We have recently experienced cases of students submitting articles to Telegraph that contain subtle advertisements, spam and offensive content. In those cases, we removed the articles promptly thanks to whistleblowing from our blog readers. If you find any spam, advertising, or offensive content either in articles or the comments section, please report it immediately to and we will edit or remove the article as necessary. Thank you.

Trump Repealism Rolls Back Obama’s Cuba Reforms

Grunge Cuban flag, image is overlaying a detailed grungy texture

Donald Trump’s push to repeal many of the Obama administration’s foreign policy initiatives has extended to the landmark lifting of the embargo against Cuba. Will the new hardline approach be effective in achieving its goal of encouraging political reform and economic liberalisation? 

On 16 June, US President Donald Trump announced a long-expected change in US foreign policy towards Cuba. The new policy will roll back many of the Obama administration’s reforms including travel liberalisation, while imposing further restrictions.

The exiles and dissidents here today have witnessed communism destroy a nation, just as communism has destroyed every single nation where it has ever been tried. But we will not be silent in the face of communist oppression any longer. You have seen the truth, you have spoken the truth, and the truth has now called us—this group—called us to action.Last year, I promised to be a voice against repression in our region—remember, tremendous oppression—and a voice for the freedom of the Cuban people. You heard that pledge. You exercised the right you have to vote. You went out and you voted. And here I am like I promised—like I promised.Remarks by President Trump on the Policy of the United States Towards Cuba 16 June 2017, Manuel Artime Theater, Miami, Florida, US.

Specific elements of the Trump policy include restrictions that prohibit individual travel (with the exception of Cuban Americans who will continue to be able to visit relatives in Cuba and send remittances) and limit non-academic educational travel to organised groups. While the US embassy in Havana will remain, the policy effectively reaffirms the statutory embargo of Cuba.

The stated objectives of the Trump policy are to:

  • “enhance compliance with United States (US) law—in particular, the provisions that govern the embargo of Cuba and the ban on tourism”;
  • hold Cuba “accountable for oppression and human rights”;
  • further US “national security and foreign policy interests”; and
  • empower the “Cuban people to develop greater economic and political liberty”.

The policy changes seek to prohibit business, trade and financial transactions between US companies and entities linked to the Cuban military’s holding company Grupo de Administración Empresarial (GAESA). Instead, it seeks to promote direct economic ties between US individuals and entities and the private sector in Cuba. According to the White House, the policy will promote commerce with “free Cuban businesses and pressure the Cuban government to allow the Cuban people to expand the private sector”.

The Trump policy was announced at the Manuel Artime Theater in Miami, Florida, before a gathering of Cuban Americans. The new policy fulfilled a commitment made by the Trump campaign several weeks before the 2016 election in which Donald Trump pledged to roll back the Obama administration’s reforms. It was made in order to secure the presidential endorsement of the Brigade 2506 Veterans Association—the organisation of veterans of the failed 1961 Bay of Pigs invasion of Cuba. Florida Republicans Senator Marco Rubio and Representative Mario Diaz-Balart, both influential advocates for the continuation of the US embargo against Cuba, supported the Trump initiative.

On the day of the announcement, the Cuban government responded in the strongest terms. In a statement published in Cuba’s official newspaper Granma, the government condemned Trump’s action as a “setback in the relations between both countries”.

“Once again, the US government resorts to coercive methods of the past when it adopts measures aimed at stepping up the blockade, effective since February 1962, which not only causes harm and deprivations to the Cuban people and is the main obstacle to our economic development, but also affects the sovereignty and interests of other countries, which arouses international rejection…

“The Government of Cuba condemns the new measures to tighten the blockade, which are doomed to failure, as has been repeatedly evidenced in the past, for they will not succeed in their purpose to weaken the Revolution or bend the Cuban people, whose resistance against aggressions of all sorts and origins has been put to the test throughout almost six decades….”

With the exception of hardline anti-communist Cuban Americans, the Trump administration’s approach to Cuba has limited support within the US. For example, a December 2016 Pew Research Center poll found that 75 per cent approved of the 2015 Obama administration decision to re-establish US relations with Cuba, while approximately 73 per cent favoured ending the trade embargo against Cuba.

Following the Trump announcement, the Engage Cuba Coalition—a US lobby group which advocates for the lifting of the embargo—published a statement noting that the directive would negatively impact Cuban entrepreneurs and that the new restrictions could cost the US economy “billions of dollars and affect thousands of jobs”.

In the days leading up to the Trump announcement, human rights groups, such as Amnesty InternationalHuman Rights Watchand the Washington Office on Latin America, also expressed concerns about the implications of the proposed changes.

Many Republicans also don’t support the policy. On 16 June, Senator Jeff Flake (R-AR), a member of the Senate Foreign Relations Committee, released a statement in which he criticised renewed restrictions on US citizens’ ability to travel to Cuba. Other Republicans known to be critical of the policy include Senator Rand Paul (R-KY), Senator John Boozman (R-AR), Senator Jerry Moran (R-KS), Representative Tom Emmer (R-MN), Representative Rick Crawford (R-AR), Representative Ted Poe (R-TX), Representative Justin Amash (R-MI), Representative Mark Sanford (R-SC) and Representative Rodney Davis (R-IL).

Several conservative organisations and think tanks are also critical of the Trump approach, including the Cato InstituteReasonCampaign for Liberty and the Federalist.

While some dissidents in Cuba reportedly support a hardline policy approach, it is difficult to ascertain—on account of restricted access to the internet and social media in Cuba—whether the policy has any support among moderates who might be critical of the regime. However, some Cuban academics and entrepreneurs have expressed concern about the implications for Cuba of the election of Donald Trump.

Following the Trump announcement, one academic commented privately that “what happened in Miami… was imaginable”. She added, however, that it would be difficult to reverse what had hitherto been achieved in terms of bilateral engagement and closer ties between the two countries. That said, it was necessary for Cuba to continue to implement political and economic reforms; Cuba “must make deeper and better paced transformations”.

