First Reviews

MUMBAI (Reuters) –
Jack Sim, founder of the World Toilet Organization, has a theory about why governments and people are so reluctant to talk about hygiene: it isn't cool.

"People demand a TV, not a toilet, because it is not aspirational or charismatic," said Sim, who does not hesitate to talk in graphic detail about the dangers of poor sanitation.

"Governments and people are not very receptive to being told they're dirty, that they need more toilets," said Sim on a visit to Mumbai, where more than half its 18 million residents live in slums and where the average ratio of people to toilets is 81:1.

In Mumbai, where teeming slums sit cheek by jowl with gleaming office blocks and luxury apartments, sanitation is not just a poor person's problem, said Sim, a native of Singapore.

"You are in such close proximity to slums, to people defecating and peeing in the open, that basically, you are walking in someone's poo," Sim said.

But the sight of people defecating by railway tracks or even by the roadside is so common that residents turn a blind eye to the problem and do not give it the seriousness it deserves.

"You see it long enough, and there is a basic acceptance that dirt is normal. But being repulsed by dirt, it's smell and sight is a natural defense against disease," Sim said.

With better sanitation in India, where thousands die of diarrhea and gastro-intestinal disease, people will not fall ill so much, can work better and get out of poverty, Sim said.

In India, Sim's outfit, which he calls the WTO, works with several NGOs that build and maintain public toilets. But they need to think beyond just building more toilets that are seldom maintained and get taken over by encroachers, he said.

WTO, along with consumer goods maker Hindustan Unilever, has launched a pilot programme on some premium Rajdhani Express trains to keep the toilets clean in return for advertising space.

"This is an example of market factors solving a big problem," said Carolyn Jones, global hygiene manager at Unilever.

"It is a sensitive issue, but a serious one that has to be a shared responsibility of the government, companies and people."

(Editing by Alistair Scrutton and Miral Fahmy)

MELBOURNE (AFP) –
Australian doctors successfully separated joined-at-the-head Bangladeshi twins after more than 24 hours of surgery on Tuesday, describing the moment as "surreal".

Two-year-old Trishna and Krishna, rescued from certain death in a Dhaka orphanage, were said to be "very well" after leaving the operating theatre in induced comas and unattached for the first time.

"The moment of separation was a rather surreal moment," Leo Donnan, chief of surgery at Melbourne's Royal Children's Hospital, told reporters.

"There was relief but I think everyone realised there was still a long way to go and that the girls have a very difficult time ahead of them."

Doctors worked through the night to prise apart the twins' brain tissue at about 11:00 am (0000 GMT) before reconstruction experts closed up their heads using bone and skin tissue, some 32 hours after they were wheeled into the operating room.

"The girls have now come out of the theatre and they're in intensive care," Donnan said.

"Everything's gone very well. They're in great shape which is fantastic... they're both in good condition and healthy. I think they're better than we thought they'd be."

The girls will spend the next few days sedated, on ventilators and under close monitoring before being gradually woken up, Donnan said, adding they faced myriad possible dangers.

"They've got a long process to go through and it will be many days before we know how well it's gone," he said.

Related article: Aid worker tells of Bangladesh twins' miraculous journey "There's still considerable risks they've got to face, like any child who's been through a major procedure. They've got a long recovery ahead of them -- there are many unknowns after this sort of surgery."

Moira Kelly, the girls' legal guardian who brought them to Australia from Bangladesh, was said to be overcome by the day's dramatic developments.

"I think she's overwhelmed this has come to fruition," said Margaret Smith, her colleague at the Children First Foundation charity. "She's just so grateful to the team here that they've been able to pull this off."

Some 16 specialists worked through the night, taking occasional food and rest breaks and listening to pop music in the operating theatre to stay alert, as the operation ran hours past its scheduled midnight finish.

Donnan said there was quiet elation among the surgeons when they finally separated the girls after more than 24 hours of painstaking work.

"The moment of separation was a rather surreal moment ... Everyone has known these girls as one with their individual personalities, so to see them as separate human beings is a pretty amazing moment," he said.

