projected to increase by up to 16 percent because of the war in Ukraine and the pandemic, which made ingredients, packaging and supply chains more costly, according to UNICEF.

displaced by the drought this year. As many as three million Somalis have also been displaced by tribal and political conflicts and the ever-growing threat from the terrorist group Al Shabab.

cyclones, rising temperatures, a locust infestation that destroyed crops, and, now, four consecutive failed rainy seasons.

spend 60 to 80 percent of their income on food. The loss of wheat from Ukraine, supply-chain delays and soaring inflation have led to sharp rises in the prices of cooking oil and staples like rice and sorghum.

At a market in the border town of Doolow, more than two dozen tables were abandoned because vendors could no longer afford to stock produce from local farms. The remaining retailers sold paltry supplies of cherry tomatoes, dried lemons and unripe bananas to the few customers trickling in.

perished since mid-2021, according to monitoring agencies.

The drought is also straining the social support systems that Somalis depend on during crises.

As thousands of hungry and homeless people flooded the capital, the women at the Hiil-Haween Cooperative sought ways to support them. But faced with their own soaring bills, many of the women said they had little to share. They collected clothes and food for about 70 displaced people.

“We had to reach deep into our community to find anything,” said Hadiya Hassan, who leads the cooperative.

likely fail, pushing the drought into 2023. The predictions are worrying analysts, who say the deteriorating conditions and the delayed scale-up in funding could mirror the severe 2011 drought that killed about 260,000 Somalis.

Famine in Somalia.”

For now, the merciless drought is forcing some families to make hard choices.

Back at the Benadir hospital in Mogadishu, Amina Abdullahi gazed at her severely malnourished 3-month-old daughter, Fatuma Yusuf. Clenching her fists and gasping for air, the baby let out a feeble cry, drawing smiles from the doctors who were happy to hear her make any noise at all.

“She was as still as the dead when we brought her here,” Ms. Abdullahi said. But even though the baby had gained more than a pound in the hospital, she was still less than five pounds in all — not even half what she should be. Doctors said it would be a while before she was discharged.

This pained Ms. Abdullahi. She had left six other children behind in Beledweyne, about 200 miles away, on a small, desiccated farm with her goats dying.

“The suffering back home is indescribable,” she said. “I want to go back to my children.”

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Russians Crowdsource Supplies for Their Army in Ukraine

Natalia Abiyeva is a real-estate agent specializing in rental apartments in the city of Nizhny Novgorod, east of Moscow. But lately, she has been learning a lot about battlefield medicine.

Packets of hemostatic granules, she found out, can stop catastrophic bleeding; decompression needles can relieve pressure in a punctured chest. At a military hospital, a wounded commander told her that a comrade died in his arms because there were no airway tubes available to keep him breathing.

Ms. Abiyeva, 37, has decided to take matters into her own hands. On Wednesday, she and two friends set out in a van for the Ukrainian border for the seventh time since the war began in February, bringing onions, potatoes, two-way radios, binoculars, first-aid gear and even a mobile dentistry set. Since the start of the war, she said, she has raised more than $60,000 to buy food, clothes and equipment for Russian soldiers serving in Ukraine.

“The whole world, it seems to me, is supporting our great enemies,” Ms. Abiyeva said in a phone interview. “We also want to offer our support, to say, ‘Guys, we’re with you.’”

Russia, grass-roots movements, led in large part by women, have sprung up to crowdsource aid for Russian soldiers. They are evidence of some public backing for President Vladimir V. Putin’s war effort — but also of the growing recognition among Russians that their military, vaunted before the invasion as a world-class fighting force, turned out to be woefully underprepared for a major conflict.

care packages familiar to Americans from the Iraq war. The most sought-after items include imported drones and night vision scopes, a sign that Russia’s $66 billion defense budget has not managed to produce essential gear for modern warfare.

“No one expected there to be such a war,” Tatyana Plotnikova, a business owner in the city of Novokuybyshevsk on the Volga, said in a phone interview. “I think no one was ready for this.”

155-millimeter shells fired by American howitzers, and that Russia’s leadership may have underestimated the determination of the West to support Ukraine.

“It’s not making the military operation go any faster from our point of view — it’s making our situation more difficult, I don’t deny it,” Mr. Borodai said, referring to Western weapons deliveries. “It’s possible that our military leaders were not ready for there to be such massive support on the part of the West.”

benefiting from a far more extensive crowdfunding campaign that is delivering millions of dollars’ worth of donations in items like drones, night vision scopes, rifles and consumer technology.

Most of the groups collecting donations for Russian soldiers appear to be operating independently of the Russian government. They mostly rely on volunteers’ personal contacts in individual units and at military hospitals who pass along lists of what they most urgently need.

segment in April about such volunteers explained, “but a mother’s heart has a will of its own.”

Outside state media, however, supporters of the war are pointing to private donations as a key to victory. Pro-Russian military bloggers, some of them embedded with Russian troops, are urging their followers to donate money to buy night vision equipment and basic drones.

“Our guys are dying because they lack this equipment,” one blogger wrote, while “the entire West is supplying the Ukrainian side.”

