Passes away does not do so from some part it is a months long dealing with internal cancer or congestive Heart Failure and so on. We do not have the rituals for how to even talk about what that process is like. All that and more coming up. Welcome to democracy now . The Supreme Court has dealt a major victory for marriage equality. The decision leaves intact Lower Court Rulings that struck down samesex marriage bans in virginia, utah, oklahoma, indiana, and wisconsin. Caseintiff in the indiana celebrated with his husband. We have been together for 27 years. This just kind of makes it official and we can check a few boxes and get some Health Insurance for stephen because he needed Health Insurance. They cannot deny that for me anymore. Our daughter is protected. If something happened to us. Of the ruling, county clerks across the five states begin issuing marriage licenses to samesex couples. The Supreme Court decision will also expand samesex marriage rights to six additional states. That will bring the total number of states where samesex marriage is legal to 30, a majority of the country. Planes are targeting Islamic State militants near the besieged syrian town of kobani along the turkish border. Kurdish forces are struggling to push back the militants after they danced into the town monday, claiming eastern neighborhoods and causing hundreds of civilians to flee. Have so fares failed to halt the militant advance. If the militants capture co ,onnie, they will kobani they will control a large swath of the turkish border. The United States and its allies airstrikes inut iraq, 70 of them in iraq. All of the strikes targeted the Islamic State. Airstrikes had combat positions, training positions, and arms caches. They destroyed or damaged more than 300 vehicles. Also said it has begun flying helicopters in iraq for the first time as part of the campaign. The step could put u. S. Troops at risk for fire from militants on the ground. A new report finds a large percentage of the ammunition used by Islamic State militants in iraq and syria came from the United States. Conflict Armament Research analyzed small caliber ammunition recovered from the militants. The cartridges originated in 21 countries, nearly 20 of them came from the United States. The report states that i s forces appear to have acquired a large part of their current seized from stocks or abandoned by Iraqi Defense and Security Forces the u. S. Gifted much of this material to iraq. Missing00 people are after a boat carrying migrants from syria and Subsaharan Africa sank in the Mediterranean Sea off the coast of libya. Dozens of other migrants were rescued. A report found more than 3000 migrants have died crossing the Mediterranean Sea this year, more than twice the previous high from 2011. Strike has killed six people in northwest pakistan. Unnamed intelligence officials told reuters the target was a suspected militant training cap in the area of south waziristan. Theattack was at least third u. S. Strike in the area and at least three days. The two earlier strikes killed five people each on sunday and monday. Kenyan president kenyatta announced he is temporarily stepping down in order to face charges of crimes against humanity at the International Criminal court. Kenyatta and his deputy ruto stand accused of inciting Ethnic Violence which killed 1200 people after the kenyan election. By turning power over to ruto, kenyatta will avoid becoming the first sitting president to appear before the court. I now take the extraordinary and unprecedented step of invoking article 140 73 of the constitution and i will shortly issue the legal notice necessary to appoint william ruto the deputy present as acting theident while i attend conference at the hague in the netherlands. The u. S. Practice of forcefeeding hunger striking prisoners at Guantanamo Bay is receiving an unprecedented public hearing in civilian court. The case involves a syrian Hunger Striker involved for over a decade. Abu wael dhiab remains a quantum on being cleared for release in 2009. He has been on Hunger Strike periodically for seven years to protest his indefinite detention. His attorneys are challenging forcefeeding practice this is practices. As well as the use of the torture chair where the heads in all four limbs are restrained as a feeding tube is an suited in their nose. The Justice Department tried to keep the hearing secret, but u. S. District court judge Gladys Kessler rejected that request. She ordered videotapes of the forced feeding to be publicly released after they are rejected. Redacted. At quintanasoner most said he guantanamo said retrieve the british hostage was beheaded last month. He was released after the case to against him collapsed. It he he was released, began talks to help secure the release of henning. The bbc he wanted to send a video message he believed to the militants would heed. I can make a video message, deliver it in a language that Islamic State would understand to say that i myself was a former guantanamo prisoner facing execution. He had been a prisoner of the americans. It was a direct statement i wanted to make in the arabic language. Inhe said he spent time syria before the rise of isis and secure the release of other hostages. He said the British Government failed to look at his offer seriously due to its attempt to demonize and criminalize me, he said. To see our interviews, we went to interview him after he was released by authorities, you can go to democracynow. Org. The Mexican Government has sent federal police to take over security and the severance date Southern State of guerrero disappearance of 43 students. Police and unknown gunmen ambushed their buses. 