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Singapore Prepares for Doctor Visits over Video Call

In a 2017 episode of the TV show “The Good Wife,” a doctor in Chicago is seen advising a dental surgery in Syria, over Skype. Such remote operations, part of an emerging sector known as telemedicine, is not only the stuff of televised fiction, but a real technology that is attracting increasing attention from business and government. That includes Singapore, which has introduced telemedicine legislation in a nation whose medical research and development already has impacts across borders.Telemedicine lawSingapore will regulate telemedicine businesses as part of its upcoming Healthcare Services Act 2020.These services already “have become increasingly popular and are poised to become a key feature of Singapore’s health care system,” said Marian Ho, a senior partner in the corporate division of Dentons Rodyk Singapore, a law firm.Regulate medical services not premisesShe said in a legal briefing that what makes the new law significant is that Singapore will focus on the types of medical services provided, rather than on the premises where they’re provided. For instance, if a patient only needs to refill his painkiller prescription, it is less important that he is on the premises of a hospital, and more important that he is receiving consultation services from a doctor, even if it is over Skype.Citizens of Singapore are readySingaporeans have already started using smartphone apps for simple check-ins with their doctors, using text messages and video calls. The apps range from Doctor Anywhere to MaNaDr. However the new law will be the overarching framework that the island nation uses to regulate this business, including to authorize the Ministry of Health to issue licenses for new services.As businesses develop new ways to provide health services over the internet, the impacts are likely to spread beyond Singapore. The rich micro-state is already a world leader in biomedical science, manufacturing four out of the world’s top 10 drugs, for instance, according to a 2019 report from consulting firm TMF Group and Singapore’s Economic Development Board, a government board.RisksHowever the new technology also comes with risks, such as a doctor’s accuracy rate over a video call versus in person, whether personal data will be protected as it is handed over to apps, and insurance and liability questions in case of malpractice.“My understanding is that out of 10 startups, maybe one survives,” gastroenterologist Desmond Wai told Singapore’s Business Times. “When the rest close down, who will be keeping the patient records?”Large part of the Singapore economyThe Healthcare Services Act, approved by parliament this month, will regulate one of Singapore’s biggest sectors.  National manufacturing decreased overall from December to January, yet biomedical production increased 10.3% annualized, including a 20% increase in medical technology production, according to research from Singapore’s OCBC Bank.That makes medtech a significant part of the Southeast Asian economy, one that will see even more telemedicine in the future.“Singapore’s strong digital capabilities and vibrant research ecosystem aided by close collaboration between the public, private and academic sectors make it the region’s leading center for biomedical sciences,” the TMF-EDB report said. “Over 30 of the world’s major biomedical science and pharmaceutical companies have established their regional clinical trial centers in Singapore.”   

Turkish Court Defies Europe, Leaves Philanthropist Behind Bars

An Istanbul court has defied the European Court of Human Rights, ruling in favor of the continued detention of prominent philanthropist Osman Kavala. In December, the European Court demanded the immediate release of Kavala, who is on trial for sedition.Kavala and 15 other civil society activists are accused of supporting anti-government protests in 2013 against then-Prime Minister Recep Tayyip Erdogan, who is now president.  The protest action came to be known as the Gezi movement, named after an Istanbul park where the unrest started. Prosecutors are calling for life imprisonment without parole.The ECHR condemned the case, calling for an end to Kavala’s more than two years in prison and describing it as “arbitrary” and “politically motivated.”The Istanbul court ruled Tuesday the ECHR decision was provisional because Ankara was appealing the verdict and that Kavala should remain in jail.”The court’s decision is flawed because the European Court ruling was clear in its call for Kavala’s immediate release,” said Emma Sinclair Webb, Turkey researcher for New York-based Human Rights Watch.”We saw multiple signs of how unfair this trial is,” said Webb, speaking after attending Tuesday’s court hearing. “The lawyers for Kavala raised many objections to the way witness evidence is used in this case. The court turns a deaf ear to all objections. It’s a shocking indication that once again, Turkey’s judiciary seems to be under heavy pressure of the executive.”Tuesday’s court hearing was marred by chaos, with Kavala’s lawyers challenging the judge’s decision to hear some witnesses without their presence, prompting the lawyers to walk out of the room.  Ankara strongly rejects the ECHR verdict, maintaining that the judiciary is independent. But observers note the case has strong political undertones.  Three months ahead of Kavala’s prosecution, Erdogan accused him of “financing terrorists” and that Kavala was a representative for “that famous Jew [George Soros,] who tries to divide and tear up nations.” Erdogan did not elaborate on the comments about George Soros, who is an international philanthropist.Erdogan’s allegations against Kavala resemble the prosecution case against the jailed activist.Kavala is a pivotal figure in Turkey, using his wealth to help develop the country’s fledgling civil society after a 1980 military coup.
 
