AUCKLAND, New Zealand — Rawiri Jansen, a Maori doctor, had an urgent message for the 150 people, mostly patch-wearing members of New Zealand’s plentiful street gangs and their families, who sat before him on a bright Saturday afternoon.
Covid is coming for them, he said. Cases in New Zealand’s hospitals are rising rapidly. Soon, dozens of new infections a day might be hundreds or even a thousand. People will die. And vaccination is the only defense. “When your doctors are scared, you should be scared,” he said.
By the end of the day, after an exhaustive question-and-answer session with other health professionals, roughly a third of those present chose to receive a dose then and there.
Having abandoned its highly successful “Covid-zero” elimination strategy in response to an outbreak of the Delta variant, New Zealand is now undergoing a difficult transition to trying to keep coronavirus cases as low as possible. On Friday, the country set a target of getting at least 90 percent of the eligible population fully vaccinated — a goal, the highest in the developed world, whose success hinges on persuading people like those who gathered to hear Dr. Jansen.
intensely criticized, including by police leaders.
Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines. Pfizer and Moderna recipients who are eligible for a booster include people 65 and older, and younger adults at high risk of severe Covid-19 because of medical conditions or where they work. Eligible Pfizer and Moderna recipients can get a booster at least six months after their second dose. All Johnson & Johnson recipients will be eligible for a second shot at least two months after the first.
Yes. The F.D.A. has updated its authorizations to allow medical providers to boost people with a different vaccine than the one they initially received, a strategy known as “mix and match.” Whether you received Moderna, Johnson & Johnson or Pfizer-BioNTech, you may receive a booster of any other vaccine. Regulators have not recommended any one vaccine over another as a booster. They have also remained silent on whether it is preferable to stick with the same vaccine when possible.
The C.D.C. has said the conditions that qualify a person for a booster shot include: hypertension and heart disease; diabetes or obesity; cancer or blood disorders; weakened immune system; chronic lung, kidney or liver disease; dementia and certain disabilities. Pregnant women and current and former smokers are also eligible.
The F.D.A. authorized boosters for workers whose jobs put them at high risk of exposure to potentially infectious people. The C.D.C. says that group includes: emergency medical workers; education workers; food and agriculture workers; manufacturing workers; corrections workers; U.S. Postal Service workers; public transit workers; grocery store workers.
Yes. The C.D.C. says the Covid vaccine may be administered without regard to the timing of other vaccines, and many pharmacy sites are allowing people to schedule a flu shot at the same time as a booster dose.
Chris Hipkins, the minister responsible for New Zealand’s Covid-19 response, acknowledged earlier this month that the decision to enlist gang leaders was an unusual one.
“Our No. 1 priority here is to stop Covid-19 in its tracks, and that means doing what we need to do to get in front of the virus,” he said. “Where we have been able to enlist gang leaders to help with that, and where they have been willing to do so, we have done that.”
Some gang leaders have acted independently to help the vaccination effort. They have connected members of their community to health officials, organized events with health professionals like Dr. Jansen, and streamed events on Facebook Live to allow an open forum for questions about rare health risks. In some cases, they have taken vaccines to communities themselves.
“Our community is probably less well informed; they’re probably not as health literate,” said Mr. Tam, the Mongrel Mob member, who is a former civil servant and who received the border exemption. Constant media criticism has turned them off from reading traditional news outlets, he added.
“They then resort to social media, because they have much greater control,” he said. “It’s also a space that perpetuates conspiracy theories and false information and all the rest of it.” Health advice has to come from trusted individuals and leaders in the community, he said.
In the past week, Mr. Tam has traveled almost the length of the country organizing pop-up vaccination events for members and their communities, as well as coordinating with other chapter leaders to get their members vaccinated, he said.
It was difficult work that put him at personal risk, he said, and that invited intense skepticism from people who thought of gangs only as violent or connected to organized crime.
“Why do we bother?” Mr. Tam said. “We bother because we care about those people that others don’t care about, as simple as that. They can talk about my gang affiliation, all the rest of it. But it’s that affiliation that allows me to have that penetration, that foot in the door. I can do the stuff that they can’t do.”
The country’s experience has become a sobering case study for other nations pursuing reopening strategies without first having had to deal with large outbreaks in the pandemic. For the Singapore residents who believed the city-state would reopen once the vaccination rate reached a certain level, there was a feeling of whiplash and nagging questions about what it would take to reopen if vaccines were not enough.
“In a way, we are a victim of our own success, because we’ve achieved as close to zero Covid as we can get and a very, very low death rate,” said Dr. Paul Tambyah, an infectious diseases specialist at National University Hospital. “So we want to keep the position at the top of the class, and it’s very hard to do.”
vaccinated people are already gathering at concerts, festivals and other large events. But unlike Singapore, both of those places had to manage substantial outbreaks early in the pandemic.
Lawrence Wong, Singapore’s finance minister and a chair of the country’s Covid-19 task force, said the lesson for “Covid-naive societies” like Singapore, New Zealand and Australia is to be ready for large waves of infections, “regardless of the vaccine coverage.”
up against the Delta variant, Mr. Wong said.
“In Singapore, we think that you cannot just rely on vaccines alone during this intermediate phase,” he said. “And that’s why we do not plan an approach where we reopen in a big bang manner, and just declare freedom.”
highest since 2012, a trend that some mental health experts have attributed to the pandemic. People have called on the government to consider the mental health concerns caused by the restrictions.
“It’s just economically, sociologically, emotionally and mentally unsustainable,” said Devadas Krishnadas, chief executive at Future-Moves Group, a consultancy in Singapore. Mr. Krishnadas said the decision to reintroduce restrictions after reaching such a high vaccination rate made the country a global outlier.
granted full approval to Pfizer-BioNTech’s coronavirus vaccine for people 16 and up, paving the way for mandates in both the public and private sectors. Such mandates are legally allowed and have been upheld in court challenges.
College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
Schools. California became the first state to issue a vaccine mandate for all educators and to announce plans to add the Covid-19 vaccine as a requirement to attend school, which could start as early as next fall. Los Angeles already has a vaccine mandate for public school students 12 and older that begins Nov. 21. New York City’s mandate for teachers and staff, which went into effect Oct. 4 after delays due to legal challenges, appears to have prompted thousands of last-minute shots.
Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get vaccinated. Mandates for health care workers in California and New York State appear to have compelled thousands of holdouts to receive shots.
