For nearly six decades, Vivian Scarpati has lived within blocks of the Gowanus Canal in Brooklyn. In the 1970s, she married a man who lived on her street. Her husband’s family had lived a block east of the Canal—for four generations.

Tragedy struck in 1981: Scarpati’s husband, James, passed away from lung and bone cancer at 33 years old, leaving her with two kids to raise. Perhaps only a coincidence, her husband’s grandfather also died young of cancer.

And perhaps also only a coincidence, the Gowanus had long been a heavily polluted industrial area. The Canal was created in the 1860s to bring raw
w material to rapidly developing residential Brooklyn. Within years, toxic waste was in the water and on its banks.

“There were other people in the neighborhood who died around the same age, so we always wondered,” Scarpati said. For over 25 years she has wondered; no one has conducted a comprehensive study of residents’ health in the area.

It is impossible to conclusively link Scarpati’s death, or illness in general, to contamination, scientists say. There can be myriad possible factors. Even so, for residents who live near the Gowanus Canal, concerns about toxic hazards are certainly legitimate. Dangerous chemicals—usually measured in parts per million or billion—have been measured in parts per hundred here.

“It’s dangerous, let’s face it,” said Linda Mariano, a neighborhood resident since 1974 and member of the group, Friends and Residents Of the Greater Gowanus. “The federal government said it’s highly toxic,” she said, as she stood on the Carroll Street Bridge gagging on the putrid air. “There are dozens of contaminants that I can barely understand or even read, they’re so exotic sounding. But they are real. And we should not be living with this.”

They may not have to. After years of debate, the federal Environmental Protection Agency fhas inally declared the Canal a “Superfund” site. It’s a designation reserved for the nation’s most contaminated toxic waste sites.

Yet a careful examination by the NYCity News Service of thousands of pages of documents has illustrated just how entrenched the pollution actually is. As early as the 1880s, local residents have protested the contamination, sewage overflows and foul odors. Public records have also revealed a number of companies are potentially liable for clean-up costs. Some joined with developers and property owners to form a coalition opposed to Superfund and to support the city’s plan. Details also emerged about the city’s strategy to avoid a listing. And interviews with various stakeholders and scientists have illuminated the complex nature of a cleanup, potential health risks accompanying development plans, and competing visions for the Canal’s future.

For nearly a year, residents, politicians, businesspeople and others battled over the EPA’s consideration of the 1.8-mile waterway for a Superfund listing. Mayor Michael R. Bloomberg opposed the Superfund process and instead the city presented its own alternative clean-up proposal. His administration said a listing would lower property values and delay or even kill ambitious development plans for the area.

EPA Regional Administrator Judith Enck has disputed some of the city’s claims and said the Superfund process was superior to the city’s alternative. “We have determined that it is the most efficient and comprehensive cleanup,” Enck said, estimating it would take 10-12 years. She also added that it took decades for the Canal to become polluted so a cleanup that lasts as long should be reasonable. “This is not going to happen overnight,” Enck said.

Although the Superfund cleanup will take years, and possibly decades, some local residents can hardly contain their excitement when envisioning a clean canal.

“If we were able to clean it up and restore the ecosystem—wow, what a great resource it could be for the community,” said Ludger Balan, an area resident and program director of the Urban Divers Estuary Conservancy, an environmental group. “Engaging people in coming out to the water—it could be a place you could bring your kids.”

Balan has long studied the Canal and sees more than just pollution when he scans the banks. He sees America’s growth, including when the nation’s first president visited the area. “The kind of history the Canal has, there would be plaques all along it: ‘Here’s where George Washington sailed across.’ ‘Here are the historic bridges,’” said Balan.

But that’s only a vision. “For our community, it’s been no more than a blight,” he said.

The prospect of economic development along the Canal has long been appealing. The Canal sits in a valley between the desirable neighborhoods of Park Slope and Carroll Gardens. For Mayor Bloomberg, whose legacy includes rezoning former industrial areas into a mix of residential and other uses and who has cheered new construction, the location is too tempting not to pursue.

The city claimed there was no time to waste and that polluters would pay sooner for a cleanup if the Canal was not on the Superfund list. But development critics argued that a comprehensive cleanup was required and that this would happen only under Superfund.

Officially the “Comprehensive Environmental Response, Compensation, and Liability Act of 1980,” the Superfund process forces polluters to pay for cleanups, through lawsuits if necessary. If polluters cannot be found, then the EPA is able to use some of its own funds. The EPA estimates the total cost of the Gowanus Canal cleanup will be about $300-500 million.

The EPA’s announcement clears the way for the next stage of the process to begin. The EPA says it hopes to complete a Remedial Investigation and an Ecological and Risk Assessment by the end of the year.

Understanding how the Canal is polluted is key to finding a comprehensive solution. It is, however, complicated. At least three distinct areas have been polluted.

LAYERS OF POLLUTION

First is the water itself. The quality of the water has been tainted over time, due to accidental and intentional toxic spills. Complicating matters, due to its relatively low level, the Canal receives sewage overflow and street run-off that cascades from surrounding neighborhoods when it rains heavily. This is often the source of pathogens in the water and the material seen floating on its surface.

Second, pollution is present in the Canal banks and the land farther from the water, known as the “upland” areas. Over generations, the pollution—from direct spills or waste disposal—has spilled onto the land nearer Carroll Gardens and Park Slope, both of which are family neighborhoods. Also, because of the soil composition, some of the contaminants have seeped from the water into the land—sort of a two-way toxic street.

Third, at least six feet of sediment make up the bed beneath the water. Contaminants include coal tar sludge, heavy metals, PCBs, pesticides, and volatile organic compounds, all of which can be carcinogenic. Scientists also talk about a chemical “plume” that exists below the sediment. It contains some of the most hazardous toxins that possibly leach into the water. Roughly the top three feet of sediment are comprised of settled material. The bottom three feet consists of accumulated sediment that traces its contamination back over a century and a half.

One of the most spectacular incidents was a massive 1976 fire at the Patchogue Oil Terminal. It destroyed underground fuel tanks and resulted in about 2 million gallons of oil spilling into the Canal—at the time, the largest oil spill in the nation’s history.

But this sort of pollution wasn’t always there. Prior to the days of Abraham Lincoln and the Civil War, the Gowanus was a tidal inlet comprised of small creeks winding through fertile salt marshes. Before the 1860s, the Gowanus Creek was teeming with oysters, shrimp, soft-shell crab, lobsters, clams, a host of fish species, as well as deer and beavers that roamed the grasslands, and a remarkable array of bird species. But by the second half of the 19th century, an exploding population and the rise of manufacturing began rapidly destroying the animal and plant habitats.

In the late 1840s, the United States’ western border had just recently reached the Pacific Ocean and steamboats roared through bays, inlets, and rivers transporting materials for the country’s rapid expansion. To accommodate growing industrialization, in 1848 the New York State Legislature authorized the construction of a canal, two and a half miles long, secured by bulkheads that would allow ships to navigate in and out. By the 1860s the Canal was completed, and it quickly became the hub of Brooklyn’s maritime and commercial activity. Stone that was used to build up brownstone and limestone homes was brought in through the Gowanus.

Coal yards, sawmill and lumberyards, coal manufacturing gas plants, oil refineries, printing, paint and ink factories, cement makers, a tartar manufacturer, soap makers, chemical plants, machine shops and tanneries sprouted up along the embankments.

Within a few short decades neighborhood residents began to complain about pollution and odors. The contamination was compounded by a sewer system that deposited raw waste from surrounding neighborhoods directly into the canal and residents’ dumping of garbage in the streets and water.

In 1880 and 1885 the Canal was dredged to deepen the water, which had become so shallow from sewage and waste that ships were getting grounded in the muck.  As government officials and business owners fought over who would pay for canal cleanups and improvements, some local residents concluded that the Canal should be closed altogether. A commission was formed in the late 1880s to study the issue and then report to the mayor.

The pollution was the death knell for Gowanus’ sea and plant life. Though the state passed a bill making it illegal to dump industrial waste and refuse into waterways containing oyster beds in 1886, businesses flagrantly ignored the law.

WHO MAY BE RESPONSIBLE

Hundreds of companies and government entities have polluted the Gowanus Canal since it began hosting ships with industrial cargo in the 1860s. Some continue to pollute today.

The most notorious actors were three manufactured gas plants (MGPs), which spewed coal tar and chemicals into the water and onto the banks of the Canal. These plants produced fuel oil for gas street lamps and heaters during the 19th and 20th centuries.

Near the turn of the 20th century, the MGPs were acquired by Brooklyn Union Gas, which operated them into the 1960s. Eventually, through various mergers and acquisitions, National Grid, a multinational electricity and natural gas corporation, became the owner of the three sites. The company has been working with the state Department of Environmental Conservation through its “Brownfield” program to clean up the contaminated land so that it can be redeveloped for other uses.

Today, National Grid and others may be on the hook for cleaning up both their own sites and the Canal itself.

In 2007, National Grid’s predecessor company, KeySpan, prepared a report identifying the nature and location of contaminants, as well as many of the industrial companies that have existed along the Canal.

Karen Young, a spokeswoman for National Grid, said the company had supported the city’s alternative cleanup plan because it closely would have involved the U.S. Army Corps of Engineers, which has already been working on a Gowanus cleanup project. Also the Army Corps has unique experience working in urban waterways around the country.

Bloomberg officials consistently cited the city’s partnership with National Grid as proof they could get responsible parties to voluntarily step forward to contribute funds for a cleanup, which was a linchpin of their plan. They argued that many years of litigation would delay the cleanup process as companies defend themselves against EPA lawsuits; this scenario has played out at other Superfund sites.

Caswell F. Holloway, the commissioner of the city Department of Environmental Protection and the mayor’s point man on the Gowanus issue, explained last year how the city would have gotten companies to voluntarily pay: “We’re saying ‘Look, you’re going to have to get involved in this one way or another-—either you’re going to be sued and get forced to pay or we can work out a plan, get it done more quickly, and you don’t have to go through the cost of litigation and so forth,’” he said.

The city hoped that it could leverage its relationship with the Army Corps to provide an added financial incentive for companies to step forward on their own. City officials wanted use federal matching funds from Congress through the Water Resources Development Act. They said this would provide 65 percent of the total cost, leaving only 35 percent to be paid by the city and liable companies, reducing the portion those companies will have to pay. However, the federal funds are not guaranteed.

State officials were not convinced. In an August letter to Holloway, Stuart F. Gruskin, the executive deputy commissioner of the state Department of Environmental Conservation, which had originally requested the EPA consider the Gowanus for its Superfund list, seemed doubtful about the viability of the city’s plan. “There are many assumptions in the proposal, including among other things, a requirement for a very high degree of cooperation among responsible parties,” he wrote.

Holloway also pointed to National Grid as a party that could have signed a binding agreement with the EPA to clean the Canal, an agreement legally required by the alternative approach under which the city submitted its plan. Yet the company appeared to be open to working with the feds whether the Canal was listed or not.

“Given the positive interaction that we have had with the EPA and the openness towards all ideas that they have shown, we are confident that these same benefits can be achieved with either the traditional or alternative regulatory process,” Young said.

In its announcement designating the Canal a Superfund site, the EPA named a number of companies it is holding responsible for contamination (potentially responsible parties or PRPs), with more to be identified in the coming months. Walter Mugdan, the Superfund director for the region, said that an agreement has already been reached with National Grid. Other PRPs include the City of New York, the U.S. Navy, Con Ed, Chemtura Corporation, Rapid American Corporation, Brinks, Beazer East, and Cibro Petroleum Products.

ConEd, the major gas and electric utility, had reportedly spilled oil and gasoline from 14 underground storage tanks located just two blocks east of the canal. In 2002 it removed those tanks, which were the subject of at least six reported spills. Besides the reported incidents, regulators have found illegal levels of volatile organic compounds and lead in the soil and groundwater near the old tanks.

This location used to be closer to the water. Prior to the 1950s, the 1st Street Basin extended from the Canal eastward toward 3rd Avenue. It was filled in sometime between 1953 and 1965. It is unknown what contaminants might be in the landfill.

Bob McGee, a spokesman for ConEd, said that the company’s environmental department wasn’t aware of the 1st Street Basin. “We don’t feel we have a role based on where we were located and what we did,” he said before the EPA made the Superfund designation.

The EPA requested documents and information about two of ConEd’s facilities – the refueling and truck yard near 3rd Avenue and its Gowanus substation located at the intersection of 27th Street and 3rd Avenue. ConEd lawyers replied with a detailed, firmly worded response.

“Con Edison expressly denies any liability for contamination at the Gowanus Canal Site, or for any investigation, response or remediation costs for the Gowanus Canal Site,” they wrote.

So at least one potentially responsible party has begun to fulfill the Bloomberg administration’s prophecy of litigation. “Obviously, there are a lot of lawyers involved. Who knows where it’s going to go,” said McGee.

A slew of toxic chemicals have been detected in the soil surrounding Chemtura Corporation’s former plant near the mouth of the Canal. Chemtura acquired the property in 2005 when the previous owner, Witco Corporation, was merged into the larger organization. Today, Chemtura is a global corporation with $3.8 billion in annual sales. The Gowanus plant closed in 1999, but before that groundwater samples had shown elevated concentrations of benzene, acetone, lead and cadmium and other chemicals. A phone message left with Chemtura seeking comment was not returned.

In recent months, the EPA sent more than 20 letters notifying other companies that they may be on the hook to pay for the cleanup.

One of the recipients of those letters was Amerada Hess Corporation, a global oil and natural gas company, which has operated a petroleum terminal at the mouth of the Gowanus since 1977.

Since the mid-1980s, when the federal government began maintaining detailed databases of hazardous spills, the Hess terminal has had at least 15 reported spills, leaks or instances of contaminated soil, with over 1,200 gallons of diesel and fuel oil spilled or leaked either directly into the canal or onto the land. It also occupies the site of the former Patchogue Oil Terminal, where the 1976 fire spilled millions of gallons of oil.

In early 2008 Hess settled a lawsuit brought by the state DEC alleging violations at the facility’s tanks and bulkheads, by paying $1.1 million.

Lorrie Hecker, a spokeswoman for Hess, said in an e-mail that the company is cooperating with the EPA but declined to comment further.

Bayside Fuel Oil Depot Corp., a family-owned fuel company with one active terminal on the Canal, also received an EPA letter. Up until 2005 it had operated a similar facility near the head of the Canal, selling various types of fuel oil, kerosene and diesel. There is still a potent smell of petroleum and one can see a slick sheen on the surface of the water near Sackett Street where it was located. Government records indicate that Bayside has spilled at least 300 gallons of fuel oil at its two facilities since 1990.

Reached on the phone, an unidentified Bayside representative said that they are barred from speaking about the Canal by the U.S. Department of Homeland Security.

Today, the area along the Canal remains partially industrial, but much less so than in the past. Busy cranes can still be seen scooping scrap metal from yards onto barges. The last large-scale industry that exists here is the cement business.

Ferrara Brothers Building Materials, one of the largest concrete providers in the city, has operated at the major bend in the Canal on the west side at Hoyt Street between 4th and 5th Street since the early 1970s.

The company was one of three that the environmental organization Riverkeeper threatened to sue in September after it allegedly observed Ferrara polluting the Canal. Riverkeeper says it observed and documented the company discharging liquid cement and stone into the water.

Ferrara Brothers greatly benefitted from the building boom of the last few years. It produces half a million cubic feet of concrete annually—about half comes from the Gowanus plant—for major projects in the city, including the new Mets’ Citi Field baseball stadium and the Second Avenue Subway.

As of April, a representative from Riverkeeper said that the state was taking enforcement actions against Ferrara Brothers and 107 Sixth Street LLC and 32-2nd-J Corp., which jointly operate a parking lot on their property.

The third company Riverkeeper was pursuing, 6th Street Iron and Metal, has taken substantial steps to clean its shoreline, said Joshua Verleun, an attorney and investigator for Riverkeeper. It moved large piles of metal further away from the edge of the canal and built a concrete wall along the edge of the property. Verleun has been patrolling the Gowanus on the organization’s boat at least nine months of the year since 2005, looking for violators of environmental laws.

Ferrara Brothers has been in the unkind spotlight before. In the early ’90s, The New York Times reported it was accused of making payoffs to the Colombo crime family in exchange for favors. Calls to Ferrara Brothers were not returned.

CONFLICTING INTERESTS?

Others involved with the Canal have connections that have not been previously disclosed before now. Some were prominent figures in the run-up to the Superfund decision.

