Punjab doctor arrested for raping woman

LUDHIANA: A doctor in Ludhiana, Punjab allegedly raped a girl after invited her to the city promising to get her admission in a post-graduate course. He has been arrested and sent to police remand till January 1.

According to the police, the accused Kanwar Samrat was arrested after a complaint by a 29-year-old woman. The woman, a divorcee, said that she got in touch with the accused from Samana in Patiala district through the internet.

They decided to get married and the woman got engaged to Samrat on May 22.Samrat promised her that he would get her admission into a post-graduate course and called her to Ludhiana on October 10. Samrat then raped her. Threatening her not to disclose about the incident to anyone, he raped her several times.

When Samrat neither got her an admission nor married her, she went to the police.

"We have registered a case of cheating and rape against the accused on the basis of complaint. He was arrested from Samana on Sunday morning and produced before the court which sent him to two days police remand. We are interrogating him," a police officer said.

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AP IMPACT: Big Pharma cashes in on HGH abuse

A federal crackdown on illicit foreign supplies of human growth hormone has failed to stop rampant misuse, and instead has driven record sales of the drug by some of the world's biggest pharmaceutical companies, an Associated Press investigation shows.

The crackdown, which began in 2006, reduced the illegal flow of unregulated supplies from China, India and Mexico.

But since then, Big Pharma has been satisfying the steady desires of U.S. users and abusers, including many who take the drug in the false hope of delaying the effects of aging.

From 2005 to 2011, inflation-adjusted sales of HGH were up 69 percent, according to an AP analysis of pharmaceutical company data collected by the research firm IMS Health. Sales of the average prescription drug rose just 12 percent in that same period.

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EDITOR'S NOTE — Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.

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Unlike other prescription drugs, HGH may be prescribed only for specific uses. U.S. sales are limited by law to treat a rare growth defect in children and a handful of uncommon conditions like short bowel syndrome or Prader-Willi syndrome, a congenital disease that causes reduced muscle tone and a lack of hormones in sex glands.

The AP analysis, supplemented by interviews with experts, shows too many sales and too many prescriptions for the number of people known to be suffering from those ailments. At least half of last year's sales likely went to patients not legally allowed to get the drug. And U.S. pharmacies processed nearly double the expected number of prescriptions.

Peddled as an elixir of life capable of turning middle-aged bodies into lean machines, HGH — a synthesized form of the growth hormone made naturally by the human pituitary gland — winds up in the eager hands of affluent, aging users who hope to slow or even reverse the aging process.

Experts say these folks don't need the drug, and may be harmed by it. The supposed fountain-of-youth medicine can cause enlargement of breast tissue, carpal tunnel syndrome and swelling of hands and feet. Ironically, it also can contribute to aging ailments like heart disease and Type 2 diabetes.

Others in the medical establishment also are taking a fat piece of the profits — doctors who fudge prescriptions, as well as pharmacists and distributors who are content to look the other way. HGH also is sold directly without prescriptions, as new-age snake oil, to patients at anti-aging clinics that operate more like automated drug mills.

Years of raids, sports scandals and media attention haven't stopped major drugmakers from selling a whopping $1.4 billion worth of HGH in the U.S. last year. That's more than industry-wide annual gross sales for penicillin or prescription allergy medicine. Anti-aging HGH regimens vary greatly, with a yearly cost typically ranging from $6,000 to $12,000 for three to six self-injections per week.

Across the U.S., the medication is often dispensed through prescriptions based on improper diagnoses, carefully crafted to exploit wiggle room in the law restricting use of HGH, the AP found.

HGH is often promoted on the Internet with the same kind of before-and-after photos found in miracle diet ads, along with wildly hyped claims of rapid muscle growth, loss of fat, greater vigor, and other exaggerated benefits to adults far beyond their physical prime. Sales also are driven by the personal endorsement of celebrities such as actress Suzanne Somers.

Pharmacies that once risked prosecution for using unauthorized, foreign HGH — improperly labeled as raw pharmaceutical ingredients and smuggled across the border — now simply dispense name brands, often for the same banned uses. And usually with impunity.

Eight companies have been granted permission to market HGH by the U.S. Food and Drug Administration, which reviews the benefits and risks of new drug products. By contrast, three companies are approved for the diabetes drug insulin.

