Asean nations sign first charter

Leaders of the South East Asian group of countries, Asean, have signed a landmark charter committing them to promote human rights and democracy.

The document, agreed by the 10 member states at a summit in Singapore, sets out Asean's principles and rules for the first time in its 40-year history.

But the signing ceremony took place amid continued condemnation of the rights record of Asean member Burma.

Critics say the charter will not rein in Burma's military regime.

The generals sparked international outrage when they violently suppressed anti-government protests in September - killing at least 15 people and imprisoning thousands more.

The controversy continued at the summit, where host nation Singapore had invited the UN's special envoy to Burma, Ibrahim Gambari, to make a speech.

Burmese officials objected, and gained the support of the eight other member nations, blocking Mr Gambari's briefing.

Earlier, a senior US official had warned that Asean's credibility was at stake over its handling of the crisis in Burma.

'Momentous step'

One of the most significant pledges in the charter is to set up a regional human rights body.

But critics say it will have limited impact as it will not be able to punish governments that violate the human rights of their citizens.

Negotiators rejected some more radical plans for the charter - such as enabling sanctions and possible expulsions against member states which seriously breached agreements.

"Of course there has been some watering down," former Indonesian Foreign Minister Ali Alatas, who helped draft the charter, told the Associated Press. But he said the document still represented a "momentous step forward".

After the signing ceremony, Singapore Prime Minister Lee Hsien Loong was similarly upbeat, saying the charter would pave the way for closer ties between member states.

"To make Asean strong and relevant, we must accelerate and deepen regional integration," he said.

"The Asean charter is a crucial step in this process."

The Association of South East Asian Nations (Asean) is composed of Brunei, Cambodia, Indonesia, Laos, Malaysia, Burma, the Philippines, Singapore, Thailand and Vietnam.

BBC

Top surgeon lists five key blunders that may have cost Diana her life

Diana, Princess of Wales, might have survived the car crash in which she died had French medical staff not squandered vital time, her inquest was told yesterday.

Thomas Treasure, a leading British surgeon, told the inquest that a "window of opportunity" may have existed to get her to hospital half an hour before she was taken there. Professor Treasure, a former president of the European Association for Cardiothoracic Surgery, said that medics had done "very substantial good" in the initial period after the accident but that once the Princess was in the ambulance time began "slipping away".

The professor, who was asked to review records of the treatment given to the Princess for Lord Justice Scott Baker, the coroner, conceded that the combination of her internal injuries was extremely rare and serious but said it was theoretically possible that she might have been saved.

The inquest heard of a sharp divide between the French approach to multiple-injury patients - which favours treatment by doctors at the scene - and the "scoop and run" approach taken in Britain.

The jury has been told that the Princess was freed from her Mercedes within 35 minutes of the crash on August 31, 1997. She suffered an apparent cardiac arrest and had to be given heart massage and stabilised on the road before being put inside the ambulance, where she was intubated and ventilated and given a fuller examination.

At one stage the Princess shouted out, pulled out her drip and was so distressed that she had to be restrained, the inquest was told. It was not until 1.40am that she was judged sufficiently stable to be taken to hospital.

Dr Jean-Marc Martino, the emergency resuscitation specialist, then told the ambulance driver to go slowly so as not to destabilise the Princess further. At one point the vehicle had to stop for about five minutes near the hospital entrance when her blood pressure dropped to perilously low levels and she needed stabilisation.

A series of senior doctors have told the inquest that if she had not had such intense treatment on the way she would have been dead on arrival.

The jury has been told how she suffered massive internal bleeding because of a rupture to one of her pulmonary veins - attached to her heart - as well as the casing of the heart itself. Once in hospital just after 2am, an X-ray showed massive internal bleeding on the right side of her chest.

A surgeon opened up her thorax to search for the source of the bleeding but could not immediately find the ruptured vessel. Professor Alain Pavie, one of the top cardio-thoracic surgeons in France, who had been called in from home, then took over, extending the cut to find that the rupture was on the left rather than the right where the bleeding was.

He sewed it up but, despite prolonged resuscitation attempts with oxygen, heart massage, electric shocks and massive doses of adrenalin, doctors finally gave up the battle at 4am.

Professor Andr‚ Lienhart, who reviewed the case for a French investigating magistrate, told the inquest yesterday that there were no recorded cases in medical literature of patients with the same combination of ruptures arriving at hospital alive.

Professor Treasure said: "They had done some very substantial good relatively quickly - stabilising the neck, getting her out of the car - with just a brief episode when they lost the pulse, they got things going again and produced a normal blood pressure."

But, describing the further treatment at the scene and the subsequent journey to hospital, he said: "That's where the time was slipping away."

He went on: "That's my analysis, they had done a lot of good in that first half hour but from there, the next big amount of good that could be done required a surgeon."

Nicholas Hilliard, counsel to the inquest, asked: "Is it your view that part of that time, the essential period, was squandered?" Professor Treasure replied: "It's a hard word, isn't it, but I think opportunities were lost."