Holloway, who had been the point man for the Bloomberg administration on the Gowanus issue over the last year, is also the son of a prominent luxury residential developer, Caswell F. Holloway, III. The younger Holloway has attended community meetings and has been heavily involved in developing the specifics of the city’s alternative clean-up plan. He is now the newly-appointed commissioner of the city DEP, but had no prior environmental experience, having previously worked at a corporate law firm before joining the mayor’s office.

The elder Holloway’s business, C.F. Holloway, III and Company, which builds fancy houses and small-scale developments outside Philadelphia, Penn., has no vested interest in property along the Canal. But critics who say Mayor Bloomberg opposes the Superfund listing simply because he wants to save private development like the Toll Brothers luxury residential project, may be suspect. Repeated requests for an interview with Holloway for this story were denied.

Owen Foote, the treasurer of the Gowanus Dredgers Canoe Club, a local nonprofit, had criticized the potential Superfund designation while at the same time serving as an assistant vice president with the New York City Economic Development Corporation, which has board members appointed by the mayor.

“Any and all statements made [regarding the Gowanus] have been in my personal time and not while employed by the EDC,” Foote said in an email message. “What I do for a living has no relation to my hobby,” he added.

The Gowanus Dredgers are not directly supported by the city government, but take funding and grants from private donors, including the Citizens Committee for New York City, which is supported by city government funds. Also, if Toll Brothers is able to develop a condominium project on the canal’s banks, it would build a boathouse where the Gowanus Dredgers could store its canoes. Officially, the club did not have a stance about the Superfund controversy.

Since April 2009, the city worked to avoid a Superfund listing, both publicly and behind the scenes. While developing its own clean-up plan, the city employed a high-powered Washington, D.C. lobbying firm to provide consulting and technical services. Dawson & Associates specializes in water and environmental issues and regulatory compliance.

At a June meeting between EPA and city officials, three Dawson employees—Stephen D. Luftig, Dr. Jonathan P. Deason and Lester Edelman—attended on behalf of the city. Each has extensive connections in Washington to the agencies and players that will decide if the Gowanus Canal gets listed as a Superfund site, in addition to a high-level of expertise on environmental regulation. Although the mayor’s office says the three were not involved in lobbying activities, on the company’s Web site, it says the “firm has access to leaders and opinion makers in Washington.”

Marc LaVorgna, a mayoral spokesman, said that Dawson & Associates was retained because of its substantive expertise with the Superfund process and the Water Resources Development Act. “They did not have a role in lobbying Washington officials,” he said. “City officials, including the Mayor, have made our case in Washington.” While the Superfund decision was pending, Mayor Bloomberg called EPA Administrator Lisa P. Jackson on at least one occasion.

HOW DANGEROUS ARE THE CHEMICALS?

In 1997, Ben Longstreth, a member of Baykeeper, an environmental group, placed a mound of oysters covered in netting in the Gowanus Canal, as part of a project to test the health of various New York waterways.

The oysters died within a week. “They were white—seemed like they had just been bleached and then it looked like a rat had clawed a hole in the net,” said Longstreth. “It seemed to be purely a toxicity issue.”

The oysters’ plight is a far cry from the days when they bloomed in the Gowanus Creek. Dutch travelers visiting the area in 1679-1680 deemed them the best in the country. “They are large and full, some of them not less than a foot long, and they grow sometimes ten, twelve and sixteen together,” Jasper Dankers and Peter Lyster marveled in their journal.

Over 300 years later, the Canal’s water and surrounding soil have been contaminated with numerous chemicals and thousands of people have lived in the immediate area surrounding the Canal.

“If somebody were to do a health survey, they would find that people who grew up in these environments all their lives and raise children in these environments have issues,” said Balan of Urban Divers. “And most people in my neighborhood, elders that I’ve met, who have come and died in my time, they’ve died of cancer.”

The city Department of Health does study cancer clusters, but doesn’t break down data specifically for the Gowanus area. The exact risks to human health are debated within the scientific community. Experts do agree that eating fish or swimming in the Canal is considered highly dangerous, but the health risks of simply living near the Canal are less clear. There has never been a comprehensive health study of the area around it.

James Corrigan, a biologist who has studied the Canal for over 30 years, stood on the Third Street Bridge looking down and yelling at some brave folks paddling a canoe. Earlier in the morning, he had been helping one of his graduate students collect samples to test water quality and thought it was important to warn those below. “If your hands were near the water you should go home and launder the clothing well and wash your hands well,” he said, leaning against the drawbridge railing. “What you’ll find in here is fecal contamination bacteria.”

Corrigan was talking about the pathogens found in floating raw sewage. It had rained the night before. Following heavy rains, the sewage overflow runs into the Canal and contact with the water can lead to staph and e.coli infections.

Additionally, Corrigan is concerned about effects of contaminants from a process known as biological amplification. Levels of toxic chemicals become more concentrated, and more toxic, as they make their way through the food chain. Not only is this a problem as it relates to eating fish from the Canal, but it is also an issue if people grow gardens nearby.

“Back in 1983 I had the soil in my garden tested, and, as a result grow only decorative plants in the ground. Many people told me I was paranoid,” wrote Christine Mackellar, a neighborhood resident for almost 30 years, in a letter to the EPA. “However, testing conducted in recent years by the people from The Earth Institute at Columbia University confirmed my worst nightmares concerning the levels of toxicity resident in this body of water and its uplands.

While Corrigan stresses the risk of eating vegetables grown on the land, Joshua Cheng, a geochemist at Brooklyn College, says the risk is greatest from working with the soil. If its contaminants can be ingested – by inhaling dust from a condo construction site or by rubbing an eye after planting gardenias – then the dirt surrounding the canal becomes highly dangerous to human health, he says.

Also, according to Cheng, hydrogen sulfide is one of the biggest risks to human health.  This is the pervasive rotten egg smell in areas of the Canal. Its primary source is human fecal matter in the water. Chronic exposure to low levels of hydrogen sulfide has been implicated in miscarriages and harm to reproductive health.  At high levels it can cause eye irritation, sore throat, cough and nausea.

Another concern is the combined effect of all of the chemicals.

“The health risks of individual compounds are well known,” said Cheng. “But the combination of many contaminants is a huge issue. I don’t think people really know what the risk is.”

While Cheng is more conservative about the health risks of living near the canal and more optimistic about the ability to clean the area, Corrigan is less so.

Given the long history of industrial contamination of the soil, he worries that pollutants are seeping into underground waterways—the land used to be a salt marsh. He argues that attempts to clean the canal will continually be thwarted if the contamination from surrounding soil is not addressed. “The surrounding soil hasn’t been adequately studied,” said Corrigan.

Beyond his concern for plants and vegetable gardens, Corrigan had a more disturbing thought.

“Let’s say everything went well,” he said of plans to develop Gowanus. “The buildings went up, the playgrounds went in, all the wonderful Venice in Brooklyn went in that they want to do. And then 10 or 15 years down the road, all of a sudden they’re getting children coming down with leukemia and all kinds of other medical problems, allergic reactions and everything else. And then they turn around and say the soil has been contaminated all along. Where are we? What went wrong?”

DREAMS OF ECONOMIC DEVELOPMENT

Of course, there are residents who dream of redevelopment along the Canal and see it as the key to the area’s future. Almost all agree that such reinvestment is key to the region. So it’s ironic that the very thing that got the canal into the most trouble – development – is the same thing that might save it.

The Bloomberg administration argued that it made sense for developers to be responsible for cleaning up the land they wished to develop.

Before the EPA decision, the administration maintained that a Superfund designation would harm development prospects along the Gowanus Canal. For the past seven years, the administration has been attempting to rezone the land around the Canal from industrial to a mix of residential and other uses.

Critics accused the city of opposing the Superfund because of its cozy relationships with developers. “The city bent over backwards to try to make developers who want to develop on the Canal happy,” said Verleun of Riverkeeper.

However, the city recently received a letter from the EPA notifying it that it will be potentially responsible for paying a portion of a Superfund cleanup. The city ran multiple facilities along the banks of the Canal, including a Department of Sanitation Incinerator on Hamilton Avenue. This alone would give the city good reason to oppose a listing. Still, stalled development appears to be the driving motivation for Superfund opposition.

A listing could have “a significant negative impact” on Gowanus neighborhood rezoning, said a survey conducted by the Bloomberg administration. The 25-block rezoning was placed on hold pending the EPA’s decision. According to the city, stigma related to Superfund site designations will be an impediment to fast and efficient development.

Toll Brothers Inc., the luxury condo builder, had publicly considered backing out of its plans unless the city’s cleanup plan moves forward. David Von Spreckelsen, a Toll spokesman, said that people would have such little contact with the sediment it wouldn’t be worth the cost to remove it. “It’s a lofty goal to take that out, but what’s the purpose?” he said. Shortly after the EPA announced its decision, Toll Brothers followed through on its threat and pulled out.

During the two years preceding the EPA announcement, Toll and other builders around the nation had backed out of development projects because the financials didn’t pencil. It was one of the worst housing markets in modern U.S. history. Yet in this case Toll Brothers representatives said that a Superfund designation was reason enough to leave.

Other projects have also been stalled. Whole Foods, the gourmet supermarket, had been developing a site just one block from the Canal, but has since suspended construction and has no immediate plans to build the store.

A mixed-use project, Gowanus Village, which was to include townhouses and loft condos, fell through a year before the Superfund controversy erupted. Africa-Israel, U.S.A., which has a controlling stake in ownership of the land, is still seeking to sell the property. When asked if the company was concerned about liability under Superfund, Andy Ashwal, a senior developer, said it was premature for him to comment.

Studies do show that there is a significant stigma associated with a Superfund listing. They also show that this stigma has created real economic impacts to surrounding property values.

Hilary Sigman, a professor who specializes in environmental economics at Rutgers University, points out that to economists, there is a difference between perceived risk from pollution and actual risk. According to Sigman, if people believe property is worth less, then it is worth less.  “To what extent you can say this is Superfund designation or actual contamination is hard to separate,” she said.

Lindsay Wilhelm, a senior project manager for the city’s Economic Development Corporation, conceded that the stigma may not be directly caused by a Superfund designation. “There is a lot of question over whether property values actually drop because of Superfund listing or if it’s just the knowledge of contamination that makes property values drop,” she said.

Enck, of the EPA, directly addressed the suggestion that development would be impeded by the Superfund listing. Pro-development and business groups had claimed that developers within 3,000 feet of the Canal would have difficulty securing private financing and obtaining loans due to the stigma caused by a listing. “Unfortunately, there is already a stigma there,” Enck said. “I reject this as a reason why development can’t move forward.”

The Gowanus Canal is in some ways the exception to the rule because it’s a densely populated area. Most Superfund sites are in solely industrial areas. Another anomaly is that with most cleanups, the choice is usually Superfund or nothing. In this case there was an alternative approach proposed by the city. No major studies have been conducted that look at the stigma or development costs related to an alternative cleanup option.

“We are not saying under the alternative plan there is not going to be any effect on real property taxes,” said Francesco Brindisi, a chief economist with the EDC, before the EPA’s decision. “There is going to be an effect, except that it’s shorter than what the effect would be under the Superfund listing.”

Therein lies the assumption made by city officials advocating for their proposal: that the city’s clean-up plan will take less time than the Superfund process.

The EDC made the same assumption when it conducted an analysis of the tax impact of a Superfund designation. While the EDC says that the actual analysis itself is confidential, officials were willing to talk about the report’s methodology.

Given the two scenarios—Superfund and the city’s alternative proposal—they relied on an assumption that the city’s plan would allow development in five years and that the Superfund cleanup would allow development in eight to 15 years.

If the Canal is not listed, they said, the planned projects along the Canal alone will generate over $500 million in tax revenue. Assuming that a Superfund designation moves forward, the EDC estimates that it will cost the city between $120 million and $189 million in lost tax revenue, depending on the length of the cleanup.

These projections came during the worst recession since the great depression. Despite the economic conditions, the Bloomberg administration reasoned that tax revenues from development would begin much sooner than if the Canal was listed.

“We’re not painting doomsday scenarios where all investment is delayed forever under Superfund designation,” Brindisi said. “Clearly there is going to be investments in the future when it’s cleaned up and the city is eventually going to get some taxes related to those investments. The city would rather have those tax revenues earlier rather than later.”

ANOTHER ERA’S ALTERNATIVE PLAN

The debates about how to handle the Canal’s pollution problems actually parallel the discussion and arguments being made 100 years ago. A mere 20 years after the Canal’s completion, industrialization had already taken its toll.

The Gowanus Canal Commission, formed in 1889, in a report to the mayor, deemed the Canal detrimental to health and called for it to be permanently filled in.

In its few decades of existence, the Canal was already seen as The Brooklyn Eagle put it in 1902, “a festering pool of filth.” Close living quarters throughout the city hadn’t helped—instead, they encouraged disease. Outbreaks of smallpox, cholera, scarlet fever, dysentery, typhus, typhoid, tuberculosis, yellow fever, diptheria, and malaria plagued the city, and disproportionately affected areas like Gowanus, where there were particularly squalid living conditions.

By 1893, it was described as a disease-breeding, foul-smelling, open sewer, and a “disgrace to Brooklyn,” by The New York Times, a notable accolade for a city whose streets were becoming lined with trash, sewage, horse manure, rats, and rotting horse corpses.

Despite the commission’s report, business interests won—the canal was not closed. The city approved an alternative plan to create a flushing tunnel that would continually refresh the waterway by pushing sewage, trash and industrial waste out to sea.

In 1911, the 6,200 foot underground tunnel, equipped with a 7-foot propeller was revealed to great fanfare. The New York Times wrote: “In gala attire, all South Brooklyn took a holiday yesterday to celebrate its long-looked-for emancipation from the evil smells given forth by the murky waters of Gowanus Canal.”

A parade of decorated craft drifted through the waterway surrounded by factories bedecked with flags and cheering crowds. Nine-year-old Jeanne Haviland, who held the honor of “Miss Gowanus,” threw white lilies out into the putrid water, symbolizing its future purity.

While sewage overflows and industrial pollution continued over the next four decades, the flushing tunnel replaced the water in the canal at an astounding rate of five times a day, washing away evidence of its contamination and significantly decreasing the pungent odors of the Canal.

In the 1950s, the creation of the Gowanus Expressway signaled the end of maritime commerce for Gowanus.  In 1955, the Army Corps abandoned its periodic dredging, and six years later the flushing station broke. For decades, the layers of contaminated sediment at the bottom of the Canal and the raw sewage would fester.

In 2009, the Bloomberg administration announced plans to partially address the issue of combined sewer overflows, or CSOs, which have been an inherent infrastructure problem in the city for over 70 years. In October, Mayor Bloomberg announced that $150 million worth of work would soon begin.

Of that, $85 million will go toward enhancing the pumping station, $50 million will go toward expanding the flushing tunnel’s capacity, and $15 million would go toward dredging the 750 feet at the head of the Canal.

Early on in the clean-up debate, the city worried that this work would not be able to move forward if the Canal were to be designated a Superfund site. EPA officials quickly dispelled this notion.

The work will increase flushing rates by approximately 40 percent and will reduce the volume of sewage discharges by 34 percent. For that reason, some residents remain worried that if the sewage is only reduced by a third, then even while the Canal cleanup moves forward—regardless of the process—sewage discharges will continue to pollute the Canal. Add to that the fact that the EPA says a Superfund cleanup will focus on the contaminated sediments in the Canal—not the floating sewage and storm run-off.

Still, as the Superfund cleanup moves forward, all stakeholders will have to temper their expectations about how fast the process can move. Because of the need for a comprehensive cleanup and considering the multiple levels of government involved, the process will be inherently slow. Compromises will need to be made while keeping a long-term vision for the Gowanus and the community’s health at the forefront.

There are 530 calories, 18 grams of fat, and 2/3 of the daily value of cholesterol in a bacon, egg, and cheese from Dunkin Donuts.

Diana Blanco doesn’t care. Blanco, 19, a senior at Lehman High School in the Bronx, gets the breakfast sandwich four times a week.

“The reason I come here is because it’s really close,” said Blanco, as she gestured to her school’s main entrance steps right across the street. “I never eat school lunch.”

But having fast food restaurants so close to schools may pose health risks for students. A recent study by University of California, Berkeley and Columbia University found that California 9th graders who attend schools with a fast food restaurant one-tenth of a mile away are 5.2 percent more likely to be obese.

