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Our World Transcript — 4 March 2006

This transcript is provided as a service; there may be some variation between it and the program as broadcast.

MUSIC: "Our World" theme

Straight ahead on "Our World" ... health of immigrants in decline ... preparing for the next face transplant surgery ... and finding a way around Internet censorship

HASELTON: "When you connect to this web address instead of connecting to the target website, like 'Falun Gong,' which would be blocked, you connect to your friend's computer and you are surfing the Internet through your friend's computer."

Those stories, Living With Parkinson's Disease and more. I'm Art Chimes. Welcome to VOA's science and technology magazine, "Our World."

A U.S. government study finds that immigrants are generally healthier than native-born Americans when they arrive in the United States and for the first few years after they get here. But after they've been here awhile, and as they adapt to the American lifestyle, their health declines. VOA's David McAlary reports.

McALARY: The saying "When in Rome, do as the Romans do" speaks of assimilating into a new culture. But assimilating can mean adopting the bad along with the good. In just such an example, a new study from the U.S. Centers for Disease Control shows that immigrants from Asia, Africa, and Latin America lose the health advantages they come with about five years after migrating.

One of the study's authors is Achintya Dey, a native of India.

DEY: "In general, immigrant adults enjoy considerable advantages over their U.S.-born counterparts on many health measures, despite limited access to health care. However, the longer these immigrants live in the U.S., the more their health resembles their U.S.-born counterparts."

McALARY: For example, the government report shows that obesity affected 22 percent of Hispanic immigrants living in the United States five years or longer compared to 16 percent residing in the country less than five years. The earlier immigrants were also likelier to have high blood pressure and heart disease than recent ones.

Black and Asian immigrant adults showed similar patterns of health decline with longer U.S. residence. Only white immigrants avoided this trend.

Achintya Dey says foreigners come to the United States healthier than the average American adult probably because people who leave their countries tend to be among the healthiest in their lands. But he points out that, after a few years, Americanization sets in.

DEY: "What happens over the years, they adopt the lifestyle, you know, diet change, they have less exercise or the tobacco use goes up. So their behavior and the lifestyle changes, and that could explain why there is a decline in their overall health."

McALARY: The findings are based on U.S. national health surveys taken between 1998 and 2003.

KRIMGOLD: "This study is a typical pattern that we're seeing now among immigrants."

McALARY: This is Barbara Krimgold of the Center for the Advancement of Public Health, a health policy research organization in Washington.

KRIMGOLD: "Immigrants tend to be in neighborhoods with, say, lots more advertising of alcohol, lots more fast food, less access to fresh fruits and vegetables."

McALARY: The United States is not the only country where immigrant health deteriorates. A 2002 study found that the health of Asian immigrants in Canada also worsens. Its lead author, Mark Kaplan of Portland State University in Oregon, says immigrants' new, less healthy lifestyles present challenges to health policy makers with limited resources in ethnically diverse societies. He suggests directing health awareness programs at those who have lived in North America the longest, since the research shows that they are the unhealthiest.

KAPLAN: "There is a lot of mobility around the world. So the question is, how do we design public health programs that effectively target those immigrant groups who are at greatest risk?"

McALARY: David McAlary, VOA News, Washington.

In an unusual new study, U.S. Army researchers have found that about one-third of returning veterans of the Iraq war are seeking help for mental health issues.

The research focused on some 300,000 soldiers and Marines back from service in Iraq, Afghanistan and other foreign assignments. The Iraq veterans were half-again more likely to visit outpatient mental health clinics than other veterans, says the man who led the study, Dr. Charles Hoge of the Walter Reed Army Research Institute.

HOGE: "The study shows that soldiers who are returning from Iraq, that a higher percentage of those soldiers report mental health concerns and use mental health services when they get home from Iraq compared to soldiers who are returning from deployment to Afghanistan or other locations."

Despite the large number of troops who were worried about their mental health, only about one-third of the Iraq veterans who sought help were actually diagnosed with a mental health condition. That translates to about one out of nine Iraqi war veterans.

