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A number of the 21 Coptic Christians who were recently shown being beheaded in a horrific video by Islamic State militants in Libya were reportedly whispering the name of Jesus as their

A number of the 21 Coptic Christians who were recently shown being beheaded in a horrific video by Islamic State militants in Libya were reportedly whispering the name of Jesus as their

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We are different. We, the adherents of Kreutz Ideology and Kreutz Religion, think that sex is the most important aspect in life. Everything else is just logistics.

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Anesthesia Awareness

Duke University Scool of Medicine Duke Anesthesiology

When the movie “Awake” came out in theaters it sparked much controversy throughout the country about the condition also known as anesthesia awareness. Following the release of the movie, Larry King Live did a special about this issue, in which King interviewed physicians and patients who have suffered from awareness. In response to the recent influx in publicity over the issue, the DREAM Campaign has taken the initiative to interview Dr. Tong Joo (TJ) Gan, who sheds light on many concerns that patients have when considering a surgical procedure as well as the misconceptions about anesthesiology in general. With so much focus on awareness and the negative impacts of anesthesia, it is important that the public be properly informed. Awareness can be a highly unpleasant experience, but most times the alternative is a surgery with negative outcomes or even worse, death.

There are about 100 to 150 reported cases of anesthesia awareness per year in the United States. It is very difficult to get an exact figure because it is under reported. Dr. Gan shared with us a case in which a patient of his experienced anesthesia awareness. The patient had come to the Emergency Room with a gunshot wound to the abdomen. He was suffering from massive blood loss and had very faint blood pressure so the anesthesiologist had to administer a safe dosage of anesthesia that would not hinder the overall well being of the patient as well as the blood pressure. When questioned post-operatively, the patient reported that he could hear voices during a brief period in surgery.

Hearing is said to be the last sense to go and the first to return under general anesthesia. As in the case of Dr. Gan’s patient, the modifications that had to be made because of low blood pressure caused the patient to become slightly aware and that is why he was able to hear briefly during his operation. “He did not suffer from any consequences after that and in fact, he thought that it was part of the operation,” said Dr. Gan.

When asked the common question, how can a person feel pain when they are paralyzed, Dr. Gan discussed the three areas of anesthesia; paralysis which paralyzes the muscles, analgesic which block pain signals to the brain, and anesthetic which puts the person to sleep so that they do not remember anything. For this reason, a person can be physically paralyzed but they may still feel pain. The human body does have natural responses to pain such as sweating, increased blood pressure and movement which may indicate to the anesthesia care provider that they are not fully anesthetized.

New technology allows anesthesiologists to measure the brain waves of a patient even while they are under anesthesia. “By using specific monitors, one can tell how deep a person is in anesthesia,” says Dr. Gan, “It is a bit like an iceberg; if it is below the water, it is very difficult to know how deep the iceberg is, and the monitor tells you what the depth of anesthesia is even when the patient is asleep.” The Bi-spectral Index Monitor, or BIS monitor is an example of such a device. Brainwaves are measured on a range of numbers from 0 to 100 in which 0 equates no brain activity and 100 is the mental state of a person when fully awake. During general anesthesia, brainwaves are measured between 40 and 60. If the BIS monitor measures activity above 70, there is a very good chance that the patient may not be fully anesthetized.

Dr. Gan mentions several fascinating facts throughout the interview one being that genetic factors can influence the way a patient reacts to anesthesia. Studies have shown that women tend to wake up about 10 minutes sooner than men when the anesthesia is cut off. This means that women need more anesthesia in order to produce the same effect. Redheads are also said to need more as well.

The revolutionary research that is being done by researchers like Dr. Gan is vital to prevent cases of unpleasant experiences and side effects. “One of the most effective ways to try and prevent this problem is to raise awareness of this problem, no pun intended,” Dr. Gan explains, “So we educate our staff, anesthesiologists and anesthesia care providers to let them know that this problem does exist and therefore it is important to take steps as well as understand the patient to try and prevent it.” He also mentions that there are mandatory educational modules that every anesthesia care provider must take. These modules go through various aspects of educational awareness such as the incidents of awareness, the scenarios where awareness may happen, the drugs or drug combinations that would reduce the incidents of awareness as well as monitoring the inter-operative awareness.

The Department of Anesthesiology is committed to find as many ways possible to provide the best patient care. Dr. Gan’s research in particular focuses on steps that could alleviate patients from the common unpleasant side effects of anesthesia and surgery by improving patient outcomes during the perioperative (before, during and after surgery) period including anesthesia awareness, pain, nausea and vomiting, and bowel dysfunction through the use of drug and non-drug method, such as acupuncture. Our hope is that through listening to this interview, people will become educated about the issue and in turn they will be relieved of any anxiety they may face about being under anesthesia.

Dr. Gan is a professor and devoted researcher here at Duke, whose interests include Anesthetic-related Clinical Pharmacology, Inter-operative Awareness and Post-Operative Pain, Nausea and Vomiting, and using Acupuncture. He came to Duke as a visiting associate and fellow in 1993 is now serving as both professor and Vice Chairman of Clinical Research. Dr. Gan is also known for his research on the Bi-spectral Index (BIS) Monitor.

Patient Awareness Under General Anesthesia Lifeline to Modern Medicine

What is patient awareness under general anesthesia? Awareness under general anesthesia is a rare condition that occurs when surgical patients can recall their surroundings or an event—sometimes even pain—related to their surgery while they were under general anesthesia.

When using other kinds of anesthesia, such as local, sedation or regional anesthesia, it is expected that patients will have some recollection of the procedure.

Studies are not conclusive on the frequency of awareness under general anesthesia, but even one case is important to anesthesia professionals (anesthesiologists and certified registered nurse anesthetists), who recognize that this can be a distressing or traumatic experience for the patient.

When awareness during general anesthesia does occur, it is usually just prior to the anesthetic completely taking effect or as the patient is emerging from anesthesia. In very few instances, it may occur during the surgery itself. Despite the rarity of awareness, members of the American Society of Anesthesiologists (ASA) and the American Association of Nurse Anesthetists (AANA) want you to know about this possibility. These organizations have been studying this issue and are in the process of evaluating the effectiveness of various technologies and techniques to decrease the likelihood of this occurring.

Why does it happen? In some high-risk surgeries such as trauma, cardiac surgery and emergency cesarean delivery, or in situations involving patients whose condition is unstable, using a deep anesthetic may not be in the best interest of the patient. In these and other critical or emergency situations, awareness may not be completely avoidable. While the safety of anesthesia has increased markedly over the last 20 years, people may react differently to the same level or type of anesthesia. Sometimes different medications can mask important signs that anesthesia professionals monitor to help determine the depth of anesthesia. In other rare instances, technical failure or human error may contribute to unexpected episodes of awareness. The ultimate goal is always to protect the life of the patient and to make the patient as comfortable as possible. That is why it is important to have highly trained anesthesia professionals involved in your surgery.