Indoor activities. New York City requires workers and customers to show proof of at least one dose of the Covid-19 for indoor dining, gyms, entertainment and performances. Starting Nov. 4, Los Angeles will require most people to provide proof of full vaccination to enter a range of indoor businesses, including restaurants, gyms, museums, movie theaters and salons, in one of the nation’s strictest vaccine rules.
At the federal level. On Sept. 9,President Biden announced a vaccine mandate for the vast majority of federal workers. This mandate will apply to employees of the executive branch, including the White House and all federal agencies and members of the armed services.
In the private sector. Mr. Biden has mandated that all companies with more than 100 workers require vaccination or weekly testing, helping propel new corporate vaccination policies. Some companies, like United Airlines and Tyson Foods, had mandates in place before Mr. Biden’s announcement.
“I think a lot of times we are so focused on wanting to get good results that we just have tunnel vision,” she said.
Ms. Ng lives across from a testing center. Almost daily, she watched a constant stream of people go in for tests, a strategy that many public health experts say is a waste of resources in such a highly vaccinated country.
“Freedom Day — as our ministers have said — is not the Singapore style,” said Jeremy Lim, an associate professor at the National University of Singapore and an expert on health policy, referring to England’s reopening in the summer. But moving too cautiously over the potential disadvantages of restrictions is a “bad public health” strategy, he said.
The government should not wait for perfect conditions to reopen, “because the world will never be perfect. It’s so frustrating that the politicians are almost like waiting for better circumstances,” Dr. Lim said.
Sarah Chan, a deputy director at Singapore’s Agency for Science, Technology and Research, said she had a fleeting taste of what normal life was like when she arrived in Italy last month to visit her husband’s family.
No masks were required outdoors, vaccinated people could gather in groups, and Dr. Chan and her son could bop their heads to music in restaurants. In Singapore, music inside restaurants has been banned based on the notion that it could encourage the spread of the virus.
Dr. Chan said she was so moved by her time in Italy that she cried.
“It’s almost normal. You forget what that’s like,” she said. “I really miss that.”
NECOCLÍ, Colombia — For decades, the Darién Gap, a roadless, lawless stretch of jungle linking South America to the north, was considered so dangerous that only a few thousand people a year were daring, or desperate, enough to try to cross it.
But the economic devastation wrought by the pandemic in South America was such that in the first nine months of this year, Panamanian officials say, an estimated 95,000 migrants, most of whom are Haitian, attempted the passage on their way to the United States.
They made the journey in shorts and flip-flops, their possessions stuffed in plastic bags, their babies in arms and their children by the hand. It’s uncertain how many made it — and how many didn’t. And yet tens of thousands more are gathered in Colombia, eager for their turn to try.
Del Rio and thrusting the Biden administration into a crisis, were just the leading edge of a much larger movement of migrants heading for the jungle and then the United States. People who had fled their troubled Caribbean nation for places as far south as Chile and Brazil began moving north months ago, hoping they would be welcomed by President Biden.
“We very well could be on the precipice of a historic displacement of people in the Americas toward the United States,” said Dan Restrepo, the former national security adviser for Latin America under President Barack Obama. “When one of the most impenetrable stretches of jungle in the world is no longer stopping people, it underscores that political borders, however enforced, won’t either.”
The Darién, also known as the Isthmus of Panama, is a narrow swath of land dividing the Pacific Ocean and the Caribbean Sea. Parts are so inaccessible that when engineers built the Pan-American Highway in the 1930s, linking Alaska to Argentina, only one section was left unfinished. That piece — 66 roadless miles of turbulent rivers, rugged mountains and venomous snakes — became known as the Darién Gap. Today, the journey through the gap is made more perilous by a criminal group and human traffickers who control the region, often extorting and sometimes sexually assaulting migrants.
a growing number of migrants had begun to brave the corridor, a journey that can take a week or more on foot. But after the pandemic, which hit South America particularly hard, that surge has become a flood of desperate families. At least one in five of those who crossed this year were children, Panamanian officials said.
As the number of migrants arriving at the U.S. border grew, the Biden administration retreated from a more open approach to migration embraced in the president’s first days in office to a tougher stance with a singular goal: deterring people from even attempting to enter the United States.
said in September. “Your journey will not succeed, and you will be endangering your life and your family’s lives.”
But the warning is unlikely to turn back the tens of thousands of Haitians who are already on the road.
On a recent day, there were about 20,000 migrants in Necoclí, in Colombia. And there are up to 30,000 Haitian migrants already in Mexico, according to a senior official in the Mexican foreign ministry who spoke on the condition of anonymity.
“They’ve already started the journey, they’ve already started to think about the U.S.,” said Andrew Selee, president of the Migration Policy Institute. “It’s not that easy to turn that off.”
On a recent morning, Ms. Alix and Mr. Damier woke their children before dawn in the small home they’d been sharing with a dozen other migrants. Their turn had come to board the boat that would take them to the edge of the jungle.
In the darkness, Ms. Alix threw her backpack over her shoulders and strapped Vladensky to her chest. In one hand she carried a pot of spaghetti, meant to sustain them while it lasted. Her other hand reached out to her toddler, Farline.
On the beach the family joined a crowd of others. A dockworker handed a large life vest to Ms. Alix. She draped it over Farline’s small body and climbed into the boat. Aboard: 47 adults, 13 children, seven infants, all migrants.
“Goodbye!” yelled a man from the boat company. “Have a good trip!”
Government officials are largely absent from the Darién. The area is controlled by a criminal group known as the Clan del Golfo, whose members view migrants much as they view drugs: goods they can tax and control.
Once the migrants step off the boats, they are met by smugglers — typically poor men in the area who offer to take them into the jungle, starting at $250 a person. For an extra $10 they will carry a backpack. For another $30, a child.
Farline and her family spent the night in a tent at the edge of the jungle. In the morning, they set out before sunrise, alongside hundreds of others.
Soon, a vast plain became a towering forest. Farline clambered between trees, following her parents. Vladensky slept on his mother’s chest. Other children cried, the first to show signs of exhaustion.
As the group crossed river after river, tired adults began to abandon their bags. They clambered up and then down a steep, muddy slope, only to stare up at the next one. Faces that were hopeful, even excited, that morning went slack with exhaustion.
A woman in a leopard-print dress fainted. A crowd formed. A man gave her water. Then they all rose, picked up their bags and began to walk.
Today, after all, was just day one in the Darién, and they had a long journey ahead.
Julie Turkewitz reported from Necoclí, Colombia; Natalie Kitroeff from Mexico City; and Sofía Villamil from Necoclí and Bajo Chiquito, Panama. Oscar Lopez contributed reporting from Mexico City, and Mary Triny Zea from Panama City.
