France to stay in Mali until stability restored

BAMAKO/DUBAI (Reuters) - France will end its intervention in Mali only once stability has returned to the West African country, French President Francois Hollande said on Tuesday, raising the prospects of a costly, drawn-out operation against al Qaeda-linked rebels.

Paris has poured hundreds of soldiers into Mali and carried out air raids since Friday in the northern half of the country, which Western and regional states fear could become a base for attacks by Islamist militants in Africa and Europe.

Thousands of African troops are due to take over the offensive but regional armies are scrambling to accelerate the operation - initially not expected for months and brought forward by France's bombing campaign aimed at stopping a rebel advance on a strategic town last week.

"We have one goal. To ensure that when we leave, when we end our intervention, Mali is safe, has legitimate authorities, an electoral process and there are no more terrorists threatening its territory," Hollande told a news conference during a visit to the United Arab Emirates.

Foreign Minister Laurent Fabius, accompanying Hollande, said the offensive against the Malian rebels could take some time, and the current French level of involvement could last weeks. Elections, however, would take months to organize.

French aircraft earlier hit rebels with fresh air strikes and a column of dozens of French armored vehicles rumbled into the dusty riverside capital of Bamako overnight, bringing to about 750 the number of French troops in Mali.

Paris has said it plans to deploy 2,500 soldiers in its former colony to bolster the Malian army and work with the intervention force provided by West African states.

West African defense chiefs met in Bamako on Tuesday to approve plans for speeding up the deployment of 3,300 regional troops, foreseen in a United Nations-backed intervention plan to be led by Africans.

Nigeria pledged to deploy soldiers within 24 hours and Belgium said it was sending transport planes and helicopters to help, but West Africa's armies need time to become operational.

Mali's north, a vast and inhospitable area of desert and rugged mountains the size of Texas, was seized last year by an Islamist alliance combining al Qaeda's north African wing AQIM with splinter group MUJWA and the home-grown Ansar Dine rebels.

Any delay in following up on the French air bombardments of Islamist bases and fuel depots with a ground offensive could allow the insurgents to slip away into the desert and mountains, regroup and counter-attack.

The rebels, who French officials say are mobile and well-armed, have shown they can hit back, dislodging government forces from Diabaly, 350 km (220 miles) from Bamako on Monday.

Residents said the town was still under Islamist control on Tuesday despite a number of air strikes that shook houses.

An eye witness near Segou, to the south, told Reuters he had seen 20 French Special Forces soldiers driving toward Diabaly.

Malians have largely welcomed the French intervention, having seen their army suffer a series of defeats by the rebels.

"With the arrival of the French, we have started to see the situation on the front evolve in our favor," said Aba Sanare, a resident of Bamako.

QUESTIONS OVER READINESS

Aboudou Toure Cheaka, a senior regional official in Bamako, said the West African troops would be on the ground in a week.

The original timetable for the 3,300-strong U.N.-sanctioned African force - to be backed by western logistics, money and intelligence services - did not initially foresee full deployment before September due to logistical constraints.

Senegal, Burkina Faso, Niger, Nigeria and Guinea have all offered troops. Col. Mohammed Yerima, spokesman for Nigeria's defense ministry, said the first 190 soldiers would be dispatched within 24 hours.

But Nigeria, which is due to lead the mission, has already cautioned that even if some troops arrive in Mali soon, their training and equipping will take more time.

Sub-Saharan Africa's top oil producer, which already has peacekeepers in Sudan's Darfur and is fighting a bloody and difficult insurgency at home against Islamist sect Boko Haram, could struggle to deliver on its troop commitment of 900 men.

One senior government adviser in Nigeria said the Mali deployment was stretching the country's military.

"The whole thing's a mess. We don't have any troops with experience of those extreme conditions, even of how to keep all that sand from ruining your equipment. And we're facing battle-hardened guys who live in those dunes," the adviser said, asking not to be named because of the sensitivity of the subject.

FRENCH LINING UP SUPPORT

France, which has repeatedly said it has abandoned its role as the policeman of its former African colonies, said on Monday that the U.S., Canada, Denmark and Germany had also offered logistical support.

