Russian Hospital Finds Push for Progress Blocked

Privately Funded Improvements Run Afoul of Local Bureaucracy

By Peter Finn
Washington Post Foreign Service
Friday, March 21, 2008; A10

TARUSA, Russia -- When a new cardiac unit opened at the municipal hospital here last month, Russian Health Minister Tatyana Golikova sent a letter of congratulations, calling the new facility a "vivid example" of the medical community and private donors working together to improve the lives of ordinary Russians.

The good feeling didn't last long.

Three days after the unit's opening, Tarusa's mayor fired the hospital's head doctor and sent in the police to check for possible fraud in the refurbishing of the hospital, all of which had been financed privately.

Doctors at the hospital said the crackdown was the culmination of a two-year campaign by local officials to wrest control of tens of thousands of dollars that were to transform the once-crumbling hospital into a model of preventive medicine in a rural community.

The hospital funding was a bright example of the growing philanthropy of Russia's wealthy. But it was also a window into the stifling role Russia's bureaucracy can play, even in a sector deemed a national priority by President-elect Dmitry Medvedev.

"Every improvement caused difficulties," said Maxim Ossipov, a Moscow cardiologist who works three days a week at the Tarusa hospital. "Bureaucrats have to fight for their existence, and if they don't control something, then they are no longer bureaucrats. They are a real disaster for today's Russia."

Tarusa is a river town of 9,000 people about 85 miles south of Moscow. Popular with Muscovites, such as Ossipov, who maintain second homes in the region, the town's summer population swells to 80,000.

In an interview, Ossipov said he started volunteering at the 135-bed hospital in 2005 as a route back into regular practice, which he had abandoned in the 1990s to open a medical publishing company in Moscow. He had old ties to the town -- his grandfather, also a doctor, was exiled there after a prison camp term during the repressive rule of Joseph Stalin.

"By Western standards, it was not a hospital at all," said Ossipov, who was a research fellow at the University of California at San Francisco in 1991 and 1992.

Ossipov said he began turning to friends and colleagues for equipment, such as defibrillators, and even basic drugs to improve the quality of care. At the same time, the Russian government's $6.5 billion spending plan to improve health care brought a much-needed ambulance and pay increases for the hospital's medical staff.

The effects were quickly apparent, doctors at the hospital said. Its mortality rate was halved, and the death rate in Tarusa from heart attacks, a major killer in Russia, was cut by five-sixths, according to regional government figures.

"I have problems with my heart and I remember when they couldn't help me here and they would immediately sent me to Kaluga," the provincial capital, said Pyotr Dovbnyak, a 65-year-old pensioner. "Now they call me on the phone and invite me in for examinations."

In 2006, the hospital was offered a new X-ray machine through the "national projects" led by Medvedev. But the hospital's electric wiring was unable to support the new equipment. Mayor Yury Nakhrov refused to upgrade the hospital's power supply, the doctors said. Irina Oleinikova, the head doctor, reluctantly turned down the X-ray machine.

Nakhrov was reprimanded by the regional administration for "frustrating" the national projects, and he, in turn, reprimanded Oleinikova for "safety violations" and for failing to properly treat a patient. Oleinikova appealed to the courts and the reprimands were overturned, which she said infuriated the local administration.

Nakhrov was not available to answer a reporter's questions; officials in his office said no one else could comment.

In the meantime, Valery Balikoyev, a Moscow businessman, committed approximately $130,000 to renovate one of the hospital's wings for the new cardio-therapy unit. According to the doctors, Nakhrov told Oleinikova her "sponsor" should visit him to introduce himself. She declined to make the introduction. Nakhrov also told her she should move the town's pharmacy -- which was located on a prime piece of real estate -- into the hospital. She again refused.

In another example of bureaucratic pressure, Ossipov said that an official, whom he wouldn't name, suggested overbilling -- doubling the amount on an invoice for some new equipment that another wealthy sponsor was willing to buy, so that the balance could be used for other purposes. Ossipov declined.

Researchers at the Russian Academy of Sciences have estimated that corruption absorbs about 35 percent of all health-care spending in Russia. Ossipov said the hospital deliberately never accepted cash donations, only equipment or physical improvements, to avoid any suggestion that its personnel could benefit financially.

"My language is as impossible for them to understand as theirs is for me," Ossipov said of the local officials who, by his account, found it hard to believe that the doctors had no personal stake in the improvements.

Local officials eventually tried to close the hospital on grounds of fire safety violations, according to Oleinikova, but a higher court blocked the effort.

On March 3, Mayor Nakhrov fired Oleinikova and ordered a criminal probe into the construction of the cardiac unit. Ossipov, Balikoyev and others appealed to the regional governor, who ordered a separate investigation. He also recommended that that the local council fire Nakhrov, but it refused.

The mayor later checked into a Moscow hospital where he could not be reached by either investigators or the news media; Oleinikova was reported Thursday to be headed back to her job after the investigation by the regional government.

"We are taking the whole thing as a slap in the face," Ossipov said. "Small bureaucrats don't believe in philanthropy and they can't stand any independence on their own territory."

