May 7 2007 News

GREENSBURG, Kan. — Evelyn Ringwald had been through this drill many times before: the driving rain and pounding hail, the tornado warnings and the emergency sirens.

Each time, she and other residents of this south-central Kansas town avoided a direct hit.

Rescue crews on Sunday combed piles of debris where homes and businesses once stood in Greensburg, Kansas, in a meticulous search for survivors of a killer tornado.

By nightfall searchers had not found anyone else -- alive or dead -- in the rubble, leaving the twister's toll at eight dead in the tiny farming community of Greensburg and one dead in nearby Pratt County as a result of Friday night's twister. At least 50 people were injured, some critically.

A 10th person died and three people were injured on Saturday night when another tornado touched down in southwest Kansas not far from Greensburg.

"We didn't find any additional people today or bodies in the search and rescue effort," said Kansas Emergency Management spokeswoman Sharon Watson. "But we'll continue to search."

Some 90 percent of the businesses and homes in Greensburg, a town of about 1,800, were damaged or destroyed when the mile-wide tornado and winds of 165 mph (265 kph) ripped through.

Federal Emergency Management Agency spokeswoman Crystal Payton, in Greensburg on Sunday, compared the devastation to that wrought along the Mississippi Gulf Coast by Hurricane Katrina in August 2005.

"This may be smaller in scope than Katrina ... but it is equally devastating," she said.

FEMA director R. David Paulison is scheduled to tour the area Monday. FEMA is working to set up trailers and support services in the area and has a hotline for residents to call for assistance.

Soldiers with the Kansas National Guard were also being deployed to help remove debris.

Air patrols were also conducting reconnaissance flights along the tornado's path to search for possible victims, stranded motorists and residents.

Greensburg resident Bruce Foster, 50, said he rode out the storm in the basement of a friend's house, huddling under a mattress with a group of neighbors.

"The house started shaking and dust was falling. Our ears started popping and then it got all calm," Foster said. "We went upstairs and the house was gone, all gone. There wasn't any furniture or anything."

President George W. Bush declared the community a major disaster area and ordered federal aid to supplement state and local recovery efforts. "Our hearts are heavy for the loss of life in Greensburg, Kansas," Bush said on Sunday.

Kansans struggled to comprehend the losses. "They're still going through a little bit of shell shock," said Red Cross worker Ralph Rojas, who helped operate a shelter where about 50 Greensburg residents spent the night.

"There are still people looking for family and friends," Rojas said. "There is a major portion of the community just gone."

Greensburg's hospital and schools were among the buildings destroyed. The water tower next to the town's main tourist attraction -- the world's largest hand-dug well -- was knocked down. The nursing home was nearly leveled.

About 30 survivors were found in the remains of the hospital, according to Watson. "There was a warning in time for people to take cover so that helped," she said.

In addition to the tornado that touched down Friday night, at least three more hit the region Saturday night, the National Weather Service said.

One woman in Ottawa County, Kansas, was killed in the Saturday night storms, said Watson. She was staying in a camper near a lake when the twister hit. Three family members in the camper were injured.

Widespread flooding was also reported throughout central Kansas, closing parts of the Kansas turnpike. At least four counties issued disaster declarations due to the flooding.

The peak U.S. tornado season runs from March through early July; twisters kill an average of 70 Americans each year. The most violent single tornado appeared on March 18, 1925, killing 689 people in Missouri, Illinois and Indiana. Killer tornadoes stalk Plains

"You never think it's going to hit home," says Ringwald, 75, a retired third-grade teacher who has lived here since 1961.

"You never think you'll be in that situation, until you are," she says.
 Greensburg

On Friday, she was. Late that night, a twister raced down the highway that bisects this oil, gas and farming town of about 1,500 people. It obliterated Main Street and flattened residential neighborhoods, killing eight people and leveling or damaging most buildings.

The search for survivors continued Sunday by rescue teams from around the state and nation, some with dogs that detect human remains. They combed through mountains of bricks, splintered wood and metal looking for trapped survivors.

"It's still a search-and-rescue operation," Kansas Highway Patrol Trooper Ronald Knoefel says. "We don't want to give up hope."

Disaster area declared

The scene around Knoefel was bleak. Intact eaves sat atop flattened homes. Trees throughout town were stripped of their leaves, and in many places, their bark. Cars and trucks were strewn on sidewalks and streets as if they were Tonka trucks cast carelessly aside by children. On the western edge of town, the back end of a green Pontiac minivan jutted from the roof of a partially standing building.

Greensburg, 109 miles west of Wichita, is the county seat of Kiowa County. Billboards into town advertise its attractions: It has the world's "largest hand-dug well," at 109 feet deep and 32 feet wide, and a 1,000-pound meteorite.How tornadoes form

"It would have been nice if you could have seen what a beautiful community we had here," Knoefel says. The tornado "just flat-out leveled the town. There's no other way to put it," he says.

President Bush declared parts of Kansas disaster areas, which allows federal aid to go to the devastated region. In all, at least 10 Kansans were known dead from the weekend storms.

Gov. Kathleen Sebelius said Sunday evening that the state's response will likely be hampered because much of the equipment usually positioned around the state to respond to emergencies — including tents and semitrailers — is in Iraq, the Associated Press reported. "Not having the National Guard equipment … to bring in immediately is really going to handicap this effort to rebuild," she says.

Chris Graber, 28, who rode out the tornado in a Toyota Tundra with five family members, says, "It looked like there was a bombing raid." Several of them were hurt, including Graber and his 15-month-old son Jase, who suffered a slight concussion.

Law enforcement and emergency officials say they're stunned by the scope of the damage.

"Normally, a tornado will hit an area of town or take out the business district" or a neighborhood, says Federal Emergency Management Agency regional administrator Dick Hainje. "In this case, it's very nearly total destruction."

Not allowed to go home

Hainje says FEMA is sending mobile homes and trailers to the area and already is providing food and water. FEMA officials were at city schools and other evacuation centers to take applications for grants for disaster-related expenses.