One in six South Bronx public high school students is obese, a number 30 percent higher than the rest of the borough and 42 percent higher than all of New York City, according to a June 2007 report by the New York City Department of Health and Mental Hygiene.

Lehman High School, near the Westchester Square section of the southeast Bronx, stands near several fast food restaurants. Besides the Dunkin Donuts in front, 40 classrooms on the western wing overlook the track, football field and a White Castle.  A little bit further down the street, the crown of Burger King looms.

All students but freshmen are allowed to leave school grounds for lunch, said Delma Sosa, the community health organizer at Lehman.

“They have a short amount of time for lunch. So they run out and whatever is closest, they eat,” said Sosa, who works for Montefiore Medical Center and visits the school every Monday.

Chris Hernandez, 16, a freshman at Lehman High School, doesn’t like most of his school lunch options.

“I just buy cookies,” he said. So after school, he bounces from one fast food restaurant to another.

Students are more familiar with White Castle sliders (their miniature burgers) than Brussels sprouts and many other vegetables, said Sosa, who introduces new fruits and vegetables weekly to the 30 members of the school’s health club. Sosa says some students come for the free produce and others enjoy learning new healthy recipes.

“It’s not that they don’t want fruits and vegetables. They just don’t have the option,” Sosa said.

In 2008, the New York City Department of City Planning initiated the Supermarket Need Index (SNI) to determine the neighborhoods with the highest levels of diet-related diseases and the largest populations with limited opportunities to purchase fresh foods. Three million New Yorkers live in these areas, including parts of the South Bronx and the Williamsbridge, Wakefield and Pelham Parkway areas of the Central Bronx.

In many of these communities, healthy eating is too expensive.  At Lehman, 3,599 out of the 4,322 students qualify for free or reduced lunch, according to the National Center for Education Statistics.

A 2008 report by the Public Health Association of New York City, says “calorie-for-calorie, unhealthy foods cost less than healthy ones. Since unhealthy food is cheaper, low-income families are often forced to choose items that can lead to health problems over time.”

The abundance of fast food restaurants, especially near schools, makes the problem worse, nutrition advocates say.

“They are predatory. They try to get them young. They purposely locate themselves next to schools,” said Amie Hamlin, Executive Director at the New York Coalition for Healthy School Food.

To help combat this type of marketing, Hamlin’s coalition helps children understand food labels.  A pilot program provides a plant-based lunch menu for students at Future Leaders Institute K-8, a charter school in Harlem. The program also includes nutritional education in the classroom and cooking demos for parents. Hamlin hopes other schools will adopt the program.

“We need to make an environment so all choices are healthy choices,” said Hamlin.

“Parents come up to me and say, “My child always reads the label now. If they see partially hydrogenated oil, they put it back on the shelf,” she said.

Schools can help students make better choices, said Nick Freudenberg, Director of the Public Health program at Hunter College.  They can implement “healthy eating zones,” which parallel the no-smoking zones from a generation ago, he said. These zones would be located around schools and community centers and not allow any vending machines with sugary drinks or any advertisements of unhealthy foods.

Many aging schools, Freudenberg noted, don’t fix broken water fountains. But fixing these fountains and adding more water coolers could help curb soda drinking.

At Lehman, Sosa is working to establish a New York City Green Cart right outside the school. The carts only sell fresh produce like whole carrots, bananas, apples and berries. Sosa hopes these healthy options will have more students forgoing White Castle’s onion rings (540 calories) and picking up an apple for less than a dollar (only 80 calories).

Changing the eating habits of this young, obese community will come about only by changing the culture, according to Hamlin.

“We have to find a way to make a healthy diet hip,” Hamlin said.

Before 9/11, as told by New Yorkers who call Little Pakistan home, their neighborhood in Midwood, Brooklyn was a true microcosm of the old country 7,000 miles away. Today, this enclave, desolate and reclusive, wrestles with population loss and ignorance. And fear.

Residents say the community was thriving with few available parking spots and plenty of jewelry stores, music and DVD outlets, sweet shops, immigration and tax service shops, traditional clothing shops. People would travel from Queens and New Jersey to shop, eat and worship there.

“It was a very lively area,” said Bazah Roohi, 36, a small business owner and long time resident of “Little Pakistan.” “The restaurants [were] busy. Boutiques [were] busy. The grocery store was all the time busy.”

This all changed when the federal Department of Homeland Security created the Special Registration initiative, or Entry-Exit Registration System, a system for registration of non-citizens. It’s primary target is Muslim-majority countries, like Pakistan. Special Registration began in September 2002 in an attempt to remove members of al-Qa’eda and other terrorist organizations from the United States’ borders.

The Council of Peoples Organization (formerly Council of Pakistan Organization) was started in 2002 to respond to the crisis and fear in Little Pakistan that ensued after Special Registration.

According to CoPO, up to 45,000 of the South Asians in Brooklyn left voluntarily or were deported after Special Registration. Those who left voluntarily did so because they were illegal and feared eventual deportation or for other reasons.

They estimate that this cut the immigrant population of Little Pakistan in half.

CoPO also reports that in addition to the closing of 30 major businesses – mostly jewelry stores  – aimed at the Pakistani-American community those businesses left standing incurred losses of between 30 and 70 percent. Restaurants and the remaining jewelry stores were hardest hit.

“Could you imagine a knock on your door and a guy is holding a card like this and you don’t speak English?,” said Mohammed Razvi, the executive director of CoPO. He was holding a tattered, overstuffed album filled with the business cards of FBI and CIA agents with notes handwritten on the back.

“In this school next door to us, 50 students packed-up and left,” said Razvi, seated at his office desk in the heart of “Little Pakistan.” “Fifty students. You’re talking about fifty families.”

Residents have also suffered from post-9/11 discrimination by other locals.

From a worn, heavy, 3 inch thick binder, Razvi read accounts of harassment: A man was stabbed out of retribution for being Muslim, but didn’t tell the police because he was undocumented and feared he deportation. Another account was of an 11-year-old girl walking to school wearing her traditional headscarf. The girl was called a “sand nigger” and spit on by a woman on the street and was told she should be sorry for dropping the Twin Towers.

Where did they go?

“They went to Canada, seeking asylum from the United States, ironically. They went back to Pakistan or Bangladesh,” said Razvi. The residents of Little Pakistan also report that many of those who left went to other states.

According to reports from the Canadian Globe and Mail newspaper, Pakistanis represented five percent of people requesting refugee hearings in Canada in November 2002 and 58 percent in February 2003.

The desperation of this community is being felt all the way down to the economic level, and by everyone.

“They don’t want to spend money. If tomorrow they’ll have to leave things and fabric, everything will be [left] here. At least they have cash. They can get to their country. That’s why they are not spending money,” said Mrs. Jilani, 50, and co-owner of Zoque Fashion on Coney Island Avenue. Mrs. Jilani has been living in the area for 30 years and opened her shop, which sells traditional Pakistani women’s clothing, in 1994. She reports that business is still down for her.

The economic situation in Little Pakistan is particularly acute as the majority of residents are employed as cab drivers, or as small business owners, reports Al Jazeera English. In 2000, the per capita income of a Pakistani in New York City was $11,992 with 28 percent of the population living below the poverty line.

And the global recession isn’t helping.

According to Razvi, besides not being able to speak English, many community members did not know their rights after Special Registration began and many still don’t. CoPO also addresses these problems and offers ESL – English as a Second Language – classes and legal workshops in Urdu, Punjabi and Bengali.

According to numbers from the Office of Immigration Statistics, the number of Pakistani-born aliens deported from the U.S. only began to drop to levels similar to those of 2001 during this past year.

“And now what’s happening is it’s starting to come back,” said Razvi about Brooklyn’s South Asian population. “But it’s coming back from all the filings from family members who had filed [for immigration] for their loved ones for all these years because their cases become current.”

And the numbers demonstrate this. While Pakistanis are still coming to the U.S., they are doing so in fewer numbers. Nonimmigrant admissions for Pakistanis is still down: by 20 percent, for 2008, compared to 2001. But as previously filed immigration cases become current, the number of Pakistanis obtaining U.S. legal permanent resident status has actually increased: 40 percent higher than in 2001.

Razvi estimates it will take up to 15 years for the area to return to the way is was before 9/11.

“It’s starting to come back, but it’s still not there,” Razvi said. “Because even the cab driver was prospering at that time, prior to 9/11.”

According to residents, the deportations have not come to an end, either. Community members with citizenship are reportedly being paid by the FBI when they give information about an undocumented immigrant.

“They complain to the FBI and they [say] ‘He is illegal. She is illegal. They are illegal.’,” said Roohi. “They receive $500 from the FBI. They work for the FBI, still they are working for the FBI. And everyone knows who they are. They are very well known persons. I don’t want to mention their names.”

“A lot people, still, they are scared and don’t want to shop around here,” said Roohi.

 Soon after Nicholas Donaldi-Subero, the 18-year-old son of a Metropolitan Opera singer, was fatally stabbed in Queens, New York in January, some self-declared members of the Latin Kings gang took to the internet to boast about their prowess.

“We shut plenty of clicks down in the past and Corona Queens is not even an exception,” someone named ‘Farrocking’ from Far Rockaway wrote on the site thehoodup.com.

More and more social networking users like Farrockking are boasting about gang exploits, making threats about future activities and posting photos of themselves in gang colors. And increasingly those sites have become helpful tools for law enforcement officials who have used this material to prosecute alleged gangbangers. States like Ohio and California have introduced online evidence to link suspects with street crimes. Meanwhile, Florida has made it a felony offense to post gang-related material online. But this increased presence of both gang activity and law enforcement surveillance online raises questions about how to determine the line between youthful braggadocio and true bad behavior.

 ”If you’re a kid who wants to look cool by posing in gang colors and flashing a sign on your MySpace page it’s pretty chilling that the government can go after you,” said Rebecca Harrison Steele, the Regional Director of the ACLU Foundation of Florida.

Richard “Richy” Figueroa-Santiago has experienced the chill. Sheriff officers in Lee County, Florida, arrested Figueroa-Santiago and 13 others last November on charges that  they were violating a new state law against online gang activity. Figueroa-Santiago has pleaded not guilty.

In an interview, Figueroa-Santiago, 22, said that police singled out one image out of 200 pictures on his MySpace page. He described it as a cartoon of a car with the words “Kings drive-by” (for Latin Kings) written on the body of the car. A spokesman for the Lee County Sheriff’s Office, John Sheehan, said that Figueroa-Santiago was targeted for online gang recruitment as part of the office’s Operation Firewall program.

A Florida law passed in May 2008 makes it a third degree felony for someone to post electronic communications “furthering the interests of a criminal gang.” One of the ways he or she can do this is “to advertise his or her presence in the community” or to “intimidate or harass other persons.”

“It’s nonsense because I’m not in a gang,” said Figueroa-Santiago. “I was just having fun.” He claims he used to befriend members of the Latin Kings but was never involved in their crimes. Sherriff officials, in the record of his November 2008 arrest, listed his aliases as King Taco and King Richy.

Florida lawmakers passed this online statute and other gang measures in response to a growing presence of street gangs—a trend also seen nationwide. The 2009 FBI National Gang Threat Assessment report said that 58 percent of state and local law enforcement agencies reported that criminal gangs were active in their jurisdictions in 2008, compared with 45 percent in 2004.

Lee County Court records show Figueroa-Santiago had no prior charges against him besides traffic and vehicle code violations. Unlike some of the other arrestees who have other pending charges such as cocaine possession, he is only being tried for his online materials. His case and the cases of the others arrested in Operation Firewall are working their way through the court system. At least four have plead not guilty; six of the arrestees were juveniles so their cases are sealed.

Figueroa-Santiago faces up to five years in prison if convicted. Additionally, Florida is one of only three states where convicted felons lose their voting rights for life, even after they complete their sentences.

Police in other states have successfully investigated gang crimes with clues gathered online and provided prosecutors with web-based evidence for their trials. Cincinnati police last November arrested over 20 members of the Northside Taliband gang after tracking its members’ activities on Facebook and MySpace. The suspects were implicated in robberies, burglaries, assaults, firearms and drug trafficking, and at least one homicide, police said.

In 2006 a Northern California judge ruled that two teens charged with beating a boy into a coma could be tried as adults, after prosecutors showed MySpace.com photographs of them flashing local gang hand signs.

MySpace has a law enforcement team that works with police departments and prosecutors to identify gang members, according to a confidential MySpace law enforcement training presentation viewed by the NYC News Service.

One example from the MySpace training materials is about a member of the “Rollin 20’s” gang from Los Angeles who was suspected of murdering a rival. An expert witness needed evidence to prove gang association (which usually carries a harsher sentence). The prosecutor found photos on the suspect’s page in which he was flashing gang signs, holding weapons and hanging out with known gang members, the training materials say.

“It used to be, if you were threatening a rival, it had to be on the street, at a club or, some way or another, in person,” said Professor David Kennedy, the director of the Center for Crime Prevention and Control at John Jay College of Criminal Justice in New York City. “The net just lets it come out in different ways…in websites, rap exchanges and still photos of them brandishing guns.”

Identifying gang members through social networking sites is one of the main responsibilities of the modern gang officer, said Louis Savelli, a retired 21-year veteran of the NYPD gang unit who now trains officers in online investigating. He said law enforcement personnel troll these sites for intelligence on gang activity and to gain corroborating evidence to bolster criminal prosecutions.

“You hear something happen like a stabbing, first thing you do is hit the street, then you hit the Internet,” said Savelli.

New York gang members aren’t online as much as those in other cities, said Savelli, because they’re more focused on drug-dealing than in other parts of the U.S. and avoid this attention. “The real hardcore guys who have a business to run don’t want the pressure,” he said.

Most of the kids at the Queens Police Athletic League are not hardcore. They attend a youth employment training program coordinated by Larry Green, who at 37 is dismayed by gang violence in his hometown of South Jamaica. Green hears about street fights started by online rivals, like the one that claimed Nicholas Donaldi-Subero’s life.

Many teens claim affiliation with a gang just for their own safety, even if the group’s not known for its violence or crime, said Green. “It’s rare to find a kid who’s not part of a clique or a group.”

In March 1996, a bodega clerk scanned a lineup of suspects at a police station in Astoria, a neighborhood in the New York City borough of Queens. Two armed men in ski masks had robbed his nearby store. The clerk recalled glimpses of light black skin behind one mask, though he hadn’t seen either robber’s face.

He picked out John Scott, a construction worker. Scott later testified he was nowhere near the store. The clerk conceded at trial he was uncertain Scott was one of the robbers. Despite the clerk’s reversal, Scott was sentenced to 25 years in jail.

Scott languished in jail four years before an appeals court threw out the conviction.

For his troubles, Scott sued the state under a special law for those wrongfully convicted—a statute written to fulfill a “moral demand” to compensate those who needlessly lost years of their lives behind bars.

It took Scott 6 years to prevail under the law after he was released. He got $25,000 in compensation for each year he lost in jail.

A review by the New York City News Service shows that the state’s legal system shortchanged Scott and that there is a wide disparity in payments for the wrongfully convicted.

In the past ten years, 22 people have been compensated under the state’s law. Lawyers who have handled multiple cases in the system said they believed it doled out payments at an even rate.

But state records show Scott got more than ten times less per year in jail than the person at the upper end of the scale.

Then there are those who fared even worse than Scott—and got nothing.

The wrongful conviction compensation law, passed in 1984, includes several complex provisions so that at least one man exonerated by DNA testing was deemed ineligible for payments.

In another case, a wrongfully convicted woman spent 25 years in prison before key evidence against her was discredited. Her wrongful conviction compensation claim was denied.

And in some cases, the wrongfully convicted got compensation by circumventing the state system altogether.

But despite its drawbacks, the New York State law has some advantages over other state laws.

THE JOHN SCOTT CASE

To best understand the system and its problems, it pays to look closer at the details in the Scott case.

On March 21, 1996, two men wearing black ski masks entered a Queens bodega. Guns drawn, the taller robber demanded cash from William Vizcarrondo, who was working the register.

The robber demanded Vizcarrondo’s jewelry and a pack of cigarettes, and then left with his partner.

John Scott was brought in a week later to the 114th Precinct in Queens as a suspect in an unrelated investigation involving a shooting. He was acquitted on that charge. While there, police asked Scott to be part of a lineup in the bodega robbery investigation. Scott consented.

Vizcarrondo looked at the men arrayed against the wall. He recalled glimpses of the taller robber’s light black skin and his deep voice. Scott fit the man he remembered.