“Osman Kavala is very prominent within the civil society in this country,” said Sinan Gokcen, Turkey representative of Swedish-based Civil Rights Defenders. “He is not a man of antagonism; he is a man of preaching dialogue, a man of building bridges.”FILE – Lawyers for jailed philanthropist Osman Kavala hold a press conference in Istanbul, Turkey, Oct. 31, 2018.Gokcen works to support Turkish human rights defenders and says Kavala’s prosecution has far-reaching repercussions for civic society.”It means that they [the Turkish government] can detain any member of civil society in Turkey regardless of what this person is defending or advocating and can keep this person as long as they want despite any legal mechanism. We feel unprotected. In a way, we feel powerless to end such a situation. We feel powerless and intimidated,” added Gokcen.Turkey is in the grip of a legal crackdown following a 2016 failed coup blamed by the president on dissident military elements with links to Turkish-Islamic cleric Fethullah Gulen. Gulen lives in self-imposed exile in the United States and is a staunch opponent of Erdogan.Hundreds of journalists, human rights defenders and members of the wider Turkish civic society have been prosecuted and jailed. The government says it is defending democracy, but critics argue the crackdown is more about silencing critics.Human Rights Watch Monday called on the United Nations to review Turkey’s “human rights crisis and the dramatic erosion of its rule of law framework.” On Tuesday, Turkey faced its third Universal Periodic Review (UPR) before the U.N. Human Rights Council in Geneva.Ankara claims it remains committed to human rights and cites its plans to introduce a package of legal reforms. But critics cite the ongoing prosecutions as evidence of the government’s real intentions.”The huge number of journalists, politicians, and perceived government critics in prison and on trial flies in the face of the Turkish government’s public statements about the state of human rights in the country,” said Hugh Williamson, Europe and Central Asia director at Human Rights Watch.With the U.N. having few tools to sanction Turkey, the European Union is seen as offering the best hope by human rights advocates of applying pressure on Ankara.Turkey’s EU membership bid is already frozen, in part due to human rights concerns. But Ankara is seeking to extend a customs union, along with visa-free travel for its citizens with the EU.  “It’s time all European countries should be speaking out very loud and clear on cases like this [Kavala],” said Sinclair-Webb.But even high-profile cases like Kavala’s have seen Brussels offer only muted criticism of Ankara. German Chancellor Angela Merkel’s visit to Istanbul Friday for talks with Erdogan saw little criticism of Turkey’s human rights record. Instead, discussions focused on Ankara’s recent deployment of soldiers to Libya and the upholding of an EU-Turkish agreement controlling migrants entering Europe.”There are many issues to talk about with Turkey,” said Sinclair Webb. “Syria, Libya, Turkey, hosting so many refugees from Syria, and this often takes priority over Turkey’s domestic human rights crisis. This means there isn’t sufficient clarity on cases like this. What we are seeing is Turkey defying Europe’s human rights court.”
 
Some analysts suggest Brussels could yet be lobbying behind the scenes for Kavala’s release, tying Ankara’s calls for extra financial assistance for refugees to gestures on human rights. 

