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Volunteers such as this woman -- who's with a group that calls itself "Las Patronas" -- throws bags of food and water to migrants in Veracruz, Mexico, who are headed toward the U.S.-Mexico border. (Courtesy of Deborah Bonello)

Who Are The Kids Of The Migrant Crisis?

by NPR staff
Jul 24, 2014 (All Things Considered)

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Since last October, a staggering 57,000 unaccompanied migrant children have been apprehended at the southwestern U.S. border. Sometimes, they've been welcomed into the country by activists; other times they've been turned away by protesters.

President Barack Obama has called the flood of migrant children seeking refuge from violence and poverty in Central America a "humanitarian crisis at the border," bringing an international spotlight to a phenomenon that, for years, has been largely ignored. Earlier this month, he requested $3.7 billion from Congress to react to the crisis and urged Central American leaders to discourage more children from attempting the dangerous journey through Mexico, where they are targets for local criminal gangs and drug cartels.

The number of migrant children hailing from Honduras, El Salvador, and Guatemala has more than doubled since last year. But who are these young people? And why are they coming to the United States in ever-greater numbers?

Elizabeth Kennedy, a Fulbright Scholar in El Salvador, has some answers. As part of her research in the capital, San Salvador, on unaccompanied minor migrants, she interviewed more than 500 children and adolescents as they returned to El Salvador after being deported from Mexico.

She tells NPR's Robert Siegel that many of them are desperate.

"These are the most dangerous places in the world," Kennedy says. "The only place that has a higher murder rate than Honduras is Syria."

Of the 322 interviews she's analyzed, Kennedy says 109 interviewees "received direct threats that they could either join a gang or be killed."

In most cases, Kennedy says, kids and teenagers leave Central America to avoid climbing levels of gang violence, extortion and drug trafficking. Sometimes, it's to find their family. Ninety percent of the young people she's interviewed have relatives in the U.S.; of those, half have one or both parents there.

The Mexican government has recently announced a new initiative to step up control of its southern border. Kennedy says El Salvador is feeling the effects. The migrant return center where she works has gone from receiving one or two buses of children twice a week to receiving more than six a week.

But, Kennedy says, those kids will try again. She interviewed a 12-year-old boy who returned to El Salvador barefoot; he had been robbed of everything he owned.

"I asked him if he was going to try again," Kennedy says. "And he just burst into tears and said, 'What would you do if you were me? I haven't seen my mom or my dad in 10 years ... and no one here loves me.' "

If the children have family in the U.S., they can often afford to pay a smuggler to get them across the border. If a family is too poor to afford a coyote, however, the child will often try to ride on a network of trains that run the length of Mexico, known as "La Bestia" — The Beast.

Deborah Bonello, a freelance video journalist in Mexico, says that riding The Beast is a dangerous undertaking. Because it's a cargo train, not a passenger train, migrants have to jump on while the train's moving and climb onto the roof. Many have lost limbs; others have lost their lives.

And there are other dangers.

"Criminal groups are charging a tax now to migrants who want to ride the train, and if you can't pay, you basically get thrown off," Bonello says. "And it's half a day, a day on the train so if the train doesn't stop, they have no access to food."

Migrants riding La Bestia often have to rely on charity. Bonello says that groups like the women who call themselves "Las Patronas" throw food to migrants as the trains go by.

If they make it to the U.S.-Mexico border, children are readily giving themselves up to U.S. agents, crossing the Rio Grande on inner tubes and tires. They will be encountering even more patrols in the coming weeks; Texas Gov. Rick Perry has announced that he's sending 1,000 National Guard troops to the Texas-Mexico border.

These children hope their long journey will end here, when they surrender to U.S. officials — but as they head to crowded detention centers to await immigration court hearings, it may be just beginning.

Writing and research was contributed by Caroline Batten and Nicole Narea.

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Metropolitan Opera General Manager Peter Gelb has warned union workers of a lockout if a contract deal isn't settled by July 31. (Getty Images)

Labor Conflict May Lock Out Met Opera Workers

Jul 24, 2014 (All Things Considered)

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The clock is ticking for the Metropolitan Opera in New York. The world's largest opera company may be headed for a shutdown. Most of the union contracts for the Met expire in a week. Yesterday, Met General Manager Peter Gelb sent a letter to the unions, warning them to prepare for a lockout if they don't come to terms.

For months now, the company and its unions have been at an impasse. Management has proposed cutting 16 percent of union members' compensation. Otherwise, Gelb contends, the company could go bankrupt in two to three years.

"The fact of the matter is that two-thirds of our costs are driven by our union payments," Gelb says.

Gelb is not proposing cuts to base salary, but overtime, health and pension benefits. The musician's union says its members could actually see cuts of twice that after they crunch the numbers, according to Jessica Phillips Rieske, acting principal clarinetist of the orchestra and a member of the bargaining committee.

