US aid workers sick with Ebola leaving Africa

Members of Doctors Without Borders (MSF) wear protective gear at the isolation ward of the Donka Hospital in Conakry on July 23, 2014. Photo: CELLOU BINANI/AFP/Getty Images

Mike Stobbe

NEW YORK — When two U.S. aid workers infected with Ebola arrive in Atlanta from Africa, they will be whisked into one of the most sophisticated hospital isolation units in the country.

The specialized unit at Emory University Hospital was opened a dozen years ago to care for federal health workers exposed to some of the world’s most dangerous germs.

Now it’s being pressed into service for the two seriously ill Americans who worked at a hospital in Liberia, one of the three West Africa countries hit by the largest Ebola outbreak in history.

One of the aid workers is due to arrive Saturday, and the second a few days later, according to officials at the hospital. They are travelling in a private jet outfitted with a special, portable tent designed for patients with highly infectious diseases.

A picture taken on June 28, 2014 shows a member of Doctors Without Borders (MSF) putting on protective gear at the isolation ward of the Donka Hospital in Conakry, where people infected with the Ebola virus are being treated.

It will be the first time anyone infected with Ebola is brought into the country. U.S. officials are confident they can be treated without putting the public in any danger.

The Emory hospital unit is located just down a hill from the Centers for Disease Control and Prevention. It is one of about four such units around the country for testing and treating people infected with dangerous, infectious germs.

The unit has its own laboratory equipment so samples don’t have to be sent to the main hospital lab. Located on the ground floor, it’s carefully separated from other patient areas, said Dr. Eileen Farnon, a Temple University doctor who formerly worked at the CDC and led teams investigating past Ebola outbreaks in Africa.

The two Americans — Dr. Kent Brantly and Nancy Writebol — worked for U.S. aid groups Samaritan’s Purse and SIM at a Liberian hospital that treated Ebola patients. Late last week, the North Carolina-based Samaritan’s Purse said Brantly, 33, had been diagnosed with Ebola. Then, Writebol’s infection was disclosed.

Health workers walk in an isolation center for people infected with Ebola at Donka Hospital in Conakry on April 14, 2014.

The government is working to ensure that any Ebola-related evacuations “are carried out safely, thereby protecting the patient and the American public,” State Department spokeswoman Marie Harf said in a statement released Friday.

A Department of Defence spokesman said Dobbins Air Reserve Base in Marietta, Georgia, will be used for the transfer. Samaritan’s Purse is paying for the trip.

Ebola is considered one of the world’s deadliest diseases. The current outbreak in Liberia, Guinea and Sierra Leone has sickened more than 1,300 people and killed more than 700 this year.

The virus is spread through direct contact with blood, urine, saliva and other bodily fluids from an infected person. It is not spread through the air so it is not as infectious as a germ like the flu.

The Americans will travel on a Gulfstream jet fitted with a collapsible, clear tent built to transfer CDC employees exposed to contagious diseases. The CDC said the private jet can only accommodate one patient at a time.

A photo taken 29 September 2007 and released by the World Health Organization shows Doctors Without Borders doctor Hilde Declerck taking care of a 43-year-old patient, suffering from Ebola haemorrhagic fever (EHF) at an MSF isolation ward in Kampungu. CHRISTOPHER BLACK/AFP/Getty Images

An Emory emergency medical team in Liberia has evaluated the two aid workers, and deemed both stable enough for the trip to Atlanta, said Emory’s Dr. Bruce Ribner. Hospital spokesman Vincent Dollard said the first patient was scheduled to arrive Saturday.

“If there’s any modern therapy that can be done,” such as better monitoring of fluids, electrolytes and vital signs, workers will be able to do it better in this safe environment, said Dr. Philip Brachman, an Emory University public health specialist who for many years headed the CDC’s disease detectives program.

“That’s all we can do for such a patient. We can make them feel comfortable” and let the body try to beat back the virus, he said.