Looking at all the Iraq veterans, not just those who visited mental health clinics, about one in five reported experiences or feelings that signalled some mental health concern, such as nightmares, worry about conflict with friends or family, or depression.

Although news stories about this study focused on the large number of Iraq war veterans who are seeking mental health services, Hoge said there is a positive side to this study. At a time when mental illness still has much stigma attached, he stressed that soldiers who are worried are seeking help if they think they need it.

HOGE: "The most important finding of the study, though, is that most of the services that soldiers are receiving, the mental health services, they're coming in to get care early, within the first two months particularly of coming home. And this is very encouraging."

Dr. Charles Hoge, whose study on mental health and returning veterans appeared this week in JAMA, the Journal of the American Medical Association.

They tremble. They shake. They have problems walking and sometimes freeze up and cannot move at all. These are all signs of someone with Parkinson's, a chronic neurological disease that has no cure and afflicts 6.3 million people worldwide. Twenty-three hundred scientists, caregivers and patients met in Washington recently at the World Parkinson Congress to discuss the latest advances, current treatments and management of the disease. VOA's Rosanne Skirble met one young man searching for a cure.

SKIRBLE: Parkinson's is most common among older men, but it also attacks women and young people… like Tom Isaacs. He was diagnosed with the disease 10 years ago, when he was only 27. Parkinson's is a progressive disease and over the years Issacs has gotten worse.

When his medication wears off — or hasn't yet kicked in — he shakes, which was what he was doing when he began his remarks at the World Parkinson Congress. The session on The Hidden Challenges of Living with Parkinson's, was moderated by University of Rochester School of Medicine professor Ira Shoulson.

SHOULSON: "Just before we take questions and to take advantage of the impromptu nature of this briefing, I am going to ask Mr. Issacs [to step forward]. He wanted to just comment on some of his motor aspects in real time."

ISAACS: "I just wanted to say that I volunteered to do this. I want you to stare at me because this is what it is like."

SHOULSON: "I mentioned in the beginning that Mr. Isaacs was — about 10 minutes ago, and maybe before 5 minutes before this briefing began — he took his medication. He knew he was going off, that his mobility was fading and expectantly in the next 10, 20, 30 minutes there will be a recovery of that type of function. But we thought that we would share with you in real time what it feels like and looks like right now."

SKIRBLE: Isaacs sat down and shook, his arms waving in random jerky motions. Several researchers spoke briefly about the physical and psychological problems of living with Parkinson's before Isaacs — by then considerably more composed — stood up. He compares himself to a washing machine on the spin cycle. But, he says, those motor symptoms are not nearly as bad as the side effects of his medication...

ISAACS: "... which can send my body into uncontrollable contortions, a bit like an out of control hose pipe on full bore. And, far better the washing machine and the hose than the worst one of all which I get from time to time, the feeling like I am locked in a fridge with a frozen top compartment. I cannot move. I cannot communicate. I am hot on the outside, but cold and dark on the inside. I am trapped in my own body."

SKIRBLE: Tom Issacs says Parkinson's hasn't kidnapped his sense of humor, his spirit or his sense of worth. Four years ago, he quit his job in the real estate industry to raise money for the Cure Parkinson's Trust, a charity he helped create.

ISAACS: "And we are raising funds and raising awareness about Parkinson's and trying to put funds into research work, which is actually going to have an impact on people's lives."

SKIRBLE: But while he pushes for a cure, he says he remains stuck in a body he cannot control, not knowing from day-to-day how he is going to feel. However, his wife Lindsey says the disease doesn't make much difference at home.

LINDSEY ISAACS: "You have to be more flexible because things don't often happen on time and you can't always do what you want to do. You have to maintain a good flexible communication within the relationship, that is the most important thing, for us anyway.

TOM ISAACS: "That's what we say anyway. Lindsey is fantastic, and I genuinely feel that it is worse for her than it is for me.

SKIRBLE: Isaacs is impatient for a cure, and says greater public awareness will help.

