ... and a career boost, study finds

    EPA. AP

    Some of Hollywood's toughest leading men sport shaved heads.

    Looking for an edge at work? Break out your razor. A new study says that men with shaved heads are perceived as more dominant, more masculine, and more suited for leadership roles.

    The lead researcher, Albert Mannes at the Wharton School of Business, decided to go "bare up there" in his mid-thirties when he was starting to lose his hair. And people started treated him differently. He then designed a series of experiments to test what people really thought of guys with shaved heads.

    In the first tests, he showed participants pictures of similar-looking men with shaved heads and those with hair. The men without hair rated statistically significantly higher for dominance. They were also rated as being 3 years older, and slightly less attractive.

    To isolate the results further, Mannes devised a second experiment. He showed a panel pictures of men with hair. He also showed pictures of the same men with their hair Photoshopped out. The panel rated the men with shaved heads higher for dominance, confidence, masculinity, and leadership potential.

    But get this: The panel also said the guys with shaved heads were an inch taller and could bench-press 13 percent more weight than the guys with full hair.

    Remember, these are the same guys, just with their hair digitally erased.

    The third and final test used no photographs. Just words. Mannes asked subjects to read a two-sentence description of a man and rate him on the same attributes as the second experiment. The paragraph was the same each time, with one difference, whether the man was described as having a "shaved head," "thinning brown hair," or "thick brown hair."

    Even when responding to just the text, the guys with the shaved heads ranked higher on those alpha-dog traits.

    However, there was a much smaller margin between the "shaved" head and the "thick brown hair." The greatest difference was between "shaved" and "thinning." Which means that men with all their hair looking to jump up the ladder shouldn't rush out and go under the clipper. Only men experiencing hair loss will have a total net benefit from shaving their head. Men with all their hair who shave it all off will lose more in social and psychological ranking than they gain, said Mannes. 

    So if you have luscious locks, don't let this study be the Delilah to your Samson. Keep your hair.

    The big takeaway is that men who are losing their hair, Mannes said, "might better improve their well-being by finishing what Mother Nature has started," and shave it all off. It can give you social and psychological boost, and could open up pathways at work and in life.


    This doesn't mean that men with shaved heads are in fact better leaders. Then again, perceptions can become reality.

    "People may afford you opportunities to demonstrate your leadership if you look like someone who could be a leader. There is a reinforcement process that does happen with social perception," said Mannes. "How you're perceived affects how people treat you, which can alter your future."

    But if you're experiencing male pattern baldness, a receding hairline, or thinning hair, Mannes said, "the simple act of shaving is a viable alternative to medical or surgical procedures, at a lower cost."

    Best of all, if you try the look out and decide you don't like it, it's not irreversible.

    More money and business news:

  • Facebook hits 1 billion users

    You know what's cooler than a million users? A billion users. And now Facebook has just that.

    Yep, the social network birthed in a Harvard dorm grew in eight short years to a membership that it says accounts for nearly one-seventh of the world’s population. Not fake users or bots — which Facebook tracks closely — but real humans who actively engage on the social network, a company spokesperson told TODAY.

    Just so we’re clear: As of Sept. 14, one in seven people on this planet has been classified by the company as an active Facebook user. 

    Facebook founder and CEO Mark Zuckerberg shared the milestone in an exclusive interview with Matt Lauer, which aired Thursday on TODAY. 

    "I mean, it's just — an amazing honor," Zuckerberg said of his social network’s monolithic membership when he sat down with Lauer last week at Facebook’s campus in Menlo Park, Calif. "To be able to come into work every day and build things that help a billion people stay connected with the people they care about every month — that's just unbelievable."

    No hyperbole there. Since Facebook launched, the social network’s seen 1.13 trillion "likes" and 140.4 billion friend connections. 219 billion photos are currently being shared, while 17 billion check-ins have been made. Since the music listening app launched in September 2011, 62.6 million songs have been played 22 billion times — that's around 210,000 years of music.

    And while Zuckerberg may have a responsibility to investors to publicly boast Facebook’s accomplishments, this gives us an opportunity to wrap our heads around exactly what 1 billion means.

