Salvadoran May Be Deported From U.S. for ’80 Murders of Americans

The decision by Judge James Grim of immigration court in Orlando is the first time that federal immigration prosecutors have established that a top-ranking foreign military commander can be deported based on human rights violations under a law passed in 2004, in the aftermath of the Sept. 11 terrorist attacks, intended to bar human rights violators from coming to or living in the United States.

Judge Grim found that General Vides assisted in the killings of four American churchwomen on a rural road in El Salvador in 1980, a crime that caused shock there and in Washington and presaged the bloody violence that would engulf the Central American nation for the next decade. The immigration judge’s ruling is the first time General Vides has been held responsible for those deaths in a court of law.

Five soldiers from the Salvadoran National Guard were eventually convicted of the killings and served long prison sentences. General Vides was the commander of the National Guard at the time of the murders.

The effort by Department of Homeland Security officials to seek the deportation of General Vides, who was El Salvador’s defense minister from 1983 to 1989, is a turnabout in American foreign policy. He was a close ally of Washington throughout the war against leftist guerrillas in the 1980s, and was embraced as a reformer despite rampant rights violations by the armed forces under his command.

Judge Grim also determined that General Vides had assisted in the torture of two Salvadorans, Juan Romagoza and Daniel Alvarado, who testified against him in hearings last spring in the immigration court in Orlando.

“This is the first case where the Department of Homeland Security has taken this relatively new law and applied it to the highest military commander of their country to seek their removal,” said Carolyn Patty Blum, senior legal adviser for the Center for Justice and Accountability, a nonprofit legal group in San Francisco that represented several torture victims in the case. She called the decision “hugely significant” for future efforts to bring immigration cases for human rights abuses against the highest-level military commanders and government officials.

Many details of the judge’s decision were not available on Thursday, since in keeping with general practice in immigration courts, the ruling was not published. His main findings were described by lawyers familiar with the case.

Diego Handel, General Vides’s lawyer, said he had not had a chance to read the lengthy decision and could not comment on it.

The deportation case against General Vides was brought by prosecutors from the Human Rights Violators and War Crimes Center, a unit of Immigration and Customs Enforcement created in 2003 to focus on preventing rights violators from entering this country and deporting those already here.

General Vides contested the charges, saying he did not have any direct responsibility for, or even knowledge of, the murders and torture signaled by the government. In the hearings, witnesses, including former American diplomats, said that the general had been working to stop rights abuses by Salvadoran soldiers and to change the culture of a military known for brutality.

Judge Grim’s decision confirmed that General Vides can be deported based on the rights charges brought by the government. Federal officials and immigration lawyers cautioned that there are still several steps to go before the judge will decide whether to issue a final order for the general’s deportation. But lawyers said it would be considerably more difficult now for General Vides to avoid such an order.

A spokeswoman for Immigration and Customs Enforcement, Nicole Navas, said, “As a matter of policy, I am precluded from commenting on matters still pending before the immigration court.”

General Vides retired as defense minister in 1989, amid praise from United States officials for his performance, and came to settle in Florida as a legal permanent resident.

But the family members of the four churchwomen, as well as some Salvadorans who barely survived prolonged torture during the war, have been tenacious in seeking to hold General Vides responsible for crimes of that era.

In 2000, a Florida jury acquitted General Vides and José Guillermo García, another former Salvadoran defense minister who retired to Florida, of responsibility for the churchwomen’s murders. But in 2002, in a case brought by the Center for Justice and Accountability, another Florida jury found the two officers civilly liable for the torture of three Salvadorans and ordered them to pay $54 million. The deportation proceedings against General Vides stem from that decision.

The four churchwomen killed were Sister Dorothy Kazel of the Ursuline Order; Jean Donovan, a lay missionary; Sister Maura Clarke and Sister Ita Ford, both of the Maryknoll Order.

Sister Ita’s brother Bill Ford fought vigorously for the prosecution of General Vides. Mr. Ford died in 2008.