As Germany heads into an election that will see Angela Merkel step down after 16 years as chancellor, she leaves behind a country profoundly changed — and anxious about changing more.
By Katrin Bennhold
Photographs by Lena Mucha
STUTTGART, Germany — The small silver star at the tip of Aleksandar Djordjevic’s Mercedes shines bright. He polishes it every week.
Mr. Djordjevic makes combustion engines for Daimler, one of Germany’s flagship carmakers. He has a salary of around 60,000 euros (about $70,000), eight weeks of vacationand a guarantee negotiated by the union that he cannot be fired until 2030. He owns a two-story house and that E-class 250 model Mercedes in his driveway.
All of that is why Mr. Djordjevic polishes the star on his car.
“The star is something stable and something strong: It stands for Made in Germany,” he said.
But by 2030 there will be no more combustion engines at Daimler — or people making combustion engines.
parental leave in Catholic Bavaria. The married gay couple raising two children outside Berlin. The woman in a hijab teaching math in a high school near Frankfurt, where most students have German passports but few have German parents.
successive crises and left others unattended, there was change that she led and change that she allowed.
phase out nuclear power in Germany. She ended compulsory military service. She was the first chancellor to assert that Islam “belongs” to Germany. When it came to breaking down her country’s and party’s conservative family values, she was more timid but ultimately did not stand in the way.
Konrad Adenauer anchored Germany in the West. Willy Brandt reached across the Iron Curtain. Helmut Kohl, her onetime mentor, became synonymous with German unity. Gerhard Schröder paved the way for the country’s economic success.
Ms. Merkel’s legacy is less tangible but equally transformative. She changed Germany into a modern society — and a country less defined by its history.
She may be remembered most for her decision to welcome over a million refugees in 2015-16 when most other Western nations rejected them. It was a brief redemptive moment for the country that had committed the Holocaust and turned her into an icon of liberal democracy.
“It was a sort of healing,” said Karin Marré-Harrak, the headmaster of a high school in the multicultural city of Offenbach. “In a way we’ve become a more normal country.”
lingering inequality between East and West three decades after reunification is still evident, even though taxpayers’ money has flowed east and things have gradually improved. With the government planning to phase out coal production by 2038, billions more in funding are promised to help compensate for the job losses.
But as Mike Balzke, a worker at the nearby coal plant in Jänschwalde, put it: “We don’t want money — we want a future.”
Mr. Balzke recalled his optimism when Ms. Merkel first became chancellor. Because she was an easterner and a scientist, he expected her to be an ambassador for the East — and for coal.
Instead, his village lost a quarter of its population during her chancellorship. A promised train line from Forst to Berlin was never built. The post office shut down.
Mr. Balzke, 41, worries that the region will turn into a wasteland.
That anxiety runs deep. And it deepened again with the arrival of refugees in 2015.
Two Fathers and Two Sons
was up in arms, but only a decade later, it has become the new normal.
Ms. Merkel never backed same-sex marriage outright, but she allowed lawmakers to vote for it, knowing that it would go through.
Mr. Winkler left the party again in 2019 after Ms. Merkel’s successor as conservative leader, Annegret Kramp-Karrenbauer, disparaged same-sex marriage. But he acknowledged his debt to the chancellor.
On June 30, 2017, the day of the vote, he wrote her a letter.
“It is a pity that you could not support opening marriage to same-sex couples,” he wrote. “Still, thank you that you ultimately made today’s decision possible.”
Then he invited her to visit his family, “to see for yourself.”
She never replied. But he and his family used to live just around the corner from Ms. Merkel, who never gave up her apartment in central Berlin. They would see her occasionally in the supermarket checkout line.
“There she was with toilet paper in her basket, going shopping like everyone else,” Mr. Winkler’s partner, Roland Mittermayer, recalled. Even after 16 years, they are still trying to figure the chancellor out.
“She is an enigma,” Mr. Winkler said. “She’s a bit like the queen — someone who has been around for a long time, but you never feel you really know her.”
The Post-Merkel Generation
Six hours northwest of Berlin, past endless green fields dotted with wind farms and a 40-minute ferry ride off the North Sea coast, lies Pellworm, a sleepy island where the Backsen family has been farming since 1703.
Two years ago, they took Ms. Merkel’s government to court for abandoning its carbon-dioxide emission targets under the Paris climate accord. They lost, but then tried again, filing a complaint at the constitutional court.
This time they won.
“It’s about freedom,” said Sophie Backsen, 23, who would like to take over her father’s farm one day.
Sophie’s younger brothers, Hannes, 19, and Paul, 21, will vote for the first time on Sunday. Like 42 percent of first-time voters, they will vote for the Greens.
“If you look at how our generation votes, it’s the opposite of what you see in the polls,” Paul said. “The Greens would be running the country.”
Pellworm is flush with the sea level and in parts even below it. Without a dike ringing the coastline, it would flood regularly.
“When you have permanent rain for three weeks, the island fills up like a bath tub inside the dikes,” Hannes said.
The prospect of rising sea levels is an existential threat here. “This is one of the most important elections,” Hannes said. “It’s the last chance really to get it right.”
“If not even a country like Germany can manage this,” he added, “what chance do we stand?”
Christopher F. Schuetze contributed reporting from Berlin.
The handwritten doctor’s order was just eight words long, but it solved a problem for Dundee Manor, a nursing home in rural South Carolina struggling to handle a new resident with severe dementia.
David Blakeney, 63, was restless and agitated. The home’s doctor wanted him on an antipsychotic medication called Haldol, a powerful sedative.
“Add Dx of schizophrenia for use of Haldol,” read the doctor’s order, using the medical shorthand for “diagnosis.”
But there was no evidence that Mr. Blakeney actually had schizophrenia.
Antipsychotic drugs — which for decades have faced criticism as “chemical straitjackets” — are dangerous for older people with dementia, nearly doubling their chance of death from heart problems, infections, falls and other ailments. But understaffed nursing homes have often used the sedatives so they don’t have to hire more staff to handle residents.
one in 150 people.
Schizophrenia, which often causes delusions, hallucinations and dampened emotions, is almost always diagnosed before the age of 40.
“People don’t just wake up with schizophrenia when they are elderly,” said Dr. Michael Wasserman, a geriatrician and former nursing home executive who has become a critic of the industry. “It’s used to skirt the rules.”
refuge of last resort for people with the disorder, after large psychiatric hospitals closed decades ago.
But unfounded diagnoses are also driving the increase. In May, a report by a federal oversight agency said nearly one-third of long-term nursing home residents with schizophrenia diagnoses in 2018 had no Medicare record of being treated for the condition.
hide serious problems — like inadequate staffing and haphazard care — from government audits and inspectors.
