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Monitor Daily Podcast

September 14, 2020
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TODAY’S INTRO

Justice for El Salvador, three decades later

Even in the context of El Salvador’s brutal civil war, the 1989 massacre of five Spanish Jesuits was shocking, spurring global calls for justice. On Friday, 31 years later, those calls were answered as Spain’s top criminal court handed a life sentence to Inocente Orlando Montano, a former Salvadoran army colonel and security minister, for his role in the murders. 

The case was argued in Madrid because of universal jurisdiction, which allows one country to investigate human rights crimes in another. And it speaks to the value the world continues to assign to the promise of international justice.

Staff writer Howard LaFranchi has written frequently about international justice, most recently regarding the arrest of a fugitive complicit in the 1994 Rwandan genocide. Cases can be a long slog, he says, and in addition to global institutions, individuals play important roles. He recalls visiting Argentina years after the Dirty War of the 1970s, and going to the home of a father whose daughter was disappeared. “What struck me was how people stuck with it,” he says. “He relentlessly pursued the case. So did mothers who for years gathered every Thursday in Buenos Aires’ Plaza de Mayo demanding answers.”

In Mr. Montano’s case, prosecutor Almudena Berabéu echoed that, lauding the persistence of Salvadorans. She told The Guardian, “It doesn’t really matter if 30 years have passed. I think people forget how important these active efforts are to formalise” that someone was tortured or executed.

As Howard says, “The principle of justice remains in people’s beating hearts.”

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A deeper look

How could nursing homes have done better?

The pandemic has raised questions about how our investments as a society reflect our values. That’s come up in the context of U.S. nursing homes, where there’s often a dearth of senior nursing expertise.

Ann Hermes/Staff
Melinda Haschak, a licensed practical nurse, stands for a portrait near her home on July 20, 2020, in Stamford, Connecticut. Ms. Haschak contracted COVID-19 while working her job at RegalCare, a nursing home in Southport, Connecticut.
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Nursing home residents have accounted for some 40% of all COVID-19 deaths in the United States. To some experts, this tragic toll was simply the result of location: in hotspots such as New York City. Even well-run, highly rated, long-term care facilities were hit hard. But other analyses point to a particular problem area: understaffed homes run for profit did worse at keeping their residents safe from the coronavirus. Two peer-reviewed studies of nursing homes in Connecticut and California separately found that low nurse-to-patient ratios, particularly of registered nurses, were associated with larger and deadlier COVID-19 outbreaks.

For instance, at RegalCare at Southport, a for-profit 120-bed facility in Connecticut, payroll data indicates that registered nurses provide less than half the state average of resident coverage. It’s been on a federal watch list for two years for a list of deficiencies, including poor infection control.

By late July, RegalCare had lost 19 residents. A number of staff members caught the virus themselves.

Melinda Haschak was one of them. A licensed practical nurse, she testified before a House Ways and Means Committee hearing last month about RegalCare’s lack of staffing, shortage of personal protective equipment such as masks, and her perception that management didn’t support front-line employees.

Nurses are grateful for food donations, she said. But “my co-workers and I don’t need a pizza party. We need PPE,” she told the committee.

How could nursing homes have done better?

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As Melinda Haschak responded to the Code Blue that blared through the intercom, she was missing a crucial piece of information.

The resident she was rushing to save had tested positive for the coronavirus. 

Ms. Haschak knew that some of the residents in the Connecticut nursing home where she works as a licensed nurse had tested positive. But the fellow nurse who could have helped her most – who had begun to piece together the larger picture, who knew the resident in distress had tested positive, and whose concerns had been dismissed by management – was at home, recovering from the coronavirus herself. 

Before falling ill, Kennethe Polissaint had noticed that the first resident who tested positive and died in the hospital had never left the facility – meaning the nursing home staff itself was unwittingly spreading the virus and should be tested. Yet when she told the assistant director of nursing, a registered nurse, “they didn’t do anything about it,” Ms. Polissaint says. 

Ms. Haschak was not able to save the Code Blue resident, who never regained consciousness. 

And afterward, the senior nurses who oversee infection control didn’t send her home to isolate. Instead, she went back to her wing, which was supposed to be COVID-19-free.  

Two weeks later, Ms. Haschak fell ill with COVID-19. 

The pattern that played out in RegalCare at Southport has been mirrored at thousands of nursing facilities across the United States. More than 41% of the 186,000 Americans who have died of COVID-19 in the 47 states that reported data have been in nursing homes and assisted living centers, according to Kaiser Health News.  

SOURCE:

Kaiser Family Foundation

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Karen Norris/Staff

The question is whether nursing homes could have done better – and can do better going forward. 

To some experts, there was probably little care facilities could have done. “This pandemic hit all nursing homes. It’s a lot more about where they’re located and how much traffic they had and the neighborhoods that got hit,” says Tamara Konetzka, a professor of public health at the University of Chicago. 

Gaps and inconsistencies in reporting standards across states have also made it hard to reach clear conclusions. “There’s a lot of uncertainty around the data,” says Michael Barnett, an assistant professor at Harvard T.H. Chan School of Public Health in Boston. 

Yet two state-level studies in Connecticut and California separately found that facilities employing more registered nurses did better at keeping their residents safe. The findings are consistent with other cross-state studies, which have also found that inadequate nursing staffing, including RNs, was a factor in COVID-19 outbreaks. 

The staffing factor in COVID-19 outbreaks is persuasive, says Dr. Barnett. “I think the bottom line is that it seems like nursing homes that have worse staffing have more extensive outbreaks.”  

It’s not the only relevant factor. In hotspots, even highly regarded homes weren’t spared. But it offers a potentially valuable confirmation of the idea that investing in senior nursing expertise, along with personal protective equipment (PPE) and testing capacity, could save lives.

Importance of registered nurses

Overall nurse staffing at RegalCare at Southport, a for-profit facility, is in line with the industry average in Connecticut. But it employs relatively few registered nurses. Payroll data for the first three months of 2020 show that its RNs averaged 20 minutes a day per resident, compared with the state average of 42 minutes. 

That RN ratio seemed to be a factor in the disease’s spread in nursing homes in Connecticut, says Yue Li, a professor of public health sciences at the University of Rochester. He led a study of state data published in the Journal of the American Geriatrics Society. “A higher ratio is really helpful to identify and prevent disease,” he says.  