“Since the women were killed my father made this the single purpose of his life,” his son, Bill Ford Jr., said Thursday. Mr. Ford, who is the principal of Cristo Rey New York High School in Manhattan, said, “I’m sure he knows and is well pleased that one of the men responsible for ordering the death of the women or for the cover-up may no longer be able to live in this country to enjoy the fruits of his brutality.”

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Hepatitis C Now Kills More Americans Than HIV

MONDAY, Feb. 20 (HealthDay News) -- Deaths from hepatitis C have increased steadily in the United States in recent years, in part because many people don't know they have disease, a new government report says.

More Americans now die of hepatitis C than from HIV, the AIDS-causing virus, according to 1999-2007 data reviewed by the U.S. Centers for Disease Control and Prevention (CDC). And most of those dying are middle-aged.

"These data underscore the urgent need to address the health threat posed by chronic hepatitis B and C in the United States," said investigator Dr. Scott Holmberg, chief of the Epidemiology and Surveillance Branch in CDC's Division of Viral Hepatitis.

About 3.2 million Americans are infected with hepatitis C, a major cause of liver cancer and cirrhosis, the CDC authors said. An estimated one-half to three-quarters of infected adults are unaware they have the disease, which progresses slowly.

Hepatitis C is spread through injection drug use, from blood transfusions received before routine blood-screening began in 1992, and through sexual contact. In some cases, it passes from mothers to infants.

"Chronic hepatitis is a leading and preventable cause of premature death in the United States," Holmberg said. "Over time, leaving viral hepatitis untreated can lead to costly care and treatments, and lifetime costs can total hundreds of thousands of dollars. However, early detection and intervention can be cost-effective and save lives."

The new study highlights the need to increase hepatitis awareness and the critical importance of testing, Holmberg said. Screening will increase diagnoses and treatment, thereby reducing hepatitis-related deaths, he said.

The report is published in the Feb. 21 issue of the Annals of Internal Medicine.

Using death records from 1999 to 2007, researchers collected data on some 22 million Americans, looking for those who died from hepatitis B, C and HIV.

The investigators found deaths from hepatitis C surpassed deaths from HIV (15,000 from hepatitis C versus 13,000 from HIV). They also found that deaths from hepatitis C and B are mostly among the middle-aged.

"Seventy-three percent of hepatitis C deaths were reported among those 45 to 64 years old," Holmberg said. "As the population living with hepatitis C in the United States -- 66 percent of whom were born between 1945 and 1964 -- has aged and entered a high-risk period of life for hepatitis C-related disease, deaths associated with hepatitis C have increased substantially."

Vaccines exist for hepatitis B, but not for hepatitis C. If current trends continue, by 2030 deaths from hepatitis C are expected to reach 35,000 a year, researchers say.

According to Dr. Eugene Schiff, director of the Center for Liver Diseases at the University of Miami Miller School of Medicine, "the study is important because it documents and authenticates what we knew." But, "what we need right now, particularly for hepatitis C, is routine screening," noted Schiff, who was not involved with the study.

Dramatic changes are under way in the treatment of hepatitis C, he pointed out. Current treatment involves a cocktail of drugs, including antivirals and interferon, which many people cannot tolerate.

In about two years, interferon-free treatment will be available, Schiff said. This means higher cure rates with fewer side effects, which will make treatment tolerable by most patients, he explained.

"What's going to happen is what happened with HIV -- test and treat," Schiff said. "Patients will be given an interferon-free regimen with cure rates approaching 100 percent," he predicted.

Another study in the same journal issue found that the most up-to-date treatment for hepatitis C can cost $60,000, but may be cost-effective, according to Stanford University health policy researchers.

In a study led by Jeremy Goldhaber-Fiebert, an assistant professor of medicine at the School of Medicine, investigators developed a computer model to assess the cost-effectiveness of a new treatment for hepatitis C. Their model showed that for people with advanced disease the cost was justified in terms of results.

The treatment involves use of two drugs called protease inhibitors -- boceprevir (brand name Victrelis) and telaprevir (brand name Incivek) -- in addition to interferon and an antiviral.