The needed equipment, largely imported, can be bought at Russian sporting goods stores or ordered online. Starshe Eddy, a popular military blogger, wrote that consumer drones made by the giant Chinese company DJI “have become so firmly entrenched in combat operations that it’s become hard to imagine the war without them.”

says the item “makes seeing — and ranging — deer out to 600 yards a reality.”

wrote, adding a winking emoji and a heart emoji.

Ms. Abiyeva says she started crowdsourcing aid after her husband, a captain, was deployed to Ukraine and she felt “powerless” to affect the course of events. She visited the hospital attached to her husband’s local military base and got the contact information for surgeons deployed to the war. Ever since, they have sent requests to her directly and passed her contacts along to colleagues.

When one surgeon at a field hospital asked for arterial embolectomy catheters, for treating clogs in arteries, Ms. Abiyeva found another volunteer in St. Petersburg to make the 700-mile trip to deliver 10 of them immediately. Ms. Abiyeva said that when she met the surgeon on her own trip to the region a week later, he told her that six of the catheters had already been used.

“It’s possible that we saved six lives,” she said.

The Russian military’s apparently urgent need for essential medical equipment and basic, foreign-made consumer devices has led some Russians to wonder how the Kremlin has been spending its enormous military budget, more than 3 percent of the country’s total economic output. On the VKontakte page of Zhanna Slobozhan, a coordinator of donations in the border city of Belgorod, a woman wrote that talk of raising money for drones and gun sights “makes me think that the army is totally being abandoned to the mercy of fate.”

“Let’s make sure that at least we won’t abandon our guys,” Ms. Slobozhan wrote back. She did not respond to requests for comment.

Mr. Putin visited a military hospital on Wednesday for the first time since the war began. He later told officials that while the doctors he met had assured him that “they have all they need,” the government should “promptly, quickly and effectively respond to any needs” in military medicine.

documentary about soldiers’ mothers released last weekend by the Russian journalist Katerina Gordeyeva, seen some three million times on YouTube, one woman describes her son using a wire to reattach soles to his boots.

An association of retired Russian officers published an open letter on May 19 noting that the public was raising funds for equipment the military sorely lacked “even though the government has plenty of money.” The letter excoriated Mr. Putin’s war effort as halfhearted, urging him to declare a state of war, with the aim of capturing all of Ukraine.

But on the ground, the concerns are more prosaic. With the approach of summer, Lyme disease-bearing ticks are out, and volunteers in Belgorod have been making homemade insect repellent, putting it into spray bottles and delivering it to the front.

A group of women collecting donations in the area learned that some of the Russian-backed separatist forces were so badly equipped that they were using shopping bags to carry their belongings. In their Telegram account with about 1,000 followers, the group put out an urgent call for backpacks, along with shoes, Q-tips, socks, headlamps, lighters, hats, sugar and batteries.

“This is so they understand that they are not alone,” said one of the coordinators of the Belgorod group, Vera Kusenko, 26, who works at a beauty salon as an eyelash extension specialist. “We hope this ends soon.”

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Ukraine Live Updates: U.S. to Send More Arms to Kyiv as Russia Flattens Parts of Cities

LVIV, Ukraine — Russian forces stepped up their campaign of bombardments aimed at devastating Ukraine’s cities and towns on Saturday, as the White House announced it was sending an additional $200 million in arms and equipment to help Ukraine, defying Moscow.

Soldiers fought street-by-street battles in a leafy suburb of Kyiv, the nation’s capital, and some residents wept as they dragged belongings across a destroyed bridge, trying to escape the violence. Russian forces detained the mayor of a captured city, an act that prompted hundreds of outraged residents to pour into the streets in protest.

President Volodymyr Zelensky of Ukraine accused Moscow of terrorizing the country in an attempt to break the will of the people. “A war of annihilation,” he called it.

He said an estimated 1,300 Ukrainian soldiers had been killed in the war, the first time the government had offered the number of its own soldiers killed.

Mr. Zelensky denounced what he called the kidnapping of the mayor — who had refused to cooperate with Russian troops after they seized his city — as “a new stage of terror, when they are trying to physically eliminate representatives of the legitimate local Ukrainian authorities.”

Russian forces have not achieved a major military victory since the first days of the invasion more than two weeks ago, and the assaults reinforced Moscow’s strategic turn toward increasingly indiscriminate shelling of civilian targets.

The American announcement of more arms for Ukraine’s military, including missiles for taking out warplanes and tanks, came just hours after Russia warned that convoys used for the “thoughtless transfer” of weapons to Ukraine would be “legitimate targets” for Russian forces.

Unable to mount a quick takeover of the country by air, land and sea, Russian troops have deployed missiles, rockets and bombs to destroy apartment buildings, schools, factories and hospitals, increasing civilian carnage and suffering, and leading more than 2.5 million people to flee the country.

Credit…Lynsey Addario for The New York Times

The suffering has been particularly devastating in the besieged city of Mariupol, which is experiencing “the worst humanitarian catastrophe on the planet,” according to Ukraine’s foreign minister, Dmytro Kuleba.