Ann Hermes/Staff
Melinda Haschak, a licensed practical nurse, shows off her stethoscope "charms" including one from a current patient, near her home on July 20, 2020, in Stamford, Connecticut.

Professor Li’s study modeled the impact of having fewer RNs. At homes in Connecticut with confirmed cases, a 20-minute increase in RN staffing was associated with 22% fewer cases. In homes with at least one death, a 20-minute increase was associated with 26% fewer deaths. 

RNs are vital because they are the “top dogs” in facilities who oversee direct carers like Ms. Haschak and Ms. Polissaint and manage routine and emergency medical care. Particularly crucial during this pandemic, they are also typically in charge of infection control and for assessing residents.  

“The reason why [registered] nurses are important is that they set a standard,” says Nicole Howell, executive director of Ombudsman Services of Contra Costa, Solano and Alameda in Northern California, which represents the interests of care home residents. “It’s about leadership.”

Inside one nursing home

RegalCare at Southport has been on a federal watch list since 2018 for a string of deficiencies, including citations for infection control. Homes on the list that fail to improve care standards can be barred from federal funding. As of July, RegalCare Southport still hadn’t improved, one of 27 such homes nationwide in that category. (The U.S. has around 15,400 federally regulated nursing homes.)  

Ms. Polissaint has worked at the facility for 11 years. Even before the pandemic, she was frustrated at a lack of support for front-line carers from management. “We don’t have any support. Communication is very poor,” she says. 

When Ms. Haschak was off sick for a month with COVID-19, she says her supervisors never called to check on her. Only Ms. Polissaint called and texted her. 

By May, Ms. Polissaint was back on her wing, the designated COVID-19 section of the facility. She says the emotional strain of losing residents to the disease was compounded by their near-isolation at the end, as visitors weren’t allowed inside nursing homes. 

“The worst part is the families weren’t able to come in and see them,” she says. They never saw how Ms. Polissaint and her aides cared for them, despite the shortages of masks and gowns and other equipment in the facility. “It was a hustle to get a mask,” she says.

Ann Hermes/Staff
A sign supporting essential workers sits near the entrance of RegalCare, a nursing home that has been dealing with COVID-19 cases, on July 21, 2020 in Southport, Connecticut.

In May this year, RegalCare at Southport was cited by state inspectors twice for COVID-19-related violations: On one visit, they found single-use protective suits being reused. On another, staff told inspectors that they couldn’t obtain masks, face shields, and other PPE, and a worker said she was given a brown paper bag to use as protection. 

In response, Christopher Massaro, the facility’s executive administrator, said in a statement: “Regalcare at Southport has followed and continues to follow all CDC and State of Connecticut Department of Health guidelines for Covid 19 including the myriad of changes and updates they have made throughout this pandemic.”

On June 8, Gov. Ned Lamont ordered an independent inquiry into what had happened in nursing homes and assisted care facilities and whether more could have been done to protect residents from the coronavirus. 

By late July, RegalCare had lost 19 residents, out of more than 2,500 deaths in Connecticut nursing homes. That put it in the middle of the pack on a per-bed basis.

A different experience

River Glen Health Center in Southbury, Connecticut, is a 45-minute drive from Southport. It has the same number of beds – 120 – and is part of a for-profit regional chain, CareOne. But it has significantly more RNs per resident, averaging 48 minutes in the first quarter. 

When COVID-19 hit Connecticut in March, River Glen supervisors zeroed in on the risk of transmission both from staff and patients discharged from hospitals, says administrator Mary Noonan. They insisted that residents wear masks while receiving care. Nurses who worked in other health facilities were assessed for risk; others who had been on vacation were also monitored. 

“We were trying not to have any contamination,” she says. 

What helped, she says, was low staff turnover and having supervisors who knew them well and could be proactive at a time when testing and PPE were in short supply. The RNs “were invaluable. They knew how to be vigilant. They knew the procedures,” says Ms. Noonan. 

So far, only three residents and two employees at River Glen have tested positive for COVID-19. None have died. 

Not just a “bad apples” problem

To members of the industry, singling out nurse staffing misses the larger picture. They argue that operators followed federal guidelines and were blindsided by asymptomatic spread of an unknown virus and then left to fend for themselves as hospitals, not long-term care homes, got priority for PPE and testing. 

For example, the Centers for Disease Control and Prevention initially required only nursing home staff who served residents who had tested positive for COVID-19 to wear masks. It changed its guidance on April 2 to include all staff.   

“Even the highest quality organizations could not handle this [pandemic] because of where they were located and who the populations were in their building,” says Robyn Stone, senior vice president at LeadingAge, which represents nonprofit homes. “We have fabulous providers in New York that were filled with COVID.” 

Some research supports this view. One study looked at more than 9,000 facilities and found that most outbreaks happened inside homes where the virus was prevalent in the outside community. The study, published in the Journal of the American Geriatrics Society, found no association with quality ratings or past infection problems. 

“This suggests that COVID-19 is not a ‘bad apples’ problem, but a system-wide problem that can impact any nursing home in any state,” the study’s leader, David Grabowski of Harvard Medical School, told a U.S. House Ways and Means subcommittee hearing on June 25.

The effects of nursing levels

Yet many carers and experts say that nursing levels – and particularly RN levels – can have an important effect. While some key variables, like location, were out of nursing homes’ control, having a “strong RN, trained in up-to-date protocols” meant a facility was better prepared to respond, says Ms. Howell, the ombudsman in Northern California. “It matters what you do from there.” 

Federal law requires one registered nurse to be present at nursing facilities eight consecutive hours per day, but there are no federal minimum levels for the ratio of RNs per resident. At least one licensed nurse – Ms. Haschak’s position – must be present at all times. 

In 2018, Office of Inspector General for Health and Human Services found that nearly 1,000 nursing homes, or 7% of those surveyed, had failed to meet federal minimum staffing requirements for more than 30 days, mostly on weekends. “This raises concerns that some nursing homes may not have fully met their residents’ needs,” it wrote.

Ann Hermes/Staff
Melinda Haschak, a licensed practical nurse, demonstrates the use of a set of 60 headbands, made and donated by a friend of her family to protect the ears of essential workers wearing masks, near her home on July 20, 2020, in Stamford, Connecticut. Ms. Haschak contracted COVID-19 while working her job at RegalCare, a nursing home in Southport, Connecticut.