While the new treatment is expensive and may cause side effects, it could reduce patients' risks for cancer and liver transplants, thereby avoiding those costly events and possibly helping patients live longer, better lives, the researchers pointed out in a journal news release.

Yet another study in the journal recommends one-time screening of all those born between 1945 and 1965, instead of waiting until symptoms appear.

More information

For more information on hepatitis, visit the U.S. Centers for Disease Control and Prevention.

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Hepatitis C Now Killing More Americans than HIV

hepatitis_c_hiv_deaths Image courtesy of iStockphoto/sjlocke

The number of people who die from HIV-related causes each year in the U.S. is now down to about 12,700 from a peak of more than 50,000 in the mid-1990s thanks to condom education and distribution campaigns, increased testing and improved treatments. But now a different infectious disease is quietly killing even more people than HIV is: Hepatitis C.

The majority of the 3.2 million people who are estimated to have chronic hepatitis C virus (HCV) in the U.S. are baby boomer adults.

And most of those infected with the virus do not know that they have it, which means they could easily be spreading it to others via exposure to blood or, occasionally, sexual contact.

Although long-term intravenous drug users are at particular risk, so are “those who experimented with [such] drugs for a limited time in their youth,” Harvey Alter and T. Jake Liang, both of the National Institutes of Health, wrote in an essay published online Monday in Annals of Internal Medicine. “These bygone experiences do not often connote risk to the affected persons nor serve as a reason to seek testing,” they noted, making this slow-developing disease difficult to catch before it develops into cirrhosis or liver cancer (hepatocellular carcinoma). Their essay was part of a four-paper special series on hepatitis C.

More than 15,000 people died from hepatitis C-related issues in the U.S. in 2007 about three quarters of whom were people aged 45 to 64, according to Alter and Liang. And that number is expected to double as the bulk of the population with the disease get older. The cost of treating all of these people is likely to top $6.7 billion in the decade of 2010 to 2019.

Much of that growth is anticipated because those infected with hepatitis C often don’t seek treatment until the disease has caused serious damage, according to another paper published Monday in the same issue of Annals of Internal Medicine. “Hepatitis C virus infection is often asymptomatic or causes nonspecific symptoms (depression, arthralgia and fatigue) for decades,” Kathleen Ly, of the U.S. Centers for Disease Control and Prevention (CDC), and her colleagues wrote in their paper.

The good news for those who do get diagnosed is that new hepatitis C drugs are coming onto the market. But they are not cheap. One new promising one, a protease inhibitor called boceprevir, runs about $1,100 per week, which when added to the double-drug cocktail of interfearon and the antiviral ribavirin, makes for especially expensive treatment. Some researchers have proposed that testing patients for a genotype that has a cure rate of less than 40 percent with previous treatment might help make treatment the more cost effective.

A new analysis in the same issue of Annals of Internal Medicine, led by Shan Liu of the Center for Health Policy at Stanford University, found that giving HCV patients of all genotypes a triple-drug cocktail is, indeed, cost-effective for allowing patients to live longer, healthier lives. And as Alter and Liang pointed out, as opposed to HIV or even hepatitis B, HCV can often be effectively cured after six months to a year of antiviral treatment. “Every effectively treated high-risk individual diminishes the infectious pool and the likelihood of secondary transmission.”

With treatment options expanding, many researchers are turning their attention back to the question of locating patients. “As innovative treatments for hepatitis C follow their now-destined progression, the most burning question will not be whether to treat, but rather how to identify the many chronic HCV carriers who are unaware of their infection and are at risk for cirrhosis, end-stage liver disease, or hepatocellular carcinoma,” Alter and Liang wrote.

Knowing that those born between 1945 and 1964 are at the highest risk for HCV infection could help guide screening, according to another study published in the same issue of the journal, led by David Rein, of the CDC. “Because HCV progresses slowly, the risk for serious complications is increasing among infected Americans as time passes,” he and his colleagues wrote. “Without changes in current case identification and treatment, deaths from HCV are forecasted to increase to 35,000 annually by 2030.”

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