CHICAGO – Development of a transfusion-free surgical program for Jehovah’s Witness patients undergoing liver transplantation also has helped reduce the overall use of blood products for non-Jehovah’s Witnesses undergoing the procedure, according to a study in the September issue of Archives of Surgery, one of the JAMA/Archives journals.
“Orthotopic liver transplantation [in which a patient's diseased liver is removed and a donor liver transplanted into the same place] is typically associated with a large volume of blood loss, resulting in multiple transfusions and related complications,” the authors describe in background information in the article. “Transfusion-free surgery is rapidly gaining much-needed attention primarily because of the concerns surrounding transmission of diseases such as human immunodeficiency virus, hepatitis C and other viral infections. Additionally, long-term shortage of blood products and a paucity of alternatives put the system under duress, resulting in cancellation or postponement of elective cases.”
Nicolas Jabbour, M.D., from the INTEGRIS Baptist Medical Center, Oklahoma City, and colleagues analyzed the medical records of 365 adult and pediatric orthotopic liver transplants performed from January 1997 through December 2004 at the University of Southern California-University Hospital in Los Angeles. The investigators evaluated the impact of the initiation of a transfusion-free program for Jehovah’s Witnesses undergoing liver transplantation on the overall use of blood products in non-Jehovah’s Witnesses undergoing the procedure. The pediatric and Jehovah’s Witness transplant recipients were eliminated from the study, leaving only adult non-Jehovah’s Witness patients who either received a liver transplant from a deceased donor or a living donor (n=272). These patients were categorized into two groups based on the initiation of the Transfusion-Free Medicine and Surgery Program at USC (for Jehovah’s Witnesses) in January 2000. Group 1 consisted of recipients who received the liver transplant before January 2000 and group 2 included all patients who underwent transplantation after January 2000.
Novo método de cirurgia sem sangue chega na Região Sul
Criciúma – O Hospital São José em busca de seu aperfeiçoamento e melhorias na sua tecnologia, visando, além do atendimento mais humano e de qualidade, está adquirindo um equipamento de recuperação de sangue. Como já se sabe nas cirurgias, principalmente nas de grande porte, como a cirurgia cardíaca, ocorre uma grande perda de sangue e necessidade de transfusões. Para isso, atualmente existe uma máquina italiana chamada Cell Saver, ou seja, “Salvadora de Células”. Ela suga todo o sangue perdido durante uma cirurgia, separa suas impurezas e o prepara para ser administrado ao paciente. Isso significa que o paciente pode ter todo o seu sangue recuperado. Desta forma não existe a possibilidade de riscos das transfusões e se respeita a ideologia de todas as crenças.
Neste mês de agosto, a equipe de Cirurgia Cardíaca do Hospital São José, realizou uma cirurgia na instituição, utilizando este novo equipamento, cuja a cirurgia teve duração de oito horas. Segundo o médico e responsável pelas Cirurgias Cardíacas, Ricardo Choma, o paciente não precisou de nenhuma bolsa de hemáceas. “Sem a máquina haveria a perda de 1000 mililitros de sangue, com a necessidade de transfundirmos três ou quatro bolsas de sangue. Os resultados da cirurgia sem a necessidade de transfusões são fantásticos, com menor tempo de internação e riscos”, ressaltou o cirurgião cardíaco.
Nesta linha de tratamento o grupo está desenvolvendo o CM&CSS (Centro Médico e Cirurgia Sem Sangue), que é um hospital com pensamento e procedimentos voltados a terapia médica sem utilização de sangue e seus derivados. Em primeiro encontro, o CM&CSS, apresentou para a equipe de cirurgia do Hospital, material científico para embasamento deste trabalho. Todo o processo é apoiado pela COLI (Comissão de Ligação com Hospitais para Testemunhas de Jeová). “Recebemos todo o material científico e estamos implantado as rotinas com um grupo composto por médicos, bioquímicos, fisioterapeutas, psicólogos, enfermeiras, técnicos de enfermagem . Neste protocolo de implantação, consta a aquisição de equipamentos, mudanças de rotinas, utilização de medicação especial e principalmente na conscientização de que é possível realizar cirurgias sem utilização de sangue. Neste ponto o Cell Saver é fundamental”, conclui Choma.