He went on: "At the point at which she was in the ambulance and that initial assessment had been done pretty accurately and the neck was stabilised and the circulation . . . I'm not quite sure what happened after that, that they didn't have her in hospital and Professor Pavie alerted rather sooner."

He added: "When I pick through this with the benefit of hindsight [and ask] 'was this recoverable?' the answer is, 'Yes, it just about was'."

He also questioned the large doses of adrenalin given to the Princess at the hospital. "They ran out of syringes of adrenalin. It's quite extraordinary," he said. "They didn't lose for the lack of trying but it was not necessarily productive trying."

Professor Treasure, who is this week due to publish a study on how best to treat multiple-injury patients, also questioned the decision to stop so near to the hospital to stabilise the Princess when her blood pressure dropped.

The inquest continues.

Times, UK

Sarkozy defiant against strikers

French President Nicolas Sarkozy has vowed to maintain his controversial economic reforms despite a second week of crippling industrial action.

He said the reforms were overdue and that they were necessary "to confront the challenges set by the world".

Hundreds of thousands of civil servants joined striking transport and energy workers on Tuesday over the proposals.

The 24-hour action is said to be the largest protest against Mr Sarkozy's reforms since he took power in May.

In his first comments since the stoppage began, Mr Sarkozy said: "These reforms have been put off for too long.

"After so much hesitation, so much procrastination, so many U-turns, a complete break is now needed to stop the decline."

Adopting a defiant stance, he said French voters gave him a mandate to carry out economic reforms when they elected him.

"This clean break I promised to the French during the election campaign. The French approved it," the president said in a speech to an assembly of mayors.

"We will not surrender and we will not retreat," Mr Sarkozy added.

Analysts say Mr Sarkozy is attempting to succeed where his predecessor Jacques Chirac failed, by standing firm against the strikers and completing his reforms.

Opinion polls suggest voters back the French leader's plans to reform "special" pensions which allow transport and utility workers to retire early, but that civil servants have the sympathy of a majority of people.

Commuter chaos

Teachers, postal workers, air traffic controllers and hospital staff launched a 24-hour stoppage on Tuesday over planned job cuts and higher wage demands, as students continued to demonstrate over university funding plans.

Many thousands joined street protests in Paris, Rouen, Strasbourg, Marseille, Grenoble, Lyon and other cities.

The latest nationwide stoppage left many schools closed, hospitals providing a reduced service and newsagents without newspapers.

The French capital's two airports and Marseille airport in the south suffered delays and cancellations.

Finance Minister Christine Lagarde said the dispute was costing France up to 400m euros (œ290m) a day.

The CGT union representing French energy workers, who began a 24-hour strike on Monday night, said they had cut nearly 9% of capacity at nuclear plants.

Rail and bus workers are on their seventh day of an indefinite stoppage against planned pension cuts.

Half of the country's high-speed TGV trains were operating on Tuesday, while in Paris only one metro train in three was in service and less than half of buses were running.

State rail operator SNCF, which is due to hold talks with transport unions on Wednesday, says the number of its workers on strike had fallen since last week.

But with traffic gridlock on Tuesday, the stoppage still caused havoc for millions of commuters across France.

Eight unions representing 5.2 million state employees - around a quarter of the entire workforce - say their spending power has fallen 6% since 2000, though the government disputes that figure.

Talks to restart

They also oppose plans to cut 23,000 jobs in 2008, half in education. Students are continuing to disrupt classes in half of the country's 85 universities.

They have been protesting since the start of November over plans to let faculties pursue non-government funding.

The transport workers' strike was triggered by plans to scrap "special" pensions privileges enjoyed by half a million staff.

Transport unions voted on Monday to extend their walkout, but have agreed to attend talks with SNCF on Wednesday.

The government has relaxed its earlier stance that it would not enter talks unless strikers return to work.

On Monday Prime Minister Francois Fillon said rail traffic must "progressively restart" for talks to take place.

But he insisted the government would not budge on its commitment to overhaul the

French economy saying it had a mandate to reform.

BBC

Gender issues key to low birth rate

In January, Japanese Health Minister Hakuo Yanagisawa visited the city of Matsue to talk to party members about the falling birth rate.

Arresting the decline would be difficult, he said, because "the number of birth-giving machines and devices is fixed".

"All we can ask for is for them to do their best per head," he said.

Mr Yanagisawa's comments did not go down well. Women reacted angrily to his choice of words, while the opposition accused him of blaming women for the fertility crisis.

But the episode did highlight one thing. Government measures aimed at boosting fertility have so far failed to deliver the desired rise. So what exactly is behind Japan's low birth rate?

Work or kids

Across the developed world, as a general trend, women are working more and marrying later.

But compare Japan with Sweden, for example. More Swedish women work and they marry later, yet the country's birth rate is far healthier. So Japan's troubles cannot be attributed to these two factors alone. In Japan, people flagged up three separate issues as obstacles to child-rearing - money worries, the problems of working and having a family, and a lack of support for mothers.

"Everyone has the impression that raising a child is very expensive," one Tokyo student said. But many young couples do not have much money.