Decades of research shows that higher nursing staffing improves quality of care and that higher RN staffing in particular is associated with decreased infections and other positive indicators. Most states mandate a minimum overall staffing ratio. California sets a minimum of 3.5 hours of nursing care per resident, a standard that 1 in 4 homes failed to meet in 2017. 

A recent study of California facilities found that those where RNs averaged less than 45 minutes a day per resident were twice as likely to have resident COVID-19 infections. Homes that had no infections had both higher RN and total staffing ratios compared with those that did, according to the study. 

Charlene Harrington, who led the study, has spent decades studying how nursing homes are run and staffed, both in the U.S. and other wealthy countries. Now a professor emeritus at the University of California, San Francisco, she says that quality of care and inadequate staffing contributed to the severity of the outbreak in California’s nursing homes. Her study found that some nursing home operators substitute for RNs with nurses with less training as a way to keep down costs. 

More than a pizza party

After recovering, Ms. Haschak went back to work in May. The nursing home had fewer residents, but her wing was still short-staffed and there wasn’t enough PPE.

Her facility wasn’t alone: Around 1 in 5 nursing homes nationally reported being short of staff and lacking protective gear like N95 masks in May, according to federal data. 

In June, she was asked by her union to speak at a House Ways and Means hearing on the nursing home crisis. Ms. Haschak spent days practicing her speech, trying not to break down as she recounted her experience. Her teenage daughter encouraged her to keep going. “You can do it,” she told her.

On June 25, she sat on her sofa and spoke via video link to the committee. 

“Thank you for allowing me to share my story today,” she began, her voice wavering. “My name is Melinda Haschak. I’m a nursing home worker from Stamford, Connecticut. I’ve worked in the health care industry for over 20 years.”

She went on to describe the conditions at her facility and what she felt was the lack of support from managers, and how she had to scrounge money to buy thousands of surgical masks for the staff, before she got sick with COVID-19. Then she calmly spoke of the continued strain caused by understaffing and shortages of PPE, and not knowing which residents had tested positive. 

Nurses have received food donations, she added. Staff also received extra hazard pay in May and June. But that’s no substitute for decent wages and conditions, she told the committee.

“My co-workers and I do not need a pizza party,” she said. “We need PPE.”

Staff writers Sarah Matusek and Kelsey Olya Evans contributed to this report.

Editor’s note: As a public service, we have removed our paywall for all pandemic-related stories.

SOURCE:

Kaiser Family Foundation

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Karen Norris/Staff

The Explainer

Himalayan pullback: The tense history of India-China border

Why would China and India assert themselves right now along their disputed border? Intensifying nationalism and a desire to show strength  amid stresses like the pandemic likely play large roles.

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Late last week, India and China pledged to de-escalate the tensest standoff along their border in decades. Hand-to-hand fighting in June caused the first combat deaths along the border since 1975, and both countries accused each other of firing shots earlier this month.

“The current situation in the border areas is not in the interest of either side,” said the statement from their foreign ministers, signed in Moscow. 

But deep distrust and rising nationalism on both sides, coupled with tens of thousands of troops arrayed along the border, mean the escalation will not completely dial down overnight. China may be asserting itself for the same reason it has taken more aggressive stances recently toward Hong Kong, Taiwan, and the South China Sea – to show that it remains strong, despite internal challenges from the pandemic and economic slowdown.

“The countries desperately prize their sovereignty … so even losing a sliver of unimportant land carries a lot of political weight,” says Arzan Tarapore of Stanford University’s Asia-Pacific Research Center. “There is a political significance to this high, barren land that isn’t amenable to economic or strategic analysis.”

Himalayan pullback: The tense history of India-China border

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Dar Yasin/AP
An Indian army convoy moves on the Srinagar-Ladakh highway at Gagangeer, northeast of Srinagar, Sept. 9, 2020. Last week, India and China accused each other of sending soldiers into each other’s territory along their disputed border and fired warning shots for the first time in 45 years.

Beijing and New Delhi are taking steps to prevent recent clashes along their disputed border from escalating out of control. But deep mistrust and nationalism, coupled with tens of thousands of troops now arrayed along the remote frontier, make that challenging.

Why has fighting erupted?

Tensions have long simmered along India’s disputed border with China, but the latest clashes mark an unusual escalation. The bloody, hand-to-hand fighting in June caused the first combat deaths along the border since 1975. Twenty Indian soldiers were killed, and India said China also had casualties, but Beijing has offered no details. Both countries accused each other of firing shots in September, the first time since the 1975 skirmish.

Back in May, India accused Chinese soldiers of crossing the de facto border known as the Line of Actual Control and of building encampments, while China countered that India had crossed the LAC and provoked attacks. India was building roads and other infrastructure that Beijing may have viewed as threatening to the status quo, experts say.  

A core issue is a disagreement over where the border lies. British India and Tibet signed a treaty establishing the frontier as the McMahon Line in 1914, but China never accepted that as the official legal border. In 1962, Chinese troops crossed the McMahon Line and pushed deep into Indian territory in a monthlong war that left more than 1,000 Indians and several hundred Chinese dead. China then redrew the border unofficially to reflect these gains, calling it the Line of Actual Control. India pushed back in a second conflict in 1967, which left scores dead on either side. Today, New Delhi and Beijing disagree on the LAC’s location.

What efforts are underway to resolve the conflict?

India’s external affairs minister, Subrahmanyam Jaishankar, and Chinese Foreign Minister Wang Yi met in Moscow and issued a five-point statement on Sept. 10, pledging that forces on both sides should “continue their dialogue, quickly disengage, maintain proper distance, and ease tensions.” They also agreed that the forces should abide by existing agreements on military border patrols, which include a prohibition on the use of firearms. “The current situation in the border areas is not in the interest of either side,” the statement said.

 

Bai Xueqi/Xinhua/AP
India's external affairs minister, Subrahmanyam Jaishankar (left), and Chinese Foreign Minister Wang Yi stand together on the sidelines of a meeting of foreign ministers of the Shanghai Cooperation Organization in Moscow, Sept. 10, 2020. The ministers agreed that their troops should disengage from a tense border standoff and maintain proper distance.