ISAACS: "A change in public perception will propel us to the finish line and the word Parkinson's will never be used again, except when I say that I used to have it. I used to have Parkinson's."

SKIRBLE: I'm Rosanne Skirble

Time again for our Website of the Week, and our selection this week is a one-stop resource for everything you ever wanted to know about space exploration.

WADE: "Well the website is a reference source for anybody who's interested in space flight or space history. It tries to be comprehensive, have a page on every rocket that's ever flown or been designed, every space ship that's ever been conceived of or flown, all the astronauts that have ever trained for space flight and the engineers that have designed space craft."

Mark Wade is the enthusiast behind the Encyclopedia Astronautica at, a sprawling website with some 14,000 pages of space information, including about 8,500 images. The site includes a lot of hard-to-find information about Russian and Chinese space programs in English, and a broad historical panorama of both successful missions and ideas that never got off the drawing board.

Wade says that historical background is important because of what philosopher George Santayana said...

WADE: "You know, they say those who don't study history are condemned to repeat it, and right now NASA is doing a lot of studies about what to do in space next in terms of the next manned spacecraft and whether to go to the moon or mars, and how to do it. And all these things have been studied before in great depth. So I really hope it provides a source for people to better understand that, and not try to repeat the same mistakes that happened in the past."

Wade says his site is really pretty much of a one-person operation without any big institution behind it. Looking forward, he thinks Encyclopedia Astronautica may become more of an index to Internet space resources, rather than an online library. That's because, he says, in the 10 years since the site went online, there are more and more resources available on space topics, including more original source material that might be hard to find without a little help.

WADE: "I see it maybe getting more specialized because with the incredible explosion of the Internet it's become less necessary to have a site that tries to be a comprehensive, single place where all this information is assembled."

Mark Wade's site is the Encyclopedia Astronautica at, or you can get the link from our site,

MUSIC: "Rocket '88" by Jackie Brenston & HIs Delta Cats (1951)

And you're listening to VOA's science and technology magazine, Our World. I'm Art Chimes in Washington.

A French woman is still recovering from groundbreaking surgery in November, a partial face transplant.

Surgical teams in other countries are also planning to enter the field.

In the United States, the Cleveland Clinic is the first hospital to win approval for the procedure. The first patient is likely to be somone who has failed to receive good results from the traditional treatment — skin grafts from the patient's own body. Polish-born Dr. Maria Siemionow, a plastic surgeon at the hospital, describes a potential candidate for the long, complex, technically challenging and expensive surgery.

SIEMIONOW: "The patients we are looking for are severely disfigured patients, who have already exhausted all possible reconstructive conventional options, and the patients will include, for example, severely burned patients, trauma patients, patients who have lost their faces due to accidents."

Siemionow says it might be someone whose conventional treatment hasn't worked.

SIEMIONOW: "The potential candidates we are looking for are the patients who already were reconstructed with skin grafts in the first place. And they've done many surgical procedures using the skin grafts from their own body, and again they were left with the functional defects or disfigurements."

Those functional defects she mentions include inability to open the mouth and feed themselves, or an inability to close or open their eyes.

The surgery itself will be enormously complex. Just removing the face — they call it the "flap" — from the donor's body will take an estimated four to five hours. The transplant will take another 10 to 15 hours. Dr. Siemionow says the technical success of the surgery -- whether the blood vessels are attached correctly, that sort of thing -- will be apparent immediately. But there is more to a successful transplant than that.

SIEMIONOW: "The functional outcome and long-term effects, we'll need to wait longer, and also the fact if the tissue will take [and] will be not rejected, we'll need to wait for some time."

One thing she didn't mention is the pyschological makeup of the patient. An article in this week's "New England Journal of Medicine" notes that potential face transplant recipients will undergo psychological testing and interviews to ensure that he or she will be up to the mental challenges of not only the surgery and recovery, but a lifetime of drugs to surpress the body's rejection of the foreign tissue. And they'll want someone with a supportive family and the emotional strength to learn to look in a mirror and see a new face.