One result of the inaccurate diagnoses is that the government is understating how many of the country’s 1.1 million nursing home residents are on antipsychotic medications.
According to Medicare’s web page that tracks the effort to reduce the use of antipsychotics, fewer than 15 percent of nursing home residents are on such medications. But that figure excludes patients with schizophrenia diagnoses.
To determine the full number of residents being drugged nationally and at specific homes, The Times obtained unfiltered data that was posted on another, little-known Medicare web page, as well as facility-by-facility data that a patient advocacy group got from Medicare via an open records request and shared with The Times.
The figures showed that at least 21 percent of nursing home residents — about 225,000 people — are on antipsychotics.
The Centers for Medicare and Medicaid Services, which oversees nursing homes, is “concerned about this practice as a way to circumvent the protections these regulations afford,” said Catherine Howden, a spokeswoman for the agency, which is known as C.M.S.
“It is unacceptable for a facility to inappropriately classify a resident’s diagnosis to improve their performance measures,” she said. “We will continue to identify facilities which do so and hold them accountable.”
significant drop since 2012 in the share of residents on the drugs.
But when residents with diagnoses like schizophrenia are included, the decline is less than half what the government and industry claim. And when the pandemic hit in 2020, the trend reversed and antipsychotic drug use increased.
A Doubled Risk of Death
For decades, nursing homes have been using drugs to control dementia patients. For nearly as long, there have been calls for reform.
In 1987, President Ronald Reagan signed a law banning the use of drugs that serve the interest of the nursing home or its staff, not the patient.
But the practice persisted. In the early 2000s, studies found that antipsychotic drugs like Seroquel, Zyprexa and Abilify made older people drowsy and more likely to fall. The drugs were also linked to heart problems in people with dementia. More than a dozen clinical trials concluded that the drugs nearly doubled the risk of death for older dementia patients.
11 percent from less than 7 percent, records show.
The diagnoses rose even as nursing homes reported a decline in behaviors associated with the disorder. The number of residents experiencing delusions, for example, fell to 4 percent from 6 percent.
A Substitute for Staff
Caring for dementia patients is time- and labor-intensive. Workers need to be trained to handle challenging behaviors like wandering and aggression. But many nursing homes are chronically understaffed and do not pay enough to retain employees, especially the nursing assistants who provide the bulk of residents’ daily care.
Studies have found that the worse a home’s staffing situation, the greater its use of antipsychotic drugs. That suggests that some homes are using the powerful drugs to subdue patients and avoid having to hire extra staff. (Homes with staffing shortages are also the most likely to understate the number of residents on antipsychotics, according to the Times’s analysis of Medicare data.)
more than 200,000 since early last year and is at its lowest level since 1994.
As staffing dropped, the use of antipsychotics rose.
Even some of the country’s leading experts on elder care have been taken aback by the frequency of false diagnoses and the overuse of antipsychotics.
Barbara Coulter Edwards, a senior Medicaid official in the Obama administration, said she had discovered that her father was given an incorrect diagnosis of psychosis in the nursing home where he lived even though he had dementia.
“I just was shocked,” Ms. Edwards said. “And the first thing that flashed through my head was this covers a lot of ills for this nursing home if they want to give him drugs.”
Homes that violate the rules face few consequences.
In 2019 and 2021, Medicare said it planned to conduct targeted inspections to examine the issue of false schizophrenia diagnoses, but those plans were repeatedly put on hold because of the pandemic.
In an analysis of government inspection reports, The Times found about 5,600 instances of inspectors citing nursing homes for misusing antipsychotic medications. Nursing home officials told inspectors that they were dispensing the powerful drugs to frail patients for reasons that ranged from “health maintenance” to efforts to deal with residents who were “whining” or “asking for help.”
a state inspector cited Hialeah Shores for giving a false schizophrenia diagnosis to a woman. She was so heavily dosed with antipsychotics that the inspector was unable to rouse her on three consecutive days.
There was no evidence that the woman had been experiencing the delusions common in people with schizophrenia, the inspector found. Instead, staff at the nursing home said she had been “resistive and noncooperative with care.”
Dr. Jonathan Evans, a medical director for nursing homes in Virginia who reviewed the inspector’s findings for The Times, described the woman’s fear and resistance as “classic dementia behavior.”
“This wasn’t five-star care,” said Dr. Evans, who previously was president of a group that represents medical staff in nursing homes. He said he was alarmed that the inspector had decided the violation caused only “minimal harm or potential for harm” to the patient, despite her heavy sedation. As a result, he said, “there’s nothing about this that would deter this facility from doing this again.”
Representatives of Hialeah Shores declined to comment.
Seven of the 52 homes on the inspector general’s list were owned by a large Texas company, Daybreak Venture. At four of those homes, the official rate of antipsychotic drug use for long-term residents was zero, while the actual rate was much higher, according to the Times analysis comparing official C.M.S. figures with unpublished data obtained by the California advocacy group.
make people drowsy and increases the risk of falls. Peer-reviewed studies have shown that it does not help with dementia, and the government has not approved it for that use.
But prescriptions of Depakote and similar anti-seizure drugs have accelerated since the government started publicly reporting nursing homes’ use of antipsychotics.
Between 2015 and 2018, the most recent data available, the use of anti-seizure drugs rose 15 percent in nursing home residents with dementia, according to an analysis of Medicare insurance claims that researchers at the University of Michigan prepared for The Times.
in a “sprinkle” form that makes it easy to slip into food undetected.
“It’s a drug that’s tailor-made to chemically restrain residents without anybody knowing,” he said.
In the early 2000s, Depakote’s manufacturer, Abbott Laboratories, began falsely pitching the drug to nursing homes as a way to sidestep the 1987 law prohibiting facilities from using drugs as “chemical restraints,” according to a federal whistle-blower lawsuit filed by a former Abbott saleswoman.
According to the lawsuit, Abbott’s representatives told pharmacists and nurses that Depakote would “fly under the radar screen” of federal regulations.
Abbott settled the lawsuit in 2012, agreeing to pay the government $1.5 billion to resolve allegations that it had improperly marketed the drugs, including to nursing homes.
Nursing homes are required to report to federal regulators how many of their patients take a wide variety of psychotropic drugs — not just antipsychotics but also anti-anxiety medications, antidepressants and sleeping pills. But homes do not have to report Depakote or similar drugs to the federal government.
“It is like an arrow pointing to that class of medications, like ‘Use us, use us!’” Dr. Maust said. “No one is keeping track of this.”
published a brochure titled “Nursing Homes: Times have changed.”