There’s no specific treatment for Ebola so doctors try to ease the symptoms, which include fever, headache, vomiting and diarrhea. Some cases suffer severe bleeding.

Emory’s Ribner, one of the doctors who will be seeing the Ebola patients, stressed that safety precautions will be taken by staff.

“I have no concerns about even my personal health or the health of the other health care workers who will be working in that area,” Ribner said.

Photos August 1: Top images from around the world

Rescue workers stand in the damaged road after gas explosions in southern Kaohsiung on August 1, 2014 in Kaohsiung, Taiwan. A series of powerful gas blasts killed 25 people and injured up to 267 in the southern Taiwanese city of Kaohsiung, overturning cars and ripping up roads, officials said. (Photo by Ashley Pon/Getty Images)

The day’s best photos, as selected by editors at Postmedia News, are a stunning collection of the greatest images from around the world.

A general view shows the damaged road after the gas explosions in southern kaohsiung on August 1, 2014. A series of powerful gas blasts killed at least 24 people and injured up to 271 in the southern Taiwanese city of Kaohsiung, overturning cars and ripping up roads, officials said. (SAM YEH/AFP/Getty Images)

A general view shows the damaged road after the gas explosions in southern kaohsiung on August 1, 2014. A series of powerful gas blasts killed at least 24 people and injured up to 271 in the southern Taiwanese city of Kaohsiung, overturning cars and ripping up roads, officials said. (SAM YEH/AFP/Getty Images)

A general view shows the damaged road after the gas explosions in southern kaohsiung on August 1, 2014. A series of powerful gas blasts killed at least 24 people and injured up to 271 in the southern Taiwanese city of Kaohsiung, overturning cars and ripping up roads, officials said. AFP PHOTO / SAM YEHSAM YEH/AFP/Getty Images)

A relative, right, of a victim in the multiple explosions from an underground gas leak is consoled during a funeral service in Kaohsiung, Taiwan, Friday, Aug. 1, 2014. A series of explosions about midnight Thursday and early Friday ripped through Taiwan’s second-largest city, killing scores of people, Taiwan’s National Fire Agency said Friday. (AP Photo)

Alexandra Mae Van Kirk recovers from surgery at Helen DeVos Children’s Hospital in Grand Rapids, Mich. The 2-pound Michigan newborn dubbed “Mighty Girl” by her parents is one of the smallest babies in the world to undergo a heart procedure to open up a blocked artery caused by a congenital defect. (AP Photo/The Grand Rapids Press, Chris Clark)

Greyson Marchinko seven years from Portage la Prairie on the Wobbly Water Balls at the 2014 Queen City Ex in Regina, SK on August 01, 2014. (Don Healy/Leader-Post) (Story by Jeremy Simes) (NEWS)

Homer, an 18-week-old mastiff, is dressed as a bumblebee along with his owner, Eddyn Molden, 8, of Middletown, Va. during the judging for the Best Costumed Pet at the Frederick County Fair in Clear Brook, Va. Thursday, July 31, 2014. (AP Photo/The Winchester Star, Jeff Taylor)

Chandrakant Zanjare, who said he lost 13 family members to a landslide, wails near the site where his house stood in Malin village, in the western Indian state of Maharashtra, Friday, Aug. 1, 2014. Heavy rains hampered efforts Friday by hundreds of rescue workers digging through heavy mud and debris, as the death toll from a landslide that engulfed an entire village in western India crossed 50. (AP Photo/Rafiq Maqbool)

People burn offerings to “Pachamama,” or “Mother Earth,” on La Cumbre, a mountain that is considered scared ground, on the outskirts of La Paz, Bolivia, Friday, Aug. 1, 2014. The month of August is the time people gather in the mountains of Bolivia to make offerings in honor of the earth goddess and ask for good fortune. According to local agrarian tradition, Mother Earth awakes hungry and thirsty in August and needs offerings of food and drink in order for to be fertile and yield abundant crops. (AP Photo/Juan Karita)