A Cuban entrepreneur commented separately that the Trump policy would impact adversely on tourism and, in particular, on individuals and small businesses involved in the provision of hospitality and accommodation in private dwellings, the so-called ‘casas particulares’. Another academic noted that while the Cuban government and many Cubans had expected the announcement, they were angered to see Trump surrounded by the “most radical members of the Miami hard-right exiles, some of [whom are] associated with the old mafia and wanted by the Cuban police”. Irrespective of whether or not this was the case, there is little doubt that the Trump announcement angered both stalwart supporters of the Cuban government and Cubans of more moderate persuasion.

The new Trump Cuba policy will be implemented through a series of regulations in coming months, the full impact of which remains to be seen. Nevertheless, the policy is another example of the isolationist approach of the current US administration and will likely enhance nationalist and anti-US sentiment among key players within the region, such as Mexico and Venezuela. In terms of its impact on business, US companies and their Cuban counterparts are taking a wait-and-see approach to ascertain how and to what extent their interests will be affected.

The new Trump foreign policy towards Cuba may have additional unintended consequences. It would provide a strategic opportunity for China to enhance its relations with, and influence in, Cuba. China is already Cuba’s third destination for exports after Canada and Venezuela, and its second source of imports after Venezuela. During a 2016 visit to Cuba, where approximately 30 bilateral agreements were signed, Chinese Premier Li Keqiang spoke of the need to deepen their “traditional friendship”, enhance “pragmatic cooperation” and maintain “close cultural exchanges”.

China has previously taken a cautious approach to Cuba. However, in the wake of the Trump announcement, China is likely to assess potential trade and investment opportunities, which may be created by the US vacating the proverbial field, and seek to build on its existing interests, including with the provision of foreign loans.

The coming months will reveal the full extent of the rollback of the Obama administration’s initiatives to liberalise US-Cuba bilateral relations and its implications for the region and beyond. As always, the devil will be in the detail.

[Original published at]

To age gracefully or forever inject? The public health implications of cosmetic injectables


The Botox obsession has increased dramatically since it received FDA approval for cosmetic use in 2002. Women and men across the globe have become long-term devotees. Younger people are being encouraged to commence Botox earlier rather than later to prevent the visible signs of aging.

According to the American Society for Aesthetic Plastic Surgery, over 4.5 million Botox injections were performed in the United States in 2016, a 10% increase from 2015. The American Society of Plastic Surgeons has found that 20,676 sites were injected among patients aged 13-19 and an additional 7,000 filler procedures were performed. The International Society of Aesthetic Plastic Surgery (ISAPS) reports that in 2016 over 8.5 million dermal injections were administered globally.

The demand for Botox has given rise to increased supply, not all of which is above board. A growing number of procedures are being performed in homes by novice, unqualified practitioners or patients themselves to save time and money. Cosmetic injectables including Botox, Juvederm, Dermaveen can be purchased easily online in unregulated markets. Online purchases come with little assurance of the product’s authenticity and no reprise if anything goes wrong.

Botox parties are an increasingly popular way of accessing treatments at a lower cost with friends, advertised by some providers as “more gratifying than a Tupperware party, more fun than Pampered Chef and more twenty-first century than Avon”. In these settings, it is crucial that a patient’s medical history is screened beforehand to reduce the likelihood of adverse reactions as it should not be used in patients with autoimmune conditions. Patients with infections such as sinusitis, periodontal disease, ear, nose, or throat infections, or dental abscesses should not be treated until the condition has resolved. Practitioners must have a comprehensive understanding of facial anatomy to prevent injection into the blood stream, excessive bruising, swelling, loss of vision, droopy-eye or permanent paralysis. Although the risk of Botox spreading to other parts of the body is low, it is important to have access to a licensed health practitioner who is responsible for providing post-treatment care.

Although Botox parties are predominantly held with a qualified doctor, reports of unqualified nurses injecting patients have emerged in recent years. Some practitioners have been found guilty of re-using syringes with a new needle tip, believing a false misconception that the Centres for Disease Control and Prevention is working to eradicate. Syringes should only ever be used once, as they can transmit blood-borne diseases including Hepatitis B, C and HIV.

The risk of infection that comes with injecting in a non-sterile home environment is high and health professionals recommend that procedures be undertaken in a doctor’s office that has infection control procedures in place. According to a consensus paper developed by an international group of esthetic physicians, it is important for practitioners to choose their patients carefully to avoid complications and not allow profit motives to drive clinical decisions.

The all-too-common habit of a few units each month may seem like a harmless investment in the in youthful looks but it may not be so. The long-term health consequences of Botox are rarely discussed. Many websites advertising procedures do not adequately inform patients of the risks. The Mayo Clinic highlights that injections can induce crooked smile, drooling, dry eyes or excessive tearing. More harmful side effects indicative of botulism include trouble speaking or swallowing, trouble breathing and loss of bladder control and require immediate medical attention. Muscle wastage, weakness and bone density loss have also been demonstrated in animal and human studies. Researchers at the University of Washington demonstrate their findings in mice, with the ratio of bone volume to tissue volume decreasing in the femur and tibia of injected limbs by 43.2% and 54.3%, respectively. The first study in humans confirms this finding, with oral health radiologists observing decreased density in exposed patients. Patients are therefore at risk of facial fractures – both painful and costly to treat in terms of medical bills and lost wages.

Men and women of all ages should think carefully before deciding to put themselves at risk of infection, muscle wastage and bone density loss for the sake of esthetics. The average cost of a mandible fracture in the United States is approximately $36,000 or more if there are additional complications. Ageing is a natural part of life – why not do it gracefully?

A Global Outlook on the Pest Control Industry

The pest control industry is booming given recent global outbreaks of mosquito-borne diseases like Zika.
The pest control industry is booming given recent global outbreaks of mosquito-borne diseases like Zika.