Jehovah’s Witnesses refuse blood transfusions. This does not prevent them from contracting hepatitis C or other diseases that necessitate liver transplants. Surgeons have developed techniques–such as withdrawing up to 1,500 milliliters of the patient’s own blood for reinfusion during the surgery–to deal with these religious strictures. And a new study of liver transplant patients seems to show that avoiding donated transfusions might be good for both blood banks and patients with no religious objections.
Nicolas Jabbour of the INTEGRIS Baptist Medical Center in Oklahoma City and his colleagues reviewed the outcomes of 272 liver transplant patients–who were neither children nor Jehovah’s Witnesses–who underwent surgery between January 1997 and December 2004 at the University of Southern California-University Hospital in Los Angeles. The patients were divided into two groups: those from before and after January 2000. This was not an arbitrary date; rather it marks the start of USC surgeons using the transfusion-avoiding techniques in all patients. Although the bulk of patients studied came after that date–only 33 non-Jehovah’s Witnesses received transplants prior–the new techniques showed that transfusions of donated blood significantly declined, saving both blood and money. Even the sickest patients required fewer transfusions; typical liver transplants required as many as 14 units of packed red blood cells in 1997 compared to roughly five by 2004.
“Blood can almost never be 100 percent safe,” Jabbour and his colleagues write in the paper presenting the finding in the September issue of Archives of Surgery. “Despite the current conviction among physicians that blood products are safer than they used to be, there are reports of transfusion-related transmission of hepatitis C and [HIV] and emerging data of newer pathogens.” The doctors also note that the more blood transfusions given, the more likely organ rejection and ultimate death. The Jehovah’s Witnesses may have some trouble predicting the apocalypse, but their antitransfusion stance seems to have helped surgeons and their liver transplant patients. –David Biello
OKLAHOMA CITY, Sept. 19 — A strategy for transfusion-free liver transplantation, developed for Jehovah’s Witness patients, reduced overall blood use when applied to all patients, researchers here reported.
In a study comparing transplants in 33 transfusion and 239 transfusion-free patients, the mean number of transfusions of intraoperative packed red blood cells and fresh frozen plasma was significantly lower for those treated with bloodless strategies compared with those given transfusions, according to a report in the September issue of the Archives of Surgery.
For packed red blood cells, the mean number of units was 8.8 units versus 6.0 (P=.03), and for fresh frozen plasma, it was 7.7 versus 4.9 (P=.004), said Nicolas Jabbour, M.D., formerly of the University of Southern California in Los Angeles and now of the INTEGRIS Baptist Medical Center here, and colleagues.
Platelet use did not seem to be affected, and the preop and postop use of packed red blood cells, fresh frozen plasma, and platelet transfusions between the two groups was not statistically different, the researchers added.
In their study, the investigators evaluated the impact on standard patients of the Transfusion-Free Medicine and Surgery Program developed for Jehovah’s Witness patients in 2000. From January 1997 through December 2004, 216 patients (79.4%) received deceased-donor grafts, and 56 (20.6%) were given living-donor transplants.
Thirty-three patients treated before 2000 (prior to the start of the transfusion-free program) received liver transplantation without blood-saving or salvaging techniques, and 239 had intraoperative cell salvage and acute normovolemic hemodilution.
In the hemodilution procedure, the patient’s blood is removed and replaced with non-blood products (5% albumin and crystalloid solution) whenever feasible, the authors said. The patient’s blood is later reinfused during the operation as needed or routinely after liver implantation.