Against the setting sun the men’s 10,000 meters race starts at Hampden Park Stadium during the Commonwealth Games 2014 in Glasgow, Scotland, Friday Aug. 1, 2014. (AP Photo/ Scott Heppell)

Russian President Vladimir Putin speaks at an opening ceremony of the monument to the Heroes of the World War I, behind him, on the day of the 100th anniversary of its beginning in Victory Park on Poklonnaya Hill in Moscow, Russia, Friday, Aug. 1, 2014. Putin said in his Friday’s speech that it’s important today to remember how narrow ambitions and political interests triggered World War I in order to avoid new conflicts. (AP Photo/Yuri Kochetkov, pool)

Australian and Dutch investigators examine pieces of the Malaysia Airlines Flight 17 plane, near the village of Hrabove, Donetsk region, eastern Ukraine Friday, Aug. 1, 2014. The investigators from the Netherlands and Australia plus officials with the Organization for Security and Cooperation in Europe traveled from the rebel-held city of Donetsk in 15 cars and a bus to the crash site outside the village of Hrabove. Then they started setting up a base to work from at a chicken farm. (AP Photo/Dmitry Lovetsky)

Palestinian Nidal Abu Rjeilah, 30, leans over the blanket-covered corpse of his disabled sister Ghadeer, 17, in the southern Gaza village of Khuzaa on Friday, Aug. 1, 2014. Abu Rjeilah said he and other relatives had been forced to leave Ghadeer behind when fleeing Israeli firing nine days earlier because they could not push her wheelchair quickly enough for a safe escape. A brief lull Friday offered the first opportunity for Abu Rjeilah to find his sister’s body. (AP Photo/Khalil Hamra)

Palestinians run for cover during clashes with Israeli soldiers following a protest against the war in the Gaza Strip, outside Ofer, an Israeli military prison near the West Bank city of Ramallah, Friday, Aug. 1, 2014. (AP Photo/Majdi Mohammed)

Palestinians carry their belongings after salvaging them from their destroyed houses in the heavily bombed town of Beit Hanoun, Gaza Strip, close to the Israeli border, Friday, Aug. 1, 2014. A three-day Gaza cease-fire that began Friday quickly unraveled, with Israel and Hamas accusing each other of violating the truce. (AP Photo/Lefteris Pitarakis)

Palestinian onlookers and motorists pause to inspect an Israeli army bomb laying unexploded on the road that links northern and southern Gaza, in Deir al-Balah, in the central Gaza Strip, after at least eight people, including three children, where killed overnight, on August 1, 2014. . (MARCO LONGARI/AFP/Getty Images)

A Hindu devotee pours milk on a snake as an offering during the annual Hindu Nag Panchami festival, dedicated to the worship of snakes, in Allahabad, India, Friday, Aug. 1, 2014. (AP Photo/Rajesh Kumar Singh)

A performer breathes out fire, for visitors attending a beach carnival, in Beijing, China, Friday, Aug. 1, 2014. (AP Photo/Ng Han Guan)

A local resident looks at the gas explosion site in the southern Taiwan city of Kaohsiung on August 1, 2014. A series of powerful gas blasts killed at least 22 people and injured up to 270 in the southern Taiwanese city of Kaohsiung, overturning cars and ripping open roads, officials said. (SAM YEH/AFP/Getty Images)

Hospitals urged to prepare despite low risk of Ebola virus coming to Canada

Queen’s University infectious-disease specialist Dr. Dick Zoutman, Chaired the SARS scientific advisory committee for Ontario and spent time in Kosovo after the 1998-99 war working with local doctors treating patients with a different kind of hemorrhagic fever, Crimean-Congo hemorrhagic fever. Photo: Lars Hagberg/For Postmedia News/Files

A prominent doctor who was a leading adviser during the SARS crisis in 2003 is urging hospitals to prepare for the remote chance of Ebola coming to Canada.