How can it be avoided? Before surgery, patients should meet with their anesthesia professional to discuss anesthesia options. Should there be concerns regarding awareness, this is an ideal time to express them and to ask questions. Patients should share with their anesthesia professional any problems they may have experienced with previous anesthetics, and also discuss any prescription medications or over-the-counter medications they are taking.

As always, your anesthesia professional will guide you safely through your surgery by relying on his or her clinical experience, training and judgment combined with proven technology.

What You Should Know About Patient Awareness Under General Anesthesia It is quite rare. When it does occur, it is often fleeting and not traumatic to the patient. Patients experiencing awareness usually do not feel any pain. Some patients may experience a feeling of pressure. Awareness can range from brief, hazy recollections to some specific awareness of your surroundings during surgery. Patients who dream during surgery, or who have some perception of their surroundings before or after surgery, may think they have experienced awareness. Such a sensation or memory does not necessarily represent actual awareness during surgery. Experts in the field of anesthesiology are actively studying this condition and are seeking the most effective ways to prevent it. Awareness can occur in high-risk surgeries such as trauma and cardiac surgery in which the patient’s condition may not allow for a deep anesthetic to be given. In those instances, the anesthesia professional will weigh the potential for awareness against the need to guard the patient’s life or safety. The same is true during a cesarean section, particularly if it is an emergency and a deep anesthetic is not best for the mother or child.

It has been shown that early counseling after an episode of awareness can help to lessen feelings of confusion, stress or trauma associated with the experience. Researchers in anesthesiology have spearheaded developments in technology that have dramatically improved patient safety and comfort during surgery over the last 20 years. A highly trained anesthesia professional should be involved in your surgery. No technology can replace this expertise. New brain-wave monitoring devices currently being tested may prove to be helpful in reducing the risk of awareness, but they need to undergo the same rigorous scientific review process that has led to wide adoption of other medical technologies. Patients should talk with their anesthesia professional before surgery to discuss all of their concerns, including the remote possibility of awareness. These professionals work to ensure the best possible care of patients in the operating room.

Patient awareness happens very infrequently. This remote possibility should not deter you from having needed surgery. Your anesthesia professional can help you to feel comfortable and informed about your upcoming experience with anesthesia.

What does the future hold? As patient advocates, anesthesia professionals are working hard to reduce the likelihood of awareness under general anesthesia. Depending upon the type of surgery, these experts have an array of proven technologies that can be used to monitor various vital signs of the surgical patient. Extensive research is under way to develop and study new technologies, such as brain-wave monitoring, that may lessen the risk of awareness. At the present time, none of these new technologies has been perfected.

Remember—no monitoring device can replace the judgment and skill of an anesthesia professional who has years of training and clinical experience. Working together, you and your anesthesia professional can make your anesthetic experience as safe and comfortable as possible.

What should I do if I think I have experienced awareness? The American Society of Anesthesiologists urges you to talk with your anesthesia professional, who can explain to you the events that took place in the operating room at any stage of your surgery and why you might have been aware at certain times. It is important to note that a variety of anesthetic agents is often used, some of which may create false memories or no memory at all of the various events surrounding surgery. If you have distinct recollections of your surgery and want to discuss them, your anesthesia professional can help you or refer you to a counselor or to other appropriate resources.

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Why does this site show photos that depict brutality? Get real, man! Because reality is brutal.

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The rise of the designer vagina

Genital surgery is one of the fastest growing areas of plastic surgery.

In our quest for perfection and amid a growing obsession with body image, it seems women now have a new part of the anatomy to worry about – our vaginas. Genital plastic surgery is one of the fastest-growing areas in cosmetic surgery, and one of the most popular procedures being requested – mostly by young women – is a labiaplasty.

A labiaplasty – or labial rejuvenation – is a procedure whereby the inner labia, or labia minora, get trimmed back so they look more "tucked in". The surgery is generally done under a local anaesthetic, so the patient is awake while it is being performed. The process takes around 90 minutes and you can walk out of the surgery, returning to normal activities within a few days – except for sex, which you should hold off for four to six weeks.

The reason for the rise

"There has been a huge surge in the past five years of people looking to get genital surgery, and the vast majority of these are getting a labiaplasty, vaginoplasty (vaginal tightening) or liposuction in the pelvic area or labia," says Dr Laith Barnouti, a leading Sydney plastic surgeon.

Barnouti says that currently around 20 per cent of his clients are coming in for genital surgery. The youngest to date was 14, the oldest in her mid-sixties. A 2010 report also found that the number of clinically necessary procedures – that is, not solely for cosmetic reasons – performed by private practitioners nearly doubled in recent years.

So why are women requesting this procedure? There are a few reasons, says Barnouti, including feeling "socially embarrassed… people can't wear certain types of bathers, people feel embarrassed in intimate situations". But the reasons go beyond the aesthetic, he claims.

"Labiaplasty and vaginoplasty are often performed due to a medical condition – people actually have it for a functional reason," Dr Barnouti says. "Labial hypertrophy – enlargement or sagging of the labia – can be unhealthy and unhygienic."

Vaginoplasty, which is usually performed on women who have a weakened perineum after giving birth, is a "restorative, reconstructive procedure", says Barnouti. "This is something completely different from, say, liposuction, which is a purely cosmetic procedure."

What is normal?

But are women having genital surgery for other reasons – to please a boyfriend perhaps, or because they feel their vagina is not normal? Do women actually hate the appearance of their vulvas so much that they will have parts of them surgically removed?

The 2008 UK documentary The Perfect Vagina explored the reasons why women opt for this type of surgery, and found that many do it because they've been teased by someone close to them about the way their genitals look, or have just decided their vagina looks abnormal.

In the documentary, Professor Linda Cordoza, a leading UK gynaecologist, says while women are much more aware of what's available in terms of plastic surgery procedures, it doesn't necessarily mean they know what's normal.

"There's been a huge trend towards bikini waxing, doing things with your pubic hair as well as the hair on your head. So [women think] if you can have cosmetic surgery done to your face, you can also have cosmetic surgery done on your genitals." Cordoza says.

"I sometimes get two or three generations of women in the same family coming in saying they want their labia trimmed."

The role of pornography

Our perception of what is normal is most definitely clouded by the proliferation of pornographic images featuring women with smaller, tucked in – and often heavily airbrushed – private parts.

As women, we don't often see vaginas other than our own, so if the only images we see are of highly airbrushed genitals, naturally many of us are going to assume that what we have is "different" or "abnormal".

