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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West African army chiefs to approve Mali troops plan

BAMAKO (Reuters) - West African defense chiefs will on Tuesday approve plans to speed up the deployment of African troops against Islamist rebels in northern Mali, with some regional soldiers seen arriving next week.

France has already poured hundreds of troops into Mali and carried out days of air strikes in a vast desert area seized last year by an Islamist alliance that combines al Qaeda's north African wing AQIM with Mali's home-grown MUJWA and Ansar Dine rebel groups.

Western and regional powers are concerned the insurgents will use Mali's north as a launchpad for international attacks.

"On January 15, the committee of Chiefs of Defense Staff will meet in Bamako to approve the contingency plan," the mission head of the ECOWAS grouping of West African states, Aboudou Toure Cheaka, told Reuters.

"I can tell you that in one week, the troops will effectively be on the ground," he said, adding their immediate mission would be to help stop the rebel advance while preparations for a full intervention plan continued.

He did not say how many soldiers would arrive.

The original timetable for the 3,300-strong U.N.-sanctioned African force - 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. But regional powerhouse Nigeria, which is due to lead the mission, has cautioned that even if some troops arrive in Mali soon, training will take more time.

The plan is being fast-tracked after France rushed to respond to a plea for help by Mali's government after mobile columns of Islamist fighters last week threatened the central garrison towns of Mopti and Sevare, with its key airport.

The French defense ministry said on Monday it aimed to deploy some 2,500 soldiers to Mali to bolster the Malian army and the eventual West African force.

"SAFEGUARD MALI"

French Prime Minister Jean-Marc Ayrault said France's goals were to stop the Islamist rebels, to "safeguard the existence of Mali" and pave the way for the African-led military operation.

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 anyplace to hide," U.S. Defense Secretary Leon Panetta told reporters as he began a visit to Europe.

As French aircraft bombarded mobile columns of Islamist fighters, other insurgents launched a counter-attack further to the south, dislodging government forces from the town of Diabaly, 350 km (220 miles) from Bamako.

French intervention has raised 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.

The U.N. said an estimated 30,000 people had fled the latest fighting in Mali, joining more than 200,000 already displaced.

U.N. Secretary-General Ban Ki-moon on Monday welcomed the French-led military intervention in Mali and voiced the hope that it would halt the Islamist assault.

Amnesty International said at least six civilians were killed in recent fighting in the town of Konna, where French aircraft had earlier bombarded rebel positions, and called on both sides to spare non-combatants.

France, which has repeatedly said it has abandoned its role as the policeman of its former African colonies, is among the toughest proponents of a speedier deployment of the African troops, and convened a U.N. Security Council meeting Monday to discuss the crisis.

French U.N. Ambassador Gerard Araud told reporters after the meeting that the U.S., Canada, Belgium, Denmark and Germany had also offered logistical support for France's Mali operation.

"I felt that all the members of the Security Council were expressing their support (for) and understanding of the French decision," Araud told reporters.

No Europeans or other African Union members will be allowed in the defense chiefs meeting in Bamako on Tuesday, a western diplomat told Reuters, requesting not to be named.

"They don't want any French pressure at the meeting," the diplomat said.

(Reporting by Bate Felix; Additional reporting by Michelle Nichols and Louis Charbonneau at the United Nations Richard Valdmanis in Dakar, Brian Love in Paris and David Alexander in Lisbon; Editing by Richard Valdmanis and Giles Elgood)

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Euro gains against US dollar in positive market

NEW YORK: The euro gained ground against the US dollar Monday as positive market sentiment spurred buying of riskier assets, such as the European currency.

The euro fetched US$1.3376 around 2200 GMT, up from US$1.3341 at the same time last Friday. Earlier, the unit brushed US$1.3404, its highest level in almost 11 months.

The euro continued to rise against the Japanese currency, to 119.65 yen from 119.00 yen late Friday, while the US dollar rose to 89.45 yen from 89.18 yen.