"Actually, the cuts that we're talking about would be more like 25 to a worst-case scenario of 37 percent," Rieske says.

Since Gelb took over the Met in 2006, the company's budget has ballooned to more than $325 million. He's doubled the amount of new productions and he's created high definition broadcasts that bring Met performances to movie theaters around the world.

"When I took over the Met," Gelb says, "the budget was about $200 million a year and we invested in new efforts to help make the opera more accessible and more successful."

More successful, but revenues from those efforts have not come close to matching expenses, so Gelb is more dependent than ever on private and corporate donors. "We had to raise about $150 million in the last fiscal year in annual donations to make ends meet," he says. "And that's a level that our donors are not willing to continue to bear."

The unions counter that Gelb has been reckless in his spending and now they're being asked to pay the tab. They say that all this new activity has triggered costly overtime payments and the expensive new productions haven't filled the theater.

"We consider the Met Opera our family," says D. Joseph Hartnett of the International Alliance of Theatrical Stage Employees. He's at the bargaining table for the six unions that represent the stagehands, wardrobe workers and box office personnel, among others. "We feel that, just as any family that has a budgetary crisis, everything needs to be on the table. And that includes Mr. Gelb's spending. And if we're being asked to tighten our belts, Mr. Gelb is gonna have to cut up some credit cards."

One credit card is Gelb's salary, which is roughly $1.4 million. Unions say Met management has withheld crucial financial information that would help them negotiate. And they contend that Gelb has wanted to lock them out all along. But Gelb says a lockout isn't the point.

"But more important than even the opening night is that we fix this economic problem that the Met has," Gelb says, "so that we have many opening nights in the years to come."

All of the unions have bargaining sessions scheduled in the coming week. But if they don't reach an agreement, a lockout would almost certainly delay the Met's opening night in September.

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Noah Hawley (left) and Warren Littlefield, executive producers of the FX series Fargo, speak at Television Critics Association's summer press tour. (Getty Images)

5 Things I Learned About TV's Future From The Critics Press Tour

Jul 24, 2014

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The voice came from over my shoulder; a shouted greeting in a room crowded with journalists, publicists, network executives, producers and stars.

I tuned to see David Boreanaz, star of the Fox TV show Bones, calling out to me like a long lost friend. I knew he had mistaken me for someone else — in a party held by Fox at the exclusive Soho House club, where everyone from Kelsey Grammer to David Tennant was sipping cocktails and talking shop, it wasn't hard to make that kind of mistake.

I shook his hand, reaching over a clutch of fellow journalists to give him a smile before walking on. It wasn't until he posted a sheepish note online that I found out that he thought I was a superstar bassist turned American Idol judge.

Crazy as it sounds, these are the kind of experiences you can have at the Television Critics Association's press tours, where TV stars, journalists, producers and executives are mashed together by a two-week blizzard of press conferences, cocktail parties and special events.

The value of the press tours, which happen in January and July, can vary for each journalist. But at its best, the TCA press tour allows an up-close look at the TV industry in ways few other big business institutions allow. (Imagine a two-week event where all the leaders of the auto industry hang out with the journalists who cover them, and you have an idea of how odd this event seems outside hype-dependent Hollywood.)

One minute, you can be commiserating with Andre Braugher on the set of Brooklyn Nine-Nine about transitioning to comedy, and the next you can be publicly pressing CBS entertainment head Nina Tassler on why there is so little ethnic diversity among lead characters in its new shows.

Or you can be explaining to a celebrity how you are not the guy who says "yo" and ends every sentence with "dawg."

But the question that consumes us all annually, and this year in particular, is simple: Where is TV's future?

It's embedded in every question to a TV executive about casting diversity, or to a producer about what distinguishes a miniseries from a series, or to an actor about why they chose a television project over a movie deal.

There is a sense in Hollywood that the TV industry is exploding in slow motion, swelling to accommodate newer players like Netflix, Amazon, Yahoo and Xbox, with little sense of where the endgame may lead.

As the press tour ends this week, here's what I found out about the future of television.

1: No one knows anything about TV's future, except that there will be more of it. The only certainty is that more players are making more original TV shows in an effort to make their media platforms more attractive to their target audiences.

That means video game developers are hiring producers from scripted TV shows to craft the storylines for their top games, and that video game makers like Xbox and PlayStation are joining websites, cable channels and networks in making new shows.

Which means that the biggest problem most may face in the immediate future is getting noticed amid the deluge.

2: Despite all the new TV, the actual structure of television episodes isn't changing much. Watch one of the eight drama pilots Amazon picked to turn into series and you'll see very little deviation from the structure of most traditional TV shows: They last about an hour, they have close to the same production values, they slot neatly into a genre — cop drama, family drama, sci-fi drama and so on.