Magnitude 7.7 Earthquake Hits Between Cuba and Jamaica

A powerful magnitude 7.7 earthquake struck in the Caribbean Sea between Jamaica and eastern Cuba on Tuesday, shaking a vast area from Mexico to Florida and beyond, but there were no immediate reports of casualties or heavy damage.The quake was centered 139 kilometers (86 miles) northwest of Montego Bay, Jamaica, and 140 kilometers (87 miles) west-southwest of Niquero, Cuba, according to the U.S. Geological Survey. It hit at 2:10 p.m. (1910 GMT) and the epicenter was a relatively shallow 10 kilometers (6 miles) beneath the surface.Dr. Enrique Arango Arias, head of Cuba’s National Seismological Service, told state media that there had been no serious damage or injuries reported.The quake was felt strongly in Santiago, the largest city in eastern Cuba, said Belkis Guerrero, who works in a Roman Catholic cultural center in the center of Santiago.”We were all sitting and we felt the chairs move,” she said. “We heard the noise of everything moving around.”She said there was no apparent damage in the heart of the colonial city.”It felt very strong but it doesn’t look like anything happened,” she told The Associated Press.It was also felt a little farther east at the U.S. Navy base at Guantanamo Bay, Cuba, on the southeastern coast of the island. There were no immediate reports of injuries or damages, said J. Overton, a spokesman for the installation, which has a total population of about 6,000 people.Several South Florida buildings were evacuated as a precaujtion, according to city of Miami and Miami-Dade County officials. No injuries or road closures had been reported.The quake also hit the Cayman Islands, leaving cracked roads and what appeared to be sewage spilling from cracked mains. There were no immediate reports of deaths, injuries or more severe damage, said Kevin Morales, editor-in-chief of the Cayman Compass newspaper.Witness reportsThe islands experience so few earthquakes that newsroom staff were puzzled when it hit, he said.”It was just like a big dump truck was rolling past,” Morales said. “Then it continued and got more intense.”Dr. Stenette Davis, a psychiatrist at a Cayman Islands hospital, said she saw manhole covers blown off by the force of the quake, and sewage exploding into the street, but no more serious damage.Claude Diedrick, 71, who owns a fencing business in Montego Bay, said he was sitting in his vehicle reading when the earth began to sway.”It felt to me like I was on a bridge and like there were two or three heavy trucks and the bridge was rocking but there were no trucks,” he said.He said he had seen no damage around his home in northern Jamaica.The Pacific Tsunami Warning Center said the quake could generate waves 1 to 3 feet above normal in Cuba, Jamaica, the Cayman Islands, Honduras, Mexico and Belize.The USGS initially reported the magnitude at 7.3.
 

Energy Giant Total Taken to French Court for Climate Inaction  

In a groundbreaking case in France, energy giant Total is being sued for allegedly failing to adequately fight climate change.The lawsuit was filed on Tuesday by environmental groups and local authorities who feel it has potential global implications.The legal action against Total will be the first use of a 2017 French law to sue for climate inaction. The legislation requires major French companies to draft so-called “vigilance plans” to prevent environmental damage, among other areas. The plaintiffs said Total has not done so when it comes to climate change.  “We’re filing a lawsuit against them because they’re still not making the energy transition necessary to limit global warming to 1.5 degrees,” said Paul Mougeolle, who represents Notre Affaire a Tous, an environmental NGO that has filed a separate climate action case against the French government.  “Total has 1% of greenhouse gases worldwide — more than the carbon footprint of France,” Mougeolle said. “So, we think Total has a special responsibility towards this energy transition.”Fourteen local authorities and five civil society groups have joined the Total lawsuit, which reflects a broader grass-roots uprising on climate in Europe and elsewhere.  This alliance said companies that contribute to climate change should help pay the price for mitigating it and dealing with the consequences.France’s central Val de Loire region is part of the lawsuit.Regional councilor Benoit Faucheaux describes last summer’s devastating drought, which dried up rivers in his region of central France. Experts said climate change will make such droughts longer, more frequent and more devastating.  “We hope Total will change its business model, that it will shift from that situation where it produces energy and fossil energies (to) another model where they are involved in energy transition,” Faucheaux said.Sebastien Mabile of Seattle Advocates law group, which has taken on the case, is uncertain about its chances — because it’s a legal first. But if it succeeds, he said, its impact could be big.  “Because Total … operates in 130 countries,” Mabile said. “So, this case can have implications all over the world, such as the U.S., Africa, in all of the oil and gas basins.”Total faces a separate but somewhat similar lawsuit for allegedly failing to plan for potential human and environmental impacts of an Ugandan oil project. The company did not respond VOA’s requests for comment.