The market showed little reaction to a speech by Federal Reserve Chairman Ben Bernanke on the challenges facing the US economy, analysts said.

"I saw nothing very different from what has already been announced by the Fed," whether it be in the minutes from the last Federal Open Market Committee policy meeting in December or the FOMC statement, Charles St-Arnaud, a Nomura economist, said.

Wading into the Washington political fray over the federal budget and the borrowing limit, Bernanke called on Congress to lift the debt limit to avoid putting the country into default.

Kathy Lien of BK Asset Management said the market was waiting for Tuesday's US retail sales data for December, which covers the important holiday-shopping season.

"Consumer spending is the backbone of the US economy, and the only reason why investors obsess over the labour market is because they hope that stronger job growth will translate into stronger spending," Lien said.

The euro rise was buoyed by last week's upbeat comments by European Central Bank president Mario Draghi.

The yen, meanwhile, remained under selling pressure after Japanese Prime Minister Shinzo Abe on Friday unveiled a US$226.5 billion stimulus plan in the latest bid to boost the world's fragile number-three economy.

The US dollar rose against the Swiss currency, buying 0.9216 francs compared with 0.9135 francs late Friday.

The pound fell to US$1.6074 from US$1.6129.

- AFP/jc

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Kerala drug dealers home deliver banned aphrodisiac

KOCHI: Illegal drug dealers have found a 'safe' method to carry out their business.

With authorities cracking down on the illegal sale of medicines containing sildenafil citrate — an ingredient in aphrodisiacs, black marketers have started door delivery of such drugs, especially in Malappuram and Kozhikode districts.

"Sildenafil citrate is schedule H medicine, which should be given only under prescription. But over-the-counter sales of the drug have been very high, especially in Malappuram district and interior areas of Kozhikode," said G Ashok Kumar, assistant drug controller, Kozhikode.

He said there was dip in over-the-counter sales after the state drugs control department formed a special team. "But there are reports that the offenders now deliver these medicines at home. Unless there is proper and timely tip off, we will not be able to catch the offenders," Kumar said.

Sources said suppliers in Karnataka have been sending these drugs to the state using their network. "They would lure the salesmen in medical stores with perks. These salesmen would direct the customer to the network. Once the deal is struck, they would give the 'customers' these medicine at their place," an official in Malappuram said.

Most customers were NRIs working in the Middle East, the official said. The drugs bought in the state were taken to Gulf countries, where the medicine has been banned.

Officials, recently, had seized a huge quantity of medicines containing sildenafil citrate from Manjeri. A year ago, such drugs were seized from a shop on TD Road in Kochi, officials said. "On questioning, the shop owners said that the transaction is being carried out through home delivery," the official said.

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Arias Denied Guilt Despite Sex Photos, DNA

A defiant Jodi Arias insisted she was innocent of killing her ex-boyfriend Travis Alexander even after a detective told her that he had nude photos of them together on the day he died.

"Are you sure it's me? Because I was not there," Arias is heard saying in the police interrogation tape played for the Arizona jury today.

When Detective Esteban Flores tells Arias she is seen in pigtails in the photos, she asks with a tone of incredulity, "Pigtails?"

As Flores laid out more incriminating evidence, including that investigators found DNA of their blood mixed together, her hair stuck with blood and her palm print in blood, Arias was insistent.

"I would not hurt Travis. I would not hurt Travis. I would not do that to him," she told Flores.

At another point Arias said, "If I hurt Travis I would beg for the death penalty."

"Jodi, this is over. … you have to tell me the truth," Flores says. The detective suggests a motive for the killing to be jealousy, and cites the opinion of Alexander's friends.

"They don't just say you were jealous. You were absolutely obsessed… a fatal attraction," Flores in heard on the tape.

Arias, now 32, has since admitted to killing Alexanderfollowing their tryst in 2008, but has claimed it was self-defense. She is accused of stabbing Alexander 27 times in the chest, back, and head, slashing his throat from ear to ear, and shooting him the head with a .25 caliber handgun.