Extrajudicial slayings on rise in Colombia

Soldiers, under pressure to show progress in a U.S.-funded war, allegedly are killing civilians and passing them off as rebels.

By Chris Kraul
Los Angeles Times Staff Writer

March 21, 2008

GRANADA, COLOMBIA — Street vendor Israel Rodriguez went fishing last month and never came back. Two days later, his family found his body buried in a plastic bag, classified by the Colombian army as a guerrilla fighter killed in battle.

Human rights activists say the Feb. 17 death is part of a deadly phenomenon called "false positives" in which the armed forces allegedly kill civilians, usually peasants or unemployed youths, and brand them as leftist guerrillas.

A macabre facet of a general increase in "extrajudicial killings" by the military, "false positives" are a result of intense pressure to show progress in Colombia's U.S.-funded war against leftist insurgents, the activists say.

Rodriguez's sister Adelaida said he had served three years in the army and was neither a guerrilla nor a sympathizer. "He never made any trouble for anyone," she said, adding that she believed the army killed her brother to "gain points."

Such killings have spread terror here in the central state of Meta. Last year the state led Colombia in documented cases of extrajudicial killings, with 287 civilians allegedly slain by the military, according to the Colombian Commission of Jurists, a human rights group. That's a 10% increase from the previous year

Although there appear to be no official -- or unofficial -- tallies of "false positives," human rights activists say they believe such incidents are on the rise, along with the overall increase in killings by the military, based on their discussions with victims' families and analyses of circumstances surrounding individual cases.

"It's quite likely, because the same scenario appears over and over again in the cases I review," said John Lindsay-Poland of the New York-based Fellowship of Reconciliation. "Victims last seen alive in civilian clothing later are found dead dressed in camouflage and claimed as guerrilla casualties."

The killings have increased in recent years amid an emphasis on rebel death tolls as the leading indicator of military success, the human rights groups say. Even Colombian officials acknowledge that soldiers and their commanders have been given cash and promotions for upping their units' body counts.

Since President Alvaro Uribe took office in 2002, the military has scored notable successes in winning back territory from leftist rebel groups and improving security, buoyed by billions of dollars in military aid from the United States under Plan Colombia, the program that fights drug trafficking and terrorism.

But at the same time, the military's human rights record is getting worse, charged a coalition of Colombian and international human rights groups.

And new research by two U.S. peace groups into the killings raises serious questions about whether the United States is doing enough, as required by law, to bar U.S. funding to Colombian military units that have elicited allegations of killings and other human rights violations.

Amnesty International USA and the Fellowship of Reconciliation have found that the U.S. government "vetted" or approved military assistance to at least 11 Colombian armed forces units last year despite "credible allegations regarding killings, disappearances and collaboration with outlawed paramilitary forces," Renata Rendon of Amnesty International USA said in Washington this month.

"It's outrageous this is happening. It's up to the [U.S. government] to ensure that we are not providing aid to abusive units," Rendon said.

While not responding specifically to the claims, an official at the U.S. Embassy in Bogota said this month that Colombian armed forces' killings of civilians were a "serious problem, a serious concern."

"It's something we take very seriously. If you're going to win a war like this, a big part is establishing rule of law and winning the people's confidence in your legitimacy and commitment to legal institutions," said the official, who was not authorized to speak for attribution. He defended the vetting process but said it was complicated by the fact that allegations of human rights abuses often were "not sufficiently specific or verifiable."

To address the issue of impunity, Colombia's attorney general last year set up special investigative teams in Meta and Antioquia states, which had the highest numbers of alleged abuses by the military. In November, Defense Minister Juan Manuel Santos sent a directive to military commanders ordering major changes, including giving civil courts more jurisdiction in investigating incidents.

But the killings are still spreading terror here in Meta state. Ramiro Orjuela Aguilar, a Bogota human rights attorney representing 20 families of suspected "false positive" victims in Meta, blamed the military's use of paid informants or demobilized guerrillas for many of the killings.

"They have an incentive to name people as rebels because they are paid for information whether it's correct or not," Orjuela said.

Several of the Meta victims last year were youths living in and around Granada, the hub of a cattle and farming region that has been fiercely contested in recent years by leftist guerrillas, the armed forces and right-wing paramilitary troops. It is also home to the army's 12th Mobile Brigade, a unit that Orjuela says is implicated in many of the killings.

Orjuela alleges that the army is engaging in "social cleansing" in Meta, home to four of the five municipalities that made up the so-called neutral zone occupied by Colombian guerrillas from 1998 to 2002. Killings and mass displacements of residents here are efforts to deprive guerrillas of sympathizers, Orjuela said.

"They are trying to deprive the fish of its water," he said.

Kidnapped on an outing to the Ariari River, Rodriguez, the street vendor, may have been in the wrong place at the wrong time, relatives theorize, caught by a band of police officers or soldiers who were on a "fishing trip" of their own for victims.

