In 2018, senior executives at one of the country’s largest nonprofit hospital chains, Providence, were frustrated. They were spending hundreds of millions of dollars providing free health care to patients. It was eating into their bottom line.
The executives, led by Providence’s chief financial officer at the time, devised a solution: a program called Rev-Up.
Rev-Up provided Providence’s employees with a detailed playbook for wringing money out of patients — even those who were supposed to receive free care because of their low incomes, a New York Times investigation found.
nonprofits like Providence. They enjoy lucrative tax exemptions; Providence avoids more than $1 billion a year in taxes. In exchange, the Internal Revenue Service requires them to provide services, such as free care for the poor, that benefit the communities in which they operate.
But in recent decades, many of the hospitals have become virtually indistinguishable from for-profit companies, adopting an unrelenting focus on the bottom line and straying from their traditional charitable missions.
focused on investments in rich communities at the expense of poorer ones.
And, as Providence illustrates, some hospital systems have not only reduced their emphasis on providing free care to the poor but also developed elaborate systems to convert needy patients into sources of revenue. The result, in the case of Providence, is that thousands of poor patients were saddled with debts that they never should have owed, The Times found.
provide. That was below the average of 2 percent for nonprofit hospitals nationwide, according to an analysis of hospital financial records by Ge Bai, a professor at the Johns Hopkins Bloomberg School of Public Health.
Ten states, however, have adopted their own laws that specify which patients, based on their income and family size, qualify for free or discounted care. Among them is Washington, where Providence is based. All hospitals in the state must provide free care for anyone who makes under 300 percent of the federal poverty level. For a family of four, that threshold is $83,250 a year.
In February, Bob Ferguson, the state’s attorney general, accused Providence of violating state law, in part by using debt collectors to pursue more than 55,000 patient accounts. The suit alleged that Providence wrongly claimed those patients owed a total of more than $73 million.
Providence, which is fighting the lawsuit, has said it will stop using debt collectors to pursue money from low-income patients who should qualify for free care in Washington.
But The Times found that the problems extend beyond Washington. In interviews, patients in California and Oregon who qualified for free care said they had been charged thousands of dollars and then harassed by collection agents. Many saw their credit scores ruined. Others had to cut back on groceries to pay what Providence claimed they owed. In both states, nonprofit hospitals are required by law to provide low-income patients with free or discounted care.
“I felt a little betrayed,” said Bev Kolpin, 57, who had worked as a sonogram technician at a Providence hospital in Oregon. Then she went on unpaid leave to have surgery to remove a cyst. The hospital billed her $8,000 even though she was eligible for discounted care, she said. “I had worked for them and given them so much, and they didn’t give me anything.” (The hospital forgave her debt only after a lawyer contacted Providence on Ms. Kolpin’s behalf.)
was a single room with four beds. The hospital charged patients $1 a day, not including extras like whiskey.
Patients rarely paid in cash, sometimes offering chickens, ducks and blankets in exchange for care.
At the time, hospitals in the United States were set up to do what Providence did — provide inexpensive care to the poor. Wealthier people usually hired doctors to treat them at home.
wrote to the Senate in 2005.
Some hospital executives have embraced the comparison to for-profit companies. Dr. Rod Hochman, Providence’s chief executive, told an industry publication in 2021 that “‘nonprofit health care’ is a misnomer.”
“It is tax-exempt health care,” he said. “It still makes profits.”
Those profits, he added, support the hospital’s mission. “Every dollar we make is going to go right back into Seattle, Portland, Los Angeles, Alaska and Montana.”
Since Dr. Hochman took over in 2013, Providence has become a financial powerhouse. Last year, it earned $1.2 billion in profits through investments. (So far this year, Providence has lost money.)
Providence also owes some of its wealth to its nonprofit status. In 2019, the latest year available, Providence received roughly $1.2 billion in federal, state and local tax breaks, according to the Lown Institute, a think tank that studies health care.
a speech by the Rev. Dr. Martin Luther King Jr.: “If it falls your lot to be a street sweeper, sweep streets like Michelangelo painted pictures.”
Ms. Tizon, the spokeswoman for Providence, said the intent of Rev-Up was “not to target or pressure those in financial distress.” Instead, she said, “it aimed to provide patients with greater pricing transparency.”
“We recognize the tone of the training materials developed by McKinsey was not consistent with our values,” she said, adding that Providence modified the materials “to ensure we are communicating with each patient with compassion and respect.”
But employees who were responsible for collecting money from patients said the aggressive tactics went beyond the scripts provided by McKinsey. In some Providence collection departments, wall-mounted charts shaped like oversize thermometers tracked employees’ progress toward hitting their monthly collection goals, the current and former Providence employees said.
On Halloween at one of Providence’s hospitals, an employee dressed up as a wrestler named Rev-Up Ricky, according to the Washington lawsuit. Another costume featured a giant cardboard dollar sign with “How” printed on top of it, referring to the way the staff was supposed to ask patients how, not whether, they would pay. Ms. Tizon said such costumes were “not the culture we strive for.”
financial assistance policy, his low income qualified him for free care.
In early 2021, Mr. Aguirre said, he received a bill from Providence for $4,394.45. He told Providence that he could not afford to pay.
Providence sent his account to Harris & Harris, a debt collection company. Mr. Aguirre said that Harris & Harris employees had called him repeatedly for weeks and that the ordeal made him wary of going to Providence again.
“I try my best not to go to their emergency room even though my daughters have gotten sick, and I got sick,” Mr. Aguirre said, noting that one of his daughters needed a biopsy and that he had trouble breathing when he had Covid. “I have this big fear in me.”
