Despite photos, doubts remain on health of Venezuela's Hugo Chavez

President Hugo Chavez of Venezuela has not been seen in public for more than two weeks following an operation for pelvic swelling in Cuba. His absence has prompted widespread speculation about his health and his ability to govern, report special correspondents for The Times.

The Venezuelan and Cuban governments insist Chavez is OK and recovering at an undisclosed location. Cuba's Communist government released photos of President Raul Castro and former President Fidel Castro visiting Chavez in what appears to be a hospital room, but the Venezuelan leader has otherwise been absent from public view.

Chavez's Twitter has also largely been inactive since earlier this month, although on Friday a flurry of messages appeared. These made no mention of the president's health or location.

Speculation persists in the opposition news media over whether "Chavez has a life-threatening disease such as cancer, and even whether he is alive," The Times reports. 

As Chavez's absence enters its 17th day, political opponents in Venezuela have ramped up criticism of the government's silence. The opposition is demanding Chavez delegate power to his vice president while he recovers. Relatives, including Chavez's mother, Elena Frias de Chavez, have asked that Venezuelans pray for his recovery (link in Spanish).

Chavez, who is 56, leads one of the world's biggest oil-producing nations and is an ardent antagonist of the United States. He hopes to be reelected in 2012 but faces rising domestic problems — including crime, inflation, and energy woes — that have hampered his ability to lead a leftist anti-U.S. bloc in the region at large.

Cuba is known to release photographs of the Castro brothers, ages 80 and 84 respectively, when public doubt rises over their health. In the past, such photos have come under scrutiny by bloggers, who have claimed they were faked. (The Chavez photos, in a medium resolution, are reproduced here.)

If Chavez remains in Cuba for "10 or 12 days" more, as his brother Adan Chavez said Sunday, and he does not delegate presidential powers, he will have governed Venezuela from afar for more than a month.

— Daniel Hernandez in Mexico City

Photo: Former Cuban President Fidel Castro, President Hugo Chavez of Venezuela, and current President Raul Castro of Cuba, in a photo released on June 17, 2011. Credit: Government of Cuba 

MEXICO: Withering heat prompts warnings

Extreme temperatures are gripping much of Mexico, prompting warnings from health officials and causing concern among some residents over the absence of seasonal rainfall this week.

Temperatures soared above 100 degrees Fahrenheit in 11 states (link in Spanish) on Thursday, from Chihuahua in the north to Chiapas in the south. In Campeche, on the southern coast of the Gulf of Mexico, the temperatures topped 112 degrees.

Health Secretary Jose Angel Cordova said that diahretic diseases have risen in recent days, as infection-causing bacteria in meat, vegetables, and dairy products flourish in the heat and many Mexicans are accustomed to eating meals at street stalls.

Officials warned residents to stay indoors in midday hours, wear hats outdoors, and to drink water "constantly." The National Meteorological Service forecast (link in Spanish) temperatures for Friday above 100 degrees in 18 states.

In metropolitan Mexico City, home to millions of smog-causing automobiles and large and active industrial sectors, the day was baking hot once more on Friday. Temperatures read at 83 degrees at 1 p.m. but "felt" like 97 degrees, according to AccuWeather. The forecast for Saturday could bring heat that breaks the record temperature for the day set in 1919.

This city is not a pleasant place in high heat. The Metro system — one of the largest and busiest in the world, with more than 4 million riders a day — does not have air conditioning, nor do most taxi cabs or buses. Commutes are correspondingly miserable.

Worse, at least for residents of the capital, there's been little to no rainfall across the Valley of Mexico in weeks. The rainy season usually runs from May through September, bringing afternoon-to-evening showers on a reliably daily basis for much of subtropical Mexico. But so far, in late May in Mexico City, there've been some electrical storms here and there, some droplets, but no significant rain. 

Complaints and bewilderment over the weather are popping up across Mexico via Twitter.

"You can study indigenous cultures and do the rain dance, all of Monterrey would appreciate it," said one Twitter user in Mexico's third largest city.

"Let's all do the rain dance to get rid of this heat!" said another user in Campeche.

Any day now?

— Daniel Hernandez in Mexico City

Photo: Trying to keep cool in Monclova, Coahuila. Credit: ElUniversal.com.mx

 

Is it safe to eat on the street in Mexico City?

Many U.S. travelers in Mexico hold fast to a few overblown myths about culinary life here: Don't trust the water, ever, and avoid those tempting street tacos! Blogger Lesley Tellez suggests a more liberating approach.