Orjuela said cases involving alleged "false positives" seemed to decline after the Colombian army issued the November directive to all commanders ordering that officers and the rank and file be made aware that the most important standards of success are demobilizations and captures of guerrillas, and then body counts. But he said he had noticed a resurgence lately, noting the Rodriguez killing.

Adelaida Rodriguez said that despite the government's initiatives, she and her family were reluctant to press for an investigation. Referring to her brother, she said, "If we make noise, we'll end up like him."

chris.kraul@latimes.com

World Bank, India to Probe 5 Health Projects

By Anthony Faiola
Washington Post Staff Writer
Saturday, March 15, 2008; D01

The World Bank and the Indian government have launched official investigations in response to an internal bank report that found "serious" incidents of fraud and corruption in five bank-financed health projects in India.

The findings in the report, released in January by the World Bank's internal investigation arm, include possible bid-rigging in a bank-funded program that may have distributed faulty HIV-test kits to clinics and blood banks in India. Although the bank did not specify which allegations it would probe, its board Thursday agreed to work with the Indian government to conduct independent procurement audits.

The bank said it would launch nine separate investigations that could lead to broad institutional revisions of how its programs are monitored and conducted. The government of India also referred three related cases to its Central Bureau for Investigation.

"We take these indicators of fraud and corruption extremely seriously," World Bank President Robert B. Zoellick said in a statement. "Working with the Indian authorities, we will take action against those responsible, including debarment and sanctions against firms and individuals from doing business with the Bank and disciplinary action against bank staff if warranted."

Critics said the case has highlighted a history of lax oversight on a number of World Bank projects. Yesterday, some of them took aim at the bank for a slow, convoluted response to allegations of corruption in the India projects.

The report, published by the bank's Department of Institutional Integrity, reviewed funds for five projects, some dating back to 1997, to combat HIV-AIDS, malaria and tuberculosis. Some of the most notable findings involved programs aimed at preventing the spread of HIV, the virus that causes AIDS, including funds for HIV-test kits.

The report noted that five medical facilities in Mumbai that received HIV test kits from one supplier hired by the Indian government and paid with World Bank funds had complained in 2004 and 2005 of high rates of false negatives and other invalid results. After reviewing data on test-kit use, the examiners determined that "some of the test kits supplied by particular companies often performed poorly by producing erroneous or invalid results, potentially resulting in the further spread of disease or in the wastage of blood."

In addition, the examiners found evidence of corruption. The review showed one supplier had won a test-kit contract even though the firm appeared not to have complied with technical specifications, had submitted apparently fraudulent documents and was not the lowest bidder.

The findings appeared to lend credence to warnings from Kunal Saha, a physician specializing in AIDS retained by the World Bank to review some of those programs last April. After his trip, Saha said he had brought evidence of faulty test kits to the attention of both Indian and World Bank officials in May. Of particular concern, he said, were high rates of false negatives, which posed the risk of tainting blood supplies and failing to notify HIV-positive patients of their conditions.

"But nothing was done," said Saha, a self-described crusader who founded a patients' rights group in India after the death of his wife there in 1998 from what he says was medical negligence. In recent months, he has worked closely with the Government Accountability Project, a Washington nonprofit group, to press the bank on faulty HIV test kits in India. "Everyone did everything they could to ignore this," he said.

World Bank officials said that following Saha's claims, they hired a consultant late last year from the Centers for Disease Control and Prevention to review the data. The consultant's findings, the officials said, did not support Saha's opinion that the kits were faulty. In a news release dated Dec. 14, 2007, and distributed in India by health authorities there, Saha's findings were directly refuted. The statement said there was "no evidence of use of poor quality HIV test kits in India."

Despite the examiners' findings, Kees Kostermans, the bank's lead public health specialist for the South Asia Region, refuted claims that some patients tested with some kits in India may have received false results, and said yesterday that he remained confident that the HIV test kits were not faulty. He cited a second outside consultant, Australian HIV expert Elizabeth Dax, who was contracted for a further program review in January. Her review, Kostermans said, indicated that the problems with false negatives were a result of human error rather than with the kits.

"There is no evidence in the data that we reviewed that any patients were given a final false negative HIV results," he said.

Kostermans said the World Bank had received notification from the Indian government that all of the kits in question had stopped being used in 2006. But Saha said he uncovered evidence last April that the kits were still being used in at least one hospital.

Russia: How The Kremlin Manages To Get The Right Results

By RFE/RL analyst Robert Coalson

One day after the March 2 presidential ballot in Russia put the final seal of approval on Dmitry Medvedev's carefully orchestrated win, the head of the country's election commission, Vladimir Churov, had warm words of praise for the vote, saying: "There is no more open, more transparent, and more organized election system than the election system of the Russian Federation."

Churov added that perhaps the greatest innovation of the Russian voting system is the complex, multilayered system used for counting votes, a system he claims virtually precludes the possibility of falsification.

But to independent observers of both the presidential poll and the December 2007 Duma elections, the system seems geared for getting the right results for the Kremlin -- rather than for getting the results right.