Arias is charged with murdering her ex-boyfriend in a "heinous and depraved" way and could face the death penalty if convicted.

The interrogation tape was played after the jury was shown sexually graphic photos that police recovered from Alexander's digital camera. Among the pictures were shots of Arias and Alexander posing naked on Alexander's bed, as well as pictures of Alexander in the shower.

Those photos were the last pictures of Alexander while he was alive.

Jodi Arias Trial: Jurors See Photos of Bloody Handprint Watch Video

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The final photos in the series show a body partly covered in blood on the bathroom floor.

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Arias looked away from the screen in the courtroom where the sexual photos were shown, as her mother watched from the gallery. Alexander's sisters, also seated in the gallery, looked away from the photos of their brother.

Computer analysts for the city of Mesa, Ariz., where Alexander lived, went over the photos in detail during the sixth day of testimony in the trial. The photos were time stamped June 4, 2008, beginning around 1:45 p.m.

Prosecutors have said that Arias drove from her California home to Alexander's house, arriving early in the morning on June 4. The pair had sex in the afternoon, took photos of one another, and then Arias killed Alexander, age 30, around 5:30 p.m., they said.

The photos on the bed occurred around 1:45 p.m., according to the data on the camera. The shower photos and the pictures of a bloody body part occurred around 5:30 p.m.

In earlier testimony today, the jury watched video taped interrogations of Arias as she repeatedly denied to police stealing and using the handgun that killed Alexander.

Arias told police that she had never seen a .25 caliber handgun and had no idea her grandparents owned one until they reported it stolen a week before Alexander's killing, according to the police interrogation tapes played in court today.

Police from Yreka, Calif., where Arias lived with her grandparents, described the scene of the home when Arias's grandparents reported a break-in. The door was pushed in, breaking the door jamb, and many drawers were opened in Arias' bedroom and her grandparents' room.

The only things reported taken were the handgun, a DVD player, and $30, while other valuable items, including a large pile of quarters and three other guns, were left untouched. Arias told police that her laptop computer was not taken because she had hidden it in a laundry basket covered with clothes.

Officer Kevin Friedman of the Yreka police department told the court today that burglary struck him as odd.

"I believed it was unusual that small items worth money or money, for instance, that the change was not taken," said Officer Kevin Friedman, of the Yreka police department, who investigated the alleged robbery. "I also thought it was strange that only one of the firearms was stolen from the cabinet."

In the police videos, Arias is seen calmly denying stealing the gun from her grandparents' home and using it when she killed Alexander in June 2008, a week after the burglary.

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Flu more widespread in US; eases off in some areas

NEW YORK (AP) — Flu is now widespread in all but three states as the nation grapples with an earlier-than-normal season. But there was one bit of good news Friday: The number of hard-hit areas declined.

The flu season in the U.S. got under way a month early, in December, driven by a strain that tends to make people sicker. That led to worries that it might be a bad season, following one of the mildest flu seasons in recent memory.

The latest numbers do show that the flu surpassed an "epidemic" threshold last week. That is based on deaths from pneumonia and influenza in 122 U.S. cities. However, it's not unusual — the epidemic level varies at different times of the year, and it was breached earlier this flu season, in October and November.

And there's a hint that the flu season may already have peaked in some spots, like in the South. Still, officials there and elsewhere are bracing for more sickness

In Ohio, administrators at Miami University are anxious that a bug that hit employees will spread to students when they return to the Oxford campus next week.

"Everybody's been sick. It's miserable," said Ritter Hoy, a spokeswoman for the 17,000-student school.

Despite the early start, health officials say it's not too late to get a flu shot. The vaccine is considered a good — though not perfect — protection against getting really sick from the flu.

Flu was widespread in 47 states last week, up from 41 the week before, the Centers for Disease Control and Prevention said on Friday. The only states without widespread flu were California, Mississippi and Hawaii.