At least 1,582 civilians have died since the Russian siege of Mariupol began 12 days ago, he said, and residents are struggling to survive and have been forced to bury the dead in mass graves.

“There is no drinking water and any medication for more than one week, maybe even 10 days,” a staff member who works for Doctors Without Borders in Mariupol said in an audio recording released by the organization on Saturday.

“We saw people who died because of lack of medication, and there are a lot of such people inside Mariupol,” the staff member said.

During a 90-minute call with President Vladimir V. Putin of Russia, Chancellor Olaf Scholz of Germany and President Emmanuel Macron of France urged Mr. Putin to accept an immediate cease-fire, according to the French government, which described the talks as “frank” and “difficult.”

France said that Mr. Putin showed no willingness to stop the war, and said he “placed the responsibility for the conflict on Ukraine” and sounded “determined to attain his objectives.”

Credit…Maciek Nabrdalik for The New York Times

In its summary of the call, the Kremlin said Mr. Putin had discussed “several matters relating to agreements being drafted to meet the well-known Russian demands,” but did not specify those demands.

In the coming weeks, NATO, which has vowed to defend allied countries from any incursion by Russian forces, plans to gather 30,000 troops from 25 countries in Europe and North America in Norway to conduct live-fire drills and other cold-weather military exercises.

The exercises, which Norway hosts biannually, were announced more than eight months ago, NATO said, and are not linked to Russia’s invasion of Ukraine, which NATO said it was responding to with “preventive, proportionate and non-escalatory measures.”

But the training has taken on greater significance as Russia steps up its bombardment of Ukrainian population centers.

Around Kyiv, the capital, Russian forces have advanced into the suburbs but have been slowed by Ukrainian troops that have counterattacked with ambushes on armored columns. On Saturday, artillery fire intensified around Kyiv, with a low rumble heard in most parts of the city.

By Saturday, there were no indications of further efforts by the Russian army to move armored columns closer to the capital. Instead, soldiers appeared to be fighting for control of the towns along the highways that encircle it.

In Irpin, about three miles from Kyiv city limits, Ukrainian and Russian soldiers were fighting a street-by-street battle on Saturday, turning what was a quiet suburb just two weeks ago into a suburban battleground.

Credit…Lynsey Addario for The New York Times

“We are trying to push them back but we don’t control the town,” said Vitaly, a Ukrainian soldier who asked that his last name not be published for security reasons.

He had taken up a position outside what would once have been an unlikely spot for combat: a gas station mini-market, its windows blown out by shelling, on the city’s western edge. Irpin is his hometown, and he joined the volunteer forces called the Territorial Defense Forces to try to protect it just two weeks ago.

He described Irpin’s Unity Street as Ukrainian-controlled; Central Street as a no-man’s land, exposed to both Ukrainian and Russian forces; and University Street as taken by Russian forces.

But the situation was fluid. Ukrainian soldiers had a “little island” around a shopping center near the city center, he said, but otherwise it wasn’t always clear who was where.

In the southern city of Mykolaiv, residents awoke on Saturday morning to the sounds of a fierce battle hours after Russian shells hit several civilian areas, damaging a cancer hospital and sending residents fleeing into bomb shelters.

The early-morning fight was concentrated in the north of the city, said Col. Sviatoslav Stetsenko of the Ukrainian Army’s 59th Brigade, who was stationed near the front lines.

“They are changing their tactics,” Vitaliy Kim, the governor of the Mykolaiv region, said. “They are deploying in the villages and lodging in village schools and homes. We cannot shoot back. There are no rules now. We will have to be more brutal with them.”

For nearly two weeks, Russian forces have been trying to surround Mykolaiv and cross the Southern Buh River, which flows through the city and is a natural defense against a Russian push toward the west and Odessa, the Black Sea port that appears to be a prime Russian objective.

Russian forces had not crossed the river as of Saturday morning, Colonel Stetsenko said, but “they are continuing to shell Mykolaiv.”

Credit…Tyler Hicks/The New York Times

In Melitopol, Russian troops on Friday forced a hood over the mayor’s head and dragged him from a government building, according to Ukrainian officials, prompting hundreds of residents to demonstrate in the streets.

“Return the mayor!” the protesters shouted, according to witnesses and videos. “Free the mayor!”

But nearly as soon as the demonstrators gathered, Russian military personnel moved to shut them down, arresting a woman who they said had organized the protest, according to two witnesses and the woman’s Facebook account.

The episode was part of what Ukrainian officials said was an escalating pattern of intimidation and repression. It also illustrated a problem that Russia is likely to face even if it manages to pummel cities and towns into submission: In at least some of the few cities and towns that Russia has managed to seize — mostly in the south and east — they are facing popular unrest and revolt.

Mr. Zelensky sought to tap into public rage in an address to the nation overnight.

Credit…Tyler Hicks/The New York Times

“The whole country saw that Melitopol did not surrender to the invaders,” he said. “Just as Kherson, Berdyansk and other cities where Russian troops managed to enter didn’t.” He said that popular resistance “will not be changed by putting pressure on mayors or kidnapping mayors.”