Election management in Russia, of course, begins long before election day. It involves the massive distortion of public opinion through the control of the media, the abuse of public office at all levels for political ends, the manipulation of election law and the composition of election commissions, and the use of a variety of means to ensure that only approved parties and candidates appear on ballots at all.

Population Shifts?

One of the clearest macro-manipulations is the compilation of the official voter list. “Vedomosti” reported on March 6 that, according to official figures, there were 107.6 million eligible voters in Russia as of June 2007. By the time of the December legislative elections, that figure had risen to 109.15 million.

The hike might be explained by the fact that Unified Russia wanted as many votes as possible because Duma seats are allocated according to the number of votes. In addition, the federal budget provides parties who pick up more than 3 percent of the vote to qualify for annual state funding of 5 rubles ($0.20) for each vote they received.

By the time of the March presidential election, in which the Kremlin was interested in the highest possible voter turnout rather than a particular number of votes, the official voter list was back down to 107 million, “Kommersant" reported. According to official figures, St. Petersburg lost 11 percent of its voting-age population between December 2007 and March 2008.

But these macro-management means alone cannot ensure the kind of precision that Kremlin politicos seem to require of the results. For instance, First Deputy Prime Minister Dmitry Medvedev polled 70.2 percent, according to preliminary official results. Interestingly, that was slightly better than the 70.08 percent the pro-Kremlin Unified Russia party polled in the December legislative elections, but slightly worse than the 71.3 percent that President Vladimir Putin garnered in his 2004 reelection. Clearly, the Kremlin wants Medvedev to seem popular. To be more popular than his predecessor, however, would be unseemly.

Something Rotten In The Republics

Andrei Buzin, chairman of the Interregional Association of Voters, told gazeta.ru on March 5 that his monitoring group has noticed an increasing trend of election-day falsification. Such violations have long been de rigueur in the so-called ethnic republics such as Tatarstan and Bashkortostan and, especially, in the North Caucasus. In Ingushetia, to take one example, officials reported a startling 98-percent turnout for the Duma elections, but in the weeks following the vote, more than 50 percent of the republic's eligible voters signed statements saying they did not vote.

Following that embarrassment, Election Commission Chairman Churov announced that he would order the installation of video cameras at all Ingush polling stations for the presidential election. But the president of the republic and the chairman of its legislature announced that such measures were unnecessary and no cameras appeared. “Novaya gazeta" journalists in the republic on March 2 asked about the cameras and election officials "simply laughed." Official turnout in the republic on March 2 was 92 percent (with 91 percent of them voting for Medvedev), while independent monitors counted 5,742 voters -- putting estimated turnout somewhere closer to 3.5 percent.

Earlier this month, two bloggers -- a chemist named Maksim Pshenichnikov and a person who goes by the online name Podmoskovnik -- published a damning statistical analysis that used Central Election Commission statistics to shed light on the extent of the fraud in the December Duma elections. The two made a graph of the voter-turnout percentage reported by each polling station. Under normal conditions, one would expect a bell-shaped curve, with few or no polling stations reporting 0 percent turnout and few or none reporting 100 percent. The normal curve would peak at the point representing the national average voter turnout, which for these elections was officially put at 63 percent.

What the bloggers found instead was a curve that began normally on the zero side of the graph and ran upward to a peak of 51 percent. On the right side of the graph, the side representing polling stations reporting higher-than-average turnout, the graph meandered in a spiked line and ended with a peak at 100 percent that was higher even than the number of polling stations reporting the apparent national average of 51 percent. Moreover, they found sharp spikes at all the "round" numbers above that average -- 55, 60, 65, 70, etc. For instance, 633 polling stations reported an 89-percent turnout and 770 reported 91 percent, while 927 reported a nice, round 90 percent. "It is a study that explicitly demonstrates that the results were manipulated," economist Konstantin Sonin told "The Moscow Times."

Moreover, the bloggers created a second graph showing the number of votes reported by each polling station as being cast for each party. The second graph shows nearly normal bell-curves for all of the minor parties in the election, but the curve for the pro-Kremlin Unified Russia party nearly precisely follows the curve for overall voter turnout. This seems to indicate conclusively that all the "additional" votes that appeared in contravention of statistical logic were cast for Unified Russia. According to their analysis, Unified Russia should have been given 277 seats in the Duma, instead of the 315 (more than the constitutional majority of 300) that the party was awarded.

'Brazen' Falsifications

Independent monitor Buzin told gazeta.ru that there are increasing signs that brazen election-day manipulation is on the rise across the country, including in cities like Moscow and St. Petersburg. He noted that polling station No. 1257 in Moscow reported a 100-percent turnout (2,400 registered voters). "Such results have been seen in Karachayevo-Cherkesia and other Caucasian republics, but in the capital -- this is a first," he said. "Reports of such statistics are coming in from cities nationally."

On the evening of March 2, St. Petersburg Yabloko official Maksim Reznik appeared on a small local television station and told of an experiment that he carried out during the presidential vote. He reported that he and six other activists visited seven St. Petersburg polling stations. At each one, they told officials that they were residents of Murmansk without identification or absentee ballots and in each case they were admitted to vote in violation of election rules.