Fabius has said Gulf Arab states would help the Mali campaign while Belgium said on Tuesday it would send two C130 transport planes and two medical helicopters to Mali following a request from Paris.

A meeting of donors for the operation was expected to be held in Addis Ababa at the end of January.

Security experts have warned that the multinational intervention in Mali, couched in terms of a campaign by governments against "terrorism", could provoke a jihadist backlash against France and the West, and African allies.

U.S. officials have warned of links between AQIM, Boko Haram in Nigeria and al Shabaab Islamic militants fighting in Somalia.

Al Shabaab, which foiled a French effort at the weekend to rescue a French secret agent it was holding hostage, urged Muslims around the world to rise up against what it called "Christian" attacks against Islam.

"Our brothers in Mali, show patience and tolerance and you will win. War planes never liberate a land," Sheikh Ali Mohamud Rage, al Shabaab's spokesman, said on a rebel-run website.

U.S. officials said Washington was sharing information with French forces in Mali and considering providing logistics, surveillance and airlift capability.

"We have made a commitment that al Qaeda is not going to find any place to hide," U.S. Defense Secretary Leon Panetta told reporters as he began a visit to Europe. Panetta later said the U.S. had no plans to send troops to Mali.

"I don't know what the French endgame is for this. What is their goal? It reminds me of our initial move into Afghanistan," a U.S. military source told Reuters.

"Air strikes are fine. But pretty soon you run out of easy targets. Then what do you do? What do you do when they head up into the mountains?"

(Additional reporting by Elizabeth Pineau and Raissa Kasolowsky in Abu Dhabi; Felix Onuah in Abuja and Tim Cocks in Lagos; Abdi Sheikh in Mogadishu; Michelle Nichols Louis Charbonneau at the United Nations; Richard Valdmanis in Dakar; Joe Bavier in Abidjan; Jan Vermeylen in Brussels; Writing by Pascal Fletcher and David Lewis; editing by Richard Valdmanis and Giles Elgood)

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Thousands commemorate Kurds slain in France

VILLIERS-LE-BEL: Thousands of mourners gathered in the French capital on Tuesday to pay an emotional final tribute to three female Kurdish activists who were shot dead there last week.

Coffins containing the bodies of the three women and draped in the Kurdish flag were carried by female pall-bearers into a community centre in the Paris suburb of Villiers-le-Bel.

They were then placed on an altar surrounded by candles and wreaths in the yellow, red and green of the Kurdish flag before black-clad mourners, many of them clutching a single rose, filed past.

Photographs of the three women, Sakine Cansiz, Fidan Dogan and Leyla Soylemez were placed in front of their coffins for a ceremony attended by Kurds from all over Europe.

"We are here to ensure their commitment to the cause they fought for will not be forgotten," said 20-year-old Jiyan.

Fellow mourner Guler Biger wiped away tears and added: "May their killers be found soon."

The bodies of the three women were found inside a Kurdish information centre in Paris last Thursday. They had all been shot repeatedly in the head in what French authorities have described as an execution.

Victim Sakine Cansiz was a founding member of the Kurdistan Workers' Party (PKK) and the other two women also had links to the outlawed group, which has been fighting for Kurdish self-rule in southeastern Turkey for nearly three decades.

The killings could have been linked to ongoing negotiations between the Turkish authorities and jailed PKK leader Abdullah Ocalan that have raised hopes of a deal to end the conflict.

The negotiations are controversial with hardliners on both sides and one theory is that the murders may have been designed to derail the talks.

Kurdish activists believe the killings must have been the work of Turkish extremists while Turkey has suggested an internal PKK feud is a more likely explanation.

French police are investigating the possibility of a link to PKK fundraising activities, some of which have been described as extortion.

The women's coffins are due to be flown to Turkey on Wednesday for burial in their native towns or villages in the southeast of the country.

- AFP/jc

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Asaram says media twisted his words

ALLAHABAD: Self-styled godman Asaram Bapu, in the eye of a storm over his remarks on the Delhi gang-rape victim, on Tuesday said he was quoted out of context and announced a reward of 50 lakh to anyone who could prove that he blamed the victim for the horrific crime.

"I have been quoted out of context. The poor girl was young enough to be my own granddaughter," he said.