Residents were prohibited from entering town Sunday because "the city just isn't safe yet," Hainje says, citing the dangers of unstable debris. Residents will be allowed to return to their homes this morning to assess damage and gather small salvageable items but cannot remain overnight, he says.

The blockade frustrated many residents who waited at friends' and relatives' homes or temporary emergency shelters, where they sleep on cots and scour piles of donated shirts and pants to find a clean change of clothing.Most of Greensburg is gone

"I want to go home so bad. That's where I belong," says Tammy Wittig, 39, who fled to the basement of the local hospital to ride out the storm. Wittig says she has pictures at home of two nieces who died.

"The only pictures in existence of them are in that house," she says.

Like fellow resident Ringwald, Wittig says she never expected a tornado to hit her home, even though she lives in a twister hot-spot. "The sirens have gone off before, many a time, but the tornado would go over or around the town," she says. "That's why so many people got hurt. That's why so many people stayed home.

"Nobody thought it was going to hit," she says.

Schools were destroyed

The city's two school sites are "both gone," says Darin Headrick, superintendent of Greensburg Public Schools, a district of about 300 students. Headrick says graduation, which was set for next Saturday, will likely be rescheduled. "In August, we plan on having school," he adds. "We're trying to make sure people do know Greensburg's going to rebuild."

Some residents aren't so sure they want to rebuild.

Ringwald, who lives alone, hid in the basement during the tornado and crawled out of a window to escape. She says she doesn't know what shape her house is in because she hasn't been allowed to go back. Nor does she know the fate of four cats that were in a pen in the backyard, treasured family pictures or her Mercury Grand Marquis, which had fewer than 3,000 miles on it.OFFICIALS ARRESTED 4 soldiers, reserve cop accused of looting

Ringwald's voice quivers when she discusses whether to rebuild.

"It's questionable. I don't know," she says. "The way things are in town and at my age, I don't know what I should do."

May 6, 2007 —

President Bush's approval rating has dropped to 28 percent in a Newsweek poll released this weekend, the lowest of any president in a generation.

Bush's low is now tied with Jimmy Carter during the Iran hostage crisis. Only two modern presidents have fared worse -- Richard Nixon, at 23 percent, and Harry Truman, bogged down in the Korean War, at 22 percent.

"When presidents get down into the 20's -- as Harry Truman, Jimmy Carter, Richard Nixon [did], of course -- what it tells us, of course, is that they have lost their hold on the public's imagination. The public is so at odds with them, they don't have credibility any more. The public does not trust them -- and it's ruinous."

Like President Carter, Bush faces domestic and international crises -- in Iraq and on such pocketbook issues as a housing slump and rising gas prices.

"This has been the year of horrors for the Bush administration, reeling from an election result and then moving into scandal after scandal," said Norman Ornstein, political analyst at the American Enterprise Institute. "The clear majority of Americans, if they could, would just TiVo through the rest of this administration and move on to the next."

Nearly two-thirds of respondents also found Bush "stubborn and unwilling to admit mistakes."

The president has now had less-than-majority favorability numbers for three years. Only President Truman was as low for longer. It has been a steep fall from Bush's peak approval rating of 92 percent after the attacks of Sept. 11, 2001, the highest on record for any president.

While other recent polls showed different results, this poll found disaffection with the president may be dragging down Republican presidential hopefuls.

"No Republican will win in 2008 on keeping Washington as it is," former House Speaker Newt Gingrich said on CBS' "Face the Nation" program. "Unless they're prepared to offer that change, I think the country will almost certainly elect a Democrat."

[Today, House Republican Leader John Boehner, R-Ohio, suggested public support among Republicans for President Bush's Iraq policy could crumble in the fall without clear success.

"Over the course of the next three to four months, we'll have some idea how well the plan's working. Early signs are indicating there is clearly some success on a number of fronts," he said on "Fox News Sunday. "By the time we get to September or October, members are going to want to know how well this is working, and if it isn't, what's Plan B."]

During last week's Republican presidential debate at the Reagan presidential library, Bush's name was mentioned just once. Candidates instead cited Ronald Reagan, the GOP standard-bearer of the 1980s, 20 times.

May 06, 2007

Muslim extremists attacked a children's festival at a U.N.-run elementary school Sunday, killing a politician's bodyguard and wounding seven people in the latest incident of lawlessness engulfing the Gaza Strip.

The gun and homemade bomb attack on the U.N. school in the southern Gaza refugee camp of Rafah began with a protest by Muslim extremists in long robes, who said a sports festival the school was hosting was un-Islamic. One protester's sign said the U.N. 'is turning schools into nightclubs.'

Protesters also accused the top U.N. official in Gaza, John Ging, who was in the school, of leading a movement to weaken people's Islamic faith.

The group of protesters tried to enter the school and Palestinian security officers fired in the air to keep them away. In the ensuing chaos, at least one bomb was thrown into the school, wounding many of the seven who were hurt. A gun battle followed.

A senior Fatah official, Majed Abu Shamaleh, was leaving the school when his bodyguard was killed in sight of terrified youngsters. Ging was not hurt.

The shooting appeared to be carried out by the same extremists behind a string of bombings of Internet cafes and pool halls in Gaza, said Abu Shamaleh.

Police said they were interrogating two of the gunmen.

The Palestinian unity government formed two months ago appears powerless to end extremist groups on foreigners, music shops and Internet cafes. Clan fighting, kidnappings and other attacks have added to the chaos.

Hours after Sunday's attack, moderate Palestinian President Mahmoud Abbas of Fatah and Prime Minister Ismail Haniyeh of Hamas met in another attempt to put together a security plan. The meeting ended without agreement, and another was set for Monday, government spokesman Ghazi Hamad said.

The author of the plan, Interior Minister Hani Kawasmeh, has threatened to resign because security commanders refuse to cooperate with him, mainly because of rivalries between coalition partners Hamas and Fatah.

New statistics showed that during the first three months of the year 147 Gazans, including 10 children, were killed by fellow Palestinians, according to the Palestinian human rights group Al-Mezan.