The next day, Reznik was arrested in the middle of the night for allegedly assaulting a police officer and a St. Petersburg court ordered him held without bond pending trial because his previous involvement with opposition protests supposedly demonstrated contempt for the law. He could face up to six years in prison.

Election commission head Vladimir Churov (ITAR-TASS) Buzin told gazeta.ru that on election day, he was at Moscow polling station No. 1513. He said that independent monitors there discovered a fully stuffed ballot box and were guarding it. For a long time, election officials on the site discussed the situation. After a while, a civil-defense alarm sounded and police appeared, ordering the evacuation of the polling station. The monitors were ushered out of the building, although according to election law, in such situations monitors are supposed to be evacuated together with all the ballot boxes. Buzin said that during the evacuation, he spoke personally with the chairman of the Moscow municipal election commission. After the alarm was ended, representatives of the Prosecutor-General's Office appeared and confiscated the suspicious ballot box. Nothing was heard about it again.

"This story once again confirms how all these organs act as one," Buzin concluded. "They have a single leadership, and this combination of all branches of power and state organs enables them to perpetrate rather brazen direct falsifications."

Not Adding Up

“Novaya gazeta" reported this week on the election-day experience of Olga Pokrovskaya, a well-known St. Petersburg lawyer and liberal activist who has served on election commissions in the past. Pokrovskaya told the paper she spent election day monitoring polling station No. 488. She reported spending the entire day there and waiting after polls closed while officials filled out the station's voting protocol. She then asked for and received an officially signed copy of the protocol and accompanied polling-station officials to the territorial election commission, where they were to submit the documents. Pokrovskaya said that she noticed one of the officials was carrying a blank election protocol that had been signed and stamped, in addition to the document that had been shown to Pokrovskaya earlier.

Pokrovskaya later compared the document she had with the official Central Election Commission data for polling station No. 488. Both sets of figures showed 23 votes for Democratic Party leader Andrei Bogdanov, 68 votes for Liberal Democratic Party of Russia leader Vladimir Zhirinovsky, and 188 votes for Communist Party leader Gennady Zyuganov. Pokrovskaya's document also shows 620 votes for Dmitry Medvedev, while the official tally for Medvedev for that polling station was 1,412. Pokrovskaya showed total turnout (including spoiled ballots and others) as 965, while the official figure is registered as 1,641.

"I suppose similar methods were used at other polling stations as well," Pokrovskaya said. "There were very few observers. At my polling station, for example, there was no one but me."

Lilia Shabanova, executive director of the independent NGO Golos, also monitored the elections and noticed the same trend of more brazen falsification and officials from all levels of government and all agencies working in tandem.

"Administrative resources have always been used," she told “Novaya gazeta," "but when there was political competition in earlier elections, control over the elections was incomparably greater. The commission under [former Central Election Commission head Aleksandr] Veshnyakov came to help at least during local elections, but the current [Central Election Commission] is deaf, blind, and dumb. It does not react to anything; it doesn't want to see or hear anything."

Drug Gang, Police Battle For 5 Hours In Tijuana

By Manuel Roig-Franzia
Washington Post Foreign Service
Tuesday, March 4, 2008; A13

MEXICO CITY, March 3 -- Mexican soldiers and federal police fought a five-hour gun battle with suspected drug gang hit men late Sunday and early Monday in a residential area of Tijuana. At least one of the heavily armed suspects was killed and two were injured, authorities said.

The confrontation was the latest in a series of street battles that have terrorized the border city, where rival drug cartels also turn their weapons on each other. In January, another residential neighborhood was paralyzed by a three-hour gun battle that prompted the evacuation of a preschool and ended with the discovery of six dead kidnapping victims inside a cartel safe house.

Monday's battle took place in Tijuana's La Mesa neighborhood, a troubled area where the police commander was killed in January, a spokesman for the Baja California public safety agency told reporters. Federal police and soldiers were conducting an operation to shut down a suspected cartel safe house. Local police, many of whom are suspected of helping cartels, did not take part.

Soldiers and police began exchanging gunfire with the suspects at about 10 p.m. Sunday and fought through the night. At least 200 soldiers cordoned off several blocks during the battle, authorities said. Horrified neighbors told local news media that they hid inside their homes until the shooting stopped at about 3 a.m.

In Tijuana, two powerful drug gangs -- the Arellano Felix cartel and the Sinaloa cartel -- have been fighting over control of smuggling routes. Mexican President Felipe Calderon has dispatched hundreds of troops and federal police to the city to confront the cartels.

In Monday's shootout, authorities appeared to make new use of a strategy initiated after Calderon took office, according to Jorge Chabat, a Mexico City-based drug expert. Rather than focusing primarily on nabbing kingpins, Chabat said in an interview, soldiers also are attacking the safe houses that serve as refuges for hit squads and are trying to disrupt street operations of smugglers.

"There's a bigger focus on gathering intelligence," Chabat said. "But the narcos are responding with violence, and we're going to probably see a lot more of these street fights because the narcos have big numbers of assassins on their side."