That is the outcome that hospitals like Providence may be hoping for, said Dean A. Zerbe, who investigated nonprofit hospitals when he worked for the Senate Finance Committee under Senator Charles E. Grassley, Republican of Iowa.
“They just want to make sure that they never come back to that hospital and they tell all their friends never to go back to that hospital,” Mr. Zerbe said.
The Everett Daily Herald, Providence forgave her bill and refunded the payments she had made.
In June, she got another letter from Providence. This one asked her to donate money to the hospital: “No gift is too small to make a meaningful impact.”
Following a Script ‘Like Robots’
In 2019, Vanessa Weller, a single mother who is a manager at a Wendy’s restaurant in Anchorage, went to Providence Alaska Medical Center, the state’s largest hospital.
She was 24 weeks pregnant and experiencing severe abdominal pains. “Let this just be cramps,” she recalled telling herself.
Ms. Weller was in labor. She gave birth via cesarean section to a boy who weighed barely a pound. She named him Isaiah. As she was lying in bed, pain radiating across her abdomen, she said, a hospital employee asked how she would like to pay. She replied that she had applied for Medicaid, which she hoped would cover the bill.
After five days in the hospital, Isaiah died.
Then Ms. Weller got caught up in Providence’s new, revenue-boosting policies.
The phone calls began about a month after she left the hospital. Ms. Weller remembers panicking when Providence employees told her what she owed: $125,000, or about four times her annual salary.
She said she had repeatedly told Providence that she was already stretched thin as a single mother with a toddler. Providence’s representatives asked if she could pay half the amount. On later calls, she said, she was offered a payment plan.
“It was like they were following some script,” she said. “Like robots.”
Later that year, a Providence executive questioned why Ms. Weller had a balance, given her low income, according to emails disclosed in Washington’s litigation with Providence. A colleague replied that her debts previously would have been forgiven but that Providence’s new policy meant that “balances after Medicaid are being excluded from presumptive charity process.”
Ms. Weller said she had to change her phone number to make the calls stop. Her credit score plummeted from a decent 650 to a lousy 400. She has not paid any of her bill.
Susan C. Beachy and Beena Raghavendran contributed research.
Ruto had been the deputy to outgoing President Uhuru Kenyatta but had a bitter split that left the two not speaking for months at a time.
William Ruto was sworn in as Kenya’s president on Tuesday after narrowly winning the Aug. 9 election in East Africa’s most stable democracy, and quickly signaled that his leadership will be a strongly Christian one.
The Supreme Court last week rejected a challenge by losing candidate and longtime opposition figure Raila Odinga of the official results, completing a markedly peaceful election in a country with a history of troubled ones.
The 55-year-old Ruto had been the deputy to outgoing President Uhuru Kenyatta but had a bitter split that left the two not speaking for months at a time. On Tuesday, the audience cheered as the two shook hands, and again as Kenyatta handed over the instruments of power.
Ruto, who had dropped to his knees in tears and prayer when the court upheld his win, knelt on the stage minutes after his swearing-in during an extended sermon.
Related StoryU.S. Senator Urges Kenyan President To Aid Peaceful Transition
“A chicken seller to a president,” intoned the pastor, highlighting Ruto’s humble youth. “A village boy has become the president of Kenya,” Ruto said in his speech.
In his first tweet as president, the evangelical Christian quoted Psalms: “This is the day the Lord has made; let us rejoice and be glad in it.” His speech praised both the church and Islamic leadership, and he vowed that “we will enhance our partnership, build on our collaboration and enhance our support to them.”
The event began with some chaos. Scores of people were crushed and injured as they forced their way into the packed stadium. Medic Peter Muiruri said a fence fell as people pushed it and about 60 were injured, though the number may rise.
People tried to dodge baton-wielding security forces. Some failed. “I was beaten by the police after trying to get inside,” said a witness, Benson Kimutai.
Ruto takes power in a country heavily burdened by debt that will challenge his efforts to fulfill sweeping campaign promises made to Kenya’s poor, whom he has described as getting by on “stubborn hope.” In his speech, he acknowledged that “clearly, we are living beyond our means.”
He promised cheaper fertilizer as food prices rise and more affordable credit. He also vowed more money for the judiciary, financial independence for the national police from the presidency and efforts to fight a drought in Kenya’s north that brings the threat of famine.
Ruto also asked Kenyatta to continue “chairing discussions” on the regional crises in neighboring Ethiopia, where the government is fighting Tigray forces, and in eastern Congo, where tensions exist with Rwanda. Kenyatta has accepted, the new president said.
“Will come as a big relief to diplomats who worried Nairobi would back out of the two initiatives,” tweeted Murithi Mutiga, Africa director with the International Crisis Group.
But Ethiopian Prime Minister Abiy Ahmed didn’t shake hands with other African leaders afterward, even rejecting his Kenyan Foreign Ministry escort, and went straight to his car.
With the transition, Kenya’s presidency moves from one leader indicted by the International Criminal Court to another. Both Kenyatta and Ruto were indicted over their roles in deadly 2007 post-election violence, but the cases were later closed amid allegations of witness intimidation.
The August election was calm in a country with a history of political violence. Chaos erupted only in the final minutes when the electoral commission publicly split and prominent Odinga supporters tried to physically stop the declaration of Ruto as the winner.
Ruto’s campaign portrayed him as a “hustler” with a humble background of going barefoot and selling chickens by the roadside, a counterpoint to the political dynasties represented by Kenyatta and Odinga. His presidential flag features a wheelbarrow, the symbol of his campaign.