"It's a myth that eating any street food in Mexico City will make you sick," writes Tellez, a former Dallas Morning News reporter who now lives in the Mexican capital. At her blog, the Mija Chronicles, Tellez lists a few tips on how to pick and navigate among this city's countless stands of sizzling tacos, fragrant quesadillas and steaming tamales:

1. Pick a street food stand that looks crowded.

2. Glance around and see if the stand looks clean.

3. Who takes the money?

4. The food must be freshly prepared.

5. Feel free to make small talk while you eat, if you speak Spanish.

6. Go during peak hours.

For the details, read the whole post here. Reader comments are also illuminating. One recommends: "Open containers of help-yourself salsa or lime wedges?! I prefer that a place serve its salsas in re-purposed bottles to squirt or pour. Lime wedges should just be handed out."

The Mija Chronicles is part of an active and flourishing food-blogger community in this foodie's dream of a city. La Plaza sometimes peeks into Good Food in Mexico City by Nicholas Gilman, and the blog by food historian Rachel Laudan, who posted earlier this year, "Mexican Potatoes. Why Are They So Lousy?"

-- Daniel Hernandez in Mexico City

Photo: A woman prepares quesadilla at a street stand in the Roma neighborhood of Mexico City. Credit: Lesley Tellez / The Mija Chronicles

Madonna's new gym in Mexico City lacks permits

Pop superstar Madonna caused a stir in Mexico City this week when she arrived to inaugurate her first gym, but the borough chief where she opened Hard Candy Fitness said Wednesday that the singer's venture lacks the proper permits to operate (link in Spanish).

Demetrio Sodi, who is a kind of mayor in the Miguel Hidalgo borough of Mexico City, said Madonna's gym obtained a permit for the glittery inauguration party it held on Monday night, but has no other permits necessary to open.

"They only let us know Friday that they were going to have an inauguration, and when we had a meeting, they didn't have a single permit ... to operate," Sodi said in a television interview. "No protection program, no license, not even a certificate assuring they have parking."

Madonna chose Mexico City to launch what her website said will be a worldwide chain of gyms containing her "input on every detail." The gym opened in the swanky and exclusive Bosques de las Lomas neighborhood in Miguel Hidalgo, the city's wealthiest borough. Mondays night's inauguration (see photos here) featured a red carpet and was attended by Mexico City Mayor Marcelo Ebrard.

Attempts to reach California-based New Evolution Ventures, Madonna's partner company in the venture, for comment were unsuccessful.

-- Daniel Hernandez in Mexico City

Photo: A look inside the Madonna's new Hard Candy fitness center in Mexico City. Credit: Associated Press

WikiLeaks on Latin America: Clinton asks personal questions about Argentina's Kirchners

A secret U.S. diplomatic cable published by Wikileaks reveals requests by Secretary of State Hillary Rodham Clinton on the mental health and decision-making style of Argentine President Cristina Fernandez de Kirchner.

The cable bearing Clinton's name was dated Dec. 31, 2009, and sent to the U.S. Embassy in Buenos Aires. It asks:

How is Cristina Fernandez de Kirchner managing her nerves and anxiety? How does stress affect her behavior toward advisors and/or her decisionmaking? What steps does Cristina Fernandez de Kirchner or her advisers/handlers, take in helping her deal with stress? Is she taking any medications? Under what circumstances is she best able to handle stresses? How do Cristina Fernandez de Kirchner's emotions affect her decisionmaking and how does she calm down when distressed?

The cable also inquires about the health and decision-making style of Nestor Kirchner, Fernandez's husband and the former president. Nestor Kirchner died suddenly late last month. In the 2009 cable, questions then turn to the interpersonal dynamic between the two Kirchners.

"How do Cristina Fernandez de Kirchner and Nestor Kirchner divide up their day?" it asks. "On which issues does Cristina Fernandez de Kirchner take the lead and which issues does she leave to Nestor Kirchner?"

Clinton made no direct reference to any specific leaked cables in statements she made on Monday at the State Department in Washington, and no statements in response to the leaked cable were reported Monday from Fernandez de Kirchner in Argentina.

