Doctors in Cuba Start Over in the U.S.

MIAMI — In 1991, Carlos Domínguez, a family doctor in one of Havana's poorest neighborhoods, bought a boat for 12,000 pesos — the equivalent of saving his entire paycheck for three years — to escape the government that had trained him to be an international doctor.

The boat was old and needed to be outfitted with the transmission from a 1952 Ford, one of the many American cars that still cruise the streets of Havana. The mechanic warned him there was no reverse gear. The boat could only go forward.

"Perfect," Dr. Domínguez, now 46, said he replied. "I don't plan on coming back. From now on, I'm just going forward."

And so, armed with his grandfather's World War II compass, he left Cuba and made his way to Miami, rowing the last seven hours after the gasoline ran out. He was 28 years old and ready to resume his life as a doctor.

But first he needed to pass four exams given only in English, and then put in several years of training as a hospital resident.

Dr. Domínguez, who had been taught Russian in his military school in Cuba, knew no English. Still, he passed one exam before failing the second by a few points. Already married and saddled with family responsibilities, he put away his medical school books, and signed up for a program to become a nurse in one year. Since 2001 he has worked as a hospice admissions nurse, a job that allows him to work with patients while avoiding the hurdles that doctors have to overcome to practice medicine in the United States.

While the rest of the country is suffering from a shortage of primary care physicians, Miami is awash with Cuban doctors who have defected in recent years. By some estimates, 6,000 medical professionals, many of them physicians, have left Cuba in the last six years.

Cuban doctors have been fleeing to South Florida since Fidel Castro seized power in 1959, but the pace intensified after 2006, when the Department of Homeland Security began a program that allowed Cuban medical personnel "who study or work in a third country under the direction of the Cuban government" to travel to the United States legally. The program has effectively turned a crowning achievement of Cuba's foreign policy on its head.

In the 50 years since the revolution, Cuba has sent more than 185,000 health professionals on medical missions to at least 103 countries. About 31,000, most of them doctors, are in Venezuela, where they work in exchange for cheap oil and other trade benefits for the Cuban government.

And more are in the pipeline. Cuba's official news agency reported that more than 25,000 health professionals graduated this year, "the largest graduation ever."

But many doctors on the island are now vying to be tapped for an international mission, in part because they know that no matter where they are sent, they will be one step closer to a visa to the United States.

The missions have earned Cuba much recognition, goodwill and bargaining power. President Obama told reporters at the end of a recent hemispheric meeting in Trinidad that he found it "interesting" to learn from Latin American leaders "about the thousands of doctors from Cuba that are dispersed all throughout the region, and upon which many of these countries heavily depend."

Yet for many Cuban doctors, who earn the equivalent of $25 a month, the lure of a life of freedom and opportunities in the United States is too strong to resist. And so these children of the revolution, educated by a Communist regime to reject capitalism and embrace socialism, have ended up in Miami, often tending to elderly Cubans who fled the island before the doctors were born.

Ana Carbonell, chief of staff for Representative Lincoln Diaz-Balart, Republican of Florida, said more than 2,000 Cubans had already settled in the United States under the parole program.

"It brings to our community highly qualified professionals at a time of great need," Ms. Carbonell said. "They work alongside U.S.-trained doctors, and they enhance any practice or wherever they work."

Many have been able to obtain licenses and practice medicine. Others have chosen to settle for careers in the medical field but not as physicians, and some work in fields that have nothing to do with medicine.

"I know neurosurgeons who are working in warehouses or factories or as gas attendants," said Julio César Alfonso, 40, who graduated from medical school in Cuba in 1992 and works as a clinic manager in Miami. "But I know many more who are working as nurses, medical assistants and technicians."

 

By MIRTA OJITO

link : http://www.nytimes.com/2009/08/04/health/04cuba.html?_r=1&partner=rss&emc=rss

Out of Search Business, Yahoo Shifts Its Focus

SUNNYVALE, Calif. — Carol A. Bartz, chief executive of Yahoo, has been hobbled.

 

Three weeks ago, doctors gave her a new left knee, made of titanium and plastic. As a result, she is limping around Yahoo's headquarters here, occasionally standing to hold a chair and stretch her leg while a bottle of Percocet sits at the ready on her desk.

Yahoo also underwent invasive surgery recently, selling its search business to Microsoft for an initial 88 percent share of search revenue in a 10-year deal. Since that move last week, Yahoo too has limped along, with disappointed investors asking whether Ms. Bartz could have won more favorable terms and with Yahoo shares tumbling more than 15 percent.

In a lengthy interview on Friday before departing for a vacation, Ms. Bartz said she sold the search business because Yahoo could no longer continue to match the level of investment Google and Microsoft were making in searching, one of the Web's most lucrative and technologically complex businesses.

While reducing the marketing and infrastructure costs associated with search, the deal will also provide money that Yahoo can use to bolster other businesses. Ms. Bartz plans to invest the money in Yahoo's display ad, content and mobile services technology.

"My first reaction when I got here was that I wouldn't even do a search deal," she said, "until I looked at our expense structure and our actual options and looked at what our prime job was, which is to grow audience."

Yahoo will lose some of its most talented engineers to Microsoft and as many as 400 employees through layoffs. The deal also undercuts years of investment around search technology. By selling the technological crown jewels, the company may lose some of its high-tech credibility among employees and others in Silicon Valley, as well as among customers.

But the core of Yahoo remains intact, according to Ms. Bartz. "We haven't eviscerated the company," she said.

Given Yahoo's battering by investors, Ms. Bartz lamented that Yahoo and Microsoft failed to explain the relationship better to Wall Street. She blamed herself for a comment she made several weeks ago, at an industry conference, that Microsoft would have to pay Yahoo "boatloads of cash" to win its search business. That statement, she said, helped to solidify an expectation that Yahoo would receive $1 billion or more upfront as part of the deal.