“Nursing homes have replaced restraints and antipsychotic medications with robust activity programs, religious services, social workers and resident councils so that residents can be mentally, physically and socially engaged,” the colorful two-page leaflet boasted.
Last year, though, the industry teamed up with drug companies and others to push Congress and federal regulators to broaden the list of conditions under which antipsychotics don’t need to be publicly disclosed.
“There is specific and compelling evidence that psychotropics are underutilized in treating dementia and it is time for C.M.S. to re-evaluate its regulations,” wrote Jim Scott, the chairman of the Alliance for Aging Research, which is coordinating the campaign.
The lobbying was financed by drug companies including Avanir Pharmaceuticals and Acadia Pharmaceuticals. Both have tried — and so far failed — to get their drugs approved for treating patients with dementia. (In 2019, Avanir agreed to pay $108 million to settle charges that it had inappropriately marketed its drug for use in dementia patients in nursing homes.)
‘Hold His Haldol’
Ms. Blakeney said that only after hiring a lawyer to sue Dundee Manor for her husband’s death did she learn he had been on Haldol and other powerful drugs. (Dundee Manor has denied Ms. Blakeney’s claims in court filings.)
During her visits, though, Ms. Blakeney noticed that many residents were sleeping most of the time. A pair of women, in particular, always caught her attention. “There were two of them, laying in the same room, like they were dead,” she said.
In his first few months at Dundee Manor, Mr. Blakeney was in and out of the hospital, for bedsores, pneumonia and dehydration. During one hospital visit in December, a doctor noted that Mr. Blakeney was unable to communicate and could no longer walk.
“Hold the patient’s Ambien, trazodone and Zyprexa because of his mental status changes,” the doctor wrote. “Hold his Haldol.”
Mr. Blakeney continued to be prescribed the drugs after he returned to Dundee Manor. By April 2017, the bedsore on his right heel — a result, in part, of his rarely getting out of bed or his wheelchair — required the foot to be amputated.
In June, after weeks of fruitless searching for another nursing home, Ms. Blakeney found one and transferred him there. Later that month, he died.
“I tried to get him out — I tried and tried and tried,” his wife said. “But when I did get him out, it was too late.”
U.S. Embassy warned Americans to stay away from the Kabul airport and told anyone outside the perimeter to “leave immediately,” citing unnamed security threats.
The British and Australian governments issued similar warnings, with Australian officials describing “an ongoing and very high threat of terrorist attack.”
The warnings came as the last of the estimated 1,500 Americans and countless other foreigners still in Afghanistan try to make it to the airport to leave before the U.S. withdrawal on Aug. 31. Thousands of Afghan nationals are camped outside the perimeter of the airport in desperate attempts to escape on the last flights out, some with documents allowing them to leave.
A senior U.S. official, who spoke on the condition of anonymity about confidential assessments, confirmed that the United States was tracking a “specific” and “credible” threat at the airport from the Islamic State affiliate in Afghanistan, which has carried out dozens of attacks in recent years, many targeting ethnic minorities and other civilians.
The U.S. Embassy in Kabul cited three areas of particular concern in its advisory.
“U.S. citizens who are at the Abbey Gate, East Gate, or North Gate now should leave immediately,” the statement said, without further detail.Marise Payne, Australia’s foreign minister, said at a news conference Thursday that the Taliban will allow Australian citizens and visa holders to leave safely but added, “Our travel advice remains: You should not come to Hamid Karzai airport because it is not safe to do so, and if you are in Kabul, you should shelter in place, move to a safe location and await further advice.”
The U.S. government has been warning about potential security threats at the airport, and access to the airport has been adjusted accordingly, with some gates temporarily closed.
WASHINGTON — About 1,500 American citizens remain in Afghanistan, and about a third of them are in contact with the U.S. government and hope to leave in the coming days, Secretary of State Antony J. Blinken said on Wednesday.
Some of the remaining 1,000 may not want to leave, Mr. Blinken said, describing an ever-changing estimate that the Biden administration has tried to pin down as American troops wind down an evacuation effort that has overwhelmed the airport in Kabul, the capital.
That number does not include legal permanent American residents or green card holders, he said.
Mr. Blinken said more than 4,500 U.S. citizens have so far been flown out of Afghanistan since Aug. 14, as the Taliban bore down on Kabul. He said the State Department has sent more than 20,000 emails and made 45,000 phone calls to identify and locate Americans in Afghanistan ahead of an Aug. 31 withdrawal of U.S. troops from the country after 20 years of war.
But Mr. Blinken sought to assure that any Americans or Afghans who have worked with the U.S. mission and want to leave after that date should be free to do so.“That effort will continue every day,” he said.
U.S. and allied planes flew an additional 19,200 people out of Kabul in the past 24 hours, officials said on Wednesday, as the Biden administration made substantial inroads into evacuating American citizens and Afghans who worked for the United States over the last 20 years.
More than 10,000 people were still inside the international airport in Kabul awaiting flights out of the country on Wednesday, and Afghans with proper credentials continued to be cleared into the airfield, Pentagon officials said.
With President Biden’s Aug. 31 deadline for the withdrawal of American troops rapidly approaching, tens of thousands of Afghans who qualify for special immigration visas are also waiting to be evacuated.
As of 3 a.m. in Washington, the United States had evacuated about 82,300 people from Kabul’s international airport since the government fell to Taliban forces.
John F. Kirby, the chief Pentagon spokesman, told reporters that American officers in Kabul, including the top commander, Rear Adm. Peter G. Vaseley, were talking daily with Taliban counterparts to ensure safe passage of Americans and Afghan allies with proper credentials.
Experts predict that hundreds of thousands of Afghans will be targeted by the Taliban if they stay, including Afghan security forces, government officials, women’s rights advocates and other defenders of democracy. Those Afghans are desperately hoping to join the U.S. military’s airlift before it begins to wind down, potentially as soon as this weekend.
For the third time in a week, American military helicopters rescued Americans inside Kabul. On Tuesday, about 20 American citizens who were flown onto the airfield from a location inside the city, Maj. Gen. William Taylor told reporters. A similar flight rescued 169 Americans from a Kabul hotel meeting place last week.
Though Mr. Biden has vowed to stick to the Aug. 31 exit plan, as the Taliban have demanded, he also has instructed Mr. Blinken and Defense Secretary Lloyd J. Austin to draw up plans to push back the date if necessary.
The Taliban have warned of potential reprisals should the United States renege on its promise to withdraw its forces by the deadline, and Mr. Biden on Tuesday noted the danger to American troops should they remain much longer.