Melitopol’s mayor, Ivan Fyodorov, had remained stubbornly defiant even after Russian soldiers took over the city after a fierce assault on the first day of the invasion. “We are not cooperating with the Russians in any way,” he had said.

Last weekend, with Mr. Fyodorov’s encouragement, people waving Ukrainian flags took to the streets of Melitopol and other occupied cities. For the most part, Russian soldiers stood aside, even as protesters commandeered a Russian armored vehicle in one town and drove it through the streets.

Credit…Evgeniy Maloletka/Associated Press

While the protests in Melitopol were quickly put down, the Ukrainian government renewed efforts to bring aid to Mariupol, dispatching dozens of buses with food and medicine, Ukrainian officials said.

Similar relief efforts had failed in recent days as fighting raged around the city and land mines pocked roads in the area. In an overnight address, Mr. Zelensky said that the inability to bring aid to the city showed that Russian troops “continue to torture our people, our Mariupol residents.”

Still, he said, “We will try again.”

Marc Santora reported from Lviv, Ukraine, Michael Schwirtz from Mykolaiv, Ukraine, and Michael Levenson from New York. Reporting was contributed by Andrew E. Kramer in Kyiv, Ukraine; Eric Schmitt in Washington; Ivan Nechepurenko in Istanbul; Norimitsu Onishi in Paris; and Julie Turkewitz in Bogotá, Colombia.

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Live Updates: Biden Bans Russian Oil Imports as Civilian Toll in Ukraine Grows

One million children have fled Ukraine in less than two weeks of war, James Elder, a spokesman for UNICEF, said on Tuesday, calling it “a dark historical first.”

Since the start of the Russian invasion on Feb. 24, two million people have fled Ukraine, according to the U.N. — more than those who left Syria in the first three years of the civil war there.

“We have not seen a refugee crisis of this speed and scale since World War II,” Mr. Elder said. “and this is a children crisis.”

About one in seven Ukrainian children have already left the country. At least 29 have been killed, by bombings or by mortar shells, in the street as they tried to escape, a figure that humanitarian groups say is almost certainly an underestimate. Since the start of the conflict, UNICEF estimates that 4,000 babies have been born in Ukraine “including dozens in makeshift maternity wards and underground shelters,” the agency said in a statement to The New York Times.

“Despite the best efforts of doctors and midwives, they are setting up I.C.U.s or surgeries in basements and bunkers — no way it can be as safe as where a child should be born,” Mr. Elder said.

In some areas, families are living without electricity and water, with children exposed to the cold, disease, hunger and thirst. Families from Mariupol recounted that some children drank water from water heaters, Mr. Elder said.

Catherine M. Russell, the executive director of UNICEF, called the situation of children in Ukraine “a moral outrage,” and said that countless of them were traumatized.

In a bunker near her home in Kharkiv, 5-year-old Eva Zozulia learned how to distinguish the sound of Ukrainian and Russian artillery before she and part of her family fled the city. The first produced only loud “booms” but when the Russians struck, the whole building trembled.

“It was scary,” Eva said in a phone call from the train station in the western city of Lviv, where she had spent the previous night, sleeping in a restaurant with her mother and older brother.

Many of the children fleeing are unaccompanied, according to a U.N. statement. Their parents or family members stayed in Ukraine, or were killed, Mr. Elder said, adding that he had met a mother who was traveling with her three children and three children of her sister, with whom she had lost contact.

About 100,000 children, half of them with disabilities, are living in institutions and boarding schools that are at risk, as schools, orphanages, homes and hospitals had all come under attack, the U.N. said.

Rev. Vyacheslav Grynevych, the executive director of Caritas-Spes, a Ukrainian Latin Catholic charity, said the group took in 200 children with their mothers in a center in the ski resort of Yablunytsia, in Western Ukraine.

Rev. Grynevych said in a phone call from Yablunytsia that while many orphans had left Ukraine, his organization was still trying to coordinate the evacuation of many of them who are still in bomb shelters around the country, sometimes alone.

Children have also shown great resilience, from singing in bomb shelters to undertaking trips alone to join relatives abroad. Vardkes Arzumanyan, a restaurant owner who has been distributing meals at the Lviv train station, said he saw a child tearing the piece of the cardboard he was sitting on, to offer part of it to a stranger.

Most of the Ukrainian refugees in other countries are women and children, because men between the ages of 18 and 60 are not allowed to leave. But to some mothers, their 18-year-old sons are still children.

Eva Zozulia’s brother Kyryll, a high school student, turned 18 on March 1, a day before the family fled Kharkiv.

“He is not prepared,” said Irene Zozulia, Eva and Kyryll’s mother. “The only way in which he could help is go in front of a Russian soldier and say, ‘kill me.’”

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With Remote Work, Women Decide Who Knows They’re Pregnant

For the past nine months, I have been pregnant. But I have not — for the most part — been pregnant at work.

In the beginning, when I felt nauseous, I threw up in my own bathroom. Saltine crackers became a constant companion but remained out of view of my Zoom camera. A couple of months later, I switched from jeans to leggings without any comment from my co-workers.