Factional fighting killed 57 people in 2004, followed by 101 in 2005 and 252 last year.

'People aren't safe,' said Samir Zakkout, author of the report. 'The increasing lawlessness is putting this government at a crossroads.'

May 7 2007The United Nations urged far tougher action to fight climate change at a 166-nation climate conference on Monday, the first after reports warning of growing damage from droughts, floods or rising seas.

More than 1,000 government delegates at the May 7-18 meeting will try to find ways to break gridlock in international negotiations on widening action to slow global warming beyond 2012 amid widening public concern about the risks.

"Deep emissions cuts by industrialized countries are needed," Yvo de Boer, head of the U.N. Climate Change Secretariat, told the officials at a Bonn hotel. He urged them to take heed of three reports in 2007 by the U.N. climate panel.

He said poorer nations should get more involved in fighting climate change, especially big emitters, and that developing nations should be provided with incentives to take part.

China is set to overtake the United States as the top emitter of greenhouse gases in coming years. Neither have goals under the Kyoto Protocol, the U.N. plan by 35 industrial nations to cut emissions by 5 percent below 1990 levels by 2008-12.

"The international community should urgently embark on a transition to low carbon societies," The European Union, a main backer of Kyoto, said in a statement at the start of the talks.

Reports by U.N. climate scientists this year have blamed mankind for stoking warming, mainly by burning fossil fuels. And they have predicted impacts such as heatwaves, a spread of disease, cuts in crop yields in Africa and melting glaciers.

The third report, issued in Bangkok on Friday, said fighting global warming could brake global economic growth by up to 3 per cent in 2030 and that less stringent curbs on emissions of greenhouse gases could even slightly boost the world economy.

The Bonn talks are preparing the ground for a meeting of environment ministers in Bali, Indonesia, in December. Many nations want to launch formal 2-year negotiations at Bali to agree ways to widen the U.N.'s Kyoto Protocol beyond 2012.

"My sense is of an increasing sense of urgency," De Boer told a news conference, but said many nations were "holding their cards close to their chests" about measures they might take.

President George W. Bush opposes Kyoto-style caps on emissions, reckoning they will cost U.S. jobs and that Kyoto wrongly omits developing nations until 2102.

Some delegates in Bonn want a presentation of the U.N. climate panel's findings to ministers on the opening day in Bali to put pressure on them to act.

Hans Verolme, climate expert at the WWF environmental group, said ministers had to act in Bali to start formal talks or they would disappoint ordinary citizens increasingly worried by climate change.

"Ministers will have to unclog the traffic jam," he said.

Many developing nations are wary of limiting their emissions, that rising energy use is vital for growth.

The EU said that the U.N. reports meant the world had to cut emissions of greenhouse gases by 50 percent below 1990 levels by 2050 to limit global warming to a 2 Celsius (3.6 Fahrenheit) rise over pre-industrial times, seen by the EU as a threshold for "dangerous" changes.

"This will require emissions to peak within the next 10-15 years," the EU said in a statement written by Germany, which holds the EU's rotating presidency.

May 7 2007 After a few minutes tossing a string of flat beads and chanting, Rogelio Castellano decides his tourist client is emotionally scarred by an old conflict. Only a $500 ritual goat sacrifice will put it right.

He's insistent. Even after he halves the fee, it's more money than he could make in a year on a Cuban state salary.

A babalawo, or priest, of Cuba's ritual-filled Santeria religion, Castellano wears a gold chain and has a TV and a telephone that stand out from the animal skulls, pigeon blood, melted candle wax and feathers that litter his dingy home.

Such modern accoutrements are testament to a flow of tourists that has made Santeria a lucrative business for some, bringing in foreign currency that makes the difference between a frugal lifestyle or relative wealth in communist-run Cuba.

"I see seven or eight foreigners a week. Germans, Mexicans, Italians, Americans," said Castellano, who spent years studying the African-based faith of ancestral spirits and shrines teeming with fruit, horse hair, ribbons and rum.

"Quite a few come off the cruise ships," he added, grinning to reveal a set of gold-rimmed teeth that most Cubans could not afford.

Whereas a Cuban would pay with a fistful of pesos, a foreigner might spend $20 to meet a priest and $50 on good-luck charms like gravel-filled gourds or plastic bead bracelets.

A full-on initiation ceremony into Santeria, which grew out of the Yoruba religion brought to the Americas by African slaves, would cost a foreigner well over $1,000.

Such prices are normal for Yoruba-style rituals in much of the continent, but they are dizzying in Cuba, where people get by on a state wage of around $15 a month plus whatever they can do on the side.

"It can be a swindle. But not with me. Foreigners have come to me for years," said Castellano, dusting off a feathered clay head which for $10 -- and if one pours rum and honey on it and blows cigar smoke over it -- will keep bad spirits away.

WARM BLOOD

Some seven in 10 Cubans are Santeria followers and consult babalawos, or "santera" priestesses, about health, financial or relationship woes, like followers of Yoruba-based faiths in countries like Haiti and Brazil.

Everyone in Cuba knows somebody whose life was changed forever by a Santeria ritual, which can entail being beaten with herbal plants or sprayed with warm animal blood.

Yet backpackers directed to babalawos by tour guides or taxi drivers invariably pay more than the couple of dollars guide books suggests for a "fast-food" helping of Santeria.

Across the Havana bay in the Santeria-rich port of Regla, santeras greet tourists arriving off a rickety ferryboat.

After a fortune-telling session with Tarot cards or seashells, they offer to stay in touch by e-mail and urge foreigners to send over their friends.

"Tourists come every day to see me. Mostly Spanish and Mexicans," says Laura, a voluptuous santera decked out in a tight lycra bodysuit and a mass of tinkling gold jewelry.

"People come back to Cuba to see me or stay in touch by e-mail. I send advice and they send gifts. I even have "ahijados" (godchildren) in France," she said, pausing to sell half a dozen $10 amulet bracelets to a Mexican tourist clutching a wishlist from his friends back home.

Her speedy $20 consultations, next to a bead-strewn altar to the Virgin of Charity El Cobre, Cuba's patron saint, are entertaining -- but a little short on insight.