Powerful Earthquake Hits between Cuba and Jamaica

The U.S. Geological Survey says a powerful magnitude 7.7 earthquake has struck south of Cuba and northwest of Jamaica.
It was centered 125 kilometers north-northwest of Lucea, Jamaica, and hit at 2:10 p.m. (1910 GMT) Tuesday. The epicenter was a relatively shallow 10 kilometers (6 miles) beneath the surface.
It’s not immediately clear if there are damage or injuries.
The USGS initially reported the magnitude at 7.3.

New Pressure on Prince Andrew to Help Epstein Investigation

The pressure on Britain’s disgraced Prince Andrew increased Tuesday after the revelation by U.S. authorities that he has failed to cooperate with the FBI’s investigation into his ties with the late convicted sex offender Jeffrey Epstein.
Lawyer Lisa Bloom, who represents five of Epstein’s alleged sexual trafficking victims, said Tuesday that it’s time for Andrew “to stop playing games and to come forward to do the right thing and answer questions.”
Bloom said her clients were “outraged and disappointed at Prince Andrew’s behavior.”
Andrew remained out of the public eye Tuesday. Buckingham Palace and his legal team maintained a “no comment” policy one day after U.S. Attorney Geoffrey Berman said Andrew has provided “zero cooperation” to the FBI and the U.S. prosecutors seeking to speak with him about Epstein.
The statement Monday by Berman, the top federal prosecutor in Manhattan, was the first official confirmation that the leading U.S. law enforcement agency had sought — and failed — to obtain evidence from Andrew, third child of Queen Elizabeth II, despite his pledge in November that he would cooperate with legitimate law enforcement agencies.
The U.S. decision to make the 59-year-old prince’s silence public may be part of a strategy to increase public calls for him to cooperate.FILE – Financier Jeffrey Epstein looks on during a bail hearing in his sex trafficking case, in this court sketch in New York, July 15, 2019.Andrew is being sought for questioning as a witness who may be able to shed light on the illegal activities of Epstein, who died in a New York prison in August while awaiting trial on sexually abusing teenage girls. There’s no indication that U.S. officials are pursuing criminal charges against the prince.
The FBI only has limited ways to try to convince Andrew to give evidence.
U.S. officials have not provided details, so it’s not clear if the FBI made an informal request through Andrew’s lawyers or went through formal police channels, which if successful would have led to an interview conducted by U.K. police, possibly with an FBI agent present.
“They can’t compel him to do any of those things,” said British lawyer Ben Keith, a specialist in extradition and law enforcement. “The next stage after that is to issue a formal Mutual Legal Assistance Request, which would go through the Foreign Office and be dealt with in the court system.”
That could lead, Keith said, to the prince giving evidence via video link to U.S. investigators.
Andrew has been accused by a woman who says that she had several sexual encounters with the prince at Epstein’s behest, starting when she was 17.
Virginia Roberts Giuffre says after meeting Epstein as a teenager in Florida in 2000, he flew her around the world and pressured her into having sex with numerous older men, including Andrew, two senior U.S. politicians, a noted academic, and the attorney Alan Dershowitz, who is now part of President Donald Trump’s impeachment defense team.
Giuffre has said she had sex with Andrew three times, including once in London in 2001 at the home of Epstein’s girlfriend, Ghislaine Maxwell. Giuffre claims that she was paid by Epstein for her sexual encounters.
Andrew and Dershowitz have denied any wrongdoing. But the royal family forced Andrew to step down from his royal duties and charity patronages in November after giving a disastrous television interview in which he defended his friendship with Epstein and failed to express sympathy for the girls and women who Epstein abused.
Andrew is also being pursued by several lawyers representing Epstein victims who are pushing civil suits against Epstein’s estate.
Those lawyers could choose to bring their request to a British high court, seeking to have an examiner take a statement from Andrew or pursue other ways to obtain his evidence. So far they are only making public calls for him to make himself available and threatening to subpoena Andrew if he travels to the U.S.
The complex legal situation may make Andrew reluctant to visit the U.S., where his evidence is sought on both criminal and civil cases, but lawyers say it’s unlikely to restrict his travel to other countries.
New York criminal defense lawyer Ron Kuby says it’s unlikely the prince will ever voluntarily agree to an interview and said the FBI doesn’t have the means to force him to.
“The likelihood of him participating is very, very small,” Kuby said. “Why would he? The last time Prince Andrew spoke on the relevant topic he was yanked from public life and universally ridiculed.”
Andrew, eighth in line to the throne, has been seen at occasional royal family events since November but has not commented on Epstein since his TV interview backfired.  

