Is everything you think you know about depression wrong?

In this extract from his new book, Johann Hari, who took antidepressants for 14 years, calls for a new approach

In the 1970s, a truth was accidentally discovered about depression one that was quickly swept aside, because its implications were too inconvenient, and too explosive. American psychiatrists had produced a book that would lay out, in detail, all the symptoms of different mental illnesses, so they could be identified and treated in the same way across the United States. It was called the Diagnostic and Statistical Manual. In the latest edition, they laid out nine symptoms that a patient has to show to be diagnosed with depression like, for example, decreased interest in pleasure or persistent low mood. For a doctor to conclude you were depressed, you had to show five of these symptoms over several weeks.

The manual was sent out to doctors across the US and they began to use it to diagnose people. However, after a while they came back to the authors and pointed out something that was bothering them. If they followed this guide, they had to diagnose every grieving person who came to them as depressed and start giving them medical treatment. If you lose someone, it turns out that these symptoms will come to you automatically. So, the doctors wanted to know, are we supposed to start drugging all the bereaved people in America?

The authors conferred, and they decided that there would be a special clause added to the list of symptoms of depression. None of this applies, they said, if you have lost somebody you love in the past year. In that situation, all these symptoms are natural, and not a disorder. It was called the grief exception, and it seemed to resolve the problem.

Then, as the years and decades passed, doctors on the frontline started to come back with another question. All over the world, they were being encouraged to tell patients that depression is, in fact, just the result of a spontaneous chemical imbalance in your brain it is produced by low serotonin, or a natural lack of some other chemical. Its not caused by your life its caused by your broken brain. Some of the doctors began to ask how this fitted with the grief exception. If you agree that the symptoms of depression are a logical and understandable response to one set of life circumstances losing a loved one might they not be an understandable response to other situations? What about if you lose your job? What if you are stuck in a job that you hate for the next 40 years? What about if you are alone and friendless?

The grief exception seemed to have blasted a hole in the claim that the causes of depression are sealed away in your skull. It suggested that there are causes out here, in the world, and they needed to be investigated and solved there. This was a debate that mainstream psychiatry (with some exceptions) did not want to have. So, they responded in a simple way by whittling away the grief exception. With each new edition of the manual they reduced the period of grief that you were allowed before being labelled mentally ill down to a few months and then, finally, to nothing at all. Now, if your baby dies at 10am, your doctor can diagnose you with a mental illness at 10.01am and start drugging you straight away.

Dr Joanne Cacciatore, of Arizona State University, became a leading expert on the grief exception after her own baby, Cheyenne, died during childbirth. She had seen many grieving people being told that they were mentally ill for showing distress. She told me this debate reveals a key problem with how we talk about depression, anxiety and other forms of suffering: we dont, she said, consider context. We act like human distress can be assessed solely on a checklist that can be separated out from our lives, and labelled as brain diseases. If we started to take peoples actual lives into account when we treat depression and anxiety, Joanne explained, it would require an entire system overhaul. She told me that when you have a person with extreme human distress, [we need to] stop treating the symptoms. The symptoms are a messenger of a deeper problem. Lets get to the deeper problem.

*****

I was a teenager when I swallowed my first antidepressant. I was standing in the weak English sunshine, outside a pharmacy in a shopping centre in London. The tablet was white and small, and as I swallowed, it felt like a chemical kiss. That morning I had gone to see my doctor and I had told him crouched, embarrassed that pain was leaking out of me uncontrollably, like a bad smell, and I had felt this way for several years. In reply, he told me a story. There is a chemical called serotonin that makes people feel good, he said, and some people are naturally lacking it in their brains. You are clearly one of those people. There are now, thankfully, new drugs that will restore your serotonin level to that of a normal person. Take them, and you will be well. At last, I understood what had been happening to me, and why.

However, a few months into my drugging, something odd happened. The pain started to seep through again. Before long, I felt as bad as I had at the start. I went back to my doctor, and he told me that I was clearly on too low a dose. And so, 20 milligrams became 30 milligrams; the white pill became blue. I felt better for several months. And then the pain came back through once more. My dose kept being jacked up, until I was on 80mg, where it stayed for many years, with only a few short breaks. And still the pain broke back through.

I started to research my book, Lost Connections: Uncovering The Real Causes of Depression and the Unexpected Solutions, because I was puzzled by two mysteries. Why was I still depressed when I was doing everything I had been told to do? I had identified the low serotonin in my brain, and I was boosting my serotonin levels yet I still felt awful. But there was a deeper mystery still. Why were so many other people across the western world feeling like me? Around one in five US adults are taking at least one drug for a psychiatric problem. In Britain, antidepressant prescriptions have doubled in a decade, to the point where now one in 11 of us drug ourselves to deal with these feelings. What has been causing depression and its twin, anxiety, to spiral in this way? I began to ask myself: could it really be that in our separate heads, all of us had brain chemistries that were spontaneously malfunctioning at the same time?

To find the answers, I ended up going on a 40,000-mile journey across the world and back. I talked to the leading social scientists investigating these questions, and to people who have been overcoming depression in unexpected ways from an Amish village in Indiana, to a Brazilian city that banned advertising and a laboratory in Baltimore conducting a startling wave of experiments. From these people, I learned the best scientific evidence about what really causes depression and anxiety. They taught me that it is not what we have been told it is up to now. I found there is evidence that seven specific factors in the way we are living today are causing depression and anxiety to rise alongside two real biological factors (such as your genes) that can combine with these forces to make it worse.

Once I learned this, I was able to see that a very different set of solutions to my depression and to our depression had been waiting for me all along.

To understand this different way of thinking, though, I had to first investigate the old story, the one that had given me so much relief at first. Professor Irving Kirsch at Harvard University is the Sherlock Holmes of chemical antidepressants the man who has scrutinised the evidence about giving drugs to depressed and anxious people most closely in the world. In the 1990s, he prescribed chemical antidepressants to his patients with confidence. He knew the published scientific evidence, and it was clear: it showed that 70% of people who took them got significantly better. He began to investigate this further, and put in a freedom of information request to get the data that the drug companies had been privately gathering into these drugs. He was confident that he would find all sorts of other positive effects but then he bumped into something peculiar.

Illustration
Illustration by Michael Driver.

We all know that when you take selfies, you take 30 pictures, throw away the 29 where you look bleary-eyed or double-chinned, and pick out the best one to be your Tinder profile picture. It turned out that the drug companies who fund almost all the research into these drugs were taking this approach to studying chemical antidepressants. They would fund huge numbers of studies, throw away all the ones that suggested the drugs had very limited effects, and then only release the ones that showed success. To give one example: in one trial, the drug was given to 245 patients, but the drug company published the results for only 27 of them. Those 27 patients happened to be the ones the drug seemed to work for. Suddenly, Professor Kirsch realised that the 70% figure couldnt be right.

It turns out that between 65 and 80% of people on antidepressants are depressed again within a year. I had thought that I was freakish for remaining depressed while on these drugs. In fact, Kirsch explained to me in Massachusetts, I was totally typical. These drugs are having a positive effect for some people but they clearly cant be the main solution for the majority of us, because were still depressed even when we take them. At the moment, we offer depressed people a menu with only one option on it. I certainly dont want to take anything off the menu but I realised, as I spent time with him, that we would have to expand the menu.

This led Professor Kirsch to ask a more basic question, one he was surprised to be asking. How do we know depression is even caused by low serotonin at all? When he began to dig, it turned out that the evidence was strikingly shaky. Professor Andrew Scull of Princeton, writing in the Lancet, explained that attributing depression to spontaneously low serotonin is deeply misleading and unscientific. Dr David Healy told me: There was never any basis for it, ever. It was just marketing copy.

I didnt want to hear this. Once you settle into a story about your pain, you are extremely reluctant to challenge it. It was like a leash I had put on my distress to keep it under some control. I feared that if I messed with the story I had lived with for so long, the pain would run wild, like an unchained animal. Yet the scientific evidence was showing me something clear, and I couldnt ignore it.

*****

So, what is really going on? When I interviewed social scientists all over the world from So Paulo to Sydney, from Los Angeles to London I started to see an unexpected picture emerge. We all know that every human being has basic physical needs: for food, for water, for shelter, for clean air. It turns out that, in the same way, all humans have certain basic psychological needs. We need to feel we belong. We need to feel valued. We need to feel were good at something. We need to feel we have a secure future. And there is growing evidence that our culture isnt meeting those psychological needs for many perhaps most people. I kept learning that, in very different ways, we have become disconnected from things we really need, and this deep disconnection is driving this epidemic of depression and anxiety all around us.

Lets look at one of those causes, and one of the solutions we can begin to see if we understand it differently. There is strong evidence that human beings need to feel their lives are meaningful that they are doing something with purpose that makes a difference. Its a natural psychological need. But between 2011 and 2012, the polling company Gallup conducted the most detailed study ever carried out of how people feel about the thing we spend most of our waking lives doing our paid work. They found that 13% of people say they are engaged in their work they find it meaningful and look forward to it. Some 63% say they are not engaged, which is defined as sleepwalking through their workday. And 24% are actively disengaged: they hate it.