The No. 1 maker, Roche subsidiary Genentech, had nearly $400 million in HGH sales in the U.S. last year, up an inflation-adjusted two-thirds from 2005. Pfizer and Eli Lilly were second and third with $300 million and $220 million in sales, respectively, according to IMS Health. Pfizer now gets more revenue from its HGH brand, Genotropin, than from Zoloft, its well-known depression medicine that lost patent protection.

On their face, the numbers make no sense to the recognized hormone doctors known as endocrinologists who provide legitimate HGH treatment to a small number of patients.

Endocrinologists estimate there are fewer than 45,000 U.S. patients who might legitimately take HGH. They would be expected to use roughly 180,000 prescriptions or refills each year, given that typical patients get three months' worth of HGH at a time, according to doctors and distributors.

Yet U.S. pharmacies last year supplied almost twice that much HGH — 340,000 orders — according to AP's analysis of IMS Health data.

While doctors say more than 90 percent of legitimate patients are children with stunted growth, 40 percent of 442 U.S. side-effect cases tied to HGH over the last year involved people age 18 or older, according to an AP analysis of FDA data. The average adult's age in those cases was 53, far beyond the prime age for sports. The oldest patients were in their 80s.

Some of these medical records even give explicit hints of use to combat aging, justifying treatment with reasons like fatigue, bone thinning and "off-label," which means treatment of an unapproved condition

Even Medicare, the government health program for older Americans, allowed 22,169 HGH prescriptions in 2010, a five-year increase of 78 percent, according to data released by the Centers for Medicare and Medicaid Services in response to an AP public records request.

"There's no question: a lot gets out," said hormone specialist Dr. Mark Molitch of Northwestern University, who helped write medical standards meant to limit HGH treatment to legitimate patients.

And those figures don't include HGH sold directly by doctors without prescriptions at scores of anti-aging medical practices and clinics around the country. Those numbers could only be tallied by drug makers, who have declined to say how many patients they supply and for what conditions.

First marketed in 1985 for children with stunted growth, HGH was soon misappropriated by adults intent on exploiting its modest muscle- and bone-building qualities. Congress limited HGH distribution to the handful of rare conditions in an extraordinary 1990 law, overriding the generally unrestricted right of doctors to prescribe medicines as they see fit.

Despite the law, illicit HGH spread around the sports world in the 1990s, making deep inroads into bodybuilding, college athletics, and professional leagues from baseball to cycling. The even larger banned market among older adults has flourished more recently.

FDA regulations ban the sale of HGH as an anti-aging drug. In fact, since 1990, prescribing it for things like weight loss and strength conditioning has been punishable by 5 to 10 years in prison.

Steve Kleppe, of Scottsdale, Ariz., a restaurant entrepreneur who has taken HGH for almost 15 years to keep feeling young, said he noticed a price jump of about 25 percent after the block on imports. He now buys HGH directly from a doctor at an annual cost of about $8,000 for himself and the same amount for his wife.

Many older patients go for HGH treatment to scores of anti-aging practices and clinics heavily concentrated in retirement states like Florida, Nevada, Arizona and California.

These sites are affiliated with hundreds of doctors who are rarely endocrinologists. Instead, many tout certification by the American Board of Anti-Aging and Regenerative Medicine, though the medical establishment does not recognize the group's bona fides.

The clinics offer personalized programs of "age management" to business executives, affluent retirees, and other patients of means, sometimes coupled with the amenities of a vacation resort. The operations insist there are few, if any, side effects from HGH. Mainstream medical authorities say otherwise.

A 2007 review of 31 medical studies showed swelling in half of HGH patients, with joint pain or diabetes in more than a fifth. A French study of about 7,000 people who took HGH as children found a 30 percent higher risk of death from causes like bone tumors and stroke, stirring a health advisory from U.S. authorities.

For proof that the drug works, marketers turn to images like the memorable one of pot-bellied septuagenarian Dr. Jeffry Life, supposedly transformed into a ripped hulk of himself by his own program available at the upscale Las Vegas-based Cenegenics Elite Health. (He declined to be interviewed.)

These promoters of HGH say there is a connection between the drop-off in growth hormone levels through adulthood and the physical decline that begins in late middle age. Replace the hormone, they say, and the aging process slows.

"It's an easy ruse. People equate hormones with youth," said Dr. Tom Perls, a leading industry critic who does aging research at Boston University. "It's a marketing dream come true."