A reading of a time-worn pack of cards and some cowrie shells cheerily predicts wealth, career success and an imminent love affair leading to marriage and two kids.

But you're obliged to buy a tiny cloth bag of gravel, for luck, a bead bracelet and a wooden figurine -- total $30 -- and there's an order to come back soon with friends.

MARITAL TIPS

Blending Yoruba deities called "Orishas" with Catholic saints, Santeria took root among slaves on sugar plantations run by Spanish colonialists. It thrived after Castro's 1959 revolution displaced Catholicism, with babalawos offering personal advice in intimate consultations.

As Cuba opened up to tourism in the 1990s, some babalawos were licensed to deal in dollars with foreigners, from curious academics to would-be priests, and sell Santeria souvenirs.

Today, these white-clad taxpaying babalawos are on a level with Cubans with permits to run book stores or drive taxis.

And the ones working on the quiet make more than they would as cigar hawkers or tour guides. Many are among the few Cubans with access to a phone or e-mail.

Still, like anything in life, when Santeria goes too commercial, it loses much of its magic.

"Santeria is not a commercial thing. Everyone has to pay to be cleansed, but priests shouldn't pester people for business," said Cuban anthropologist and Santeria expert Natalia Bolivar.

"Foreigners have always come to see babalawos, because it's fashionable or someone told them about it. There are unscrupulous people who take advantage of that. But truly religious people never would."

May 7 2007 The kidneys fail first. Then the central nervous system begins to misfire. Paralysis spreads, making breathing difficult, then often impossible without assistance. In the end, most victims die.

Many of them are children, poisoned at the hands of their unsuspecting parents.

The syrupy poison, diethylene glycol, is an indispensable part of the modern world, an industrial solvent and prime ingredient in some antifreeze.

It is also a killer. And the deaths, if not intentional, are often no accident.

Over the years, the poison has been loaded into all varieties of medicine — cough syrup, fever medication, injectable drugs — a result of counterfeiters who profit by substituting the sweet-tasting solvent for a safe, more expensive syrup, usually glycerin, commonly used in drugs, food, toothpaste and other products.

Toxic syrup has figured in at least eight mass poisonings around the world in the past two decades. Researchers estimate that thousands have died. In many cases, the precise origin of the poison has never been determined. But records and interviews show that in three of the last four cases it was made in China, a major source of counterfeit drugs.

Panama is the most recent victim. Last year, government officials there unwittingly mixed diethylene glycol into 260,000 bottles of cold medicine — with devastating results. Families have reported 365 deaths from the poison, 100 of which have been confirmed so far. With the onset of the rainy season, investigators are racing to exhume as many potential victims as possible before bodies decompose even more.

Panama’s death toll leads directly to Chinese companies that made and exported the poison as 99.5 percent pure glycerin.

Forty-six barrels of the toxic syrup arrived via a poison pipeline stretching halfway around the world. Through shipping records and interviews with government officials, The New York Times traced this pipeline from the Panamanian port of Colón, back through trading companies in Barcelona, Spain, and Beijing, to its beginning near the Yangtze Delta in a place local people call “chemical country.”

The counterfeit glycerin passed through three trading companies on three continents, yet not one of them tested the syrup to confirm what was on the label. Along the way, a certificate falsely attesting to the purity of the shipment was repeatedly altered, eliminating the name of the manufacturer and previous owner. As a result, traders bought the syrup without knowing where it came from, or who made it. With this information, the traders might have discovered — as The Times did — that the manufacturer was not certified to make pharmaceutical ingredients.

An examination of the two poisoning cases last year — in Panama and earlier in China — shows how China’s safety regulations have lagged behind its growing role as low-cost supplier to the world. It also demonstrates how a poorly policed chain of traders in country after country allows counterfeit medicine to contaminate the global market.

Last week, the United States Food and Drug Administration warned drug makers and suppliers in the United States “to be especially vigilant” in watching for diethylene glycol. The warning did not specifically mention China, and it said there was “no reason to believe” that glycerin in this country was tainted. Even so, the agency asked that all glycerin shipments be tested for diethylene glycol, and said it was “exploring how supplies of glycerin become contaminated.”

China is already being accused by United States authorities of exporting wheat gluten containing an industrial chemical, melamine, that ended up in pet food and livestock feed. The F.D.A. recently banned imports of Chinese-made wheat gluten after it was linked to pet deaths in the United States.

Beyond Panama and China, toxic syrup has caused mass poisonings in Haiti, Bangladesh, Argentina, Nigeria and twice in India.

In Bangladesh, investigators found poison in seven brands of fever medication in 1992, but only after countless children died. A Massachusetts laboratory detected the contamination after Dr. Michael L. Bennish, a pediatrician who works in developing countries, smuggled samples of the tainted syrup out of the country in a suitcase. Dr. Bennish, who investigated the Bangladesh epidemic and helped write a 1995 article about it for BMJ, formerly known as the British Medical Journal, said that given the amount of medication distributed, deaths “must be in the thousands or tens of thousands.”

“It’s vastly underreported,” Dr. Bennish said of diethylene glycol poisoning. Doctors might not suspect toxic medicine, particularly in poor countries with limited resources and a generally unhealthy population, he said, adding, “Most people who die don’t come to a medical facility.”

The makers of counterfeit glycerin, which superficially looks and acts like the real thing but generally costs considerably less, are rarely identified, much less prosecuted, given the difficulty of tracing shipments across borders. “This is really a global problem, and it needs to be handled in a global way,” said Dr. Henk Bekedam, the World Health Organization’s top representative in Beijing.

Seventy years ago, medicine laced with diethylene glycol killed more than 100 people in the United States, leading to the passage of the toughest drug regulations of that era and the creation of the modern Food and Drug Administration.

The F.D.A. has tried to help in poisoning cases around the world, but there is only so much it can do.