“Sitting here in southern Ontario, I could be complacent and say, ‘well, it’s never going to happen here, why would I worry?’ In fact, we are prepared,” said Queen’s University infectious-disease specialist Dr. Dick Zoutman, chief of staff at Quinte Health Care in Belleville, Ont., which operates four hospitals. “We have a protocol. We have updated all of the contacts in the province we would call if a patient gives us a history of having been in western Africa and has what could be interpreted as early signs, or later signs, of a hemorrhagic fever like Ebola.”

Zoutman chaired the SARS scientific advisory committee for Ontario and spent time in Kosovo after the 1998-99 war working with local doctors treating patients with a different kind of hemorrhagic fever, Crimean-Congo hemorrhagic fever.

“I think every hospital, I hope, is doing the same, and needs to be doing the same,” he said.

The World Health Organization says the Ebola outbreak in West Africa is unprecedented in its scale, with at least 1,323 cases and 729 deaths as of Friday.

At a crisis summit with the heads of four West African nations, WHO director-general Dr. Margaret Chan said the virus is outrunning every effort to halt it. Chan  warned of “catastrophic” consequences, including a high risk of spreading to other countries, if the situation continues to deteriorate.

In some areas, “chains of transmissions have moved underground,” she said.

Villagers are hiding the infected or turning to traditional healers rather than allow the sick to be sent to special isolation units, which are seen as death beds where Ebola victims go to die.

WHO will convene an emergency committee meeting next week to determine whether the outbreak constitutes a “public health emergency of international concern,” and, if it does, “to recommend appropriate temporary measures to reduce international spread,” the health body said in a statement Friday.

Meanwhile, Canada’s public health agency is warning Canadians to avoid all nonessential travel to Guinea, Liberia and Sierra Leone.

The agency said the outbreak is straining health systems and travellers could find it difficult to get medical care if they get sick. They also risk being exposed to the virus if they seek treatment in a clinic or hospital.

The outbreak in West Africa is being caused by the most lethal strain of Ebola known to humankind.

The risk of the virus coming to Canadians is low, but it isn’t non-existent, said Zoutman. However, there are stark differences in the conditions that would allow its spread, he said.

In Africa, fruit bats are believed to be the natural reservoir for Ebola, and outbreaks are occurring in remote villages without the medical resources to cope. The death rate is extraordinarily high (up to 90 per cent) because the virus attacks the cells lining the blood vessels “throughout your whole body,” Zoutman said.

There is no cure for Ebola, or antivirals. Severely sick patients require intensive supportive treatment — preventing dehydration from vomiting and diarrhea, controlling fever and blood loss and transfusing blood if necessary.

This Oct. 7, 2013 photo provided by Jeremy Writebol show his mother, Nancy Writebol, with children in Liberia. Writebol is one of two Americans working for a missionary group in Liberia that have been diagnosed with Ebola. Plans are underway to bring back the two Americans from Africa for treatment. (AP Photo/Courtesy Jeremy Writebol)

Canadian hospitals have sophisticated infection control procedures and systems to limit the spread of contagious diseases, including high-containment isolation.

”We have private rooms, we have infection control systems — we have all these resources, so that if we did get an isolated case of hemorrhagic fever we would take it very seriously and put all the precautions in place,” Zoutman said. “The chance of it spreading in our hospital setting is not zero but it’s pretty remote, if we have our guard up and we ask the right questions at the right time and use the right precautions.”

In addition, procedures set out under the Quarantine Act are in place at borders to identify sick travellers arriving in Canada, Dr. Gregory Taylor, Canada’s deputy chief public health officer, said this week.

Taylor said the agency is working closely with provincial and territorial partners, as well as the National Microbiology Laboratory in Winnipeg and its network of provincial labs, “to ensure we are ready to detect and respond quickly in the unlikely event that a case arrives in Canada.”

Plans were underway Friday to return two American aid workers sick with Ebola to the U.S.

A small private jet equipped with a portable tent designed for transporting patients with highly infectious diseases was dispatched to Liberia, where the two work for missionary groups.