But Scott, a part-time construction worker, wasn’t the taller robber. He wasn’t even in Queens at the time. He was watching television with friends in Manhattan.

During the trial, Vizcarrondo conceded that because the men wore masks, there was no way he could be sure Scott was one of them; witness misidentification is not uncommon in wrongful conviction cases. Still, the jury convicted Scott.

Four years into a 25-year sentence, Scott’s case was reopened before the Second District Court of Appeals.

“The chief witness for the People in this case made no visual identification of the defendant at trial, and conceded his inability to do so,” Judge Lawrence J. Bracken wrote. “This witness also made no in-court identification of the defendant based on his presumed ability to recall the supposedly distinctive voice of the tall robber.”

Scott was free.

Scott then made a wrongful imprisonment compensation claim, something that is possible in 26 states.

“The whole reason that this wrongful conviction statute was enacted in New York was to try to make it quicker and easier, and more certain, for people who it’s quite clear have been wrongfully convicted, and have been exonerated, to get some money,” said Adele Bernhard, a law professor at Pace University who has studied New York’s wrongful conviction compensation statute.

Under the statute a judge reads the facts in the case and, if the lawsuit is appealed by the state—many are—the judge determines whether the facts fit the law’s criteria. If it does, the state tends to settle the claim rather than proceed with a potentially lengthy trial.

In Scott’s case, instead of going to trial, the sides settled for $100,000—an average of $25,000 for every year Scott spent in jail.

Bernard and other attorneys said that while the state law has no explicit provision for evenhanded payments, considering such factors as a person’s income and potential career trajectory, they believe the payments have been about the same—around $100,000 per year of incarceration.

But at $25,000 per year incarcerated, Scott got one of the lowest average payouts in the past ten years.
James O’Donnell, for instance, was wrongfully convicted in the late 1990s of sodomy and spent two years in jail, half the time of Scott. Yet in 2006 he settled to get $150,000 for each year in jail.

Robert McLaughlin, wrongfully convicted of murder and robbery in 1981, spent six years in jail before he was exonerated. In 1989 he was awarded $1.9 million—more than $300,000 per year he spent in jail.

Settling out of court tends to result in slightly less money. Settlements resulted in a median of about $82,000 per year of incarceration for the 29 cases in which the number of years the wrongfully convicted person spent in jail could be determined.

Awards—where the case goes to trial and a judge decides the final amount—resulted in a median of just over $86,000 per year of incarceration.

Yet in the past decade only one case has gone to trial. The other eighteen cases during that period have been settled out of court.

Lawyers interviewed said that if a claim has merit, settling is simply less time consuming and less costly for the claimant and for the state, and that there was once a cap on settlements.

BIRTH OF A WRONGFUL CONVICTION LAW

Before 1984, most wrongful conviction claims were nearly impossible to secure. They required special legislation signed by the governor. From 1947 to 1984, five wrongfully convicted people received awards from the state, ranging from $7,000 to $1 million.

Then came the case of Isidore Zimmerman, which captured headlines and spurred public debate.

Zimmerman, a Columbia student convicted of killing a police detective in 1947, filed one of the state’s most well known unjust conviction claims during that time.

After serving 25 years in prison, an appeals court ruled in 1962 that prosecutors suppressed evidence pointing to Zimmerman’s innocence, and he was freed.

Zimmerman then made several unsuccessful attempts to recover damages. Finally, Governor Hugh Carey signed special legislation in 1981 that allowed Zimmerman to sue the state.

Zimmerman was awarded $1 million by the Court of Claims in 1983, an average of $40,000 for each year he was incarcerated. A year later, Zimmerman died of a heart attack at age 66.

His case, among others, led Governor Mario Cuomo to request that the New York State Law Review Commission draft a wrongful conviction compensation law. The resulting report says “morality demands” that the state compensate the wrongfully convicted, but it does not say much a year in prison might be worth.

“Few occurrences are more tragic than the conviction and imprisonment of a person for a crime he did not commit,” the report says. For a wrongfully convicted person, money is, “the most viable method of assisting him to recoup what he lost.”

“By imposing financial liability upon the State, recognition is given to a proposition that would seem to be self-evident, namely that it is the State’s obligation, and no one else’s, to do what justice and morality demand when an innocent person is convicted of a crime he did not commit,” the report says.

The commission identified four basic criteria for wrongful conviction claims: a person must have been convicted and incarcerated; that conviction must have been overturned or vacated; the convicted person must be able to prove his innocence; and, he must not have contributed to his conviction by his own conduct, for instance, by confessing to police.

Since the law was enacted in 1984, at least 250 compensation claims have been filed, resulting in 15 awards and 27 settlements totaling nearly $24 million in payments.

HOW AWARDS ARE MADE

Many of the cases that went to trial are not easily available, but one case that is available provides some insight into the judge’s thought process.

Terrence Ferrer filed a claim after he was exonerated of a Bronx murder in 1984. He spent about 12 years in prison.

“I tried Ferrer because you couldn’t settle for more than $50,000 in those days,” said Ferrer’s attorney, Irving Cohen, who has represented people in roughly a dozen wrongful compensation claims.

At trial, Cohen called an economic expert to estimate Ferrer’s foregone earning potential. Ferrer was awarded a Master’s degree in prison and expressed interest in getting a law degree. The expert found Ferrer would have earned a total of $1.58 million in past and future wages alone.

Judge Robert Abrams disagreed. He mentioned Ferrer’s past employment at fast food restaurants, though not how much Ferrer earned. The judge said there was no way of knowing whether Ferrer’s employment goals would have been met.

But Abrams was much more sympathetic to the stigma attached with a prison term.

“It is as if a man’s life has been terminated at one point and then resurrected later; yet with all the intervening traumas, dangers and injuries that will endure, linger and become a permanent part of his life,” Abrams wrote.

For past wages, the judge awarded $135,000, roughly $11,250 per year incarcerated. For the loss of future earning capacity, Abrams awarded $225,000, without explaining how he arrived at the amount.

The remainder of Ferrer’s $1.56 million award was for mental anguish and loss of reputation.

At age 43 Ferrer died of a heart attack.

THE NATIONAL LANDSCAPE

New York’s compensation law does have some distinct advantages compared with the rest of the country. The Court of Claims may award any amount—there is no floor or ceiling.

Federal claims, meanwhile, are capped at $100,000 per year of incarceration for plaintiffs sentenced to death, and $50,000 per year of incarceration for all others.

In Montana, people wrongfully convicted of a felony who served time are entitled only to financial aid toward education at state colleges.

In Missouri, only those who are found wrongfully convicted by DNA evidence may apply for restitution, at a limit of just over $18,000 per year of incarceration. A wrongfully convicted person is barred from civil lawsuits if he makes a claim under that law.

The New Jersey law creates a floor of $20,000 for each year incarcerated, making it one of the few states that has a minimum award. The maximum is twice the yearly salary of the person the year before he was convicted.

Awards in Massachusetts are limited to $500,000, but the court may also order the state to provide physical and emotional health services, and half-off tuition at state universities.

And in North Carolina, awards are capped at $750,000, but job training and tuition reimbursement may also be awarded.

In New York, innocence must be shown by clear and convincing evidence—not the lowest burden of proof, but also not the highest. In contrast, claimants in Connecticut need only show a preponderance of evidence, the lowest burden of proof.

Once a New York claimant proves his innocence he has a good chance of winning an award or reaching a settlement. In a way, the case is decided before it is accepted by the court.

“It’s an odd statute that way, but I understood why they did it,” Cohen said. “But, I think if the case is reversed or thrown out on any ground you should be able to bring the lawsuit and let the judge decide early on.”

“There are going to be people prevented from suing,” he added.

UNABLE TO SUE

In 1973, Betty Tyson was a 25-year-old drug addict and prostitute working the streets of Rochester.

In December that year, a consultant to the Eastman Kodak Company soliciting prostitution was found strangled in an alley.

Tyson was convicted of the murder based on two eyewitness accounts. There was no physical evidence linking her to the crime.

After more than two decades in prison, Rochester media and activists took up Tyson’s case. By 1998, Betty Tyson was free—but her $12.5 million wrongful conviction claim was denied.

That’s because her conviction was reversed based on police misconduct. The police had withheld evidence that showed to her innocence. But prosecutors did not retry her case, and Tyson was never acquitted.

Even as he upheld the state’s appeal of Tyson’s suit, Court of Claims judge Donald Corbett wrote that her case highlighted problems with the New York law.

“The Legislature, in its wisdom, has placed a high threshold upon those seeking recompense under this statute, and unfortunately for Betty Tyson, her claim cannot surmount that limitation,” Corbett wrote. “So, unfortunately for Betty Tyson, there can be no recovery here, and no opportunity for her to prove her innocence, perhaps her ultimate goal. Regardless of whether this decision survives appellate scrutiny, the Legislature may wish to revisit this ‘structurally complicated statute.’”

There has been only one legislative update to the statute since it was passed. “Anthony’s Law” named for Anthony Capozzi, a wrongfully convicted man who was exonerated by DNA evidence after more than 20 years in prison, gives docket priority to compensation claims in which innocence is proven through DNA evidence.

WHEN SCIENCE FAILS

Deoxyribonucleic acid (DNA) contains the genetic code that convicts criminals and sets the innocent free.

But when New York’s compensation law was passed, DNA technology was in its infancy. If a person confessed to a crime, he probably did it, the thinking went.

“One of the things we’ve learned is that people can be innocent and still confess,” said Adele Bernhard, the Pace professor.

That’s exactly what Douglas Warney did when he confessed to a stabbing murder in Rochester in 1996.

Warney’s knowledge of the crime scene ultimately led to his conviction. He knew the layout of the murder victim’s house, according to court papers. He knew what the victim was cooking. When an officer asked how he was doing, Warney said, “not good…I got a body.”

He was convicted on the strength of his unrecorded confession—though blood found at the scene did not match his, or the victim’s.

Ten years later, DNA testing matched that blood and other physical evidence to Eldred Johnson, who was already in prison for a similar murder. Johnson confessed to the crime, and Warney was freed.

Earlier this year, Warney sued the state for wrongful conviction compensation. Despite the DNA evidence, his $10 million claim was denied.

“There is no doubt that this confession contributed to [Warney’s] conviction,” Court of Claims Judge Renee Forgensi Minarik wrote. “[Warney] argues, however, that because his confession contained information that [he] could not possibly have known, his confession was obviously the product of misconduct and coercion on the part of the police officers that secured it.”

Judge Minarik decided that Warney did not provide substantial evidence of coercion. She decided that Warney had contributed to his own conviction and that, by law, he was not entitled to compensation.

When Warney was released in 2006, news reports elaborated on his psyche and pointed to a different conclusion. They pointed to a man who was, at the least, confused when he confessed.

Warney had AIDS-related dementia, an eighth-grade education, and an IQ of 68, according to the news reports. He claimed he was ill when he confessed. Several points in his confession were patently untrue—at one point he said he’d used his brother’s car that day, a car the brother gave up six years before the murder.

THE CIVIL ROUTE

But compensation through the state law is not the only means for the wrongfully convicted to recover money. If there is evidence of a civil rights violation the wrongfully convicted may successfully file a civil rights lawsuit.

Although the Court of Claims process is streamlined compared to the civil route, attorney Joel Rudin complained that in the Court of Claims, “you have a trial in front of a single judge paid by the State of New York.”

Awards in civil suits are decided by a jury, and damages tend to be higher than in the Court of Claims, Rudin said. The burden of proof in civil cases is also lower—the claimant does not have to clearly and convincingly prove his innocence.

In 2003, Rudin helped secure a $5 million settlement for Albert Ramos, who spent seven years in jail on a rape conviction that resulted from prosecutorial misconduct. That settlement is far higher than any of the settlements or awards under the state’s wrongful conviction law.

Betty Tyson, the former prostitute and drug addict, got $1.2 million in 1998 by filing a civil rights suit against the City of Rochester.

In 1989, five teenagers from Harlem admitted to beating and raping then-Salomon Brothers employee Trisha Meili in Central Park. The teenagers, aged 14 to 16, were all convicted and sentenced to prison.

But the confessions, four of which were videotaped, were coerced, and DNA evidence found at the scene matched none of the boys’.

The confessions were secured using, “force and trickery, sleep deprivation and isolation from their families,” according to court documents.

The DNA evidence matched that of Matias Reyes, who was in jail for a separate rape and murder. The boys were not fully cleared until Reyes confessed to the crime in 2002.

The wrongfully convicted men and their families have since filed a $250 million federal civil rights lawsuit against the police and prosecutors who arrested them and tried their case.

At least one of the exonerated men, Yusef Salaam, has also filed a compensation claim with the Court of Claims. His lawyer, Myron Beldock, said it would “complicated” to win damages under the state’s wrongful conviction law because Salaam and the others made false confessions.

“We decided to bring both cases,” Beldock said. “There are a lot of reasons why, but that is something I would consider confidential.”

He added, “If we recover full damages in the civil rights case there is no reason to go back,” to the Court of Claims.

LEFT WANTING

For more than a decade, Michael Clancy’s life was reduced to confinement and routine. He was convicted in 1999 of a murder in the Bronx that witness testimony would later show he didn’t commit.

“Every morning I woke up and I saw those bars, and that was my greeting every morning,” Michael Clancy said. “Every morning I’d wake up, I would sit up, I would look up—and there they are. And that’s what I went through for 11 years.”

Clancy didn’t know what to do when he was released. He didn’t know how to establish credit. He didn’t know how to get a state ID.

“Thank God” his lawyer was waiting for him outside, Clancy said, because he didn’t even know how to use a Metrocard.

State-funded programs to help ex-convicts readjust to life outside of prison were unavailable to him. Their money was reserved for people who had actually committed crimes, Clancy said.

Indeed, no social services, such as job and readjustment training, were awarded to those wrongfully convicted in any of the cases reviewed for this article.

“They didn’t have a system for a person who was found innocent,” he said.

Clancy is doing well for himself now. He has an apartment, owns an Ipod, and says he bought an $8,000 bed.

But in a way, Clancy was lucky. His sister was able to support him after his release, and his union, the International Union of Elevator Constructors, offered him work immediately.

“They welcomed me with open arms,” Clancy said. “They said, ‘listen, you’ve been through so much the least we can do is at least give you an opportunity to prove yourself.’”

“People in my position, I hate to say, usually don’t get a break. A lot of these people, even though they’re found innocent, there’s always a question in the back of an employer’s mind, you know? This guy’s been in jail for this amount of time, you know? What did that do to him?”

On the advice of his lawyer, Clancy wouldn’t say whether he would file a claim under New York’s wrongful conviction law.

Additional reporting by Steven Bronner, Joshua Cinelli, Dan Macht, Rosaleen Ortiz and Matt Townsend.

Many gay and lesbian bookstores followed, all over the country, as the movement grew in the following years. Many of those bookstores have closed recently, however, including the Oscar Wilde. Many see the disappearance of the stores as a sign of success growing out of the wider acceptance of gays and lesbians throughout society. They don’t need their own special bookstores any more because so many general bookstores carry gay and lesbian books.

The doors at Oscar Wilde closed in the spring of 2009, only weeks before Amazon.com accidentally pushed all books deemed gay and lesbian to the pornography section, a sad reminder of the days when a gay and lesbian bookstore was necessary due to discrimination. It’s worth taking a look back on those days.

Forty years ago, Christopher Street was the center of the Stonewall Inn riots. Today, the street still has problems with theives and vandals, but it still lies in one of the pricest areas of real estate, even for New York. Those riots of the 1960s and ‘70s, when Greenwich Village was the heart of a revolution seem like a long time ago in an age when gay marriage has been passed in Iowa, and when the Oscar winner for Best Picture played gay politician Harvey Milk, who was frequent visitor to the store and, for a time, a boyfriend of Craig Rodwell, the founder.

“You could say it’s really good because it means we don’t need segregated facilities but at the same time there’s something about going to a queer space that gets lost,” said Sarah Chinn, the executive director of the Center for Gay and Lesbian Studies at CUNY Graduate Center.

In 42 years, however, Rodwell’s tiny shop became packed with not only books and DVDs, but also people. Located on Christopher Street in Greenwich Village—just one block from the infamous Stonewall Inn—the bookstore became an information center, intellectual hothouse gather place and a home for the gay and lesbian movement.

When the Oscar Wilde Bookshop first opened its doors, the nearby Christopher Street park was home to homeless gay youths, now a statue stands in memory of the Stonewall Inn riots. The Christopher Street Liberation Parade, organized at the Oscar Wilde, is now known as the Gay Pride Parade.