"How can I ever be so insensitive as to blame her for the very tragedy that had stricken her. The media reports have twisted my words," said Asaram.

"I will give a reward of Rs 50 lakh to anybody who is able to prove that I had blamed the rape victim herself for the heinous crime," Bapu said at his discourse.

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Risk to all ages: 100 kids die of flu each year

NEW YORK (AP) — Twenty flu-related deaths have been reported in children so far this winter — one of the worst tolls this early in the year since health officials began keeping track.

Still, experts say that doesn't mean this year will turn out to be unusually deadly. Roughly 100 children die in an average flu season, and it's not clear that will happen this year.

The deaths have included a 6-year-old girl in Maine, a 15-year-old Michigan boy who loved robotics and a tall high school senior from Texas who got sick in Wisconsin while visiting his grandparents for the holidays.

On average, an estimated 24,000 Americans die each flu season. Elderly people with chronic health conditions are at greatest risk.

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Lance Armstrong Apologizes to Livestrong Staff

Lance Armstrong apologized today to the Livestrong staff ahead of his interview with Oprah Winfrey, a foundation official said.

The disgraced cyclist gathered with about 100 Livestrong Foundation staffers at their Austin, Texas, headquarters for a meeting that included social workers who deal directly with patients as part of the group's mission to support cancer victims.

Armstrong's "sincere and heartfelt apology" generated lots of tears, spokeswoman Katherine McLane said, adding that he "took responsibility" for the trouble he has caused the foundation.

McLane declined to say whether Armstrong's comments included an admission of doping, just that the cyclist wanted the staff to hear from him in person rather than rely on second-hand accounts.

Armstrong then took questions from the staff.

Armstrong's story has never changed. In front of cameras, microphones, fans, sponsors, cancer survivors -- even under oath -- Lance Armstrong hasn't just denied ever using performance enhancing drugs, he has done so in an indignant, even threatening way.

Riccardo S. Savi/Getty Images|Ray Tamarra/Getty Images

Lance Armstrong Doping Charges: Secret Tapes Watch Video

Lance Armstrong's Winfrey Interview: Expected to Admit to Doping Watch Video

Today, sources tell ABC News, will be different. Today Armstrong is expected to rewrite his own, now infamous story, to Winfrey. So what should she ask? There are enough questions to fill a book, but here's our shot at five, for starters, all based on the belief that his first words will be an admission. Feel free to comment and add your own.

1) Witnesses have told the U.S. Anti Doping Agency that after recovering from cancer, you increased your use of performance enhancing drugs, but swore off one of them—Human Growth Hormone—specifically noting your cancer as a reason to avoid it. Do you believe your cancer may have been caused by performance enhancing drug use?

2) Some people seem able to forgive or rationalize the use of performance enhancing drugs, but what troubles them is the vicious cover-up. Why did you feel it necessary to go beyond denials, to attack and even threaten and file legal claims against those who accused you of drug use, even to the point of causing serious harm to people's lives and reputations?

3) In 1996, while recovering from cancer, your former close friend Frankie Andreu and his wife Betsy say they were in the hospital room when you told doctors you'd used several different performance enhancing drugs during your career. They testified under oath about this, but you always denied it and vilified them. This caused the Andreus great harm. Did it happen?

4) What do you tell your kids?

5) Up until today, everything you've said and done—even that picture on twitter of you and your yellow jerseys—has said to the world that you're not sorry, and that you're the real winner of seven Tours. Aren't you just coming forward now to help yourself, rather than to come clean or set the record straight?

Whatever the answers, a small army of lawyers and even criminal investigators will be listening closely. Will Armstrong's interview be the start of his redemption or the beginning of even bigger problems?

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Mali Islamists counter attack, promise France long war

BAMAKO/PARIS (Reuters) - Al Qaeda-linked Islamist rebels launched a counteroffensive in Mali on Monday after four days of French air strikes on their northern strongholds, seizing the central town of Diabaly and promising to drag France into a brutal Afghanistan-style war.

France, which has poured hundreds of troops into the capital Bamako in recent days, carried out more air strikes on Monday in the vast desert area seized last year by an Islamist alliance grouping al Qaeda's north African wing AQIM alongside Mali's home-grown MUJWA and Ansar Dine militant groups.