    How big?
    If Facebook were a country, it would have the third largest population, right behind China (1,347,350,000) and India (1,210,200,000), and ahead of the United States (314,500,000).

    If steampunk Facebook existed in 1804 — precisely when the world population hit 1 billion — everyone on Earth would have a profile: Thomas Jefferson, Ludwig Van Beethoven, Jane Austen ... and every other living soul. 

    Rock Center: Zuckerberg defends Facebook as it reaches 1 billion users

    What may be more staggering than the "1 billion users" milestone is how quickly Facebook reached it.

    "I don’t think in the history of the world that there's been a single medium that's amassed a billion users as fast as Facebook did," Steve Rubel told TODAY.com. As vice president of all-encompassing public relations firm Edelman, Rubel is a well-regarded expert in the many ways we consume information, and what that means on a large scale. 

    Radio, television, even mobile phones — Rubel notes none of these were adopted at the rapid global rate comparable to Facebook’s eight-year rise. "Considering I struggle to think of anything that touches as many people as much as Facebook does," he said. "Maybe water ..."

    True enough, if you're not on Facebook now, you are — quite literally — not participating in the global conversation, which is taking place on Facebook. It's your friends, your family, your employers, your interests and that's just in the United States. Everywhere, as we continually see, Facebook aids all sides of revolution.

    As Zuckerberg told Lauer, "There's no way that when we were getting started with (Facebook) that I would have ever thought that, you know, myself or any of the people around me would be able to — to be a part of something like this."

    The average Facebook user worldwide — now around age 22 — would've been about 14 when Zuckerberg famously launched the first version of Facebook in 2004. As the Aaron Sorkin-penned movie "The Social Network" depicts, thefacebook.com was first available only to Harvard students, before rolling out to other Ivy League schools in the U.S. and Canada.

    Whether cunningly planned or by accident, exclusivity was a successful strategy. By opening first to upwardly mobile students, the word spread organically. Early Facebook offered a clean, well-ordered alternative to the glitter GIFs and chaos of MySpace, the the social media leader of the time. People wanted in.

    So in 2005, Facebook opened its doors to high school students in the U.S. and six other countries, including Canada, Mexico, the United Kingdom, Ireland and Australia. And, in a politically savvy move, a few choice employees at high-tech companies including Apple and Microsoft were also invited to join.

    Matt Harnack / Facebook

    Facebook CEO Mark Zuckerberg speaks to TODAY's Matt Lauer.

    Then, in 2006, your mom was allowed to join — along with everybody else age 13 and older. Things quickly got interesting.

    Story: Mark Zuckerberg confirms: 'I wear the same thing every day'

    Going global
    By December 2006, Facebook had reached 12 million users. (An earlier version of this story citing statistics provided by Facebook reported that by January 2006, Facebook reached 25 million users.) At that time, Australia, Canada, Germany, the United Kingdom and the United States as the top five countries signing up for the social network. The average Facebook user was 19 years old, and had 598 Facebook friends.

    In a reverse British invasion, Facebook saturated the U.K. in four years, stomping both MySpace and Bebo. By 2010, Facebook accounted for more than 50 percent of the U.K.'s Web traffic, according to Hitwise. (Neither Bebo nor MySpace accounted for even 2 percent.) While membership in the U.K. has since leveled of at 32 million members, it is the sixth highest amount of Facebook users, according to Socialbakers, a social media analytic firm.

    The first countries to adopt the social network have leveled off — the U.S. itself started to slow down at 150 million in 2011. Pretty much everyone who’s going to join has joined, because "younger people can’t use it and some older people never will," noted Jan Rezab, Socialbakers CEO.

    Outside the United States however, "growth is huge," said Rezab. Brazil, India, Indonesia and Mexico join the U.S. as the top five countries currently engaging with Facebook. Further, Rezab noted, Facebook has handily overtaken the native social networks in other countries. The only notable exceptions are China, where Facebook is not allowed, and Russia, where VKontakte has 290 million users, over Facebook’s 6.7 million. 

    Russia is also the largest Internet market in Europe, so it's no mystery why Zuckerberg would have visited the country earlier this week. While there, he met with Russian prime minister Dmitri A. Medvedev, a vocal fan of technology.