Drug Gangs Use Violence to Sway Guatemala Vote

By MARC LACEY

GUATEMALA CITY — It is election time in Guatemala and that means rallies and banners — and body bags.

In the campaigning leading up to elections on Sept. 9, the authorities have reported 61 violent attacks on candidates and political activists. The death toll is 26, including seven national congressmen and numerous other office seekers.

The flurry of bullets, and the occasional machete attack, make this the bloodiest campaign season in the history of a country with a long tradition of political violence, including 36 years of civil war that ended in 1996. But what makes the bloodletting different this time is that it has been attributed to narcotics traffickers and their allies intent on infiltrating Guatemala’s political system.

So dangerous is campaigning that Álvaro Colom, the leading presidential candidate, flies in a helicopter to avoid being ambushed and travels with a physician with extensive experience in bullet wounds. He is careful what he eats, lest someone poison it. “I hate to say this, but it’s more violent now than during the war,” he said.

It is not only South America’s drug-producing countries that are at risk these days from the impact of the drug trade, or even of becoming narcostates. More and more, corrosive effects are being felt in the countries where the drugs transit, like Guatemala, Mexico and Haiti, as competition grows, in effect, to set up toll roads on the drug routes to the United States.

Somewhere between 60 and 90 percent of the South American cocaine that enters the United States now comes through Central America, American officials say, pulling rising levels of political instability, violence and corruption in its wake.

The most popular trafficking routes shift constantly to stay one step ahead of law enforcement efforts, the officials say. “If you attack the cockroach in one corner, the son of a gun shows up in another,” said a senior American counternarcotics official in the region, who spoke on background to avoid compromising future investigations.

Cartels active in Colombia, where much of the region’s cocaine is produced, have connections with politicians, military officers and others throughout the area to assist them in getting drugs and drug profits out, whether on small planes or boats.

Guatemala provides an increasingly important transit point, American officials say, as traffickers take advantage of the country’s dire poverty and lawlessness. They have already made considerable progress over the years, political analysts and law enforcement officials say, by installing sympathetic politicians in Congress and in local city halls.

“Controlling the political system is their goal,” said Iduvina Hernandez, an analyst at a Guatemalan research group called Security in Democracy. “If they can control a small town, they can build a landing strip there and use it as a base. If they have someone in Congress, all the better.”

With plenty of money to spend, drug dealers finance as many campaigns as they can and put forward candidates who are on the take. Resistance is met with gunfire.

José Carlos Marroquín, Mr. Colom’s chief strategist, might have joined the list of victims as well. Last year, as campaigning got under way, assailants lobbed three grenades at his motorcade and opened fire on the vehicles with automatic weapons. He survived but the threats against him and his family have not let up.

“Politics is dangerous here,” said Mr. Marroquín, a former newspaper editor. “Along with the regular campaigns, there is a campaign of fear.”

In addition to the traffickers, an array of other heavily armed groups, including rogue soldiers, paramilitary groups, street gangs and smugglers, are fueling the violence. None of them are trigger shy.

Street violence is part of life in Guatemala even when an election is not around the corner. People are shot by muggers, caught in the cross fire of rival gangs and taken out by hit men as a matter of course.

Campaign season brings a spike in the killing, although homicides are only rarely solved here and political crime is no exception. [Guatemala’s Congress voted Aug. 1 to approve an initiative backed by President Óscar Berger’s administration that would allow United Nations investigators to aid in the prosecution of armed groups. It is being called the International Commission Against Impunity in Guatemala.]

In one example of how hard it is to crack a case here, three Salvadoran members of the Central American Parliament and their driver were murdered in Guatemala in February. The suspected killers, four police officers, were themselves later murdered in prison. A police officer and five men with links to a drug cartel have been arrested, although the motive for the attacks and counterattacks remains unknown. Mr. Berger’s security minister resigned in the wake of the killings.

The effect of all the violence on the candidates is profound. They move around with their own private armies, usually in bullet-proof vehicles loaded with small arsenals.

One of those who feel most vulnerable is Mr. Colom, a businessman who is leading the pack in the presidential race. People affiliated with his party have suffered more attacks, 16 of the 61, than any other.

Besides the recent attacks on members of his party, he is haunted by the past. His uncle, Manuel Colom Argueta, was a leading presidential candidate in 1979, when he was gunned down.

One candidate forced out of Mr. Colom’s National Unity for Hope party in 2005 was Manuel de Jesús Castillo, a congressman who has been accused but never convicted of links to drug interests.

He is running for mayor of the provincial town of Jutiapa as an independent. It is a campaign he is expected to win, largely because of his precampaign giveaways of everything from farming tools to livestock. The raffles he sponsors even offer free plots of land to lucky residents — but only if he wins.

“I’m clean, and it’s a lie what they say about me,” Mr. Castillo, who has formed his own civic organization called El Castillo, or the Castle, has told reporters. He travels his rural district in a yellow Hummer and has burly men nearby to protect him.