Beyond the Taliban, extremists affiliated with the Islamic State are also believed to pose a threat to the evacuation effort that has drawn crowds of people to Kabul’s airport gates, clamoring to be allowed on one of the flights that are departing every 45 minutes.
“I’m determined to ensure that we complete our mission,” Mr. Biden said at the White House on Tuesday. “I’m also mindful of the increasing risks that I’ve been briefed on and the need to factor those risks in. There are real and significant challenges that we also have to take into consideration.”
But the dwindling hours are weighing heavily on the minds of people seeking to flee Afghanistan and members of Congress who want the United States to retain a presence there until Americans and high-risk Afghans can get out.
The Pentagon spokesman, Mr. Kirby, said that the military would put high priority on flying out American troops and equipment in the mission’s final days. “There will be a transition more toward getting military assets out as we get closer to the end, but again, we’re going to continue to work the evacuation mission right up until the last day,” he said.
KABUL, Afghanistan — In his first sit-down interview with a Western media outlet since the Taliban took full control of Afghanistan, one of the group’s leaders on Wednesday offered a portrait of a group intent on rebuilding a country shattered by decades of war.
“We want to build the future, and forget what happened in the past,” the spokesman, Zabihullah Mujahid, said in an interview with The New York Times. He rejected widespread fears that the Taliban are already exacting vengeance on those who opposed them and want to reimpose the harsh controls on women that made them notorious when they ruled the country 20 years ago.
The interview came just a day after Mr. Mujahid warned the women of Afghanistan that it might be safest for them to remain home until more rank-and-file Taliban fighters have been trained in how not to mistreat them.
It was a notable acknowledgment of the many changes to Afghan society that greeted the Taliban when they re-entered a city they had not controlled for two decades.
Many of those changes involve women. Not only have they been free to leave home unaccompanied — dressed as they see fit — they have also returned to school and jobs, and their images can be seen on everything from billboards to TV screens.
On Wednesday, Mr. Mujahid suggested that longer-term, women would be free to resume their daily routines.
Concerns that the Taliban would once again force them to stay in their homes or cover their faces are baseless, he said. He added that the requirement they be accompanied by a male guardian, known as a mahram, was misunderstood. It applies only to journeys of three days or longer, he said.
“If they go to school, the office, university, or the hospital, they don’t need a mahram,” said Mr. Mujahid, who also serves as the Taliban’s chief spokesman.
He also offered assurances to Afghans trying to leave the country, saying — contrary to news reports based on his news conference on Tuesday, including in The Times — that those with valid travel documents would not be prevented from entering the airport.
“We said that people who don’t have proper documents aren’t allowed to go,” Mr. Mujahid said. “They need passports and visas for the countries they’re going to, and then they can leave by air. If their documents are valid, then we’re not going to ask what they were doing before.”
He also denied allegations that the Taliban have been searching for former interpreters and others who worked for the American military, and claimed that they would be safe in their own country. And he expressed frustration at the Western evacuation efforts.
“They shouldn’t interfere in our country and take out our human resources: doctors, professors and other people we need here,” Mr. Mujahid said. “In America, they might become dishwashers or cooks. It’s inhuman.”
For the past decade, Mr. Mujahid had been a key link between the militants and the news media, but remained faceless. On Wednesday, he granted the interview at the Ministry of Information and Culture as Taliban leaders and other Afghan power brokers were engaging in protracted discussions about the future shape of the country.
Mr. Mujahid is seen as likely to be the future minister of information and culture. Fluent in both Pashto and Dari, the country’s principal languages, Mr. Mujahid, 43, described himself as a native of Paktia Province and a graduate in Islamic jurisprudence from the well-known Darul Uloom Haqqania madrasa in Pakistan.
Despite the tense situation at the airport on Wednesday, where thousands of people were still crowded around most entrance gates, Mr. Mujahid expressed hope that the Taliban would build good relations with the international community, pointing out areas of cooperation around counterterrorism, opium eradication and the reduction of refugees to the West.
Although he sought to convey a much more tolerant image of the Taliban, Mr. Mujahid did confirm one report: Music will not be allowed in public.
“Music is forbidden in Islam,” he said, “but we’re hoping that we can persuade people not to do such things, instead of pressuring them.”
— Matthieu Aikins and Jim Huylebroek
The Americans are all but gone, the Afghan government has collapsed and the Taliban now rule the streets of Kabul. Overnight, millions of Kabul residents have been left to navigate an uncertain transition after 20 years of U.S.-backed rule.
Government services are largely unavailable. Residents are struggling to lead their daily lives in an ecconomy that, propped up for the past generation by American aid, is now in free fall. Banks are closed, cash is growing scarce, and food prices are rising.
Yet relative calm has reigned over Kabul, the capital, in sharp contrast to the chaos at its airport. Many residents are hiding in their homes or venturing out only cautiously to see what life might be like under their new rulers.
Even residents who said they feared the Taliban were struck by the relative order and quiet, but for some the calm has been ominous.
A resident named Mohib said that streets were deserted in his section of the city, with people hunkering down in their homes, “scared and terrorized.”
“People feel the Taliban may come any moment to take away everything from them,” he said.
WASHINGTON — The United States has been battling the Taliban and their militant partners in Afghanistan, Al Qaeda and the Haqqani network, for 20 years.
But the biggest immediate threat to both the Americans and the Taliban as the United States escalates its evacuation at the Kabul airport before an Aug. 31 withdrawal deadline is a common rival that is lesser known: Islamic State Khorasan, or ISIS-K, the terrorist group’s affiliate in Afghanistan.
Created six years ago by disaffected Pakistani Taliban, ISIS-K has carried out dozens of attacks in Afghanistan this year. American military and intelligence analysts say threats from the group include a bomb-laden truck, suicide bombers infiltrating the crowd outside Hamid Karzai International Airport and mortar strikes against the airfield.
These threats, coupled with new demands by the Taliban for the United States to leave by Aug. 31, probably influenced President Biden’s decision on Tuesday to stick to that deadline. “Every day we’re on the ground is another day we know that ISIS-K is seeking to target the airport and attack both U.S. and allied forces and innocent civilians,” Mr. Biden said.
The threats lay bare a complicated dynamic between the Taliban, Al Qaeda and the Haqqani network, and their bitter rival, ISIS-K, in what analysts say portends a bloody struggle involving thousands of foreign fighters on both sides.