    But the next great territory for Facebook might lie elsewhere. In fact, the next billion Facebook users may rely on mobile technology. "There’s a lot of potential in Africa," Rezab said, especially since it's a region where many don’t have computers but they do have phones. Mobile phones are largely credited with Facebook’s explosion — there are more than 600 million mobile Facebook users, and that number is growing at a rapid rate.

    Pew Research Center

    Facebook triggered a global hunger for social networking. The Pew Research Center mapped it out in February, and the findings were astounding. In addition to the expected high levels of engagement from the U.S., Britain, Spain and Germany, there were even some countries — Russia, Ukraine, Turkey, Jordan, Egypt — where having Internet access almost automatically means social network membership.

    Growing pains
    With extreme growth comes extreme headaches — for both Facebook and its users. Civilian users wrapped their heads around a new social ettiquette, uploading our real world quirks to online and expecting Facebook to referee. And to both earn money and serve a growing and diverse demographic, the once streamlined social network which users flocked to for a sense of privacy not afforded on MySpace has changed.  A lot.

    In its march toward global acceptance, Facebook pummeled Flickr to become the biggest photo-sharing outlet on the Internet. The now-ubiquitous "like" button lives all over the Internet. Timeline and Open Graph allow users to advertise not just what they "like," but what they're reading, watching and listening, too.

    With all this action, it's no wonder Facebook is now the focal point of our Internet privacy fears. Earlier this year, Facebook finally reached a settlement with the FTC stemming from it's privacy rollbacks in 2009. That's when Facebook made much of your previously private "personal information" widely available to the public and third-party advertisers.

    According to the FTC complaint, Facebook "deceived consumers by telling them they could keep their information on Facebook private, and then repeatedly allowing it to be shared and made public." The FTC settlement didn't make Facebook roll anything back — you must actively "opt out" to lock down what privacy remains. Going forward, however, the settlement requires Facebook, in part, to give "consumers clear and prominent notice and obtaining their express consent before sharing their information beyond their privacy settings."

    Throughout, Zuckerberg and Facebook have maintained dedication to their product.

    "Our responsibility as a company is just to do the best that we can and build the best products for people," Zuckerberg told Lauer, echoing assertions he's made over the years when consumer advocates called out the site over user privacy and users griped about every service addition and site redesign. "And if we build the best products," he told Lauer, "then I think that we can continue leading in this space for a long time."

    Industry watchers such as Edelman's Rubel say it would take a real game changer to usurp Facebook from its social media dominance — a zombie apocalypse perhaps, or Google Glass, the search giant's high-concept glasses that promise to make social media integration wearable, and thus, more mobile than the mobile phone.

    As we await that possible Google Glass future, Facebook is already locking it down with purchases such as mobile photo sharing network Instagram, cementing its hold on the increasingly popular photo sharing aspect of social media. The tiny, powerful computers in our pockets are the next frontier for social media, and as Zuckerberg told Lauer, Facebook is on it.

    "The future is really gonna be about mobile, right? And the opportunities for growth there," Zuckerberg explained to Lauer.

    When queried by Lauer about whether Facebook is still playing catch-up in the mobile area, Zuckerberg quickly pointed out, "Well, we do have the most used mobile apps. There's five billion people in the world who have phones. So we should be able to serve many more people — and — and grow the user base there." That confidence may border on bluster, but if anybody can do it, Facebook can.

    Watch Matt Lauer's interview with Zuckerberg on Oct. 4 on Rock Center with Brian Williams.

    Helen A.S. Popkin goes blah blah blah about the Internet. Join her, won't you, on Twitter and/or Facebook. Also, Google+.  

    More about Facebook:

  • Fungal meningitis suspected in four deaths, 26 cases as outbreak grows

    Dr. William Schaffner,  Vanderbilt University Medical Center, on the unusual form of meningitis caused by a fungus in medication and says if patients have any symptoms they need to get medical care.        

    Courtesy Centers for Disease Control and Prevention

    The fungus aspergillus is suspected in four deaths and 26 cases.