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Antidepressant prescriptions have doubled over the last decade. Photograph: Anthony Devlin/PA

Most of the depressed and anxious people I know, I realised, are in the 87% who dont like their work. I started to dig around to see if there is any evidence that this might be related to depression. It turned out that a breakthrough had been made in answering this question in the 1970s, by an Australian scientist called Michael Marmot. He wanted to investigate what causes stress in the workplace and believed hed found the perfect lab in which to discover the answer: the British civil service, based in Whitehall. This small army of bureaucrats was divided into 19 different layers, from the permanent secretary at the top, down to the typists. What he wanted to know, at first, was: whos more likely to have a stress-related heart attack the big boss at the top, or somebody below him?

Everybody told him: youre wasting your time. Obviously, the boss is going to be more stressed because hes got more responsibility. But when Marmot published his results, he revealed the truth to be the exact opposite. The lower an employee ranked in the hierarchy, the higher their stress levels and likelihood of having a heart attack. Now he wanted to know: why?

And thats when, after two more years studying civil servants, he discovered the biggest factor. It turns out if you have no control over your work, you are far more likely to become stressed and, crucially, depressed. Humans have an innate need to feel that what we are doing, day-to-day, is meaningful. When you are controlled, you cant create meaning out of your work.

Suddenly, the depression of many of my friends, even those in fancy jobs who spend most of their waking hours feeling controlled and unappreciated started to look not like a problem with their brains, but a problem with their environments. There are, I discovered, many causes of depression like this. However, my journey was not simply about finding the reasons why we feel so bad. The core was about finding out how we can feel better how we can find real and lasting antidepressants that work for most of us, beyond only the packs of pills we have been offered as often the sole item on the menu for the depressed and anxious. I kept thinking about what Dr Cacciatore had taught me we have to deal with the deeper problems that are causing all this distress.

I found the beginnings of an answer to the epidemic of meaningless work in Baltimore. Meredith Mitchell used to wake up every morning with her heart racing with anxiety. She dreaded her office job. So she took a bold step one that lots of people thought was crazy. Her husband, Josh, and their friends had worked for years in a bike store, where they were ordered around and constantly felt insecure, Most of them were depressed. One day, they decided to set up their own bike store, but they wanted to run it differently. Instead of having one guy at the top giving orders, they would run it as a democratic co-operative. This meant they would make decisions collectively, they would share out the best and worst jobs and they would all, together, be the boss. It would be like a busy democratic tribe. When I went to their store Baltimore Bicycle Works the staff explained how, in this different environment, their persistent depression and anxiety had largely lifted.

Its not that their individual tasks had changed much. They fixed bikes before; they fix bikes now. But they had dealt with the unmet psychological needs that were making them feel so bad by giving themselves autonomy and control over their work. Josh had seen for himself that depressions are very often, as he put it, rational reactions to the situation, not some kind of biological break. He told me there is no need to run businesses anywhere in the old humiliating, depressing way we could move together, as a culture, to workers controlling their own workplaces.

*****

With each of the nine causes of depression and anxiety I learned about, I kept being taught startling facts and arguments like this that forced me to think differently. Professor John Cacioppo of Chicago University taught me that being acutely lonely is as stressful as being punched in the face by a stranger and massively increases your risk of depression. Dr Vincent Felitti in San Diego showed me that surviving severe childhood trauma makes you 3,100% more likely to attempt suicide as an adult. Professor Michael Chandler in Vancouver explained to me that if a community feels it has no control over the big decisions affecting it, the suicide rate will shoot up.

This new evidence forces us to seek out a very different kind of solution to our despair crisis. One person in particular helped me to unlock how to think about this. In the early days of the 21st century, a South African psychiatrist named Derek Summerfeld went to Cambodia, at a time when antidepressants were first being introduced there. He began to explain the concept to the doctors he met. They listened patiently and then told him they didnt need these new antidepressants, because they already had anti-depressants that work. He assumed they were talking about some kind of herbal remedy.

He asked them to explain, and they told him about a rice farmer they knew whose left leg was blown off by a landmine. He was fitted with a new limb, but he felt constantly anxious about the future, and was filled with despair. The doctors sat with him, and talked through his troubles. They realised that even with his new artificial limb, his old jobworking in the rice paddieswas leaving him constantly stressed and in physical pain, and that was making him want to just stop living. So they had an idea. They believed that if he became a dairy farmer, he could live differently. So they bought him a cow. In the months and years that followed, his life changed. His depressionwhich had been profoundwent away. You see, doctor, they told him, the cow was an antidepressant.

To them, finding an antidepressant didnt mean finding a way to change your brain chemistry. It meant finding a way to solve the problem that was causing the depression in the first place. We can do the same. Some of these solutions are things we can do as individuals, in our private lives. Some require bigger social shifts, which we can only achieve together, as citizens. But all of them require us to change our understanding of what depression and anxiety really are.

This is radical, but it is not, I discovered, a maverick position. In its official statement for World Health Day in 2017, the United Nations reviewed the best evidence and concluded that the dominant biomedical narrative of depression is based on biased and selective use of research outcomes that must be abandoned. We need to move from focusing on chemical imbalances, they said, to focusing more on power imbalances.

After I learned all this, and what it means for us all, I started to long for the power to go back in time and speak to my teenage self on the day he was told a story about his depression that was going to send him off in the wrong direction for so many years. I wanted to tell him: This pain you are feeling is not a pathology. Its not crazy. It is a signal that your natural psychological needs are not being met. It is a form of grief for yourself, and for the culture you live in going so wrong. I know how much it hurts. I know how deeply it cuts you. But you need to listen to this signal. We all need to listen to the people around us sending out this signal. It is telling you what is going wrong. It is telling you that you need to be connected in so many deep and stirring ways that you arent yet but you can be, one day.

If you are depressed and anxious, you are not a machine with malfunctioning parts. You are a human being with unmet needs. The only real way out of our epidemic of despair is for all of us, together, to begin to meet those human needs for deep connection, to the things that really matter in life.

This is an edited extract from Lost Connections: Uncovering the Real Causes of Depression and the Unexpected Solutions by Johann Hari, published by Bloomsbury on 11 January (16.99). To order a copy for 14.44 go to guardianbookshop.com or call 0330 333 6846. Free UK p&p over 10, online orders only. Phone orders min p&p of 1.99. It will be available in audio at audible.co.uk

Read more: https://www.theguardian.com/society/2018/jan/07/is-everything-you-think-you-know-about-depression-wrong-johann-hari-lost-connections

Why the UN is investigating extreme poverty in America, the world’s richest nation

At the heart of Philip Alstons special mission will be one question: can Americans enjoy fundamental human rights if theyre unable to meet basic living standards?

The United Nations monitor on extreme poverty and human rights has embarked on a coast-to-coast tour of the US to hold the worlds richest nation and its president to account for the hardships endured by Americas most vulnerable citizens.

The tour, which kicked off on Friday morning, will make stops in four states as well as Washington DC and the US territory of Puerto Rico. It will focus on several of the social and economic barriers that render the American dream merely a pipe dream to millions from homelessness in California to racial discrimination in the Deep South, cumulative neglect in Puerto Rico and the decline of industrial jobs in West Virginia.

With 41 million Americans officially in poverty according to the US Census Bureau (other estimates put that figure much higher), one aim of the UN mission will be to demonstrate that no country, however wealthy, is immune from human suffering induced by growing inequality. Nor is any nation, however powerful, beyond the reach of human rights law a message that the US government and Donald Trump might find hard to stomach given their tendency to regard internal affairs as sacrosanct.

The UN special rapporteur on extreme poverty and human rights, Philip Alston, is a feisty Australian and New York University law professor who has a fearsome track record of holding power to account. He tore a strip off the Saudi Arabian regime for its treatment of women months before the kingdom legalized their right to drive, denounced the Brazilian government for attacking the poor through austerity, and even excoriated the UN itself for importing cholera to Haiti.

The US is no stranger to Alstons withering tongue, having come under heavy criticism from him for its program of drone strikes on terrorist targets abroad. In his previous role as UN special rapporteur on extrajudicial executions, Alston blamed the Obama administration and the CIA for killing many innocent civilians in attacks he said were of dubious international legality.

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United Nations Special Rapporteur on extreme poverty and human rights, Philip Alston. Photograph: Ng Han Guan/AP

Now Alston has set off on his sixth, and arguably most sensitive, visit as UN monitor on extreme poverty since he took up the position in June 2014. At the heart of his fact-finding tour will be a question that is causing increasing anxiety at a troubled time: is it possible, in one of the worlds leading democracies, to enjoy fundamental human rights such as political participation or voting rights if you are unable to meet basic living standards, let alone engage, as Thomas Jefferson put it, in the pursuit of happiness?

Despite great wealth in the US, there also exists great poverty and inequality, Alston said in remarks released before the start of the visit. The rapporteur said he intended to focus on the detrimental effects of poverty on the civil and political rights of Americans, given the United States consistent emphasis on the importance it attaches to these rights in its foreign policy, and given that it has ratified the International Covenant on Civil and Political Rights.

Poverty experts are watching the UN tour closely in the hope that it might draw public attention to a largely neglected but critical aspect of US society.

David Grusky, director of the Center on Poverty and Inequality at Stanford, said the visit had the potential to hold a mirror up to the country at a moment when globalization combined with a host of domestic policies have generated a vast gulf between rich and poor.

The US has an extraordinary ability to naturalize and accept the extreme poverty that exists even in the context of such extreme wealth, he said.

Grusky added that the US reaction to Alstons visit could go either way. It has the potential to open our eyes to what an outlier the US has become compared with the rest of the world, or it could precipitate an adverse reaction towards an outsider who has no legitimacy telling us what to do about internal US affairs.