Over time, an increased need for hygienic and pest-free environments has increased the need and demand for pest control services. Expected to grow at a healthy rate, the international pest control services market is intended to exceed US $22 Billion by 2026. Pest control is a process for managing or exterminating various living organisms which are harmful to human beings. Pests can include bedbugs, cockroaches, termites, reptiles and other unwanted organisms. These animals are considered “pests” because they interfere in residential, commercial, agriculture and industrial processes.

Residentially and commercially, living in a cockroach-infested house makes you more vulnerable to allergies, germs, and ultimately diseases. Cockroaches eat many types of material besides food scraps (paper products, clothing items, cardboard) and can adapt to an environment quickly and adopt high endurance levels that makes it even more difficult to get rid of them. Roach killer techniques can range from chemical control to mechanical control and pest control. Chemical control can be in the shape of a killer spray that contains toxic chemicals, poison gel baits that kill entire colonies or sticky glue traps where you can find out which areas are more infested than others depending on how many dead roaches you find on the trap. Because of recent concerns of health and environmental impact from customers however, companies have been using more organic chemicals.

Agriculturally, when rodents aren’t controlled, they can come overnight and completely destroy crops, causing widespread economic repercussions on the agricultural industry. They can inflict a large number of economic damage because of their population size, diversity and feeding habits. Agricultural pests are one of the number one key factors affecting small farm production. Industrially, pests can cause serious damage to existing structure and foundations (rotting wood or other soft materials). Sometimes the damage is serious enough that a whole structure can become useless, for example termites eating on a leg of a wooden table.

Although North America and Western Europe are currently the largest markets for pest control services, Asia-Pacific has a high-growth potential. Demand for pest control services could be attributed to the fact that there is a rise in international tourism and that various pests thrive in warmer climates. Some pests are displaying unusual migration habits due to both manmade and natural factors, such as global warming. Climate change not only affects farming practices, but also affects the distributions and life cycles of pests, disease-causing organisms and crop-pollinating insects and animals. Some insects and flying creatures are also multiplying at faster rates.

China and India have enough cultivable land to grow crops, factoring in the urbanization and technological growth in agriculture. People are looking into pest control services for crop protection to prevent and avoid losses. Emerging economies within the nation also mean higher standards of living and an increase in disposable income amongst the community, resulting in the continuous demand of hygiene and cleanliness.

One of the ongoing challenges the pest control industry is facing is how expensive the services are. Some people have resorted to studying reports by themselves and learning how to DIY the methods. It is important to note that however, research have shown that there is indeed a direct correlation between cleanliness and health. Patients admitted to rooms previously occupied by infected individuals are at a higher risk of acquiring these organisms from contaminated surfaces. This means improved hand hygiene can prevent multidrug-resistant organisms which has been recognized as one of the defining factors to outbreaks. Cleaning your home can help prevent pest outbreaks and also include benefits for good mental and physical health. Firstly, not only does it help to clear your airways, it also cleans all the places rodents can potentially habituate. The Environmental Protection Agency says that indoor air can be up to five times more polluted than the outdoors. Indoor air means we are breathing in dust mites, pet fur residue, pollen, mold, bug skeletons, toxins from cleaning products and chemicals from our own clothing and bedding. Secondly, the act of cleaning your house actually gives you sufficient exercise, leading to a healthier and more active life.

People who were surveyed reported that they get a better night’s rest when their sheets are freshly cleaned – a prevention and elimination of potential bedbugs. People who described their living spaces as “cluttered” are proven to be more tired and stressed out compared to those who have clean and organized rooms. Cockroaches find shelter in holes or cracks around window and door frames, water pipes and baseboards. If there is a hole in the water pipe, this leakage needs to be fixed immediately because water on the ground can lure the cockroach out. Brad Fischer, the District Service Manager at Batzner Pest Control says, “The real problem tends to come from the unseen areas, like a spill underneath an oven, or crumbs not being vacuumed along the walls in a dining area.”

How Far Is Too Far? The Booming Cosmetic Surgery Industry and the Never-Ending Strive for Perfection


In today’s hyper-perfectionist world, almost any cosmetic procedure can be performed to nip, tuck, lift or fill anything the patient deems to be “in need of fixing”. Labiaplasties can be performed improve the appearance of female genitals, belly button surgery can change “outies” to “innies” and eyelash transplants can solve the problem of thinning lashes. Eyelid procedures are common among women of Asian descent to form European eyelid creases. New mothers can return to their pre-pregnancy physique with a post-partum “mummy makeover” to lift and augment the breasts, tuck the tummy and remove unwanted fat.

Esthetics are not just for women. Men are increasingly large consumers in the cosmetic surgery industry, seeking perfect proportions, shapes and sizes in all parts. Gynaecomastia procedures, otherwise known as a male breast reduction, are being performed to improve the size of male breast tissue and correct for areola deformity. Washboard abs can be created with high-definition Vaser liposuction, touted as “a less invasive treatment alternative, with less pain and no skin damage”.

More alarmingly, adolescents are becoming increasingly fixated on perfection. Developmental changes during puberty can leave many young people feeling self-conscious. Given the ease with which surgery can be performed today, what was once a normal, albeit inconvenient stage of growing up, is now entirely avoidable. Breast implants are a growing trend in graduation gifts with parents giving implants to their graduating daughters before college. In the United States, the number of 18-year-olds who underwent breast-implant surgery nearly tripled from 2002 to 2003, to 11,326.

According to the American Society of Plastic Surgeons, 15.9 million surgical and minimally invasive cosmetic procedures were performed in the United States in 2015. Since the year 2000, the overall number of procedures in the United States alone has risen by 115 percent.

Last year, Americans spent $16 billion on procedures.

The cost of surgery has dramatically decreased with the rise of medical tourism, making procedures more accessible to the everyday consumer. A rhinoplasty no longer requires a lifetime of saving and can come with post-operative down-time in an exotic resort. Epidemiological data on medical tourism is difficult to obtain, though ongoing case reports and infection outbreaks serve as a reminder that it is not without risks.