One reason may be that creators of these new shows are trying to sell them to many different outlets at once, which means the shows have to be in a format that cable TV, the networks or an online service all can easily program.

"We treated Hulu like any (other) TV network," said Paul Scheer, an actor and producer (The League) who serves as executive producer and appears in the Hulu series The Hotwives of Orlando. "We pitched the show to a few different people. ... Hulu came to us and was the most passionate to let us do this show. But we treat it the same way that you would treat any other network. So there are restrictions within some of the things that we can do. We can't show nudity. We can't have cursing. We're not pay cable."

3: No one can really agree what a series is anymore. The big story of the summer is that three different, Emmy-nominated programs violated the traditional rules of TV series structure.

HBO's True Detective, which earned Emmy nominations as a drama series, will return next year with new stars, new actors and a new setting. FX's American Horror Story: Freakshow, nominated for Emmys as a miniseries, also returns next season with a new story and new setting, but with many actors from past AHS incarnations playing different roles and a new guy, The Shield alum Michael Chiklis, joining the cast.

And FX's Fargo also will return next year without superstars Billy Bob Thornton or Martin Freeman, but with a new story set in 1979 — nearly 30 years before the events of this season — and centered on Season 1 hero Molly Solverson's father as a younger man.

Such structures allow big stars, who normally wouldn't stop doing films to tackle quality TV projects, to shoot for shortened periods of time. But the resulting confusion about terms like "limited series," "miniseries" and "anthology series" have left people in the industry a little confused.

"Part of what we're trying to embrace about this idea and this show is it's an anthology ... and we want to take the leap. We want the creative challenge," said Warren Littlefield, once the head of entertainment for NBC, who now serves as an executive producer on Fargo. "It's a lot easier saying, 'the cast comes back, and we're going back to our standing sets.' ... (But) everything we did was kind of making a 10-hour movie. And that challenge, I think, brought out the best in us, the best in all the talent, from our crew, from all the local talent that was a part of it. I think somehow we must be gluttons for punishment."

4: Some TV networks still haven't gotten the memo on diversity. ABC saw fewer pointed questions about its ratings during press tour as critics noted their astonishing level of diversity in new shows; six new shows with either non-white characters as leads or co-leads or a non-white person as the show creator.

But CBS still seemed mired in the past on that score; just one of its new shows features a person of color as a co-lead, while its NCIS spin-off set in New Orleans — a city where more than 60 percent of the population is black — has just one black person in the core cast.

"We don't look at fall as the defining mark of giving us our diversity quota," said Tassler, chair of CBS Entertainment, suggesting that summer series starring Halle Berry and Cote de Pablo could pick up the slack for fall and winter TV seasons sorely lacking in diversity. "We look at the entire year; we look at the entire daypart. And if we don't reach, if we don't have as diverse casts as we would like to going into the season, we see where we can add."

5: No one knows how to make lots of people watch smart, critically adored comedy. It's a frustrating paradox for critics; some of TV's smartest comedies don't draw big audiences, including NBC's Parks and Recreation and Community — both shows shot with a single camera, like a movie. Instead, comedies filmed live with several cameras and staged like plays — such as CBS' Two and Half Men, Big Bang Theory and The Millers — seem to draw the big numbers

But Mike Schur, executive producer and co-creator of another smart comedy that's struggling for an audience, Brooklyn Nine-Nine, suggested one show has cracked the code: ABC's Modern Family.

Modern Family, Schur said, has the rapid-fire joke rhythm of a multiple camera comedy, but is filmed with a single camera for a more sophisticated look. The result is a sitcom with the rhythms of a broadly popular comedy but the feel of a better-crafted product — resulting in great ratings and Emmy nominations.

Bob Greenblatt, chair of entertainment for NBC, noted something similar when asked why broadcast networks haven't created shows as acclaimed as True Detective or Fargo.

His answer: Too few people will watch that kind of show for a broadcast network to consider it a success. He used their own critical favorite, Hannibal, as an example.

"I don't know why 5 million people or 8 million people won't watch Hannibal on a broadcast network," Greenblatt said, citing the number of viewers needed to make it a hit on NBC. "Three million might watch it on Showtime or 2 million on another cable network, and that's okay. The minute you try to do something that is dark and subversive and frightening and gets into that territory, you start to peel away the mass audience. It's just the way it is — because the quality of (Hannibal) is undeniable."

Time for somebody to crack the code for the networks, again...