"France has opened the gates of hell for all the French," said Oumar Ould Hamaha, a spokesman for MUJWA, which has imposed strict sharia, Islamic law, in its northern fiefdom of Gao. "She has fallen into a trap which is much more dangerous than Iraq, Afghanistan or Somalia," he told Europe 1 radio.

Paris is determined to shatter Islamist domination of the north of its former colony, an area many fear could become a launchpad for terrorism attacks on the West and a base for coordination with al Qaeda in Yemen, Somalia and North Africa.

The French defense ministry said it aimed to deploy 2,500 soldiers in the West African state to bolster the Malian army and work with a force of 3,300 West African troops from the immediate region foreseen in a U.N.-backed intervention plan.

The United States, which has operated a counter-terrorism training program in the region, said it was sharing information with French forces and considering providing logistics, surveillance and airlift capability.

"We have a responsibility to go after al Qaeda wherever they are," Defense Secretary Leon Panetta told reporters heading with him on a week-long tour of European capitals.

As French aircraft bombarded mobile columns of Islamist fighters, other fighters launched a counter-attack to the southwest of recent clashes, dislodging government forces from the town of Diabaly, just 350 km (220 miles) northeast of Bamako. French and Malian troops attempting to retake the town were battling Islamists shouting 'Allahu akbar', residents said.

The rebels infiltrated the town overnight from the porous border region with Mauritania, home to AQIM camps housing well-equipped and trained foreign fighters. A spokesman for Ansar Dine said its fighters took Diabaly, working with AQIM members.

Dozens of Islamist fighters died on Sunday when French rockets hit a fuel depot and a customs house being used as a headquarters. The U.N. said an estimated 30,000 people had fled the fighting, joining more than 200,000 already displaced.

France, which has repeatedly said it has abandoned its role as the policeman of its former African colonies, convened a U.N. Security Council meeting for Monday to discuss the Mali crisis.

The European Union announced it would hold an extraordinary meeting of its foreign ministers in Brussels this week to discuss speeding up a EU training mission to help the Malian army and other direct support for the Bamako government.

French Foreign Minister Laurent Fabius said France would do everything to ensure that regional African troops were deployed quickly to follow up on the French military action, which was launched to block a push southwards by the Islamist rebels.

"ORGANISED AND FANATICAL"

"We knew that there would be a counter-attack in the west because that is where the most determined, the most organized and fanatical elements are," French Defense Minister Jean-Yves Le Drian told France's BFM TV.

France has said its sudden intervention on Friday, responding to an urgent appeal from Mali's president, stopped the Islamists from seizing the dusty capital of Bamako.

President Francois Hollande says Operation Serval - named after an African wildcat - is solely aimed at supporting the 15-nation West African bloc ECOWAS which received U.N. backing in December for a military intervention to dislodge the rebels.

Hollande's robust intervention has won plaudits from Western leaders and has also shot down domestic criticism which portrayed him as spineless and indecisive.

Under pressure from Paris, regional states have said they hope to send in their forces this week. Military chiefs from ECOWAS nations will meet in Bamako on Tuesday but regional powerhouse Nigeria, which is due to lead the mission, has cautioned that training and deploying troops will take time.

Two decades of peaceful elections had earned Mali a reputation as a bastion of democracy in turbulent West Africa but that image unraveled after a military coup in March left a power vacuum for MNLA Tuareg rebels to seize the desert north.

MUJWA, an AQIM splinter group drawing support from Arabs and other ethnic groups, took control of Gao, the main city of the north, from the Tuaregs in June, shocking Mali's liberal Muslim majority with amputation of hands for theft under sharia.

Malian Foreign Minister Tyeman Coulibaly said the situation had become "untenable" in the north. "Every day, we were hearing about feet and hands being cut off, girls being raped, cultural patrimony being looted," he told the French weekly Paris Match.

ISLAMISTS DESTROY TIMBUKTU SHRINES

Last week's drive toward Bamako appeared to have been led by Ansar Dine, founded by renegade Tuareg separatist commander Iyad ag Ghali in his northern fiefdom of Kidal.

The group has said that the famed shrines of ancient desert trading town Timbuktu - a UNESCO world heritage site - were un-Islamic and idolatrous. Much of the area's religious heritage has now been destroyed, sparking international outrage.