Melinda Tankard Reist is a media commentator and author of Big Porn Inc and Getting Real – Challenging the Sexualisation of Girls (Spinifex Press). She believes pornography is a big driver in the rise in cosmetic surgery.

"Girls are made to feel inadequate and think that there's something wrong with their perfectly natural, healthy bodies. And boys are expecting girls to provide the porn star experience," Reist says.

Reist adds that it's important women pass on positive body image messages to their daughters, and that cosmetic surgeons should play their part by refusing to operate on very young women, rather than "capitalising on the body angst of girls".

Barnouti says women contemplating any type of cosmetic surgery should be doing it for themselves, not anyone else.

"What we do here is for the patient, not their partner," Barnouti says. "If you're going to have a procedure, have it for yourself. Just because someone makes a negative comment doesn't mean you should change your whole body."

Labiaplasty – the facts

The procedure: A labiaplasty takes around 90 minutes and patients are usually under twilight sedation – either local anaesthetic or IV sedation – meaning they are awake for the surgery. During the procedure the surgeon removes a wedge-shaped piece of tissue and re-attaches the labium so the inner lips no longer protrude beyond the outer lips.

The recovery: Three to four days for normal activities, including going back to work, but avoid exerting yourself physically. You can't run or jog for two weeks, and no sex for four to six weeks. The stitches used are usually dissolvable.

The cost: Labiaplasty costs around $4000 to $5000 if you have private healthcare cover, otherwise you can expect to add another $2000. To be available under Medicare it must be deemed clinically necessary.

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The destruction of the Western World will not be achieved by suicide bombers but by arsonists. Suicide bombers are a waste of human resources because the dedication of just one suicide bomber could set hundreds of square kilometers of forests on fire. And the personal risk? A comfortable prison sentence of just a few years.

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First federal case under female genital mutilation ban spurs efforts for harsher penalties

Minnesota state Rep. Mary Franson received a note from a friend last year urging her to draft stricter legislation against female genital mutilation. The state had banned the practice in 1994, so the Republican worried that a new law would seem “Islamophobic,” given its target audience.

One case changed her mind.

Federal prosecutors last month charged a Michigan doctor and his wife in connection with performing the procedure on two Minnesota girls. The parents of one girl — believed to have been involved in arranging the procedure — lost custody “for a whopping 72 hours,” Franson told lawmakers on the floor of the Minnesota statehouse last week.

Another Michigan doctor, Jumana Nagarwala of Detroit, has been charged in a separate case.

Now Franson wants Minnesota to pass a bill that would send perpetrators to prison for up to 20 years, targeting parents as well as doctors.

“We’re saying that if you harm your child in this way, you’re going to be held responsible,” she said.

Female genital mutilation has been a federal crime in the United States for more than two decades, carrying a maximum sentence of five years in prison. But the three doctors are the first to be charged under the law. The case has set off a flurry of new bills across the country, with a growing number of states moving to extend penalties to the parents and hit them with lengthy prison terms.

The issue has been a lightning rod in right-wing political circles for years, with anti-Muslim and anti-immigration activists linking it explicitly to Islam. In fact, there is no mention of female genital mutilation in the Koran, and the procedure is rare in most Muslim countries. But attorneys for the doctors, all three of whom are Muslim, say their trial defense next month is likely to invoke religious freedom, a move that is sure to lend the case even more political ammunition.

Republican-authored bills are pending in Michigan, Minnesota, Texas and Maine, and activists say Massachusetts is also weighing legislative action.

In Minnesota, which is among the 25 states that ban female genital mutilation, state representatives on May 15 voted 124 to 4 in favor of expanding the penalties. The bill will go to the state Senate for consideration, but it will probably be signed into law before the fall.

Female genital mutilation (FGM), sometimes called female genital cutting or circumcision, refers to the ancient, ritual practice of cutting off parts of a girl’s genitalia, and sometimes sewing shut the vaginal opening. It has no health benefits and can result in serious complications, including hemorrhaging and death, the lifelong loss of sexual pleasure, painful intercourse, and chronic infections.

The World Health Organization says more than 200 million women and girls living in 30 countries have experienced FGM. Most of those countries are in Africa.

The practice spans an array of ethnic and religious groups despite nearly universal national bans. Although the rationale for the practice varies, experts say it is often driven by social pressures to control women’s sexuality and ensure girls’ virginity before marriage. Some practitioners also believe that it serves a religious mandate, although the practice has no root in religious doctrine.

Some Muslim clerics have endorsed the practice, but a number of major Muslim leaders have condemned it. The three doctors in Michigan and the girls whom investigators say they cut are from the tiny Dawoodi Bohra sect of Shiite Islam, in which the practice is common and clerics are said to endorse it. The doctors’ trial is set for next month.

There’s no reliable data on how common the practice is in the United States, according to the authors of a 2016 Government Accountability Office report. But the Centers for Disease Control and Prevention estimates that about 513,000 women and girls in the United States either had the procedure or are at risk of experiencing it in the future, based on immigrant populations from countries where the practice is prevalent, including Somalia, Ethiopia and Sudan.

The Maine law would make parents who consent to FGM liable for up to 10 years behind bars. This month, the Texas state Senate unanimously approved a similar bill that would allow the state to prosecute people “who transport or permit the transport of a person for the purpose of FGM,” said the bill’s author, state Sen. Jane Nelson (R).

In Michigan, where the state Senate unanimously approved a package of bills on female genital mutilation May 17, perpetrators and accomplices would face up to 15 years in prison.

“We want to send the message that Michigan is not the place to bring your daughter for this evil, horrific, demonic practice,” state Sen. Rick Jones (R) told his colleagues during a recent hearing on the measure.

The Department of Homeland Security, which is responsible for criminal investigations under the federal ban, is set to launch a pilot program next month that aims primarily to reduce FGM abroad by warning travelers of its illegality. The practice of taking girls abroad to be cut, sometimes called “vacation cutting,” was banned in 2013.

The program, Operation Limelight USA, will be limited to John F. Kennedy International Airport in New York, although officials said they are still drafting specifics on how it will work.

The fresh wave of attention has been bittersweet for the U.S.-based activists who have spent years campaigning to end a practice that they say is poorly understood and generally ignored by the public, law enforcement and U.S. officials.

“When things like this happen, people just want to focus on getting all states to penalize it. But there’s a bigger picture out here that we’re not focusing on,” said Jaha Dukureh, the founder of the Atlanta-based Safe Hands for Girls, a leading advocacy group against FGM.

Dukureh, who underwent the procedure as an infant in Gambia, said she would rather see education and outreach aimed at preventing the practice than punishment alone.