The patients in the transfusion-free group tended to be sicker, the researchers reported. They had significantly higher mean levels of endstage liver disease (MELD score above 25), and yet they used fewer blood products compared with the transfusion patients (P=.001).
Primary diagnoses included hepatitis C cirrhosis, hepatitis B cirrhosis, autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis.
“In liver transplantation, the colossal intraoperative blood loss that necessitates massive blood transfusion is not unusual, putting patient and graft at risk and challenging the surgeon,” Dr. Jabbour said. “The MELD score has pushed many centers to perform transplantations in much sicker patients than was done before 2002.This occurrence is seen in our own series, in which more than 30% of our patients had MELD scores higher than 30.”
Discussing the pros and cons of the technique, the researchers said that intraoperative cell salvage is an effective method for collecting blood from the operative field, but a drawback is that it salvages only red blood cells and no clotting factors.
On the other hand, they said, acute normovolemic hemodilution preserves the integrity of the red blood cells and clotting factors, ensuring the availability of safe, fresh autologous blood. There are, however, a few contraindications to the hemodilution procedure, including coronary heart disease, significant anemia, and severe pulmonary hypertension.
Transfusion-free surgery is rapidly gaining much needed attention primarily because of concerns surrounding transmission of diseases such as HIV, hepatitis C, and other viral infections, as well as the strain on blood-banks resources, the researchers said.
“Surgeons are the leading consumers of blood products,” Dr. Jabbour wrote, “and it is important that we are leaders in promoting transfusion-free techniques.”
In conclusion, he wrote, “We propose that the recognized need to minimize the use of blood products be elevated to the same level as antibiotic and deep venous thrombosis prophylaxis.”
Transfusion-free surgical program reduced use of blood products for all liver transplant patients
Development of a transfusion-free surgical program for Jehovah’s Witness patients undergoing liver transplantation also has helped reduce the overall use of blood products for non-Jehovah’s Witnesses undergoing the procedure, according to a study in the September issue of Archives of Surgery, one of the JAMA/Archives journals.
“Orthotopic liver transplantation [in which a patient's diseased liver is removed and a donor liver transplanted into the same place] is typically associated with a large volume of blood loss, resulting in multiple transfusions and related complications,” the authors describe in background information in the article. “Transfusion-free surgery is rapidly gaining much-needed attention primarily because of the concerns surrounding transmission of diseases such as human immunodeficiency virus, hepatitis C and other viral infections. Additionally, long-term shortage of blood products and a paucity of alternatives put the system under duress, resulting in cancellation or postponement of elective cases.”
Nicolas Jabbour, M.D., from the INTEGRIS Baptist Medical Center, Oklahoma City, and colleagues analyzed the medical records of 365 adult and pediatric orthotopic liver transplants performed from January 1997 through December 2004 at the University of Southern California-University Hospital in Los Angeles. The investigators evaluated the impact of the initiation of a transfusion-free program for Jehovah’s Witnesses undergoing liver transplantation on the overall use of blood products in non-Jehovah’s Witnesses undergoing the procedure. The pediatric and Jehovah’s Witness transplant recipients were eliminated from the study, leaving only adult non-Jehovah’s Witness patients who either received a liver transplant from a deceased donor or a living donor (n=272). These patients were categorized into two groups based on the initiation of the Transfusion-Free Medicine and Surgery Program at USC (for Jehovah’s Witnesses) in January 2000. Group 1 consisted of recipients who received the liver transplant before January 2000 and group 2 included all patients who underwent transplantation after January 2000.