And as my baby grew from the size of a lemon to a grapefruit to a cantaloupe, the box through which my colleagues see me on video calls cropped out my basketball-sized gut.

Outside the virtual office, an airport security screener scolded me for trying to pick up a suitcase, cashiers became extra nice and strangers informed me of how big or small or wide or high my belly was.

Bureau of Labor Statistics.

commonplace.

And research suggests that pregnant women tend to be seen as less competent, more needing of accommodation, and less committed to work as compared with women who don’t have children, said Eden King, a professor of psychology at Rice University who studies how pregnancy affects women in the workplace.

Similar stereotypes affect mothers — 63 percent of whom are working while their youngest child is under three, according to the Labor Department — but pregnancy is a more visible identity, said Ms. King. “It can be a very physical characteristic in a way that motherhood isn’t,” she said. “So some of those experiences and expectations may be exacerbated.”

In interviews with 10 pregnant or recently pregnant remote workers for this article, several women said that being visibly pregnant in real life but not on a work Zoom screen helped them feel more confident and less apprehensive about what parenthood might mean for their career. Christine Glandorf, who works in education technology and is due with her first child this month, said that like many professionals on the brink of parenthood, she worried that people’s expectations of her in the workplace could change. Remote work solves part of that equation.

“It’s nice that it’s literally not in people’s face in any way, shape or form unless I choose for it to be a part of the conversation,” she said.

a study published in the journal Personnel Psychology in 2020, Ms. King and her colleagues asked more than 100 pregnant women in a variety of industries to track how much their supervisors, without having been asked for help, did things like assign them less work so they wouldn’t be overwhelmed or protect them from unpleasant news.

Women who received more unwanted help reported feeling less capable at work, and they were more likely to want to quit nine months postpartum.

“The more you experienced those seemingly positive but actually benevolently sexist behaviors, the less you believed in yourself,” Ms. King said.

Journal of Applied Psychology in 2019, examined this apparent shift in treatment.

believe women and men should be treated equally at work and at home, mothers in opposite-sex relationships still handle a majority of the housework and child care. The same pattern holds for parental leave. While almost half of men support the idea of paid paternity leave, fewer than five percent take more than two weeks.

In 2004, California began a paid family leave program that provides a portion of a new parent’s salary for up to eight weeks. Though the program offers the same benefit to both new fathers and new mothers, a 2016 study found that it increased the leave women took by almost five weeks and the leave that men took by two to three days.

That was the disparity when new fathers actually had an option to take paid paternity leave. Most don’t. Paid leave is still uncommon for both men and women. According to the Bureau of Labor Statistics, in 2021, 23 percent of all private industry workers had access to parental leave, up from 11 percent 10 years earlier. Although the Department of Labor stopped differentiating between maternity and paternity leave in its data more than 25 years ago, other surveys suggest that paid leave is far more uncommon for fathers.

These inequalities are one reason the gender pay gap, even between spouses, widens after women have children.

The virtual office may be relatively new, but women have long thought about how to shape their colleagues’ perception of their pregnancies. In a 2015 study conducted by Ms. Little, researchers interviewed 35 women about their experience being pregnant at work.

companies summon people back to the office, fewer people will have that choice. But there is part of the remote work pregnancy experience that can be replicated offline, Ms. King said.

“Some women do need help, and some women do want accommodations,” she said. But “you have to ask women what they want and what they need and not assume that we know.”

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Afghanistan’s Health Care System Is Collapsing Under Stress

KABUL, Afghanistan — Amena, 7 months old, lay silently in her hospital crib amid the mewling of desperately ill infants in the malnutrition ward.

Her mother, Balqisa, had brought the child to Indira Gandhi Children’s Hospital in Kabul, Afghanistan’s capital, the night before. “Her body was so hot,” she said, stroking her daughter’s emaciated leg.

The baby had a high fever, convulsions and sepsis, said Dr. Mohammad Iqbal Sadiq, a pediatrician, glancing at her chart.

“Her chances are not good,” the doctor said. “We got her too late.”

At the Indira Gandhi hospital, and in faltering hospitals across Afghanistan, famished children arrive by car and taxi and ambulance every day and night. Acute malnutrition is just one of a cascade of maladies that threaten to topple the country’s fragile health system.

acute poverty, with 4.7 million Afghans likely to suffer severe malnutrition this year, according to the United Nations. Last month, the organization made its biggest appeal ever for a single country, asking international donors to give more than $5 billion to fend off a humanitarian disaster.

doubled since August, with 40 children dying in December on their way to receive medical care.

Jonas Gahr Store, the prime minister of Norway, whose country hosted meetings between Taliban representatives and Afghan civil society groups last week, spoke to the Security Council about the urgency to expedite aid.

“We need new agreements and commitments in place to be able to assist and help an extremely vulnerable civil population, and most vulnerable among them, the children who face hunger and suffering,” he said.

Before the U.S.-backed Afghan government disintegrated in August as the Taliban overran the country, the health system relied on international aid to survive. But much of that funding has been frozen to comply with sanctions imposed on the Taliban.