A United Nations report in June concluded that 8,000 to 10,000 fighters from Central Asia, the North Caucasus region of Russia, Pakistan and the Xinjiang region in western China have poured into Afghanistan in recent months. Most are associated with the Taliban or Al Qaeda, the report said, but others are allied with ISIS-K.
“Afghanistan has now become the Las Vegas of the terrorists, of the radicals and of the extremists,” said Ali Mohammad Ali, a former Afghan security official. “People all over the world, radicals and extremists, are chanting, celebrating the Taliban victory. This is paving the way for other extremists to come to Afghanistan.”
Adam Nossiter contributed reporting from Paris.
Germany will maintain support for Afghans who remain in their country after the deadline for the U.S. troop withdrawal and evacuation mission passes in six days, Chancellor Angela Merkel said on Wednesday. She also called for talks with the Taliban to preserve progress made in Afghanistan in the last two decades.
Speaking to a session of Parliament convened to discuss the Taliban’s rapid takeover of Afghanistan, the chancellor defended Germany’s decision to join the international intervention there in 2001.
“Our goal must be to preserve as much as possible what we have achieved in terms of changes in Afghanistan in the last 20 years,” Ms. Merkel told lawmakers. “This is something the international community must talk about with the Taliban.”
She cited changes such as improved access to basic necessities, with 70 percent of Afghans now having access to clean drinking water and 90 percent having access to electricity, in addition to better health care for women.
“But what is clear is that the Taliban are reality in Afghanistan and many people are afraid,” Ms. Merkel said. “This new reality is bitter, but we must come to terms with it.”
Germany pulled its last contingent of soldiers, about 570 troops, out of Afghanistan in June, but several hundred Germans were still engaged in development work funded by Berlin, and the German government believed they would be able to remain in Afghanistan after the withdrawal of U.S. and international forces.
Ms. Merkel defended her government’s decision to leave development workers on the ground, saying that they had hoped to continue to provide essential support for Afghans after the troop withdrawal, and that an earlier retreat could have appeared as if they were abandoning people.
“At that time there were very good reasons to stand beside the people in Afghanistan after the troops were gone,” Ms. Merkel said.
But the opposition leaders criticized her government for not developing a plan to bring people to safety in the spring, when other European countries were evacuating citizens and Afghan support staff.
“The situation in Afghanistan is a catastrophe, but it did not come out of nowhere,” said Christian Lindner, the head of the Free Democratic Party, which together with the Green Party petitioned Parliament in June to begin evacuations of German staff and Afghans who could be in danger.
Ms. Merkel did not apologize, instead calling for a deeper examination of where the West went wrong in Afghanistan and what lessons could be learned. That will be the work of the next government, as she is stepping down after the German elections on Sept. 26.
“Many things in history take a long time. That is why we must not and will not forget Afghanistan,” said Ms. Merkel, who was raised in communist East Germany.
“Even if it doesn’t look like it in this bitter hour,” she said, “I remain convinced that no force or ideology can resist the drive for justice and peace.”
When President Biden briefly referred to the Berlin airlift — the operation 73 years ago to feed a city whose access had been choked off by the Soviet Union — in describing the United States’ evacuation efforts in Afghanistan, he was revealing the inspiration for a broader plan to redeem America’s messy exit.
After 10 days of missed signals, desperate crowds and violence around Hamid Karzai International Airport in Kabul, Mr. Biden and his team are eager to shift the narrative about the chaotic end of America’s longest war.
Jake Sullivan, his national security adviser, said on Monday that the scores of rescue flights the United States was initiating each day were likely to be regarded as “one of the largest airlifts in history.”
“There is no other country in the world who could pull something like this off — bar none,” he said.
As of Tuesday evening, 12,000 people had been evacuated from Kabul during the previous 12 hours, Biden said. That brought the total number evacuated since the end of July to 75,900 people, the president said.
The comparison to the rescue operation in Berlin is not a bad one. Berlin had been divided since the end of World War II, and tensions were growing. The United States and Britain took to the sky to carry in material by plane.
The two countries managed to get just shy of 300,000 flights into Berlin over 11 months, from June 24, 1948, to May 11, 1949, and the State Department’s record notes that “at the height of the campaign, one plane landed every 45 seconds at Tempelhof Airport,” which until recently was Berlin’s main air hub.
The United Nations leadership faced growing anger from staff unions Wednesday over what some called its failure to protect Afghan co-workers and their families, who remain stuck in Afghanistan at the mercy of the Taliban even as the majority of the organization’s non-Afghan staff have been relocated to other countries.
Many of the Afghan employees, their foreign colleagues say, are in hiding or are reluctant to keep working, fearful of reprisals by triumphant Taliban militants who may perceive them as apostates, traitors and agents of foreign interference.
That fear has persisted even though the Taliban’s hierarchy has indicated that the U.N. should be permitted to work in the country unimpeded during and after the forces of the United States and NATO withdraw, a pullout that is officially scheduled for completion in less than a week.
An internal U.N. document reported by Reuters on Wednesday said Taliban operatives had detained and beaten some Afghan employees of the United Nations. Stéphane Dujarric, a spokesman for Secretary General António Guterres, did not confirm or deny the report but said it was “critical is that the authorities in charge in Kabul and throughout Afghanistan realize that they have the responsibility to protect U.N. premises and for the safety of U.N. staff.”
Mr. Guterres has repeatedly said the U.N. fully supports the Afghan staff, who are said to number between 3,000 and 3,400, and that he is doing everything in his power to ensure their safety. Mr. Dujarric said about 10 percent of those Afghan workers are women, who are especially at risk of facing Taliban repression.
The secretary general reiterated his assurances during a private virtual town hall meeting on Wednesday with staff members, said Mr. Dujarric, who told reporters that Mr. Guterres “understands the staff’s deep anxiety about what the future holds.”
But rank-and-file staff members of the United Nations have grown increasingly skeptical of Mr. Guterres’s pronouncements. A resolution passed on Tuesday by the U.N. staff union in New Yorkurged Mr. Guterres to take steps that would enableAfghan staff members to avoid “unacceptable residual risks by using evacuation from Afghanistan as soon as possible.”
U.N. officials have said they are powerless to issue visas to Afghan personnel without cooperation from other countries willing to host them. U.N. officials also have said the organization remains committed to providing services in Afghanistan, where roughly half the population needs humanitarian aid. Such services, including food and health care, are impossible to conduct without local staff.
The town hall was held a few days after a second batch of non-Afghan U.N. staff had been airlifted from Kabul. Many of the roughly 350 non-Afghan U.N. personnel who had been in the country, including Deborah Lyons, head of the U.N. Assistance Mission for Afghanistan, are now working remotely from Almaty, Kazakhstan.