While there was a once a network of gay and lesbian bookstores in New York, the Oscar Wilde was the first and now the last to fall. Other famous institutions such as Creative Visions on Hudson Street and A Different Light in Chelsea all closed their doors in the last decade. The website for Oscar Wilde suggests only three stores for patrons looking for gay titles: Lambda Rising in Washington D.C., Giovanni’s Room in Philadelphia and Common Language Bookstore in Ann Arbor, Michigan.

Martin Duberman, the author of the book “Stonewall” and a professor emeritus at Lehman College and the City University of New York Graduate Center, suggested this is part of a trend of gay bookstores closing.

“I’m always sad when a bookstore closes, especially a gay bookstore,” Duberman said.

Rodwell died in 1993, and the neighborhood surrounding his store is no longer the revolutionary one it once was. While up and down Christopher Street, from its western edges near the Hudson to the eastern end at Sixth Avenue, gay pride flags still wave proudly outside many of the stores and the Stonewall Inn still stands, instead of having a notorious reputation, the old articles about the Stonewall riots are framed in the window in order to attract tourists. A Starbucks is now at the corner of Sheridan Square, where young homeless gay youths used to sleep because they had nowhere to go. Christopher Street has become one of the priciest areas of real estate, with tree-lined streets and old buildings that were once dilapidated have been fixed up and for sale for high prices.

In the last few weeks before the store closed, the shop filled with regulars, tourists and reporters.

Cecilia Martin, 39, working the register, called the store a “safe place” for the gay community. She herself remembered her first time visiting the store, which she loved so much she later applied for a job.

“I didn’t even know what being gay was—when I was 16, I thought I was the only one that was,” said Gary Merston, 46, of East Orange. “Since I was 16, I’ve been coming to this store. I love this place.”

Merston stopped by with one his 14-year-old son, one of two children he adopted with his partner. Merston and his son said were saving souvenirs from the bookstore, right down to the shopping.

“When I saw Channel 7 broadcast, I couldn’t believe it,” Merston said. “I said, this is not really happening. We must have watched it 10 times, and repeated the news over and over again.”

Both Martin and the last owner of the bookstore, Kim Brinster, a former manager who bought the place after one of the store’s near-death experiences in 2003, said they felt the store is a victim of the current hard economic times, and the increasing presence of on-line retailers.

“Unfortunately, we do not have the resources to weather the current economic crisis and find it’s time to call it a day,” Brinster said.  “So thanks to all those who have been a part of the Oscar Wilde family over the years, you have truly been a part of the global community.”

Rodwell had been one of the more militant members of the homophile movement in the early 1960s, but by 1966, he was fed up with the Mattachine organization, the leading group fighting for gay rights across the country. Rodwell wanted to open a bookstore that would be an intellectual gathering place for gay people, and in fact, he banned the sale of any pornography in the early years. In order to save up the money for the bookstore, he worked summers at a motel at the Fire Island Pines, the popular vacation spot for gays on Long Island.

After two summers, Rodwell had saved enough money to rent space at 291 Mercer Street, the first location of the store. It moved two years later to its famed home on Christopher Street. The Mercer Street location, according to Duberman, was the cheapest place Rodwell could find.

Duberman profiles Rodwell in his book and wrote Rodwell struggled in those early days—and even had to ask his own mother to help set up the store the night before it opened due to a lack of resources. Rodwell later relented on the pornography ban in order to make some money, Duberman said.

When the bookstore first opened, the mainstream press either ignored it or attacked its existence. According to Duberman, a columnist for the New York Post compared it with see-through dresses and topless flicks, despite Rodwell’s hatred of pornography. Some gay activists were not happy with the store because it did not stack pornography, and other claimed it was stinted more toward men. Still, Rodwell put in 70-hour weeks and ran the store by himself for the first 18 months.

In addition to the bookstore, Rodwell also began his own gay and lesbian organization, called the Homophile Youth Movement—later amended to Homophile Youth Movement in Neighborhoods, so the acronym would be HYMN and less gender-specific—and used the store as the headquarters. He published a newsletter called The New York Hymnal, where he called for homosexual law reform in New York State. Rodwell even hung a banner in the front window proclaiming “Bookshop of the Homophile Movement.” He would later replace it with a bumper sticker proclaiming “Gay is Good.”

During the early morning hours of June 28, 1969, the police attempted to raid the Stonewall Inn, located at 51 Christopher Street, only a few doors down from the new location of the bookstore. But the raid did not go as planned and turned into a full-scale riot. Rodwell, who personally hated the Stonewall Inn because he thought it was unsanitary, could see the riot going on from Oscar Wilde and called the newspapers and three New York papers—The New York Times, the New York Post, and the New York Daily News—all covered the siege. For the next few nights, people gathered on Christopher Street to protest—and Rodwell printed leaflets from the bookstore to help organize. From the back room of the bookstore, Rodwell encouraged a boycott of the Stonewall Inn, which closed only a few weeks after the riot.

One year later, Rodwell organized “Christopher Street Liberation Day” from Oscar Wilde, now celebrated each year as “Gay Pride Day.” The gay rights revolution had been born.

Rodwell died of stomach cancer in 1993, and one of the store’s managers, Bill Offenbaker, bought the store. After Offenbaker struggled to keep it afloat, Larry Lingle took over in 1996.

But Lingle could not save it either, and he announced he would have to close its doors in 2003. At the last minute, Deacon Maccubbin, the owner of gay bookstore Lambda Rising in Washington D.C., bought the store and rescued it at the last minute. Three years later, Brinster, then one of the store’s managers, took over.

While rents in Greenwich Village have increased over the years, Brinster said the Oscar Wilde Memorial Bookshop paid only $3,000 a month, well below market value. But that was still too much.

Sarah Chinn, the gay and lesbian center director at CUNY, said she thought the world around Oscar Wilde had changed too much for it to survive.

“Now you don’t have to schlep all the way to the Village to buy a gay book—you can just go on-line and order it,” Chinn said. “I think someone could see it as a good sign. That we’re not totally marginalized, but at the same time, community-run institutions have a place and they have a value beyond what’s available. It’s essentially a shame that it’s the oldest gay bookshop in the United States and it’s closing.”

Martin said the full force of the bookstore’s closing hadn’t hit her yet.

“I think it’s definitely a loss,” Martin said. “It’s like, you may realize someone is dying, but you don’t understand the real impact…and they won’t until they don’t have us as a resource—the regulars who come in every week.”

One month before the scheduled closing date, the last meeting of the Lesbian Book Club still met. Instead of Rodwell’s famous “Gay is Good” sticker in the front windows, they were covered in “Final Sale” stickers. The club was meeting to discuss “Aimee and Jaguar” by Erica Fisher.

On the last day, the store officially closed at 7 p.m. The doors were locked, but the club members lingered in the trailblazing store for just a little while longer.

Sometimes, the bus will lurch forward as you make your well practiced bargaining pitch. You find yourself scrambling to reach your prize– goat meat on a stick, golden and dripping with grease, throwing coins down to your seller’s hands, while your neighbor pulls a loud, distressed chicken through the window.  It’s awkward, but the bounty is worth it.  Even as I write on my laptop in New York, thousands of miles away, I still feel hungry thinking about it.  Goat meat is fairly easy to get in my Queens neighborhood, but it just doesn’t taste like it did on a bumpy, late-night bus ride along a dirt highway in East Africa.

It was not a likely place for a girl from Long Island to be going, that’s for sure.  Most of my classmates from high school were probably speeding along the Long Island Expressway, or going out to Jones Beach.  But I was making my way to northern Uganda.  I had visited the country several times over the past year and a half, and had been working as a journalist for a daily newspaper in the capital, Kampala.  But I had never spent more than a couple of days in the north.  When you live in Uganda, the north feels like a different country—as if you might need a visa stamp to drive the five or six hours from Kampala to Lira or Gulu, the major Northern towns.  The rest of Uganda is generally perceived internationally as stable, democratic, a loyal friend of the U.S.  The north is a historical and present-day landmine, where more than a million people have been displaced by two decades of civil war.  Even though there is a ceasefire now, and a peace treaty is being negotiated, the region is devoid of almost any effective government, cut off from many services.  Among all its other crises is a world-class killer: northern Uganda is the deadliest malaria zone in the world.

I had been assigned to go to Lira and interview children who had been traumatized by the recent war.  The war in northern Uganda was different than most conflicts, because it relied heavily on child soldiers.  Almost ninety percent of the soldiers in the rebel army were children abducted from Ugandan families, forced to fight against their communities and the Ugandan government.  The use of child soldiers made fighting against the rebel group, called the Lord’s Resistance Army, difficult—any battle against the LRA was often considered a massacre, since most of the casualties were children who didn’t want to be there in the first place.

Although there was a ceasefire now in Uganda, many of the children had not been freed yet, and those who had came home to communities that had been attacked by the very army they had been forced to join.  Boys and girls were both captured by the LRA, and the girls, despite their young age, were often forced to serve as ‘wives’ of the LRA commanders, basically sex slaves.  Many became what are called ‘child mothers’ in Uganda, or young girls who became pregnant by rape when they had barely reached puberty.  The child mothers were still forced to fight against the Ugandan government, and they carried the babies on their small bodies from battle site to battle site.  When the government was really cracking down on the LRA, the rebel army forced them to flee to the Sudan, where the Sudanese government, angry with Uganda for supporting Sudanese rebels, gave them a base from which to launch attacks against Uganda.

Many international journalists have gone to Lira or Gulu to interview and catch glimpses of the child soldiers.  Those who have escaped present compelling stories- their reunions with communities they thought would reject them, child mothers escaping on foot for hundreds of miles to reach home, and complex, difficult ways of learning to forgive those who had abducted them.  But New Vision, a national daily paper, gave me a unique story assignment—I would interview both child soldiers and children not captured but affected by the war, and tell their stories through the newspaper’s pullout on children so other Ugandan kids could get a glimpse into their lives.

I was eager to tell the silent stories of war-affected children, who might not have been abducted but lived one evening at a time, not sure if they would survive another year without being abducted, or their family’s fields or store looted by rebels.  Although many journalists wrote about child soldiers, no one really wrote about the kids who weren’t abducted, but were afraid.  Those children had to cope with the fact that the rebels looked just like them: small, afraid, living evening by evening.

I didn’t know what to expect.  I had been to northern Uganda so briefly before, and if I hadn’t known the history of the region, it would have looked like any other part of the country.  Cassava, coffee, and peanut farms, farmers living in huts made of mud and wattle.   Kids who waved excitedly when they saw you.  One-story homes and the smell of charcoal from cooking stoves.  This time would be similar, since I was still just going for two nights.  But this time, I planned to immerse myself in the place where I would be going: Lira, a devastated farming town trying to rebuild after decades of terror and violence.

I was nervous going on the bus ride, unsure how the interviews would go.  What if I couldn’t find any child soldiers, or children who had been impacted by the war, who wanted to talk? What if I re-opened memories that were better left unsealed? After all, many of the kids, as well as the adults, suffered from post-traumatic stress disorder.

Of course, there were other worries, too.  The one that felt the most intimate had to do with the slight itching on my left leg.  I feared the anopheles mosquito, which spread malaria.  Rumor had it that it hit foreigners twice as hard as Ugandans, since we lacked centuries of immunity built through our family blood lines.  Even with some immune resistance, malaria is the number one threat Ugandans face when it comes to their safety- not rebel armies, or HIV.

Malaria is the top killer of Ugandan children, and a major killer of refugees from other countries, as well as internally displaced people.  If you walk into a major hospital in Uganda, twenty percent of their admissions are malaria-related.  Every year, between 70,000 and 110,000 Ugandan children die from malaria, according to the health ministry—or between 190 and 300 deaths a day on average.

Unfortunately, I knew this intimately.  About two weeks before I left the United States to work in Uganda as a reporter, I called my boyfriend, who lives in Kampala, and he told me that his six-year-old stepsister had died from the disease.  When I called his mother later that day, she told me that his sister developed a rare form of the disease called cerebral malaria, which can kill almost instantly.  The malaria went straight to her brain, and she died shortly after.  That type of malaria was rare, but not rare enough for most Ugandan families.  Cerebral malaria is the number one cause of malaria deaths, and is any Ugandan mother’s worst nightmare.

In Kampala, where I had been working, the malaria rates were significant, but not as high as they were in northern Uganda.  Many of the districts within northern Uganda are part of significant water basins, which attract mosquitoes in drove, and the whole region lacks basic health infrastructure.  In one district in northern Uganda, called Apac, residents suffer a breathtaking 1,568 bites from malaria-infected mosquitoes a year.

As an ivory-skinned, wimpy American with virtually no immunity to the disease, I often felt like a beacon in Uganda, calling all mosquitoes to deposit their deadly parasites into my bloodstream.  I had been wimpier than my American colleagues when I studied abroad in Uganda the first time around, picking up as many as twenty mosquitoes bites when we went hiking.  That time, I took medicine daily to prevent malaria.  The other college students would get one bite here, one bite there.  We would walk through eerily beautiful forest landscapes, and while other students would take pictures of waterfalls on their digital cameras, I would be scratching my legs.  Even as I write this, I still have faint scars on my legs from mosquito bites I really shouldn’t have been scratching.

While I was attracting mosquitoes working and studying in Uganda, many of the Ugandans around me were less worried about the disease than about the latest campaign against malaria – a national program to wipe out the mosquitoes by spraying the indoor walls of people’s homes with a pesticide, DDT, which was banned in the United States. Which was a greater danger, many of my friends wanted to know, the disease or the possibly carcinogenic cure?

I would put my fears aside, play the situation by ear, and call my editor if I encountered problems.  The newspaper had been surprised that I even wanted to go.  Wouldn’t it be better to stay in Kampala, where things were safe? But I wanted to cross the boundary between what felt like two countries, and see what Uganda was like when you crossed that invisible line between north and south. It’s why I hopped on the bus from Kampala to Lira.  Now, who knew what good stories were waiting for me?

****

On my way north, I had sat next to a young man who was unusually quiet, almost New York City subway-passenger quiet.  He looked about seventeen or eighteen, and who knows, maybe he was actually a New Yorker, because he didn’t greet me or glance my way, even though we were crammed into two seats by the window. He was a skinny guy, but he seemed to need two seats, because with each turn, he would slam his body weight against mine. He kept quietly shoving me against the bus wall, until I gave up half of my seat and he stretched over one and a half. Definitely, I thought, a secret New Yorker. I could easily picture his slender frame, jeans and cotton t-shirt on a subway in Manhattan, perhaps the 2 train.

I declared defeat, silently of course, and looked out the window, watching the sun set into Uganda’s dark green hills in the distance. Our bus left Kampala around four p.m., and around six, the sun went down peacefully over the endless acres of farms and hills, and I wondered how the bus driver could see the dusty road without street lights. Some questions, of course, are better left unanswered.

I was going to see my friend Zack, whose work in northern Uganda had given me a news peg to get a reporting assignment upcountry. Zack was an unusual guy. He had graduated from a private high school in Los Angeles, a school that the Olsen Twins had gone to, and then headed off to college in Colorado, where he developed an interest in Africa through some classes he took.

Most people would stop there, but Zack boarded a plan to Ghana and then Uganda, feeling as comfortable in places like Lira as he would at an upscale neighborhood in L.A. The year before, we had attended the same study-abroad program in Uganda, and during our visit to rural eastern Uganda, Zack had built a mud-wattle cottage by himself, slaughtered chickens, talked about politics, and had drunk from a grainy, communal alcohol pot with about twenty men, each with their own straw. The boy was far from L.A., and he didn’t want to go back. The next summer, after a year of fundraising using his family’s connections, he raised about $30,000 and decided to hold a three-day conference for former child soldiers in Lira.

By the time the conference was held, I’d be on a plane back home, but I wanted to see how his preparations were going.  I thought the work he was doing was both important and gutsy.  The twenty years of civil war killed between ten and twenty thousand people, and also displaced hundreds of thousands of peasant farmers. They were tired of being attacked and abused by the government and rebel forces, each of which accused the farmers of collaborating with the other side.  For Zack to pick up his bags in L.A. and move to Northern Uganda, I thought, was pretty shocking.