    Four people have died and 22 were made sick by meningitis linked to a rare fungal infection blamed on contaminated steroids, health officials said on Wednesday. They are “almost certain” more will be identified before it’s over.

    The 26 cases include 18 people in Tennessee, one in North Carolina, two in Florida, three in Virginia and two in Maryland, the U.S. Centers for Disease Control and Prevention reported. Two of the deaths were in Tennessee, one in Virginia and one in Maryland.

    Several of the patients are seriously ill, says Tennessee Department of Health Commissioner Dr. John Dreyzehner. Two clinics have closed voluntarily and a third is no longer giving the injections.

    Officials said the chief suspect is contaminated vials of a pain treatment injected directly into the spine. The drug is called methylprednisolone acetate.

    “We have notified medical professionals the prime suspect for this outbreak is methylprednisolone,” Dreyzehner told reporters in a telephone briefing. He said it was not yet clear how widely the drug was distributed.

    Late Wednesday, the Food and Drug Administration confirmed that New England Compounding Center, a Framingham, Mass., compounding pharmacy, on Sept. 26 voluntarily recalled three lots of 80-milligram injection doses of methylprednisolone acetate (PF) produced by the firm. The lots included #05212012@68 with a had beyond use date of Nov. 17, 2012; #06292012@26 with a beyond use date of Dec. 26, 2012; and #08102012@51 with a beyond use date of Feb. 6, 2013. The firm's website was not working on Wednesday evening.

    It’s not entirely certain the steroid is to blame, said the health department’s Dr. Marion Kainer. The health officials, the CDC and the FDA are testing the pain medications and other materials used with the steroid injections, as well as samples from the patients. Patients were also treated with injections of lidocaine and a povidone iodine skin preparation solution, the CDC said. 

    Meningitis is an inflammation of the spinal cord, usually caused by bacteria or viruses. It can be very serious and is marked by a headache, fever, often a stiff neck and balance problems. Fungi and parasites can also cause this inflammation and in this case the common mold aspergillus is suspected. “The type of meningitis we are dealing with in this situation is not communicable person to person,” Dreyzehner said.

    The 18 Tennessee cases are associated with Tennessee centers: Saint Thomas Outpatient Neurosurgery Center in Nashville, a center in Crossville, and now a third center in Oak Ridge, the officials said. The cases were all injected from two lots of steroids. 

    Everyone treated at the centers since July 1 is being cautioned to look for symptoms and to see a doctor immediately if they develop any. More than 700 people were treated, Dreyzehner said. “Everybody who been exposed to the lot numbers that are suspect, the vast majority have not been symptomatic,” he said.

    The incubation period -- the time between treatment and the first symptoms-- ranges from two days to two months, the officials said. No one treated before July 30 has turned up sick but they said they were checking people back to July 1 out of an abundance of caution. The first 12 patients who were identified range in age from 49 to 89.

    The CDC and FDA are testing samples of the drug, which has been recalled nationwide, as well as samples from the patients to be sure it’s aspergillus. Aspergillus has not been isolated yet from the steroid.

    Aspergillus is tricky to treat. It’s an infection that patients with damaged immune systems can get – notably cancer patients and those with HIV infection. It’s often found in the lungs because the mold – found in dead leaves and elsewhere -- can be breathed in. An antifungal drug called voriconazole can treat the infection but the health officials said in this case they want to be sure before they try it. The side effects from the antifungal treatment can be severe and include kidney and liver damage.

    It's also hard to reach an infection in the spinal cord.

    The health officials stress that women who got epidural injections while giving birth are not at risk in this outbreak. In 2005, after a giant quake and tsunami devastated shorelines around the Indian Ocean, a team of doctors in Sri Lanka reported on an outbreak of aspergillus meningitis among women who got epidurals during childbirth. Five young women were infected and three of them died.

    In that case, they reported in several medical journals, the anesthetics used had been stored in hot and dirty warehouses in the aftermath of the tsunami’s devastation.