“Recipients in group 1 underwent orthotopic liver transplants without intraoperative blood-saving or salvaging techniques, whereas all transplant recipients in group 2 underwent intraoperative cell salvage (ICS) and acute normovolemic hemodilution (ANH) whenever feasible,” the authors report. “ANH indicates a therapeutic initiative that involves simultaneously removing the patient’s blood and replacing it with nonblood products…”
“In comparing group 2 with group 1, the mean (average) MELD [model of end-stage liver disease] score was statistically significantly higher, whereas the mean number of intraoperative PRBC (packed red blood cells) and FFP (fresh frozen plasma) transfusions were significantly lower,” the authors report. The MELD score describes the survival probability of a patient with end-stage liver disease, with higher scores indicating sicker patients. “The number of preoperative and postoperative PRBC, FFP and platelet transfusions between the two groups was not statistically different.”
“The development of a transfusion-free surgical program for Jehovah’s Witness patients has had a positive impact on reducing the overall blood use in non-Jehovah’s Witness patients,” the authors note. According to the authors, autotransfusion decreases some of the complications of transfusions, such as transmission of unknown pathogens, and also helps to preserve blood bank resources, which consequently reduces the overall procedure cost. “Surgeons are the leading consumers of blood products, and it is important that we are leaders in promoting transfusion-free techniques. In conclusion, we propose that the recognized need to minimize the use of blood products be elevated to the same level as antibiotic and deep venous thrombosis prophylaxis (prevention).”
This is a stitched-together panorama made up of 18 individual photos from the Budweiser Events Center in Loveland, Colorado. The song playing is number 212 from “Singing Praises to Jehovah.” …
Fecha de embargo: 18 de septiembre de 2006 a las 00:01 horas GMT
Eritrea: Después de cinco años, parlamentarios y periodistas siguen en detención secreta sin juicio, y se teme que algunos hayan muerto bajo custodia
Hoy se cumplen cinco años desde la detención sin cargos ni juicio de 11 ex parlamentarios, 10 periodistas y cientos de personas más en la represión contra los opositores al gobierno que pedían reformas democráticas en septiembre de 2001.
Recientemente han circulado denuncias según las cuales varios de los 11 ex parlamentarios detenidos en una prisión secreta, y algunos periodistas que al parecer fueron recluidos con ellos, han muerto bajo custodia debido a las duras condiciones y a la denegación de tratamiento médico. Se afirma por ejemplo, sin que se haya podido confirmar ninguna respuesta por parte de las autoridades eritreas, que el general Ogbe Abraha, ex jefe del estado mayor de la Armada, murió en julio de 2002 a causa de las heridas sufridas en un intento fallido de suicidio, a pesar de haber recibido tratamiento médico. Al parecer, las otras muertes se produjeron en años posteriores por enfermedad de los detenidos. Amnistía Internacional no ha podido conseguir la confirmación de estas denuncias y está investigándolas. A pesar de los numerosos llamamientos que se han hecho en estos años y de la preocupación internacional por las detenciones, las autoridades nunca han desvelado el paradero ni las condiciones de detención de estas personas, ni han permitido acceso alguno a ellas.
Con el fin de aclarar la situación de estas personas, que de hecho “desaparecieron” tras su detención, Amnistía Internacional pide al gobierno que forme un equipo de investigación independiente e imparcial para que visite la prisión secreta en la que están, las entreviste en privado e informe públicamente sobre su situación y sus condiciones de detención y de salud. Amnistía Internacional insta de nuevo a que se encuadren las detenciones en el marco de las disposiciones constitucionales y legales de Eritrea, así como de los tratados internacionales de derechos humanos que este país ha ratificado, como el Pacto Internacional de Derechos Civiles y Políticos. Este tratado prohíbe la detención arbitraria y en régimen de incomunicación, la tortura y otros tratos crueles, inhumanos o degradantes a los presos y los juicios sin garantías.
Los 11 parlamentarios (conocidos como miembros del “G15″ o “Grupo de los 15″, entre los que había varios ex ministros) fueron acusados públicamente de “traición” durante la guerra con Etiopía, y los periodistas detenidos fueron acusados de apoyarlos con sus publicaciones como “espías y mercenarios”. No se han presentado cargos contra ninguno ni se los ha puesto a disposición judicial. Amnistía Internacional los considera presos de conciencia, encarcelados por sus opiniones y su postura crítica frente al gobierno. La organización reitera su petición para que estas personas sean puestas en libertad sin condiciones, al igual que otros presos de conciencia, incluidos los encarcelados a causa de sus creencias religiosas.