But Ruto received powerful political mentoring as a young man from former President Daniel arap Moi, who oversaw a one-party state for years before Kenyans successfully pushed for multiparty elections.
Ruto now speaks of democracy and has vowed there will be no retaliation against dissenting voices. “I will work with all Kenyans irrespective of who they voted for,” he said in his speech.
But in a warning sign for media, local broadcasters that were accused by Ruto of bias in the past were restricted in their coverage of the inauguration, forced to use a feed from a South African broadcaster in which Kenya’s national broadcaster has a share.
The losing candidate, 77-year-old Odinga, is setting himself up to be a prominent opposition voice once again after former rival Kenyatta backed him in the election. In a statement on Monday, Odinga said he would skip the inauguration and later “announce next steps as we seek to deepen and strengthen our democracy.”
Though Odinga also asserted that “the outcome of the election remains indeterminate,” a spokesperson told The Associated Press it was “highly unlikely” he would seek to declare himself the “people’s president” as he did after losing the 2017 election.
Disney Plus released a new series that gives us a never-before-seen look at what it takes to make some iconic movies visual masterpieces.
It’s the story of the cutting-edge special effects company almost as famous as the movies it helps make.
Industrial Light and Magic, or ILM, was founded by George Lucas in 1975.
“When I was writing Star Wars, there were no special effects houses anywhere in the world. So how were we going to do the effects? I realized I was going to have to start a company,” Lucas said.
A new six-part Disney-Plus series pulls back the curtain on the people and inventions that helped ILM transform movie-making.
“We were departing from convention. We had to build equipment from scratch. This was a long shot,” said John Dykstra, Academy-Award winning, special effects artist.
“Light & Magic” is directed by Larry Kasdan, a longtime screenwriter who knows Star Wars. He’s always been impressed with ILM’s wizardry.
“What a lot of these people share and what the company shares is this ethos: you will run into problems. But we know we’re going to solve them. We don’t yet have the tool to do this new thing. But we will not give up until we do,” Kasdan said.
Stop Motion Animator Phil Tippet helped Lucas fill the galaxy with strange new creatures.
“So I spent a day just drawing really quickly. It could be this, could be that. Could be this could be that? And sent it to George and he picked one,” Tippet said.
“Think it’ll be alright because it’s superimposed and there’s snow blowing in front of it and all kinds of stuff,” Lucas said.
Joe Johnston was there in ILM’s early days, too.
“I didn’t particularly know what I was doing. And a lot of people really didn’t know what they were doing. They were we made a lot of mistakes. And we had a lot of failures,”Johnston said. “And we’ve been — we’ve had a lot of successes and we sort of learned how to do it. George really gave us and I think particularly me, he gave me a lot of freedom to design this stuff and to experiment and see what worked.’
Johnson went on to direct his own films including Marvel’s first Captain America movie.
Recently, he and a few former ILM-ers reunited at Skywalker Ranch. George Lucas built the pastoral filmmaker’s retreat in the hills of Marin County, California near San Francisco.
NEWSY’S CLAYTON SANDELL: Do you remember the first time you came here?
JOE JOHNSTON: I do.
SANDELL: What was it like?
JOHNSTON: There was nothing here. Literally nothing here. George had just bought the land and we had a picnic. I think there were only like fifteen of us.
Today, the Victorian house where Lucas keeps offices and a research library overlooks Lake Ewok; there’s goats, chickens, and even a dedicated fire department.
Vineyards produce a Skywalker-brand wine, but what looks like an 1880s winery is actually full of state-of-the art sound editing rooms, recording studios and a theater.
For decades it’s been the professional home of Academy-Award-winning Sound Designer Ben Burtt.
“I first came out here with a gang led by George Lucas in 1978,” Burtt said. “We had a shooting range right in this area where we are, where we did all the guns for “Raiders of the Lost Ark,” machine guns, and bullet ricochets.”
The countless sounds recorded at Skywalker Ranch help complete the illusions created by ILM.
“The opening of the first Star Wars movie, people really thought it came out fine and people were excited to see it. But once the sound was put in for that shot, it just elevated it to something quite different. And that that’s the magic of sound, which is, it brings to life the visuals,” Burtt said.
ILM was always evolving, but nothing disrupted the company culture more than the arrival of computer graphics.
Ed Catmull was the co-founder of Pixar and the President of Walt Disney Animation.
“What was cool about ILM was they were just trying to get the image on the screen. So they were neutral about this stuff when we weren’t good enough. But when we started to get good at this stuff, they were open to it,” Catmull said.
But others, especially in the ILM model shop, felt threatened.
Modelmaker John Goodson successfully made the switch from plastic to pixels.
SANDELL: Not everybody was happy about the digital revolution.
JOHN GOODSON: No! I would say most of us were not, that were not part of it. That was really difficult. Really difficult.
“Well I always say that visual effects, we’re visual liars. And if we’ve done our job well, you don’t realize you’ve been lied to. And that’s kind of the trick, you know, it’s to convince you, something is real, that doesn’t exist,” Goodson said.
Doug Chiang joined ILM in 1989. He’s now Lucasfilm’s executive creative director. He says, despite growing to thousands of employees in five countries, the ILM DNA is intact.
“I kind of grew up idolizing all these guys,” Chiang said. “The way I look at it is, it’s like the old school of ILM magnified by ten. But all the inherent qualities that makes it ILM are still there. It’s the people, it’s the family.”
Over nearly 50 years much of ILM’s story has been told. But at Skywalker Ranch Joe Johnston says there are still a few secrets literally buried away.
JOHNSTON: In the foundation of the main house there’s a time capsule.