Both of us had entered Uganda at a time when the government was stirring up more resentment when it started spraying inside people’s homes with DDT, a program supported by the U.S. Agency for International Development and the World Health Organization. Environmental groups and organic farming organizations had sued the Ugandan government, and a court injunction had temporarily stopped the spraying, but the region, as well as the country, was locked into a fierce debate over whether it was safe to spray the pesticide, even in small doses. Some Ugandans, paranoid after decades of living under dictatorships, thought the government might be attempting to wipe out the ethnic groups of northern Uganda through the allegedly carcinogenic chemical. Others wondered why the United States would fund the spraying of DDT after the chemical had been banned in America in the 1970s.

Dichloro-diphenyl-trhichloroethane, or DDT, remains one of the most controversial chemicals in existence. The synthetic pesticide became popular during the second half of World War Two, used to fight malaria and typhus, and caught on during peacetime as an agricultural insecticide. DDT wasn’t always a dirty name; in fact, a chemist from Switzerland won the Nobel Prize for his work in using DDT as an insecticide.

Othmar Zeidler, a German-Austrian chemistry student at a university in France, first created DDT from a mixture of alcohol, chlorine, and sulfuric acid. However, Zeidler didn’t realize the potential that the compound had as an insecticide, and DDT was largely unused until a Swiss chemist created the same compound on his own when trying to create a pesticide. The chemist, Paul Müller, found the chemical to be effective in killing house flies during the first chemical trial, and DDT products were soon developed to target mosquitoes, lice, and some other pests.

In the 1940s, DDT was celebrated internationally as the super chemical that would wipe out everything from malaria to bedbugs, cockroaches, and the common household fly. It was also believed that DDT would protect the world’s crops from debilitating insects.

After World War II, the U.S. government used DDT to control pests on crops and forestlands, and people used the chemical in their own homes and gardens. In 1955, after Europe and the United States used the pesticide to eliminate malaria from their own countries, the World Health Organization started a program to eradicate the disease worldwide, relying mostly on DDT. The WHO eliminated malaria in Taiwan, most of the Caribbean, northern Africa, and much of the South Pacific. It also had some significant successes in reducing malaria mortality in Sri Lanka and India. WHO did not really attempt to wipe out malaria from sub-Saharan Africa, however, stating that the lack of public health infrastructure on the continent was too limited, and the life cycle of mosquitoes too long, to make DDT effective.

Eventually, the United States came to have second thoughts about DDT. In 1962, Rachel Carson published Silent Spring, a book that launched the modern-day environmental movement by triggering public interest in pesticides and pollution. Carson said she did not advocate banning the use of pesticides domestically, just using them in a well-managed way. Her book generated a public uproar, however, and DDT was banned in the United States in 1972.

Many other countries also decided to ban DDT, sometimes with critical health consequences. Zanzibar, an island that is part of Tanzania, had used DDT to bring rates of malaria drastically down to 5 percent, but after its ban, the malaria rate in Tanzania rose, until between 50 and 60 percent of the population suffered from malaria for at least a year.
When I first started traveling to Uganda in 2007, the government hadn’t started spraying inside of people’s home yet, but newspaper editorial pages and radio talk shows were debating the proposal.

Malaria was constantly on my mind, and my parents were even more worried about my decision to visit a malaria zone. After all, the disease hits hardest those – like me – who have not developed a resistance to it.

I already had habits that drove my parents crazy. I rode the subway late at night, I forgot to carry cash on me, I would always lose my keys and wallet.  How could I be trusted to take precautions against malaria? My father became addicted to Google, and he read about the ins and outs of the disease, the proper prophylactic treatment (the nasty drugs that make you sick from the side effects, but keep you disease-free) and the mosquito nets.

During that first trip to Uganda during a college study abroad program, I took an expensive little drug called Malarone, which cost $6 a day to keep me malaria-free.  The drug gave me weird, eerie dreams, but those were nothing compared to the dreams that my colleagues on Larium, a much more toxic drug, were having.  For Americans interested in traveling to major malaria zones, Larium can be tempting.  It is much cheaper than other malaria drugs, and doesn’t need to be taken every day.  One dose of Larium every 7 days is all you need.  But the side effects are notorious: visual disturbances, vivid dreams, and anxiety attacks.  In the long-term, Larium can damage both your liver and your eyes.

Although I stuck with the Malarone when I was in Uganda the first time, when I came back to work for a daily paper, I knew there was no way I was taking any anti-malaria drug.  If I got malaria, I decided, I would go to a clinic, take a couple of shots, swallow some tablets, and take a day off from work.  This is more than what most Ugandans would be able to do if they came down with a malaria spell, and I figured I would be okay.  However, as I sat on that bus to northern Uganda, I knew that the region had the worst malaria rates in the world, and that the mosquitoes would be more intense.  The one good thing was that I was traveling during the dry season. If it had been the rainy season, the road could have been washed away, and thirty to forty bites could have been easily waiting for me.

As I sat on the bus, watching the sun set over Uganda’s dark green hills, I thought about my first week in Uganda, and my first night with my homestay family.  Living them had changed my attitudes towards malaria, how it could be viewed almost in the way colds and flus were seen in the U.S.  Even if the disease was a deadly killer.  During that first night, I was navigating both the time change, anti-malaria drugs and cultural shock.  I was a twenty-one-year-old New Yorker, a coffee-drinking, 1-train hating, fast-talking, skittish female. I was in a Kampala suburb called Kanyanya, a semi-rural town that juxtaposed cell phones, American hip-hop fashion, and bootlegged Indian movies with roosters, cows, and red-brown dirt roads that turned into tiny, messy rivers during the rainy season. My home-stay family had volunteered to adopt me for three months and teach me how to survive, to bargain, to speak in conversational Luganda, and to learn the polite decorum of the society.

My Ugandan family was initially skeptical. I had been told to dress up for my first meeting with them, and when they saw my business attire and huge suitcases, I later learned, they predicted I would head back to the United States in less than a week. They were, of course, wrong. As I was trying to absorb my introduction to Uganda, learning new words and seeing new things, my Ugandan family became more relaxed – and my American family more nervous. At night in Uganda, I would collapse as soon as my mosquito net was tucked into my mattress. At night back in the States, my parents lay sleepless.

I was living in a typical home of a middle-class Ugandan family. The unpainted walls were covered with colorful newspaper pages. The furniture was simple. I slept in a guest room with two beds. Bright light emanated from an energy-saving light bulb dangling from the ceiling. There were two trunks filled with school papers and saved writings on one side of the room, and I had stacked my own green suitcase on top of the trunk. The family I had temporarily joined offered me four coat hangers, which I had to use as efficiently as possible.

I could dimly hear the sound of the TV coming from the room of my home-stay mother, Justine, an accountant working in Kampala’s city center. She still volunteers to host American students when they attend a grassroots development studies program at Makerere University. The houses in Kanyanya are built close together, and I could hear the sounds of conversation in Luganda coming from the neighbors’ houses nearby. I could also faintly hear the sound of the woman sleeping in the bed next to mine.

In Ugandan families, it is bad luck to sleep alone. Many Ugandans grow up with six to ten or even twelve brothers and sisters, and rarely spend time alone. Some feel anxious at the thought of being by themselves, and if guests visit, it is considered rude to give them a room for themselves. After all, wouldn’t your guest be lonely? The cultural differences made me smile; as an only child of divorced parents, I was used to my own company. On my first night with them, my family had the mother’s niece come and sleep in the bed next to mine, so I could have a roommate who also was my agemate.

The next night, I shared the room with the family’s oldest daughter, a ten-year-old girl named Jaliah. Both Jaliah and the niece were experts at using mosquito nets. They knew how to tuck their nets in, or re-hang them from the ceiling if the net slipped from its hook. Like most Ugandans, they had had malaria countless times; the symptoms usually begin within four weeks of infection, when the sufferer develops high fevers, shaking chills, muscle aches, and tiredness. The nets offered some protection from the potentially life-threatening mosquitoes, and saved the family’s pocketbook from a treatment that would take any money they had planned on using for groceries or transport that week.

Once, I made the mistake of putting down my mosquito net when there were already two mosquitoes circulating around my bed, and I trapped them both inside my net. I had been exhausted, and fell asleep almost before my head touched my pillow. I awoke two hours later, covered with swollen bites, and attempted to chase the mosquitoes away from my bed, lifting up the net. The family’s electricity had gone out, so I swatted my hands aimlessly in the dark.

That first night in Uganda, my mouth was dry. I didn’t like the taste of the family’s drinking water. They collected rainwater in a large, rusty, blue-red bucket that came up to my waist. They then boiled the rainwater on a charcoal stove in the kitchen, the room next to the guest room. There was a vague scent of charcoal in the guest room. I reminded myself to buy some bottled water the next day.

The blanket was wool – hot and itchy. The net kept me sweating, trapping hot air over my bed. I kicked off the blanket and slept under only the sheet. I had to go to the bathroom, but I was scared of using the latrine, where there was no light and just a small hole that went down 20 feet into the ground. It was very dark. What if I dropped something by accident, and it rolled into the hole? Where, exactly, did I put my flashlight? The last time I had tried to use the latrine in the dark, earlier in the evening, I had missed the hole and peed on my feet. Plus, going to the latrine at night meant I might get bitten by more mosquitoes. I was learning quickly: during my time in Africa, the threat of malaria would accompany me everywhere.

In Uganda, poverty and malaria are inextricably linked. Many poor, tropical countries suffer immensely from malaria. Poverty both causes and is caused by malaria. Poor countries are less able to devote precious public resources to the disease, and spending money on disease treatment can wipe out a family’s savings, or put it into debt. In one year, a poor family in Uganda can spend as much as 25% of its income on malaria treatment. The rainy season in Uganda, a critical time for agriculture, often causes higher rates of malaria, and farmers lose time they might spend working recovering from the disease.

Malaria also causes absenteeism from school, since children suffer six cases of malaria a year on average in Uganda, and affects school performance when children make it to the classroom. For pregnant women, malaria becomes an even more serious disease. The health ministry estimates that malaria causes 60% of miscarriages that Ugandan women experience, and the disease frequently causes low weights in newborns, as well as stillbirths.

Malaria is spread by anopheles mosquitoes, but the root of infection are the malarial parasites that feast on their victims’ red blood cells. When a mosquito bites an infected person, it consumes a blood meal full of malarial parasites. It will take a week for the mosquito, now infected, to be able to transmit the disease to another human being. If the mosquito lives another week, it becomes capable of transmitting malaria to everyone it bites.

Let’s say it bites my Ugandan home-stay sister Jaliah, when she gets up in the middle of the night. She lifts up her mosquito net, picks up the kerosene lantern next to her bed and goes to use the latrine. As she walks to use the toilet, a mosquito could bite her. If the mosquito carried the malarial parasites, they would be passed through the mosquito saliva into her body. About ten days later, Jaliah could wake up with a high fever, terrible chills, and nausea. If she was already malnourished or suffering from HIV, the disease could be lethal, particularly if her family could not raise the money in time for her to get treatment.

The best solution, of course, would be to remove the mosquitoes from Jaliah’s path.  In 1998, the World Health Organization, many African governments, and charities launched a campaign called “Roll Back Malaria,” which planned to halve the number of malaria deaths worldwide by 2010, through a combination of mosquito bed nets, insecticides, and medicine for patients when they did fall sick.  However, in 2007, a million people died of malaria, and 500 million people were infected with the disease.

Five years into the program, malaria deaths were actually increasing worldwide, though countries like Rwanda and Eritrea had made significant strides in fighting the disease.   Roll Back Malaria struggled with four major leadership changes in five years. Also, it was difficult to find a baseline measuring how many malaria deaths occurred each year. A misestimate in 1998 could make it appear that malaria was on the rise, when actually doctors, scientists, and public health advocates were simply recording deaths more accurately.

Another critical problem with Roll Back Malaria was that donors gave tangible commodities, such as bed nets or medicines, when many countries lacked the public health systems to effectively deliver either.  During British colonialism, the Ugandan colony had invested in the health infrastructure of the central Buganda kingdom for decades, but had neglected many other regions of the country, such as northern Uganda.  The Buganda kingdom was considered pivotal to the success of British colonialism in East Africa, and its people had more access to education and civil service jobs.  On the other hand, northern Ugandans were restricted to only joining the military or working in agriculture.

The neglect in infrastructure, resulting in everything from lack of jobs to poor education and health facilities, caused people to migrate to Kampala, where the poor built huge slums in swampy, low-level parts of the city. This rush to Kampala, particularly during the war in northern Uganda, overwhelmed the public health systems that had been relatively strong.

In April 2008, the Ugandan government began a new strategy. Coordinating with and using the funds of the World Health Organization (WHO) and USAID, it began spraying DDT in Oyam and Apac districts, two districts in the north. Once again, all did not go smoothly. Three weeks after the spraying began, the government began to squabble with exporters of organic products in Uganda, which sell organic crops to Europe and the United States. A group of organic companies filed a lawsuit against the government, arguing that Uganda had violated the WHO guidelines for indoor residual spraying, doing the spraying in a way that could contaminate the Ugandan food chain.

Although the European Union had said it would continue to accept Ugandan exports as long as the standards of WHO were met, organic companies were afraid that they would lose their market, worth about $500 million a year, if traces of DDT were found. Even British American Tobacco joined the group, stressing a potential health risk if traces of DDT were found in its tobacco products.

On May 30th, the Ugandan High Court called for a temporary halt to the use of DDT in the districts that had been scheduled for spraying, even though the WHO and Ugandan Health Ministry reported significant drops in both malaria cases and deaths in the communities they sprayed.

The Ministry of Health has been trying to have the DDT ban overturned, but faces strong opposition, particularly from Ken Lukyamuzi, a popular environmental and political figure in Uganda. The DDT spraying has been halted. More expensive, but less effective insecticides are being used for indoor spraying.  USAID continued to support the spraying, stating that DDT had now been endorsed by the World Health Organization as an important tool in the fight against malaria.

My journey to northern Lira took me into the center of this bitter debate.  And when the bus pulled into Lira, I didn’t know what to expect.  It was almost midnight, and there were almost no streetlights in the town.  All I could think about was the recent war, and how it had affected Lira.  I remembered a BBC article I had read about a massacre in Lira in 2004, when the rebels attacked a refugee camp outside the town, and the government fought back.  The civilians were the ones who suffered, with 200 people dying in the crossfire.  Many people died in their grass, homes at the camp when rebels lit the makeshift structures on fire.  The name of the camp was Barlonyo, and it had suffered the most devastating attack in northern Uganda in ten years.  Now, the war was over, but I wondered how much the memory of the attack on Barlonyo lingered.  It had only been four years ago.

As I checked into a hotel after leaving the bus, I couldn’t help but realize how far I was from the refugee camps where the displaced Northerners lived.  Not in terms of physical distance, but in the emotional distance between the hotels that had started to spring up in the wake of the ceasefire as people began to travel again, and the million people who would never go on vacation, or even just return to the simple homes they left.  The hotel was called the White House Hotel.  Though it would have been a modest motel in the United States, it felt like a small castle within the small, farming town.

I entered the small room I had booked for two nights, and was relieved to see that it had a mosquito net already hanging from the ceiling. I thought of the time I went to a shopping mall in Kampala, and saw a worker who had been mopping a floor drop her mop and collapse against the wall.  Sweat dripped down her forehead, and she held her hand to her forehead limply.  When I asked her if she was okay, she told me she had malaria, and indicated that she had a terrible headache.  And I knew it hit foreigners much worse than Ugandan.  Just thinking about the disease made me shudder.

I thought about this as I turned on the shower handle, and watched steam come from the water.  Forget malaria, I thought, I have hot water! I had been living in an apartment in Kampala for several months with only cold water, which had had a tragic effect on my hygiene.  I had started to bathe every other day, and my showers lasted about thirty seconds.  Sometimes, I would heat water in a small percolator I bought at Uganda’s version of Wal-Mart, fill a bucket, and take a hot shower that way.  But this, an overhead shower? All thoughts of malaria were gone, and I was overjoyed.  I stood under the hot water for over thirty minutes, feeling the tension of the bus ride eased from my body.

When I got out of the shower after flooding the bathroom, I hung my mosquito net over the bed, climbed underneath, and reviewed my questions for the next day.  I had general questions about Lira that I could ask anyone I talked to, whether they were a farmer or shopkeeper, and questions that were specific to children who had been kidnapped and forced to serve in the LRA.  But soon, I closed my eyes and fell asleep instantly.  Outside of my mosquito net, there was a faint buzz, but whether it was part of a dream or the Lira experience, I wasn’t sure.

The next morning, I joined a mixed group of middle-class Ugandans and expatriate American charity workers for a breakfast of white toast, passion fruit juice, and scrambled eggs.  “Where is the coffee?” I asked the kitchen staff, trying not to sound too anxious.  I was a terrible coffee addict.