Alstons findings will be announced in preliminary form in Washington on 15 December, and then presented as a full report to the UN human rights council in Geneva next June. An especially unpredictable element of the fallout will be how Trump himself receives the final report, given the presidents habit of lashing out at anyone perceived to criticize him or his administration.

Trump has also shown open disdain towards the world body. In the course of the 2016 presidential campaign he griped that we get nothing out of the United Nations other than good real-estate prices.

On the other hand, observers have been surprised that the White House has honored the invitation to host Alston after the initial offer was extended by Barack Obama. US diplomats on more than one occasion since Trumps inauguration have said they welcomed the UN party.

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Ruby Dee Rudolph in her home in Lowndes County. A recent study suggests that nearly one one in three people in Lowndes County have hookworm, a parasite normally found in poor, developing countries. Photograph: Bob Miller for The Guardian

Alston himself is reserving his comments until the end of the tour. But his published work suggests that he is likely to be a formidable critic of the new president. In a lecture he gave last year on the challenges posed by Trump and other modern populist leaders, he warned that their agenda was avowedly nationalistic, xenophobic, misogynistic, and explicitly antagonistic to all or much of the human rights agenda.

Alston concluded the speech by saying: These are extraordinarily dangerous times, unprecedentedly so in my lifetime. The response is really up to us.

The UN poverty tour falls at a singularly tense moment for the US. In its 2016 state of the nation review, the Stanford Center on Poverty and Inequality placed the US rank at the bottom of the league table of 10 well-off countries, in terms of the extent of its income and wealth inequality.

It also found that the US hit rock bottom in terms of the safety net it offers struggling families, and is one of the worst offenders in terms of the ability of low-income families to lift themselves out of poverty a stark contrast to the much-vaunted myth of the American dream.

To some extent, Trumps focus on making America great again a political jingo that in itself contains an element of criticism of the state of the nation chimes with the UNs concern about extreme poverty. His call for greater prosperity for white working Americans in declining manufacturing areas that proved so vital to his election victory will be echoed in Alstons visit to the depressed coal-producing state of West Virginia, which backed Trump in 2016 by a resounding 69%.

In many other ways, though, the Trump administration in its first year has taken a radically hostile approach towards communities in need. He has tried, so far unsuccessfully, to abolish Obamacare in a move that would deprive millions of low-income families of healthcare insurance, was widely criticized for his lackluster response to the hurricane disaster in Puerto Rico that has left thousands homeless and without power, and is currently pushing a tax reform that would benefit one group above all others: the super rich.

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A man who lost his home during Hurricane Maria in September sits on a cot at a school turned shelter in Canovanas. Photograph: Alvin Baez/Reuters

The US poses an especially challenging subject for the UN special rapporteur because unlike all other industrialized nations, it fails to recognize fundamental social and economic rights such as the right to healthcare, a roof over your head or food to keep hunger at bay. The federal government has consistently refused to sign up to the international covenant on economic, social and cultural rights arguing that these matters are best left to individual states.

Such an emphasis on states rights has spawned a patchwork of provision for low-income families across the country. Republican-controlled states in the Deep South provide relatively little help to those struggling from unemployment and lack of ready cash, while more assistance is likely to be forthcoming in bigger coastal cities.

By contrast, raging house prices and gentrification is fueling a homelessness crisis in liberal cities such as Los Angeles and San Francisco the first stop next week of the UN tour.

Martha Davis, a law professor specializing in US human rights at Northeastern University, said that such vast regional variations present the UN monitor with a huge opportunity. Unlike other international officials, he has the ability to move freely at both federal and state levels and be equally critical of both.

Theres a lot that Philip Alston can say about basic inequality that goes to the heart of the rights that he is reviewing, Davis said.

Read more: https://www.theguardian.com/world/2017/dec/01/un-extreme-poverty-america-special-rapporteur

Aisling Bea: My fathers death has given me a love of men, of their vulnerability and tenderness

The comedians father killed himself when she was three. She was plagued by the fact he made no mention of her or her sister in the letter he left. Then, 30 years after his death, a box arrived

My father died when I was three years old and my sister was three months. For years, we thought he had died of some sort of back injury a story that we had never really investigated because we were just too busy with the Spice Girls and which one we were (I was a Geri/Mel B mix FYI). Then, on the 10th anniversary of his death, my mother sat us down and explained the concept of suicide. Sure, we knew about suicide. At 13, I had already known of too many young men from our town who had taken their own lives. Spoken about as inexplicable sadnesses for the families, spoken about but never really talked about terrible tragedy nobody knows why he did it. What we had not known until that day, was that our father had, 10 years beforehand, also taken his own life.

When I was growing up, I idolised my father. I thought his ghost followed me around the house. I had been told how he adored me, how I was funny, just like him. Because of our lovely Catholic upbringing, I secretly assumed that he would eventually come back, like our good friend Jesus.

My mother, being the wonder woman that she is, never held his death against him. When she looked into his coffin, she felt she saw the face of the man she had married: his stress lines had gone, he seemed free of the sadness that had been dogging him of late. But it was still tough for her to talk about. She didnt want to have to explain to a stranger in the middle of a party how he was not defined by his ending, but how loved he was, how cherished the charismatic, handsome vet in a small town had been. She didnt want his whole person being judged.

Once she had told us, I did not want to talk about him. Ever again. I now hated him. He had not been taken from us, he had left. His suicide felt like the opposite of parenting. Abandonment. Selfishness. Taking us for granted.

I didnt care that he had not been in his right mind, because if I had been important enough to him I would have put him back into his right mind before he did it. I didnt care that he had been in chronic pain and that men in Ireland dont talk about their feelings, so instead die of sadness. I didnt want him at peace. I wanted him struggling, but alive, so he could meet my boyfriends and give them a hard time, like in American movies. I wanted him to come to pick me up from discos, so my mother didnt have to go out alone in her pyjamas at night to get me.

I look like him. For all of my teens and early 20s, I smothered my face in fake tan and bleached my hair blond so that elderly relatives would stop looking at me like I was the ghost of Christmas past whenever I did something funny. You look so like your father, they would say. And as much as people might think a teenage girl wants to be told that she looks like a dead man, she doesnt.

Aisling
Aisling Bea with her father. Photograph: Aisling Bea

And then there was the letter.

My mother gave us the letter to read the day she told us, but, in it, he didnt mention my sister or me.

I had not been adored. He had forgotten we existed. I didnt believe it at first. When I was 15, I took the letter out of my mothers Filofax and used the photocopying machine at my summer job to make a copy so I could really examine it. Like a CSI detective, I stared at it, desperate to see if there had been a trace of the start of an A anywhere.

I would often fantasise that, if I ever killed myself, I would write a letter to every single person I had ever met, explaining why I was doing it. Every. Single. Person. Right down to the lad I struck up a conversation with once in a chip shop and the girl I met at summer camp when I was 12. No one would be left thinking: Why? I would be very non-selfish about it. When Facebook came in, I thought: Well, this will save me a fortune on stamps.

Sometimes, in my less lucid moments, I was convinced that he had left a secret note for me somewhere. Maybe, on my 16th no, 18th no, 21st no, 30th birthday, a letter would arrive, like in Back to the Future. Aisling, I wanted to wait until you were old enough to understand. I was secretly a spy. That is why I did it. I love you. I love your sister, too. PS Heaven is real, your philosophy essay is wrong and I am totally still watching over you. Stop shoplifting.

This summer was the 30th anniversary of his death. In that time, a few things have happened that have radically changed how I feel.

Three years ago, Robin Williams took his own life. He was my comedy hero, my TV dad he had always reminded my mother of my father and his death spurred me to finally start opening up. I had always found it so hard to talk about. I think I had been afraid that if I ever did, my soul would fall out of my mouth and I would never get it back in again.

Last year, I watched Grayson Perrys documentary All Man. It featured a woman whose son had ended his life. She thought that he probably hadnt wanted to die for ever, just on that day, when he had been in so much pain. A lightbulb moment it had never occurred to me that maybe suicide had seemed like the best option in that hour. In my head, my father had taken a clear decision, as my parent, to opt out for ever.

My father had always seemed like an adult making adult decisions, but I suddenly found myself at almost his age, still feeling like a giant child. I looked at some of my male friends gorgeous idiots doing their gorgeous, idiotic best to bring up little daughters, just like he would have been.

Finally, just after my 30th birthday, a box turned up.

The miserable people he had worked for had found a box of his things filed away and rang my mother (30 years later) wondering whether she wanted them or whether they should just throw them in the bin.

She waited for us to fly home and we opened it together three little women staring into an almost-abandoned cardboard box.

Now, most of the box was horse ultrasounds which, Ill be honest, I am not into. But there was also his handwriting around the edges and, then, underneath the horse X-rays and files, there were the photographs.

Any child who has lost a parent probably knows every single photograph in existence of that parent. I had pored over them all, trying to put together the person he might have been.

The photos in the box had been collected from his desk after he had died. We had never seen them before. They were nearly all of me. He had had all of these photos stuck on his desk. I was probably the last thing he looked at before he died.

My fathers death has given me a lot. It has given me a lifelong love of women, of their grittiness and hardness traits that we are not supposed to value as feminine. It has also given me a love of men, of their vulnerability and tenderness traits that we do not foster as masculine or allow ourselves to associate with masculinity.