La mayoría de los varios miles de personas que son presos políticos y religiosos en Eritrea están en régimen de incomunicación en cárceles secretas de seguridad o militares, sin que se hayan presentado cargos contra ellas ni hayan sido puestas a disposición judicial. A menudo sus familiares no saben dónde están, ni siquiera si están vivas. Las autoridades les dicen: “No tienen derecho a preguntar”. La atención médica que reciben estas personas es sumamente deficiente. Los malos tratos sistemáticos y las duras condiciones de detención, a menudo en contenedores metálicos de transporte de mercancías, han seguido invariables año tras año. La tortura sigue usándose habitualmente como castigo contra los presos reclutas y las personas presas por sus creencias religiosas.
Continúa la persecución religiosa
Continúa la constante de persecución religiosa de la que informó Amnistía Internacional en diciembre de 2005. Según los informes, unos 50 estudiantes fueron detenidos en mayo de 2006 por no asistir a una marcha el día de la independencia. A mediados de agosto de 2006, 29 personas que asistían a reuniones de oración en domicilios fueron detenidas en la capital, Asmara, la ciudad de Keren y el puerto de Massawa.
En total son unos 2.000 los hombres, mujeres y menores que están recluidos en unas 14 cárceles de todo el país. Entre ellos hay 35 pastores pertenecientes a iglesias cristianas evangélicas cerradas en 2002. La cantante de gospels Helen Berhane, en favor de la cual ha habido miles de llamamientos en todo el mundo sin que el gobierno haya respondido a ellos, lleva en régimen de incomunicación bajo la custodia del ejército más de dos años. Aunque a estas personas les han ofrecido la libertad si firman un documento en el que declaran abandonar su fe y dejar el culto clandestino, pocas de ellas lo han hecho, ni siquiera bajo tortura.
También hay detenidos 31 personas pertenecientes a los testigos de Jehová, 3 de las cuales llevan 13 años encarceladas, y cuatro religiosos de la Iglesia Ortodoxa de Eritrea, cuyo patriarca, según los informes, está bajo arresto domiciliario.
Unos 70 integrantes de un grupo musulmán disidente llevan 2 años detenidos sin cargos.
INFORMACIÓN COMPLEMENTARIA
La independencia oficial de Eritrea data del 24 de mayo de 1993 y se produjo tras un referéndum de la ONU, pero el país estaba independizado de hecho de Etiopía desde 1991, cuando el Frente Popular de Liberación de Eritrea formó nuevo gobierno. Desde el conflicto fronterizo con Etiopía (1998-2000) el ex dirigente del Frente Popular de Liberación de Eritrea y actual presidente y dirigente del Frente Popular para la Democracia y la Justicia, Issayas Afewerki, ha pospuesto indefinidamente la introducción de un sistema multipartidista y la celebración de elecciones, elementos clave en la Constitución de 1997. El contencioso fronterizo entre Eritrea y Etiopía aún está sin resolver, y sigue generando una gran tensión en la región. A principios de septiembre de 2006, la ONU volvió a criticar las restricciones del gobierno eritreo sobre el trabajo de observación de la misión de mantenimiento de la paz de la ONU en la zona fronteriza, las expulsiones de cinco miembros del personal internacional y la detención de un voluntario de la organización.
No están permitidos los partidos de oposición, las organizaciones independientes de la sociedad civil ni los grupos de defensa de los derechos humanos. Los medios de comunicación no estatales permanecen cerrados desde septiembre de 2001 y hay 14 periodistas detenidos. La crítica al gobierno es reprimida enérgicamente. El culto religioso de grupos a los que se ha negado su inscripción en el registro oficial (es decir, todos menos las iglesias ortodoxa, católica y luterana y el islam) está prohibido, en contra de la protección de la Constitución al derecho a la libertad de creencias.