SANDELL: Do you remember what’s in it?
JOHNSTON: All kinds of great stuff. There’s one of my sketchbooks in it. A bunch of other things, including a $1 bill that I wrote a message on. You’ll have to wait.
SANDELL: You’re not going to tell us what the message was?
JOHNSTON: No. That’s what time capsules are all about!
“Light & Magic” is its own time capsule.
A love letter to an origin story of innovation and creativity.
“It was a really special time that I don’t think could ever be repeated. That experience of bringing people together who had never worked on films before,” Johnston said.
Heat and dry conditions prompted an out of control wildfire in Northern California, near Yosemite National Park.
“The fire’s been coming towards us faster and faster,” said Wes Detamore, a Mariposa resident.
A wildfire is out of control in Northern California.
The nearly 17,000 acre Oak Fire exploded over the weekend into the state’s largest active fire.
It forced evacuations in California’s Mariposa County near Yosemite National Park.
“We made it out, the animals. I can always rebuild,” said Rodney McGuire, a Mariposa, California resident.
Heat and dry conditions prompted an unprecedented growth of a fire that just started Friday.
“It’s it’s really heartbreaking because it’s been year after year, you know, and just to think about the entire state here and everywhere else, you know, there’s been so many fires and so many homes,” said Boone Jones, a Mariposa, California resident.
Firefighters are struggling to contain a fire burning in steep, rugged terrain.
“It’s not giving people a lot of time and they sometimes they’re just going to have to evacuate with the shirts on their back,” said Jon Heggie, the Battalion Chief of Cal Fire.
Firefighters say a handful of homes have been destroyed so far — as thousands get orders to leave.
Lori Wilson is the executive director at the American Red Cross Central Valley chapter.
“You have a lot of uncertainty. You have a lot of fear. Of course, we have a place for people to sleep, to get food and to get some information. We have nurses here in case there’s any health issues,” Wilson said.
Amber Blalock and her kids were among the evacuees.
“We had to quickly get as much as we can. And so we were able to get one dog and one cat and we had to just open the gate to let our chickens save themselves. But we couldn’t find Coda,” Blalock said.
One of the family’s cats got left behind as the flames grew closer.
“And my sweet daughter was outside calling his name and calling his name. And I finally had to tell her that we had to go,” she said.
But as crews battle by land and air to save life and property, there’s victory amid the flames.
“We got the word today that animal control went out and they found Coda the kitty. And so he is at the shelter right now and we’re actually hoping to go get him right now,” Blalock said.
It’s a much-needed shot of good news in a place staring down the barrel of a hot, dry climate, ripe for spreading fire.
“I feel like we’re going to do what we can to at least have a chance,” said Jerry Cal, who was ordered to evacuate.
HOUSTON — When President Biden meets Crown Prince Mohammed bin Salman in Saudi Arabia, he will be following in the footsteps of presidents like Jimmy Carter, who flew to Tehran in 1977 to exchange toasts with the shah of Iran on New Year’s Eve.
Like the prince, the shah was an unelected monarch with a tarnished human rights record. But Mr. Carter was obliged to celebrate with him for a cause that was of great concern to people back home: cheaper gasoline and secure oil supplies.
As Mr. Carter and other presidents learned, Mr. Biden has precious few tools to bring down costs at the pump, especially when Russia, one of the world’s largest energy producers, has started an unprovoked war against a smaller neighbor. In Mr. Carter’s time, oil supplies that Western countries needed were threatened by revolutions in the Middle East.
During the 2020 campaign, Mr. Biden pledged to turn Saudi Arabia into a “pariah” for the assassination of a prominent dissident, Jamal Khashoggi. But officials said last week that he planned to visit the kingdom this summer. It was just the latest sign that oil has again regained its centrality in geopolitics.
oil prices fell below zero at the start of the pandemic. Big companies like Exxon Mobil, Chevron, BP and Shell have largely stuck to the investment budgets they set last year before Russia invaded Ukraine.
The Russia-Ukraine War and the Global Economy
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A far-reaching conflict. Russia’s invasion on Ukraine has had a ripple effect across the globe, adding to the stock market’s woes. The conflict has caused dizzying spikes in gas prices and product shortages, and is pushing Europe to reconsider its reliance on Russian energy sources.
Global growth slows. The fallout from the war has hobbled efforts by major economies to recover from the pandemic, injecting new uncertainty and undermining economic confidence around the world. In the United States, gross domestic product, adjusted for inflation, fell 0.4 percent in the first quarter of 2022.
Russia’s economy faces slowdown. Though pro-Ukraine countries continue to adopt sanctions against the Kremlin in response to its aggression, the Russian economy has avoided a crippling collapse for now thanks to capital controls and interest rate increases. But Russia’s central bank chief warned that the country is likely to face a steep economic downturn as its inventory of imported goods and parts runs low.
Trade barriers go up. The invasion of Ukraine has also unleashed a wave of protectionism as governments, desperate to secure goods for their citizens amid shortages and rising prices, erect new barriers to stop exports. But the restrictions are making the products more expensive and even harder to come by.
Prices of essential metals soar. The price of palladium, used in automotive exhaust systems and mobile phones, has been soaring amid fears that Russia, the world’s largest exporter of the metal, could be cut off from global markets. The price of nickel, another key Russian export, has also been rising.
Energy traders have become so convinced that the supply will remain limited that the prices of the U.S. and global oil benchmarks climbed after news broke that Mr. Biden was planning to travel to Saudi Arabia. Oil prices rose to about $120 a barrel on Friday, and the national average price for a gallon of regular gasoline was $4.85 on Sunday, according to AAA, more than 20 cents higher than a week earlier and $1.80 above a year ago.