The unequal treatment of non-Afghan and Afghan personnel working for the U.N. has become an increasingly bitter sore point between management and staff at the global organization. An online petition started this past weekend by staff union members calling on Mr. Guterres to do more to help Afghan employees and their families had, as of Wednesday, garnered nearly 6,000 signatures.
An earlier version of this item misidentified the U.N. staff union organization that passed a resolution urging the U.N. secretary general to help Afghan employees evacuate Afghanistan. It was the U.N. staff union in New York, not the coordinating committee of the association of staff unions.
When the Taliban were last in power, Afghan women were generally not allowed to leave their homes except under certain narrowly defined conditions. Those who did risked being beaten, tortured or executed.
In the days since the Taliban swept back into control, their leaders have insisted that this time will be different. Women, they say, will be allowed to work. Girls will be free to attend school. At least within the confines of their interpretation of Islam.
But early signs have not been promising, and that pattern continued on Tuesday with a statement from a Taliban spokesman that women should stay home, at least for now. Why? Because some of the militants have not yet been trained not to hurt them, he said.
The spokesman, Zabihullah Mujahid, called it a “temporary” policy intended to protect women until the Taliban could ensure their safety.
“We are worried our forces who are new and have not been yet trained very well may mistreat women,” Mr. Mujahid said. “We don’t want our forces, God forbid, to harm or harass women.”
Mr. Mujahid said that women should stay home “until we have a new procedure,” and that “their salaries will paid in their homes.”
His statement echoed comments from Ahmadullah Waseq, the deputy of the Taliban’s cultural affairs committee, who told The New York Times this week that the Taliban had “no problem with working women,” as long as they wore hijabs.
But, he said: “For now, we are asking them to stay home until the situation gets normal. Now it is a military situation.”
During the first years of Taliban rule, from 1996 to 2001, women were forbidden to work outside the home or even to leave the house without a male guardian. They could not attend school, and faced public flogging if they were found to have violated morality rules, like one requiring that they be fully covered.
The claim that restrictions on women’s lives are a temporary necessity is not new to Afghan women. The Taliban made similar claims the last time they controlled Afghanistan, said Heather Barr, the associate director of women’s rights at Human Rights Watch.
“The explanation was that the security was not good, and they were waiting for security to be better, and then women would be able to have more freedom,” she said. “But of course in those years they were in power, that moment never arrived — and I can promise you Afghan women hearing this today are thinking it will never arrive this time either.”
Brian Castner, a senior crisis adviser at Amnesty International who was in Afghanistan until last week, said that if the Taliban intended to treat women better, they would need to retrain their forces. “You can’t have a movement like the Taliban that has operated a certain way for 25 years and then just because you take over a government, all of the fighters and everyone in your organization just does something differently,” he said.
But, Mr. Castner said, there is no indication that the Taliban intend to fulfill that or any other promises of moderation. Amnesty International has received reports of fighters going door to door with lists of names, despite their leaders’ public pledges not to retaliate against Afghans who worked with the previous government.
“The rhetoric and the reality are not matching at all, and I think that the rhetoric is more than just disingenuous,” Mr. Castner said. “If a random Taliban fighter commits a human rights abuse or violation, that’s just kind of random violence, that’s one thing. But if there’s a systematic going to people’s homes and looking for people, that’s not a random fighter that’s untrained — that’s a system working. The rhetoric is a cover for what’s really happening.”
In Kabul on Wednesday, women in parts of the city with minimal Taliban presence were going out “with normal clothes, as it was before the Taliban,” said a resident named Shabaka. But in central areas with many Taliban fighters, few women ventured out, and those who did wore burqas, said Sayed, a civil servant.
Ms. Barr, of Human Rights Watch, said that in the week since the Taliban said the new government would preserve women’s rights “within the bounds of Islamic law,” the Afghan women she has spoken to offered the same skeptical assessment: “They’re trying to look normal and legitimate, and this will last as long as the international community and the international press are still there. And then we’ll see what they’re really like again.”
It might not take long, Ms. Barr suggested.
“This announcement just highlights to me that they don’t feel like they need to wait,” she said.
A group of Afghans who worked for The New York Times, along with their families, touched down safely early Wednesday — not in New York or Washington, but at Benito Juárez International Airport in Mexico City.
Mexican officials, unlike their counterparts in the United States, were able to cut through the red tape of their immigration system to quickly provide documents that, in turn, allowed the Afghans to fly from Kabul’s embattled airport to Qatar.
The documents promised that the Afghans would receive temporary humanitarian protection in Mexico while they explored further options in the United States or elsewhere.
“We are right now committed to a foreign policy promoting free expression, liberties and feminist values,” Mexico’s foreign minister, Marcelo Ebrard, said in a telephone interview.
He cited a national tradition of welcoming people including the 19th-century Cuban independence leader José Martí, German Jews and South Americans fleeing coups, and he said that Mexico had opened its doors to the Afghan journalists “in order to protect them and to be consistent with this policy.”
But the path of the Afghan journalists and their families to Mexico was as arbitrary, personal and tenuous as anything else in the frantic and scattershot evacuation of Kabul.
Just days after the Taliban swept into Kabul and toppled Afghanistan’s government, a group of former mujahedeen fighters and Afghan commandos said they had begun a war of resistance in the last area of the country that is not under Taliban control: a narrow valley with a history of repelling invaders.
The man leading them is Ahmad Massoud, the 32-year-old son of the storied mujahedeen commander Ahmad Shah Massoud. And their struggle faces long odds: The resistance fighters are surrounded by the Taliban, have supplies that will soon start dwindling and have no visible outside support.
For now the resistance has merely two assets: the Panjshir Valley, 70 miles north of Kabul, which has a history of repelling invaders, and the legendary Massoud name.
Spokesmen for Ahmad Massoud insist that he has attracted thousands of soldiers to the valley, including remnants of the Afghan Army’s special forces and some of his father’s experienced guerrilla commanders, as well as activists and others who reject the Taliban’s Islamic Emirate.
The spokesmen, some of whom were with him in the Panjshir Valley and some who were outside the country drumming up support, said that Mr. Massoud has stocks of weapons and matériel, including American helicopters, but needs more.
‘‘We’re waiting for some opportunity, some support,” said Hamid Saifi, a former colonel in the Afghan National Army, and now a commander in Mr. Massoud’s resistance, who was reached in the Panjshir Valley by telephone on Sunday. “Maybe some countries will be ready for this great work. So far, all countries we talked to are quiet. America, Europe, China, Russia, all of them are quiet.’’