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Associated Press Writer David B. Caruso reported from New York and AP National Writer Jeff Donn reported from Plymouth, Mass. AP Writer Troy Thibodeaux provided data analysis assistance from New Orleans.

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AP's interactive on the HGH investigation: http://hosted.ap.org/interactives/2012/hgh

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The AP National Investigative Team can be reached at investigate(at)ap.org

EDITOR'S NOTE _ Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.

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Hillary Clinton's Blood Clot Located in Her Head

Michal Sula/MAFRA/isifa/Getty Images

The blood clot that put Secretary of  State Hillary Clinton in the hospital was found in her head between her brain and skull behind the right ear, her doctors said today.

“It did not result in a stroke, or neurological damage,” her doctors,  Drs. Lisa Bardack and Gigi El-Bayoumi, said in a joint statement. “To help dissolve this clot, her medical team began treating the secretary with blood thinners.”

The doctors  said Clinton will be released “once the medication dose has been established.”

Clinton, 65, was admitted to New York Presbyterian hospital on Sunday for treatment of a blood clot stemming  from a concussion she sustained a few weeks ago, a Clinton aide said.

“In the course of a routine follow-up MRI on Sunday, the scan revealed that a right transverse sinus venous thrombosis had formed. This is a clot in the vein that is situated in the space between the brain and the skull behind the right ear,” the doctors said.

“In all other aspects of her recovery, the secretary is making excellent progress and we are confident she will make a full recovery. She is in good spirits, engaging with her doctors, her family, and her staff,” the statement said.

Clinton was supposed to be back at work at the State Department this week, but now the date of her return in unknown.

Details of Clinton’s blood clot had not been immediately released after her hospitalization.

Members of Congress wished Clinton a speedy recovery today, while pressing their call for her to testify before Congress about the U.S. consulate attack in Benghazi.

“We just want to say how much Secretary Clinton is in our prayers this morning and hope she recovers rapidly from this health problem,” Sen. Joe Lieberman, I-Conn.,   said at a press conference today. Lieberman is chairman of the Senate Homeland Security Committee.

“Secretary Clinton has made clear that she will testify. And I think that’s a good idea,” said Lieberman.

House Foreign Affairs Chairman Rep. Illeana Ros-Lehtinen, R.-Fla., tweeted get well wishes to Clinton Sunday night,  but also mentioned Benghazi. “Wishing Secretary Clinton a full + speedy recovery!,” Ros-Lehtinen wrote. “She’s looking forward 2 testify on #Benghazi and is bummed she can’t travel now like b4.”

The committee released a new report last week which concludes that the security system was “flashing red” in Benghazi shortly before Ambassador Christopher Stevens and three other Americans were killed in an attack by terrorists on Sept. 11. The report cited a “rising crescendo of evidence” from the U.S. intelligence community that Benghazi had become “dangerous and unstable, and that a significant attack against American personnel there was becoming more and more likely.”

Lieberman called the administration’s reaction to the flashing red indicators as “woefully inadequate.”

Sen.  Susan Collins, R-Maine, said she thinks other must be held accountable at the State Department, in addition to those who have already resigned following the release of the State Department’s internal investigation. The Accountability Review Board issues a scathing report which faulted some senior management at the State Department for the breakdown of security and resulted in the four officials stepping down.

“My hope is, and my expectation is, that once Secretary Clinton is well enough, that she will carefully review our report and see if there are other officials that need to be held accountable,” Collins said. “It is difficult for us to make that judgment, but I believe that it is likely that there are others that do need to be held accountable.”

The congressional report found that the environment in Benghazi was dangerous and that local security was inadequate for protection. The report also found that the departments of Defense and State had not jointly assessed the availability and the accessibility of U.S. assets to support the mission facility in Benghazi in the event of an attack, such as the one that occurred.

“We should have closed this facility in Benghazi until we were prepared to provide the security necessary to give minimal protection, adequate protection to American personnel,” Lieberman said.

The report concludes that it is clear that terrorists were responsible for the attack on the consulate and that the administration response bouncing between the State Department, the Pentagon and the intelligence community added to some “confusion” over the attack.

Many conservatives have been skeptical of  Clinton’s illness, with former U.N. ambassador John Bolton telling Fox News  Clinton had come down with a “diplomatic illness” to avoid testifying on Dec. 2o, a charge the State Department vigorously denied.