With the murder rate at roughly 6,000 deaths a year, it is not hard to understand why security has emerged as the chief issue of the campaign.

“There are presidential candidates who are trying to scare the people,” Mr. Colom said the other day, an indirect attack at Otto Pérez Molina, a tough-talking former general who is considered to be No. 2 in the polls. “We have a plan to bring security but also health and education and jobs.”

Mr. Pérez Molina’s campaign symbol is a fist. He is all about “mano dura,” or “strong hand,” his shorthand for a no-holds-barred crackdown on delinquency. The tough message has appeal among crime-weary Guatemalans, who were shown in a recent survey to back extreme methods, even vigilantism, to cut the country’s murder rate.

The population applauded Alejandro Giammattei, a former director of prisons and the candidate of the ruling party, when he ordered a raid on a notorious prison last year that had become a center for organized crime. Subsequently, gunmen tried to end his life, Mr. Giammattei said.

After that, Guatemala’s top human rights official said there was evidence that the police had shot and killed seven prisoners after they had been detained in the raid. Mr. Giammattei denied that account, although public sympathy for the prisoners who were killed has been minimal.

Even the candidacy of Efraín Ríos Montt, a former dictator who is running for a congressional seat, has not prompted much of an uproar here. Mr. Ríos Montt is expected to win a seat, which will make it harder to prosecute him on charges of violating human rights during the country’s long civil war.

In April, 31 members of the United States Congress sent a letter to Guatemala’s attorney general calling for the immediate arrest of Mr. Ríos Montt, who ruled the country from 1982 to 1983, which was considered the bloodiest period of the civil war.

Warrants for Mr. Ríos Montt’s arrest, issued by a Spanish judge, stem from complaints filed by another presidential candidate, Rigoberta Menchú, winner of the 1992 Nobel Peace Prize for her work on behalf of Guatemala’s marginalized indigenous communities, which bore the brunt of the violence during the war.

With little in the way of resources, her campaign is struggling, despite its message of breaking with the country’s violent past. A Quiche Indian, she would be the first woman and the first indigenous person to serve as president.

As a symbol of the peace he wants, Mr. Colom, who is in his third bid for the presidency, threw a dove in the air at a recent campaign rally. It went up for a moment, its wings flapping furiously, then quickly plummeted to the ground.

Prosperous Haven in Mexico Is Invaded by Drug Violence

By Manuel Roig-Franzia
Washington Post Foreign Service
Saturday, August 4, 2007; A01

MONTERREY, Mexico -- Biti Rodriguez could have gone anywhere for her 10-year-old's birthday party. But Incredible Pizza, a mammoth restaurant and fun house tucked into the corner of a strip mall here, offered her something that suddenly has become a consuming obsession: safety.

She herded her daughter, Alejandra, and a dozen other giggling girls through two metal detectors one recent afternoon at this pizza parlor that promises "incredible security for your children," then dumped bags of presents on a table to be probed by a guard. It took a while to actually get inside, but Rodriguez didn't care. She thinks all the extra security is "super bien" -- super good.

Not so long ago, metal detectors at a pizza place would have been unimaginable in Monterrey, Mexico's third-largest metropolitan area, with more than 3.6 million residents. The city once seemed as if it could do no wrong -- two years ago it was named the safest city in Latin America by an international consulting group, it boasted the region's wealthiest residential neighborhood, and it was a strong competitor for the Major League Baseball franchise that became the Washington Nationals.

But in the past year, the drug violence raging across Mexico has landed hard in Monterrey, jarring residents who once felt immune to the shootouts so common in other big Mexican cities.

In the first six months of 2007, Monterrey registered 162 killings, nearly as many as were recorded in all of last year and about 50 more than in all of 2004. But it wasn't just the killings that shook up the Biti Rodriguezes of this city -- it was the brazenness of the killers.

A hit man walked calmly into the landmark Gran San Carlos restaurant, past rows of Monterrey's signature hanging roasted cabrito, or goat, and shot dead a man seated at a table beneath the stained-glass cupola. Gunmen launched volleys of bullets into a popular seafood restaurant at the height of the lunch rush, and police officers were mowed down in broad daylight.

The killings triggered tremors of fear. Newspapers now run daily tallies of slayings. A roadside hotel has advertised bulletproof rooms. Heavily armored cars have become a new status symbol, with corporate chieftains dishing out as much as $400,000 for Mercedes-Benz sedans that ward off not only bullets but also grenades. In the San Pedro Garza Garcia suburb, where hillside palaces rival the mansions of Beverly Hills, a new saying was born: "There are no Tuesdays without killings."

"I can't say Monterrey is the safest city in Mexico anymore -- that would be a lie," Jesús Marcos Giacomán, president of the 122-year-old Monterrey Chamber of Commerce and Tourism, said in an interview. "I can say we're going to make it the safest again."
An Economic Powerhouse

Monterrey wraps around the stunning, rocky peaks of the Sierra Madre, 130 miles southwest of McAllen, Tex. Gleaming towers form its skyline, and U.S.-style malls and upscale restaurants line its wide boulevards.