Varios miles de personas han huido de Eritrea desde 2001. Las que fueron devueltas desde Malta en 2002 y desde Libia en 2004 fueron detenidas y torturadas. Varias personas solicitantes de asilo eritreas han sido rechazadas en países occidentales y algunas están detenidas en espera de una posible expulsión a Eritrea. Hasta ahora se han respetado en general las directrices de la Oficina del Alto Comisionado de las Naciones Unidas para los Refugiados que se oponen a la devolución de los solicitantes de asilo rechazados a Eritrea debido a la mala situación de los derechos humanos en este país. Trescientos solicitantes de asilo eritreos que huyeron a Libia desde Sudán, entre los que hay 80 mujeres y tres menores de corta edad, fueron detenidos en Libia en agosto de 2006 y pueden ser devueltos a Eritrea.
VOLUNTEERS FROM NEBRASKA & SOUTH DAKOTA ARE TRYING TO GET NEW JEHOVAH WITNESS KINGDOM HALL BUILT IN JUST FOUR DAYS. THE PARKING LOT & FOUNDATION WERE ALREADY LAID DONW SOME TIME AGO.THERE ARE ABOUT 600 WORKERS AND THEY PLAN ON HAVING EVERYTHING DONE, & THAT INCLUDES CARPETING, ELECTRICAL,& LANDSCAPING DONE. THEY ARE ALSO USING MASTER ELECTRICIANS & PLUMBERS FROM BOTH STATES. tHEY ARE GOING TO BE DOING THE SME THING IN SCOTTSBLUFF NEXT APRIL.
U.S. Says Religious Freedoms Restricted in Russia
The Moscow Times
The rights of Jehovah’s witnesses and other religious groups are being restricted in Russia, the U.S. State Department’s International Religious Freedom Report states.
The report, released Friday by the department’s Bureau of Democracy Human Rights and Labor, also noted that the country’s security services continued to view some Muslim groups as a national security threat and that religiously motivated violence persisted.
The report groups Russia with 19 other nations cited for both curbing religious freedom and taking some positive steps to promote it. The group includes Afghanistan, China, Cuba and Iran.
“There were indications that the security services, including the Federal Security Service increasingly treated the leadership of some minority religious groups as specific threats,” the report states. “Popular attitudes toward traditionally Muslim ethnic groups are negative in many regions, and there are manifestations of anti-Semitism as well as hostility towards Roman Catholics and other non-Orthodox denominations.”
The report cites a high-profile knife attack in January at a Moscow synagogue. Nine people were injured in that incident.
On Friday, Alexander Koptsev was sentenced to 16 years in prison for the attack. The report praised President Vladimir Putin for quickly condemning the attack.
The report also lamented that Jehovah’s Witnesses had been banned in Moscow since 2004.
Representatives of the group in St. Petersburg did not answer the phone Monday.
A Foreign Ministry spokesman, who declined to give his name, refused to comment on the report Monday.
NAGORNO-KARABAKH: Uncertainty faces Baptist conscientious objector
By Felix Corley, Forum 18 News Service
It is unclear whether the authorities will take further action against a young Baptist conscript who refuses to swear the military oath and bear arms on grounds of conscience, Forum 18 News Service has found. Gagik Mirzoyan was freed from prison at the end of a jail sentence, held by the Military Police and, after eight days, transferred to a military unit. “They are still pressuring him to swear the military oath and take up weapons,” Baptist pastor Garnik Abreyan told Forum 18. “He still has three months to serve of his military service and we just don’t know what they will do with him.” Albert Voskanyan, of the Centre for Civilian Initiatives – who has regularly visited both Gagik Mirzoyan and jailed Jehovah’s Witness conscientious objector Areg Hovhanesyan – told Forum 18 that “the danger is real that Mirzoyan could be imprisoned again.” Deputy Foreign Minister Masis Mailyan told Forum 18 that he does not know what the military will now do.