In Canada, Medecins San Frontieres/Doctors Without Borders said there is minimal risk of staff bringing Ebola home to Canada. Two Canadian MSF doctors — Montreal’s Marc Forget and Tim Jagatic, of Windsor — recently returned from Ebola missions in Guinea.

The organization said it ensures a high level of infection control measures in the field to minimize the risk of infection in the first place.

“With Ebola, you are not infectious if you have no symptoms, which means there is no risk for a staff member to infect anyone when they come home if they are not sick,” the group said in an email.

When returning home, staff is asked to stay within a short driving distance of a hospital that can rule out Ebola “and has the capacity to provide the necessary infection control measures and treat the other illnesses the person may actually have.”

Zoutman said medical missionaries should wait an appropriate number of days after treating their last patient before boarding planes home.

“Be aware of how your body is feeling, take your temperature, limit your social contacts,” Zoutman said. “You don’t necessarily lock yourself in a room, but you try to give a buffer of five, 10 days before you board a plane, if you can at all do that, which is what I tried to do when I was working in Kosovo.”

— With files from The Associated Press

skirkey@postmedia.com

California farmers panic as drought worsens in America’s Garden of Eden

California's drought has forced farmers like Bill Dietrich to make some hard choices about which crops to water and which crops to let die. This almond orchard still struggles along on salty ground water. Photo: William Marsden/Postmedia News

MENDOTA, Calif. – It’s a windy, hot and very dry day on the road to Mendota.

The temperature readout in the car hits 39 C. Flat empty, brown fields stretch toward the distant coastal mountains. Tiny dirt devils race across the landscape. Two tractors, enveloped in clouds of dust, plow under a withered crop.

Then suddenly, as if by magic, the brown turns green and we enter a modern Garden of Eden. Endless fields of lush orchards and verdant crops line the road. Concrete canals brim with still water. Fruit and vegetables over-flow roadside produce stands. It’s hard to believe that California is experiencing its worst drought on record.

But this is no hoax. The impression of plenty may be real but it is also a mirage. Behind this blooming desert lies the grim reality of critically persistent water shortages caused by a drought now in its third year. What you don’t see are reservoirs (http://cdec.water.ca.gov/cdecapp/resapp/getResGraphsMain.action) at record lows; farmers forced to cut off water to crops and orchards and lay fields fallow; unemployment at 45 per cent; the threat of total disaster if the drought continues into next year.

“I classify this year’s farming on my orchards and my neighbour’s orchards as a catastrophe,” Jim Jaspers, 70, said as he drove past some of his  2,000 acres of mostly almond trees some 30 kilometres north of the small town of Mendota. “I have never experienced anything like this.”

Jaspers, who also operates an almond processing plant, ships his nuts all over the world including large amounts to Canada.

Like thousands of other farmers in the Central Valley, the drought has forced him to cut off water to almost 20 per cent of his orchards so he can concentrate his irrigation on younger trees. This means that older trees, which take at least three years to produce a first crop and then last for up to 30 years, have been left to die.

“We are trying to keep our younger ones going,” he said. “If the drought continues, meaning that we don’t get rain and snow here in California for another 12 months, we’ll be over in that young orchard with no leaves and no crops.”

California’s damned lakes and reservoirs are all suffering record low. The San Luis reservoir is at 23 per cent capacity and getting lower by the day.  Photo: William Marsden/Postmedia News

The Central Valley, with its deep and rich topsoil, runs almost 600 kilometres from the Cascade Mountains in northern California to Tehachapi Mountains in the south. It produces about 25 per cent of the U.S. table foods on only one per cent of its farmland. Comb the full list of fruits, vegetables and nuts known to mankind and for most of it the Central Valley ranks number one, or close to it. So if this valley goes dry, prices will skyrocket as the world’s agriculture adjusts to a new reality.

Almonds are a prime example. The valley produces 82 per cent of the world’s crop. Because of the drought, prices have almost doubled to $3.50 a pound. If it continues into next year, “without a doubt, we’re going to $5 a pound,” Jaspers said.