For instance, many activists, doctors and lawmakers have said they want better training for medical professionals so they can address the issue with pregnant women who have experienced FGM before they give birth to girls. And they want to see efforts to spread awareness of the procedure’s dangers in vulnerable schools and communities, enlisting the support of neighborhood and religious leaders in condemning it.

Somali American activists have been pushing legislators for funds to prevent the practice through education and outreach, said Minnesota state Rep. Susan Allen of the Democratic-Farmer-Labor Party.

“They have not gotten resources,” she said.

The United States banned female genital mutilation in 1997, and in 2003 banned the transport of a minor abroad to have the procedure. But there have been only two other FBI investigations into the practice over the past two decades. In both cases, the FBI was unable to find victims, and only one of the cases, in California, led to charges, according to the GAO report.

Experts say a culture of shame and secrecy — or even ignorance of having undergone a procedure that they might have been too young to remember — keeps many from talking about FGM in the United States.

Deborah Thorp, who is an obstetrician-gynecologist in Minneapolis, said she sees at least one patient a day who has undergone FGM. Many are older refugees from Somalia, where the prevalence rate is 98 percent.

But she said she doubts that the practice is common for Somali American children who are born in the United States.

“I’m seeing a lot of moms who are so angry that it got done to them that I have a hard time thinking that they would ever have anything to do with it,” she said.

Some activists and Democratic lawmakers have argued — in lieu of hard data about the prevalence of FGM — that racism, Islamophobia and anti-immigrant sentiments have played a role in fueling enthusiasm for the new policies.

Far-right blogs and news websites have long perpetuated the myth that FGM is a common Islamic practice by immigrants who are fundamentally at odds with American society.

FGM and honor killings “would not exist in the U.S. without mass immigration bringing its practitioners into U.S. communities,” Breitbart reporter Katie McHugh wrote in March. Stephen Miller, a top aide to President Trump, has voiced the same sentiment.

In Minnesota last week, some dissenting lawmakers worried that meting out “draconian” punishment for a poorly understood crime might make it worse. The Minnesota law would make it easier and more likely for the state to take custody of a child whose parent is suspected of involvement in FGM. For suspects who are not yet U.S. citizens, the crime would probably mean deportation.

“When you start removing children from their families, increasing penalties for families,” Allen, the state lawmaker, said, “it’s likely that it may deter them from reporting the violence. They may not cooperate with police.”

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Feminism in Europe makes second-generation male Muslim immigrants suicide bombers. Up to now it's only explosives. But a poison gas attack isn't far away.

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This man advertises suicide in Cambodia. I lost my sister to him

Telegraph

Distraught and depressed after the break-up of a relationship, Kim Walton surfed the internet until she found euthanasiaincambodia.com.

"In Cambodia anything is possible," it read. "For those of you who prefer to take charge of your own destiny, come to Cambodia! Live your life the way you want and end it when you are ready."

Mrs Walton, 46, a mortgage adviser, who was divorced more than 20 years ago, sent an e-mail to the site operator with the simple subject heading "Death". A brief correspondence ensued.

Within a fortnight she had left her home in Penn, Bucks, and was travelling 6,000 miles to Kampot, a quiet, dilapidated riverside town.

There, several days later, she wrote a five-page suicide note and overdosed on medicines and alcohol in a £5-a-night guesthouse.

Her sister is convinced that had it not been for the website she would still be alive. "We were very close," said Sally Spring, 46. "She couldn't have done it to me in this country. She would never have put us in a situation where we might find her body."

The relationship that had so upset her had lasted only two months, she added. "If she had been here I would have got her through it," she said. "There's nothing we can do to bring Kim back but I just want the website closed down.

"Any vulnerable person could see it and I don't want any other family to suffer. It's just got to be stopped. It's disgusting and it beggars belief."

The site contains a detailed description of an elasticated plastic bag, available through it for £55, and helium gas to ensure a "peaceful and painless death".

It is operated by Roger Graham, a 57-year-old American former arts and antiques dealer from Paradise, California, where he founded an assisted euthanasia society.

He moved to Cambodia two and a half years ago in response, he says, to the US invasion of Iraq. He adopted the name "Tola", bestowed on him by a bar girl.

According to a legal opinion he obtained from a law firm in Phnom Penh, the Cambodian capital, the country has no law against assisted suicide.

On the site, which he has taken off-line after provincial authorities filed a defamation action against him, he said: "I am not going to pull any switches. I will do whatever it is that is necessary, within the law and my own comfort level, for you to have a satisfying end-of-life experience. I let you make all of your own choices. It is your life."

He asked for £14,000 in charitable donations from potential users of his service.

At his cafe on the bank of the Kampot river, he said: "I don't put the stigma on death that most people have. Death is simply the end point of life. To deny it exists is to be afraid of it, is to be ridiculous. Cambodia is a good country. If you are going to die, come here, leave some money.

"I will do whatever I can to make their experience enjoyable but it remains up to them what they want to do, when they want to do it, how they want to do it."

When his time comes, he added, he will kill himself.

"I'm not going to go plugged into some machine. I don't intend to do it tomorrow, but I might. It's my choice."

He does not differentiate between the terminally ill and those who want to die for other reasons.

"I don't care if you have a problem or not, that's not for me to decide, it's your life."

He declined to answer when asked if he had ever helped anyone to die in America. But he insisted that even though Mrs Walton went to his cafe when she arrived in Kampot, she never broached suicide, or revealed herself as the e-mail sender, and he never saw her again. No witnesses have contradicted him.

"It may sound implausible, but it's true," said Mr Graham. "The inference is I was involved, and I was not."

She did not give him any money or ask him to make any charitable donations for her, he said, and independent witnesses say that all the money she had with her was returned to her family.

No other foreigner is known to have committed suicide in Kampot since Mr Graham arrived and, while he receives e-mails on the subject "all the time", he is not aware of anyone else coming to the town due to the site. He suggested that euthanasia tourism could be "positive" for Cambodia.

Others are revolted by the concept. When the website became public knowledge after Mrs Walton's death in September a third of Kampot's expatriate population signed a petition calling on the authorities to take action.

Prosecution authorities say they will question Mr Graham over alleged defamation soon. But Kampot's vice-commissioner of police, Lt-Col In Chiva, admitted that they had been unable to find any law against the website itself.

Puth Chandarith, the governor of Kampot, said his legal action was for defamation and "false statements that Cambodia is the best place to commit suicide".

If the action failed, he could revoke Mr Graham's business licence.

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As long as you can fall in love again with a beautiful young woman, you will never die. That is the power of butea superba.

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Can all women climax?

Dear Dr. G,

I understand you mainly answer questions about men's health, but I hope you can accommodate my query about female sexual health.