To Daddy, here is my note to you:

Im sad you killed yourself, because I really think that, if you could see the life you left behind, you would regret it. You didnt get to see the Berlin wall fall or Ireland qualify for Italia 90. You didnt get to see all the encyclopedias that you bought for us to one day use at university get squashed into a CD and subsequently the internet. You have never got to hear your younger daughters voice it annoys me sometimes, but it has also said some of the most amazing things when drunk. I think you would have been proud to watch your daughter do standup at the O2 and sad to see my mother watching it on her own. Then again, if you hadnt died, I probably wouldnt have been mad enough to become a clown for a living. I am your daughter and I am really fucking funny, just like you. But, unlike you, Im going to stop being it for five minutes and write our story in the hope that it may help someone who didnt get to have a box turn up, or who may not feel in their right mind right now and needs a reminder to find hope.
Aisling

In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Other international suicide helplines can be found at befrienders.org

Read more: https://www.theguardian.com/lifeandstyle/2017/nov/04/aisling-bea-my-fathers-death-has-given-me-a-love-of-men-of-their-vulnerability-and-tenderness

Acid reflux drug linked to more than doubled risk of stomach cancer study

There are more than 50m prescriptions for proton pump inhibitors in the UK, though they have previously been linked to side-effects and increased risk of death

A drug commonly used to treat acid reflux is linked to a more than doubled risk of developing stomach cancer, researchers have claimed.

Proton pump inhibitors (PPIs) reduce the amount of acid made by the stomach and are used to treat acid reflux and stomach ulcers.

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death.

A link between PPIs and a higher stomach cancer risk has previously been identified by academics but never in a study that first eliminates a bacteria suspected of fuelling the illnesss development.

Research by the University of Hong Kong and University College London found that after the Helicobacter pylori was removed, the risk of developing the disease still rose in line with the dose and duration of PPI treatment.

They compared the use of PPI against another drug which limits acid production known as H2 blockers in 63,397 adults. The participants selected had been treated with triple therapy, which combines PPI and antibiotics to kill off the H pylori bacteria over a week, between 2003 and 2012.

Scientists then monitored them until they either developed stomach cancer, died or reached the end of the study at the end of 2015.

During this period, 3,271 people took PPIs for an average of almost three years, while 21,729 participants took H2 blockers. A total of 153 people developed stomach cancer, none of whom tested positive for H plyori but all had long-standing problems with stomach inflammation, the study found.

While H2 blockers were found to have no link to a higher risk of stomach cancer, PPIs was found connected to an increased risk of more than double.

Daily use of PPIs was associated with a risk of developing the illness that was more than four times higher (4.55) than those who used it weekly. Similarly, when the drug was used for more than a year, the risk of developing stomach cancer rose five-fold, and as high as eight-fold after three or more years, the findings showed.

The study concluded no firm cause and effect could be drawn, but doctors should exercise caution when prescribing long-term PPIs even after successful eradication of H plyori.

Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: Many observational studies have found adverse effects associated with PPIs.

The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.

Read more: https://www.theguardian.com/science/2017/oct/31/acid-reflux-drug-linked-to-more-than-doubled-risk-of-stomach-cancer-study

Dyslexia: scientists claim cause of condition may lie in the eyes

In people with the condition, light receptor cells are arranged in matching patterns in both eyes, which may confuse the brain

French scientists claim they may have found a physiological, and seemingly treatable, cause for dyslexia hidden in tiny light-receptor cells in the human eye.

In people with the condition, the cells were arranged in matching patterns in both eyes, which may be to blame for confusing the brain by producing mirror images, the co-authors wrote in the journal Proceedings of the Royal Society B.

In non-dyslexic people, the cells are arranged asymmetrically, allowing signals from the one eye to be overridden by the other to create a single image in the brain.

Our observations lead us to believe that we indeed found a potential cause of dyslexia, said the studys co-author, Guy Ropars, of the University of Rennes.

It offers a relatively simple method of diagnosis, he added, by simply looking into a subjects eyes.

Furthermore, the discovery of a delay (of about 10 thousandths of a second) between the primary image and the mirror image in the opposing hemispheres of the brain, allowed us to develop a method to erase the mirror image that is so confusing for dyslexic people using an LED lamp.

Like being left- or right-handed, human beings also have a dominant eye. As most of us have two eyes, which record slightly different versions of the same image, the brain has to select one of the two, creating a non-symmetry.

Many more people are right-eyed than left, and the dominant eye has more neural connections to the brain than the weaker one. Image signals are captured with rods and cones in the eye the cones being responsible for colour.

The majority of cones, which come in red, green and blue variants, are found in a small spot at the centre of the retina of the eye known as the fovea. But there is a small hole (about 0.1-0.15 millimetres in diameter) with no blue cones.

In the newstudy, Ropars and colleague Albert le Floch spotted a major difference between the arrangement of cones between the eyes of dyslexic and non-dyslexic people enrolled in an experiment.

In non-dyslexic people, the blue cone-free spot in one eye the dominant one, was round and in the other eye unevenly shaped. In dyslexic people, both eyes have the same, round spot, which translates into neither eye being dominant, they found.

The lack of asymmetry might be the biological and anatomical basis of reading and spelling disabilities, said the studys authors.

Dyslexic people make so-called mirror errors in reading, for example confusing the letters b and d.

For dyslexic students their two eyes are equivalent and their brain has to successively rely on the two slightly different versions of a given visual scene, they added.

The team used an LED lamp, flashing so fast that it is invisible to the naked eye, to cancel one of the images in the brains of dyslexic trial participants while reading. In initial experiments, dyslexic study participants called it the magic lamp, said Ropars, but further tests are required to confirm the technique really works.

About 700 million people worldwide are known to have from dyslexia about one in 10 of the global population.

Read more: https://www.theguardian.com/society/2017/oct/18/dyslexia-scientists-claim-cause-of-condition-may-lie-in-the-eyes

Facing poverty, academics turn to sex work and sleeping in cars

Adjunct professors in America face low pay and long hours without the security of full-time faculty. Some, on the brink of homelessness, take desperate measures

There is nothing she would rather do than teach. But after supplementing her career with tutoring and proofreading, the university lecturer decided to go to remarkable lengths to make her career financially viable.

She first opted for her side gig during a particularly rough patch, several years ago, when her course load was suddenly cut in half and her income plunged, putting her on the brink of eviction. In my mind I was like, Ive had one-night stands, how bad can it be? she said. And it wasnt that bad.

The wry but weary-sounding middle-aged woman, who lives in a large US city and asked to remain anonymous to protect her reputation, is an adjunct instructor, meaning she is not a full-time faculty member at any one institution and strings together a living by teaching individual courses, in her case at multiple colleges.

about

I feel committed to being the person whos there to help millennials, the next generation, go on to become critical thinkers, she said. And Im really good at it, and I really like it. And its heartbreaking to me it doesnt pay what I feel it should.

Sex work is one of the more unusual ways that adjuncts have avoided living in poverty, and perhaps even homelessness. A quarter of part-time college academics (many of whom are adjuncts, though its not uncommon for adjuncts to work 40 hours a week or more) are said to be enrolled in public assistance programs such as Medicaid.

They resort to food banks and Goodwill, and there is even an adjuncts cookbook that shows how to turn items like beef scraps, chicken bones and orange peel into meals. And then there are those who are either on the streets or teetering on the edge of losing stable housing. The Guardian has spoken to several such academics, including an adjunct living in a shack north of Miami, and another sleeping in her car in Silicon Valley.

The adjunct who turned to sex work makes several thousand dollars per course, and teaches about six per semester. She estimates that she puts in 60 hours a week. But she struggles to make ends meet after paying $1,500 in monthly rent and with student loans that, including interest, amount to a few hundred thousand dollars. Her income from teaching comes to $40,000 a year. Thats significantly more than most adjuncts: a 2014 survey found that the median income for adjuncts is only $22,041 a year, whereas for full-time faculty it is $47,500.

We take a kind of vow of poverty

Recent reports have revealed the extent of poverty among professors, but the issue is longstanding. Several years ago, it was thrust into the headlines in dramatic fashion when Mary-Faith Cerasoli, an adjunct professor of Romance languages in her 50s, revealed she was homeless and protested outside the New York state education department.

We take a kind of vow of poverty to continue practicing our profession, Debra Leigh Scott, who is working on a documentary about adjuncts, said in an email. We do it because we are dedicated to scholarship, to learning, to our students and to our disciplines.

Adjuncting has grown as funding for public universities has fallen by more than a quarterbetween 1990 and 2009. Private institutions also recognize the allure of part-time professors: generally they are cheaper than full-time staff, dont receive benefits or support for their personal research, and their hours can be carefully limited so they do not teach enough to qualify for health insurance.

This is why adjuncts have been called the fast-food workers of the academic world: among labor experts adjuncting is defined as precarious employment, a growing category that includes temping and sharing-economy gigs such as driving for Uber. An American Sociological Association taskforce focusing on precarious academic jobs, meanwhile, has suggested that faculty employment is no longer a stable middle-class career.

Adjunct
Adjunct English professor Ellen James-Penney and her husband live in a car with their two dogs. They have developed a system. Keep nothing on the dash, nothing on the floor you cant look like youre homeless, you cant dress like youre homeless. Photograph: Talia Herman for the Guardian

The struggle to stay in housing can take many forms, and a second job is one way adjuncts seek to buoy their finances. The professor who turned to sex work said it helps her keep her toehold in the rental market.