“Over there,” a cook said, and she pointed to a small container of Nescafe instant coffee.  I pounced on it, dumped a huge spoonful into the boiling water they had given me to make tea, and asked for some milk.  Most Ugandans drank their coffee black, with about four to five spoonfuls of sugar, so the staff was a bit puzzled.

“Do you want a glass of milk?” they asked.  I gave up and drank the coffee black, which gave me a little bit of a stomachache, but I felt relaxed and happy to finally be out of Kampala.  I loved the capital, but sometimes you needed a break from the pollution, crowdedness, and traffic jams.  In Kampala, when I would sneeze, I would fill a tissue with black specks of dirt from the pollution and smog.  As I knew from health reporting, the city was a nightmare for asthma patients.  But in Lira, at least, the morning air seemed perfectly clear, as if a car or truck had never passed through.

My friend Zack met me out front, and he agreed to give me a tour of the town.  “I’m really happy you’re here,” he told me.  “Sometimes it gets really lonely.”  He told me about the preparations he was making for the child soldier conference. The children would attend workshops and talk about transitioning to life back home, but a major point of the conference was for the kids to have fun.  Most of them had missed out on their childhoods, forced to work as sex slaves if they were girls, or to fight their own families and communities, regardless of their gender.  There were stories of kids forced to kill their own parents, and loot the stores of their parents’ neighbors.  When it was over, they were told by the rebel commanders that they would never escape—their communities could never forgive them.

Zack and I headed over to a charity where he had worked as an intern when we studied abroad together, a charity started by a Ugandan who came to Europe as a refugee after being tortured during the former President Obote’s regime. The man, Nicholas, named the center after his wife, whom he met in Belgium when he fled Uganda, and the two resettled in Lira, where they work with disabled children, war-affected children, child mothers, and child soldiers.

As we walked to his charity along a dirt road where men offered bicycle rides around Lira for a low cost, we stopped in a small, tidy market full of vendors selling red groundnuts, cassava and mangos. Zack bought some groundnuts for his Ugandan “mom” in Lira, a friend he made during his first trip up there. We then stop at a vendor who sold a cheap meal of fried dough; called chapatti, eggs, and tomato slices, wrapped together to create what is called a “Rolex.” Not a watch, but a cheap, fattening dish, delicious because it’s a combination of fried dough and a lot of oil.

We then passed a large field full of homeless children, skinny and wearing ripped t-shirts and pants, who were kneeling near a tree, sniffing plastic glue containers for a high.  The field was mostly empty, but at the end there was a water pipe, where children came to fetch water and carry it back to their homes in large plastic containers.  Although I was used to seeing extreme forms of poverty in Kampala, which has been stripped of any semblance of social welfare from years of economic structural adjustment, I wasn’t used to seeing overt drug use by kids, who were looking for a moment of relief from a cheap high.  I wondered if any of the kids had been abducted by the LRA, or if they were suffering from post-traumatic stress disorder.  One thing was for sure, though, they had all been impacted by the war.

We visited the charity where Zack had worked, a rehabilitation center for disabled and war-affected children, and then went to a nearby school that had been created for former child soldiers.  The school looked like other high schools in Uganda, but a little nicer.  It wasn’t as crowded as other schools, and the facilities looked clean and new, though modest.  On a wall surrounding the school, the children had painted a mural of how they saw themselves as adults, and what they wanted their lives to be like.  Pictures of smiling lawyers, judges, and nurses decorated the wall.  Some of the children, of course, were already young adults in their twenties, trying to finally go to school after spending so many years abducted in the bush.

Zack had been to the school frequently to organize his conference, and he explained the kind of reporting I was interested in doing to the school’s headmaster.  The school was called Rachele, named after an episode in 1996 when 139 girls from a girl’s boarding school in northern Uganda were kidnapped by the LRA.  The college’s vice president, Sister Rachele Fassera, an Italian nun, offered her life to the LRA in exchange for the girls’ release.  The LRA decided to spare Rachele and gave her 109 of the abducted girls, but kept 30 of them hostage.  Five of the girls died in captivity, and 21 eventually escaped.  The Rachele School was set up, coincidentally, by the editor in chief at the newspaper I worked for, a Belgian journalist who wrote a book about the incident, called the Aboke Girls.   Sales from the book, and my editor’s fundraising, helped her put thousands of former child soldiers through school.

That day, visiting both the rehabilitation center and Rachele, I interviewed about ten children for my newspaper, and more than half had been abducted by the LRA.  The children at Rachele were very open in talking about their experiences with me, and used to having international visitors come to the school.  I interviewed a former child soldier named Bunny, who gave me his e-mail address so we could stay in touch, told me about his attempts to reconcile his former life with his current life.

The LRA had broken into Bunny’s home when he was a child, stolen his family’s few possessions, and abducted him and his brothers.  In order to be initiated into the LRA, they were whipped and beaten extensively, and forced to travel on foot for hundreds of miles to attend the LRA’S military training camps in Congo, Uganda, and Sudan.  Bunny and his brothers eventually escaped, but Bunny never prepared himself emotionally to run into the soldier who had kidnapped him.

Bunny had been in Lira when he saw the kidnapper, a young adult in his twenties. All the memories of his capture came rushing back.  I thought he would tell me then that it had been traumatizing for him to see his former captor, or that the encounter gave him nightmares.  But he didn’t.  Instead, Bunny told me that he went up to his former captor, and told him he was glad that he had escaped.  His captor, like him, was not an enemy—he was another child who had once been kidnapped and forced to serve under the LRA.  Seeing his captor in town, watching him attempt to build a life again in Lira as well, was a turning point for Bunny, who still remembered each detail of his capture vividly.

When I would go back to Kampala, Bunny’s story resonated with me, as did the story of a boarding school matron named Margaret.  Born and raised in Lira, she now worked for a rehabilitation center.  Like most northern Ugandans, she loathed the LRA and the Ugandan government in equal measure.  Both had been attacking the people in towns like Lira for two decades, each accusing them of collaborating with the other side.  But to Margaret, neither the LRA nor the Ugandan army was the largest threat to her children’s safety.  What Margaret feared was malaria.  A mother of ten, she had lost her four-year-old daughter many years ago to the disease.

We had sat in a small office room at the rehabilitation center, which had a map of Uganda neatly taped to the wall, and two large benches for guests to sit on.  Initially, Zack had had to convince her that I was not, well, a spy.

“She really doesn’t like me,” Zack whispered before he introduced me to her.  He also told me that the charity had basically run out of money three months before after Christopher, the founder of the center, got in a fight with their donors, and Margaret hadn’t been paid in three months.  Christopher and his wife had just opened a bar in Lira, planning to fund their operations by selling drinks to charity workers and farmers in the small town.  Donors be damned.

Margaret didn’t like me at first, either.  She scowled when she saw us, and reminded Zack that she hadn’t been paid by Christopher in months.  Zack responded sympathetically, then asked if I could interview her for a story I was writing about the recovery of northern Uganda, and the impact that the war had had on children.   A journalist.  Margaret gave me a disgusted looked after seeing that I had been stupid enough to wear my New Vision t-shirt around Lira—why not just wear a gigantic sign, that says, I’m a spy? After all, New Vision was partly owned by the government.  But she gave in, and told me what it was like to live in LRA in the 1980s and 1990s, when your children might be abducted, and you could never travel at night.

As we talked, Margaret told me that she hated the DDT spraying, and didn’t want them to spray her home.  She was worried that it was dangerous, or that the government knew it was dangerous and did not care.  She didn’t understand why the UN, after two decades, couldn’t round up the LRA, which consisted of about two thousand soldiers, most of them abducted children.

Even though she was against the DDT spraying, Margaret told me in detail about how the disease had killed her daughter, and how her other daughter suffered from a case of cerebral malaria, which didn’t kill her but left her physically and mentally retarded.  She blamed herself for the impact malaria had on her family, for not having enough money at the time to get treatment for her children, and told me she always kept malaria drugs in her home now, just in case.

“I feared that disease for so, so long,” she told me.  However, the DDT frightened her just as much, and she was afraid the chemical would hurt the children she still had.
I did interviews with Ugandans throughout the weekend about the effect the war had had on them, and how those who had been abducted by the LRA had attempted to rebuild their lives.  On Sunday, I caught a bus back to Kampala, and wondered what stories the other passengers carried quietly with them.  Were they like Bunny, making peace with their escape, as well as their captors? Or Margaret, afraid that the government would poison the Ugandans who had survived the decades of war?

I stayed in Uganda for a few more weeks, working as a reporter, but none of the stories compared to those that I encountered in northern Uganda.  I wondered if Margaret had ever been paid, and thought about her daughter, wasting away in Margaret’s village, unable to do basic activities at the local primary school.  The twenty mosquito bites that I had picked up in Lira faded into my skin, and I never developed a fever or chills.  I hadn’t been taking prophylactics, but I was lucky.  The mosquitoes that bit me were malaria-free.

Soon, it was time for me to head back to New York and finish a master’s degree in journalism that I had started at the City University of New York in Times Square.  I came back in August, and moved to a small room in Queens while I finished my degree.  Zack eventually came back to the United States in November, but he felt unfocused, still thinking about what would happen to the child soldiers that attended the conference he organized.  The rebel government was unable to sign a peace agreement with the Ugandan government, but they didn’t begin attacking Uganda either.  News from Uganda in the international press was dwarfed by the conflict that began to explode in Congo, Uganda’s neighbor.

But at night, when I tried to imagine my future, I couldn’t see myself working at a paper or news website in the U.S.  I had started an internship with the Queens Tribune, a weekly paper in New York City, but I checked Ugandan news websites more frequently than I did my own paper.  Somehow, I knew, I had to get back North, and I didn’t care about the threat of malaria.  I had dodged the malaria bullet, and I could do it again.  I had to go back, and chase those stories in Uganda.  All I needed was a notepad and a good mosquito net.

You are going to die. Of the more than 8 million people now alive in New York City, all will be dead, eventually. That’s a lot of bodies:  44 million feet of cadaver when laid end to end, assuming average height. And in New York City, where space is always at a premium, there’s not enough earth to grant them all eternal rest.

Green-Wood Cemetery in Brooklyn has interred almost 600,000 bodies in its 171 years of operation.  As its graves have filled, it has followed one of the tenets of good planning, build up, and developed large community mausoleums, which it markets on its website as “a choice once reserved for the wealthy, is now available to our families at prices comparable to that for in-ground burial.”

The price for in-ground burial has gone up, too.  A single, non-premium grave at Green-Wood now lists at $11,000.  The miscellaneous charges for burial, the foundation for the stone, having the funeral after 4 p.m. or on a Saturday will add an extra $2500 or so.  Gravestones, which the cemetery does not supply, cost anywhere from a few hundred to several thousand dollars, depending on the size and intricacy of the marker.

Richard Fishman, the director of the New York State Department of Cemeteries, said that the prices reflected more than supply and demand.  The cemeteries are heavily regulated non-profits and have to charge more as their capacity shrinks in order to keep themselves financially solvent in perpetuity.

“It costs $5 million a year to keep Green-Wood going as it does,” Fishman said.  “And it’s not as though those being served with that money can be charged.”

No, indeed.  So those now dying have to pay more for the upkeep of those who died before, just as those to die in the future will pay a premium for the upkeep of those now paying.  The similarities to a pyramid scheme are stark, though necessity rather than criminality is the source of the creativity.

While the department only has jurisdiction over non-denominational graveyards, those run by religious organizations have many of the same concerns.  St. Patrick’s Cathedral runs Mount Calvary Cemetery in Queens, the most populous cemetery in the city with over 3 million permanent residents.  They’re almost done, said Lyndon Roche, a spokesman for the diocese.  He said that St. Raymond’s, another Catholic cemetery in the Bronx, would have room for at least another 20 years.

“You look on either side of the Cross-Bronx, because St. Raymond’s is all around you, and there’s still plenty of space,” Roche said.

The nightmare scenario can be found in Ozone Park, at Bayside Acacia, a small Jewish necropolis.  The Upper West Side congregation, Shaare Zedek, doesn’t have enough money to pay for proper maintenance, and the cemetery has gone to seed.

Vines grow over tombs, headstones are toppled and broken, crypts and even coffins have been opened.  Calls to the Rabbi were not returned.

At Mount Olivet Cemetery, which has been pressed for space for a number of years, there haven’t been any issues of abandonment, nor have they dramatically increased their rates, nor are they completely full.  It’s just more of the same at Mount Olivet, said David Gigler, the superintendent.  They have been tearing up roads to make room for more graves and, like Green-Wood, has developed a large community mausoleum, which includes more and more niches for cremation urns.  Gigler said that there weren’t other reform options available.

“Maybe in 25 years, they’ll come up with something,” he said.  “But by then, I’ll be retired.”

In some crowded places around the world, they have come up with a broad array of somethings.  In Great Britain, where burial grounds are most often small, ancient churchyards, the government has permitted the reuse of graves that have been untended for more than 75 years.  The tiny nation-state of Singapore allows interment for 15 years, followed by mandatory exhumation and cremation.

Cremation is not allowed under Islamic law, which is why burials are still in demand, despite their impermanence.  The Italian Catholic Church, which had long opposed cremation as heretical, recently began allowing Mass for people whose remains were to be burned.  But cremation can be dangerous to the environment, as mercury from fillings is borne on the smoke.  So Sweden has permitted the use of a new method, promession, wherein the body is frozen in liquid nitrogen, shattered and then thawed, allowing the body’s water weight to evaporate and leaving a small amount of residue that can be safely recycled into the earth.

Will New York City allow these, or other new developments in the disposal of dead bodies like burying coffins upright?  Absolutely not, said Fishman, from the Department of Cemeteries.  He said there were plenty of cemeteries in Westchester County, Connecticut, New Jersey and Long Island that had room and land to expand.
As in life, so in death: when the city gets too crowded, move to the suburbs.

In the past, adults called from employment centers looking to place high school kids in Betancourt’s store. Now, they’re calling for themselves – and they’re desperate for income. “They were like, ‘Do you have anything?’” said Betancourt, who manages a Carvel’s in Forest Hills, a neighborhood in Queens in New York City. “They just wanted to work.”

Betancourt is not the only manager getting such calls. Across the country, other businesses with positions that don’t require qualifications or degrees – mainly food service, retail, and customer service – say they are being flooded with applicants who are too qualified for them. As joblessness continues to rise, people who need to pay their bills may be willing to take anything to carry them over.

Working a job that is beneath your skills is part of a broader phenomenon called underemployment. According to the Bureau of Labor Statistics, nearly one in six workers is unemployed or underemployed. That’s almost double what it was a year ago, when about one out of eleven workers was in that situation.

That captures the magnitude of the jobs crisis, said Kevin Jack, principal economist and statewide labor market analyst at the New York State Department of Labor. Historically, those rates were highest among those with low education levels. But now, even white-collar workers are vulnerable, so there is more competition for lower end jobs, Jack said.

Economists say there is no way to determine how many people are in jobs that are beneath their skill level. Other types of underemployment – working for fewer hours than you’d like and working for lower wages than your skills deserve – are quantifiable. A skills mismatch, however, is hard to measure, said David Howell, a professor and economic researcher at Milano The New School for Management and Urban Policy. “Who’s to say who is over- and under-qualified for a job?” Howell explained.

But some economists are troubled just by the concept of rising underemployment rates.

“Underemployment is a very, very corrosive thing on our economy,” said Mark Zandi, chief economist at Moody’s Economy.com, in a phone interview with students at the City University of New York’s Graduate School of Journalism.

Because people who are underemployed earn less than they used to, not only do their spending habits decrease, but their general mindset is also affected. “You’re panicked, you’re worried, you’re nervous, and that causes you to pull back even more,” said Zandi.

This anxiety can lead to a lack of confidence in both your financial future and in the country’s. “In fact, the difference between a typical recession and a depression is a loss of faith in our economy,” said Zandi. “And people who are underemployed certainly are losing faith.”

But underemployment is not necessarily a product of the recession, said John Robst, an associate professor of economics at the University of South Florida who specializes in labor economics and who recently published a paper about overeducation and underemployment.

For example, narrowing a job hunt to a specific metropolitan area – even one as large and as job-laden as New York – can make the search more difficult. In such a case, the cause of underemployment is personal, and not wholly symbolic of the job market.