“These people do not know what they are talking about,” spokesperson Victoria Nuland responded.

Dr. Howard Markel, a practicing doctor and medical historian at the University of Michigan, tells ABC News that history shows the best response to rumors is transparency.  The State Department did not disclose that Clinton had a concussion until several days after it occurred and currently waited a day to disclose what part of her body her blood clot is in, leaving the media and others to make assumptions about the seriousness of her condition.

“In the absence of information, this kind of speculation often takes up the vacuum,” says Markel, who points out that Clinton is receiving excellent medical care and that her condition sounds treatable.

State Department officials say they have been transparent about the secretary’s health, keeping the press and the public aware of all major developments within a reasonable amount of time, but they also maintain that Clinton is entitled to some degree of medical privacy, a claim Markel says held up historically but does not today.

“If you’re a private person, you are entitled to your privacy as a patient. When you’re a public figure and you’re working on behalf of the American people, you give up many aspects of your privacy,” he said.

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Body of India rape victim cremated in New Delhi

NEW DELHI (Reuters) - The body of a woman, whose gang rape provoked protests and rare national debate about violence against women in India, arrived back in New Delhi on Sunday and was cremated at a private ceremony.

Scuffles broke out in central Delhi between police and protesters who say the government is doing too little to protect women. But the 2,000-strong rally was confined to a single area, unlike last week when protests raged up throughout the capital.

Riot police manned barricades along streets leading to India Gate war memorial - a focal point for demonstrators - and, at another gathering point - the centuries-old Jantar Mantar - protesters held banners reading "We want justice!" and "Capital punishment".

Most sex crimes in India go unreported, many offenders go unpunished, and the wheels of justice turn slowly, according to social activists, who say that successive governments have done little to ensure the safety of women.

The unidentified 23-year-old victim of the December 16 gang rape died of her injuries on Saturday, prompting promises of action from a government that has struggled to respond to public outrage.

The medical student had suffered brain injuries and massive internal injuries in the attack and died in hospital in Singapore where she had been taken for treatment.

She and a male friend had been returning home from the cinema, media reports say, when six men on a bus beat them with metal rods and repeatedly raped the woman. The friend survived.

New Delhi has the highest number of sex crimes among India's major cities, with a rape reported on average every 18 hours, police figures show. Reported rape cases rose by nearly 17 percent between 2007 and 2011, according to government data.

Six suspects were charged with murder after her death and face the death penalty if convicted.

In Kolkata, one of India's four biggest cities, police said a man reported that his mother had been gang-raped and killed by a group of six men in a small town near the city on Saturday.

She was killed on her way home with her husband, a senior official said, and the attackers had thrown acid at the husband, raped and killed her, and dumped her body in a roadside pond.

Police declined to give any further details. One officer told Reuters no criminal investigation had yet been launched.

"MISOGYNY"

The leader of India's ruling Congress party, Sonia Gandhi, was seen arriving at the airport when the plane carrying the woman's body from Singapore landed and Prime Minister Mannmohan Singh's convoy was also there.

A Reuters correspondent saw family members who had been with her in Singapore take her body from the airport to their Delhi home in an ambulance with a police escort.

Her body was then taken to a crematorium and cremated. Media were kept away but a Reuters witness saw the woman's family, New Delhi's chief minister, Sheila Dikshit, and the junior home minister, R P N Singh, coming out of the crematorium.

The outcry over the attack caught the government off guard. It took a week for the prime minister to make a statement, infuriating many protesters. Last weekend they fought pitched battles with police.

Issues such as rape, dowry-related deaths and female infanticide rarely enter mainstream political discourse.

Analysts say the death of the woman dubbed "Amanat", an Urdu word meaning "treasure", by some Indian media could change that, though it is too early to say whether the protesters can sustain their momentum through to national elections due in 2014.

U.N. Secretary General Ban Ki-Moon added his voice to those demanding change, calling for "further steps and reforms to deter such crimes and bring perpetrators to justice".

Commentators and sociologists say the incident earlier this month has tapped into a deep well of frustration many Indians feel over what they see as weak governance and poor leadership on social issues.

Newspapers raised doubts about the commitment of both male politicians and the police to protecting women.

"Would the Indian political system and class have been so indifferent to the problem of sexual violence if half or even one-third of all legislators were women?" the Hindu newspaper asked.

