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Our World Transcript — 1 July 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" ... Tobacco's dangers for non-smokers ... a vaccine for tooth decay ... and computer games for social change.

BURAK: "as you make progress — if you make progress — you see less and less violence, and you see that people start to support your concessions, and that the other side is responding positively to what you're doing."

Progressive videogames ... Pets in America on our Website of the Week, and more. I'm Art Chimes. Welcome to VOA's science and technology magazine, "Our World."

A new U.S. public health report concludes there is no safe level of environmental tobacco smoke. The nation's top public health physician, the Surgeon General, says inhaling someone else's smoke leads to an immediate chain of biological events that can lead to disease ... and even death. VOA's David McAlary has this report.

McALARY: Last month, an Ontario, Canada,

woman named Heather Crowe, a non-smoker, died of lung cancer. For years, she had worked long shifts as a waitress in smoke-filled restaurants. Before her death, she filmed this statement.

CROWE: "My doctor told me I had a smoker's tumor. I never smoked. The air was blue where I worked and I am dying from second-hand smoke."

McALARY: U.S. Surgeon General Richard Carmona showed that film to emphasize the key point in his new report on the dangers of environmental tobacco smoke.

CARMONA: "There is no risk-free level of second-hand smoke exposure. Only smoke-free environments effectively protect non-smokers from second-hand smoke exposure in indoor spaces."

McALARY: Among the report's major points are these: Non-smokers exposed to second-hand smoke increase their risk of developing heart disease and lung cancer by as much as 30 percent. Exposure is also a known cause of sudden infant death syndrome and childhood ailments such as breathing problems, ear infections, and asthma attacks.

Carmona says even brief exposure to environmental tobacco smoke can cause immediate harm to the circulatory system.

CARMONA: "Science has shown now that within the first few minutes that you are exposed, there's an effect on clotting systems, there's an effect on blood vessels so that it's not going to kill you then, but what you are doing is accepting the fact that the cascade is going to start right then."

McALARY: Surgeon General Richard Carmona says second-hand smoke also leads to immediate cellular changes that can cause cancers.

The conclusions are not new. The mounting evidence has caused the World Health Organization to campaign against involuntary exposure to tobacco smoke for years. Its Framework Convention on Tobacco Control, which went into effect last year, commits the 131 signing nations, including the United States, to adopt measures against it.

The U.S. Surgeon General's report is based on the same scientific findings that drive these efforts. Carmona says he issued it now to raise the awareness of U.S. citizens. Government figures show that the percentage of Americans who smoke has dropped by half in the last 40 years, to 21 percent, but 44 million continue to do so.

He makes an appeal to them.

CARMONA: "Make your home a smoke-free environment and get help as quickly as you can."

McALARY: David McAlary, VOA News, Washington.

Tooth decay is one of the world's most common health problems. If you're lucky enough to have access to good dental care, you get to visit a dentist, who drills out the cavity and fills it with gold or some other material. It can be an expensive and painful procedure. Proper diet and regular brushing can help reduce the incidence of cavities, but now there's news of a potential breakthrough that could prevent cavities altogether. VOA's Rosanne Skirble has more.

SKIRBLE: Tooth decay affects some 5 billion people around the world. A vaccine that prevents the infection that leads to decay is not far off, say scientists at the Forsyth Institute, a research group dedicated to dental health.

Their work — reported online in the journal Nature Reviews Immunology — is based on a technique that stimulates the production of antibodies, which, in turn, inhibit the enzyme that allows bacteria to accumulate on teeth.

SMITH: "The one [enzyme] that we highlight is called streptococci mutans. It infects the dental plaque and secretes acid and that's what causes the lesion."

SKIRBLE: Smith says the vaccine under development would not be administered by injection, but in an aerosol, sprayed into the nose.

SMITH: "The immune apparatus then kicks in and makes antibody that will appear in the saliva and it is that salivary antibody that will deal with the bacteria."