The agreement is a significant step to prevent the conflict from spiraling out of control, but it does not guarantee de-escalation, Asia experts say, noting that earlier plans by both sides to disengage have been followed by clashes. “There is an absolute dearth of trust on both sides, especially on the Indian side,” says Arzan Tarapore, a South Asia research scholar at Stanford University’s Asia-Pacific Research Center. Doubts over compliance, coupled with the current militarization of the border – with an estimated 40,000 to 50,000 troops positioned there by each country – mean China and India are unlikely to return to the status quo. The border will “look different in 2021 than it did prior to this crisis,” he says.

From India’s perspective, China has raised the stakes by ordering its military to occupy Indian territory – essentially a quick land grab – instead of making a temporary incursion as in the past, says Dr. Tarapore, who is also a senior nonresident fellow at the National Bureau of Asian Research. To prevent such tactics, India dispatched special forces soldiers to occupy some strategic high ground on India’s side, complicating future moves by China, he says. For its part, China denies its military crossed into Indian territory.

What are the longer-term implications?

China may be asserting itself along the border with India for the same reason it has taken more aggressive stances recently toward Hong Kong, Taiwan, and the South China Sea – to show that, despite internal challenges from COVID-19 and an economic slowdown, it remains strong. “It’s a warning to the Indian side,” says Oriana Skylar Mastro, an expert on China’s military at the Freeman Spogli Institute for International Studies at Stanford University. India has also moved in recent years to strengthen territorial controls on its periphery, experts say.

Rising nationalism plays an important role for both China and India – a factor that makes the conflict over the desolate Himalayan territory so vital for each side, and so difficult to resolve. “The countries desperately prize their sovereignty … so even losing a sliver of unimportant land carries a lot of political weight,” says Dr. Tarapore. “There is a political significance to this high, barren land that isn’t amenable to economic or strategic analysis. It’s about national pride and national sovereignty. It’s about what it means to be China and what it means to be India.”

Amid pandemic, Britain’s slow internet throws up extra obstacle to recovery

Earlier, we looked at U.S. nursing homes and the connection between investments and values. In Britain, sharply uneven Wi-Fi access, with its impact on inequality in schooling and jobs, raises similar questions. 

Andrew Couldridge/Reuters
Noah renews his scout cub promise via the internet at his home in Hertford, England, April 23, 2020.
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As the United Kingdom claws back from its biggest economic plunge in more than 300 years due to the country’s pandemic lockdown, many in rural England and Wales are concerned that poor internet connectivity could hamper Britain’s recovery.

Britain’s internet speeds lag behind those in many smaller, less wealthy nations. According to a report by the European Commission, high-speed broadband in Slovenia and Lithuania eclipses that across Britain. Estonia, with a gross domestic product of $30.7 billion – a fraction of Britain’s 2018 GDP of $2.3 trillion – trumps the U.K. for breadth and speed of online connectivity.

Samuel Bright, an editor for a digital startup magazine, previously lived in London but returned back to his hometown of Huddersfield during the lockdown. He says connectivity in towns and cities in northern England isn’t so different until you step beyond central areas. “When you venture into more remote areas, it’s like stepping into a time machine – you’re effectively cut off from the outside world.”

He worries poor connectivity has compounded isolation and depression for rural Britons, both old and young. “Ironically, they are exactly the same people who’ve been saddled for decades with poor transport links, crumbling infrastructure, and dying industries.”

Amid pandemic, Britain’s slow internet throws up extra obstacle to recovery

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Lucy Alexandra Spencer dials in and her voice is crystal clear. She could be sitting a mere socially distant 6 feet away. Instead, she’s by a small medieval town in Austria overlooking the Alps on summer vacation. The former teacher-turned-online tutor takes advantage of exceptional internet connections.

But when she’s back at her British home in Berkshire, on the outskirts of London, internet speeds are dire enough that Ms. Spencer uses her cellphone as an internet hotspot and carries extra portable Wi-Fi to ensure as little disruption occurs as possible for her online courses teaching hundreds of children at a time. It all amounts to high monthly costs to stay connected in the United Kingdom.

“It’s a bit mad having so many backups, but being reliable is super important,” she says. “I had two lessons over the whole of lockdown which had to be rescheduled because of connectivity issues.”

Britain’s internet speeds lag behind those in many smaller, less wealthy nations. According to a report by the European Commission, high-speed broadband in Slovenia and Lithuania eclipses that across Britain. Estonia, with a gross domestic product of $30.7 billion – a fraction of Britain’s 2018 GDP of $2.3 trillion – trumps the U.K. for breadth and speed of online connectivity.

And Britain’s patchy internet connections both cause and expose inequalities across British society. These have become even more apparent under the COVID-19 lockdown. Owners of land, property, and businesses in rural England and Wales are concerned that poor connectivity could hamper Britain’s economic recovery as the country claws back from its biggest economic plunge in more than 300 years.

“Our coronavirus economy relies on people being able to work from home, yet millions are effectively stuck in the Middle Ages through no fault of their own,” says Samuel Bright, an editor for a digital startup magazine.

Better connection in a South African caravan

Britain’s problems go back to the 1980s. The privatization of state-owned assets, including telecoms, effectively created a conglomerate of companies offering high prices and little differentiation. Internet cables to this day often use existing copper wires originally designed for telephones, and which are cheap to maintain.

Wind and rain can cause outages, while signals peter out if residents have the misfortune of living at the end of phone lines. It can make everything from video calling or watching movies to accessing vital services frustrating.

Lottie Reeves lives on a boat traveling along southern England’s canals, and combines working as a web developer with running an online community for female travel bloggers. “I started my business from a caravan [camper] in South Africa and often joke I had a better connection there,” she says.

Areas in northern England, southwest England, and much of Wales suffer from little to no internet connectivity whatsoever.

Hannah McKay/Reuters
Yuhui Choe, first soloist of the Royal Ballet, practices as Nehemiah Kish, her husband and former principal of the Royal Ballet, works at their home in Wimbledon, following the outbreak of COVID-19 in London, May 1, 2020.

Mr. Bright previously lived in London but returned back to his hometown of Huddersfield during the pandemic lockdown. He says connectivity in towns and cities in northern England isn’t so different until you step beyond central areas. “When you venture into more remote areas, it’s like stepping into a time machine – you’re effectively cut off from the outside world.”

He fears poor connectivity has compounded isolation and depression for rural Britons, both old and young, “a swath of the population who’ve suffered more than most,” he says. “Ironically, they are exactly the same people who’ve been saddled for decades with poor transport links, crumbling infrastructure, and dying industries.”