Another Biden administration effort that has appeared to fall flat is a decision to release a million barrels of oil daily from the Strategic Petroleum Reserve. Analysts said it was hard to discern any impact from those releases.
The Biden team has also been in talks with Venezuela and Iran, but progress has been halting.
The administration recently renewed a license that partly exempts Chevron from U.S. sanctions aimed at crippling the oil industry in Venezuela. In March, three administration officials traveled to Caracas to draw President Nicolás Maduro into negotiations with the political opposition.
In another softening of sanctions, Repsol of Spain and Eni of Italy could begin shipping small amounts of oil from Venezuela to Europe in a few weeks, Reuters reported on Sunday.
Venezuela, once a major exporter to the United States, has the world’s largest petroleum reserves. But its oil industry has been so crippled that it could take months or even years for the country to substantially increase exports.
With Iran, Mr. Biden is seeking to revive a 2015 nuclear accord that President Donald J. Trump pulled out of. A deal could free Iran to export more than 500,000 barrels of oil a day, easing the global supply crunch and making up for some of the barrels that Russia is not selling. Iran also has roughly 100 million barrels in storage, which could potentially be released quickly.
But the nuclear talks appear to be mired in disagreements and are not expected to bear fruit soon.
Of course, any deals with either Venezuela or Iran could themselves become political liabilities for Mr. Biden because most Republicans and even some Democrats oppose compromises with the leaders of those countries.
“No president wants to remove the Revolutionary Guards of Iran from the terrorist list,” Ben Cahill, an energy expert at the Center for Strategic and International Studies in Washington, said about one of the sticking points in the talks with Iran. “Presidents are wary of any moves that look like they are making political sacrifices and handing a win to America’s adversaries.”
Foreign-policy experts say that while energy crises during war are inevitable, they always seem to surprise administrations, which are generally unprepared for the next crisis. Mr. Bordoff, the Obama adviser, suggested that the country invest more in electric cars and trucks and encourage more efficiency and conservation to lower energy demand.
“The history of oil crises shows that when there is a crisis, politicians run around like chickens with their heads cut off, trying to figure out what they can do to provide immediate relief to consumers,” Mr. Bordoff said. U.S. leaders, he added, need to better prepare the country for “the next time there is an inevitable oil crisis.”
PHNOM PENH, Cambodia —The day Kea Sokun was arrested in Cambodia, four men in plainclothes showed up at his photography shop near Angkor Wat and carted him off to the police station. Mr. Kea Sokun, who is also a popular rapper, had released two songs on YouTube, and the men said they needed to know why he’d written them.
“They kept asking me: ‘Who is behind you? What party do you vote for?’” Mr. Kea Sokun said. “I told them, ‘I have never even voted, and no one controls me.’”
The 23-year-old artist, who says his songs are about everyday struggles in Cambodia, was sentenced to 18 months in an overcrowded prison after a judge found him guilty of inciting social unrest with his lyrics. His case is part of a crackdown in which dozens have been sent to jail for posting jokes, poems, pictures, private messages and songs on the internet.
Vietnam to Turkey, and that it will deepen the clash over the future of the web.
National Internet Gateway, set to begin operating on Feb. 16, will send all internet traffic — including from abroad — through a government-run portal. The gateway, which is mandatory for all service providers, gives state regulators the means to “prevent and disconnect all network connections that affect national income, security, social order, morality, culture, traditions and customs.”
Government surveillance is already high in Cambodia. Each ministry has a team that monitors the internet. Offending content is reported to an internet crime unit in the Ministry of Interior, the center of the country’s robust security apparatus. Those responsible can be charged with incitement and sent to prison.
But rights groups say that the new law will make it even easier for the authorities to monitor and punish online content, and that the recent arrests are meant to further intimidate citizens into self-censorship in a country where free speech is enshrined in the Constitution.
“The authorities are emboldened by China as an example of an authoritarian state that gives Cambodia political cover, new technology and financial resources,” said Sophal Ear, a dean at the Thunderbird School of Global Management at Arizona State University whose family escaped the Khmer Rouge, the murderous regime that seized power in Cambodia in 1975.
arrested in October.
In August, a former agriculture professor was sentenced to 18 months in prison for making jokes on Facebook about requiring chickens to wear anti-Covid masks. He was charged with incitement and with defaming the prime minister, as well as the minister of agriculture.
Weeks later, a farmer, frustrated by the government’s failed promise to subsidize longan crops while the pandemic kept borders closed to exports, posted a video of tons of his annual harvest going to rot. He was sentenced to 10 months in prison.
Of more than 30 arrests made over digital content since 2020, the most publicized one involved an autistic 16-year-old who was released in November. The teenager, Kak Sovann Chhay, had been jailed for comments he made in a chat group on Telegram, the private messaging app.
has more than 13 million followers.
Internet service providers have asked the authorities to provide more clarity about the gateway. Meta, Facebook’s parent company, said in a statement that it had “joined with other stakeholders in sharing our feedback on this new law with the Cambodian government, and expressing our strong support for a free and open internet.”
prime minister “Zoom-bombed” an online meeting for members of the Cambodian National Rescue Party. He took to Facebook to explain the intrusion: “This entry was just to give a warning message to the rebel group to be aware that Mr. Hun Sen’s people are everywhere.”
San Mala, a senior advocacy officer with the Cambodian Youth Network, said activists and rights groups were already using coded language to communicate across online messaging platforms, knowing that the authorities had been emboldened by the decree.