SKIRBLE: Preliminary research from several small-scale clinical trials in young adults indicates that the vaccine is safe. The Forsyth Institute is searching for a partner to help fund large-scale trials. Smith says these studies would focus on youngsters, between one and two years of age.

SMITH: "That's the age at which children become infected with the organism that eventually causes tooth decay. So the idea is to block the entrance of that bacteria into the mouth so that it cannot take hold and become a permanent member of the dental plaque."

SKIRBLE: Smith says children would have to be revaccinated when they get their permanent teeth and he expects that such a vaccine could become a routine part of childhood immunization. He says a vaccine could also play a vital role in public health, especially in places where access to dental care is limited. I'm Rosanne Skirble.

Here's an update on a story we broadcast last week on "Our World."

In a piece about giant Galapagos tortoises, reporter Jim Kent spoke with Louise Martin at the Australia Zoo about their tortoise, a 175-year-old named Harriet.

MARTIN: "It's just fascinating. It really does make you realize just how special these — I mean, I'm there with the oldest living animal in the whole world."

Well unfortunately, after Jim filed his story, Harriet had a heart attack and died. The giant tortoise, weighing some 150 kilos, was said to have been collected by Charles Darwin himself, although recent DNA testing cast some doubt on that claim.

Time again for our Website of the Week, when we showcase interesting and innovative online destinations.

This week, it's an Internet site for people who have pets or just want to learn more about how we Americans relate to our companion animals. It's based on a traveling exhibition organized by the University of South Carolina's McKissick Museum.

GRIER: "The Pets in America website includes a virtual version of the exhibition with selected objects. It also includes a really nice activity area for children that has puzzles and coloring pages that can be downloaded. And it also includes photo albums that give visitors an opportunity to look at a lot of historical images of Americans with their pet animals."

Katherine Grier is the curator of the exhibit and author of a companion book, also titled Pets in America. Pets are often associated with children, and have have long been seen as a way of teaching kids responsibility. But changing demographics in the United States have made pet-keeping households more typically adult:

GRIER: "And in that case, pets get a level of attention and expenditure that they would not otherwise. People have money to spend. They develop deep emotional attachment. Some people have said, oh they're substitute children. And in some cases they may be, but I also think it's just another kind of companionate relationship."

The online exhibit focuses on pets in America, but Katherine Grier says humans enjoy the company of companion animals pretty much everywhere.

GRIER: "People have said — I have had people say to me — that pet-keeping is only something that rich, western countries do. And in fact that's not the case. Local circumstances and the kinds of animals that are available and changing cultural values all lead to differences in pet-keeping, but it does seem to be a practice that's almost universal."

The Pets in America traveling exhibit is currently (through August 6) on display at the Indiana State Museum. But if you can't visit in person, check it out online at, or get the link from our site,

MUSIC: Ray Herndon: "My Dog Thinks I'm Elvis"

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

The U.S. Senate Committee on Aging spent some time Tuesday morning considering the subject of medical tourism.

Americans pay far more per capita on medical care than people in other industrialized countries. And while private health insurance gives many Americans access to some of the best medical care in the world, millions more, mostly working-class Americans can't afford coverage. Faced with the prospect of financially ruinous medical bills, some Americans travel abroad for surgery and other procedures, paying only a fraction of what similar health care would cost here in the United States.

One such "medical tourist" is Howard Staab. Two years ago he discovered he needed heart valve surgery. He didn't have health insurance. His partner, Maggi Ann Grace, says they got a cost estimate from a hospital near their home in North Carolina.

GRACE: "The hospital bill alone was estimated at $100,000. The valve itself, the surgeon, cardiologist, anesthesiologist, radiologist, and pathologist — all billed separately — would bring the total closer to $200,000 — if there were no complications."

Instead, after considering their options, they flew to India, where Staab had a mitral valve replacement. The cost, including travel and all expenses for the both of them, was less than $7,000. Their doctor, at the Escorts Heart Institute in New Delhi, spent years in teaching and in practice in New York, and Staab says, compared with his experience in American hospitals, his hospitalization in India was superior.