Turkey Journalists Protest Press Pass Cancellations

Members of Turkey’s largest journalism trade union rallied outside Ankara’s Communications Directorate on Monday to protest the government’s mass cancellation of state-issued press credentials.According to the Journalist’s Union of Turkey, known by its Turkish acronym TGS, and international press advocacy groups, such as the International Federation of Journalists (IFJ), up to 1,400 press cards have been canceled in recent months.Most of the journalists targeted for cancellation, observers say, report for independent news outlets or publications critical of the government of Turkish President Recep Tayyip Erdogan.Although journalists are permitted to work without press cards, the passes are the only documents that allow reporters to access Parliament and other government buildings.”As journalists, we don’t need permission from anyone,” Esra Koçak, Ankara-branch chairman of TGS, told independent Turkish news agency Bianet. “We want to protect people’s right to receive information, which is our only motto.”Indefinite reviewIn 2019, Turkish communications officials announced plans to change the traditionally yellow press card to turquoise and require all reporters to submit applications for the new cards no later than Jan. 26, 2020.FILE – Journalists are seen during a stake-out in Istanbul, Turkey, Oct. 31, 2018.Since that announcement was made, hundreds of applications for renewal have remained under indefinite review without explanation, and journalists left in bureaucratic limbo have been instructed to await a ruling on the status of their individual applications.Although some reporters were told they could continue using their old yellow cards in the meantime, Ankara officials invalidated all yellow cards on the Jan. 26 deadline.Officials with Turkey’s Communications Directorate did not respond to requests for comment, but the agency’s director, Fahrettin Altun, took to Twitter Monday to deny allegations of mass decredentialing.”Reports regarding the cancellation of press passes is not accurate,” he wrote, appending a diagram showing several phases of the press card application process.Turkish communications officials, he wrote in further posts, must first determine whether applicants are “professionally engaged in journalistic activity, whether he/she is affiliated with a terrorist organization and whether he/she has been engaged in any action or conduct that tarnishes the integrity of the profession.”Altun put the number of the unconcluded applications at 894.Some cards reactivatedAfter several hours of protests on Monday, some journalists found that their cards were at least partially reactivated, suddenly indicating a “still in use” status on government web portals, leading some to questions whether the government had begun walking back the restrictions.”It appears that the Directorate decided to correct the mistake,” said a TGS spokesperson. “We call on the officials to issue the new press passes that have been put on hold for the past year with no reason provided.”Ankara’s Communications Directorate has reported to President Erdogan’s office since June 2018, when Turkey scrapped its parliamentary system for an executive presidential system of governance.FILE – Journalists work on a hilltop in Ceylanpinar, Sanliurfa province, southeastern Turkey, covering Ankara’s incursion into Syria, Oct. 20, 2019.According to the New York-based Committee to Protect Journalists, 15 reporters and the top editor of Istanbul-based Evrensel have been denied reporting credentials, as have journalists working for other left-leaning dailies such as BirGün and Cumhuriyet.”Turkey’s decision to cancel the press cards for hundreds of journalists is yet another attack on independent reporting and is absolutely unacceptable,” said Gulnoza Said, CPJ’s Europe and Central Asia program coordinator, in New York. “Authorities should immediately restore the journalists’ press credentials, and should ensure that passes are granted in an impartial process.”Paris-based Reporters Without Borders, known by its French acronym RSF, ranked Turkey 157 out of 180 countries in its 2019 annual World Press Freedom Index.”After the elimination of dozens of media outlets and the acquisition of Turkey’s biggest media group by a pro-government conglomerate, the authorities are tightening the vice on what little is left of pluralism – a handful of media outlets that are being harassed and marginalized,” said the RSF report, which identifies Ankara as the world’s second largest jailer of journalists.The 2019 RSF index ranked the United States 48 out of 180, a three-slot drop from 45th place in 2018, as “rhetorical attacks from the government and private individuals alike grew increasingly hostile.”CPJ reported that Turkey revoked press credentials of some 900 journalists after the attempted coup in 2016. 