These risks are of concern to public health professionals. Infection control policies in developing countries are often lax in comparison to developed countries. Mycobacterial infections have been recurrent in the Dominican Republic over the last five years, causing pulmonary and skin infections that can last up to 12 months. As drug-resistant superbugs continue to emerge in the United States, is it worth the risk of going under the knife in a less-developed country? Patients may also be at risk of infectious diseases more prevalent in other countries that can increase the cost of treatment and jeopardise the health of their family and friends.

An increasing body of evidence has found that Botox rapidly degrades bone density, putting patients at risk of fractures. Researchers at the University of Washington demonstrate their findings in mice, with the ratio of bone volume to tissue volume decreasing in the femur and tibia of injected limbs by 43.2% and 54.3%, respectively. The first study in humans confirms this finding, with maxillofacial radiologists observing decreased density in exposed patients.

Complications of cosmetic surgery are rare, but include infection, bleeding, fluid and salt imbalance, and allergic and potentially fatal anesthetic reactions. When PIP breast implants ruptured in a number of women throughout the world, the French manufacturer refused to pay compensation to those affected. Women who received the breast implants were faced with the cost of removal, leaving many unable to afford to remove or replace them. The impact on some patients was described as irreversible, imposing years of pain and anguish. The immune systems of some women were so low that they cannot undergo future surgeries, leaving them with a damaged version of the body they so desperately tried to change.

Surgical site infections (SSIs) are uncommon among patients in high-quality healthcare settings, however if pre-operative and post-operative procedures and antibiotics are not administered rigorously, infection can take hold. In Korea, despite having the largest per capita concentration of plastic surgeons in the world, a number of legal cases have been recorded for site infection resulting in health complications and the need for additional surgery.

In Sweden, a man in his thirties recently died during penis enlargement surgery. The process enlargement process routinely injects fat into the penis, though in this case caused an embolism resulting in cardiac arrest. Although treating doctors noted it was the first death among a healthy young man, others have spoken out against the procedure. A urologist from the Mayo clinic describes the procedure as “completely useless” that can lead to significant consequences including disfigurement and permanent erectile dysfunction.

Is perfection worth it? From a public health perspective, no.

Book Review: DragonKeeper by Carole Wilkinson

My mom bought me Dragonkeeper by Australian author Carole Wilkinson when it was first published in 2003 by Black Dog Books. Soon after, it was spun into a trilogy. A story about an ancient dragon and a slave-girl-turned-dragon-keeper’s perilous journey to get to their end destination while battling evil necromancers and greedy individuals, in the meantime creating valuable relationships and meaningful friendships; it provided a passageway to China. As I look at the publisher’s page, I see my mother’s handwritten note of the date and place where the book was purchased. Although I was eight years old when I first read it, it is a book that I return to.

Midway through the book, Ping, the book’s heroine, finds herself escaping a near-death experience as Chang’an villagers try to sacrifice her in hopes that the gods would gift them rain for their crops. Just when it seemed as if the gods were not going to answer, Danzi the dragon intervenes by flapping his wings, beating the clouds, creating rain, and allowing Ping to escape. Such moments endure not only for the rich plot but also for how the book portrays ancient Chinese life.  Wilkinson even provides a glossary of terms in the back of the book to guide readers, helping those who do not know what jujubes or chinaberry leaves are or when the Han Dynasty took place. She evocatively showcases different Chinese traditions, superstitions, as well as eating and living habits. For example, she offers a hilarious scene in which Danzi tells Ping that she smells, which Ping finds ridiculous since she had taken a bath three months earlier and did not see a need for another one so soon.

Most important, Wilkinson’s book reminds of a time when gender equality was lacking. In showcasing a young girl who was undermined from birth who eventually started to discover her strengths, learn to harness her weaknesses, and ultimately finds out who she was as a young woman, Wilkinson offers young readers hope and a positive role model with the need to persevere. A lot of people were hesitant to take Ping seriously as she was female. As the herbalist-ex-dragon keeper Wang Cao explains, “It has never been a female before.” Baby boys were seen as investments who could grow up to be strong and earn good money. Baby girls, in contrast, were seen as liabilities, quickly married off to other families. Although it is not, for the most part, prevalent in society now, existing older generations in Asia (in Korea, Indonesia, China, for example) can still maintain such views.

For me, Dragonkeeper is one of the must-read books of all time. Although coined as a children’s book, I remember grimacing at the gruesome, violent parts throughout the pages. Definitely not a Disney story, The Dragonkeeper deals with gritty issues like poverty, greed, and death. Wonderfully written, Wilkinson takes dark themes and spins them into a touching ending. With an extensive library at home, there are a few books that I return to again and again, but Carole Wilkinson’s Dragonkeeper is one of them.

Mentioned in this article: Dragonkeeper, Caroline Wilson, Best Advisor


What Does Kim Jong-Un Really Want in the North Korean Standoff?


Is there anything the US could give North Korea that would make it end its nuclear and missile programmes?

Given the escalating war of words between the US and North Korea, and Donald Trump’s warning of ‘fire and fury’ if Kim Jong-un overtly threatens the United States or launches missiles against the US territory of Guam, it is unclear how useful diplomacy is as tool for moderating regional tensions.

Secretary of State Rex Tillerson and other senior Trump administration officials have stressed the importance of diplomacy, and even Trump has in the past offered to talk to Kim, but there are no signs that the North Koreans are open to dialogue. Recent informal track-two level talks with North Korean officials in Europe suggest that Pyongyang is single-mindedly focused on continuing with its missile and nuclear-weapons testing programmes.

Strikingly at the Asean Regional Forum meeting in Manila recently, there was no meeting between Tillerson and Ri Yong-ho, the North Korean foreign minister, and a proposal for talks between Seoul and Pyongyang offered by Kang Kyung-wha, the South Korean foreign minister, was summarily rebuffed by the North Koreans.

In principle, there are incentives that the US could offer the North, including talks on a peace treaty ending the Korean War, preliminary steps towards diplomatic recognition (such as the establishment of a US liaison mission in Pyongyang), or an agreement on conventional arms reductions on the peninsula, but these are at best long-term objectives.