The Indian Express said it was more complicated than realizing that the police force was understaffed and underpaid.

"It is geared towards dominating citizens rather than working for them, not to mention being open to influential interests," the newspaper said. "It reflects the misogyny around us, rather than actively fighting for the rights of citizens who happen to be female."

(Additional reporting by Ross Colvin and Diksha Madhokin New Delhi and Sujoy Dhar in Kolkata; Editing by Louise Ireland)

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E. Timor bids farewell to peacekeepers after 13 years

DILI: The UN ends its peacekeeping mission in East Timor Monday after 13 years of boots on the ground in Asia's youngest nation following a bloody transition to independence.

The mission, which saw the presence of some 1,500 UN troops and police, will take down its flag and send home the last of its peacekeepers, including five Portuguese officers, while a "liquidation team" of 79 will remain to tie up loose ends.

The mission began withdrawing troops in earnest in October when national police resumed responsibility for security, following the peaceful election of a new president and parliament.

"The Timorese people and its leaders have shown courage and unswerving resolve to overcome great challenges," United Nations Integrated Mission in Timor-Leste (UNMIT) chief Finn Reske-Nielsen said in a statement.

"Although there remains much work ahead, this is an historic moment in recognising the progress already made."

Reske-Nielsen said the withdrawal did not mark an end to the partnership between the UN and the country, officially called Timor-Leste, as "challenges still remain".

"As peacekeepers depart, we look forward to a new phase in this relationship focusing on social and economic development."

Observers say there is little indication that there will be renewed violence in the short term, but public institutions, including the police force and judiciary, remain weak.

There are also concerns that rampant poverty, high unemployment rates among the youth and a fast-growing population could lead to future unrest.

Government critics have highlighted the economy's heavy reliance on significant but depleting offshore oil and gas reserves that they say benefit urban Timorese more than the regional poor.

The UN played a key role in the birth of East Timor, organising the 1999 vote that ended Indonesia's 24-year occupation, in which around 183,000 people -- then a quarter of the population -- died from fighting, starvation or disease.

It oversaw East Timor until 2002, when an independent government took over.

UN peacekeepers streamed in again in 2006, when a mass desertion among the armed forces prompted fighting between military factions and police, and street violence left at least 37 people dead and tens of thousands displaced.

The only major violence since was a failed assassination attempt on then-President Jose Ramos-Horta in 2008.

- AFP/jc

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GMR fallout? Visa now must for Maldivian medical tourists

NEW DELHI: India has tightened visas for Maldives in what is being seen as retaliation for the GMR fiasco in that country. New Delhi has stopped Maldivians from using their visa-free travel facilities to India for other activities like medical treatment, restricting it only to tourism.

India revised its earlier "liberal" interpretation of the 1979 bilateral visa agreement with Maldives this month which allowed thousands of Maldivians to use a 90-day visa-on-arrival facility — meant only for tourism — to travel for treatment in Indian hospitals. The Indian government indulged in Maldivians' liberal use of the facility. But that will no longer be allowed, said sources. Now, Maldivians will need valid medical visas for treatment in Indian hospitals or face deportation, New Delhi has warned.

Foreign minister Salman Khurshid suggested that a lack of reciprocity by Male had forced India to cut down on its largesse in doling out visas. "We know that people from the Maldives come here for treatment but as far as visas are concerned, we will go strictly by the rules," said Khurshid. While India allowed Maldivians to seek treatment on tourist visas — as it never questioned the purpose of their visit —authorities in Male have admitted that there always was a "mutual understanding" that such travelers required medical visa.

Indications are that Maldives is already facing the heat. Calling for its nationals not to depend on any one country for treatment, Male has now approached Sri Lanka saying it wants to extend its healthcare scheme to some of the hospitals in Colombo. Now, Maldivians are queuing up outside the Indian High Commission to seek medical visas which are limited in number. The Maldivian home minister said they would approach Thailand for help in medical treatment for its citizens.

According to the Indian government, Maldives' interpretation of the visa agreement was always different and that until now it was more difficult for Indians to get into Maldives than the other way round. The fact that India workers' passports are confiscated by their employers is something India has repeatedly taken up with authorities in Male but to no avail.