My wife and I have been married for six years and we have frequent intimacy. We now have a beautiful three-year-old daughter.

Like most couples, we do not usually discuss sexual issues openly.

However, my wife started asking me about female sexual satisfaction.

She said that most of the time, the sex has only "benefited" me and does not think she has ever climaxed.

Of course, it hurts as I assumed she was quite satisfied these six years. Now, knowing it was all "not that good", I am determined to make it right.

Is it true that some women never climax at all? Please help.

Regards,

Gordon

"Orgasm" is derived from the Greek word "orgasmos" meaning excitement and swelling. In medical terms, this terminology is used to describe the sudden escalation of sexual excitement resulting in discharge of semen or secretions and an overwhelming feeling of euphoria.

With men, orgasm is usually an outcome of physical sexual stimulation of the penis, typically accompanying ejaculation. However, this is different in women as the stimulation is usually focused on the clitoris.

For both men and women, the orgasmic state can be achieved by self-stimulation, or penetrative and non-penetrative sex with a sex partner. An orgasm can also be achieved without a sexual act, which happens subconsciously during wet dreams.

The ability to have an orgasm and its intensity in both men and women varies widely. The real control of an orgasm occurs in the central nervous system, hence the true mechanism and the evolutionary purposes of the orgasm are poorly understood. In recent years, there has also been an intensive effort and a lot of research aimed at understanding and unravelling the real mystery behind the orgasm.

Statistics indicate that 70-80% of women can derive an orgasm by direct manipulation against part of the clitoris, and the Mayo Clinic has demonstrated that an orgasm can vary in intensity between women. This means the frequency of orgasms and the amount of stimulation required to trigger it can differ substantially between individuals.

Anatomically, the clitoris has more than eight thousand sensory nerve endings that will contribute to the final climactic experience. It is also notable that although the number of nerve endings is same in the glans of the penis, the reaction to physical stimulation is very different.

Also, evidence has emerged that the labia and vagina play a major role in female orgasms. Recent studies have shown that the labial minora and urethra is particularly sensitive, hence part of achieving a satisfying outcome should involve these two organs.

Additionally, scientific literature supports the fact that 25% of women have reported difficulties in achieving an orgasm and that 10% of women have never had one. This condition is termed "female anorgasmia".

In a 1994 study, researchers found that 74% of men and 29% of women reported were able to achieve orgasm with their regular partners. The same study also revealed that women are much more likely to achieve orgasm through "self-practice" instead of with a partner.

Having said that, many women expressed that their most satisfying sexual experiences entail being connected and loved by the partner, rather than based on achieving sexual orgasm.

On the week leading to Valentine's Day, I am glad to be put on the spot to address this issue of female anorgasmia.

The advice I have for Gordon is that women's sexual health is never easily understood and an orgasm should never be considered the sole achievement of sex. When your partner is open to discussion on any shortcomings, this is the first step towards a satisfying relationship that may even result in happy endings in the future.

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Feminism is the enemy of successful men. Let millions of Arabs migrate to Europe. That will give feminists second thoughts.

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Tainted Saint: Mother Teresa Defended Pedophile Priest

SNAP January 11, 2012 9:52 AM

The death of journalist and polemicistChristopher Hitchens last month gave those familiar with his work a chance to revisit one of his more controversial subjects: the Albanian nun Agnes Gonxha Bojaxhiu, better known to the world as Mother Teresa. In his 1997 book, The Missionary Position: Mother Teresa in Theory and Practice, Hitchens argued that the "Saint of Calcutta," who founded and headed the internationalMissionaries of Charity order, enjoyed undeserved esteem.

Despite her humanitarian reputation and 1979 Nobel Peace Prize, Mother Teresa had set up a worldwide system of "homes for the dying" that routinely failed to provide adequate care to patients, Hitchens argued — an appraisal shared by The Lancet, a respected medical journal. Mother Teresa also associated with, and took large sums of money from, disreputable figures such as American savings-and-loan swindler Charles Keating and the dictatorial Duvalier family ofHaiti.

Notwithstanding these black marks on an otherwise sterling reputation, Mother Teresa — who died in 1997 and is now on the fast track to a formal proclamation of sainthood by the Vatican — was never known to have been touched by the scandal that would rock the Roman Catholic Church in the decade after her death: the systematic protection of child-molesting priests by church officials.

Yet documents obtained by SF Weekly suggest that Mother Teresa knew one of her favorite priests was removed from ministry for sexually abusing a Bay Area boy in 1993, and that she nevertheless urged his bosses to return him to work as soon as possible. The priest resumed active ministry, as well as his predatory habits. Eight additional complaints were lodged against him in the coming years by various families, leading to his eventual arrest on sex-abuse charges in 2005.

The priest was Donald McGuire, a former Jesuit who has been convicted of molesting boys in federal and state courts and is serving a 25-year federal prison sentence. McGuire, now 81 years old, taught at the University of San Francisco in the late 1970s, and held frequent spiritual retreats for families in San Francisco and Walnut Creek throughout the 1980s and 1990s. He also ministered extensively to the Missionaries of Charity during that time.

In a 1994 letter to McGuire's Jesuit superior in Chicago, it appears that Mother Teresa acknowledged she had learned of the "sad events which took [McGuire] from his priestly ministry these past seven months," and that McGuire "admitted imprudence in his behavior," but she wished to see him put back on the job. The letter was written after McGuire had been sent to a psychiatric hospital following an abuse complaint to the Jesuits by a family in Walnut Creek.

"I understand how grave is the scandal touching the priesthood in the U.S.A. and how careful we must be to guard the purity and reputation of that priesthood," the letter states. "I must say, however, that I have confidence and trust in Fr. McGuire and wish to see his vital ministry resume as soon as possible."

The one-page letter comes from thousands of pages of church records that have been shared with plaintiffs' attorneys in ongoing litigation against the Jesuits involving McGuire. (The documents were also shared with prosecutors who worked on his criminal cases.) It is printed on Missionaries of Charity letterhead but is unsigned, and thus cannot be verified absolutely as having been written by Mother Teresa. Officials in the Missionaries of Charity and the Jesuits did not respond to requests for comment on its provenance.

Yet statements throughout the letter point to Mother Teresa as the author. The writer speaks of "my communities throughout the world" and refers by name to Mother Teresa's four top deputies, calling them "my four assistants." Rev. Joseph Fessio, a Jesuit and former University of San Francisco professor who knew Mother Teresa, said the reference to her assistants is an "authentic" aspect of the letter.

The letter could have an impact on the near-complete process of canonizing Mother Teresa. In 2003 she was beatified by Pope John Paul II, the penultimate step to full sainthood.