The number of hard-hit states fell to 24 from 29, where larger numbers of people were treated for flu-like illness. Now off that list: Florida, Arkansas and South Carolina in the South, the first region hit this flu season.

Recent flu reports included holiday weeks when some doctor's offices were closed, so it will probably take a couple more weeks to get a better picture, CDC officials said Friday. Experts say so far say the season looks moderate.

"Only time will tell how moderate or severe this flu season will be," CDC Director Dr. Thomas Frieden said Friday in a teleconference with reporters.

The government doesn't keep a running tally of adult deaths from the flu, but estimates that it kills about 24,000 people in an average year. Nationally, 20 children have died from the flu this season.

Flu vaccinations are recommended for everyone 6 months or older. Since the swine flu epidemic in 2009, vaccination rates have increased in the U.S., but more than half of Americans haven't gotten this year's vaccine.

Nearly 130 million doses of flu vaccine were distributed this year, and at least 112 million have been used. Vaccine is still available, but supplies may have run low in some locations, officials said.

To find a shot, "you may have to call a couple places," said Dr. Patricia Quinlisk, who tracks the flu in Iowa.

In midtown Manhattan, Hyrmete Sciuto got a flu shot Friday at a drugstore. She skipped it in recent years, but news reports about the flu this week worried her.

During her commute from Edgewater, N.J., by ferry and bus, "I have people coughing in my face," she said. "I didn't want to risk it this year."

The vaccine is no guarantee, though, that you won't get sick. On Friday, CDC officials said a recent study of more than 1,100 people has concluded the current flu vaccine is 62 percent effective. That means the average vaccinated person is 62 percent less likely to get a case of flu that sends them to the doctor, compared to people who don't get the vaccine. That's in line with other years.

The vaccine is reformulated annually, and this year's is a good match to the viruses going around.

The flu's early arrival coincided with spikes in flu-like illnesses caused by other bugs, including a new norovirus that causes vomiting and diarrhea, or what is commonly known as "stomach flu." Those illnesses likely are part of the heavy traffic in hospital and clinic waiting rooms, CDC officials said.

Europeans also are suffering an early flu season, though a milder strain predominates there. China, Japan, the West Bank, the Gaza Strip, Algeria and the Republic of Congo have also reported increasing flu.

Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications.

Most people with flu have a mild illness. But people with severe symptoms should see a doctor. They may be given antiviral drugs or other medications to ease symptoms.

Some shortages have been reported for children's liquid Tamiflu, a prescription medicine used to treat flu. But health officials say adult Tamiflu pills are available, and pharmacists can convert those to doses for children.

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Associated Press writers Dan Sewell in Cincinnati, Catherine Lucey in Des Moines, and Malcolm Ritter in New York contributed to this report.

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Online:

CDC flu: http://www.cdc.gov/flu/index.htm

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France bombs Islamist strongholds in north Mali

BAMAKO/PARIS (Reuters) - French fighter jets pounded Islamist rebel strongholds deep in northern Mali on Sunday as Paris poured more troops into the capital Bamako, awaiting a West African force to dislodge al Qaeda-linked insurgents from the country's north.

The attacks on Islamist positions near the ancient desert trading town of Timbuktu and Gao, the largest city in the north, marked a decisive intensification on the third day of the French mission, striking at the heart of the vast area seized by rebels in April.

France is determined to end Islamist domination of northern Mali, which many fear could act as a base for attacks on the West and for links with al Qaeda in Yemen, Somalia and North Africa.

Defense Minister Jean-Yves Le Drian said France's sudden intervention on Friday had prevented the advancing rebels from seizing Bamako. He vowed that air strikes would continue.

"The president is totally determined that we must eradicate these terrorists who threaten the security of Mali, our own country and Europe," he told French television.

Residents and rebel leaders had reported air raids early on Sunday in the towns of Lere and Douentza in central Mali, forcing Islamists to withdraw. As the day progressed, French jets struck targets further to the north, including near the town of Kidal, the epicenter of the rebellion.