Poor connections also threaten agriculture. “Farms use online resources with increasing intensity, and many rural businesses take advantage of online communication to market and supply goods and services,” says Nigel Hollett, director of the Country Land and Business Association, which represents businesses and landlords in rural Wales and England.

“You’re hammering home disadvantage”

With the rise of home schooling in lockdown, Britain’s poor connectivity is also hampering children’s opportunity to get a quality education, says online tutor Zoe Hughes from her home in Devon, southwest England.

“Disadvantaged kids are already discriminated against for their financial situation, then to put them in a rural area where there are fewer opportunities to connect is a disaster waiting to happen,” she says. “If you’re reliant on charitable food banks, you don’t have £30 per month to spare.”

Many of her pupils live in socialized, local authority housing across Dartmoor, a region on the south coast known for having some of the highest value properties in the U.K. “It’s not like these are middle-class folk who escaped London to live in the country,” she says. “There are locals born and raised in working-class housing. … If there’s no decent Wi-Fi, you’re hammering home disadvantage.”

Connectivity inequalities aren’t as simple as a battle between a “super connected” London versus the rest of the country. The issue, as many Londoners attest, is patchy.

Elizabeth Lusty suffers regular outages from her West London home in Ealing, just 10 miles west of Buckingham Palace. She runs VChoir, a virtual choir business, but low speeds damage the singing experience and cause people to drop out and, in turn, dent her income.

“I can’t offer refunds. I don’t have that leeway at the moment. People are annoyed if there’s a bad internet connection, but it’s out of my hands,” she says.

Virtual singing has become a lifeline for her singers, given many of them are retired people, live with dementia, or care for their adult children. Poor connections, she says, exacerbate isolation and mental health issues.

Search for solutions

There are spots of progress. Cornwall, located next to Dartmoor, boasts some of the fastest fiber-optic broadband connections in the world thanks to £53.5 million ($71 million) in funding from the European Union. Britain’s decision to leave the European Union shuts the door on additional EU funding, however.

Solutions have been proposed but rejected at the ballot box. Former Labour Party leader Jeremy Corbyn suggested nationalizing broadband during December’s national election campaign. But the victory of Boris Johnson’s Conservative Party, which advocates market-led innovation, shut the door on potential state-run alternatives.

BT, a private telecom provider, plans to bring full-fiber broadband to 45 market towns and communities in Wales.

The Good Things Foundation, a British charity advocating digital connectivity as a means to solve societal issues, says the COVID-19 pandemic has generated “visible momentum” for state intervention and digital services.

Progress cannot come fast enough for radio presenter Meera Sharma. She used to live in the United States, “where the connection is so much better.” Back in Britain with her family, she’s left embarrassed with patchy connections disrupting on-air interviews.

“The amount we’re all paying ... the government needs to do better,” Ms. Sharma says as the call drops out momentarily. “Britain needs to drag itself into the 21st century.”

Editor’s note: As a public service, we have removed our paywall for all pandemic-related stories.

How South African activists hope to integrate cities built to divide

Housing is another area with deep links to access. In South Africa, activists are pushing city planners to look beyond simply well-built structures to the complex web of factors that create a sense of security and opportunity.

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When formal segregation ended in South African cities in the mid-1990s, their planners faced an existential puzzle: how to bring people together in cities set up to keep them apart.

For decades, planners largely sidestepped it in favor of addressing an even larger issue – how to simply provide decent housing to people who had been forcibly crowded into poor, segregated communities with few public services. But much of the government-built housing sits on the edges of cities, in places that reinforce inequalities. 

In recent years, housing activists have begun pushing city governments to reverse that trend. Living far from city centers is logistically complicated, and expensive, but for many South Africans, it is a matter of injustice in more symbolic ways as well. Under apartheid, these were the spaces they were allowed to access only with government permission, and often had to leave by the time the sun went down. 

Late last month in Cape Town, a court sided with such activists, ruling that the city must cancel the sale of a property it owned near its central business district that activists want turned into subsidized housing. The judgment, experts say, could have a ripple effect, forcing cities to begin reversing a deeply unequal status quo.

How South African activists hope to integrate cities built to divide

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Ryan Lenora Brown/The Christian Science Monitor
Sophie Rubins stands in the doorway of her new apartment in the Fleurhof housing development, west of Johannesburg. Like many South Africans, Ms. Rubins spent years on a government waiting list for free housing before receiving her apartment in September.

The last night Sophie Rubins spent in her rusted tin shack, the first rain of spring spattered against her roof. From her bed, she watched it slide between the gaps in the walls. The holes were so big “you could see the stars,” she says, and when the water came in, it pooled on the floor, just as it had every time it rained here for the last 30 years.

For nearly all of her life, Ms. Rubins had lived here, in a zozo – a sheet-metal shack – in a backyard in Eldorado Park. The township on Johannesburg’s southern edge was built for a mixed-race and Indigenous community known in apartheid’s racial hierarchy as “coloureds.” It had few jobs or services. Most work opportunities had always been a long bus ride away, in the “white” parts of town.

But this early September night was her last one here, because the following morning, she was moving to the other side of the city, to a free government-provided apartment that she would own herself. She’d been on a waiting list to receive it for 24 years. “I thought I would have this house to raise my kids,” she says. “But I am still glad I will have a beautiful place to die.”

When formal segregation ended in South African cities in the mid-1990s, their planners faced an existential puzzle: How do you integrate cities that were built to divide? For decades, city planners largely sidestepped it altogether in favor of addressing an even larger issue – how to simply provide decent housing to people who had been forcibly crowded into poor, segregated communities with few public services. Since the end of apartheid, the country’s government has built housing for millions of people like Ms. Rubin.

But many are located at the edges of cities, in places that reinforce deep inequalities, rather than shrink them. In recent years, housing activists have begun pushing city governments to reverse that trend and build subsidized rental housing near city centers, close to jobs and schools. While not free, activists say this low-cost housing is a foot in the door for working-class people trying to access parts of the city from which they were once excluded.

On Aug. 31 in Cape Town, a court sided with these activists, ruling that the city must cancel the sale of a property it owned near its central business district that activists want turned into subsidized housing. “Unless meaningful attempts are made by the authorities to redress the situation,” the judges wrote, “spatial apartheid will be perpetuated.”