"What we see here is the same thing we see over and over in regard to the [priest pedophilia] scandal — the complete lack of empathy for, or interest in, possible victims of these accused priests," said Anne Rice, the bestselling author of novels including Interview with the Vampire and a former Catholic who has been outspoken in her criticism of the church's handling of the sex-abuse scandal. "In this letter the concern is for the reputation of the priesthood. This is as disappointing as it is shocking."

Other documents that have emerged in the criminal and civil cases involving McGuire could affect the sainthood prospects of another deceased religious leader eyed by the Vatican for sainthood. Among the newly uncovered church records are letters by Rev. John Hardon, a Jesuit who also worked extensively with Mother Teresa and died in 2000. He collaborated with then-Cardinal Joseph Ratzinger, now Pope Benedict XVI, on the Catechism of the Catholic Church, a landmark summation of contemporary church doctrine. In 2005, the Vatican opened a formal inquiry into whether Hardon should be made a saint.

But statements by Hardon in his letters could complicate that process. The documents reveal McGuire admitted to Hardon that he was taking showers with the teenage boy from Walnut Creek whose complaint led to McGuire's psychiatric treatment. He also acknowledged soliciting body massages from the boy and letting him read pornography in the room they shared on trips together.

Despite these admissions, Hardon concluded that his fellow Jesuit's actions were "objectively defensible," albeit "highly imprudent," and told McGuire's bosses that he "should be prudently allowed to engage in priestly ministry."

The postulators, or Vatican-appointed researchers and advocates for sainthood, assigned to investigate Mother Teresa and Hardon did not respond to repeated requestsfor comment.

While it is unclear exactly what impact the new documents will have on the evaluation of both figures for sainthood, the evidence of involvement by two prominent and internationally respected Catholics in the McGuire sex-abuse scandal is likely to cause consternation among critics of the church's handling of predator priests. The situation is aggravated since McGuire went on to abuse more children after suggestions to return him to ministry were heeded.

"We're talking about extremely powerful people who could have gotten Father McGuire off the streets in 1994," said Patrick Wall, a lawyer and former Benedictine monk who performs investigations on behalf of abuse victims suing the Catholic Church. "I'm thinking of all those post-'94 kids who could have been saved."

It is unknown exactly when Hardon, McGuire, and Mother Teresa first crossed paths. But chances are good that the first time they all found themselves together in the same place was in San Francisco in 1981. It was the 800th anniversary of the birth of Saint Francis of Assisi, the city's namesake. Hardon invited Mother Teresa, who attended celebratory services at which she was introduced to McGuire, according to Fessio, who was present.

Fessio, who today heads the Ignatius Press, a Catholic publishing house in the Sunset District, said Mother Teresa was impressed by McGuire's reputation as an erudite, engaging preacher. She arranged to have him perform retreats — based on the Spiritual Exercises bySaint Ignatius of Loyola, founder of the Jesuit order — for her missionaries around the world. "She was always looking for priests to say mass for the different places in the world where she had missions," Fessio recalled.

In McGuire, she found a priest whose strict adherence to traditional Catholic practices matched her own views. Mother Teresa was an extreme conservative on questions of religious doctrine. She declared during her speech accepting the Nobel Peace Prize that abortion was "the greatest destroyer of peace" in the modern world. McGuire was likewise stoutly orthodox in his public persona, requesting that women wear long skirts in his presence and often assailing other Jesuits for their relatively tolerant approaches to political and social issues.

Some insight into the reverence the Missionaries of Charity held for McGuire and his retreats and sermons can be gleaned from letters sent to Wisconsin Circuit Court Judge James Carlson, who oversaw the trial that resulted in McGuire's first conviction in 2006.

Sister Nirmala, Mother Teresa's successor as the superior general of the Missionaries of Charity, wrote, "He was one of the very few priests to whom ... Teresa of Calcutta entrusted the spiritual care of the Missionaries of Charity through retreats, seminars and spiritual guidance wherever possible."

Sister Mary Christa, another nun with the Missionaries of Charity, wrote, "Father's immense love for Jesus Christ radiated brilliantly through his every word and gesture, and his whole concern was to inspire the Sisters with a more intense desire for holiness. His wisdom, immense knowledge of Holy Scripture, and saintly manner of life made a profound impression on all of us."

But McGuire's holy veneer concealed signs of a dark side that were already evident to select church officials long before he met Mother Teresa.

Documents that have emerged in the criminal prosecution of McGuire and civil litigation against the Jesuits over his actions show that suspicions about the priest were brought to his higher-ups beginning soon after his ordination in 1961. During his first teaching assignment, at Loyola Academy in Wilmette, Ill., he molested at least two boys, whose cases led to his first criminal conviction decades later.

The Jesuits, who have formally apologized to McGuire's victims for failing to adequately control the priest, have nevertheless asserted in legal filings that they should not be held liable for the harm he did to children during his career. In a June 2011 motion in a lawsuit filed against the Chicago Province of the Society of Jesus, the order's lawyers asserted that McGuire is "an evil and perverted man who used his substantial intellectual gifts and his dominating personality to disobey every tenet of his faith and his vows as a cleric."

One of the best-documented instances of abuse in McGuire's record is one in which neither the victim nor his family chose to pursue litigation against the church. Jesuit records show that in April 1993, a devout Catholic man in Walnut Creek came forward with the complaint that his 16-year-old son, who traveled with McGuire as his personal assistant, had looked at pornographic magazines, showered, and masturbated with the priest.

Following this complaint, McGuire was removed from active ministry and sent to Saint John Vianney Center, a psychiatric-treatment facility for clerics in Pennsylvania. It was there that Hardon — whom the victim's family had requested investigate their allegations — interviewed McGuire and chose to exonerate him. After six hours of face-to-face talks at the hospital, Hardon wrote to McGuire in a January 1994 letter, "I firmly expressed my belief in your innocence of any sexual misbehavior."

McGuire returned to his order at the beginning of 1994, but his future, including the extent to which he would be allowed to interact with families and children as a priest, was still unclear. Hardon's letter to McGuire reveals that the errant Jesuit still worried that the sex-abuse allegations lodged against him would mar his prospects for continued work with Mother Teresa, work that considerably enhanced McGuire's prestige among other Catholics to whom he ministered.

"You expressed your deep fear that despite your proven innocence of all charges, somehow you would nevertheless not be allowed to continue your retreat ministry to Mother Teresa's sisters," Hardon wrote. At the conclusion of his letter, Hardon indicated that the matter would soon be resolved in direct consultation with the "Saint of Calcutta" herself.

"And so, Don, this is the state of the question on this eve of my departure for Calcutta, India, where, with your permission, I will be communicating with Mother Teresa about your situation and your future," he wrote.