Many workers consider themselves underemployed – and in a sense they are, said Robst, if they have skills that are more advanced than their job requires. But when is that significant from a macroeconomic perspective? If someone is unsuccessful in a nationwide search, that is more likely to reflect the broader economy than if someone is unsuccessful in a search that is geographically limited, which reflects personal choices, Robst said.

“Is it really there?” asked Robst about a recession-related rise in underemployment. “It’s tough to say.” In a weak economy, he explained, there’s probably a slight increase in underemployment, but it gets a lot more attention because the press picks up on it.

Unemployment has taken its severest toll on the young labor force, said Joseph McLaughlin, a senior research associate at the Center for Labor Market Studies in Northeastern University in Boston. Workers between the ages of 16 and 29 make up more than 52 percent of this recession’s laid off work force, said McLaughlin. And some of those newly unemployed young workers are turning to all sorts of jobs, at least to support themselves temporarily.

Twenty-six-year-old Eric Rubin of Linden, N.J. may soon join the ranks of the underemployed. Rubin is an environmental engineer who was laid off in October. He has a bachelor’s degree in geography from George Washington University, a master’s in environmental management from Montclair State and a 3.92 GPA, but he’s having a hard time landing a new job.
Rubin said if he doesn’t find something within the next few months, when his unemployment runs out, he may need to resort to working at a local fast food joint. “It’s weird,” said Rubin. “If you asked me five years ago where I would be, it wouldn’t be here. I wouldn’t be unemployed. I said I’m going to school, I’m getting my master’s degree, I’m going to have a job. And here I am with a master’s degree, but with no job.”

Because so many young workers are the victims of layoffs and hiring freezes, underemployment and its effect on morale is a big concern for that age group. “It’s not ideal to come out of Harvard and work out of McDonalds, not Goldman Sachs,” said Lindsey Pollak, a career development guide writer whose focus is young professionals.

People in these situations sometimes believe that if they start at a low salary, they might never recover, but Pollak discourages that notion. “I refuse to be one of those people who says that you’re destroyed because the economy is bad,” said Pollak.

Zandi, on the other hand, said he was worried because acquired skills can degrade if people aren’t working in their fields. “You get thrown out of a job that utilized your education and background and you get pushed into something that doesn’t, you lose the skills and talents pretty fast,” he said. This can also have a significant impact on the economy at large, because it can slow down the country’s economic recovery and subsequent growth.

Not everyone is as worried about skill loss. Ann Baehr, a certified professional resume writer and president of Best Resumes of New York, said, “No one is going to think that you lost your edge and your skills if you’re in a temporary position for six months or a year.” In fact, workers in these positions may even expand their skill set, possibly in another industry.

Some workers are willing to do whatever is necessary to stay afloat, but they worry about listing menial jobs on a resume. Pollak said it shouldn’t be a concern. “I think that no one will fault you for what you do during the great recession of 2009 just to get by,” she said.

But for many, it’s not just a matter of making a living – it’s also a matter of pride. “It’s more of a concern on my ego,” said Rubin. “I went to school for eight years for a reason. And here I am and I might be working at McDonald’s or Barnes and Noble.”

Here are some tips for the underemployed from Lindsey Pollack, who writes career development guides for young professionals:

•    Pride shouldn’t get in the way. “Don’t crawl under a rock because you’re embarrassed.”
•    “You’ve got to stay in the game”
o    Keep up on industry news – “If you want to work on Wall Street but you’re now working in retail, read the Wall Street Journal.”
o    Network, network, network.
•    Volunteer – you can get experience and it looks great on your resume.

Cleveland is not the only city struggling with providing access to the uninsured. Many hospitals around the country are making it more difficult for the uninsured to receive health care. Hospitals in several U.S cities have been consolidating and expanding their facilities outside of the city center where many uninsured live. In Cincinnati and Denver, new outpatient centers are springing up in wealthy suburbs. These hospitals are designed to look like high-end health spas. Hospitals in the city, where most uninsured receive care, remain overcrowded and run-down.

“What’s happened more and more— I guess you can call it uninsured and Medicaid patients are marginalized—but I like to say they’re abandoned,” said Gary Benjamin, a spokesperson from the Universal Health Care Action Network of Ohio.
One-third of U.S hospitals are operating in the red. In order to stay afloat, many of these hospitals have decided to relocate to areas where there is a better payer mix. “It’s just like retail, they are going where the well off live—out of the city into better paying neighborhoods,” said Alan Zuckerman, president of Health Strategies and Solutions. Zuckerman said it’s tough to operate a hospital in the city these days. Not only are urban hospitals caring for the uninsured, they also have larger amounts of debt, density issues, more competition, and higher labor costs because of a unionized work force.

The Cleveland Clinic and University Hospital are the two big hospitals operating in greater Cleveland. Although the main facilities for both the Cleveland Clinic and University Hospital have remained in the city, both hospitals built outpatient facilities in the suburbs to boost revenue and attract insured patients. “And they wonder why poor people are using the ER in the city? It’s all that’s left,” said Benjamin.

As cities expand, hospitals are taking advantage of an opportunity to open up new outpatient facilities out in the suburbs so that they can make money.

Cincinnati is steadily growing. By 2020, the area between Dayton and Cincinnati is expected to fuse together. Tom McCormally, a spokesperson for Children’s Hospital in Cincinnati, said there is a demand for more space at Children’s Hospital, the big nonprofit hospital in the city center. “It’s not like we’re cannibalizing. Our growth has been phenomenal in the last 10 years, and I’m not seeing the numbers drop when we open up new facilities.” Children’s has set up 10 outpatient centers in the suburbs of Cincinnati in the past several years.

In Denver, the population has already grown out toward Aurora and Boulder. The Denver-Aurora-Boulder combined statistical area had an estimated population of 2,998,878 in 2007, and ranked 17th most populous U.S. metropolitan area. Mike Romano, a spokesperson for the Catholic Health Initiatives, thinks that if hospitals want to make money, expanding into suburbs is certainly one way to do it. Denver’s expanding metropolitan area has made it one of the nation’s hottest markets for healthcare construction.

As hospitals follow the money out to the suburbs, they’re also able to embark on a new image that’s designed to attract patients with money.

While care is compromised for the uninsured in Cleveland, it’s top notch for those who can pay. In September, the Cleveland Clinic opened up two new buildings. The first was the state-of-the-art Sydell and Arnold Miller Family Pavilion, home to the Clinic’s cardiovascular program. The center is recognized as being the best in the world, according to U.S News and World Report, which is why the Cleveland Clinic is able to transport non-local patients in one of their two private jets.

University Hospital, the Cleveland Clinic’s main competitor, is trying to catch up. Their new projects include a $232 million cancer hospital, a seven-story garage, and a $45 million emergency center, scheduled for completion in 2010.

In Cincinnati, hospitals are not reaching out to uninsured patients as they expand. Instead, new hospitals are marketing their facilities to the insured, taking advantage of population growth just north of the city.

The Westchester Medical Center is currently being built from the ground up and will be operational next year. A new hospital hasn’t been built in Cincinnati for the last 25 years. But this hospital is being built in the suburbs, not on “Pill Hill”—the area in the city where the most hospitals had been located for decades. “Pill Hill” is also known as Clifton Heights, near the University of Cincinnati and walking distance from downtown Cincinnati where most poor, African-Americans live.

Most recently, Children’s Hospital opened up an outpatient facility in Liberty Township, a suburb north of Cincinnati, in the center of the fast-growing Cincinnati-Dayton metroplex. Although the two big nonprofit hospitals have been able to stay in the city center, they have also been able to expand elsewhere.

The suburban areas of Denver are being populated at a rapid rate. Douglass County—where two state of the art hospitals have been constructed—has been one of the nation’s fastest-growing areas for the past decade. From 1990 to 2001, the population increased by 224%. People in this part of town are also considered high-end patients. In Douglas County the median income in 1999 was $82,929—more than double the figure in the city of Denver. In the Sky Ridge area, about 73% of the population is covered by private insurance. Both hospitals in Douglass County—Sky Ridge Hospital and Parker Adventist Hospital—were designed with marble floors and healing gardens to appeal to this wealthy demographic.

The same is true in Denver’s northern suburbs where the Exempla Health Care System is trying to control the market. The median income there is almost 40% higher than Denver’s urban center.

Dr. David Sbarbaro, medical director of University Physicians, a doctor and patient resource at the University of Denver School of Medicine, said that Denver’s construction boom is designed to meet demand. “The city has grown, so the question is how to redistribute services,” he said. “It’s become increasingly difficult to maneuver around Denver because it has gotten so crowded. We’re seeing a redistribution of services that will be better balanced.”

Rick Wade, vice president of the American Hospital Association, said hospitals usually follow population growth. He said hospitals are the economic engines of an area. They create jobs within, and commerce is built up around them. “They [hospitals] have a dual and conflicting role as a hospital and an economic engine. They have to deliver care but also be economically strong because the city depends on it,” he said.

The Center for Studying Health Care Change, a nonpartisan policy research organization, published a study this summer that said safety net hospitals are suffering because of the liberties private hospitals are taking in expanding to affluent suburbs. Newer suburban facilities are taking away paying patients from these safety net hospitals and further straining them with a disproportionate number of uninsured. In addition to the nice rooms, patients now can stay in the suburbs for their hospital care instead of traveling longer distances to downtown areas. These new suburban facilities are also equipped with the latest technology and amenities. This creates the impression that the suburban facilities have higher quality of care than some of the older looking safety-net hospitals. Disparities in health care are only getting worse as a result.

Cleveland’s shrinking hospital system has certainly hurt the uninsured. Ashwini Sehgal, co-medical director at the Cleveland’s Department of Public Health and a kidney specialist a MetroHealth Medical Center, moved to the city 15 years ago. There were 22 hospitals then, now there are only four. The Cleveland Clinic controls half of the market and University Hospital controls one-third. The other small hospitals—MetroHealth, Parma Community Hospital, St. Vincent Charity Hospital and the VA Medical Center— take on the remaining patients. Most of them are uninsured. With so few hospitals and so many uninsured people in Cleveland, it’s an unfair burden.

Both the Cleveland Clinic and University Hospital have primarily been sending their uninsured patients to MetroHealth. Sehgal said that most recently, MetroHealth had to lay off staff and in turn, they have had to send some of these uninsured patients to the Free Clinic or the Neighborhood Family Practice. Peggi Chella, a spokesperson from the Neighborhood Family Practice, said her clinic has been overwhelmed in recent months because of an influx of so many uninsured patients.

In Cincinnati, Children’s Hospital and University Hospital take in most of the uninsured. As a result, their emergency rooms are overwhelmed. McCormally said Children’s Hospital has had to turn away patients from the main campus hospital in the city for the first time this year. Similarly, University Hospital has had to send their ambulances to other hospital emergency rooms, usually further away, because their emergency rooms are full to capacity.

But care at an outpatient center away from the city is even harder to come by for an uninsured patient in Cincinnati. Trey Daly, a senior lawyer from the Legal Aid Society in Cincinnati, said the typical scenario follows along these lines if a patient from Children’s Hospital or University Hospital is sent to an outpatient facility: “someone needs surgery at an outpatient center, and the surgeon requires payment upfront but the client can’t afford to pay so they are turned away.”

If the city’s nonprofit hospitals are turning away the uninsured because their emergency rooms are full, and the outpatient facilities are not accepting them because they can’t pay, uninsured patients only have clinics to turn to. Cincinnati has a total of eight free clinics set up to treat the poor. But, these clinics are only opened during business hours and are going to be more overwhelmed as the uninsured population grows. In October, the Greater Cincinnati Health Council released a report that said the number of uninsured people in Cincinnati has increased. Approximately 250,000 persons are estimated to be uninsured in Greater Cincinnati.

In Denver, four new hospitals have been built in the suburbs, and the three existing downtown facilities are uprooting. Presbyterian St. Luke’s Medical Center and St. Joseph’s are both building facilities on the University of Denver’s campus nine miles from downtown, while still maintaining services at the city hospitals. St. Anthony’s Hospital is leaving the city altogether and moving south to Lakewood where there is a better payer mix. Sbarbaro said this leaves the predominately Hispanic northwest Denver uncovered. There will be 39% fewer hospital beds in downtown Denver in the next couple of years because of these moves. This means less access to care for poor, uninsured patients.

Jim Hertel, manager of Managed Care Review, a monthly newsletter that covers Denver’s insurance and healthcare industry, said Denver Health has had to take on all the city’s poor since they are the remaining public hospital for uninsured. Rose and Swedish Medical Centers downtown are also feeling the impact of poor, he said.

Certain policies have fostered these health disparities between the insured and uninsured.
The certificate of need laws, originally designed to limit health care facility costs and allow coordinated planning of new services and construction, were repealed many years ago in several cities. Cleveland, Cincinnati and Denver are just a few examples where this has happened.

Benjamin said that doing away with the certificate of need laws has allowed hospitals to get away with a lot. “That they set it up that way is debatable, but the design of it was to abandon folks in the city,” he said. And unlike some other countries, the United States has no federal agency charged with hospital oversight. As is the American way, hospitals have turned into big conglomerates that compete with each other for business.

Although these big hospitals that are abandoning the poor could be easily mistaken for-profit hospitals, most are nonprofits. By law, nonprofit hospitals receive a tax exemption for providing charity care since they were originally set up to serve the poor. But after Medicare and Medicaid were created in 1965, the hospital industry argued that there would no longer be enough demand for charity care to satisfy the IRS’s tax-exemption standards. Most Americans, they said, would be covered either by the new government programs for the poor and elderly or by private health insurance.

Some of these hospitals have come under fire recently from patient advocates and members of Congress for slacking on charity care—especially as they build these new facilities away from the city center. Instead of defining charity work as caring for the poor, some hospitals think it’s acceptable to count health fairs as charity care. Still, they receive millions of dollars in tax exemptions and are able to compete as big businesses.

Colleen O’Toole, president of the Greater Cincinnati Health Council, attributes the
growth and expansion of the city’s hospitals to better reimbursement levels after federal budget cutbacks during the 1990s. By combing with other hospitals to form large health systems, individual hospitals have gained leverage and are able to negotiate better prices with health insurance companies.

One of the main reasons hospitals have done so well in the competitive health-care market today is because they have merged with a number of regional hospitals and family health centers in order to offer a single, stronger source for health insurance negotiations.

With this new capital, hospitals have been able to take on major construction projects, advance sophisticated technology and market it to paying patients. It makes sense that many of these new facilities are most accessible to affluent, well-insured consumers.

Hertel thinks the smarter hospitals saw an opportunity with the Bush administration and went on construction sprees. “The financial market was willing to finance hospital expansion… tied with the best level of Medicare payments in decades and the laissez-faire attitude of the government,” he said.

But as the number of uninsured keep growing, cities and states realize something has to be done. Twenty percent of adults in Colorado are uninsured. To make matter worse, Colorado has one of the most limited Medicaid programs in the country. The Blue Ribbon Commission on Health Care Reform was created by the Colorado legislature in 2006 to come up with ways to cover the uninsured and control health care costs. The commission realized hospitals played a significant role in the well-being of the uninsured. In its recommendation, the commission stated that “safety net providers such as community clinics and hospitals play an essential role in caring for those on public programs and those without any health coverage. If we expand public programs to include more people, and as we recognize that noncitizens will continue to need care even if they do not have coverage, we must preserve and enhance safety net providers’ ability to serve these populations.” This past March, however, health policy analysts in Colorado criticized the recommendations, saying they would damage the market and decrease consumer choice.

In Cincinnati, the situation is a little brighter. For the past 40 years, Cincinnati taxpayers have voted on a levy that gives money to Children’s Hospital and University Hospital. The indigent care levy is a measure that uses city revenue dollars to pay for the poor’s health care. University Hospital receives 80 percent of the local levy funds and Children’s Hospital gets the rest. On top of the money generated by local taxpayers, a federal program called the Hospital Care Assurance Program, or HCAP, has sent more than $147 million to the hospitals since 1996. Even with the extra money, hospitals said they lost a combined $12 million last year in providing health care to poor people.

Policies for hospital charity care have also improved in Cincinnati. Policies have  expanded income eligibility levels at a higher percentage above federal poverty levels recently. The Greater Cincinnati Health Council said in a report this year that while policies from hospital to hospital vary, a family of four with a household income of $80,000 would in some instances meet the requirements to receive discounted care.

Back at the uninsured forum in Cleveland, organizers believed they were doing something revolutionary when they got hospital representatives and uninsured people in the same room together that Saturday in November. “It’s a totally local level and it remains to be seen how much momentum this will get,” said Chella.