“As a civil society organization, we are concerned about this internet gateway law because we fear that our work will be subjected to surveillance or our conversations will be eavesdropped on or they will be able to attend online meetings with us without invitation or permission,” said Mr. San Mala, 28.
Khmer Land,” one of the songs that got him arrested, now has more than 4.4 million views on YouTube, and Mr. Kea Sokun is already working on his next album.
“I’m not angry, but I know what happened to me is unfair,” he said. “The government made an example out of me to scare people who talk about social issues.” He said he could have had his sentence reduced if he had apologized, but he refused.
“I won’t say I’m sorry,” Mr. Kea Sokun said, “and I never will.”
WEE WAA, Australia — Two years ago, the fields outside Christina Southwell’s family home near the cotton capital of Australia looked like a dusty, brown desert as drought-fueled wildfires burned to the north and south.
Last week, after record-breaking rains, muddy floodwaters surrounded her, along with the stench of rotting crops. She had been trapped for days with just her cat, and still didn’t know when the sludge would recede.
“It seems to take for bloody ever to go away,” she said, watching a boat carry food into the town of Wee Waa. “All it leaves behind is this stink, and it’s just going to get worse.”
Life on the land has always been hard in Australia, but the past few years have delivered one extreme after another, demanding new levels of resilience and pointing to the rising costs of a warming planet. For many Australians, moderate weather — a pleasant summer, a year without a state of emergency — increasingly feels like a luxury.
Black Summer bush fires of 2019 and 2020 were the worst in Australia’s recorded history. This year, many of the same areas that suffered through those epic blazes endured the wettest, coldest November since at least 1900. Hundreds of people, across several states, have been forced to evacuate. Many more, like Ms. Southwell, are stranded on floodplain islands with no way to leave except by boat or helicopter, possibly until after Christmas.
La Niña in full swing, meteorologists are predicting even more flooding for Australia’s east coast, adding to the stress from the pandemic, not to mention from a recent rural mouse plague of biblical proportions.
pregnancies on pause, shows that the El Niño-La Niña cycle has been around long enough for flora and fauna to adapt.
more than doubled since the 1970s.
Ron Campbell, the mayor of Narrabri Shire, which includes Wee Waa, said his area was still waiting for government payments to offset damage from past catastrophes. He wondered when governments would stop paying for infrastructure repairs after every emergency.
“The costs are just enormous, not just here but at all the other places in similar circumstances,” he said.
60 percent of the trees in some places. Cattle farmers culled so much of their herds during the drought that beef prices have risen more than 50 percent as they rush to restock paddocks nourished (nearly to death) by heavy rain.
Bryce Guest, a helicopter pilot in Narrabri, once watched the dust bowls grow from above. Then came “just a monstrous amount of rain,” he said, and new kind of job: flights to mechanical pumps pushing water from fields to irrigation dams in a last-ditch effort to preserve crops that had been heading for a record harvest.
On one recent flight, he pointed to mountains of stored grain — worth six figures, at least — that were ruined by the rains, with heavy equipment trapped and rusting next to it. Further inland, a home surrounded by levees had become a small island accessible only by boat or copter.
“Australia is all about water — everything revolves around it,” he said. “Where you put your home, your stock. Everything.”
The flood plains in what is known as the Murray-Darling basin stretch out for hundreds of miles, not unlike the land at the mouth of the Mississippi River. The territory is so flat that towns can be cut off with roads flooded by less than an inch of additional rain.
That happened a few weeks ago in Bedgerabong, a few hundred miles south of Narrabri. On a recent afternoon, a couple of teachers were being driven out of town in a hulking fire truck — equipment for one disaster often serves another. Across a flooded road behind them, three other teachers had decided to camp out so they could provide some consistency for children who had already been kept out of school for months by pandemic lockdowns.
Paul Faulkner, 55, the principal of the school (total enrollment: 42), said that many parents craved social connection for their children. The Red Cross has sent in booklets for those struggling with stress and anxiety.
“Covid has kept everyone from their families,” he said. “This just isolates them even more.”
He admitted that there were a few things they did not discuss; Santa, for one. The town is expected to be cut off until after the holidays as the waters that rose with surging rains over a few days take weeks to drain and fade.
In Wee Waa, where the water has started to recede, supplies and people flowed in and out last week by helicopter and in a small boat piloted by volunteers.
Still, there were shortages everywhere — mostly of people. In a community of around 2,000 people, half of the teachers at the local public school couldn’t make it to work.
At the town’s only pharmacy, Tien On, the owner, struggled with a short-handed staff to keep up with requests. He was especially concerned about delayed drug deliveries by helicopter for patients with mental health medications.
Ms. Southwell, 69, was better prepared than most. She spent 25 years volunteering with emergency services and has been teaching first aid for decades. After a quick trip into Wee Waa by boat, she returned to her home with groceries and patience, checking a shed for the stray cats she feeds and discovering that only one of her chickens appeared to have drowned.
She said she wasn’t sure how much climate change could be blamed for the floods; her father had put their house on higher stilts because they knew the waters would rise on occasion.
All she knew was that more extreme weather and severe challenges to the community would be coming their way.
“The worst part of it is the waiting,” she said. “And the cleanup.”
On a recent episode of his podcast, Rick Wiles, a pastor and self-described “citizen reporter,” endorsed a conspiracy theory: that Covid-19 vaccines were the product of a “global coup d’état by the most evil cabal of people in the history of mankind.”
“It’s an egg that hatches into a synthetic parasite and grows inside your body,” Mr. Wiles said on his Oct. 13 episode. “This is like a sci-fi nightmare, and it’s happening in front of us.”