A letter written less than a month later, on Feb. 2, 1994, appears to contain an answer to the questions about his future with the Missionaries of Charity that dogged McGuire after his release from treatment at Saint John Vianney. It is addressed to Brad Schaeffer, Provincial, or head, of the Chicago section of the Jesuits. (While McGuire's ministry took him across the U.S. and into foreign countries, he was officially under the supervision of the Jesuits' Chicago Province.)

The letter is not signed, though it begins with a handwritten salutation in Mother Teresa's characteristic looping script. It is unclear whether additional pages are missing from the document, or whether the writer simply failed to attach a signature. Clues throughout the letter, however, indicate that Mother Teresa is the author. The writer refers to "my communities throughout the world" and praises McGuire's preaching to "my novices in our new novitiate in San Francisco" in 1982. (Novices are aspiring nuns who have not yet taken vows.)

More significantly, the writer refers to "my four assistants, Sisters Mary Frederick, Priscilla, Monica and Joseph Michael." In 1994, the councilors general of the Missionaries of Charity — a group of four senior nuns who directly advised Mother Teresa, and were subordinate to no one else in the order — were Sisters Frederick, Priscilla, Monica, and Joseph Michael (Upon taking vows, nuns sometimes assume the names of male religious figures).

"That's authentic, mentioning those people," Fessio said. "Those were herfour councilors."

(View the original letter, and other documents mentioned in this story in the "details" box.)

Nuns at the primary U.S. office of the Missionaries of Charity, in New York City, referred all questions related to McGuire to the Mother Teresa Center in San Ysidro, Calif. Rev. Brian Kolodiejchuk, postulator for the sainthood cause of Mother Teresa and director of the center, did not respond to calls and e-mails seeking comment.

Schaeffer, the letter's recipient, is now the rector of a Jesuit community in Brighton, Mass., and serves on the board of trustees of Boston College. He did not respond to phone messages. The Chicago Province of the Jesuits also did not respond to requests for comment.

If Mother Teresa did write the letter to Schaeffer, it is unclear how much she learned about the circumstances under which McGuire was disciplined. The letter states, "During his recent visit to Calcutta in the past month, Fr. John Hardon, S.J., brought a letter to me from Fr. McGuire, describing the sad events which took him from his priestly ministry these past seven months. Fr. Hardon explained ... how he had established Father's innocence of the allegations against him. Father Hardon said that Fr. McGuire admitted imprudence in his behavior."

SF Weekly could not obtain the letter written by McGuire that is mentioned, or find anyone who had seen it. Following the exhortation that McGuire be returned to active ministry, the Missionaries of Charity letter concludes, "We, in the Missionaries of Charity, will do all in our power, to protect him and the Priesthood of Jesus Christ which he bears, when he once more takes up his mission with us."

Tariq Ali, the British intellectual who produced and co-wrote with Hitchens the sharply critical 1994 documentary film on Mother Teresa, Hell's Angel, said the letter fit with what he described as the nun's pattern of consorting with dubious personalities.

Among the problems chronicled in Hell's Angel were substandard care for the poor who filled her hospitals, and her willingness to accept money from notorious figures such asJean-Claude "Baby Doc" Duvalier of Haiti, who presided over a brutally repressive regime under which most Haitians lived in abject poverty. Duvalier's own lifestyle was luxurious, thanks to revenue from his participation in the drug trade and practice of selling dead Haitian citizens' cadavers overseas. Mother Teresa once posed for a photograph holding hands with Duvalier's wife, Michèle.

"When Christopher Hitchens and I made the film on her, the research was impeccable," Ali said. "She was close to dictators. She took money wherever she could. The care in her hospitals was poor. It was just one nightmare after another. From that time on, I saw her as a total fake," Ali said. The letter, he added, "would only be surprising if one saw her as a moral person, and I don't."

Anne Sebba, a biographer of Mother Teresa, said the founder of the Missionaries of Charity had never before been tainted by knowing involvement with a pedophile priest. However, she said the nun's response to criticism of her coziness with figures such as the Duvaliers and savings-and-loan scamster Charles Keating — for whom she pleaded for leniency during his trial and eventual conviction on fraud charges — was that she was practicing forgiveness in line with Christian ideals.

"Her answer was always that any miserable sinner deserved to be given a chance to do good," Sebba said. "She argued that Jesus always offered redemption, and no sinner was beyond redemption."

In McGuire, Mother Teresa encountered a challenge to that belief. After his return to ministry in 1994, McGuire would see eight new abuse allegations lodged against him by boys' families. In 2006, he was found guilty of molesting two boys decades earlier at theLoyola Academy. In 2008, he was convicted in federal court of taking a boy across state lines for the purpose of sexually abusing him. According to federal prosecutors, McGuire probed the boy's anus with his fingers during "massages," examined his penis with a magnifying glass, and looked at pornography with him.

McGuire has maintained his innocence of the charges against him, asserting that his victims fabricated stories to secure financial settlements from the Jesuits. His Chicago-based lawyer, Stephen Komie, said that McGuire's appeals of his state and federal convictions were unsuccessful, however. "He's going to die in prison, absent a pardon, and I don't think that's in the cards," Komie said.

The father of the Walnut Creek boy whose abuse allegation prompted McGuire's psychiatric treatment in 1993 said the information in the new documents is unfortunate, but not shocking. "That McGuire fooled Father Hardon and Mother Teresa like he did so many others is disappointing, but not a surprise," he said. "It shows that a person doesn't have to be a mind-reader in order to be a saint."

A second Walnut Creek man who says McGuire abused him as a child, and who is participating in a lawsuit against the Jesuits, reacted to the letter that might be from Mother Teresa more strongly.

"I was totally blown away by it," said the man, who is identified in court records only as John Doe 129 and whom SF Weekly is not identifying by name because he is an alleged victim of childhood sexual abuse. "I just don't know how somebody supposedly so saintly, supposedly such a protector of the weak and the poor, could be so indifferent to it," he said.

Hardon's letter to McGuire, as well as the letter that appears to have been written by Mother Teresa, indicate it was Hardon who personally carried news of McGuire's situation to Calcutta. It is thus important to understand how much Hardon knew when he visited Mother Teresa in January 1994. On this front, newly uncovered documents show the Jesuit in an unflattering light, and may have a serious impact on his prospects for sainthood.

In addition to his January 1994 letter to McGuire, Hardon wrote a detailed explication of his knowledge of and involvement in McGuire's case to Schaeffer, the Jesuits' Chicago provincial, in November 1993. The father of the alleged abuse victim from Walnut Creek had requested that Hardon personally intercede to assess exactly what McGuire had done to the teenage boy. At the time, Hardon was an internationally known and beloved priest who had staked his reputation on championing a conservative strain of Catholicism, not dissimilar to McGuire's, that was often at odds with the beliefs of his more liberal-minded fellow Jesuits.