As a result, the International Rescue Committee recently predicted that 90 percent of Afghanistan’s health clinics were likely to shut down in the coming months. The World Health Organization has said that outbreaks of diarrhea, measles, dengue fever, malaria and Covid-19 threaten to overwhelm overburdened hospitals.

including $308 million in relief authorized by the United States, they have not been enough to cover 1,200 health facilities and 11,000 health workers.

Though the drastic decline in war-related casualties has relieved the burden of such patients on many hospitals, the suspension of operations by private facilities and the ability to safely travel Afghanistan’s roads has left other hospitals overrun with people.

On a recent morning, the corridors of Indira Gandhi hospital were crammed with beds as patients’ family members squatted on floors amid parcels of food bought at the local bazaar.

Patients’ meals consist of an egg, two apples, a milk packet, rice and juice, so many families supplement them with outside food. Some buy medicine at local pharmacies because the hospital can provide only about 70 percent of required medication, Dr. Sadiq said.

has now claimed more than 900,000 lives across the country, and the Covid death rates remain alarmingly high. The number of new infections, however, has fallen by more than half since mid-January, and hospitalizations are also declining.

Few Afghans wear masks — even at the Ministry of Public Health in Kabul. There, officials clustered in groups on a recent weekday, greeting visitors with hugs and kisses, and ignoring faded signs saying masks were required throughout the building.

At the Afghan-Japan Communicable Disease Hospital in Kabul, the only remaining Covid-19 facility in the capital, few staff members or patients complied with worn stickers on the floors that proclaimed: “Let’s Beat Coronavirus — Please keep at least 2 meters from people around you.”

“When I try to talk to people about Covid-19, they say we have no food, no water, no electricity — why should we care about this virus?” said Dr. Tariq Ahmad Akbari, the hospital’s medical director.

Dr. Akbari suspected that the Omicron variant had entered the country, but the hospital lacked the medical equipment to test for variants. He and his staff had not been paid for five months, he said, and the hospital was critically low on oxygen supplies and health care workers.

Seven of the hospital’s eight female doctors fled after the Taliban takeover in August, part of a hollowing out that reduced the staff from 350 to 190 the past five months. Four of the five staff microbiologists quit. And only five of the country’s 34 Covid-19 centers were still operating, Dr. Akbari said.

Several staff members lived in the hospital in Kabul because, without salaries, they cannot afford rent, he said.

The hospital was recently buoyed by a two-month stopgap grant of $800,000 from an affiliate of Johns Hopkins Hospital, Dr. Akbari said. And Afghanistan’s relative isolation following the Taliban takeover had likely helped contain the spread of Covid-19, he said.

Up to 20 patients died per day during the previous wave, but just one or two a day now. And the hospital tests about 150 patients a day now, down from 600 to 700 daily tests during the second wave, Dr. Akbari said.

He speculated that Afghans are so overwhelmed by other survival issues that they are less likely to seek treatment for Covid-19.

Before the Taliban takeover, the Ministry of Public Health published detailed daily charts showing the number of coronavirus cases, hospitalizations and deaths — and the positivity rate for testing. But now the poorly funded ministry struggles to keep tabs on the pandemic.

Of the more than 856,000 tests conducted since the first wave of Covid-19 in early 2020 — of an estimated population of nearly 40 million — roughly 163,000 were positive, a health ministry spokesman said. More than 7,400 Covid-19 deaths had been confirmed since 2020, he said.

But because testing is extremely limited and the cause of death is not recorded in many instances, particularly in rural areas of Afghanistan, no one knows the pandemic’s true scale.

Dr. Akbari shook his head in frustration as he described how little was known about the virus in Afghanistan.

Looking defeated, he said, “If we have a surge like we had during the second and third wave, we would not be equipped to handle it.”

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Germany’s Vaccine Mandate Forges Unlikely Coalition of Protestors

NUREMBERG, Germany — Maria Liebermann came wrapped in fairy lights and waved a peace flag featuring a white dove. Martin Schmidt carried a Germany flag with the word RESIST scrawled across it in capital letters.

She is a self-described “eco-leftist.” He votes for the far-right Alternative for Germany. They disagree on everything from immigration to climate change, but on a recent Monday they marched side by side against the prospect of a general Covid vaccine mandate, shouting “Freedom!”

At the start of the pandemic, Germany was widely lauded as a model of unity in combating the coronavirus. A general trust in government encouraged citizens to comply with lockdowns, mask guidance and social distancing restrictions.

But that confidence in the authorities has steadily waned as the pandemic enters its third year and the fight has shifted toward vaccines, exposing deep rifts in German society and setting back efforts to combat Covid cases.

death threats from vaccine opponents in recent weeks.

In western Germany, the picture is more complicated.

A well-established tradition of homeopathy and natural cures has meant that a certain distrust of science and medicine has long been widely accepted in Germany’s middle class. Homeopathic doctors are commonplace, their services reimbursed by public health insurers. Germany’s new age esoteric industry — books, crystals, courses and the like — brings in an estimated 20 billion euros in revenue a year. Bavaria has the highest number of certified healers in the country.

unlikely coalition of protesters that includes naturalists, neo-Nazis and ordinary citizens alike. In China, authorities said that the 13 million residents in Xi’an will be allowed to travel in and out of the city, ending a 32-day lockdown.