France's intervention raises the threat for eight French hostages held by al Qaeda allies in the Sahara and for 30,000 French expatriates living in neighboring, mostly Muslim states.

Concerned about reprisals at home, France has tightened security at public buildings and on public transport.

However, top anti-terrorist judge, Marc Trevidic, played down the imminence of the risk, telling French media: "They're not very organized right now ... It could be a counter attack later on after the defeat on the ground. It's often like that."

Military analysts warn that if French action was not followed up by a robust deployment of ECOWAS forces, with logistical and financial support from NATO, then the whole U.N.-mandated Mali mission was unlikely to succeed.

"The French action was an ad-hoc measure. It's going to be a mess for a while, it depends on how quickly everyone can come on board," said Hussein Solomon, a professor at the University of the Free State, South Africa.

(Additional reporting by Emmanuel Jarry, Brian Love and Catherine Bremer in Paris, Justyna Pawlak and Adrian Croft in Busssels and Louis Charbonneau in New York; writing by Daniel Flynn; editing by Pascal Fletcher)

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Lance Armstrong apologises in person to Livestrong staff

AUSTIN: Fallen cycling hero Lance Armstrong personally apologised Monday to staff members of the Livestrong cancer charity ahead of his much anticipated interview with talk show diva Oprah Winfrey.

"Lance came to the Livestrong Foundation's headquarters today for a private conversation with our staff and offered a sincere and heartfelt apology for the stress they've endured because of him," Livestrong spokeswoman Rae Bazzarre told AFP.

She added that Armstrong -- a cancer survivor who founded the charity in 1997 -- urged Livestrong staffers "to keep up their great work fighting for people affected by cancer."

Journalists staked out Armstrong's home in Austin earlier Monday ahead of his interview with Winfrey, during which the disgraced cyclist is reportedly planning to admit to doping.

For years he has repeatedly denied taking performance enhancing drugs to win the Tour de France and other big cycling events.

Reporters, photographers and TV crews took up positions Monday across the street from Armstrong's opulent Austin home, which is surrounded by a 2.4-metre stone wall.

The interview with Winfrey is scheduled to be taped at Armstrong's home on Monday and is to air on her OWN cable network on Thursday.

The announcement that Armstrong had agreed to an interview has sparked widespread speculation that he might finally confess to being a drug cheat after years of strenuous denials.

According to USA Today, Armstrong plans to confess in the interview to doping throughout his career, but will not go into great detail about specific cases and events.

It will be Armstrong's first interview since he was stripped in October of his seven Tour de France titles after the US Anti-Doping Agency (USADA) said he helped orchestrate the most sophisticated doping program in sports history.

Any confession by Armstrong could have legal or financial ramifications, particularly among big-name corporate sponsors such as Nike that had loyally stood by him even as doping allegations grew.

Since the International Cycling Union effectively erased him from the record books, Britain's The Sunday Times has sued Armstrong for more than £1 million over a libel payment made to him in 2006.

It had paid Armstrong £300,000 to settle a libel case after publishing a story suggesting he may have cheated, and now wants that money plus interest and legal costs repaid.

On Sunday, the Sunday Times took out an ad in the Chicago Tribune newspaper setting out 10 questions that Winfrey, whose OWN media network is based in the Midwestern metropolis, should ask Armstrong.

"Is it your intention to return the prize money you earned from Sept. 1998 to July 2010?" read one question. "Did you sue the Sunday Times to shut us up?" went another.

A Texas insurance company has also threatened legal action to recoup millions of dollars in bonuses it paid him for multiple Tour victories.

Armstrong's years of dominance in the sport's greatest race raised cycling's profile in the United States to new heights.

It also gave the Texan -- diagnosed in 1996 with late-stage testicular cancer that had spread to his brain and lungs -- a unique platform to promote cancer awareness and research.

The Lance Armstrong Foundation has raised almost US$500 million since its creation in 1997.

In the wake of the allegations, several top sponsors dumped Armstrong and on November 14 the Livestrong Foundation dropped his name from the non-profit organisation he founded.