During a visit to Saint John Vianney, Hardon had a frank conversation with McGuire in which the latter admitted to taking showers with his alleged victim, asking the boy to massage his body, and allowing him to possess pornography in the room they shared while traveling. McGuire denied additional allegations that he had touched the boy's genitals and watched him masturbate.

Hardon was apparently satisfied with what he heard. As he wrote to Schaeffer, "Regarding showering, Fr. Don said that it was true, but the picture is not one of a lingering sensual experience. It was rather the picture of two firemen, responding to an emergency, one of whom was seriously handicapped and in need of support and care from the other."

On the body rubs: "Regarding the massages, Fr. Don said they were done with attention to modesty and were necessary to relieve spasm at the 4th-5th lumbar disc and the right leg, involving the sciatic nerve." (The fourth and fifth lumbar vertebrae are at the bottom of the spine, just above the buttocks.)

And the dirty magazines: "Regarding pornography Fr. Don said that there were Playboy andPenthouse magazines, which he neither got nor threw away."

Hardon concluded in the letter, "I do not believe there was any conscious and deliberate sexual perversity." He added, "I do believe Fr. McGuire was acting on principles which, though objectively defensible, were highly imprudent." He also concluded that another serious charge against McGuire, that the priest had violated the seal of confession by disclosing private information about the boy during an argument with his father, was unfounded.

The 1993 victim's family did not respond to requests for comment regarding the revelations in the letters. Other observers, noting the blasé manner in which Hardon speaks of a priest showering with a teenage boy and his unconcern with a supposedly orthodox cleric's tolerance for porn, say the letter will cast a shadow on the late Jesuit's reputation.

"I will never look at John Hardon the same way again," said Wall, the former Benedictine monk.

Phil Lawler, editor of Catholic World News, said the letter could be a stumbling block for the sainthood cause of Hardon, who is still in the early stages of being investigated by Vatican deputies. The most rigorous review of a candidate's life typically comes prior to the first milestone in the process, called veneration. Following that are beatification and canonization.

Lawler described Hardon's statements about McGuire as "shocking."

"What will it do for his cause? It will slow it down," Lawler said.

Rev. Robert McDermott, a priest in theArchdiocese of Milwaukee and postulator for Hardon's cause, initially agreed to review Hardon's letter about McGuire and comment on it. After receiving it, he did not respond to subsequent calls and e-mails from SF Weekly.

Lawler said the letter apparently written by Mother Teresa, by contrast, is unlikely to stop her from clearing the final hurdle of canonization.

"I think her reputation is safe," Lawler said. "It doesn't fluster me that she would try to help a friend, and didn't know what was going on. Her reputation is so safe that, even if this is a negative, it doesn't much weighon it."

The extent to which the new documents will influence the canonization of either Hardon or Mother Teresa should, ideally, only be assessed after a thorough investigation of what both figures knew about McGuire, and how much influence their advocacy on his behalf had in the disastrous decision to return him to ministry in 1994. But in light of the church's past lack of diligence in dealing with priestly abuse, that might be a lot to hope for.

Mother Teresa is perhaps the most famous and popular Catholic religious leader of the second half of the 20th century, rivaled only by the late Pope John Paul II. Hardon's cause is likewise dear to senior officials in the Vatican. The investigation into his potential sainthood was initiated by Raymond Burke, the cardinal and former archbishop of St. Louis who is now prefect of the Supreme Tribunal of the Apostolic Signatura — a position that could be described as the chief justice of the Catholic Church's supreme court.

Lawler pointed out that dozens of American bishops who protected known child molesters in the clergy remain on the job today. Will similar efforts to shield a predator by figures of possibly saintly stature haveany fallout?

"You asked me whether this matter could affect the progress of Father Hardon's cause [for canonization], and I said that it definitely would. It might have been more accurate if I had said it definitely should," Lawler said. "I hope that people would recognize this as a serious issue that demands attention. But this is an issue on which the record of the American Catholic hierarchy is still not good."

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Restoring hope to FGM victims

Victims of female genital mutilation experience multiple short-term and long-term health and psychological risks. The practice causes excessive bleeding, infections, painful urination, keloids, trauma and childbirth problems.

There is, however, hope for Female Genital Mutilation (FGM) victims in Kenya after clitoral reconstructive surgery was introduced in the country last week.

Over 45 victims of FGM aged between 16 and 68 years have undergone the procedure at Mama Lucy and the Karen hospitals. The procedure is aimed at restoring the dignity and sexuality of the victims whose clitoris have been mutilated resulting in painful side effects and abnormalities in sexual function.

Dr Marci Bowers, a gynaecology surgeon at Clitoraid, a US-based non-profit organisation, FGM takes away the identity of women and a part of them. The surgery aims at enabling them feel whole again.

Clitoraid, working in collaboration with Kenyan non-governmental organisation, Garana and Dr Abdullahi Adan, a plastic reconstructive surgeon, introduced Clitoral restorative surgery in the country.

The clitoris is one of the parts of the female anatomy that’s adversely affected during FGM. It affects sexuality of women and even causes problems in marriages. “The physiology of the clitoris is underestimated.

It is at least 11 cms in an average woman, which means even in the worst FGM cases less than five per cent is removed. We are bringing back the remaining part of clitoris,” says Bowers.

According to Adan, the main body of the clitoris is buried beneath the genitalia. What is normally cut during FGM is the tip. During the procedure the surgeon dissects the area removing the scar tissue.

This allows it to come to the surface and put it in place where it can be contacted sexually. Clitoroplasty, as the procedure is referred to, was developed by French urologist Dr Pierre Foldes. It has achieved a high-level of effectiveness in the US and Burkina Faso where it was introduced first.

“Clitoraid was getting a lot of enquiries about clitoral reconstructive surgery. Some women from Kenya actually flew all the way to California,” says Adan. There has been a great degree of effectiveness of the Clitoroplasty technique.

“According to a study of more than 3,000 patients half of them are able to get an orgasm – some for the first time in their lives. More than 90 per cent report that their function in sex is better,” says Dr Bowers.

A majority of those that have undergone the procedure have regained their sexual sensitivity. “Most importantly, most of them feel a sense of completeness because something that was taken away from them has been brought back.

This is something that has brought problems in marriages. It may underestimate but it’s a big thing for a woman,” says Adan. A total of 16 doctors in Kenya have received training on the procedure to enable more victims of the FGM benefit.

Two obstetricians in Mama Lucy, one urologist and four plastic surgeons have been trained. Even with the high success rate, Bowers is quick to add that the perfect solution to the problem is to put an end to FGM.

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