Drought in the Central Valley is not as you might expect. Modern watershed engineering can localize it and postpone its nastier effects. Lack of rain or snow does not immediately harm everybody.

California’s vast, engineered water delivery system of canals, aqueducts, dams and reservoirs, sees to that. It annually transports about 34 million acre-feet of water from the mountains to the arid valley. (That’s more than enough water to meet the demands of every Canadian.)

Transformed over the last 60 years from wetlands, flood plains and desert into lush farmland, the valley is considered the largest man-made alteration of surface land in the world. Studies show that the amount of water pushed around the state is so huge that each year it doubles the amount of water vapor in the air, dumps an average 15 per cent more summer rain in other states and increases the Colorado River runoff by 28 per cent. But without a winter of dense mountain snow, the valley will die.

California’s drought has forced farmers to fallow thousands of acres of cropland. Photo: William Marsden/Postmedia News

The allocation of water is decided by two state and federal agencies. They dictate how much water each of the state’s 600 water and irrigation districts annually receive. The present drought is so bad that most of the districts in the central part of the Central Valley — such as Jaspers’ district — have received zero water allocation.

This means that farmers have to get by with whatever surplus allocation they have from the previous year. They also bid for water – inevitably at inflated prices — from districts that have surpluses. Many farmers are forced to dig wells and pump ground water even though this water is often salty.

One almond farmer paid $2.1 million to a neighbouring farmer for water just to keep his orchard alive for another year. If there is no water next year, he will be broke.

Buying from other farmers can be chancy. Jaspers’ Del Porto Water District last year paid $18 million US to farmers north of San Francisco Bay not to grow rice only to have the state agency use rice farmers’ water allocation to feed the wetlands of the Bay Delta.

As competition for water grows, nothing raises a valley farmer’s ire more than the thought of the state watering the delta eco-system to keep its wetlands and native species alive while their fields lie parched and empty.

“How many jobs does that shrimp provide,” Jaspers asks. “How much taxes does it provide?”

Jay Lund, director of the Center for Watershed Sciences at the University of California, says that’s not the point.

“Do you know what they call water used by somebody else in California?” he asks. “Waste. So when you hear people complaining about other people wasting water, you sort of have to keep that in mind.”

He said California’s diverse environment is what makes the state attractive to the 95 per cent of the people not engaged in agriculture. “How much less is the attraction of California that has basically denuded itself of a basic eco-system,” he asks. “It is hard to quantify that but it is nevertheless quite important.”

When a drought subsides, farming can always be brought back. That’s not so for ecosystems, he said. Yet only five per cent of the original 750,000 acres of tidal delta wetlands remain.

Farmer Bill Dietrich said that while the drought has crushed some farmers, the people who are really hurt are workers. “They are not working because there is no need for them because the fields are all blank.”

Farmers have been forced to fallow about 200,000 of 600,000 arable acres in the Westlands Water District. Located in central California, it’s the largest water district in the state with Mendota at its centre. Yet they have zero water allocation. Unemployment is 34 per cent and is expected to rise to 45 per cent.

To feed their families, workers depend on state-run food banks that travel from town to town in two-week cycles.

Juan Beltran, 53, is an unemployed tractor driver with a family of eight. Only one of his sons is working. He picks melons.

In good years, he said, as he carried boxes of food to his pickup truck from the Mendota food bank, “people would come knocking at the door to offer me work. Now, there’s nothing.”

Rosa Maya, 27, was laid off earlier this month. Her husband has only part-time work. And she has a five-year-old to feed. Without the food bank she couldn’t get by. “Because of the drought there’s not enough work,” she said. “It’s the worst that I have seen it.”

wmarsden@postmedia.com

Abel: Echoes of 2008 as Africans hail Obama

U.S. President Barack Obama is shown arriving at the Washington Fellowship for Young African Leaders Presidential Summit in Washington, D.C. The three-day summit brings together 500 of sub-Saharan Africa's young leaders to meet with business and governmental leaders from the United States. Photo: Win McNamee/Getty Images

WASHINGTON — To see Barack Obama vault out of a groping, greying presidency and into a hotel ballroom filled with men and women standing on their chairs and pumping their fists and shouting “We want selfies!” is to travel back in time to the summer of 2008, although nobody knew what a selfie was, way back then.