The North’s repeated violations of past diplomatic agreements with the US has eroded any appetite for concessions in Washington where there is deep-seated distrust of the North on both sides of the political aisle and an assumption that pressure, via the latest round of tougher UN sanctions targeting the North’s mineral and food exports, and restrictions on North Korean overseas labour, is the best way of bringing Pyongyang to heel.

Is North Korea’s ultimate or unswayable goal the possession of a nuclear deterrent?

Since coming to power in late 2011, Kim Jong-un’s priorities have been focused consistently on two simple objectives of military modernization and delivering economic prosperity for the North Korean public.

The North’s nuclear aspirations date from the 1960s and are consistent with the regime’s desire for political and military autonomy in the face of opposition not only from its traditional enemies such as the United States, Japan and South Korea, but also over the objections of its historical partners such as China and Russia.


Part of the North’s motivation is a rational assessment of the country’s strategic interests. The experience of Libya and Iraq is a reminder to Pyongyang that the only guarantee of national survival is the possession of a credible weapons of mass destruction capability. While Washington has expressed no ‘hostile intent’ to the North, Pyongyang maintains that the United States, as a conventionally superior and nuclear armed power, with 28,000 troops in South Korean, and a policy of maintaining a first-use nuclear option, represents a clear threat to the country.

Kim’s nuclear and missile testing ambitions are also an expression of identity politics. The legitimacy of the Kim dynasty’s political leadership is rooted in a narrative of defence against an implacably hostile United States. The 1950-53 Korean War, framed in North Korean propaganda as the result of direct US aggression, is used to depict the United States to the North Korean people as an adversary intent on destroying the country. For the country’s older generation that recall US actions during the war, when virtually every urban centre in the North was obliterated by American bombing, this narrative is a convincing one and is routinely reinforced for the wider population in the state’s daily political messages.

Trump’s recent bellicose public statements are a propaganda gift to Kim Jong-un, allowing him to bolster his standing as the nation’s commander in chief and protector of the country.

Could a nuclear-armed North Korea co-exist with the US?

The North’s accelerated missile testing campaign and last year’s two successful nuclear tests have materially enhanced the country’s deterrent capabilities. Recent intelligence reports from the US have suggested that the country may have as many as 60 nuclear bombs (a figure disputed by some analysts) and its long-range missile tests of 4 and 28 July indicate that the North may have the capacity to hit parts of the United States.

A recent report in the Bulletin of Atomic Scientists has questioned the extent to which this improved missile capability genuinely allows the North to deploy a nuclear warhead against the US, but there is little doubt that Pyongyang has made dramatic progress in the last year in securing full de-facto membership of the nuclear club.

Washington, however, has made it clear that it will not recognize or tolerate such a development. To do so would offer a propaganda victory to the North, critically undermine America’s relations with its key regional allies – Japan and South Korea – prompt a destabilizing arms race in the region, and destabilize the global nuclear non-proliferation regime.

Is any of what North Korea wants realistic?

Pyongyang’s priority is to push ahead aggressively with testing, both of its missiles and its nuclear weapons, in an effort to solidify its deterrent capabilities. For Kim, this makes sense as means of boosting his political authority and legitimacy at home. He can take comfort from China’s apparent reluctance to impose, serious crippling economic restrictions on the North, despite its recent support for tougher UN sanctions.

He can also calculate rationally that ultimately the United States, as many experienced observers are arguing, will accept the need to negotiate some form of intermediate freeze in the North’s military capabilities in the hope that this will stabilize the strategic situation while keeping the door open to future disarmament. By then, Kim may hope he will be able to secure a range of concessions from the US and South Korea, whether in the form of economic assistance, conventional arms reductions, or more importantly the political respect and status as an independent, sovereign state that the North has long craved.

The wild card in the current situation is how far President Trump’s rhetorical brinkmanship will deter the North from pushing ahead with its missile testing programme. The North Korean military has threatened to test fire four intermediate range missiles in the vicinity of the US military facilities on Guam later this month. No US president could tolerate a direct attack, but a test launch in the international waters close to the island would arguably represent a ‘grey zone’ contingency that would require a more nuanced response, stopping short of full-blown military conflict.

Discussions of the current stand-off have focused on the parallels with the Cuban Missile Crisis of 1962 and the strategic judgment of the US president at the time, John F Kennedy. His caution in seeking to avoid nuclear war was shaped by his reading of Barbara Tuchman’s book The Guns of August and its insights into the lessons of the First World War.

It is ironic and telling that once again August is a time of acute strategic risk and uncertainty, when the rhetoric, assessments and actions of national leaders are likely to carry profound significance for regional and global security.

This article was originally published by BBC News.

Citizens cry for help: Shortage of medical help in rural areas

One of America's few young doctors in rural Alaska
One of America’s few young doctors in rural Alaska

It’s an ongoing issue. States across America have struggled to entice and maintain well-trained medical physicians for rural communities. Although the federal government has implemented a few programs to rectify this problem, the shortage of doctors is still very much prevalent. The question we should all be thinking about is, how do we get health care professionals and trusted surgeons to willingly work in non-metropolitan destinations?

The federal government has been taking steps to provide programs that can solve the issue, and they have been receiving additional funding support from the 2009 American Recovery and Reinvestment Act and the 2010 Patient Protection and Affordable Care Act Legislation. The first is Area Health Education Centers which are community-based and patient-directed organizations that aim to provide comprehensive and quality primary care to communities with limited access to health care. According to the Federal Office of Rural Health Policy Updates dated August 3, 2017, the resource of the week was a video of two grantees sharing information and resources across different healthcare settings, especially in rural communities. Within the document, there sections encompassing of Rural Promise Neighborhoods funding opportunities and Public-private partnerships for rural health, among others. The third is National Health Service Corps already provides scholarships and loan-repayment programs for primary care providers practicing in rural areas. This itself should be a major incentive for students with huge amounts of loans, however, many doctors who graduated after years of difficult schooling are reluctant to go out of their comfort zone.