Pay is often linked to age, while a disproportionate number of young people and women are employed on poorly-paid temporary contracts. Child allowances are low, while housing and education costs are high.

The financial situation for young couples can be even harder because many women give up work when they have children - sometimes reluctantly. Some workplaces are unwilling to keep jobs open for mothers-to-be, who can come under both direct and indirect pressure to leave.

In small and medium-sized firms, says Dr Kuniko Inoguchi, former minister for gender equality and social affairs, around 70% of pregnant women end up quitting.

For those women who do return to work, things can be hard.

Many struggle to find affordable child care facilities that can keep infants all day. Others discover that although they have jobs, they bear no resemblance to the ones they left and promotion is no longer a possibility.

"Many women want to work and have kids," said Mitsuko Kamaya, a housewife.

"But it's still the case that it is either work or kids. Women feel that they have to throw one dream or the other away," she said.

"If there was a system that guaranteed women could get back to work, I think more would feel secure enough to have kids."

Hard work

Then there are the practicalities of raising children.

"Families used to live with all the generations together," said one Tokyo pensioner.

"That was good for everybody, as there were more people around to provide support."

In rural areas where this is still common, birth rates are above the national average. But many young couples live in cramped city apartments far from relatives and when babies are born, husbands tend not to compensate for the lack of family assistance.

According to a lifestyle survey in 2001, married men only spent about 30 minutes each day on household tasks or with their children.

This is partly down to traditional attitudes - Japanese men tend not to cook, clean or change nappies. But another problem is a culture of long working hours, followed by compulsory after-work socialising.

"My colleague's wife has just had a baby, but he has to work until 11 o'clock every night," said one Tokyo businessman.

"He only ever sees the baby when it's asleep."

So child-rearing can, in some cases, prove a lonely and exhausting solo experience for mothers, many of whom then decide to stick with just one child.

Social change

Osaka City has the second lowest birth rate in the country, behind the capital, Tokyo. In 2005 it stood at 1.15 births per woman, well below the national average of 1.26.

In recent years, officials there have worked hard to introduce family-friendly policies.

There are now more day care places available for children of working mothers and the facilities are staying open longer each day.

Primary schools are running after-school programmes for children whose parents both work, while stay-at-home mothers can now use a pay-per-hour baby-sitting service when they need some time to themselves.

But the birth rate is not rebounding. "We can try to publicise the idea that having a child is a good experience, and work to create an environment in which women feel secure enough to have one," said Yasuko Baba of the city's Children and Youth Bureau.

"But we can't say 'please have a child'. Ultimately it is up to them."

Dr Inoguchi says the government needs to spend more on helping young families. But she says there also needs to be social change so that both men and women have a better balance between work and family.

Japan Times

UN HIV estimates reduced to 33m

The United Nations has reduced its estimates of how many people are infected with HIV in 2007 from nearly 40m to 33m.

Revised figures for India account for much of the decrease, experts say.

But the rate of new cases and mortality levels are declining, although figures still show that there are 6,800 new cases each day and over 5,700 deaths.

Africa has by far the most number of cases, while parts of Asia have the fastest growing rates of infections.

Some 22.5m in sub-Saharan Africa have HIV but the number of new cases - 1.7m a year - is a smaller increase than in previous years.

In Asia there are 4.9m people with the condition with Vietnam seeing a doubling of cases since 2000.

UNAids executive director Dr Peter Piot said: "The improved data presents us with a clearer picture of the Aids epidemic, one that reveals both challenges and opportunities. "Unquestionably, we are beginning to see a return on investment.

"But we must expand our efforts in order to significantly reduced the impact of Aids worldwide."

The figures show there were 2.5m new cases in 2007, down from a peak in the late 1990s when there was over 3m new infections a year.

The fall in annual deaths to 2.1m has been put down to wider access to antiretroviral drug treatments.

It means some 33.2m have HIV, down from 39.5m in 2006.

UNAids said the figures for 2006 were likely to be inaccurate after an intensive assessment exercise in India showed fewer cases than estimated. Other countries, including Nigeria, Mozambique and Zimbabwe, also had their figures reduced.

Prevention

Experts say the true 2006 figure was likely to be about 32.7m.

Professor Brookmeyer, a US public health expert at the Johns Hopkins Bloomberg School of Public Health, said having accurate figures was important in combating HIV. "More accurate estimates and trends will ultimately lead to improvements in the design and evaluation of prevention programmes."

But Michael Weinstein, of the US group, the Aids Healthcare Foundation, questioned how accurate the latest figures were.

"Because the vast majority of people who are infected with HIV don't know it, there is actually no way to know if this new WHO figures is any more reliable than the previous estimation."

And the Terrence Higgins Trust said more needed to be done to tackle HIV in the UK as recent figures suggest the rate of new cases is rising. Chief executive Nick Partridge said: "There is too little local investment and too little national focus on HIV which means our prevention efforts are not enough to keep it at bay.

"We need to refocus on HIV in the UK and reinvest in prevention, rather than stand by and watch the spiralling costs of treatment as ever more people test HIV positive."