In Gao, a dusty town on the banks of the Niger river where Islamists have imposed an extreme form of sharia law, residents said French jets pounded the airport and rebel positions. A huge cloud of black smoke rose from the militants' camp in the city's north, and pick-up trucks ferried dead and wounded to hospital.

"The planes are so fast you can only hear their sound in the sky," resident Soumaila Maiga said by telephone. "We are happy, even though it is frightening. Soon we will be delivered."

Paris said four Rafale jets flew from France to strike rebel training camps, logistics depots and infrastructure around Gao with the aim of weakening the rebels and preventing them from returning southward.

"We blocked the terrorists' advance and from today what we've started to do is to destroy the terrorists' bases behind the front line," French Foreign Minister Laurent Fabius told LCI television.

France has deployed about 550 soldiers to Mali under "Operation Serval" -- named after an African wildcat -- split between Bamako and the town of Mopti, 500 km (300 miles) north.

In Bamako, a Reuters cameraman saw more than 100 French troops disembark on Sunday from a military cargo plane at the international airport, on the outskirts of the capital.

The city's streets were calm, with the sun streaking through the dusty air as the seasonal Harmattan wind blew from the Sahara. Many cars had French flags draped from the windows to celebrate Paris's intervention.

"We thank France for coming to our aid," said resident Mariam Sidibe. "We hope it continues till the north is free."

AFRICAN TROOPS EXPECTED

More than two decades of peaceful elections had earned Mali a reputation as a bulwark of democracy, but that image unraveled in a matter of weeks after a military coup in March which left a power vacuum for the Islamist rebellion.

France convened a U.N. Security Council meeting for Monday to discuss Mali. French President Francois Hollande's intervention has won plaudits from leaders in Europe, Africa and the United States but it is not without risks.

It raised the threat level for eight French hostages held by al Qaeda allies in the Sahara and for the 30,000 French expatriates living in neighboring, mostly Muslim states.

Concerned about reprisals, France has tightened security at public buildings and on public transport. It advised its 6,000 citizens to leave Mali as spokesmen for Ansar Dine and al Qaeda's north Africa wing AQIM promised to exact revenge.

In its first casualty of the campaign, Paris said a French pilot was killed on Friday when rebels shot down his helicopter.

Hours earlier, a French intelligence officer held hostage in Somalia by al Shabaab extremists linked to al Qaeda was killed in a failed commando raid to free him.

Hollande says France's aim is simply to support a mission by West African bloc ECOWAS to retake the north, as mandated by a U.N. Security Council resolution in December.

With Paris pressing West African nations to send their troops quickly, Ivory Coast President Alassane Ouattara, who holds the rotating ECOWAS chairmanship, kick-started the operation to deploy 3,300 African soldiers.

Ouattara, installed in power with French military backing in 2011, convened a summit of the 15-nation bloc for Saturday in Ivory Coast to discuss the mission.

"The troops will start arriving in Bamako today and tomorrow," said Ali Coulibaly, Ivory Coast's African Integration Minister. "They will be convoyed to the front."

The United States is considering sending a small number of unarmed surveillance drones to Mali as well as providing logistics support, a U.S. official told Reuters. Britain and Canada have also promised logistical support.

Former French colonies Senegal, Niger and Burkina Faso have all pledged to deploy 500 troops within days. In contrast, regional powerhouse Nigeria, due to lead the ECOWAS force, has suggested it would take time to train and equip the troops.

HOUSE-TO-HOUSE SEARCHES

France, however, appeared to have assumed control of the operation on the ground. Its airstrikes allowed Malian troops to drive the Islamists out of the strategic town of Konna, which they had briefly seized this week in their southward advance.

Calm returned to Konna after three nights of combat as the Malian army crushed any remaining rebel fighters. A senior army official said more than 100 rebels had been killed.

"Soldiers are patrolling the streets and have encircled the town," one resident, Madame Coulibaly, told Reuters by phone. "They are searching houses for arms or hidden Islamists."