EU Slaps Sanctions on 7 over Elections in East Ukraine

The European Union on Tuesday slapped sanctions on seven people accused of undermining Ukraine’s sovereignty for their role in organizing Russian local elections in the Crimean Peninsula, annexed by Moscow in 2014.The seven, who will see their assets frozen and face travel bans in Europe, include a top official in Crimea and senior electoral commission officers in the city of Sevastopol whom the EU blame for running the elections on Sept. 8.”Through their involvement in the elections, these people actively supported actions and implemented policies which undermine or threaten the territorial integrity, sovereignty and independence of Ukraine,” EU headquarters said in a statement.The move means that 177 people and 44 “entities” – organizations, associations or companies – are now under EU sanctions over allegations of undermining Ukraine’s territorial integrity.The EU imposed sanctions on Russia after it annexed Ukraine’s Crimean Peninsula in 2014 and the bloc refuses to recognize Moscow’s authority there. It has separate sanctions targeting the Russian economy which are due to remain in place until at least July 31. 

Moderate Quake Shakes Western Turkey, No Injuries Reported

A moderate earthquake shook buildings in western Turkey on Tuesday, sending people running into the streets for safety, Turkish media reports said. Authorities said there were no immediate reports of any injury or major damage.
    
The quake came just four days after a strong earthquake struck eastern Turkey on Friday, toppling buildings and causing 41 deaths. More than 1,600 people were also hurt in the 6.8-magnitude quake.
    
Turkey’s emergency and disaster management agency, AFAD, said Tuesday’s quake measured 4.8 and was centered near the town of Kirkagac, in Manisa province. It occurred at 2:26 p.m. (1126 GMT) at a depth of 6.99 kilometers (4.34 miles). The Istanbul-based Kandilli seismology center said the quake measured 5.1.
    
Interior Minister Suleyman Soylu told reporters there were no initial reports of damage or injuries. Turkish media said the quake was felt in Istanbul and Izmir.
    
In Manisa, people ran out into the streets in panic when they felt the shaking, private NTV television said. An abandoned house collapsed in one village near Kirkagac, the station reported.
    
Earthquakes are frequent in Turkey, which sits atop two major fault lines. Manisa was hit by a magnitude 5.4 earthquake on Jan. 22 which caused a few derelict structures to collapse.
    
Turkey’s worst quake in decades came in 1999, when a pair of strong earthquakes struck northwest Turkey, killing around 18,000 people.

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