Sophia, a 22-year-old who described herself as an “energetic healer,” and who was chatting to friends about an hour before the Nuremberg march, lamented the lack of opposition coming from parties on the left like the Greens that had traditionally challenged the status quo.

“Now they’re all backing the vaccine mandate,” she said. In the recent German election, Sophia, who declined to give her last name, supported the Basis party, a newly founded anti-vax party that garnered less than 3 percent of the vote.

Sophia comes from a family of doctors, and both her parents and her older brother got fully vaccinated and have urged her to do the same. But she is concerned that the vaccine was developed too fast, and doesn’t trust the government to disclose any serious side effects.

“My body is telling me that this is not a good idea,” she said. “I have a pretty good connection to my body.”

Her friends concurred. “It’s not about keeping us healthy, it’s about giving us all a QR code,” said Stefan, a 35-year-old father of five who advocates civil disobedience and also did not want his full name used. “They rule with fear. It’s a kind of tyranny.”

“Mainstream science is a religion,” he added.

Distrust in “mainstream science,” and mainstream politics, is one thing esoterics and the far right can agree on, said Mr. Grande of the WZB.

“The common denominator is distrust,” he said. “What unites these two very different groups is an alienation from traditional parties, from science, from media.”

Mr. Grande said the high levels of trust in government shown by Germans early in the pandemic, when nine in 10 backed the coronavirus restrictions, began to erode after the first lockdown as weariness with the pandemic set in.

The danger now, Mr. Grande said, is that the weekly contact with the far right on the streets normalizes that group for those who belong to what he calls “the distrustful center.” Both camps share a belief in conspiracy theories, which have the power to radicalize the movement beyond the fringes.

The vaccine mandate, which will be debated in parliament at the end of the month, is the decisive driver of the protests. “The debate about vaccine mandate is oil into the fire of the radicalization,” Mr. Grande said.

“I fear we have a difficult political phase ahead of us in this pandemic,” he said.

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Live Updates: Covid Wave Dampens New Year Observances Worldwide

Life was supposed to return to normal this year. Instead, 2021 turned into a kind of purgatory. But there is good reason to hope 2022 will be better.

As this year comes to a close, we want to look back on the arc of the pandemic — and look ahead to the new year that starts Saturday.

This past year began with the ramping up of a mass vaccination campaign, which many people celebrated by taking post-shot selfies of their bandaged arms. By February, new Covid-19 cases were plummeting, and by spring, the virus seemed as if it might be in permanent retreat. On June 2, President Biden gave a speech looking ahead to “a summer of freedom, a summer of joy.”

But then came a turning point of 2021: the emergence of the Delta variant.

It began spreading in the U.S. in the late spring and caused many more infections among the vaccinated than earlier versions of the virus. The overwhelming majority of these breakthrough infections were mild, but they did have the potential to cause serious illness in the older and other vulnerable people.

Delta also sparked new outbreaks among the unvaccinated, and tens of thousands of them died. Ultimately, the U.S. death toll from Covid in 2021 — more than 475,000 — exceeded the 2020 toll. The increase is especially tragic, epidemiologists say, because the availability of vaccines had made most of those deaths avoidable.

Altogether, the year ending tonight has often felt disappointing and grim.

In addition to the direct damage from Covid, the disruptions to daily life — intended to slow the spread of the virus — have brought their own costs. Children have fallen behind in school, and for many, isolation has worsened their mental health. Adults are struggling, too; Americans’ blood pressure has risen, and drug overdoses have soared.

Even people who have avoided the worst of the pandemic’s damage often feel fed up. And the latest variant, Omicron, has sent cases soaring again, to their highest levels yet, and raised the prospect that 2022 will be another year of pandemic purgatory.

At this point, it should be clear that there are no Covid guarantees. Perhaps future variants will emerge, even more dangerous than Omicron or Delta. But the most likely scenario is more hopeful, many experts believe. As the New Year arrives, there are reasons to hope that 2022 will become what people expected 2021 to be — the year that Covid switched from being a pandemic to an endemic virus, not so different from the flu.

Emerging evidence suggests that Omicron really is milder than earlier versions of this coronavirus (either because of intrinsic biological reasons or because of higher levels of population immunity). In South Africa and England, as well as New York, San Francisco and other parts of the U.S., hospitalization numbers are lower than doctors feared.

Omicron will still do terrible damage, especially among the millions of middle-aged and older Americans who remain unvaccinated as well as the hundreds of millions of adults worldwide who remain unvaccinated, because of either vaccine skepticism or unavailability. Many hospitals face the risk of being overwhelmed in the coming weeks.

But when the current surge begins receding, it will likely have left a couple of silver linings. Omicron is so contagious that it will have infected a meaningful share of the population, increasing the amount of Covid immunity and helping defang the virus.

As important, the world has more powerful weapons to fight Covid than it did only a few weeks ago: two new post-infection treatments, one from Merck and a more powerful one from Pfizer, that lower the risk of hospitalization and death. With Pfizer’s treatment, the reduction is almost 90 percent, according to early research trials.