-- Daniel Hernandez in Mexico City

Photo: U.S. Secretary of State Hillary Rodham Clinton, left, and Argentine President Cristina Fernandez de Kirchner in Buenos Aires on March 1. Credit: Pablo Martinez Monsivais / Associated Press

Obama orders review after revelations of '40s-era Guatemala syphilis study

The White House has ordered a comprehensive review of medical research guidelines after revelations last month that the U.S. knowingly infected hundreds of Guatemalan prisoners and patients with syphilis or gonorrhea in the 1940s.

President Obama's directive last week to convene a Presidential Commission for the Study of Bioethical Issues is another acknowledgement of, as the president said, "past abuses" in U.S. medical research since medical historian Susan Reverby revealed that the U.S. Public Health Service exposed thousands in Guatemala to the sexually transmitted diseases without their knowledge or consent.

Obama called Guatemalan President Alvaro Colom in early October to apologize on behalf of his government, and Secretary of State Hillary Rodham Clinton called the research "abhorrent." Here's previous coverage in La Plaza. Here's the U.S. Department of Health and Human Services information page on the Guatemalan experiment.

Conducted between 1946 and 1948, the study in Guatemala was meant to test whether penicillin could treat syphilis and other STDs. It was led by an American doctor, John Cutler, who would later lead the infamous Tuskegee experiment in Alabama, in which African American men with syphilis were observed as the disease progressed without treatment.

Although the Guatemalan study occurred more than 60 years ago, some pharmaceutical companies have shifted their clinical trials overseas, making the question of protection of human subjects in medical research still relevant today, notes the journal Nature.

Obama's order calls for a panel to work for nine months beginning in January to examine whether federal and international regulations adequately guard subjects in medical studies supported by the U.S. government.

"While I believe the research community has made tremendous progress in the area of human subjects' protection, what took place in Guatemala is a sobering reminder of past abuses," Obama said. "We owe it to the people of Guatemala and future generations of volunteers who participate in medical research."

-- Daniel Hernandez in Mexico City

Cholera detected in the Dominican Republic

A case of cholera has been detected in the Dominican Republic, the first sign that the worsening epidemic in neighboring Haiti could be crossing the border shared by the island nations. The cholera case was diagnosed in a 32-year-old Haitian man who works in the Dominican Republic and visited Haiti between Oct. 31 and Nov. 12, reports said.

A cholera case has also been detected in Florida, involving a woman who recently returned from Haiti.

The man's diagnosis in the Dominican Republic sent authorities scrambling to identify any other possible cholera cases; several suspected cases have turned out negative. The Dominican Republic has tightened control of its border with Haiti, including temporarily shutting down a traditional cross-border market in the Dominican border town of Dajabon.

At least 1,100 people in Haiti have succumbed to cholera since the outbreak began last month.

The Dominican government said Wednesday that it would ask employers in the tourism and construction sectors to temporarily stop hiring Haitian workers. Carpets doused with chlorine were being placed on border bridges to disinfect tires and shoes, reported Dominican Today. The man with cholera is in stable condition in a hospital in eastern Dominican Republic, the Miami Herald reported.

Times staff writer Joe Mozingo recently reported on a woman who attempted to save her 2-year-old son from the disease. The mother, Rosemane Saintelone, was unsuccessful, and then was turned away from public transit trucks when drivers saw her carrying her child's corpse. Mozingo and staff photographer Rick Loomis observed dozens of bodies piling up in pits.

Haiti has a presidential election scheduled for Nov. 28, but the campaigns are being hampered by the cholera outbreak, deadly anti-U.N. riots, and continued recovery efforts after the devastating January earthquake.

-- Daniel Hernandez in Mexico City

Photo: A cholera victim in Port-au-Prince. Credit: Rick Loomis / Los Angeles Times

Dominican Republic closes border with Haiti over cholera scare; nearly 300 are dead

The Dominican Republic sealed its border with Haiti this week to ward off a cholera outbreak that is spreading inside the Carribean nation, which is still struggling to recover from January's devastating earthquake. The Dominican government closed the border to most Haitians and stepped up patrols along the 130-mile-long boundary after U.N. peacekeeping troops Monday fired tear gas to disperse a crowd of Haitians seeking to cross.

As of early Wednesday, nearly 300 Haitians have died in the cholera outrbreak, in what The Times reported as the worst cholera outbreak in Haiti in more than a century. The World Health Organization said the death rate was slowing, though the outbreak had not yet "peaked," meaning more deaths are likely. About 4,000 are reportedly sick.

The outbreak in St. Marc — which was not severely hit by the January quake — is blamed at least partly on contaminated water from the Artibonite River.