Ryan Lenora Brown/The Christian Science Monitor
Since 1994, the South African government has provided over 3 million housing units to poor South Africans, including these apartments in Fleurhof, west of Johannesburg.

The judgment, experts say, could have a ripple effect, forcing South Africa’s cities to at last begin to reverse a deeply unequal status quo.

“It’s significant because for the first time a court is saying, well-placed affordable housing isn’t something that’s nice to have, it’s something you must have,” says Nobukhosi Ngwenya, a junior research fellow at the African Centre for Cities in Cape Town who studies housing inequality in the city. 

Mixed success

That goes against the tides of history, but it also cuts against the present.

The apartment Ms. Rubins moved into last week on the western edge of Johannesburg was built as part of the Reconstruction and Development Program (RDP), a herculean government effort begun in the 1990s to reverse decades – in many places centuries – of segregation and Black dispossession from land. Building on the South African Constitution’s mandate to provide “adequate housing” to every citizen, the project promised to provide free housing to millions who had been denied basic services and decent living conditions by the white government.

By some measures, the RDP has been a major success. By 2018, government had built some 3.2 million housing units, and was still delivering. That year, approximately 13.6% of South Africans lived in either free or state-subsidized housing.

But to cut costs, nearly all of it has been built on city peripheries, in the same kinds of marginal areas that Black, Asian, and mixed-race South Africans were once confined by law.

Ms. Rubins’ new apartment, for instance, backs up against a mine dump on the city’s western edge, in a rambling, low-slung neighborhood of factories and warehouses. It costs about $2 – more than the country’s hourly minimum wage – to travel to the city center.

Distance from city centers is logistically complicated, but for many South Africans, it is a matter of injustice in more symbolic ways as well. Under apartheid, these were the spaces they were allowed to access only with government permission, and often had to leave by the time the sun went down. 

“There have been a lot of struggles for access to land in cities and towns across South Africa, and they have done a lot of good for people,” says Mandisa Shandu, executive director of Ndifuna Ukwazi, a housing rights nongovernmental organization in Cape Town, which brought the court challenge there. “But one thing we’ve done in our fight is say that not just access, but location must be considered too.”

Many-pieced puzzle

In early 2016, Ndifuna Ukwazi heard that the city of Cape Town had sold a central site, called Tafelberg, to a local private school. Although the sale had already gone through, the NGO brought a court case arguing that the land wasn’t eligible to be sold, because the city was obligated to use the resources it had to provide subsidized housing – including this parcel of land.

The case dragged on for nearly four years, until the court’s decision last week to cancel the sale. And the city and provincial governments were given until the end of May 2021 to present a plan to create low-cost housing in Cape Town’s inner city.

“I think this judgment will have a major impact beyond Cape Town,” says Edgar Pieterse, director of the African Centre for Cities. “Nationwide, it’s likely to give greater momentum to the social housing agenda,” he said, referring to what in the United States is called public housing.

Even with the added momentum, subsidized housing is only one piece of the puzzle. He says that government must find ways to make sure free and low-cost housing is built not only to put a roof over people’s heads, but to make South African cities more equal places to live. In Johannesburg, for instance, the city government recently spent several years improving public transport and encouraging construction along key routes – designed to make it easier to move between neighborhoods once cleaved apart by segregationist city planning.

But when Ms. Rubins moved into her new apartment last week, she wasn’t thinking about any of that. A swarm of government movers in red overalls carried in her shelves and armoires, whose wooden legs were warped and bloated by 30 years of rainstorms. She peeked out the window of her new bedroom, which overlooked a field strewn with garbage.

Her niece, June Rubins, who had moved into an apartment one floor up the week before, helped her aunt sort through the bags and boxes coming in the door.

She wondered aloud if there were any good public schools around, or if the nearby factories might be hiring. She hoped so, since the city center was a 30-minute drive.

“If you’re desperate and God provides, you must not complain. You must just say thank you,” June said. “It’s a great opportunity for us, even if this place is far away.”

Beyond the gallery wall: Art world retrains the public, virtually

“Art that transcends boundaries” is taking on new meaning in the pandemic era. And museums are adapting, with more seeing the online world as opening the door to an additional “campus.” 

Courtesy of The Peabody Essex Museum
The Peabody Essex Museum offers livestreamed yoga classes like this one, held within artist Anila Quayyum Agha’s “All the Flowers Are for Me” installation.
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It’s not a new rule of thirds that the art world wants to embrace: An estimated 1 out of 3 museums could close permanently as a result of the pandemic. But like many types of nonprofit and for-profit businesses, museums and galleries have spent the past six months getting creative.

There are virtual exhibit tours, artist interviews, educational classes, and more, with some surprising benefits: the ability to reach a global audience, to provide access to those with restricted mobility, and to attract young people. “No matter how old school one might be,” says gallery owner Sundaram Tagore, “people in the art world were recognizing that technology is pervasive, and we all need to adapt to it. COVID-19 has accelerated that process.”

With travel limited, artists and their promoters are networking less in person. Art collectors and aficionados have more opportunities to assess blank walls that need filling. Painter Jeanne Rosier Smith credits a live video exhibit opening for a boost in sales of her work. “People are staying home with their families,” she says. “Their worlds have become smaller. They are looking around their space and wanting to bring joy and beauty into their lives now more than ever.”

Beyond the gallery wall: Art world retrains the public, virtually

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When a pipe burst in January at the Center for Maine Contemporary Art, it caused a flood that shuttered the popular museum in Rockland for a few months. The crisis forced a deep dive into technology to keep audiences engaged – and it left the CMCA staff better prepared for the pandemic-related shutdown in mid-March. 

“The flood gave us a head start so that when COVID hit, we could respond rapidly and continue to offer the three-dimensional, virtual tours that we’d just produced,” says CMCA Executive Director Suzette McAvoy. “We’d also received some great feedback by then, so we were awarded a grant that has helped us move forward.” 

As museums and art galleries look for the resources to stay open and preserve staffing, some are finding that a hybrid approach – part virtual, part in-person – is the best way to engage with the public. 

“For a long time, it’s been hard for people to understand the role that digital can play in the life of a museum. But since we were forced to go digital in March, even our directors now refer to digital as our ‘third campus,’” says Derek O’Brien, chief marketing officer for the Peabody Essex Museum in Salem, Massachusetts. The PEM, with campuses for both the museum and a collection center, recently reopened at limited capacity for fewer days than usual and will continue to host virtual events. 