This is something I chose to do, she said, adding that for her it is preferable to, say, a six-hour shift at a bar after teaching all day. I dont want it to come across as, Oh, I had no other choice, this is how hard my life is.

Advertising online, she makes about $200 an hour for sex work. She sees clients only a handful of times during the semester, and more often during the summer, when classes end and she receives no income.

Im terrified that a student is going to come walking in, she said. And the financial concerns have not ceased. I constantly have tension in my neck from gritting my teeth all night.

To keep their homes, some adjuncts are forced to compromise on their living space.

Caprice Lawless, 65, a teacher of English composition and a campaigner for better working conditions for adjuncts, resides in an 1100 sq ft brick house near Boulder, Colorado. She bought it following a divorce two decades ago. But because her $18,000 income from teaching almost full time is so meager, she has remortgaged the property several times, and has had to rent her home to three other female housemates.

I live paycheck to paycheck and Im deeply in debt, she said, including from car repairs and a hospitalization for food poisoning.

Like every other adjunct, she says, she opted for the role thinking it would be a path to full-time work. She is so dependent on her job to maintain her living situation that when her mother died this summer, she didnt take time off in part because she has no bereavement leave. She turned up for work at 8am the next day, taught in a blur and, despite the cane she has used since a hip replacement, fell over in the parking lot.

If she were to lose her home her only hope, she says, would be government-subsidized housing.

Most of my colleagues are unjustifiably ashamed, she said. They take this personally, as if theyve failed, and Im always telling them, you havent failed, the system has failed you.

A precarious situation

Even more desperate are those adjuncts in substandard living spaces who cannot afford to fix them. Mindy Percival, 61, a lecturer with a doctorate from Columbia, teaches history at a state college in Florida and, in her words, lives in a shack which is in the woods in middle of nowhere.

Lecturer
Lecturer Mindy Percivals mobile home in Stuart, Florida. Her oven, shower and water heater dont work. Photograph: Courtesy of Mindy Percival

The mobile home she inhabits, located in the town of Stuart, north of Miami, was donated to her about eight years ago. It looks tidyon the outside, but inside there are holes in the floor and the paneling is peeling off the walls. She has no washing machine, and the oven, shower and water heater dont work. Im on the verge of homelessness, constantly on the verge, she said.

Percival once had a tenure-track job but left to care for her elderly mother, not expecting it would be impossible to find a similar position. Now, two weeks after being paid, I might have a can with $5 in change in it. Her 18-year-old car broke down after Hurricane Irma, and she is driven to school by a former student, paying $20 a day for gas.

I am trying to get out so terribly hard, she said.

Homelessness is a genuine prospect for adjuncts. When Ellen Tara James-Penney finishes work, teaching English composition and critical thinking at San Jose State University in Silicon Valley, her husband, Jim, picks her up. They have dinner and drive to a local church, where Jim pitches a tent by the car and sleeps there with one of their rescue dogs. In the car, James-Penney puts the car seats down and sleeps with another dog. She grades papers using a headlamp.

Over the years, she said, they have developed a system. Keep nothing on the dash, nothing on the floor you cant look like youre homeless, you cant dress like youre homeless. Dont park anywhere too long so the cops dont stop you.

James-Penney, 54, has struggled with homelessness since 2007, when she began studying for her bachelors degree. Jim, 64, used to be a trucker but cannot work owing to a herniated disk. Ellen made $28,000 last year, a chunk of which goes to debt repayments. The remainder is not enough to afford Silicon Valley rent.

At night, instead of a toilet they must use cups or plastic bags and baby wipes. To get clean, they find restrooms and we have what we call the sink-shower, James-Penney said. The couple keep their belongings in the back of the car and a roof container. All the while they deal with the consequences of ageing James-Penney has osteoporosis in a space too small to even stand up.

James-Penney does not hide her situation from her class. If her students complain about the homeless people who can sometimes be seen on campus, she will say:Youre looking at someone who is homeless.

That generally stops any kind of sound in the room, she says. I tell them, your parents could very well be one paycheck away, one illness away, from homelessness, so it is not something to be ashamed of.

Ellen
Ellen James-Penney teaching an English class at San Jose State University in California. She tells her students, youre looking at someone who is homeless. Photograph: Talia Herman for the Guardian

I hung on to the dream

Many adjuncts are seeking to change their lot by unionizing, and have done so at dozens of schools in recent years. They are notching successes; some have seen annual pay increases of about 5% to almost 20%, according to Julie Schmid, executive director of the American Association of University Professors.

Schools are often opposed to such efforts and say unions will result in higher costs for students. And for certain adjuncts, any gains will come too late.

Mary-Faith Cerasoli, 56, the homeless adjunct who captured the publics attention with her protest in New York three years ago, said that in the aftermath little changed in termsof her living situation. Two generous people, a retiree and then a nurse, offered her temporary accommodation, but she subsequently ended up in a tent pitched at a campground and, after that, a broken sailboat docked in the Hudson river.

But there was, however, one shift. All the moving around made it hard for her to make teaching commitments, and in any case the pay remained terrible, so she gave it up. She currently lives in a subsidized room in a shared house in a wealthy county north of New York.

For Rebecca Snow, 51, another adjunct who quit teaching after a succession of appalling living situations, there is a sense of having been freed, even though finances continue to be stressful.

Author
Author Rebecca Snow, now retired from adjuncting, has moved to a small apartment just north of Spokane, Washington. Photograph: Rajah Bose for the Guardian

She began teaching English composition at a community college in the Denver area in 2005, but the poor conditions of the homes she could afford meant she had to move every year or two. She left one place because of bedbugs, another when raw sewage flowed into her bathtub and the landlord failed to properly fix the pipes.

Sometimes her teenage son would have to stay with her ex-husband when she couldnt provide a stable home. Snow even published a poem about adjuncts housing difficulties.

In the end she left the profession when the housing and job insecurity became too much, and her bills too daunting. Today she lives in a quiet apartment above the garage of a friends home, located 15 miles outside Spokane, Washington. She has a view of a lake and forested hills and, with one novel under her belt, is working on a second.

Teaching was the fantasy, she said, but life on the brink of homelessness was the reality.

I realized I hung on to the dream for too long.

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Read more: https://www.theguardian.com/us-news/2017/sep/28/adjunct-professors-homeless-sex-work-academia-poverty

Exclusive: footage shows young elephants being captured in Zimbabwe for Chinese zoos

Rare footage of the capture of wild young elephants in Zimbabwe shows rough treatment of the calves as they are sedated and taken away

The Guardian has been given exclusive footage which shows the capture of young, wild elephants in Zimbabwe in preparation, it is believed, for their legal sale to Chinese zoos.

In the early morning of 8 August, five elephants were caught in Hwange national park by officials at Zimbabwe Parks and Wildlife Management Authority (Zimparks).

These captures are usually kept as secret as possible. The Guardian understands that in this case the usual procedure was followed. First, a viable herd is identified. Then operatives in a helicopter pick off the younger elephants with a sedative fired from a rifle. As the elephant collapses, the pilot dive-bombs the immediate vicinity so the rest of the herd, attempting to come to the aid of the fallen animal, are kept at bay. When things quieten down, a ground-team approaches the sedated elephants on foot, bundles them up, and drags them on to trailers.

The footage, a series of isolated clips and photographs provided to the Guardian by an anonymous source associated with the operation, documents the moment that operatives are running into the bush, then shows them tying up one young elephant. The elephants are then seen herded together in a holding pen near the main tourist camp in Hwange.

Elephant
In this part of the footage, a young female elephant is seen being kicked in the head repeatedly by one of the captors. Photograph: The Guardian

Finally, in the most disturbing part of the footage, a small female elephant, likely around five years old, is seen standing in the trailer. Her body is tightly tied to the vehicle by two ropes. Only minutes after being taken from the wild, the animal, still groggy from the sedative, is unable to understand that the officials want her to back into the truck, so they smack her on her body, twist her trunk, pull her by her tail and repeatedly kick her in the head with their boots.

Altogether, 14 elephants were captured during this time period, according to the source, who asked to remain to anonymous for fear of reprisal. The intention was to take more elephants, but the helicopter crashed during one of the operations. It is estimated that 30-40 elephants were to be captured in total.

The elephants that were taken are now in holding pens at an off-limits facility within Hwange called Umtshibi, according to the source. One expert who reviewed the photographs, Joyce Poole, an expert on elephant behaviour and co-director of the Kenya-based organisation ElephantVoices, said the elephants were bunching huddling together because they are frightened.

The
The young elephants in their enclosure. According to experts, they are bunching, huddling together because they are frightened. Photograph: The Guardian

Audrey Delsink, an elephant behavioural ecologist and executive director for Executive Director for Humane Society International Africa, also reviewed the photos and footage. She believed that most of the elephants were aged between two and four. Basically, these calves have just been weaned or are a year or two into the weaning process. In the wild, elephants are completely dependent on their mothers milk until they are two, and are not fully weaned until the age of five.

A number of the calves, she said, were displaying temporal streaming a stress-induced activity. Many of the gestures indicate apprehensive and displacement behaviour trunk twisting, trunk curled under, face touching, foot swinging, head-shaking, ear-cocking, displacement feeding, amongst others. Zimparks were approached but did not make a comment.