On Wednesday, the Dominican Republican reopened its border with Haiti under tight controls, reported Dominican Today. Health authorites ordered doctors to be on alert for patients with acute vomiting or diarrhea, symptoms related to the cholera infection.

— Daniel Hernandez in Mexico City

Photo: A man who doctors say died of cholera is carried to a morgue in St. Marc, Haiti. Credit: Ramon Espinosa / Associated Press

Trapped miners in Chile now arguing over who gets rescued last

Deprived of sunlight and fresh air since a shaft in their mine collapsed Aug 5., Chile's trapped miners are now so confident that their rescue from 2,300 feet underground is just days away that they are arguing over who will be lifted out last.

None of the miners wants to be first to hoisted up to the surface. "They were fighting with us yesterday because everyone wanted to be at the end of the line, not the beginning," Chilean Health Minister Jaime Manalich told reporters Sunday.

The two-month ordeal of "Los 33," as the trapped miners are known, has riveted Chileans and the world at large with its stark drama of human survival. The miners, a remarkably healthy and sometimes testy bunch, have at times argued with the surface crews over their requests for wine and cigarettes.

The Times' special correspondent in South America, Chris Kraul, has a recent update on the rescue effort, a delicate and unprecedented process that will see the 33 men lifted one-by-one in a narrow capsule through an escape hole.

Miners who emerge at night will be wearing sweaters because of the dramatic change in temperature they will experience, from 90 degrees in the mine to near freezing above on the Atacama desert. Those pulled to safety in the daytime will be wearing sunglasses.

The lift operations could begin as early as Wednesday. The L.A. Times photography blog Framework has a stirring gallery of images.

-- Daniel Hernandez in Mexico City

Photo: Trapped miners in Chile speak with rescuers via a video-conference feed. Credit: Government of Chile, via Framework

U.S. apologizes for experiment that infected Guatemalans with syphilis

The United States apologized to Guatemala on Friday for a 1940s research program in which Guatemalans were intentionally infected with the sexually transmitted disease syphilis without their knowledge or consent.

Between 1946 and 1948, the agency then known as the U.S. Public Health Service infected Guatemalan sex workers, prison inmates, and mental health patients with syphilis. The program was conducted in order to examine whether penicillin, relatively new at the time, could be used to treat the disease. It was led by John Cutler, the U.S. doctor who later led the infamous Tuskegee experiment, in which African American men in Alabama infected with syphilis were observed without receiving treatment.

The Guatemala program was "clearly unethical," Secretary of State Hillary Clinton and Health and Human Services Secretary Kathleen Sebelius said in a joint statement.

"Although these events occurred more than 64 years ago, we are outraged that such reprehensible research could have occurred under the guise of public health," the statement said. "We deeply regret that it happened, and we apologize to all the individuals who were affected by such abhorrent research practices."

Archival research conducted by medical historian Susan Reverby, a professor at Wellesley College in Massachusetts, uncovered the Guatemala syphilis experiment. Reverby, who has written extensively on the Tuskegee experiment, found documents on the Guatemala program at a library at the University of Pittsburgh. The professor discovered that the Public Health Service sent Cutler to Guatemala to study syphilis transmission, with the backing of Guatemalan health officials and the Pan-American Sanitary Bureau.

Cutler and Guatemalan doctor Juan Funes induced the disease by allowing prison inmates to have sex with infected prostitutes, or by inoculating the syphilis-causing bacteria in inmates through a solution. The patients, who remained uninformed, were then given penicillin to see if the antibiotic could treat syphilis.

"In addition to the penitentiary, the studies took place in an insane asylum and an army barracks," Reverby said in a Wellesley College release on her work. "In total, 696 men and women were exposed to the disease and then offered penicillin. The studies went on until 1948 and the records suggest that despite intentions not everyone was probably cured."

The Wellesley release has more details. U.S. Health and Human Services has posted an information page on the Guatemala syphilis study at its website.

President Barack Obama called Guatemalan President Alvaro Colom on Friday to apologize on behalf of the United States for the 1940s syphilis program. Colom's government posted a message on its official website condemning the experiment and requesting a full investigation, which the U.S. has promised to carry out.

A separate statement on the government's Facebook page said Guatemala "reserves the right" to further denounce the experiment in an international forum, but did not elaborate.

-- Daniel Hernandez in Mexico City

Photo: U.S. Health and Human Services Secretary Kathleen Sebelius. Credit: Agence France-Presse