- AFP/jc

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Sangam of 82 lakh devotees for holy dip

SANGAM (Allahabad): Mist envelopes a stretch of sand-bed cordoned off to create an expanse the size of five football fields. Down below, the waters of Sangam appear black under a 4.30am sky. Drenched under sodium vapour lights, the vast area is fenced off for tens of thousands of people with barricades of horizontal wooden beams.

The faithful wait breathlessly for the day's royalty, an army of sadhus from 14 akharas, to march in, their devotees holding up caparisoned umbrellas over the sect leaders' heads. All for Monday's Makar Sankranti shahi snaan. A few hundred worshippers throw themselves desperately into the waist-deep water as mounted policemen canter in to clear the ground. Cops blowing whistles reach a crescendo as rapid action force personnel with AK-47s slung from their shoulders arrive in what seems an over-explicit signal that the business end of the day is here. The ground is ready for the hermits.

And then it begins. After hours of wait for tens of thousands of people through the winter night, the moment of the day arrives with the energetic dash of the sadhus towards the confluence of the Ganga, Yamuna and the mythical Saraswati amid cries of Har Har Mahadev and Bum Bhole.

From sadhus in sack-cloth and ashes to mahamandaleshwars in their silken finery, from women and children to Indian and foreign nationals, and from dancing Nagas with swords to dandiswamis with their tall wooden staffs, all rush into the Sangam in waves after human waves, a sight captured eagerly by hundreds of photographers, their movements scribbled by scrums of reporters all around.

Soon the main ghat is fragrant with sandalwood with sadhus emerging from the water and rubbing themselves with its powder. Garlands of marigold are tossed at devotees. Worshipped by people from villages as Lord Shiva's regal children, or as the Trinetra's incarnates themselves, the Nagas celebrate with a zealous display of calisthenics and mock sword fights.

It's a medley of songs, slogans and slokas, as more than 82 lakh people wade into the water throughout the day — which hasn't been without its fears of a stampede when hundreds of people surge ahead to reach for the waters where the snaan is on. The pressure from surging crowds leads to a wooden beam snapping, and a photographer perched on it falls to the ground. Alert policemen may well have prevented things from going awry.

The public address system crackles to life, asking bathers to leave the ghats after their holy dips immediately. Allahabad IG Alok Sharma, while pointing out that the snaan went off peacefully, admitted there were a few anxious moments.

Asked what the holy dip meant to him, Jeevanand Yogi from Andhra Pradesh said, "There is an invisible power today between the earth and the moon. This energy helps cure disease and clears all mental blocks."

Devendra Giri from Noida said, "Ganga jitni nirmal honi chaahiye, utni nahi hai. Hamey dukh hai iska (Ganga's water isn't as clean as it should be. It's sad." But a banker from Lucknow, Ashok Khanna, wasn't affected. "The event gives us a chance to revive our faith in spirituality, which is essential to keep humanity alive. I think our ancestors were very far-sighted to have thought of such a ritual," he said.

For the next 50-odd days, the Sangam city won't sleep. With crores of people expected to pour into Prayag every day, the largest gathering of humanity on earth under makeshift tents and open air with people from the world over, will celebrate India's deep and abiding connection with one of its greatest traditions, the Mahakumbh.

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Hospitals crack down on workers refusing flu shots

CHICAGO (AP) — Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal.

"Where does it say that I am no longer a patient if I'm a nurse," wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.

Hospitals' get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.

Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.

In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.

Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.

Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.

"We would all like to see stronger data," she said. But other evidence shows flu vaccination "significantly decreases" flu cases, she said. "It should work the same in a health care worker versus somebody out in the community."

Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly "a personal thing." She's among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body."

Medical ethicist Art Caplan says health care workers' ethical obligation to protect patients trumps their individual rights.

"If you don't want to do it, you shouldn't work in that environment," said Caplan, medical ethics chief at New York University's Langone Medical Center. "Patients should demand that their health care provider gets flu shots — and they should ask them."

For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.

A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.

At Calhoun's hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, "I'm wearing the mask for your safety," Calhoun says. She says that's discriminatory and may make patients want to avoid "the dirty nurse" with the mask.

The hospital justified its vaccination policy in an email, citing the CDC's warning that this year's flu outbreak was "expected to be among the worst in a decade" and noted that Illinois has already been hit especially hard. The mandatory vaccine policy "is consistent with our health system's mission to provide the safest environment possible."