Six years ago, Newsweek was hailing what it called the nation’s “unabashed love” for its incoming president. “He has a chance to realign the national landscape and create a new government ideology for the West,” the magazine crowed. In Denver, the last week of that July, 100,000 of us jammed a football stadium to see him accept a summons to change the world.

Six years later, Obama’s 40 per cent approval rating signifies that three-fifths of Americans are abashed that he ever was elected in the first place. A deathscape of war from Donetsk to Damascus belies his vacuous Nobel Peace Prize, and a solid majority of U.S. voters told a pollster last week that, granted a do-over of 2012, they would select the wise and steadying hand of W. Mitt Romney.

So I am almost nostalgic as I watch 500 people explode in exultation at Obama’s arrival for a speech and a Q and A at a downtown hotel, and it is especially heartwarming in this congressional election year to be able to report that the Wangler in Chief has not come to ask them for money. The audience is, instead, half a thousand Young African Leaders from three dozen countries, flown to Washington by the U.S. government to promote entrepreneurship, engage socially, and ratify Obama’s humanitarian initiatives on a continent that has not been sufficiently bloodied or famished during his presidency to make many headlines in America at all.

When the program begins, the 44th president stands on a riser and shouts out Young Leaders named Ndiaye and Mkandawire and Ngom. Pacing the platform and speaking without notes, he heralds the continent’s rapidly decreasing toll of malaria, tuberculosis, AIDS, and infant and maternal mortality, and offers informed comments on subjects ranging from export tariffs in Madagascar to Liberian antitrust law. He seems truly engaged and pleased with himself, the arisen son of his hearers’ fathers.

“The point of all of this is we believe in you,” he says. “I believe in you. I believe in every one of you who are doing just extraordinary things.”

Seated directly in front of me is a woman named Sarah Ferdjani, wearing a traditional cotton scarf and a Hook ’Em Horns lapel pin from the University of Texas, where, in a meaningful reversal of recent history, the African helped to deliver charity meals to hungry American families. (Each Young Leader’s fellowship includes a term at a U.S. college.)

In Niamey, the capital of sandy, radioactive Niger, Ferdjani works for the World Food Program and has started her own business manufacturing organic hair-care and beauty products. (The former French colony is one of the world’s principal suppliers of uranium ore, while French troops patrol its Saharan wastes against Islamist rebels.) She is erudite, trim and 21st-century web-smart. But when Barack Obama bounces into the ballroom, Ferdjani goes absolutely nuts.

“What happened to the man who promised so much Hope and Change?” I ask the young businesswoman, after she calms down.

“What happened to him?” the African replies, with a sigh. “He became president.”

“People thought he was Superman, he was a superhero, there was ‘Yes we can’ and all those things,” Ferdjani explains. “People thought he would solve all the problems and do everything. Now, we still have a lot do to, but it doesn’t really have anything to do with him.”

Nearby, in a motorized wheelchair, is Michael Mihayo, a social welfare officer from Dar es Salaam, Tanzania, who has been unable to walk since contracting polio at the age of three.

“I feel that Barack Obama values me,” Mihayo says. “He values me, and he understands that I have a contribution to make to my family, to my country, and to the world. There is no discrimination against me from disability, no discrimination from race, no discrimination from religion, and Obama is committed to this.”

“Why do you think he has become so unpopular in this country?” I ask.

“It’s not easy to be loved by everybody,” the Young Leader answers. “Other people will always trash you. America cannot do it alone. I think that the interference in the other countries sometimes doesn’t work out so well.”