When at least 88 children died in Haiti a decade ago, F.D.A. investigators traced the poison to the Manchurian city of Dalian, but their attempts to visit the suspected manufacturer were repeatedly blocked by Chinese officials, according to internal State Department records. Permission was granted more than a year later, but by then the plant had moved and its records had been destroyed.

“Chinese officials we contacted on this matter were all reluctant to become involved,” the American Embassy in Beijing wrote in a confidential cable. “We cannot be optimistic about our chances for success in tracking down the other possible glycerine shipments.”

In fact, The Times found records showing that the same Chinese company implicated in the Haiti poisoning also shipped about 50 tons of counterfeit glycerin to the United States in 1995. Some of it was later resold to another American customer, Avatar Corporation, before the deception was discovered.

“Thank God we caught it when we did,” said Phil Ternes, chief operating officer of Avatar, a Chicago-area supplier of bulk pharmaceuticals and nonmedicinal products. The F.D.A. said it was unaware of the shipment.

In China, the government is vowing to clean up its pharmaceutical industry, in part because of criticism over counterfeit drugs flooding the world markets. In December, two top drug regulators were arrested on charges of taking bribes to approve drugs. In addition, 440 counterfeiting operations were closed down last year, the World Health Organization said.

But when Chinese officials investigated the role of Chinese companies in the Panama deaths, they found that no laws had been broken, according to an official of the nation’s drug enforcement agency. China’s drug regulation is “a black hole,” said one trader who has done business through CNSC Fortune Way, the Beijing-based broker that investigators say was a crucial conduit for the Panama poison.

In this environment, Wang Guiping, a tailor with a ninth-grade education and access to a chemistry book, found it easy to enter the pharmaceutical supply business as a middleman. He quickly discovered what others had before him: that counterfeiting was a simple way to increase profits.

And then people in China began to die.

Cheating the System

Mr. Wang spent years as a tailor in the manufacturing towns of the Yangtze Delta, in eastern China. But he did not want to remain a common craftsman, villagers say. He set his sights on trading chemicals, a business rooted in the many small chemical plants that have sprouted in the region.

“He didn’t know what he was doing,” Mr. Wang’s older brother, Wang Guoping, said in an interview. “He didn’t understand chemicals.”

But he did understand how to cheat the system.

Wang Guiping, 41, realized he could earn extra money by substituting cheaper, industrial-grade syrup — not approved for human consumption — for pharmaceutical grade syrup. To trick pharmaceutical buyers, he forged his licenses and laboratory analysis reports, records show.

Mr. Wang later told investigators that he figured no harm would come from the substitution, because he initially tested a small quantity. He did it with the expertise of a former tailor.

He swallowed some of it. When nothing happened, he shipped it.

One company that used the syrup beginning in early 2005 was Qiqihar No. 2 Pharmaceutical, about 1,000 miles away in Heilongjiang Province in the northeast. A buyer for the factory had seen a posting for Mr. Wang’s syrup on an industry Web site.

After a while, Mr. Wang set out to find an even cheaper substitute syrup so he could increase his profit even more, according to a Chinese investigator. In a chemical book he found what he was looking for: another odorless syrup — diethylene glycol. At the time, it sold for 6,000 to 7,000 yuan a ton, or about $725 to $845, while pharmaceutical-grade syrup cost 15,000 yuan, or about $1,815, according to the investigator.

Mr. Wang did not taste-test this second batch of syrup before shipping it to Qiqihar Pharmaceutical, the government investigator said, adding, “He knew it was dangerous, but he didn’t know that it could kill.”

The manufacturer used the toxic syrup in five drug products: ampules of Amillarisin A for gall bladder problems; a special enema fluid for children; an injection for blood vessel diseases; an intravenous pain reliever; and an arthritis treatment.

In April 2006, one of southern China’s finest hospitals, in Guangzhou, Guangdong Province, began administering Amillarisin A. Within a month or so, at least 18 people had died after taking the medicine, though some had already been quite sick.

Zhou Jianhong, 33, said his father took his first dose of Amillarisin A on April 19. A week later he was in critical condition. “If you are going to die, you want to die at home,” Mr. Zhou said. “So we checked him out of the hospital.” He died the next day.

“Everybody wants to invest in the pharmaceutical industry and it is growing, but the regulators can’t keep up,” Mr. Zhou said. “We need a system to assure our safety.”

The final death count is unclear, since some people who took the medicine may have died in less populated areas.

In a small town in Sichuan Province, a man named Zhou Lianghui said the authorities would not acknowledge that his wife had died from taking tainted Amillarisin A. But Mr. Zhou, 38, said he matched the identification number on the batch of medicine his wife received with a warning circular distributed by drug officials.

“You probably cannot understand a small town if you are in Beijing,” Zhou Lianghui said in a telephone interview. “The sky is high, and the emperor is far away. There are a lot of problems here that the law cannot speak to.”

The failure of the government to stop poison from contaminating the drug supply caused one of the bigger domestic scandals of the year. Last May, China’s premier, Wen Jiabao, ordered an investigation of the deaths, declaring, “The pharmaceutical market is in disorder.”

At about the same time, 9,000 miles away in Panama, the long rainy season had begun. Anticipating colds and coughs, the government health program began manufacturing cough and antihistamine syrup. The cough medicine was sugarless so that even diabetics could use it.

The medicine was mixed with a pale yellow, almost translucent syrup that had arrived in 46 barrels from Barcelona on the container ship Tobias Maersk. Shipping records showed the contents to be 99.5 percent pure glycerin.

It would be months and many deaths later before that certification was discovered to be pure fiction.

A Mysterious Illness

Early last September, doctors at Panama City’s big public hospital began to notice patients exhibiting unusual symptoms.

They initially appeared to have Guillain-Barré syndrome, a relatively rare neurological disorder that first shows up as a weakness or tingling sensation in the legs. That weakness often intensifies, spreading upward to the arms and chest, sometimes causing total paralysis and an inability to breathe.

The new patients had paralysis, but it did not spread upward. They also quickly lost their ability to urinate, a condition not associated with Guillain-Barré. Even more unusual was the number of cases. In a full year, doctors might see eight cases of Guillain-Barré, yet they saw that many in just two weeks.