According to India, Maldives detains and deports about 50 Indian nationals every year. Maldivian home minister Mohammed Jameel Ahmed denied the charge, saying that only four have been deported this year. But the Indian High Commission contradicted him on Saturday. "Regarding the deportation of Indian travelers from Male International Airport, the High Commission of India stands by its figures," said the High Commission in a statement. Unlike Maldives, India has also been giving tourist visas free of cost. After tightening visa regulations, India has put forward a list of demands to Maldives in which it has also sought quick release of 14 Indians detained in the Indian Ocean nation.

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Kenya hospital imprisons new mothers with no money

NAIROBI, Kenya (AP) — The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he's accused of: detaining mothers who can't pay their bills. Lazarus Omondi says it's the only way he can keep his medical center running.

Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn't let them leave after delivering their babies. The bills the mothers couldn't afford were $60 and $160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.

Now, a New York-based group has filed a lawsuit on the women's behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.

"We hold you and squeeze you until we get what we can get. We must be self-sufficient," Omondi said in an interview in his hospital office. "The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers."

"They stay there until they pay. They must pay," he said of the 350 mothers who give birth each week on average. "If you don't pay the hospital will collapse."

The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi's poorest with hardly anyone to stand up for them.

Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi's slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn't pay the $60 bill, and was held with what she believes was about 60 other women and their infants.

"We were sleeping three to a bed, sometimes four," she said. "They abuse you, they call you names," she said of the hospital staff.

She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor's 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family's 50-square-foot shack, where rent is $18 a month. She says she was released after 20 days after Nairobi's mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.

A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.

"I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me," said Anyoso, a vegetable seller and a single mother with five children who makes $5 on a good day.

Anyoso said she didn't have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.

One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.

Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.

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Associated Press reporter Tom Odula contributed to this report.

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Cliffhanger: 'Major Setback' For Budget Talks

With less than two days remaining for Congress to reach a budget agreement that would avoid the so-called "fiscal cliff," a senior White House official tells ABC News that President Obama is still "modestly optimistic" that a deal can be struck to prevent middle class taxes from increasing on New Year's Day.

Vice President Biden has now re-emerged as a key player, back in Washington and playing "a direct role" in trying to make a deal with Senate Republicans. Biden has been tapped because of his long-standing relationship with Senate Republican Leader Mitch McConnell.

A Democratic source says that McConnell seems to be genuinely interested in getting an agreement. The news dovetails with reports that the GOP has backed off a key Social Security measure that had stalled negotiations.

According to sources, the row was sparked when the GOP offered a proposal that included a new method of calculating entitlement benefits with inflation. Called the "chained consumer price index," or Chained CPI, the strategy has been criticized by some Democrats because it would lower cost of living increases for Social Security recipients.

"We thought it was mutually understood that it was off the table for a scaled-back deal," a Democratic aide said. "It's basically a poison pill."

President Obama has floated chained CPI in the past as part of a grand bargain, despite opposition from the AARP and within his own party.

Also in the Republican plan brought today: An extension of the current estate tax and no increase in the debt ceiling. Higher income earners would see their taxes increase, but at levels "well above $250,000," the sources said.

J. Scott Applewhite/AP Photo

Sens. Charles Schumer and Jon Kyl on 'This Week' Watch Video

Fiscal Cliff Negotiations: Could Economy Slip Back into Recession? Watch Video

That "major setback" in the talks was evident on the floor of the Senate this afternoon.

"I'm concerned about the lack of urgency here, I think we all know we are running out of time," Senate Minority Leader Mitch McConnell, R-Ky., said, "I want everyone to know I am willing to get this done, but I need a dance partner."

McConnell said he submitted the Republican's latest offer to Majority Leader Harry Reid, D-Nev., at 7:10 pm last night and was willing to work through the night. Reid promised to get back to him at 10 this morning, but has yet to do so.

Why have the Democrats not come up with a counteroffer? Reid admitted it himself moments later.

"At this stage we're not able to make a counteroffer," Reid said noting that he's had numerous conversations with Obama, but the two parties are still far apart on some big issues, "I don't have a counteroffer to make. Perhaps as the day wears on I will be able to."

McConnell said he believes there is no major issue that is the sticking point but rather, "the sticking point appears to be a willingness, an interest, or frankly the courage to close the deal."

Reid said the fiscal cliff negotiations are getting "real close" to falling apart completely.