    Related links:

     

  • Too fat for TV? Anchor fires back at critic; outpouring ensues

    Support flooded in for Wisconsin news anchor Jennifer Livingston after she was criticized for her weight, but the man who wrote the letter isn't backing down. In a statement, he said he would be happy to help her "transform herself." TODAY's Natalie Morales reports.

    "What has happened has been really inspiring, but overwhelming at the same time," Wisconsin television anchor Jennifer Livingston told TODAY's Savannah Guthrie Wednesday.

    The 37-year-old anchor/reporter at WKBT-TV in La Crosse, Wis., became the center of attention Tuesday after she went on air to respond to what she called "a personal attack," a harshly critical email from a viewer who suggested she was too fat to be on TV. Her bold retort has become national news, spurring a heartwarming response from the public and a new discussion about the boundaries of bullying.

    "I have never gone in the public and said I was a shining example of what your health should be," Livingston told TODAY Wednesday. "And I have never said girls should aspire to have a body like mine."

    She continued, "When you attack somebody on a level that is personal, it’s not fair."

    In the original email, the viewer wrote: “Obesity is one of the worst choices a person can make and one of the most dangerous habits to maintain. I leave you this note hoping that you’ll reconsider your responsibility as a local public personality to present and promote a healthy lifestyle.”

    Many media types may have shrugged off the criticism as part of the job. Anyone who’s in the public eye is used to hate mail, name-calling -- and worse. But then Livingston’s husband, fellow WKBT anchor Mike Thompson, posted the email on the station’s Facebook page.

    Hundreds of people left comments; more than 2,200 “liked” the posts.

    When Wisconsin news anchor Jennifer Livingston received a message from a viewer criticizing her weight, she decided to speak out about it on air, calling the viewer a bully. NBC's Mara Schiavocampo reports and Livingston explains why she needed to address this letter publicly.

    And so Livingston decided to fight back.

    In an on-air segment that ran more than 4 minutes, she acknowledged that she is overweight – “You can call me fat, and yes, even obese on a doctor’s chart,” she said -- but then she lashed out at the viewer for contributing to a culture of bad-mouthing and bullying.

    “If you are at home and you are talking about the fat newslady, guess what, your children are probably going to go to school and call someone fat,” she said.

    She urged children and others who have been victims of cruel criticism to take heart.

    “Do not let yourself be defined by bullies,” she said.

    On TODAY Wednesday, Livingston, the mother of three girls, said it wasn't the fat-shaming that upset her, but the accusation of being a bad role model.

    "I can deal with being called fat ... with being called obese," she told TODAY's Guthrie. "It was calling me a bad role model that rubbed me the wrong way, and not only a bad role model for our community, but for young girls, in particular."

    The man who wrote the email, Kenneth Krause, told the Associated Press that his emails had nothing to do with bullying. Livingston and Krause exchanged a few emails, but Livingston said he wouldn't back down from his opinion that she was a bad role model.

    On Tuesday Krause stood by his initial email and issued a statement: "I hope she will finally take advantage of a rare and golden opportunity to influence the health and psychological well-being of coulee region children by transforming herself for all of her viewers to see over the next year, and, to that end, I would be absolutely pleased to offer jennifer any advice or support she would be willing to accept."

    Livingston told TODAY she believed the viewer's concern about obesity was genuine, but "I think his approach was totally inappropriate."

    Livingston’s move is a step toward civility in a society that thinks a woman’s weight is fair game, said Dr. Robyn Silverman, a body image expert and author of the book “Good Girls Don’t Get Fat: How Weight Obsession is Messing Up Our Girls & How We Can Help Them Thrive Despite It.”

    “I applaud her for her response,” Silverman said. “It was a very responsible response.”

    We’ve become a “fault-finding” society where it’s acceptable to make snarky comments about anyone, but especially those in the public eye, Silverman said.

    When Livingston stood up to the mean-spirited viewer, she was helping combat the messages that say it’s OK to judge people based on weight.

    “We send the message to our children that they are not good enough, they are not valuable enough, unless they look a certain way,” Silverman said.

    Though some of the responses to Livingston’s video were as cruel as the original comments, others were an affirmation of her individuality and courage. 

    “Tell your wife she rocks,” one poster wrote.