The buyer for the young elephants is a Chinese national, according to inside sources who asked not to be named. Last year he was associated with a case involving 11 wild hyenas, who were discovered in a truck at Harare international airport that had been on the road for 24 hours without food or water and were reportedly in an extremely stressed condition, dehydrated and emaciated and, in some cases, badly injured.

One
One of the hyenas found in a consignment at Harare airport in Zimbabwe. Photograph: The Guardian

The legal live trade in wild animals

The capture of the baby elephants is just one of a number of operations that have taken place in Zimbabwe and across the continent over several decades. Nine elephants were reportedly exported from Namibia to Mexico in 2012, six from Namibia to Cuba in 2013, and more than 25 from Zimbabwe to China in 2015. In 2016, the US imported 17 elephants from Swaziland despite objections from the public and conservationists. From 1995-2015, more than 600 wild African elephants and 400 wild Asian elephants are reported to have been traded globally, according to a database kept by the Convention on International Trade in Endangered Species (Cites).

Under Cites, trading live elephants is legal, with a few stipulations. The destination must be appropriate and acceptable, and the sale must benefit conservation in the home country. But elephant conservationists and animal welfare advocates point out a number of flaws in the system. There are no criteria setting out what appropriate and acceptable means and what is really contributing to conservation, explained Daniela Freyer of Pro-Wildlife, a German-based organisation that seeks to improve international legislation protecting wildlife. Currently, it is entirely up to authorities in the importing countries to define and decide. There are no common rules and no monitoring of the conditions of the capture, the number of animals being traded, where they will end up or the conditions in which they will be kept at their destination. There is also no monitoring of the requirement that a sale benefit conservation.

For example, Zimbabwe and China are the biggest players in the live elephant trade, but Iris Ho, wildlife programme manager at Humane Society International (HSI), says they have found little information from the importing countries on the animals arrival. We dont know how many facilities in China have received the elephants imported from Zimbabwe during the last few years. We dont know the status of these animals.

Attempts to comply with the few Cites stipulations such as appropriate and acceptable destinations are sometimes dismissed. In 2016, a Zimbabwe delegation of Zimparks and ZNSPCA inspectors travelled to China to access the facilities, where they found that most of the zoos showed signs of poor treatment of the animals. But their recommendation that a shipment of 36 elephants remain in Zimbabwe until the holding facilities in China were completed and assessed for compliance by Zimbabwe, was ignored.

On September 16 Chinese papers announced in cheery headlines that three elephants two females and a male, aged approximately four years old had arrived at the Lehe Ledu wildlife zoo. Photographs of the elephants from Chinese media were analysed by Poole, who noted that the face one of the females looked pinched and stressed. The elephant appears to have begun to wear her tusks down on the bars, rubbing back and forth in frustration. Poole added that the sunken look, dark eyes and mottled skin are common for young, captured elephants. In the wild, you only see the pinched, sunken look in sick or orphaned elephants.

The zoo has said that it is providing more than 1,000 square metres of indoor space and 3,000 sq metres outdoors. The animals have six full-time babysitters and every meal is prepared carefully, based on scientific recommendation.

A video posted on YouTube celebrating the arrival of the elephants at Lehe Ledu zoo.

Finally, questions have been asked about whether Zimbabwe is complying with the Cites stipulation that the sale of the elephants must benefit their conservation in the wild. The environment minister, Oppah Muchinguri-Kashiri, was reported in the Guardian last year as saying the sale of the elephants was necessary to raise funds to take care of national parks in Zimbabwe, which have been ravaged by drought and poaching. But in the past, there have been unconfirmed reports of Grace Mugabe, the presidents wife, using funds from the sales of elephants to pay off a military debt to the Democratic Republic of the Congo.

The international body governing the trade, Cites, is increasingly coming under fire for its role. The scientific literature states that captive facilities continue to fall far short of meeting elephants natural needs for movement, space and extended social networks, with negative effects on health, behavior and reproduction, said Anna Mul, a legal adviser on animal law at Fondation Franz Weber, an organisation that is lobbying Cites to end the trade of live elephants.

A spokesman for CITES said: The triennial CITES conference held last year (CoP17) agreed that appropriate and acceptable destinations was defined as destinations where the importing State is satisfied that the recipient of the live animals is suitably equipped to house and care for them. CoP17 also agreed on a process to assess if additional guidance on this matter is required. Further, both the importing and exporting countries are now required to be satisfied that any trade in live elephants should promote the conservation of elephants in the wild. In addition, the exporting Party must also be satisfied that animals are prepared and shipped so as to minimize the risk of injury, damage to health or cruel treatment of live elephants in trade… CITES does not address the way in which the animals are captured or stored prior to export.

But for now, China continues to import the vulnerable elephants at almost conveyor-belt speed. According to Ho, some pressure to stop the practice is beginning to be felt, but the country is influenced by the view that breeding is conservation. And then, of course, there is a willing partner in Zimbabwe and the thrill of seeing African elephants by the visitors.

Its a win-win, she said, for those who are financially profiting from the legal trade in the calves. But its a lose-lose for the animals, both imported and left behind.

Read more: https://www.theguardian.com/environment/2017/oct/03/exclusive-footage-shows-young-elephants-being-captured-in-zimbabwe-for-chinese-zoos

Hookworm, a disease of extreme poverty, is thriving in the US south. Why?

Exclusive: in America, the worlds richest country, diseases that thrive amid poverty are rampant, the first study of its kind in modern times shows

Children playing feet away from open pools of raw sewage; drinking water pumped beside cracked pipes of untreated waste; human faeces flushed back into kitchen sinks and bathtubs whenever the rains come; people testing positive for hookworm, an intestinal parasite that thrives on extreme poverty.

These are the findings of a new study into endemic tropical diseases, not in places usually associated with them in the developing world of sub-Saharan Africa and Asia, but in a corner of the richest nation on earth: Alabama.

Scientists in Houston, Texas, have lifted the lid on one of Americas darkest and deepest secrets: that hidden beneath fabulous wealth, the US tolerates poverty-related illness at levels comparable to the worlds poorest countries. More than one in three people sampled in a poor area of Alabama tested positive for traces of hookworm, a gastrointestinal parasite that was thought to have been eradicated from the US decades ago.

The long-awaited findings, revealed by the Guardian for the first time, are a wake-up call for the worlds only superpower as it grapples with growing inequality. Donald Trump has promised to Make America Great Again and tackle the nations crumbling infrastructure, but he has said very little about enduring chronic poverty, particularly in the southern states.

The study, the first of its kind in modern times, was carried out by the National School of Tropical Medicine at Baylor College of Medicine in conjunction with Alabama Center for Rural Enterprise (ACRE), a non-profit group seeking to address the root causes of poverty. In a survey of people living in Lowndes County, an area with a long history of racial discrimination and inequality, it found that 34% tested positive for genetic traces of Necator americanus.

Lowndes

The parasite, better known as hookworm, enters the body through the skin, usually through the soles of bare feet, and travels around the body until it attaches itself to the small intestine where it proceeds to suck the blood of its host. Over months or years it causes iron deficiency and anemia, weight loss, tiredness and impaired mental function, especially in children, helping to trap them into the poverty in which the disease flourishes.

Hookworm was rampant in the deep south of the US in the earlier 20th century, sapping the energy and educational achievements of both white and black kids and helping to create the stereotype of the lazy and lethargic southern redneck. As public health improved, most experts assumed it had disappeared altogether by the 1980s.

But the new study reveals that hookworm not only survives in communities of Americans lacking even basic sanitation, but does so on a breathtaking scale. None of the people included in the research had travelled outside the US, yet parasite exposure was found to be prevalent, as was shockingly inadequate waste treatment.

The peer-reviewed research paper, published in the American Journal of Tropical Medicine and Hygiene, focuses on Lowndes County, Alabama the home state of the US attorney general, Jeff Sessions, and a landmark region in the history of the nations civil rights movement. Bloody Lowndes, the area was called in reference to the violent reaction of white residents towards attempts to undo racial segregation in the 1950s.

It was through this county that Martin Luther King led marchers from Selma to Montgomery in 1965 in search of voting rights for black citizens, More than half a century later, Kings dream of what he called the dignity of equality remains elusive for many of the 11,000 residents of Lowndes County, 74% of whom are African American.

Raw
Raw sewage is carried through a PVC pipe to be dumped only a few yards away from a nearby home. Photograph: Bob Miller for the Guardian

The average income is just $18,046 (13,850) a year, and almost a third of the population live below the official US poverty line. The most elementary waste disposal infrastructure is often non-existent.

Some 73% of residents included in the Baylor survey reported that they had been exposed to raw sewage washing back into their homes as a result of faulty septic tanks or waste pipes becoming overwhelmed in torrential rains.

The Baylor study was inspired by Catherine Flowers, ACREs founder, who encouraged the Houston scientists to carry out the review after she became concerned about the health consequences of having so many open sewers in her home county. Hookworm is a 19th-century disease that should by now have been addressed, yet we are still struggling with it in the United States in the 21st century, she said.

Our billionaire philanthropists like Bill Gates fund water treatment around the world, but they dont fund it here in the US because no one acknowledges that this level of poverty exists in the richest nation in the world.

Flowers took the Guardian on a tour of Lowndes County to witness the conditions in which hookworm continues to proliferate. One stop was at a group of mobile homes outside Fort Deposit that graphically illustrated the crisis.