Doctors sought help from an infectious disease specialist, Néstor Sosa, an intense, driven doctor who competes in triathlons and high-level chess.

Dr. Sosa’s medical specialty had a long, rich history in Panama, once known as one of the world’s unhealthiest places. In one year in the late 1800s, a lethal mix of yellow fever and malaria killed nearly 1 in every 10 residents of Panama City. Only after the United States managed to overcome those mosquito-borne diseases was it able to build the Panama Canal without the devastation that undermined an earlier attempt by the French.

The suspected Guillain-Barré cases worried Dr. Sosa. “It was something really extraordinary, something that was obviously reaching epidemic dimensions in our hospital,” he said.

With the death rate from the mystery illness near 50 percent, Dr. Sosa alerted the hospital management, which asked him to set up and run a task force to handle the situation. The assignment, a daunting around-the-clock dash to catch a killer, was one he eagerly embraced.

Several years earlier, Dr. Sosa had watched as other doctors identified the cause of another epidemic, later identified as hantavirus, a pathogen spread by infected rodents.

“I took care of patients but I somehow felt I did not do enough,” he said. The next time, he vowed, would be different.

Dr. Sosa set up a 24-hour “war room” in the hospital, where doctors could compare notes and theories as they scoured medical records for clues.

As a precaution, the patients with the mystery illness were segregated and placed in a large empty room awaiting renovation. Health care workers wore masks, heightening fears in the hospital and the community.

“That spread a lot of panic,” said Dr. Jorge Motta, a cardiologist who runs the Gorgas Memorial Institute, a widely respected medical research center in Panama. “That is always a terrifying thought, that you will be the epicenter of a new infectious disease, and especially a new infectious disease that kills with a high rate of death, like this.”

Meanwhile, patients kept coming, and hospital personnel could barely keep up.

“I ended up giving C.P.R.,” Dr. Sosa said. “I haven’t given C.P.R. since I was a resident, but there were so many crises going on.”

Frightened hospital patients had to watch others around them die for reasons no one understood, fearing that they might be next.

As reports of strange Guillain-Barré symptoms started coming in from other parts of the country, doctors realized they were not just dealing with a localized outbreak.

Pascuala Pérez de González, 67, sought treatment for a cold at a clinic in Coclé Province, about a three-hour drive from Panama City. In late September she was treated and sent home. Within days, she could no longer eat; she stopped urinating and went into convulsions.

A decision was made to take her to the public hospital in Panama City, but on the way she stopped breathing and had to be resuscitated. She arrived at the hospital in a deep coma and later died.

Medical records contained clues but also plenty of false leads. Early victims tended to be males older than 60 and diabetic with high blood pressure. About half had been given Lisinopril, a blood pressure medicine distributed by the public health system.

But many who did not receive Lisinopril still got sick. On the chance that those patients might have forgotten that they had taken the drug, doctors pulled Lisinopril from pharmacy shelves — only to return it after tests found nothing wrong.

Investigators would later discover that Lisinopril did play an important, if indirect role in the epidemic, but not in the way they had imagined.

A Major Clue

One patient of particular interest to Dr. Sosa came into the hospital with a heart attack, but no Guillain-Barré-type symptoms. While undergoing treatment, the patient received several drugs, including Lisinopril. After a while, he began to exhibit the same neurological distress that was the hallmark of the mystery illness.

“This patient is a major clue,” Dr. Sosa recalled saying. “This is not something environmental, this is not a folk medicine that’s been taken by the patients at home. This patient developed the disease in the hospital, in front of us.”

Soon after, another patient told Dr. Sosa that he, too, developed symptoms after taking Lisinopril, but because the medicine made him cough, he also took cough syrup — the same syrup, it turned out, that had been given to the heart patient.

“I said this has got to be it,” Dr. Sosa recalled. “We need to investigate this cough syrup.”

The cough medicine had not initially aroused much suspicion because many victims did not remember taking it. “Twenty-five percent of those people affected denied that they had taken cough syrup, because it’s a nonevent in their lives,” Dr. Motta said.

Investigators from the United States Centers for Disease Control and Prevention, who were in Panama helping out, quickly put the bottles on a government jet and flew them to the United States for testing. The next day, Oct. 11, as Panamanian health officials were attending a news conference, a Blackberry in the room went off.

The tests, the C.D.C. was reporting, had turned up diethylene glycol in the cough syrup.

The mystery had been solved. The barrels labeled glycerin turned out to contain poison.

Dr. Sosa’s exhilaration at learning the cause did not last long. “It’s our medication that is killing these people,” he said he thought. “It’s not a virus, it’s not something that they got outside, but it was something we actually manufactured.”

A nationwide campaign was quickly begun to stop people from using the cough syrup. Neighborhoods were searched, but thousands of bottles either had been discarded or could not be found.

As the search wound down, two major tasks remained: count the dead and assign blame. Neither has been easy.

A precise accounting is all but impossible because, medical authorities say, victims were buried before the cause was known, and poor patients might not have seen doctors.

Another problem is that finding traces of diethylene glycol in decomposing bodies is difficult at best, medical experts say. Nonetheless, an Argentine pathologist who has studied diethylene glycol poisonings helped develop a test for the poison in exhumed bodies. Seven of the first nine bodies tested showed traces of the poison, Panamanian authorities said.

With the rainy season returning, though, the exhumations are about to end. Dr. José Vicente Pachar, director of Panama’s Institute of Legal Medicine and Forensic Sciences, said that as a scientist he would like a final count of the dead. But he added, “I should accept the reality that in the case of Panama we are not going to know the exact number.”

Local prosecutors have made some arrests and are investigating others connected to the case, including officials of the import company and the government agency that mixed and distributed the cold medicine. “Our responsibilities are to establish or discover the truth,” said Dimas Guevara, the homicide investigator guiding the inquiry.

But prosecutors have yet to charge anyone with actually making the counterfeit glycerin. And if the Panama investigation unfolds as other inquiries have, it is highly unlikely that they ever will.