Mr. Wiles belongs to a group of hosts who have made false or misleading statements about Covid-19 and effective treatments for it. Like many of them, he has access to much of his listening audience because his show appears on a platform provided by a large media corporation.
Mr. Wiles’s podcast is available through iHeart Media, an audio company based in San Antonio that says it reaches nine out of 10 Americans each month. Spotify and Apple are other major companies that provide significant audio platforms for hosts who have shared similar views with their listeners about Covid-19 and vaccination efforts, or have had guests on their shows who promoted such notions.
protect people against the coronavirus for long periods and have significantly reduced the spread of Covid-19. As the global death toll related to Covid-19 exceeds five million — and at a time when more than 40 percent of Americans are not fully vaccinated — iHeart, Spotify, Apple and many smaller audio companies have done little to rein in what radio hosts and podcasters say about the virus and vaccination efforts.
“There’s really no curb on it,” said Jason Loviglio, an associate professor of media and communication studies at the University of Maryland, Baltimore County. “There’s no real mechanism to push back, other than advertisers boycotting and corporate executives saying we need a culture change.”
Audio industry executives appear less likely than their counterparts in social media to try to check dangerous speech. TruNews, a conservative Christian media outlet founded by Mr. Wiles, who used the phrase “Jew coup” to describe efforts to impeach former President Donald J. Trump, has been banned by YouTube. His podcast remains available on iHeart.
Asked about his false statements concerning Covid-19 vaccines, Mr. Wiles described pandemic mitigation efforts as “global communism.” “If the Needle Nazis win, freedom is over for generations, maybe forever,” he said in an email.
The reach of radio shows and podcasts is great, especially among young people: A recent survey from the National Research Group, a consulting firm, found that 60 percent of listeners under 40 get their news primarily through audio, a type of media they say they trust more than print or video.
unfounded claim that “45,000 people have died from taking the vaccine.” In his final Twitter post, on July 30, Mr. Bernier accused the government of “acting like Nazis” for encouraging Covid-19 vaccines.
Jimmy DeYoung Sr., whose program was available on iHeart, Apple and Spotify, died of Covid-19 complications after making his show a venue for false or misleading statements about vaccines. One of his frequent guests was Sam Rohrer, a former Pennsylvania state representative who likened the promotion of Covid-19 vaccines to Nazi tactics and made a sweeping false statement. “This is not a vaccine, by definition,” Mr. Rohrer said on an April episode. “It is a permanent altering of my immune system, which God created to handle the kinds of things that are coming that way.” Mr. DeYoung thanked his guest for his “insight.” Mr. DeYoung died four months later.
has said his research has been “misinterpreted” by anti-vaccine activists. He added that Covid-19 vaccines have been found to reduce transmissions substantially, whereas chickens inoculated with the Marek’s disease vaccine were still able to transmit the disease. Mr. Sexton did not reply to a request for comment.
more than 600 podcasts and operates a vast online archive of audio programs — has rules for the podcasters on its platform prohibiting them from making statements that incite hate, promote Nazi propaganda or are defamatory. It would not say whether it has a policy concerning false statements on Covid-19 or vaccination efforts.
Apple’s content guidelines for podcasts prohibit “content that may lead to harmful or dangerous outcomes, or content that is obscene or gratuitous.” Apple did not reply to requests for comment for this article.
Spotify, which says its podcast platform has 299 million monthly listeners, prohibits hate speech in its guidelines. In a response to inquiries, the company said in a written statement that it also prohibits content “that promotes dangerous false or dangerous deceptive content about Covid-19, which may cause offline harm and/or pose a direct threat to public health.” The company added that it had removed content that violated its policies. But the episode with Mr. DeYoung’s conversation with Mr. Rohrer was still available via Spotify.
Dawn Ostroff, Spotify’s content and advertising business officer, said at a conference last month that the company was making “very aggressive moves” to invest more in content moderation. “There’s a difference between the content that we make and the content that we license and the content that’s on the platform,” she said, “but our policies are the same no matter what type of content is on our platform. We will not allow any content that infringes or that in any way is inaccurate.”
The audio industry has not drawn the same scrutiny as large social media companies, whose executives have been questioned in congressional hearings about the platforms’ role in spreading false or misleading information.
The social media giants have made efforts over the last year to stop the flow of false reports related to the pandemic. In September, YouTube said it was banning the accounts of several prominent anti-vaccine activists. It also removes or de-emphasizes content it deems to be misinformation or close to it. Late last year, Twitter announced that it would remove posts and ads with false claims about coronavirus vaccines. Facebook followed suit in February, saying it would remove false claims about vaccines generally.
now there’s podcasting.”
The Federal Communications Commission, which grants licenses to companies using the public airwaves, has oversight over radio operators, but not podcasts or online audio, which do not make use of the public airwaves.
The F.C.C. is barred from violating American citizens’ right to free speech. When it takes action against a media company over programming, it is typically in response to complaints about content considered obscene or indecent, as when it fined a Virginia television station in 2015 for a newscast that included a segment on a pornographic film star.
In a statement, an F.C.C. spokesman said the agency “reviews all complaints and determines what is actionable under the Constitution and the law.” It added that the main responsibility for what goes on the air lies with radio station owners, saying that “broadcast licensees have a duty to act in the public interest.”
The world of talk radio and podcasting is huge, and anti-vaccine sentiment is a small part of it. iHeart offers an educational podcast series about Covid-19 vaccines, and Spotify created a hub for podcasts about Covid-19 from news outlets including ABC and Bloomberg.
on the air this year, describing his decision to get vaccinated and encouraging his listeners to do the same.