An eight-year-old child was sitting on the stoop of one of the trailers. Below him a white pipe ran from his house, across the yard just a few feet away from a basketball hoop, and into a copse of pine and sweet gum trees.

The pipe was cracked in several places and stopped just inside the copse, barely 30ft from the house, dripping ooze into a viscous pool the color of oil. Directly above the sewage pool, a separate narrow-gauge pipe ran up to the house, which turned out to be the main channel carrying drinking water to the residents.

The open sewer was festooned with mosquitoes, and a long cordon of ants could be seen trailing along the waste pipe from the house. At the end of the pool nearest the house the treacly fluid was glistening in the dappled sunlight a closer look revealed that it was actually moving, its human effluence heaving and churning with thousands of worms.

Ruby
Ruby Dee Rudolph, 66, noticed her septic tank was slowly sinking unevenly into the ground. Photograph: Bob Miller for the Guardian

This is the definition of Make America Great Again, said Aaron Thigpen, 29, a community activist who assisted with the hookworm study. This is the reality of how people are being forced to live.

Thigpens cousins live in the trailer park, and he has talked to them about the perils of piping sewage from their homes and dumping it in the open just a few feet away. They are disgusted about it, theyre sick and tired of living like this, but theres no public help for them here and if youre earning $700 a month theres no way you can afford your own private sanitation.

He added that people were afraid to report the problems, given the spate of criminal prosecutions that were launched by Alabama state between 2002 and 2008 against residents who were open-piping sewage from their homes, unable to afford proper treatment systems. One grandmother was jailed over a weekend for failing to buy a septic tank that cost more than her entire annual income.

People are scared. They dont like to speak out as theyre worried the health department will come round and cause trouble, Thigpen said.

The challenge to places like Lowndes County is not to restore existing public infrastructure, as Trump has promised, because there is no public infrastructure here to begin with. Flowers estimates that 80% of the county is uncovered by any municipal sewerage system, and in its absence people are expected and in some cases legally forced to provide their own.

Even where individuals can afford up to $15,000 to install a septic tank and very few can the terrain is against them. Lowndes County is located within the Black Belt, the southern sweep of loamy soil that is well suited to growing cotton and as a result spawned a multitude of plantations, each worked by a large enslaved population.

The same thing that made the land so good for cotton its water-retaining properties also makes it a hazard to the thousands of African Americans who still live on it today. When the rains come, the soil becomes saturated, overwhelming inadequate waste systems and providing a perfect breeding ground for hookworm.

Ruby Rudolph lives just beside the main Selma to Montgomery road where King led the protest walk. On the other side of the road theres a brown history placard to mark the spot where her grandmother, Rosie Steele, ran a campsite for the weary marchers.

After they moved on and the campsite was cleared, Rudolph said, her grandmothers grocery store was set on fire in an arson attack. She was 13 at the time, and can remember the flames leaping into the night sky.

Rudolph, now 66, does have her own septic tank at the back of her house, which she shows us in the sweltering 41C (105F) heat. But it doesnt function properly and when it rains the tank spills over, spreading raw waste all over the yard. Thats better than when it flushes back into the house, and Ive had that too, she said.

Shes been told a replacement system would cost her at least $12,000, which is beyond her means. She runs through her finances: she gets up at 4am every day to do an early shift at a Mapco convenience store, which brings in less than $1,200 a month. From that amount she has to pay $611 for her mortgage and theres the electricity bill that can be more than $300 a month when its hot and the air conditioning is busy. Theres not a lot left to put toward a new tank.

Perman
Perman Hardy, 58, stands with her grandson Carlos near the pipes that carry sewage from a relatives nearby trailer home into the woods, approximately 30ft from the back door. Photograph: Bob Miller for the Guardian

Perman Hardy, 58, lives in nearby Tyler in a collection of seven single-storey homes all occupied by members of her extended family. Only two of them have septic tanks, the rest just pipe raw waste into the surrounding woods and creeks.

Hardy is one of the lucky ones with a treatment system of her own, but like Rudolphs it is often overwhelmed in the rains with faeces washed back into her home. Last year the stench was so bad she had to vacate the property for two weeks over Christmas while it was professionally cleaned.

Hardy has traced her family back to slaves held on the Rudolph Bottom plantation about five miles away. The road that leads to the old plantation from her house is still called to this day by white neighbors Nigger Foot Road, she said, though she and other African Americans call it Collerine Cutoff Road.

As a child, Hardy worked in the cotton fields after school and, mindful of that and her familys slave history, shes determined to see a better future for her grandchildren. I dont want the same for my boys. But its still a struggle. Its the 21st century and we shouldnt be struggling like we still are today.

The daily hardship faced by Hardy, Rudolph and fellow inhabitants of Lowndes County is reflected in the Baylor studys glaring statistic of 34% testing positive for hookworm. The sample size was low 67 people participated with 55 giving stool samples, all of whom were African American but the results are so stark that the Houston scientists now want to conduct a larger survey across the region.

We now need to find how widespread hookworm is across the US, said Dr Peter Hotez, dean of the National School of Tropical Medicine, who led the research team along with Rojelio Mejia. Hotez, who has estimated that as many as 12 million Americans could be suffering from neglected tropical diseases in poor parts of the south and midwest, told the Guardian the results were a wake-up call for the nation.

This is the inconvenient truth that nobody in America wants to talk about, he said. These people live in the southern United States, and nobody seems to care; they are poor, and nobody seems to care; and more often than not they are people of color, and nobody seems to care.

Read more: https://www.theguardian.com/us-news/2017/sep/05/hookworm-lowndes-county-alabama-water-waste-treatment-poverty

This is how your world could end

In an extract from his book Ends of the World, Peter Brannen examines mass extinction events and the terrifying outcomes of rising temperatures for the human race

Many of us share some dim apprehension that the world is flying out of control, that the centre cannot hold. Raging wildfires, once-in-1,000-years storms and lethal heatwaves have become fixtures of the evening news and all this after the planet has warmed by less than 1C above preindustrial temperatures. But heres where it gets really scary.

If humanity burns through all its fossil fuel reserves, there is the potential to warm the planet by as much as 18C and raise sea levels by hundreds of feet. This is a warming spike of an even greater magnitude than that so far measured for the end-Permian mass extinction. If the worst-case scenarios come to pass, todays modestly menacing ocean-climate system will seem quaint. Even warming to one-fourth of that amount would create a planet that would have nothing to do with the one on which humans evolved or on which civilisation has been built. The last time it was 4C warmer there was no ice at either pole and sea level was 80 metres higher than it is today.

I met University of New Hampshire paleoclimatologist Matthew Huber at a diner near his campus in Durham, New Hampshire. Huber has spent a sizable portion of his research career studying the hothouse of the early mammals and he thinks that in the coming centuries we might be heading back to the Eocene climate of 50 million years ago, when there were Alaskan palm trees and alligators splashed in the Arctic Circle.

The modern world will be much more of a killing field, he said. Habitat fragmentation today will make it much more difficult to migrate. But if we limit it below 10C of warming, at least you dont have widespread heat death.

In 2010, Huber and his co-author, Steven Sherwood, published one of the most ominous science papers in recent memory, An Adaptability Limit to Climate Change Due to Heat Stress.

Lizards will be fine, birds will be fine, Huber said, noting that life has thrived in hotter climates than even the most catastrophic projections for anthropogenic global warming. This is one reason to suspect that the collapse of civilisation might come long before we reach a proper biological mass extinction. Life has endured conditions that would be unthinkable for a highly networked global society partitioned by political borders. Of course were understandably concerned about the fate of civilisation and Huber says that, mass extinction or not, its our tenuous reliance on an ageing and inadequate infrastructure, perhaps, most ominously, on power grids, coupled with the limits of human physiology that may well bring down our world.

In 1977, when power went out for only one summer day in New York, swaths of the city devolved into something like Hobbess man in a state of nature. Riots swept across the city, thousands of businesses were destroyed by looters and arsonists lit more than 1,000 fires.

Sami
Sami village, Gujurat, western India in August 2012. Villagers were forced to migrate due to lack of water after the monsoon failed. Photograph: Ahmad Masood/Reuters

In 2012, when the monsoon failed in India (as its expected to do in a warmer world), 670 million people that is, 10% of the global population lost access to power when the grid was crippled by unusually high demand from farmers struggling to irrigate their fields, while the high temperatures sent many Indians seeking kilowatt-chugging air-conditioning.

The problem is that humans cant even handle a hot week today without the power grid failing on a regular basis, he said, noting that the ageing patchwork power grid in the United States is built with components that are allowed to languish for more than a century before being replaced. What makes people think its going to be any better when the average summer temperature will be what, today, is the hottest week of the year in a five-year period and the hottest temperatures will be in the range that no one has ever experienced before in the United States? Thats 2050.

By 2050, according to a 2014 MIT study, there will also be five billion people living in water-stressed areas.

Thirty to 50 years from now, more or less, the water wars are going to start, Huber said.

In their book Dire Predictions, Penn States Lee Kump and Michael Mann describe just one local example of how drought, sea level rise and overpopulation may combine to pop the rivets of civilisation:

Increasingly severe drought in West Africa will generate a mass migration from the highly populous interior of Nigeria to its coastal mega-city, Lagos. Already threatened by rising sea levels, Lagos will be unable to accommodate this massive influx of people. Squabbling over the dwindling oil reserves in the Niger river delta, combined with potential for state corruption, will add to the factors contributing to massive social unrest.