22 Police Officers have been detained. The mayor and police chief appear to have fled. The police have been accused of collaborating with a drug gang. The mexican president vowed to bring the perpetrators to justice. I particularly regret the violence that has occurred and above all else that they are mostly young students. Mexican society, the families of the young people, are rightly demand and clarification on the incident and that justice be done and that those found be brought to justice and that there is no impunity in the case. The families have continued to them protest to the government. The mother of a missing student said authorities would do more if it was their child missing. Andhey will move heaven earth to find them. This is what we are going to do. We are going to do whatever it takes to find them and we will not rest until we find them. Womens Health Providers and taxes have in texas have asked to block sweeping legislation that would block choice. They would shatter all but eight abortion facilities in texas where there were previously more than 40. The only two remaining clinics in the Rio Grande Valley were forced to close. Abortion patients who arrived on friday were told that the nearest legal Abortion Facility was now about four hours north. Have filed ans emergency application asking the high court to intervene, saying we are being forced to turn women away from safe compassion and health care simply because of our politicians ideological agenda. Immigrant women in prison in south texas have accused guards of sexually assaulting them. County Detention Center opened in august and is run by the private company they geo group. It holds more than 500 mothers and children who are seeking asylum after fleeing violence and persecution in central america. Guards are promising women help with immigration cases in return for sexual favors and removing them from their cells at night to sexually abuse them. With more on the Detention Center and on the crisis of on wednesdayss, when we broadcast live from san antonio. Members of the Ohio Student Association have occupied the Police Station in the town of beaver creek to protest the Fatal Police Shooting of john crawford. A 22yearold africanamerican, crawford was killed inside a walmart in august and a 911 call or falsely accused him of pointing a gun at customers. He had picked up an unloaded bb air rifle, which was on sale at the store. A grand jury declined to indict the officer who fatally shot him. 20 students slept in the lobby of the beaver creek police department. They are demanding the firing of the officer who shot crawford and criminal charges against the 911 caller whose account was contradict it by surveillance footage. Ruled policege has and ferguson, missouri violated the constitution when responding to protests over the Fatal Shooting of michael brown. The case concerned the Police Practice of forcing protesters to remain in constant motion, telling them they were not allowed to stand still or that they were walking to slowly. The activist professor and writer Betty Reid Mandell has died in massachusetts at the age of 89. Known locally as the fairy godmother of the welfare office, she distributed survival tips to help Homeless People obtain aid and published frequent articles challenging what seesaw she saw as a war against the poor. Those are some of the headlines. This is democracy now im amy goodman. Welcome to our listeners and viewers around the country and around the world. Leone is pleading for more International Help despite the Ebola Outbreak in west africa. Recorded 120 deaths on saturday in one of the single deadliest days since the disease appeared more than four months ago. The president spoke on monday. We should be this, mindful that ebola is still around. We need more Treatment Centers. We need 1000 Treatment Centers in the whole country. What we are doing is our responsibility. As a government, it is our responsibility to do it. But we need the partners who want to help us to come as fast as possible. We need them yesterday. If it until today they are not here, they should not wait for another day. At least 678 people have died in sierra leone. Says at least 3404 have died of a cola in west africa. The actual title is believed to be higher. President obama said his administration is working on fortional protocols screening airplane passengers to identify people who might have ebola. Without a travel ban on africa. Protocols to do additional pass through at the source and in the United States. All of these things because confident that the chances of an outbreak in the United States are extraordinarily low. The first patient diagnosed on u. S. Soil, thomas eric duncan, remains in Critical Condition at a dallas hospital. He was diagnosed after flying in from liberia. Duncan is now receiving an experimental therapy initially intended for other viral diseases. The handling of his case has raised questions about how u. S. Hospitals are prepared to handle and Ebola Outbreak. At texas Treatment Health presbyterian after he began feeling ill. Despite telling a nurse he had just returned from liberia, he was initially discharged with antibiotics. He returned to the same hospital by ambulance after vomiting outside the apartment complex where he was