Analysts expressed doubt, however, that African nations would be able to mount a swift operation to retake north Mali -- a harsh, sparsely populated terrain the size of France -- as neither the equipment nor ground troops were prepared.

"My first impression is that this is an emergency patch in a very dangerous situation," said Gregory Mann, associate professor of history at Columbia University, who specializes in francophone Africa and Mali in particular.

While France and its allies may be able to drive rebel fighters from large towns, they could struggle to prise them from mountain redoubts in the region of Kidal, 300 km (200 miles) northeast of Gao.

Human Rights Watch said at least 11 civilians, including three children, had been killed in the fighting. A spokesman for Doctors Without Borders in neighboring Mauritania said about 200 Malian refugees had fled across the border to a camp at Fassala and more were on their way.

In Bamako, civilians tried to contribute to the war effort.

"We are very proud and relieved that the army was able to drive the jihadists out of Konna. We hope it will not end there, that is why I'm helping in my own way," said civil servant Ibrahima Kalossi, 32, one of over 40 people who queued to donate blood for wounded soldiers.

(Additional reporting by Adama Diarra, Tiemoko Diallo and Rainer Schwenzfeier in Bamako, Pascal Fletcher in Johannesburg, Joe Bavier in Abidjan, Catherine Bremer, Leila Aboud and John Irish in Paris and Phil Stewart in Washington; Writing by Daniel Flynn; Editing by Will Waterman and Roger Atwood)

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US played 'limited' role in botched French rescue bid

WASHINGTON: The United States said Sunday it played a limited support role in France's botched bid to rescue a kidnapped secret agent in Somalia.

"United States forces provided limited technical support to the French forces in that operation, but took no direct part in the assault on the compound where it was believed the French citizen was being held hostage," President Barack Obama said in a letter to Congress.

Saturday's failed attempt to free the French hostage from the Al Qaeda-linked Shebab group killed at least eight civilians, as well as 17 guerrillas. One French soldier died while another went missing.

"United States combat aircraft briefly entered Somali airspace to support the rescue operation, if needed," Obama wrote, adding that "these aircraft did not employ weapons during the operation."

"I directed U.S. forces to support this rescue operation in furtherance of U.S. national security interests," he wrote.

- AFP/jc

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Sangam ready for confluence of faith, 1.1 crore pilgrims may take Kumbh dip today

ALLAHABAD: Even as you read this, a sea of humanity would have already taken — or would be taking — a dip into Sangam's lapping waters along with a mass of saints rushing to take their first shahi snaan (royal bath) on Makar Sankranti on Monday. More than 1.1 crore pilgrims are expected to bathe on the first day of Mahakumbh, the festival that visits the banks of this confluence of the country's civilizational rivers, Ganga, Yamuna and the mythical as well as invisible Saraswati, every 12 years.

In fact, many of the akharas or groups of saints complete their splash into a majestically flowing Sangam well before sunrise, with others soon immersing themselves in the river with prayers on their quivering lips.

The mela administration said it has made elaborate arrangements for devotees who would be flocking to the city over the next 55 days. In fact, around 10-15 lakh pilgrims are already living in Sangam city's sprawling quarters, day and night. Most of them are in tents, make-shift shelters or with sectoral groups called akharas that are administered by sadhus and mahants.

There are people from virtually every state, with those from rural areas of UP, MP, Gujarat and Maharashtra accounting for the largest numbers. The administration has received applications from more than 100 organizations seeking land to pitch more tents, and their numbers are growing.

Wide-eyed tourists as well as professionals from abroad could not stop gushing at the sights. "This is huge," said Nick Oza, a photo-journalist from Arizona. "I don't know from where to begin and where to end!"

A young student from Bangalore, Laxman Sitapathy, said this was his first visit to a Kumbh and the experience is yet to sink in. "I had only seen Kumbh pictures. This far exceeds my expectations."