STAAB: "In the promptness, in the degree of expertise, the experience of the surgeons and staff. We had typically one to two nurses around the clock, push-button was answered within seconds. They offered and administered baths and massages, and changed the bedding daily. It was truly excellent care."

Not all the stories have a happy ending, however. In some cases, the result of medical tourism can be "disastrous outcomes" — that's the phrase used by Dr. Bruce Cunningham, who heads the American Society of Plastic Surgeons.

CUNNINGHAM: "I'm personally well aware of cases which are reported in the media and which confront myself and my colleagues and other physicians of patients returning to this country with disfigurement and nearly fatal infections associated with unaccredited hospitals and unlicensed providers."

The plastic surgeons represented by Dr. Cunningham's organization might see surgeons in India or Thailand or Mexico as business competitors. Financial considerations, as well as medical quality, are a key part of this health care debate. And not just for patients and doctors.

Except for the very poor and the elderly, most Americans who have heath insurance get it through their jobs, so the cost of health care is also a concern for employers.

Blue Ridge Paper Products is a small, employee-owned manufacturing company. The company is unionized, and American unions have been among the strongest opponents of outsourcing. But company benefits director Bonnie Blackley said workers were enthusiastic at a presentation that explained a new plan that would pay for medical treatments abroad.

BLACKLEY: "You could tell every slide that they showed, more and more people were going, 'oh my gosh, we never knew about this.' We really had some excitement there 'This sounds like a good deal, sounds like excellent health care. It's affordable. This will save our company a lot of money.'"

But in the end, American patients and their families want the assurance that an international facility will be offering them or their loved ones the best possible care.

MILSTEIN: "Many of these hospitals offer board-certified surgeons who trained at U.S. teaching hospitals."

That's Arnold Milstein of the Pacific Business Group on Health, which represents large employers who spend a lot of money on health care for their workers. They found that select accredited hospitals in India, Thailand and Mexico provided quality surgical care at costs 60 to 85 percent lower than in U.S. hospitals. At the same time, he stressed that sending patients abroad is not the answer to the high cost of medical care in the United States.

MILSTEIN: "The outmigration of Americans for surgical care is a symptom, not a solution."

The American healthcare system delivers high quality for those who can afford it, or those who have good insurance. But at a high price. Per capita costs on health care in the United States are much higher than anywhere else. But on basic measures such as infant mortality or life expectancy, Americans rank far from the top.

New research indicates that global warming could reduce crop yields, not increase them as once thought. So as the planet warms, future crop estimates may have to be lowered. Our report was written by VOA's Frank Ling and read by Susan Logue.

LOGUE: If there is any good to come from global warming, it might be that crop production would increase. After all, plants thrive on carbon dioxide, the leading greenhouse gas, which helps trap heat.

At the same time, biologists point out that in a warmer world, plant growth is slowed by higher temperatures and lower soil moisture caused by faster evaporation.

The United Nations Intergovernmental Panel on Climate Change, the world's leading authority on global warming, has concluded that these two trends balance each other, with no net affect on agriculture, based on previous experiments conducted in greenhouses.

Myron Ebell [EE-bell], a policy director at the Competitive Enterprise Institute, which opposes controls on greenhouse gas emissions, says previous studies have consistently reached the same result.

EBELL: "The results of these studies going back half a century or more are really stunning because almost every single study show not only do all kinds of plants grow more quickly with higher levels of CO-two, but they are also much hardier. They are more resistant to things like drought."

LOGUE: But a new study shows the result is different when crops are grown outdoors. According to the research, increased CO2 levels actually result in a net loss of crop yields. Writing in the journal Science, so-author Stephen Long of the University of Illinois published says previous greenhouse studies overstated the benefit of higher levels of CO2 in the atmosphere.

LONG: "If you raise the CO2 level under fully open-air conditions, do you see this large fertilization of crop yield? Roughly what we found was that under open air conditions, that increase appears to be only half of what was expected."