Baptists in the unrecognised republic of Nagorno-Karabakh in the South Caucasus are still unsure whether the authorities will take further action against a young Baptist conscript who refuses to swear the military oath and bear arms. Freed from prison in Shusha on 5 September, at the end of his sentence for refusing to perform military duties, 20-year-old Gagik Mirzoyan was held by the Military Police and, after eight days, transferred to a military unit. “No-one is doing anything bad to him in the unit, but they are still pressuring him to swear the military oath and take up weapons,” Baptist pastor Garnik Abreyan told Forum 18 News Service on 17 September from Stepanakert, the disputed enclave’s capital. “He still has three months to serve of his military service and we just don’t know what they will do with him.”
Mirzoyan, who is from Karabakh’s Mardakert district, is a member of a local congregation of the Council of Churches Baptists, who refuse on principle to register congregations with the state authorities in post-Soviet countries. He was called up in December 2004 and immediately refused to swear the military oath and carry weapons. After initially allowing him to serve without weapons and without swearing the military oath, the military authorities then changed their minds.
At the district court of Hadrut in south-eastern Karabakh in July 2005, Mirzoyan was found guilty under Article 364 part 1 of the Criminal Code, which punishes “refusal to perform one’s military duties” with detention of up to 3 months, service in a punishment battalion of up to 2 years or imprisonment of up to 2 years. Mirzoyan was sentenced to two years’ imprisonment, but this was suspended and he was then sent back to his military unit. However, in September 2005 Hadrut district court converted this into a one-year term of imprisonment at the urging of military leaders. He was beaten several times while in the hands of the army and while in prison (see F18News 22 March 2006 http://www.forum18.org/Archive.php?article_id=748).
Nagorno-Karabakh has adopted Armenia’s Criminal Code, which also punishes conscientious objection – see eg. F18News 23 February 2006 http://www.forum18.org/Archive.php?article_id=733.
Despite having served his full jail sentence for refusing to perform military duties, Gagik Mirzoyan’s two-year term of compulsory military service is not due to be completed until December of this year.
An official at the Defence Ministry, who declined to give his name, told Forum 18 from Stepanakert on 18 September that he was not familiar with Mirzoyan’s case and was not prepared to discuss it. He referred all enquiries to the Foreign Ministry, although it has no jurisdiction over what happens in the Karabakh armed forces.
Deputy Foreign Minister Masis Mailyan told Forum 18 on 18 September that he has been following Mirzoyan’s case and described his release from prison as “good news” – even though the release was at the end of the young Baptist’s full jail sentence. Mailyan said that after having spoken to the Defence Ministry about Mirzoyan’s case he thought there was “no urge to punish him again”. But he does not know what the military will now do, as Mirzoyan still refuses to swear the military oath.
Mailyan insisted that Karabakh needs to be able to defend itself because of the unresolved conflict with Azerbaijan, but said he believes young men who cannot serve in the armed forces on grounds of conscience should be offered alternative, non-military service. “We strive to meet European standards, and I’m personally in favour of introducing an alternative service,” he told Forum 18. However, he noted that no concrete draft law on alternative service has yet reached the local parliament.
Pastor Abreyan told Forum 18 that he and fellow Baptists had been able to meet Mirzoyan on 16 September, at his unit in Nagorno-Karabakh’s south-eastern Martuni district. “Gagik is being well treated at the moment, can move freely around the base and has not been made to wear a uniform,” Abreyan reported.
Also imprisoned in Shusha Prison, just south of Stepanakert, for refusing military service on grounds of religious conscience is a Jehovah’s Witness from Stepanakert, Areg Hovhanesyan. He was sentenced in February 2005 to four years’ imprisonment for refusing military service on grounds of religious conscience (see F18News 22 February 2005 http://www.forum18.org/Archive.php?article_id=517).