For doctors with families, they have to think about the comfort of their extended members, and how their spouse or child is going to assimilate in work and school. Rural patients also tend to be poorer, sicker and older who depend on Medicaid, the government health insurance program for the underprivileged. This means doctors won’t get reimbursed as much as if they were treating a patient with private insurance. Fresh medical school graduates are also petrified over the idea of being the only practitioner in a rural area because one needs to be ready to work 24/7.

Although doctors are quick to point out the cons, there are pros as well. Firstly, rural towns are generally smaller in population and geographical size and thus have less traffic and pollution compared to cities – this will ensure better quality of life, with access to wildlife and fresh produce. Secondly, rural towns will give the physicians a chance to really spend time with their patients and have experience with personable patient care, as compared to serving a big number of patients in a big hospital. Thirdly, because of inaccessibility of specialty hospitals or clinics nearby, rural physicians will receive expanded learning experiences and opportunities because they have to deal with a larger scope of illnesses, giving them the skills they could not have gotten if they were specialized in only one specific area in the hospital.

With a major incentive in loan reimbursement and benefits of working in rural communities, the number of physicians still remain low. 30 percent of primary care physicians in rural America are nearing retirement age while the younger physicians – under age 40 – account for only 20 percent of the industry. Approximately one-fifth of the United States’ population lives in a rural area, but only about 10 percent of the nation’s physicians are stationed there. This is considered to be one of the reason rural americans have higher rates of death, disabilities and chronic diseases than their urban sides.  

The federal government should quickly realize that its method of providing financial incentives is not going to be sufficient. They would need to expand to a package of incentives which may include increase in salary, enhanced opportunities for postgraduate education, better equipped and supplied health facilities, improved living conditions, clear transfer policies and ultimately proper scope for career enhancement. As President of the Odisha Medical Service Association (OMSA) Dr. Nirakar Bhatta says, “If a young doctor would get ample space for career advancement and promotions in his own state, he would surely prefer to serve the state government.”

Has Social Media Eroded Meaningful Relationships?


Social technology has enabled young Americans to be constantly connected, but has it defeated its purpose by eroding their ability to form meaningful personal relationships?

Ninety-seven percent of Americans aged 18 to 34 have access to smartphones, and almost 90 percent of them say they use at least one social media site. The millennial generation, also known as the social generation, is the most digitally connected. On average, they spend more hours texting, calling and using social media on their smartphones than any other group.

Recent research by psychologists and neuroscientists has given insight into why people, in particular adolescents and teenagers, are so hooked on social networking. The reasons are both psychological and biological. Engagement with social media releases Dopamine—the feel-good neurochemical that our brain produces after exercising, or after getting a compliment. It is the driving force behind our motivation to seek for pleasure and it is also the biggest culprit behind gambling behavior. In brain scans, the thrill that digital social interaction gives is comparable to a slot machine payout.

Researchers in a UCLA experiment last year found that a part of the brain’s reward circuitry called the nucleus accumbens becomes especially active when teenagers see large numbers of “likes” on their photos in a social network. It was the first experiment that scanned teenage brains while using social media. The nucleus accumbens is particularly sensitive during adolescence, explaining why pain and pleasure are most intensely felt during teenage years, and why gaining social approval and validation become highly important, whether online or offline. According to Neuroscientist Dar Meshi of the Free University of Berlin, the strength of the nucleus accumbens’ response to positive social feedback could even predict how intensely a person will use social networking sites.

Individualism and independence are traits highly celebrated in our modern society, but human beings are by nature social animals. For as far back as we can trace the origin of our species, we have always lived in tribes. Our most unique characteristic is our ability to cooperate flexibly and effectively on a massive scale. We create and act on collective fictions of religions, nations and money on the same basis that we find it secure to be in groups. As interdependent beings, we rely on our connections with others not just for survival, but for our well-being.

Danah Boyd, author of It’s Complicated: The Social Lives of Networked Teens, wrote, “Most teens aren’t addicted to social media; if anything, they’re addicted to each other.” Being constantly connected has caused a dependence on the presence of others for validation in the most basic ways, yet many of them have yet to learn that building trust, intimacy and depth in relationships beyond the screen takes time. It also requires the courage to be vulnerable in building genuine relationships. It has become all too easy to resort to the illusion of companionship given by electronic devices, to turn to a smartphone and to exchange the emotional risks that come with interacting with others for a constant supply of chemical rewards. Many teens say they don’t know how to have a face-to-face conversation, that they prefer to communicate over text because actual conversations reveal too much. They become overwhelmed with anxiety over not having control over what they want to say. How did communication, the most fundamental nature of human behavior, suddenly become so complicated?

These phenomena are precisely what makes social media so impactful on millennial culture and so exploitable for modern businesses. A digital marketing agency can use such research for targeted advertising, while politicians leverage such information for political campaigns (Trump and Twitter, for example). The young generation now lives in a “perfectionist culture” where people’s identities are reduced to retouched photos and perfectly-crafted narratives at the expense of their raw and authentic selves–and at the expense of genuine human connection. It is the same culture that Brene Brown, a research professor who studies human connection, blames for the sense of emotional disconnection pervasive among young adults, especially Americans. As a result, “We are the most in-debt, obese, addicted, and medicated adult cohort in US history.”

In letting a false sense of connection rob young people of their solitude and self-reflection, they rob themselves of their capacity to grow and form genuine and meaningful relationships. Millennials have the most preoccupation with themselves and how they are perceived, but they have yet to explore themselves fully and accept their flaws. They are the most addicted to each other, but they don’t know how to form real relationships. They seek to be constantly connected, but they feel unworthy of human connection. Millennials are perhaps the embodiment of the modern day paradox: they are so connected, yet so disconnected.