LOGUE: The findings suggest that without changes in the way crops are planted, future yields will drop as carbon dioxide levels go up. Stephen Long admits that his experiment isn't perfect. But he says it's a more realistic simulation than the enclosed spaces used in older experiments.

And that report, read by Susan Logue, was written by Frank Ling.

Finally today, if your impression of video games is that they're all about sex and violence ... you're not far off. But at the same time, game developers and social activists are getting together on a new generation of games that they hope will be just as captivating — addictive, even — but which also encourage players to learn about, and solve, real world problems. VOA's Adam Phillips has more.

PHILLIPS: In the main auditorium at the "Games for Change" conference, co-sponsored by New York's New School University and the Parsons School of Design, organizer Benjamin Stokes looked out with satisfaction at the 300 or so video game designers, academicians, and social activists excitedly talking together, peering at each other's laptop screens.

STOKES: "Video games are a part of life and they are not going away. And I think it's really exciting for those of us who are trying to build civic education and civic engagement, because video games, when they have people lean forward to play and to engage, thats just the sort of behavior we want to translate into the real world."

PHILLIPS: Negotiating ambiguous situations in which there is no one right answer is a difficult part of real life, but it can make for interesting gaming. Imagining, and trying to empathize with, your opponent's perspective is the basic challenge of the Peacemaker Game, a simulation of the Israeli-Palestinian conflict, developed by Asi Burak of Impact Games at Carnegie Mellon University.

BURAK: "War is challenging, fighting is challenging. Yes, A versus B is very challenging. But to make A, B, C and D live together, this is a challenge."

PHILLIPS: Like many video games, Peacemaker is based on role playing. Unlike many video games, changing roles is an important part of how one "wins."

BURAK: "So, first of all, when you just start the game, the world is very violent. The world is filled with terror attacks or military actions by the Israeli Army. And as you make progress — if you make progress — those things will start to disappear and you see less and less violence. You see that people start to support your concessions, and that the other side is responding positively to what youre doing."

PHILLIPS: Grassroots political organizers are already using video games to teach an essential tool of democracy — so-called "door-knocking" — where activists go to a neighborhood to enlist local residents to support an issue of concern. Doug Nelson, the president of Kinection has developed a game called The Organizing Game. It offers players a risk-free virtual environment where they can learn, for example, how to know when someone who says they are committing to help is saying "yes" merely to be polite or because they mean it.

NELSON: "They click yes, they click no and they click maybe. So here is an example of the game play for the 'Get a Commitment' leson: ACTIVIST: Can we count on you to come to the meeting we're having on Saturday at five o' clock? RESIDENT: I usually try to clean my house that day, but I could try to get it done by five. NELSON: That's absolutely a 'maybe'!"

PHILLIPS: The Games for Change conference also highlighted ways young people are being empowered to design their own game. At Global Kids Playing for Keeps, an after school program in one New York City high school, students created a game set in Haiti that explored the relationship of poverty and education to human rights. Global Kids Online Leadership Program director Barry Joseph says that creating games like that requires an understanding not just of the games themselves, but also of the complex global issues they portray:

JOSEPH: "When you start developing a game you have to create a simulation or a model of the thing you are trying to demonstrate. So whether you're talking about poverty in Haiti or genocide in Darfur, games offer that kind of learning."

PHILLIPS: While it can be hard to measure objectively what impact these new games are having on the real world, Joseph says they are having a subtle but significant impact on the players themselves. And by playing the games with their friends - and raising public awareness in the process, Joseph says young people can experience for the first time what it feels like to work for positive change. At the "Games for Change" Conference in New York City, I'm Adam Phillips reporting.

MUSIC: "Our World" theme

That's our show for this week. If you want to get in touch, email us at Or use our postal address -

Our World
Voice of America
Washington, DC 20237 USA.

Rob Sivak edited the show. Bob Doughty 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.