At a time of uncertainty, the art world is mustering as many options as it can. Museums from Los Angeles to New York have been laying off and furloughing hundreds of employees since March. In July, the American Alliance of Museums (AAM) released findings of its survey of 760 museum directors, including those from non-art institutions, confirming the extent of the economic toll caused by pandemic closures. The group warned that 1 out of every 3 museums could close permanently as financial reserves and funding sources dry up. 

Courtesy of CMCA
The Center for Maine Contemporary Art in Rockland is inviting visitors to its airy in-person space, while also offering online events such as art lab workshops.

All told, the ripple effect could be devastating, according to the AAM. “Museums support 726,000 direct and indirect jobs and contribute $50 billion each year to the economy,” the group said in a statement in July. 

Lasting success for galleries in particular could come down to survival of the most innovative, according to Barry Schwabsky, art critic for The Nation. “Many galleries may not survive the crisis, but those that do will have to be more creative in their thinking, and perhaps smaller and more nimble as well as more collaborative in their ways of working,” he wrote in a July 1 article, “What Are Art Galleries For?”

Reimagining interaction with art

After six months of thinking on their feet, many galleries – and museums – are proving Mr. Schwabsky’s point. They are stepping into the virtual realm with exhibit tours, artist interviews, educational classes, and more. They are also discovering some surprising benefits: the ability to reach a global audience, to provide access to those with restricted mobility, and to attract young people. 

Also, with travel limited, artists and their promoters are less busy jetting around the globe in a whirlwind of networking events. Likewise, art collectors and aficionados are staying home more, offering more opportunities to assess blank walls that need filling.  

Those interviewed concur that even the most dazzling virtual presentation cannot replicate the experience of viewing art in person, but they acknowledge the vital importance of what’s often referred to as net art, and even seem upbeat about the hybrid experience that they agree is likely here to stay.

“It’s a bit of a silver lining,” says Mr. O’Brien, at the PEM, who previously worked in the tech industry. He has been spearheading the online shift at PEM, and while excited about it, says it was difficult in early March when the museum had just opened a major exhibit on Jacob Lawrence and then, because of the pandemic, had to quickly capture it digitally for a virtual tour.

Transcending boundaries 

Sundaram Tagore, owner of the 20-year-old Sundaram Tagore Gallery with locations in New York, Singapore, and Hong Kong, says the pandemic-induced plunge into the digital realm was bound to happen. “No matter how old school one might be,” he says, “people in the art world were recognizing that technology is pervasive, and we all need to adapt to it. COVID-19 has accelerated that process.” 

Courtesy of The Peabody Essex Museum
In April 2020, the Peabody Essex Museum held a virtual Q&A with producer and director DeMane Davis, whose most recent work is "Self Made: Inspired by The Life of Madam C.J. Walker," which debuted March 20 on Netflix. The four-part series stars Octavia Spencer, Blair Underwood, Carmen Ejogo, and Tiffany Haddish.

His gallery, which states that its goal is to “provide venues for art that transcends boundaries” and is now open in all three cities, has embraced technology. His team has developed sophisticated 3D virtual tours, set aside private viewing rooms, and provided clients a tool to visualize how paintings would look in their homes. Mr. Tagore also likes to promote studio visits with artists – but they must have a bit of star quality, he says. Hiroshi Senju is one artist, he says, who is a natural for this medium. “Just producing art is no longer good enough,” he explains. “An artist needs to speak well and be engaging and entertaining, or they will be left behind.” 

Jeanne Rosier Smith is one artist who has learned to love the camera. But it took a bit of time. Ms. Rosier Smith, who paints in her studio outside Boston and is represented by several East Coast galleries from Boothbay Harbor, Maine, to St. Simons Island, Georgia, typically enjoys mingling with people at art openings and was tentative at first about taking these events online. 

But with pandemic restrictions halting those in-person openings, she realized she needed to jump in. With 35,000 followers on Instagram, she recently chose Instagram Live as a venue for a virtual tour of her exhibit at Gallery 31 in Orleans, Massachusetts. To her delight, the event generated the briskest month of sales of her two-decade career. “I’ve been shaking my head in disbelief,” she says. “More than 400 people watched, from California to Colorado and Texas. That would never have been possible in person.”

While she credits the virtual venue for helping to broaden her reach, she also says the response speaks to something deeper. “People are staying home with their families. Their worlds have become smaller. They are looking around their space and wanting to bring joy and beauty into their lives now more than ever.” 

Editor’s note: As a public service, we have removed our paywall for all pandemic-related stories.

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Who’s really ‘in the room’ of Afghan peace talks

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Peace talks rarely look like this. In a historic first for Afghanistan, the Taliban and leaders of the country’s elected government sat together Saturday in hopes of ending a 19-year conflict. Their ongoing negotiation will be closed-door, implying any final deal will be imposed top-down – much like peace deals in history. Yet these days, when more people know the benefits of peace and have the tools to advance it, plenty of players are in “the room where it happens,” in the words of the musical “Hamilton.”

At the table in Qatar is a group most at risk of the Taliban being allowed to revive their harsh Islamist rule (from 1996 to 2001). The government team includes four women. Also in the room during the opening talks were representatives of 13 countries. They gave supporting statements of the elected Afghan government. A more vicarious presence in the talks are the people of Afghanistan, especially youth. In polls, they have clearly let the Taliban know that violence is not a path to power.

These first direct talks between Afghan and Taliban delegations may be closed-door. But fresh breezes of peace are blowing in.

Who’s really ‘in the room’ of Afghan peace talks

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AP
Taliban negotiator Abbas Stanikzai, right, with his delegation attends the opening of the peace talks between the Afghan government in Doha, Qatar, Sept. 12;

Peace talks rarely look like this.

In a historic first for Afghanistan, the Taliban and leaders of the country’s elected government sat together Saturday in hopes of ending a 19-year conflict. Their ongoing negotiation will be closed-door, implying any final deal will be imposed top-down – much like peace deals in history. Yet these days, when more people know the benefits of peace and have the tools to advance it, plenty of players are in “the room where it happens,” in the words of the musical “Hamilton.”