Recently, he expressed his eagerness to get a booster shot and mentioned that he had picked up a new nickname: “The Vaxxinator.”
PORT-AU-PRINCE, Haiti — Children on their way to school, street vendors selling their wares, priests mid-sermon — few Haitians, rich or poor, are safe from the gangs of kidnappers that stalk their country with near impunity. But the abduction this weekend of 17 people associated with an American missionary group as they visited an orphanage shocked officials for its brazenness.
On Sunday, the hostages, five of them children, remained in captivity, their whereabouts and identities unknown to the public. Adding to the mystery was a wall of silence from officials in Haiti and the United States about what, if anything, was being done to secure their release.
“We are seeking God’s direction for a resolution, and authorities are seeking ways to help,” the missionary group, Christian Aid Ministries, an Ohio-based group founded by Amish and Mennonites that has a long history of working in the Caribbean, said in a statement.
The authorities identified the gang behind the kidnappings as 400 Mawozo, an outfit infamous for taking abductions to a new level in a country reduced to near lawlessness by natural disaster, corruption and political assassination. Not content to grab individual victims and demand ransom from their family members, the gang has taken to snatching people en masse as they ride buses or walk the streets in groups whose numbers might once have kept them safe.
President Jovenel Moïse. Violence is surging across the capital, where by some estimates, gangs now control roughly half of the city. On a single day last week, gangs shot at a school bus in Port-au-Prince, injuring at least five people, including students, while another group hijacked a public bus.
According to the Center for Analysis and Research for Human Rights, which is based in Port-au-Prince, this year alone, from January to September, there were 628 people reported kidnapped, including 29 foreigners.
“The motive behind the surge in kidnappings for us is a financial one,” said Gèdèon Jean, executive director of the center. “The gangs need money to buy ammunition, to get weapons, to be able to function.”
That means the missionaries are likely to emerge alive, he said
“They are going to be freed — that’s for sure,” Mr. Jean said. “We don’t know in how many days, but they’re going to negotiate.”
abducted 10 people in Croix-des-Bouquets, including seven Catholic clergy members, five of them Haitian and two French. The group was eventually released in late April. The kidnappers demanded a $1 million ransom, but it is unclear if it was paid.
Haitians have been driven to despair by the violence, which prevents them from making a living and keeps their children from attending school. In recent days, some started a petition to protest gang violence, singling out the 400 Mawozo gang and calling on the police to take action. But the police, underfunded and lacking political support, have been able to do little.
Transportation workers called a strike for Monday and Tuesday in Port-au-Prince to protest insecurity — an action that may turn into a more general strike, with word spreading across sectors for workers to stay home to denounce violence that has reached “a new level in the horror.”
“Heavily armed bandits are no longer satisfied with current abuses, racketeering, threats and kidnappings for ransom,” the petition says. “Now, criminals break into village homes at night, attack families and rape women.”
Christian Aid Ministries’ compound in Haiti overlooks the bay of Port-au-Prince, in a suburb called Titanyen.
On a visit there Sunday, three large delivery trucks could be seen on the sprawling grounds surrounded by two fences reinforced with concertina wire. Chickens, goats and turkeys could be seen near small American-style homes with white porches and mailboxes, and laundry hung out to dry.
There was also a guard dog and a sign in Creole that forbid entry without authorization.
Because the area is so poor, at night the compound is the only building illuminated by electric lights, neighbors said. Everything else around it is plunged in darkness.
The Mennonites, neighbors said, were gracious, and tried to spread out the work they had — building a new stone wall around the compound, for instance — so everyone could earn a little and feed their families. They would give workers food and water and joke with them. And Haitians would often come in for Bible classes.
Usually, children could be seen playing. There are swings, a slide, a basketball court, and a volleyball court. It was very unusual, neighbors said, to see it so quiet. Sundays, especially, it is bustling.
But not this Sunday.
Andre Paultre, Oscar Lopez, Ruth Graham, Patricia Mazzei and Lara Jakes contributed reporting.
The coronavirus pandemic and a huge explosion in the port of Beirut last August further devastated the economy.
Estimates put the central bank’s losses at $50 billion to $60 billion. The International Monetary Fund has offered assistance, but Lebanese officials accuse Mr. Salameh of blocking an audit sought by the United States and other countries that would unlock I.M.F. aid, as well as a separate investigation into alleged fraud at the central bank.
Most Lebanese have said goodbye to whatever savings they had while the currency has crashed, reducing salaries once worth $1,000 a month to about $80. The central bank is burning through its reserves, spending about $500 million per month to subsidize imports of fuel, medicine and grain.
“Lebanon has been living on borrowed time, and now the chickens have come home to roost,” said Toufic Gaspard, a Lebanese economist and former adviser at the I.M.F. “The whole banking system has collapsed, and we have become a cash economy.”
The crash has soured many Lebanese on their once celebrated central banker.
“I can’t say anything good about Riad Salameh,” said Toufic Khoueiri, a co-owner of a popular kebab restaurant, while having lunch with a friend in Beirut. “Our money is not stuck in the banks, but simply stolen.”
His friend, Roger Tanios, a lawyer, said he had once admired Mr. Salameh for keeping Lebanon financially stable but had changed his mind.
Mr. Salameh, he said, had gone spectacularly off course.
“Every country has its mafia,” Mr. Tanios said. “In Lebanon, the mafia has its country.”
Ben Hubbard reported from Beirut, and Liz Alderman from Paris. Hwaida Saad contributed reporting from Beirut, and Asmaa al-Omar from Istanbul.