The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.

According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That's up from previous years, but the government wants 90 percent coverage of health care workers by 2020.

The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.

Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.

Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.

Starting this year, the government's Centers for Medicare & Medicaid Services is requiring hospitals to report employees' flu vaccination rates as a means to boost the rates, the CDC's Bridges said. Eventually the data will be posted on the agency's "Hospital Compare" website.

Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they're adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.

Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work — partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.

While not 100 percent effective, this year's vaccine is a good match, the CDC's Bridges said.

Several states have laws or regulations requiring flu vaccination for health care workers but only three — Arkansas, Maine and Rhode Island — spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policy and co-author of a study appearing this month in the journal Vaccine.

Rhode Island's regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.

Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.

"We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole," but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.

Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.

Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.

Calhoun, the Illinois nurse, says she is unsure of her options.

"Most of the hospitals in my area are all implementing these policies," she said. "This conflict could end the career I have dedicated myself to."

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Online:

R.I. union lawsuit against mandatory vaccines: http://www.seiu1199ne.org/files/2013/01/FluLawsuitRI.pdf

CDC: http://www.cdc.gov

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Thousands Protest in Moscow Against Adoption Ban

Jan 13, 2013 10:37am

KIRILL KUDRYAVTSEV/AFP/Getty Images

MOSCOW — Thousands of Russians took to the streets on Sunday to protest Russia’s new ban on adoptions to the United States.

In what organizers called the “March Against Scoundrels” they paraded down a tree-lined boulevard in central Moscow chanting “Hands off our children” and “Russia will be free.” They also carried signs with the faces of Russian politicians who approved the ban and the word “Shame” written on them.

“I am not an apologist for the U.S. I am a patriot of this country. But this monstrous law must be canceled,” leftist protest leader Sergei Udaltsov told the crowd before the march began, according to the Interfax news agency.

As usual, organizers and police disagreed on the size of the crowd. Organizers estimated between 20,000 and 50,000 people turned out. Police put the figure much lower at about 7,000, but overhead photos of the protest appear to show a crowd larger than that.

Significantly smaller protests, some consisting of just a few dozen people, took place in other cities around the country, according to Interfax. A nationwide poll taken in December by the Public Opinion Foundation found 56 percent support for the ban.

But participants in Sunday’s protests accused the ban’s proponents of playing politics with the lives of children.

The adoption ban was a late amendment to a bill retaliating for a set of human rights sanctions that President Obama signed into law in December. It cut off adoptions to the United States, one of the most popular destinations for international adoptions from Russia, starting Jan. 1.

More than 60,000 Russian orphans have been adopted by Americans since the end of the Soviet Union, according to the State Department. Many of them are sick or suffer from disabilities.

READ: Unclear Russian Adoption Ban Frustrates US Families

But Russian officials have pointed to the cases of 19 children who died after being adopted by Americans. They also noted cases in which American parents accused of abusing their adopted children received, in their view, lenient sentences.

Since the law went into effect, Russian officials have struggled to explain whether the ban would cancel 52 adoption cases that had already received court approval and were within weeks of completion. Kremlin spokesman Dmitri Peskov said Thursday that at least some of those adoptions which had cleared the courts would be allowed to proceed, but did to say how many.

The ban was controversial even before it became law. Even though it received nearly unanimous approval from Russia’s rubber stamp parliament, prominent cabinet officials, including Russia’s Foreign Minister Sergei Lavrov, came out against the ban. Even President Vladimir Putin himself evaded questions about it when asked during an end of year press conference.

READ: Russians Rally to Help US Adoption Mom Fighting for Child

Since the ban was approved, top Russian officials have pledged to devote more resources to reforming the country’s dilapidated orphanages and to encourage more Russians to adopt.

Sunday’s protest was organized by some of the same opposition leaders who organized last year’s anti-Putin rallies. The last such protest, held without city approval and under heavy police presence, drew relatively few people in December, suggesting the protest movement had fizzled. Protest leader and anti-corruption blogger Alexy Navalny, however, told Interfax today that he hopes the adoption ban could rally more Russians to continue protesting.

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