A Suspect Factory

Panamanians wanting to see where their toxic nightmare began could look up the Web site of the company in Hengxiang, China, that investigators in four countries have identified as having made the syrup — the Taixing Glycerine Factory. There, under the words “About Us,” they would see a picture of a modern white building nearly a dozen stories tall, adorned by three arches at the entrance. The factory, the Web site boasts, “can strictly obey the contract and keep its word.”

But like the factory’s syrup, all is not as it seems.

There are no tall buildings in Hengxiang, a country town with one main road. The factory is not certified to sell any medical ingredients, Chinese officials say. And it looks nothing like the picture on the Internet. In reality, its chemicals are mixed in a plain, one-story brick building.

The factory is in a walled compound, surrounded by small shops and farms. In the spring, nearby fields of rape paint the countryside yellow. Near the front gate, a sign over the road warns, “Beware of counterfeits.” But it was posted by a nearby noodle machine factory that appears to be worried about competition.

The Taixing Glycerine Factory bought its diethylene glycol from the same manufacturer as Mr. Wang, the former tailor, the government investigator said. From this spot in China’s chemical country, the 46 barrels of toxic syrup began their journey, passing from company to company, port to port and country to country, apparently without anyone testing their contents.

Traders should be thoroughly familiar with their suppliers, United States health officials say. “One simply does not assume that what is labeled is indeed what it is,” said Dr. Murray Lumpkin, deputy commissioner for international and special programs for the Food and Drug Administration.

In the Panama case, names of suppliers were removed from shipping documents as they passed from one entity to the next, according to records and investigators. That is a practice some traders use to prevent customers from bypassing them on future purchases, but it also hides the provenance of the product.

The first distributor was the Beijing trading company, CNSC Fortune Way, a unit of a state-owned business that began by supplying goods and services to Chinese personnel and business officials overseas.

As China’s market reach expanded, Fortune Way focused its business on pharmaceutical ingredients, and in 2003, it brokered the sale of the suspect syrup made by the Taixing Glycerine Factory. The manufacturer’s certificate of analysis showed the batch to be 99.5 percent pure.

Whether the Taixing Glycerine Factory actually performed the test has not been publicly disclosed.

Original certificates of analysis should be passed on to each new buyer, said Kevin J. McGlue, a board member of the International Pharmaceutical Excipients Council. In this case, that was not done.

Fortune Way translated the certificate into English, putting its name — not the Taixing Glycerine Factory’s — at the top of the document, before shipping the barrels to a second trading company, this one in Barcelona.

Li Can, managing director at Fortune Way, said he did not remember the transaction and could not comment, adding, “There is a high volume of trade.”

Upon receiving the barrels in September 2003, the Spanish company, Rasfer International, did not test the contents, either. It copied the chemical analysis provided by Fortune Way, then put its logo on it. Ascensión Criado, Rasfer’s manager, said in an e-mail response to written questions that when Fortune Way shipped the syrup, it did not say who made it.

Several weeks later, Rasfer shipped the drums to a Panamanian broker, the Medicom Business Group. “Medicom never asked us for the name of the manufacturer,” Ms. Criado said.

A lawyer for Medicom, Valentín Jaén, said his client was a victim, too. “They were tricked by somebody,” Mr. Jaén said. “They operated in good faith.”

In Panama, the barrels sat unused for more than two years, and officials said Medicom improperly changed the expiration date on the syrup.

During that time, the company never tested the product. And the Panamanian government, which bought the 46 barrels and used them to make cold medicine, also failed to detect the poison, officials said.

The toxic pipeline ultimately emptied into the bloodstream of people like Ernesto Osorio, a former high school teacher in Panama City. He spent two months in the hospital after ingesting poison cough syrup last September.

Just before Christmas, after a kidney dialysis treatment, Mr. Osorio stood outside the city’s big public hospital in a tear-splattered shirt, describing what his life had become.

“I’m not an eighth of what I used to be,” Mr. Osorio said, his partly paralyzed face hanging like a slab of meat. “I have trouble walking. Look at my face, look at my tears.” The tears, he said apologetically, were not from emotion, but from nerve damage.

And yet, Mr. Osorio knows he is one of the lucky victims.

“They didn’t know how to keep the killer out of the medicine,” he said simply.

While the suffering in Panama was great, the potential profit — at least for the Spanish trading company, Rasfer — was surprisingly small. For the 46 barrels of glycerin, Rasfer paid Fortune Way $9,900, then sold them to Medicom for $11,322, according to records.

Chinese authorities have not disclosed how much Fortune Way and the Taixing Glycerine Factory made on their end, or how much they knew about what was in the barrels.

“The fault has to be traced back to areas of production,” said Dr. Motta, the cardiologist in Panama who helped uncover the source of the epidemic. “This was my plea — please, this thing is happening to us, make sure whoever did this down the line is not doing it to Peru or Sierra Leone or some other place.”

A Counterfeiter’s Confession

The power to prosecute the counterfeiters is now in the hands of the Chinese.

Last spring, the government moved quickly against Mr. Wang, the former tailor who poisoned Chinese residents.

The authorities caught up with him at a roadblock in Taizhou, a city just north of Taixing, in chemical country. He was weak and sick, and he had not eaten in two days. Inside his white sedan was a bankbook and cash. He had fled without his wife and teenage son.

Chinese patients were dead, a political scandal was brewing and the authorities wanted answers. Mr. Wang was taken to a hospital. Then, in long sessions with investigators, he gave them what they wanted, explaining his scheme, how he tested industrial syrup by drinking it, how he decided to use diethylene glycol and how he conned pharmaceutical companies into buying his syrup, according to a government official who was present for his interrogation.

“He made a fortune, but none of it went to his family,” said Wang Xiaodong, a former village official who knows Mr. Wang and his siblings. “He liked to gamble.”

Mr. Wang remains in custody as the authorities decide whether he should be put to death. The Qiqihar drug plant that made the poisonous medicine has been closed, and five employees are now being prosecuted for causing “a serious accident.”