Booming Cybersecurity Industry Highlights the Threat of Cyber Crimes

Young hacker in data security concept

Digital technologies have become a critical enabler for economic growth and societies now place heavy reliance on the internet. The digital world has brought not only enormous benefits, but with these benefits also come significant vulnerabilities. Cybersecurity incidents are increasing at an alarming rate and are impacting on societal norms, essential services, and organizational welfare. The rate of cyber crimes has grown exponentially and is consistent with the expansion and evolution of technology.

The proliferation of cyber attacks is causing widespread damage to companies, governments, and individuals. Cyber-attacks range from denial of service attacks, website defacements, to access to sensitive information and attacks on critical infrastructure. The recent WannaCry malware incident affected many, affecting over 230,000 computers in over 150 countries in the span of a day. WannaCry targeted computers running Microsoft Windows by encrypting data and demanding ransom payments in Bitcoin cryptocurrency. Large organizations with presumably good cyber security were affected – among them, the United Kingdom’s National Health Service (NHS), Spain’s Telefónica, FedEx and Deutsche Bahn were affected. A particularly high profile incident that arguably had an impact on the recent election campaign, was Hillary Clinton’s private emails becoming front-page news in the midst of her presidential campaign.

A screenshot of the malicious WannaCry message that sent cyberspace into disarray.
A screenshot of the malicious WannaCry message that sent cyberspace into disarray.

The ever-increasing number of cyber attacks are costing organizations large amounts of money to address and prevent them. However, the delay in operations and the potential domino effect it will have on their customers could cost the company much more in money and reputation. It isn’t just the number of cyber security attacks that is increasing. The degree of these attacks is on the rise as well. PwC reported that these attacks are “becoming progressively destructive and target a broadening array of information and attack vectors.”

Digitization is quickly increasing the impact that these cyber attacks can have and the channels in which they propagate. With the expanding number of services available online, businesses are particularly vulnerable to increasingly sophisticated attacks. An example is a vulnerability as a result of the trend toward migrating data to the cloud. A publication by White & Case outlines some of the vulnerabilities as a result. The migration of data to third-party cloud providers creates a centralization of data – this creates more opportunities for misappropriation of stolen data from a single attack. Similarly, the emphasis on mobile services has opened up corporate systems to more users, exposing sensitive data that can have regulatory, reputational, and financial impacts. With the boundaries between digital and physical realms being increasingly blurred – particularly so with the evolution of the Internet of Things, the possibility that appliances and physical objects we interact with every day can be compromised. Hackers can exploit these devices to conduct data breaches, corporate or government espionage, and damage critical infrastructure like electrical grids.

With US federal agencies and other governmental agencies around the world under pressure to increase their levels of security to defend against crippling cyber attacks, businesses are expected to follow suit when regulatory pressure increases in response to increasing public awareness. Governments are already tightening regulation to ensure businesses take greater responsibility to prevent and detect cyber security breaches, for examples through tackling malicious VPN use. In the United States alone, 47 states have laws requiring breaches that result in the theft of customer data. A key policy that governs this area in the United States is the Data Security and Breach Notification Act of 2015, a companion to the Consumer Privacy Bill of Rights Act of 2015 that governs the collection and dissemination of consumer data. The European Union have also introduced similar regulations.

“Similar to other compliance areas, board directors can be held liable for not discharging their duty to prevent harm to the corporation. In performing their oversight role, directors should stay informed about the corporation’s cyber security defenses. They must ask what the risks are and determine what needs to be done to mitigate them. In today’s connected world, it is, unfortunately, becoming a question of ‘when’ rather than ‘if’ some sort of data breach will occur.” Detev Gabel, a partner at White & Case in Frankfurt and leader of the Firm’s Data, Privacy and Cyber Security Group.

New technologies and services such as dual authentication, phishing detection, and advanced encryption improve the defence against current threats. However, as these have become widespread, cyber criminals will look to shift their focus to other unidentified vulnerabilities. While the focus has predominantly been on purchasing and deploying technical controls, a risk culture around cyber security is key to fortifying cybersecurity in the organisation. A strong risk culture enables the organization to actively identify and prevent threats. Cybersecurity culture is defined by Rod Turk (Director of Ofefice of Cybersecurity) as “making sure that users — top to bottom, right to left — [are] keeping cyber security in their thought process no matter what they’re doing in the IT world”. Organizations need to ensure focus on individual responsibility and spread awareness of the role that each individual employee plays in ensuring that the organization is protected against cyber attacks. They need to address the need to educate employees on how the cyber security dots are connected to the organization’s ability to achieve its business objectives and avoid financial loss, regulatory implications, and reputational impacts.

Cyber crime is a threat to all organisations – it is up to business leaders to recognise the potential threat to ensure that their organisation is adequately prepared and protected from the risks associated with it.

How The Digital Age is Globalizing Business


The expansion of trade has existed for millennia. Academics and economists contend that globalization, which has only gained relevance as a concept in the last decade, is as old as civilization itself. The concept of exchange, the underlying basis of market dynamics, was founded in primitive human societies. Markets began to merge as trading networks expanded and access to resources was made easier. As the Mercantilist and the Industrial revolution took place, growth and productivity continued to escalate. However, the a new commercial reality sparked by the digital age has emerged , characterized by widespread, and readily accessible sharing of information. This new era has transformed the commercial landscape into one which allows for unparalleled acceleration of globalization like never before.

According to a study conducted by Mckinsey, one in three goods now crosses national borders, and more than one-third of financial investments are international transactions. Time and geographical boundaries cease to be limiting factors in today’s business environment. The tremendous technological advances in transportation have reduced the barrier of distance a main catalyst in the development of global economics over the course of history. Over time, this has also steadily decreased the cost of distribution. A second major force shaping today’s economy is the internet, which has reduced barriers to communication. Through focusing on the online market and SEO, business is now borderless. Sales, inventory, competitor’s prices and new products now no longer have to rely on physical and unpredictable means of communication. More recently, is information communication in real-time.