"At some point in the negotiating process, it appears that there are things that stop us from moving forward," he said. "I hope we're not there but we're getting real close and that's why I still hold out hope that we can get something done. But I'm not overly optimistic but I am cautiously optimistic that we can get something done."

Reid said there are serious difference between the two sides, starting with Social Security. He said Democrats are not willing to cut Social Security benefits as part of a smaller, short-term agreement, as was proposed in the latest Republican proposal.

"We're not going to have any Social Security cuts. At this stage it just doesn't seem appropriate," he said. "We're open to discussion about entitlement reforms, but we're going to have to take a different direction. The present status will not work."

Reid said that even 36 hours before the country could go over the cliff, he remains "hopeful" but "realistic," about the prospects of reaching an agreement.

"The other side is intentionally demanding concessions they know we are not willing to make," he said.

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Syria opposition leader rejects Moscow invitation

ALEPPO PROVINCE, Syria/BEIRUT (Reuters) - Syria's opposition leader has rejected an invitation from Russia for peace talks, dealing another blow to international hopes that diplomacy can be resurrected to end a 21-month civil war.

Russia, President Bashar al-Assad's main international protector, said on Friday it had sent an invitation for a visit to Moaz Alkhatib, whose six-week-old National Coalition opposition group has been recognized by most Western and Arab states as the legitimate voice of the Syrian people.

But in an interview on Al Jazeera television, Alkhatib said he had already ruled out such a trip and wanted an apology from Moscow for its support for Assad.

"We have clearly said we will not go to Moscow. We could meet in an Arab country if there was a clear agenda," he said.

"Now we also want an apology from (Russian Foreign Minister Sergei) Lavrov because all this time he said that the people will decide their destiny, without foreign intervention. Russia is intervening and meanwhile all these massacres of the Syrian people have happened, treated as if they were a picnic."

"If we don't represent the Syrian people, why do they invite us?" Alkhatib said. "And if we do represent the Syrian people why doesn't Russia respond and issue a clear condemnation of the barbarity of the regime and make a clear call for Assad to step down? This is the basic condition for any negotiations."

With the rebels advancing steadily over the second half of 2012, diplomats have been searching for months for signs that Moscow's willingness to protect Assad is faltering.

So far Russia has stuck to its position that rebels must negotiate with Assad's government, which has ruled since his father seized power in a coup 42 years ago.

"I think a realistic and detailed assessment of the situation inside Syria will prompt reasonable opposition members to seek ways to start a political dialogue," Lavrov said on Friday.

That was immediately dismissed by the opposition: "The coalition is ready for political talks with anyone ... but it will not negotiate with the Assad regime," spokesman Walid al-Bunni told Reuters. "Everything can happen after the Assad regime and all its foundations have gone. After that we can sit down with all Syrians to set out the future."

BRAHIMI TO MOSCOW

Russia says it is behind the efforts of U.N. mediator Lakhdar Brahimi, fresh from a five-day trip to Damascus where he met Assad. Brahimi, due in Moscow for talks on Saturday, is touting a months-old peace plan for a transitional government.

That U.N. plan was long seen as a dead letter, foundering from the outset over the question of whether the transitional body would include Assad or his allies. Brahimi's predecessor, Kofi Annan, quit in frustration shortly after negotiating it.

But with rebels having seized control of large sections of the country in recent months, Russia and the United States have been working with Brahimi to resurrect the plan as the only internationally recognized diplomatic negotiating track.

Russia's Middle East envoy, Deputy Foreign Minister Mikhail Bogdanov, who announced the invitation to Alkhatib, said further talks were scheduled between the "three B's" - himself, Brahimi and U.S. Undersecretary of State William Burns.

Speaking in Damascus on Thursday, Brahimi called for a transitional government with "all the powers of the state", a phrase interpreted by the opposition as potentially signaling tolerance of Assad remaining in some ceremonial role.

But such a plan is anathema to the surging rebels, who now believe they can drive Assad out with a military victory, despite long being outgunned by his forces.

"We do not agree at all with Brahimi's initiative. We do not agree with anything Brahimi says," Colonel Abdel-Jabbar Oqaidi, who heads the rebels' military council in Aleppo province, told reporters at his headquarters there.

Oqaidi said the rebels want Assad and his allies tried in Syria for crimes. Assad himself says he will stay on and fight to the death if necessary.