The girls were brought to Australia in November 2007 after aid workers became alarmed at their fading health in Dhaka, where doctors said they were powerless to help.

But they were nursed back to health, developing a unique system of crawling on their backs and a love of Australian children's band "The Wiggles", as they underwent a series of preparatory operations.

"These are once-in-a-lifetime operations that teams would do. For the hospital it's a historic moment, for the girls it's an even more historic moment," Donnan said.

Separating conjoined twins is a notoriously difficult procedure, with attempts in Britain and Bangladesh both failing over the past year, although Saudi doctors successfully divided a pair of Egyptian brothers in February.

In one of the best known cases, Singapore doctors in 2003 made a vain attempt to separate adult twins -- Iranian law graduates Laleh and Ladan Bijani, 29 -- who died from severe blood loss after 52 hours of surgery.

A hole is classified by its par, the number of strokes a skilled golfer should require to complete play to the hole. For example, a skilled golfer expects to reach the green on a par-four hole in two strokes, one from the tee (the "drive") and another, second, stroke to the green (the "approach") and then roll the ball into the hole with two putts. Traditionally, a golf hole is either a par-three, -four or -five; some par-six holes exist, but are not usually found on traditional golf courses.

These distances are not absolute rules; for example, it is possible that a 450 metre (492 yd) hole could be classed as a par-four hole, since the par for a hole is determined by its 'effective playing length'. If the tee-to-green distance on a hole is predominantly downhill, it will play shorter than its physical length and may be given a lower par rating. Par ratings are also affected by factors affecting difficulty; the placement of hazards or the shape of the hole for example can sometimes affect the play of a hole such that it requires an extra stroke to avoid playing into the hazard or out-of-bounds.

Putting Contests

COLUMBIA, S.C. – Bug spray that produces a fog to kill insects is likely to blame for the death of a 10-month-old South Carolina boy, and his 2-year-old brother was critically injured by the fumes, authorities said Monday.
Anderson County Deputy Coroner Don McCown said the boys' mother had been using foggers in their single-wide mobile home in Williamston, in the northwest part of the state, because of an insect problem. Elizabeth Whitfield, 25, called 911 on Sunday afternoon to report her youngest son was having trouble breathing.
Paramedics took all three to a hospital, and Jacob Whitfield was pronounced dead. His brother, Kenneth, was flown to another hospital about 20 minutes north to Greenville, where he remained Monday on a respirator, but was starting to stabilize, McCown said.
Elizabeth Whitfield was coated in chemicals when she first arrived to the hospital and had to remove her clothes and take a shower. She was released Sunday, but was re-admitted to the ER on Monday with breathing problems, McCown said.
Investigators found seven fogger containers. She told authorities she set off three when she began renting a month ago, then continued using them when the insects wouldn't die.
"Most people put these foggers in — they do it one time a month or every couple of months. She was using two to three a week," McCown said. "She said she followed the directions, but you have to wonder. We can't attribute it to anything else."
A single fogger is typically used to treat 6,000 cubic feet and can leave an oily residue on furniture and floors. Directions call for residents to cover all furniture, vacate the home for four hours, then open windows and doors for an hour before returning, he said.
While the pesticides appear to be the cause of death, confirmation through toxicology reports could take eight weeks. Other air quality tests turned up nothing. The baby was otherwise healthy with no signs of abuse or neglect, McCown said.
He said the home was located in a rural area and "pretty infested with insects, roaches. It was her goal to get rid of all of them."
"The stuff didn't seem to have too much effect on the bugs," he said. "They're still running everywhere."
The scent at the home was so strong authorities called in a hazardous materials team before entering. One deputy complained of headaches, McCown said.
Investigators initially focused on a grease fire, but tests showed that didn't play any role in the illnesses, McCown said.
"Right now, we're just concerned about them. We're hoping the 2-year-old can make a recovery and hope the mom will be OK," said Sheriff's Sgt. Steve Reeves.