    “Your wife is AWESOME! You’re a lucky man,” wrote another.

    “Wish more people would focus on promoting compassion and kindness instead of focusing on appearances only,” wrote a third.

    Livingston, whose station profile says she’s the mother of three young girls,  did not respond to TODAY Health requests for comment. But in her on-air segment, she told viewers she was buoyed by the outpouring of support – and wanted others to be, too.

    “Learn from my experience,” she said. “That the cruel words of one are nothing compared to the shouts of many.”

    Do you think Livingston was right to stand up to the criticism or should she have just let it go? Tell us on Facebook

    TODAY's Kathie Lee Gifford and Hoda Kotb discuss the Wisconsin TV anchor who took a stand on-air against a viewer who wrote her a rude email about her weight and the caught-on-camera verbal "smack-down" between Nicki Minaj and Mariah Carey on "American Idol."

    The Associated Press contributed to this report

    Related stories:

     

     

     

     

     

     

     

  • Revisiting an Afghanistan orphanage

    As the security in Afghanistan crumbles, 'Nightly' returns to an orphanage that Brian Williams first visited in 2009 to find girls with big dreams who are focused on getting into college.

    Tonight NBC Nightly News returned to an orphanage in Kabul, Afghanistan that Brian Williams first visited in 2009.

    Oct. 30: Andeisha Farid is making a difference in a dangerous place, providing a safe haven in Afghanistan. NBC's Brian Williams reports.

    The orphans live together under the care of Andeisha Farid who has made it her life's work to help them. Most of the children lost their parents to war, but thanks to Farid's efforts, a happy place arose from tragedy. And despite living in a dangerous war zone, the children were well cared for.  

    Oct. 30: Brian swaps eyewear with one of the girls at the Kabul orphanage.

    Generous viewers wanted to help after they saw the report, and the donations streamed in. 

    "I just ran from home to office to check the emails and most of the emails were one-time donations and sponsorships for the children," Farid told "Nightly" in 2009.  

    Just a few days after the broadcast, viewers had donated more than $50,000. Of the 150 children who were in need of sponsors 130 of them were sponsored by "Nightly" viewers. 

    Nov. 3: The children from a Kabul orphanage who were featured in a recent Nightly News report spent the weekend writing thank-you notes to the viewers who reached out to help. NBC's Brian Williams reports.

    Afghan Child Education and Care Organization (AFCECO) is an Afghan non-profit organization based in Kabul, founded by a group of volunteers in 2001. They are working with international partners in the United States, Italy and Australia on projects that benefit Afghan children. The Child Sponsorship Program is one of the successful projects they started in 2004 through a partnership with CharityHelp International (CHI), a U.S.-based organization.

    If you would like to make a donation online or sponsor an Afghan child, please visit:  https://www.charityhelp.org/afceco

    AFCECO
    P.O. Box 5820
    Kabul, Afghanistan
    info@afceco.org

     

  • NBC's Lester Holt answers your questions about Afghanistan

    Joint US-Afghan operations are becoming more common, and so are the risks. NBC's Lester Holt reports.

    See our full coverage on international hot spots crucial to U.S. foreign policy ahead of elections in our At the Brink series here. And tune in today to special coverage on all NBC News platforms from NBC’s team of anchors and correspondents deployed in five countries across the region.

    Lester Holt, NBC News' anchor, is in Afghanistan reporting on the state of the U.S. mission there 11 years after the start of the war. 

    What is the state of the war? Where are the Taliban?  How much longer will U.S. troops be there? What about all the repeat deployments for U.S. soldiers?

    Lester answered reader questions about Afghanistan earlier today.

    Please click on the box below to replay the informative chat. 

     From Lester Holt: For US soldiers, repeat deployments 'definitely take a toll'


     

  • For US soldiers, repeat deployments 'definitely take a toll'

    The Third Infantry Division is used to being deployed. Now, after multiple deployments to Iraq, the 3rd ID has been sent to Afghanistan for the first time. NBC's Lester Holt reports.

    KABUL – “How many deployments for you? Iraq, Afghanistan or both?”