Massive social unrest here being a rather bloodless phrase masking the utter chaos coming to a country already riven by corruption and religious violence.

Its sort of the nightmare scenario, said Huber. None of the economists is modelling what happens to a countrys GDP if 10% of the population is refugees sitting in refugee camps. But look at the real world. What happens if one person who was doing labour in China has to move to Kazakhstan, where they arent working? In an economic model, theyd be immediately put to work. But in the real world, theyd just sit there and get pissed. If people dont have economic hope and theyre displaced, they tend to get mad and blow things up. Its the kind of world in which the major institutions, including nations as a whole, have their existence threatened by mass migration. Thats where I see things heading by mid-century.

And it doesnt get any better after 2050. But forecasts about the disintegration of society are social and political speculations and have nothing to do with mass extinctions. Huber is more interested in the hard limits of biology. He wants to know when humans themselves will actually start to disintegrate. His 2010 paper on the subject was inspired by a chance meeting with a colleague.

I presented a paper at a conference about how hot tropical temperatures were in the geological past and [University of New South Wales climate scientist] Steve Sherwood was in the audience. He heard my talk and he started asking himself the very basic question: How hot and humid can it get before things start dying? It was literally just an order of magnitude kind of question. I guess he thought about it and realised that he didnt know the answer and wasnt sure anyone else did either Our paper really wasnt motivated by the future climate per se, because when we started we didnt know if there was any kind of realistic future climate state that would fall within this habitability limit. When we started, it was just like, We dont know. Maybe you have to go to, like, 50C global mean temperature. Then we ran a whole set of model results and it was rather alarming to us.

Sherwood and Huber calculated their temperature thresholds using the so-called wet-bulb temperature, which basically measures how much you can cool off at a given temperature. If humidity is high, for instance, things like sweat and wind are less effective at cooling you down and the wet-bulb temperature accounts for this.

If you take a meteorology class, the wet-bulb temperature is calculated by basically taking a glass thermometer, putting it in a tight wet sock and swinging it around your head, he said. So when you assume that this temperature limit applies to a human, youre really kind of imagining a gale force wind, blowing on a naked human being, whos doused in water, and theres no sunlight, and theyre immobile and actually not doing anything other than basal metabolism.

Today, the most common maximums for wet-bulb temperatures around the world are 26C to 27C. Wet-bulb temperatures of 35C or higher are lethal to humanity. Above this limit, it is impossible for humans to dissipate the heat they generate indefinitely and they die of overheating in a matter of hours, no matter how hard they try to cool off.

So we were trying to get across the point that physiology and adaptation and these other things will have nothing to do with this limit. Its the easy-bake oven limit, he said. You cook yourself, very slowly.

What that means is that this limit is likely far too generous for human survivability.

When you do real modelling, you hit a limit much sooner, because human beings arent wet socks, he said. According to Huber and Sherwoods modelling, 7C of warming would begin to render large parts of the globe lethally hot to mammals. Continue warming past that and truly huge swaths of the planet currently inhabited by humans would exceed 35C wet-bulb temperatures and would have to be abandoned. Otherwise, the people who live there would be literally cooked to death.

People are always like, Oh, well, cant we adapt? and you can, up to a point, he said. Its just after that point that Im talking about.

Already in todays world, heated less than 1C above preindustrial times, heatwaves have assumed a new deadly demeanour. In 2003, two hot weeks killed 30,000 people in Europe. It was called a once-in-500-year event. It happened again three years later (497 years ahead of schedule). In 2010, a heatwave killed 15,000 people in Russia. In 2015, nearly 700 people died in Karachi alone from a heatwave that struck Pakistan while many were fasting for Ramadan. But these tragic episodes are barely a shade of whats projected.

Bodies
Bodies in a morgue in Karachi, June 2015, during a heatwave in which almost 700 people died. Photograph: Rizwan Tabassum/AFP/Getty Images

In the near term 2050 or 2070 the US Midwest is going to be one of the hardest hit, said Huber. Theres a plume of warm, moist air that heads up through the central interior of the US during just the right season and, man, is it hot and sticky. You just add a couple of degrees and it gets really hot and sticky. These are thresholds, right? These arent just like smooth functions. It gets above a certain number and you hurt yourself very badly.

China, Brazil, and Africa face similarly infernal forecasts, while the already sweltering Middle East has what Huber calls existential problems. The first flickers of this slow-motion catastrophe might be familiar to Europeans struggling to accommodate the tens of thousands of refugees at their borders: the collapse and mass migration of Syrian society came after a punishing four-year drought. Still others have noted that the Hajj, which brings two million religious pilgrims to Mecca each year, will be a physically impossible religious obligation to fulfil due to the limits of heat stress in the region in just a few decades.

But for the very worst-case emissions scenarios, heatwaves would not merely be a public health crisis or a threat multiplier, as the Pentagon calls global warming. Humanity would have to abandon most of the Earth it now inhabits. In their paper, Huber and Sherwood write: If warmings of 10C were really to occur in the next three centuries, the area of land likely rendered uninhabitable by heat stress would dwarf that affected by rising sea level.

Huber said: If you ask any schoolchild, What were mammals doing in the age of the dinosaurs? theyd say they were living underground and coming out at night. Why? Well, heat stress is a very simple explanation. Interestingly, birds have a higher set-point temperature ours is 37C, birds is more like 41C. So I actually think thats a very deep evolutionary relic right there. Because that wet-bulb temperature was probably maxing out around 41C in the Cretaceous, not 37C.

Back at the diner in New Hampshire, Huber told me about his favourite story: the US Armys real-life parable of the so-called Motivated Point Man. In 1996, a platoon of light infantry spent days in the Puerto Rican jungle acclimatising to stifling heat and humidity, cautiously monitoring their water intake before simulating a night-time raid. The platoon included some of the most fit and motivated soldiers in the battalion. When the evening of the raid came, the platoon leader began leading his troops through the jungle, machete-ing a path through the brush. Before long, he was felled by fatigue and delegated his leadership to an underling. When the second private failed to advance the platoon quickly enough, the platoon leader demanded to lead again. But soon he found himself hyperthermic and unable to walk. His soldiers had to douse him in cold water and supply him with intravenous infusions. Eventually, four soldiers had to carry him. Before long, the extra demands vitiated the entire platoon, all of whom began to fall prey to heat stress. The exercise had to be called off before it became a massacre.

So I look at that as, if its night-time and acclimatised, fit people can just disintegrate into a pool of useless people on stretchers. Thats what I see happening to society, to cultures, Huber said. If you want to know how mass extinctions happen, thats how. So when people talk about the Pleistocene megafauna extinctions and Clovis people, sometimes they act like its a mystery how these things happen. But it happens in exactly the same way. You have something tearing apart the strongest members, the weaker ones try to fill in the gaps, theyre really not strong enough to take it and the whole thing collapses.

You want to know how societies collapse? Huber said. Thats how.

Extracted from Ends of the World by Peter Brannen is published by Oneworld Publications (18.99). To order a copy for 16.14 go to guardianbookshop.com or call 0330 333 6846. Free UK p&p over 10, online orders only. Phone orders min p&p of 1.99

What dies when as the temperatures rise

0.6C higher
As temperatures increase beyond preindustrial levels, widespread extinction of amphibians begins.

1.0C higher
As warming causes ice sheets to melt, krill populations suffer, threatening the penguins main food source.

1.6C higher
About half of wooded tundra is lost, putting pressure on its inhabitants such as moose, lynx and brown bears.

Emperor
Emperor penguins on Snow Hill Island, Antarctica. Photograph: Alamy

2.2C higher
At warming just over the +2C limit agreed in Paris 25% of large mammals in Africa are extinct.

2.6C higher
Major loss of tropical rainforests and the species that depend on them for habitat, including orangutans, sloths and jaguars.

More than 4C higher
At these temperatures, up to 70% of species would be extinct, coral reefs would be dead and deserts would expand across the globe.

Read more: https://www.theguardian.com/environment/2017/sep/09/this-is-how-your-world-could-end-climate-change-global-warming

Fran works six days a week in fast food, and yet she’s homeless: ‘It’s economic slavery’

Fran Marion and Bridget Hughes are leading voices in Stand Up Kansas City, part of the Fight for $15 movement that aims raise the minimum wage across the US

Once a customer has barked their order into the microphone at the Popeyes drive-thru on Prospect Avenue, Kansas City, the clock starts. Staff have a company-mandated 180 seconds to take the order, cook the order, bag the order and deliver it to the drive-thru window.

The restaurant is on short shift at the moment, which means it has about half the usual staff, so Fran Marion often has to do all those jobs herself. On the day we met, she estimates she processed 187 orders roughly one every two minutes. Those orders grossed about $950 for the company. Marion went home with $76.

Despite working six days a week, Marion, 37, a single mother of two, cant make ends meet on the $9.50 an hour she gets at Popeyes (no apostrophe founder Al Copeland joked he was too poor to afford one). A fast food worker for 22 years, Marion has almost always had a second job. Until recently, she had been working 9am-4pm at Popeyes, without a break, then crossing town to a janitorial job at Bartle Hall, the convention center, where she would work from 5pm- to 1.30am for $11 an hour. She didnt take breaks there either, although they were allowed.

Read more: https://www.theguardian.com/us-news/2017/aug/21/missouri-fast-food-workers-better-pay-popeyes-economics