One great example is the Internet of Things (IoT) which gives businesses the ability to monitor and manage objects in the physical world, digitally. This has remodeled logistics and supply chains, increasing efficiency. The technology of which the IoT is founded on, is Radio-Frequency Identification (RFID). RFID is now widely used for tracking and collecting information about a product, place, time or transaction. RFID uses electromagnetic fields to automatically identify and track tags attached to objects. Manufacturers and oil and gas companies, among others have improved their operating efficiency and reduce costs by implementing IoT technologies in their operations.

The development of information technology has also given rise to different digital platforms that makes cross-border production and exchange a lot more possible than they previously had been. In 2014, global e-commerce sales reached over US$1.3 trillion—nearly 2 percent of global GDP. About 40 percent of Amazon’s net sales in 2014 came from sales outside North America, and China’s leading e-commerce platform that includes marketplaces for business to business (B2B); business to consumer (B2C); and peer to peer (P2P) e-commerce, declared gross merchandise value of a whopping US$370 billion during the same year. These platforms allow smaller companies to participate in exporting and importing, and even compete with the largest multinationals. An MGI survey revealed that 86 percent of tech-based startups report some type of cross-border activity. Even global labor markets are being impacted by online marketplaces. Websites like and UpWork reduces yet another barrier in today’s unified global community by bringing jobs to talents abroad without requiring them to relocate or go through immigration.

The growth of the digital trade has thrusted us into yet another different era of knowledge economy, characterized by increase in high-technology and intangible investments, high-technology industries, more highly-skilled labor and associated productivity gains, rather than on the means on production and tangible capital ( This has led to the emergence of new technology giants in industries where they had not previously been viewed as competitors. Consider Airbnb’s entry into the hospitality industry. The multi-platform technology platform has served over 30 million guests since its inception in 2008. Its current value of $10 billion now exceeds well-established global hotel chains such as Hyatt.

Today, over 2.3 billion people have access to the internet and this figure is expected to grow to five billion in the next few years. Some of the most valuable companies in the world have been underpinned by its existence. In developed countries, availability of the internet results in increased standards of living and job creation. The innovation of digital technology has become a key contributor to economic growth in developed countries. The potential for digital and information technologies is limitless, and will play a key role in the development of humankind’s potential.

The Untold Story of Silk Road and America’s Devastating Online Drug Industry

Ross Ulbricht: the mastermind behind America's grimacing online drug industry.
Ross Ulbricht: the mastermind behind America’s grimacing online drug industry.

The business environment has been drastically transformed by the rise of digital technology. Today, the name ‘Silk Road’ no longer depicts the textbook definition of the ancient network of trade routes. To tech-savvy millennials, ‘Silk Road’ refers to a massive online marketplace for illicit trade, mostly drugs. The website was hidden in what is called the Dark Web—a part of the internet that can’t be accessed through search engines like Google. To enter this mysterious cyber realm, you need special cryptographic software that obscures your online identity. But aside from that, the right amount of dedication and perhaps access to Reddit, it doesn’t take much else for anyone to enter and navigate the deep web.

The mastermind behind Silk Road was a 26-year-old kid from central Texas. After earning a scholarship to the University of Texas at Dallas, Ross Ulbricht landed a graduate scholarship at Penn State, where he studied materials science and engineering. A carefree idealist, he adhered to a libertarian philosophy and spent his college days exploring Eastern philosophy. Bright, handsome, and edgy, Ross Ulbricht was a Pablo Escobar in the digital age. At the peak of his success, Ulbricht lived in Glen Park, San Francisco where he would run his virtual drug empire out of little coffee shops and libraries. Only that the magnitude of his startup’s success justifies his comparison against the Colombian drug kingpin. Through a combination of Tor (The Onion Router) anonymous browsing and enticing web design, Silk Road managed to rack up more than $1 billion dollars in sales in two years.

A screenshot from Silk Road's glory days. The site is now shutdown.
A screenshot from Silk Road’s glory days. The site is now shutdown.

The combination of an anonymous interface with traceless payments allowed thousands of drug dealers and nearly 1 million eager worldwide customers to connect —The internet has not only affected how business is conducted, it has also reshaped the criminal landscape. As the first online platform for the drug trade, Silk Road represented an unexplored intersection between technology, commerce, and drugs. This was a serious threat to law enforcement agents. Various governmental organizations spent over a year attempting to infiltrate the organization. When the site was taken down in 2013, the closure took out 13,648 different drug deals.

Ulbricht was sentenced to life in prison without parole. Fast-forward five years later now, and the explosive growth of the industry is proof that the giant crackdown was ineffective as a deterrent for illicit activity on the dark web. The online black market continues to evolve and now turns over $100 million of illegal substances a year. This “invisible” network now boasts dozens of boutique single-vendor sites selling high-quality cannabis, LSD, or cocaine to a closed network, and some offer membership discounts to regular buyers. Adam Winstock conducted the Global Drugs Survey, the largest inquiry into drug-user habits, and revealed that “convenience, product choice, price and user ratings make buying drugs online attractive to some users”, and growth in this industry is reflective of the growth of e-commerce as a whole.

With fatal adulterants found in recreational drugs off the street, the communal nature of many of the sites which assist in the regulation of drug purity provides users a safer way of obtaining drugs. This was exactly the idea which had inspired Ulbricht to create ‘Silk Road’. Like most libertarians, Ulbricht believed that drug use was a personal choice and that the war on drugs was entirely futile. The problem lied in the drug business that was opaque and violent, and that a website like Yelp would make exchanges more transparent and reduce fatal overdoses. Ulbricht also wrote that his intention was to reduce the power of cartels by empowering nonviolent, small-time dealers. According to a paper published online by academics, the crypto market may have prevented bloodshed that would have occurred in the street. Online drug trade focused far more on less addictive and harmful drugs than might have been previously assumed: “Drugs typically associated with drug dependence, harmful use and chaotic lifestyles (heroin, methamphetamine and crack cocaine) do not much appear, and generate very little revenue”.

The full effect of the online drug industry on society is still unknown. The key question is how this industry is governed in the future. Loopholes in legislation were arguably the catalyst for this industry to begin with.