At the table in Qatar is a group most at risk of the Taliban being allowed to revive their harsh Islamist rule (from 1996 to 2001). The government team includes four women. They are there not only to protect women’s rights and achievements – some 40% of girls now attend school – but also to show the Taliban that equality in citizenship has become a global norm. The world has shifted since the Taliban were ousted in the post-9/11 invasion by the United States.

Also in the room during the opening talks were representatives of 13 countries. They gave supporting statements of the elected Afghan government. Few wars are local affairs anymore, as the world has become too intertwined. Demands for peace are more prevalent. In the Afghan talks, this common demand even included rival powers, such as the U.S. and Iran as well as India and Pakistan.

A more vicarious presence in the talks are the people of Afghanistan, especially youth. In polls, they have clearly let the Taliban know that violence is not a path to power. In addition, the Afghan people “will make the final decision” on a peace deal, the government vows. Democracy, like women’s rights, has become too widespread for the Taliban to ignore.

All these players are putting pressure on the Taliban to declare a long-term cease-fire, a precondition by the government before the talks can move to other issues. The fact that both sides released prisoners before the negotiations and the Taliban even agreed to talk are signs of how negotiations work these days – in honor of popular sentiments from the people they represent and in responding to global or regional desires for an end to such wars – especially during a pandemic and recession. 

These first direct talks between Afghan and Taliban delegations may be closed-door. But fresh breezes of peace are blowing in.

A Christian Science Perspective

About this feature

Each weekday, the Monitor includes one clearly labeled religious article offering spiritual insight on contemporary issues, including the news. The publication – in its various forms – is produced for anyone who cares about the progress of the human endeavor around the world and seeks news reported with compassion, intelligence, and an essentially constructive lens. For many, that caring has religious roots. For many, it does not. The Monitor has always embraced both audiences. The Monitor is owned by a church – The First Church of Christ, Scientist, in Boston – whose founder was concerned with both the state of the world and the quality of available news.

Prayers for Belarus

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Can a prayerful stand for justice and freedom make a difference? As one woman found when faced with an oppressive situation at work, the answer is yes – and this can offer hope and inspiration for our prayers in support of those championing positive change in Belarus and elsewhere.

Prayers for Belarus

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Today's Christian Science Perspective audio edition

My husband and I have dear friends who live in Belarus, which is experiencing protests on an unprecedented scale in the aftermath of an election widely believed to have been rigged to favor longtime leader Alexander Lukashenko. It would be disheartening to think that all we can do is stand by and listen to the news, with no way to support the cries for freedom.

But through my study and practice of Christian Science I’ve seen that there is strength in active, prayerful protests for spiritual truth – in prayers based on the idea of God as the all-loving and all-powerful divine Principle. Mary Baker Eddy put forth this understanding of God, and how this spiritual Principle truly governs each of us, as she studied the instruction and effective, healing works of Christ Jesus.

This idea of God and healings that have resulted in my experience have given me confidence that we can rely on the power of prayer to bring release from oppression of all kinds, including physical, emotional, financial, and even political oppression.

Though nowhere near the scale of the circumstances in Belarus, I experienced at one point in my career how such spiritual understanding can make a difference when a change of the old guard is needed. I was working in what seemed a very oppressive environment. There was little joy expressed. Employees felt their abilities and ideas were stifled. Management’s communication often came across as abusive, and their actions inappropriate.

I began to pray every day to better understand God as omnipotent, omnipresent, and omniscient – in other words, supreme, always present, and all-knowing.

As God is omnipotent, there is no other legitimate power, ego, or personality to rule against God’s children. Infinite Love does not share governance, will, power, or strength with any other supposed will. Infinitely powerful good, God, reigns.

God is also omnipresent divine Truth. Evil, including oppression, would suggest that God can be absent. But Mrs. Eddy’s book “Science and Health with Key to the Scriptures” explains: “Because Truth is omnipotent in goodness, error, Truth’s opposite, has no might. Evil is but the counterpoise of nothingness. The greatest wrong is but a supposititious opposite of the highest right” (pp. 367-368). God is everywhere. Divine Truth and Love are never absent.

As the one divine Mind, God is omniscient. Despite contrary appearances, there are not many competing minds warring against each other. All of God’s ideas, or children, express this divine Mind, which includes only harmony and inspires solutions. In a collection of smaller writings, Mrs. Eddy states: “Immortal Mind is God; and this Mind is made manifest in all thoughts and desires that draw mankind toward purity, health, holiness, and the spiritual facts of being” (“Miscellaneous Writings 1883-1896,” p. 37).

I knew that this was the spiritual reality, even though what was happening at work didn’t line up with it. So my prayers affirmed that we could all, including the administration, feel the peaceful, harmonious governance of God, divine Love. This helped me feel calm and certain that a solution would come forth.

And it did, very quickly. After a couple of weeks, during which I had been prayerfully protesting in this way, one morning our boss came in with a surprise announcement that some in management were voluntarily retiring early. And the reason given? “They wanted their freedom.” The atmosphere at work turned around completely. We had all been set free.

This experience illustrates to me the basic point that needs to be seen in regard to the much more severe circumstances in Belarus. It helps me trust that prayer based in divine Love’s omnipotent, omnipresent care for all His children can support those standing for change in that nation (and beyond). God’s supremacy and law of good is here, and powerful enough to lift injustice and fear.

A Bible promise assures us, “I will overturn, overturn, overturn, it: and it shall be no more, until he come whose right it is” (Ezekiel 21:27). Children of Belarus, be assured, the divine Father-Mother of us all is present everywhere to impart justice, wisdom, peace, and prosperity to all, including to your warm and tender hearts. This is your divine right. We kneel in prayer with you.

A message of love

Seeking shelter

John Locher/AP
Shayanne Summers holds her dog Toph after several days of staying in a tent at an evacuation center at the Milwaukie-Portland Elks Lodge, Sept. 13, 2020, in Oak Grove, Oregon. “It's nice enough here you could almost think of this as camping and forget everything else, almost,” said Ms. Summers, who evacuated from her home near Molalla, Oregon, after it was threatened by fire.
( The illustrations in today’s Monitor Daily are by Karen Norris. )

A look ahead

Thanks for starting your week with us! Come back tomorrow for the final episode of “Perception Gaps,” Season 2. It looks at the thinking around solutions for mass incarceration. 

Also, a reminder: If you’d like to check out some of the faster-moving news stories that we’re watching, jump over to our First Look page, which we recently reformatted. We hope you’ll check it out!

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