In the rebel-held town of Kafranbel, demonstrators held up cartoons showing Brahimi speaking to a news conference with toilet bowls in front of him, in place of microphones. Banners denounced the U.N. envoy with obscenities in English.

DIPLOMATS IMPOTENT

Diplomacy has largely been irrelevant to the conflict so far, with Western states ruling out military intervention like the NATO bombing that helped topple Libya's Muammar Gaddafi last year, and Russia and China blocking U.N. action against Assad.

Meanwhile, the fighting has grown fiercer and more sectarian, with rebels mainly from the Sunni Muslim majority battling Assad's government and allied militia dominated by his Alawite sect, an offshoot of Shi'ite Islam.

Still, Western diplomats have repeatedly touted signs of a change in policy from Russia, which they hope could prove decisive, much as Moscow's withdrawal of support for Serbian leader Slobodan Milosevic heralded his downfall a decade ago.

Bogdanov said earlier this month that Assad's forces were losing ground and rebels might win the war, but Russia has since rowed back, with Lavrov last week reiterating Moscow's position that neither side could win through force.

Still, some Moscow-based analysts see the Kremlin coming to accept it must adapt to the possibility of rebel victory.

"As the situation changes on the battlefield, more incentives emerge for seeking a way to stop the military action and move to a phase of political regulation," said Dmitry Trenin, director of the Carnegie Moscow Center.

Meanwhile, on the ground the bloodshed that has killed some 44,000 people continues unabated. According to the pro-opposition Syrian Observatory for Human Rights, a monitoring group based in Britain, 150 people were killed on Thursday, a typical toll as fighting has escalated in recent months.

Government war planes bombarded the town of Assal al-Ward in the Qalamoun district of Damascus province for the first time, killing one person and wounding dozens, the observatory said.

In Aleppo, Syria's northern commercial hub, clashes took place between rebel fighters and army forces around an air force intelligence building in the Zahra quarter, a neighborhood that has been surrounded by rebels for weeks.

(Additional reporting by Omar Fahmy in Cairo, Dominic Evans in Beirut and Steve Gutterman and Alissa de Carbonnel in Moscow; Writing by Peter Graff; Editing by Giles Elgood)

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'Cliff' pessimism delivers US stocks another loss

NEW YORK: US stocks sank for a fifth straight day Friday, showing more doubts that politicians will be able to agree a deal to fix the fiscal cliff with only days before the year-end deadline.

Shares were cautiously lower for most of the day after President Barack Obama returned from his vacation early to try to broker a deal with Democrat and Republican congressional leaders in the White House.

But without any positive signs late in the day and the weekend looming, traders gave up and sold off at a stronger pace in the last half hour.

The Dow Jones Industrial Average finished off 158.20 points (1.21 percent) at 12,938.11.

The broad-market S&P 500 lost 15.67 (1.10 percent) to 1,402.43, while the tech-rich Nasdaq Composite shed 25.60 points (0.86 percent) to 2,960.31.

"In the end, fiscal-cliff concerns dominated. No deal meant more worry, and we sold off," said Ryan Detrick of Schaeffer's Investment Research.

All 30 Dow blue chips were in the red, led by Hewlett-Packard (-2.6 percent), which was pushed lower after the SEC said it was looking into its subsidiary Autonomy.

In November, HP accused Autonomy of fraudulent accounting that was uncovered only after its $10 billion purchase of the British software firm in 2011.

Also on the Dow, Exxon lost 2.0 percent and Chevron 1.9 percent.

A rare gainer for the day was embattled bookseller Barnes & Noble, which although reporting that its Nook e-reader had disappointing Christmas sales, got a 4.3 percent boost on the announcement that British publisher Pearson would take a five percent stake in its Nook unit for $89.5 million.

Herbalife, under attack for weeks from short-selling hedge funds, bounced back with a 3.9 percent gain.

Facebook, which opened more than 2.5 percent lower on a report by audience tracker AppData.com that some 3.5 million people had stopped using its photo-sharing app Instagram daily over the past week, regained ground to finish with a loss of just 0.5 percent.

Facebook acquired Instagram earlier this year. The original price was pegged at $1 billion but the final value was less because of a decline in the social network's share price.

Bond prices rose. The 10-year US Treasury yield slipped to 1.71 from 1.72 percent late Thursday, while the 30-year edged lower to 2.88 percent from 2.89 percent. Bond prices and yields move inversely.

-AFP/ac

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