All of which suggests that the U.S. could emerge from the Omicron wave significantly closer to the most realistic Covid future — one in which it becomes an endemic disease that is a more normal part of daily life. It will still cause illness and death; a typical flu season kills about 35,000 Americans, most of them older. For the foreseeable future, battling Covid — through vaccination, treatment and research — will remain important.

But endemic disease does not need to dominate life the way a pandemic does. It does not need to cause the sort of social isolation and public health problems that Covid has over the past two years.

If the U.S. reaches that point in 2022 — as looks likely — the next New Year’s Eve will feel a lot more satisfying than this one.

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A Plan Forms in Mexico: Help Americans Get Abortions

In Texas, a new law bars doctors from providing pills to induce abortions after seven weeks of pregnancy, and adds penalties of jail time and a fine of up to $10,000 for anyone who mails or delivers the medication.

Legal experts say such laws may be challenged after the F.D.A. decision, but for now, these state measures could discourage American doctors from sending pills to parts of the country with restrictive regulations.

“For the first time, Texas does have a way to protect women, through our criminal law, from people bringing dangerous abortion pills,” said Joe Pojman, executive director of the Texas Alliance for Life, an organization that helped craft the measure. “We’ll have to wait to see how well it is enforced in the coming months.”

Anti-abortion groups acknowledge that criminally punishing activists who distribute the pills, especially if they are from Mexico, may prove difficult. They would have to be caught and arrested in Texas, or extradited, experts say.

“This is a really terrible, lawless attack on life,” John Seago, the legislative director for Texas Right to Life, said of the Mexican activists’ plan to help women in Texas get abortions, adding that such efforts would “make it absolutely more difficult to do it, to enforce these laws.”

Dr. Rebecca Gomperts, the leader of Aid Access, an Austria-based group that provides abortion pills to women across the world, confirmed she has been prescribing the medication to women in Texas — who then receive the drugs by mail from a pharmacy in India — even after the state’s law went into effect this month.

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Omicron Wave Heads for U.K., but It’s Not Clear How Bad It’ll Be

LONDON — With cases of the Omicron variant doubling every three days and the government doing an about-face on restrictions it had long resisted, Britain is bracing for a new coronavirus surge, unsure if it will be a relatively minor event or a return to the dark days of earlier pandemic waves.

So far, the number of Omicron cases — 817 confirmed by Thursday, though officials say the real figure is likely much higher — is small compared with the daily average of 48,000 new coronavirus cases overall. But the government’s Health Security Agency warned that if the recent growth rate continues, “we expect to see at least 50 percent of Covid-19 cases to be caused by the Omicron variant in the next two to four weeks.”

Early evidence in Britain backs up tentative findings elsewhere, notably in South Africa, where the heavily mutated new variant is already widespread: It appears to be the most contagious form of the virus yet, a previous case of Covid-19 provides little immunity to it, and vaccines seem less effective against it. But it also seems to cause less severe illness than earlier variants.

Britain’s experience with Omicron may be a harbinger of what others can expect. Until now, it has been looser about social restrictions than many other nations in Western Europe, and Britain ordinarily has extensive travel to and from South Africa, so it could be the first wealthy country to be hit hard by Omicron. It also has one of the world’s most robust systems for sequencing viral genomes, so it can identify and track new variants earlier and more thoroughly than other countries.

opposed stricter controls that have been adopted around Europe, which was suffering through its biggest coronavirus wave so far before Omicron appeared.

Times analysis shows how infrastructure issues and the public’s level of willingness to get vaccinated may pose larger obstacles than supply.

“It’s not going to take long before it becomes obvious in other places, but it’s clearer earlier here,” Dr. Barrett said. “I think other countries should basically assume the same thing is happening.”

The genomic surveillance could also give Britain a head start in determining how severe Omicron cases are, though there will be a lag because it takes days or weeks for a person who gets infected to become seriously ill.

“It is increasingly evident that Omicron is highly infectious and there is emerging laboratory and early clinical evidence to suggest that both vaccine-acquired and naturally acquired immunity against infection is reduced for this variant,” Susan Hopkins, the chief medical adviser to the Health Security Agency, said in a statement.

Experts fear what that could mean for Britain’s already struggling National Health Service.

“A lot of staff have left or are burnt out,” Dr. English said, after months of dealing with the strains of the pandemic. “Now we’ve going to have another big hit — very likely — from Omicron. I am really, really sympathetic toward my poor colleagues working in clinical practice at the moment.”

said in a statement that the country had been having “increasingly high incidences of Covid-19 for some time,” adding that “health care workers are rightly worried about the impact the Omicron variant could have” on the health system’s ability to function if caseloads rise fast.

Some hospitals have already canceled elective care again, a strategy seen at the start of the pandemic to free up resources for treating coronavirus patients. Patients are already experiencing hourslong waits for ambulances as a result of the existing pressures on the system, Dr. Nagpaul added.

“While the number of Covid hospitalizations today is much lower than last winter, we must not risk complacency by ignoring the rapid doubling of Omicron cases every two to three days,” he said.

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