By enabling hundreds of millions of people all over the world to communicate directly with each other and to exchange scientific, cultural, and news information almost instantaneously, the Internet has been a huge boon to global trade, as well as an ongoing experiment in untamed democracy. But in some countries, the openness of the Internet is seen as a threat, and easy access to the online world is often censored or blocked to everyday users. VOA's Adam Phillips filed this report on some new technologies that can help Internet users evade government censors.

PHILLIPS: The Internet is an indispensable part of today's global economy, but the free flow of news and information — not just commodity prices and invoices — pose a tough challenge for totalitarian governments that want their citizens to get all their information from official sources.

According to Ken Berman of the Internet Anti-Censorship Office at the International Broadcasting Bureau, VOA's parent agency, China's leaders must face that challenge every day.

BERMAN: "… Because they are relying on technology to advance the people and society. [The Internet] is the basis of modern industries and all major manufacturing communications technology. But at the same time, it is a two-edged sword whereby having this extra information allows people to get viewpoints that are outside the official government point of view."

PHILLIPS: Back when state-controlled newspapers, radio and television were the only media, Chinese officials could easily control content. But that was then. Berman cites last year's efforts by China to limit news about massive drinking water contamination. The government tried to suppress the story.

BERMAN: "But the fact that there was tremendous dialogue on websites, blog sites, Internet chat, email, it [the Internet] is telling the Chinese government that 'hey there are multiple sources of information and news and you, the government, no longer have a lock [exclusive control] on it. So you've gotta kind of open up and share this because it's going to get shared one way or the other.'"

PHILLIPS: Berman says that one way people in China can get uncensored access to the websites of the Voice of America, the BBC and other unapproved media outlets is through proxy websites that are not blocked. VOA and other broadcasters send mass e-mailings to Chinese users with links to websites that bypass the so-called Great Firewall of China

BERMAN: "You click on the link and you can pull information from whatever source you want. Now since we are sponsoring it, we'd like you pull it from VOA, but you're free to go to the New York Times, [to] Chinese dissident sites, [and to] Tibetan freedom, religious [and] cultural [sites].… And again, I want to emphasize that our Internet freedom desires are not just to make people see the Voice of America or Radio Farda. It's to say there's a lot of rich information out there; here is a way to access it so you can make up your own mind."

PHILLIPS: There are disadvantages to that method. Since so many emails are sent out, the links are easy for government censors to discover and block. An alternative approach is a free software program called the Circumventor.

Bennett Haselton, the program's author, says that to use Circumventor, someone outside China must download the program to their computer, then provide a user in China with a sharable web address not yet known to government censors.

HASELTON: "When you connect to this new web address — this new one that is generated — instead of connecting to the target website in questiontion — like 'Falun Gong,' which would be blocked -- you come to your friend's computer and you are surfing the Internet through your friend's computer."

PHILLIPS: And that's its major drawback, at least in China. Mr. Haselton notes that a user must have a contact outside the country to make the arrangement work, and many Chinese do not know any foreigners. Ken Berman of the IBB's Anti-Censorship office says no one solution is perfect, and that to reach China's billion plus potential users, it is necessary to use many approaches.

BERMAN: "You're looking at text messaging, instant messaging, cell phones, mobile downloaded content on cell phones, online chat using different addresses than voanews dot com - because that's been filtered. We are open to almost any technical solution that is available to people inside China… so that we stay ahead of the censors… And it's a cat and mouse game. And sometimes we win and sometimes we lose. But we're still in it for the fight."

PHILLIPS: To learn more about Circumventor software go to For "Our World," I'm Adam Phillips reporting from New York.

MUSIC: "Our World" theme

That's our show for this week. We always like to hear from you. Email us at Or use the postal address —

Our World
Voice of America
Washington, DC 20237 USA.

Our show was edited by Faith Lapidus. Eva Nenicka is our technical director. And this is Art Chimes, inviting you to join us online at or on your radio next Saturday and Sunday as we check out the latest in science and Our World.