staying. He was then diagnosed with ebola. In madrid hasrse become the first person to contract the disease outside of west africa. She treated a priest who returned to spain from sierra leone. , one have dr. Atul gawande of the most Influential Health policy writers in the country. Surgeon inwande is a boston, a professor at Harvard Medical School. He is a staff writer at the new yorker. Author offfer of several books. His most recent book has been published. Being mortal. We will talk about the new book in the coming segments. We are going to start off with ebola. A welcome to democracy now lets talk for a moment about the piece you just wrote on mr. Duncan and what happened in the hospital. Weit showed some of the gaps have that i have been writing for a long time. We know the checklist for what needs to be done when people come in with potentially infectious disease. They deployed the checklist at this hospital about asking about somebody who has a fever and a travel history. The nurse captured he did not tell them liberia. He was more vague. He said africa. She recognized that this might be an ebola case. She entered it into the records. There is a communication breakdowns. The doctor did not pick it up. This kind of breakdown likely happens all over the country all the time. This was not a special event. It has forced our hospitals to realize that they have to download the checklist and then learn how to use them. The most common failure is a communication breakdown like this. A failure to pass on information that is critically important. I wanted to go back to the checklist manifesto. You were making about a surgeon being in surgery and what it means just to a knowledge the people, the nurses and the others, who are with him to assist him. Talk about that whole scenario. This is almost a philosophical issue in our profession. Do we follow the known procedures that exist or do we just kind of go with our judgment every time . In the operating room, the known way to make it more safely is there are a few things you do around infection practices, there are a few things you do around communication. You make sure nurses can speak their concerns. You make sure the anesthesiologist has reviewed the medical history. The surgeon reviews the Major Concerns and plans the operation. You would think we would do this every time. It is like getting in an airplane. We had not. , weound that making that can lower the death rate. Knowing the nurses names can decrease the death rate . It is like a Football Team having the huddle before they go to the line. If they did not have the huddle, people would not necessarily know, they just assume you know where the ball is going. The same thing happens on ebola. In an operating room, we are seeing reduction in death when people use these kinds of basic tools. The netherlands implemented this across the country and they lowered the death rate 47 compared to the control group. It is hard to pull off because of the cultural barrier. That is the barrier we saw in the texas hospital that is happening all over the country. 2 Million People come into hospitals and they pick up infections in the hospital that they did not come in with because people were not wearing the counts properly, putting on the gloves properly, washing hands properly. Rightw how to do the thing, but we do not always systematically walk our way through it. You talk about simple verbal comp formation confirmation. The most common breakdown in the safety of a hospital is that people do not communicate the critical information. Just because you put it in the computer does not mean anyone will know it or use it. In high risk other industries, you communicate verbally to somebody else the critical information and make sure they received it and understood it. It could be electronically confirming they got the information or facetoface. If you are concerned you have someone with ebola, you do not put it in the computer. You tell them and you hear that it has been fed back. That is where it broke down. This goes to the whole issue of digital medical records. Having spent time visiting people in hospitals, seeing the frustration with nurses and doctors spending more time facing the computer screen trying to figure out how to categorize particular things, when they want to just convey impressions that they have. Dos windows the phase of american computerization. There is no question that it has made life incredibly safer for patients. Information you would otherwise not have, prescriptions are not eligible and hard to read. Nowhe same time, we are spending our lives facing the computer screen instead of the patient. Surveys have looked at theralization and find that computers are themselves causing tremendous demoralization. We have all become data entry morers, spending more and time entering data and not doing what is really the work of taking good care of patients. The design of the system is what has to change. , maked that userfriendly it easier to be inexpert. I dont think the computer industry is waking up to that yet. Go larger than mr. Duncan in the texas hospital. Talk about the ebola crisis. Thousands of people are now dead. The president of sierra leone is desperately reaching out for help. What is going wrong here . Why isnt this being contained . What are the implications for Public Health . The epidemic in west africa is severe and getting worse fast. Ist people dont understand that this outbreak started last december, starting at mar