Concerned over both Mirzoyan and Hovhanesyan is Albert Voskanyan, head of the Centre for Civilian Initiatives, a local human rights group, who has regularly visited both in Shusha Prison. “The danger is real that Mirzoyan could be imprisoned again,” Voskanyan told Forum 18 on 15 September.
Voskanyan had written on 21 August to the president of the unrecognised republic, Arkady Gukasyan, explaining that Mirzoyan had rejected the military oath because of his belief as a Baptist that the Bible forbids the swearing of oaths and had expressed his willingness to serve in the armed forces without swearing the oath. “The following, complex situation has emerged, almost an impasse,” Voskanyan told Gukasyan. “The sentenced man, having served the punishment given to him, will again be called up to military service, will again refuse to swear the oath although he is ready to serve the remainder of the term he is due to serve, and will again be sentenced, this time as a recidivist.” Voskanyan called on Gukasyan to have Mirzoyan treated “leniently”.
Pastor Abreyan told Forum 18 that Mirzoyan is the only Baptist in Nagorno-Karabakh facing such problems. He also reported that Baptist congregations are not obstructed in meeting for worship. “No-one is restricting us – we can hold meetings, pray and worship.”
Quand la religion fait progresser la science
(Agence Science-Presse) – Le refus obstiné des Témoins de Jéhovah à recevoir des transfusions force les médecins à développer de nouvelles approches. Des approches qui, en retour, bénéficient à tous, peu importe leur religion.
” Plusieurs médecins refusent de traiter les Témoins de Jéhovah. Moi, j’y ai plutôt vu une opportunité d’améliorer nos pratiques. Opérer sans transfusion, c’est comme faire du trapèze sans filet : il faut être beaucoup plus prudent “, explique le Dr Nicolas Jabbour, qui dirige actuellement l’Institut de transplantation du Integris Baptist Medical Center, à Oklahoma City.
Il y a six ans, la Southern California University lançait un programme de greffes du foie sans transfusion. Initialement destiné aux Témoins de Jéhovah, le programme a eu des résultats si positifs qu’il a été élargi à l’ensemble des patients, révèlent le Dr Jabbour et ses collègues dans l’édition du 18 septembre de la revue médicale Archives of Surgery.
Il faut savoir que pendant une greffe de foie, les malades perdent généralement beaucoup de sang et nécessitent de nombreuses transfusions. Or, les patients qui perdent beaucoup de sang ont de moins bonnes chances de survie.
Pour réduire le recours aux transfusions, les patients commencent par se constituer des “réserves” de globules rouges en prenant du fer et de l’EPO (érythropoïétine, l’hormone dopante des sports d’endurance) plusieurs semaines avant leur opération. Cela donne une meilleure marge de manœuvre aux médecins en cas d’hémorragie.
Ensuite, durant la greffe elle-même, deux techniques permettent d’éviter le recours à des produits sanguins. Les médecins peuvent diluer le sang du patient avec un autre liquide, ce qui permet de maintenir la pression et la circulation dans le corps. Ils peuvent aussi réinjecter, une fois filtré, le sang perdu par le patient.
” Ce sont des techniques simples, mais encore peu utilisées “, explique le Dr Jabbour. Elles sont jugées acceptables par les Témoins de Jéhovah, qui refusent de recevoir le sang d’autrui ou de stocker leur propre sang en prévision d’une opération.
Qui plus est, cette chirurgie sans transfusion permet non seulement de diminuer les risques liés aux transfusions (réaction du système immunitaire, transmission de maladies), mais elle diminue aussi la demande auprès des banques de sang, soulignent le Dr Jabbour et ses collègues dans leur étude. Comme quoi science et religion font parfois bon ménage!
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