In contrast to the Wang Guiping investigation, Chinese authorities have been tentative in acknowledging China’s link to the Panama tragedy, which involved a state-owned trading company. No one in China has been charged with committing the fraud that ended up killing so many in Panama.

Sun Jing, the pharmaceutical program officer for the World Health Organization in Beijing, said the health agency sent a fax “to remind the Chinese government that China should not be selling poisonous products overseas.” Ms. Sun said the agency did not receive an official reply.

Last fall, at the request of the United States — Panama has no diplomatic relations with China — the State Food and Drug Administration of China investigated the Taixing Glycerine Factory and Fortune Way.

The agency tested one batch of glycerin from the factory, and found no glycerin, only diethylene glycol and two other substances, a drug official said.

Since then, the Chinese drug administration has concluded that it has no jurisdiction in the case because the factory is not certified to make medicine.

The agency reached a similar conclusion about Fortune Way, saying that as an exporter it was not engaged in the pharmaceutical business.

“We did not find any evidence that either of these companies had broken the law,” said Yan Jiangying, a spokeswoman for the drug administration. “So a criminal investigation was never opened.”

A drug official said the investigation was subsequently handed off to an agency that tests and certifies commercial products — the General Administration of Quality Supervision, Inspection and Quarantine.

But the agency acted surprised to learn that it was now in charge. “What investigation?” asked Wang Jian, director of its Taixing branch. “I’m not aware of any investigation involving a glycerin factory.”

Besides, Huang Tong, an investigator in that office, said, “We rarely get involved in products that are sold for export.”

Wan Qigang, the legal representative for the Taixing Glycerine Factory, said in an interview late last year that the authorities had not questioned him about the Panama poisoning, and that his company made only industrial-grade glycerin.

“I can tell you for certain that we have no connection with Panama or Spain,” Mr. Wan said.

But in recent months, the Glycerine Factory has advertised 99.5 percent pure glycerin on the Internet.

Mr. Wan recently declined to answer any more questions. “If you come here as a guest, I will welcome you,” Mr. Wan said. “But if you come again wanting to talk about this matter, I will make a telephone call.”

A local government official said Mr. Wan was told not to grant interviews.

A five-minute walk away, another manufacturer, the Taixing White Oil Factory, also advertises medical glycerin on the Internet, yet it, too, has no authorization to make it. The company’s Web site says its products “have been exported to America, Australia and Italy.”

Ding Xiang, who represents the White Oil Factory, denied that his company made pharmaceutical-grade glycerin, but he said chemical trading companies in Beijing often called, asking for it.

“They want us to mark the barrels glycerin,” Mr. Ding said in late December. “I tell them we cannot do that.”

Mr. Ding said he stopped answering calls from Beijing. “If this stuff is taken overseas and improperly used. ...” He did not complete the thought.

In chemical country, product names are not always what they seem.

“The only two factories in Taixing that make glycerin don’t even make glycerin,” said Jiang Peng, who oversees inspections and investigations in the Taixing branch of the State Food and Drug Administration. “It is a different product.”

All in a Name

One lingering mystery involves the name of the product made by the Taixing Glycerine Factory. The factory had called its syrup “TD” glycerin. The letters TD were in virtually all the shipping documents. What did TD mean?

Spanish medical authorities concluded that it stood for a manufacturing process. Chinese inspectors thought it was the manufacturer’s secret formula.

But Yuan Kailin, a former salesman for the factory , said he knew what the TD meant because a friend and former manager of the factory, Ding Yuming, had once told him. TD stood for the Chinese word “tidai” (pronounced tee-die), said Mr. Yuan, who left his job in 1998 and still lives about a mile from the factory.

In Chinese, tidai means substitute. A clue that might have revealed the poison, the counterfeit product, was hiding in plain sight.

It was in the product name.

May 7 2007

When students at Virginia's James Madison University go back to school in the fall, they'll have 10 fewer sports to play or watch. JMU recently announced plans to eliminate seven men's and three women's programs, ranging from gymnastics to swimming. Officials blamed Title IX, the section of a 1972 law that governs how college resources are split between men and women.

To Title IX critics, JMU's cutbacks are the best case yet for undoing the way the law is enforced. But the cuts, distressing as they may be, are no reason to gut a federal program that has succeeded in bringing fairness to college athletics and equal opportunity to a generation of young women.

Colleges - among them JMU, Rutgers University, Ohio University, Butler and Clarion - are cutting back on sports programs for many reasons, including tight budgets, the primacy of football and a decline in the proportion of men attending college.

The worst that can be said about Title IX is that it compounds these problems while succeeding in providing opportunities to female athletes (such as the estimable Rutgers women's basketball team that reached the NCAA championship only to be slurred by shock jock Don Imus). To label Title IX the lone culprit is to give state legislatures a pass on their obligations to finance higher education and to give colleges a pass for their infatuation with big-time men's sports.

To comply with Title IX's three-part test, colleges must do one of the following:

•Bring the male-to-female ratio for varsity athletes in line with the overall student body ratio.

•Demonstrate a history of adding women's programs.

•Demonstrate a policy of meeting the interests and abilities of women.

Tight budgets have made the second test harder to use. The third's vagueness and cumbersome process have always made it less attractive. That often leaves the first test, known as "proportionality," as the only option.

This presents a problem. On one hand, the portion of men on campus is declining - to 42% overall and lower at some campuses, including JMU. On the other, colleges are loath to cut back on men's football.

Indeed, if JMU helps make the case against Title IX, Rutgers, which also slashed its men's programs this spring, sends a different message. It did so while increasing its football budget, suggesting the changes had more to do with the desire to build a football powerhouse than with the demands of Title IX.

The decline in men's attendance at college is a national problem that needs to be addressed. But in the short term, if women make up a majority of students, they deserve a majority of athletic slots.

As for major men's sports, the NFL gets along quite nicely with 53-man rosters, which is approximately half what major college football teams use. If colleges had fewer fourth-string safeties, they could have more men's track stars, gymnasts and such.

On many campuses, it is distressing to see sports programs eliminated. But it would be even sadder if this led to the evisceration of Title IX.

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