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Noah Hawley (left) and Warren Littlefield, executive producers of the FX series Fargo, speak at Television Critics Association's summer press tour. (Getty Images)

Botched Ariz. Execution Renews Unease Over Lethal Injections

Jul 24, 2014 (All Things Considered)

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When weighing the risk of heart disease, how the numbers are presented to patients can make all the difference. (iStockphoto)

For Better Treatment, Doctors And Patients Share The Decisions

by NPR staff
Jul 24, 2014 (All Things Considered)

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A tool to assess heart attack risks changes in response to treatment choices patients might make.

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Many of us get confused by claims of how much the risk of a heart attack, for example, might be reduced by taking medicine for it. And doctors can get confused, too.

Just ask Karen Sepucha. She runs the Health Decisions Sciences Center at Boston's Massachusetts General Hospital. A few years ago she surveyed primary care physicians, and asked how confident they were in their ability to talk about numbers and probabilities with patients.

"What we found surprised us a little bit," Sepucha says. "Only about 20 percent of the physicians said they were very comfortable using numbers and explaining probabilities to patients."

Doctors, including Leigh Simmons, typically prefer words. Simmons is an internist and part of a group practice that provides primary care at Mass General. "As doctors we tend to often use words like, 'very small risk,' 'very unlikely,' 'very rare,' 'very likely,' 'high risk,' " she says.

But those words can be unclear to a patient.

"People may hear 'small risk,' and what they hear is very different from what I've got in my mind," she says. "Or what's a very small risk to me, it's a very big deal to you if it's happened to a family member."

Simmons and her colleagues are working on ways to involve their patients in shared decision-making. The initiative at Mass General gives patients online, written and visual information to help them. One of the goals is to make risk understandable — bridging the gap between percent probabilities and words.

Dots Help Decide

Simmons tried it with her patient Joe Bianco, 60, when talking over his risk for heart disease a few weeks ago. Rather than just using a number to tell him his risk for a heart attack, she made it visual with this statin/aspirin decision aid calculator, developed by the Mayo Clinic.

The calculator displays 100 green dots arranged in a 10-by-10 grid. Each has a little smile on it and symbolizes a person. Once a patient's information is entered, some of the green dots turn yellow and some smiles may turn upside down into frowns, indicating in the next 10 years, how many people are expected to have a heart attack.

When Bianco's profile is submitted, 12 dots turn yellow and 88 remain green — meaning 12 percent of men like him will have a heart attack within 10 years. "It looks like my chances are slim," he says.

Bianco had decided earlier not to take a cholesterol-lowering statin medicine to lower his risk of a heart attack. The dozen frowning yellow dots don't change his mind.

Next, Simmons enters another factor into the online calculator. What if all 100 men fitting Bianco's profile take a statin drug every day for the next ten years?

The number of yellow dots on the screen — the percent who will have a heart attack — changes for the better.

"That number goes down to seven — so five people are saved from a heart attack by taking a medication," Simmons says. "Some people look at that and say, 'Well that's almost cutting the risk in half.' Other people say, 'Well, that's still 88 people who didn't benefit either way. And only five who had a benefit.'"

For Bianco, seeing the graphic validated his previous decision not to take medicine. And for Simmons, as a doctor, it's made that conversation easier.

Numbers Still Valuable

But the graphics and words alone don't work for everyone. At Mass General's orthopedics department, Jim Westberg of Nashua, N.H., has come to see surgeon Andy Freiberg, who is in charge of hips and knees.

Westberg is very active at 59. He hikes, swims, skis and rock climbs when he's not at work, selling 3-D printers. He wants a hip replacement and in the course of examining him, his doctor cites some numbers.

"Your risk of infection is probably under 1 percent, probably half a percent," Freiberg tells him.

That the risk is less than 1 percent doesn't deter Westberg. Before his appointment, he had received a shared decision-making packet that included a booklet and a DVD, all about hip replacement. He also did some other research and — just as importantly — talked to people he knew who had had the surgery and were thrilled with the outcome.

For him, Westerberg says, the numbers and percent probabilities are still valuable.

"I think they're fairly important because I actually have an engineering degree," Westerberg says. "I have a technical background so maybe I'm a little biased, but numbers do mean something to me. The risk we talked about, half of 1 percent, really doesn't concern me that much."

What Is 'Very Common'?

The Food and Drug Administration also likes numbers and urges drug companies to give numerical values for risk — and to avoid using vague terms such as "rare, infrequent and frequent."

But the European Medicines Agency (a part of the European Union) has matched a scale of terms — very common, common, uncommon, rare and very rare — with numerical definitions for each of those five levels of frequency.

So, what percent of cases qualified for the top level "very common" side effect? You might think over 50 percent, but according to those EU definitions, a side effect is "very common" if occurs in more than 10 percent of cases.

And if a drug label says that a particular side effect was "very rare"? That means it occurs in fewer than one in every 10,000 cases.

This is part four of an All Things Considered series on Risk and Reason.

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