Joginder from Ludhiana, Punjab, said signboards in the Sangam city should be in other languages as well. "When people from across the world are coming for this mega event, there should be signages in more languages. Just a handful of cops or guides are not enough."

The mela administration has divided the Sangam area spread over around 40 sq km into seven zones or including Parade, Sangam, Akhara, Eyeject bridge, North Jhunsi, South Jhunsi and Arail. A zonal police officer along with magistrate has been appointed in-charge of each zone.

However, a number of organizations which were allotted land in different sectors have complained to Mela officials that their tents were too far away from the Sangam ghats and they had to walk up to 3-4 km for a dip. The mela administration said it's helpless, claiming the entire land on the banks of Ganga and Yamuna has been allocated.

ADM, Kumbh Mela, Ashutosh Kumar Dwivedi told TOI, "The main Sangam ghat is spread across 3,500 feet, while other ghats like sector 13 (2,600 feet), sector 12 (2,000 feet), sector 10 (800 feet), sector 9 (600 feet) and sector 8 (450 feet) have been prepared for the convenience of pilgrims and devotees.

None of this, however, is dampening people's fervor. Narendra Nath from Junagarh, Gujarat, said, "I am here with my family and 14 neighbours for a dip. We got a temporary shelter near Triveni Road and we are happy to share this blissful experience with others."

Work in considerable patches is yet unfinished. Basic civic amenities like water pipe connection, electricity are yet to reach out to every part of the make-shift town. Officials say they expect things to be much smoother by the date of the next Shahi snaan.

IG, Allahabad zone, Alok Sharma said, "Elaborate arrangements are in place with police teams carrying out frisking at different points and streets leading to Sangam area. Traffic police authorities have been asked to divert traffic and implement restrictions at certain points to ease flow of pilgrims."

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Dreamliner Nightmare: Another 787 Fuel Leak

Japan Airlines said a Boeing 787 Dreamliner jet leaked fuel while undergoing tests today at the airport near Tokyo, marking the latest in a string of highly-publicized problems for the jetliner as it undergoes a safety review by the U.S. government.

The Dreamliner being examined leaked around 25 gallons of fuel from a nozzle in the left wing, according to a spokesperson for Japan Airlines. It was reportedly the same aircraft that spilled fuel onto the runway at Logan International Airport in Boston earlier this week, The Associated Press reported.

On Monday, firefighters battled an electrical fire on a grounded Japan Airlines 787, also at Logan.

"We are aware of the event and are working with our customer," Boeing spokesman Marc Birtel said in an email to the Los Angeles Times.

The jetliner, which was unveiled as a luxurious and fuel-efficient way to travel, has recently been beset by problems.

Boeing Dreamliner Breaks Out in Flames in Boston Watch Video

Dreamliner Set to Change the Face of Flight Watch Video

Japan's All Nippon Airways has reported a fuel leak, a 3-foot-long crack in a cockpit window and a malfunctioning computer in its fleet of 787s.

The Federal Aviation Administration announced a comprehensive review of the carbon-fiber plane to ensure it is safe to fly, however officials did not waver in their support of the aircraft.

"I would fly on one today," Transportation Secretary Ray LaHood said at a joint news conference with Boeing on Friday.

The plane will not be grounded by the FAA, and will continue to fly during the review, FAA administrator Michael Huerta said.

"Nothing suggests the airplane is not safe," Huerta said. "We believe this is a safe aircraft. To validate the work during the certification process, we'll work with Boeing to check on systems design and production.

"We want to make sure that the approved quality-control process is in place. We want to see the entire picture and not focus on individual events, to determine the root causes of these events," he said.

Huerta said the review will focus on the Dreamliner's electrical system, including the battery and the power distribution panels, and how electrical and mechanical systems interact with one another.

Aviation experts say that, except for the fire, the issues have all been minor.

"If there was something seriously wrong with this plane there is no question they would ground it," ABC News aviation consultant John Nance said. "That's not the problem here, there's nothing seriously wrong with the 787."

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