"I made a mistake. I was never interested in doing it for upfront money. That doesn't help me operate a business," Ms. Bartz said. She noted that such a payment would have had significant tax consequences while contributing only $3 million in annual interest to Yahoo's bottom line.

Wall Street had become enamored with the previous, more immediately lucrative proposals between Microsoft and Yahoo. Last year, trying to improve its search business and better compete with its archrival Google, Microsoft offered $46 billion to buy all of Yahoo. Analysts estimate that the new deal — involving what many people saw as Yahoo's most important asset — is worth only around $4 billion to $5 billion.

"It's rather like getting a Picasso and saying, 'You know, the canvas costs $200, the paint cost $300, so we'll sell it to you for $500,' " said Jeffrey Lindsay, an analyst at Sanford C. Bernstein. "I've never seen investors so angry."

Microsoft's chief, Steven A. Ballmer, has gone to unusual lengths to defend the deal on Yahoo's behalf. Last week, he told a group of investors gathered at Microsoft's headquarters that it was "sort of unbelievable" that Yahoo got to keep such a high percentage of the ad sales while spending nothing on the underlying infrastructure to run the search operation.

And Ms. Bartz argues that the more generous offers came during far different economic times. In addition, she said, analysts have underestimated the two and half years it will take to integrate the two companies' search and advertising systems. The companies also face the daunting process of getting approval from regulatory agencies that are now closely scrutinizing deals on antitrust grounds.

Ms. Bartz said that she avoided Mr. Ballmer's immediate advances after taking the helm of Yahoo. "He called my first day," she said. "I told him: 'Go away. I haven't even found the bathroom.' "

When Ms. Bartz finally began negotiations, Mr. Ballmer presented two options: a large upfront payment or a higher percentage of revenue tied to ads sold on Yahoo Web sites. "He wasn't going to pay twice," Ms. Bartz said.

Ultimately, Mr. Ballmer, who was unavailable to comment, and Ms. Bartz ended up on the phone debating minute details, like how fast things like search results and ads would appear, at one point haggling over a margin of 100 milliseconds.

Ms. Bartz also fought to play down Microsoft's Bing brand on the Yahoo search results page, with just a bit of text instead of a logo, and she pushed Mr. Ballmer hard to make sure that Yahoo retained the right to sell its own display ads to big advertisers like Procter & Gamble and Unilever.

"I had to get Steve through the, 'we get to sell part,' " she said. Meanwhile, Ms. Bartz has plenty of other work to do at Yahoo. She has picked up on the dysfunction throughout the company during her eight months on the job.

For one, Yahoo has not poured enough money into creating a top-class technology infrastructure capable of delivering a variety of services to consumers. "We are actually behind in investing," she said. "We should have invested more."

Ms. Bartz also complained about a lack of balance among the different product groups. Motivated employees in the company's sports section have turned it into a must-visit Web destination by breaking news stories and providing witty commentary. Other sections have languished.

This is often a result of what Ms. Bartz sees as insufficient communication and barriers among the company's various American and international properties over sharing videos and other content. "We had a fight for 18 months here on what a video button should look like," Ms. Bartz said.

Spending money to fix these problems made more sense to Ms. Bartz than hemorrhaging cash in a bid to keep pace with Google and Microsoft.

Microsoft has backed its new search engine, Bing, with billions of dollars in infrastructure and marketing investments. So far, the search engine has been well received. While encouraged by some of Bing's innovations, Ms. Bartz figures that Google will most likely match them soon. "That is the arms race I don't want to be in," she said.

But some investors fear that Yahoo may be trading one of the most profitable businesses of the 21st century — search — for a deflating, hypercompetitive media business that appeared to peak in the 20th century.

"I don't think the surviving pieces are very interesting," said Michael Lippert, manager of the Baron iOpportunity fund, which acquired Yahoo shares earlier this year on the anticipation of a lucrative search partnership. Mr. Lippert was disappointed by the terms of the deal but did not make out too badly; his fund also owns Microsoft stock, which rose slightly last week.

"Ballmer got himself a fantastic deal," he said.

by : http://www.nytimes.com/2009/08/03/technology/companies/03yahoo.html?pagewanted=1&partner=rss&emc=rss

Garlic for a Healthy Heart? Go Fresh, Study Says

Much has been made of the benefits of eating garlic, but often left out of the discussion is what kind of garlic to eat. Is fresh-crushed better than paste or pre-peeled cloves? What about garlic powder? How about just popping a garlic pill?

 

A study by researchers at the University of Connecticut School of Medicine suggests that for certain elements of cardiac health, fresh-crushed is better than processed.

Subhendu Mukherjee, Dipak K. Das and colleagues prepared garlic slurries containing about two ounces of garlic (10 to 20 cloves, depending on size) in about a cup and a half of water. Two slurries were made, one with fresh-crushed garlic and the other with garlic that had been crushed but left to dry for two days, allowing hydrogen sulfide and other volatile chemicals to dissipate.

Small amounts of the slurries were force-fed to laboratory rats for 30 days, after which the animals were sacrificed and their hearts put through tests. The findings were published in The Journal of Agricultural and Food Chemistry.

The researchers found that while both slurries provided some cardioprotective benefits, the hearts of rats that had eaten the fresh-crushed garlic had less damage and better recovery after blood flow was restricted for 30 minutes. Among other things, the fresh-crushed garlic was better at suppressing chemicals that act as a "death signal" for heart muscle cells.

By HENRY FOUNTAIN

link :http://www.nytimes.com/2009/08/04/science/04obgarlic.html?partner=rss&emc=rss