    See our full coverage on international hot spots crucial to U.S. foreign policy ahead of elections in our At the Brink series here. And tune in today to special coverage on all NBC News platforms from NBC’s team of anchors and correspondents deployed in five countries across the region.

    In an army that’s been waging war in Afghanistan for 11 years, talking about past deployments is what amounts to small talk on the many bases I’ve visited this past week from Kabul to Kandahar, as well as along the Pakistan border in eastern Afghanistan. Soldiers rattle off the dates and locations of their deployments, and point out fellow soldiers with whom they served.

    The Army’s Third Infantry Division moved its headquarters recently from its home base at Fort Stewart, Ga., to Kandahar, Afghanistan. The move marked the division’s first deployment to Afghanistan, but it’s fifth to a war zone in the last 10 years. 

    The Third Infantry Division made history in 2003 when it kicked off the war in Iraq as the so-called “tip of the spear,” driving up from Kuwait straight into Baghdad in what veterans remember as the “Thunder Run.”

    Sgt. First Class Joseph Aiello says he couldn’t imagine back then that he would be in Afghanistan nine years later, still fighting a war.  When the Iraq war began, he was dating his sweetheart Terri. Today they are parents to three small children. Aiello has been on four of the division's five deployments since 2003.


    “It definitely takes a toll on family,” Aiello told me. He added, however, that worrying about home and family when you are in a war zone has its risks.

    “The minute you lose focus that’s when incidents can start to happen,” said Aiello. “You need to maintain focus while you’re here to do a job and that’s what we will get done.”

    The  Daily Rundown's Chuck Todd touches base with NBC reporters across the Mid-East including NBC's Atia Abawi in Kabul, Martin Fletcher in Tel Aviv, Ali Arouzi in Tehran and Ann Curry from the Syrian border.

    Serving on the home front, too
    Back in Georgia, Aiello’s wife, Terri, makes her own contribution to the war, as a physical therapist assistant helping wounded vets. At home she has become accustomed to living the life of a single mom.

    Photo Blog: Exploring home abroad: Afghan-Americans in Kabul

    “A bad day would be having a stressful day [at work] and then going home and the boys are fighting, Alyssa’s cranky and the homework’s not done,” she said about her three children.

    She’s learned to push ahead alone. “Nothing really changes. It’s just that he’s not there to experience everything with us.” 

    Her sacrifices are not lost on her husband.

    “A lot of people say that the soldiers got a hard job and everything like that. But the way I look at it, sir, is I definitely think the wives have the hardest job in the Army,” Aiello told me.

    ‘No different’
    Aiello is one of only a handful of Third Infantry Division soldiers with the unit today who were part of the original march into Baghdad back in 2003. The division’s pace of deployments over the last 10 years is nothing short of remarkable, but no more remarkable than the multiple deployments that have become the norm for thousands of U.S. service members.

    Eleven years of war have left tens of thousands of service families, like the Aiellos, sharing the void of long and too frequent separations.

    Maj. Gen. Robert Abrams, commanding general of the Third Infantry Division and the International Security Assistance Force’s Regional Command-South, underscored the point.

    “There are others making equal sacrifices across the army, so we don’t see ourselves any different,” Abrams said.

    Anwarullah / Reuters

    More than ten years after the beginning of the war, Afghanistan faces external pressure to reform as well as ongoing internal conflicts.

    Aiello recalled the long wait for letters from home in those early days following the Iraq invasion. Now he does video chats with his family regularly via Skype, which didn’t exist in 2003.

    On the TODAY Show this weekend, dozens of service members crowded around our broadcast location here at the joint task force headquarters for ISAF in Kabul. Many of them carried signs with pictures of the children whose birthdays, and sweet-16 parties they are missing back home.

    A suicide bomber in Afghanistan kills at least 14 people, including 3 NATO service members, bringing the US death toll on the ground to 2,000 with 20 percent of American combat deaths stemming from insider attacks. NBC's Richard Engel reports.

    The international coalition has set the end of 2014 to withdraw most combat forces from Afghanistan. In the meantime, the United States will continue to ask a lot from so few. The troops and the families will wait for them to return one day and stay home for good.

    More world stories from NBC News:

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