Known as the "Sultanate of the North" because of its popularity with Middle Eastern businessmen, Monterrey revved into an economic powerhouse after the North American Free Trade Agreement went into effect in 1994. The world's largest cement maker is here, as well as Mexico's biggest beer producer and one of the world's largest glass manufacturers. Major American corporations operate huge plants.

For the past five years, Monterrey stayed mostly peaceful while the rival Sinaloa and Gulf drug cartels fought over territory in other cities near the border, such as Nuevo Laredo. But something more complicated has happened here in the past year, Aldo Fasci Zuazua, deputy attorney general of Nuevo Leon state, said in an interview at his Monterrey office.

For unknown reasons, the local drug lords who warehouse cocaine, methamphetamines and marijuana for the big cartels began fighting each other, Fasci said. Their bloody battles unnerved the national and transnational cartels that counted on Monterrey's small-time operators to funnel tons of drugs into the United States.

A business that had run smoothly for years was suddenly a mess, and the national cartels felt compelled to sweep into Monterrey to "restore order," Fasci said. In the vernacular of organized crime, that meant killing people.
Fear Takes Hold

By April, assassinations were so rampant that the U.S. Embassy issued a travel warning for Monterrey noting that "Mexican and foreign bystanders" had been killed in Mexico. The next month, the business magazine America Economia dropped Monterrey from the top of its list of best places to do business in Latin America, a blow for a city that reaped a bonanza of publicity in 1999 when Fortune magazine dubbed it Latin America's top business locale.

Within days of America Economia's piece, Mexican President Felipe Calderón dispatched federal troops to patrol Monterrey's streets, one in a series of military assaults against cartel strongholds across the country.

Monterrey's wealthy -- the city is said to be home to more than a dozen of Mexico's most powerful families -- were well prepared to withstand the violence in their streets. Top corporations began hiring armed security forces. Executives and their families now travel in protective bubbles ringed by bodyguards and live behind high walls fitted with motion sensors and cameras.

But Monterrey's middle class, the pride of a state that boasts that its annual per-capita income of $14,000 is twice the national average, became frantic. Biti Rodriguez cringed each night when she watched the news. In her neighborhood, parents stopped letting their kids walk to school. School administrators tightened rules about who could pick up children.

Authorities know that private schools accept drug dealers' money to educate their kids, but "there's nothing that the government can do about it," Fasci said.

Rodriguez felt compelled to do something she'd never done before: She started locking the doors of her suburban Monterrey home.
Underworld Infiltration

With hundreds of millions of dollars flowing into the pockets of drug traffickers, authorities here suspect that organized crime has diversified, investing in criminal enterprises such as kidnapping and the smuggling of illegal immigrants, as well as legitimate businesses such as real estate.

The underworld has infiltrated state and municipal governments and police forces, damaging confidence in public institutions even though about 400 law enforcement officers suspected of corruption have been taken off the streets. One councilman here estimated that as many 200,000 people in the state of Nuevo Leon -- 5 percent of the population -- may be involved directly or indirectly in the drug trade.

Local politicians, especially in the many municipalities that abut Monterrey, say they feel like targets. One recent afternoon, a municipal councilman, speaking on condition of anonymity, said that he "feels threatened all the time" and that even the most minor decisions become complicating labyrinths that can paralyze local governments afraid of unknowingly angering drug lords.

To protect himself, he conducts extensive investigations, gaming out every possible scenario about the possible ripple effects of his votes. But those inquiries carry risks, too. "If you're asking all these questions," he said, "sometimes these narcos find out and get nervous."

Although he can afford to buy a car, he doesn't. He said driving the same car would make him easy to spot, so some days he grabs a taxi, other days he hops a bus. His route to the office varies from day to day -- it takes much longer, but he feels safer.

His municipality and others around Monterrey suffer from police shortages as officers quit rather than risk their lives at a time when several dozen officers have been killed. Authorities say police victims range from good cops who challenge the cartels to corrupt cops killed for favoring one cartel over another.

José Antonio Samaniego Hernández might have been one of those good cops, his family said in an interview. He survived one assassination attempt but was gunned down three months later while leaving the ramshackle home where he lived in a cramped bedroom with his wife, daughter and mother. Samaniego became a number that day -- execution victim No. 33 of 2007, according to the newspaper Milenio.

But to Anna Calderón Garcia, 15, he was the police officer down the street, the guy in the uniform who stopped to talk to all the kids. He was also one of half a dozen police officers she has known -- either as neighbors or because they spoke at her school -- who have been shot dead.

After never hearing a gunshot in her life, Calderón said, she has twice been startled by gunfire. One night while leaving a Wal-Mart, she and friends saw the bodies of two slain policemen lying in the parking lot.

"It changed my life forever," she said. "Now I'm always looking around me, wondering if I might get shot."

While most of the shooting victims in Monterrey have been alleged drug traffickers, innocent victims have also fallen, including a 42-year-old mother of five caught in the crossfire during a gun battle in December.

Kids in Calderón's class, like children in so many other places, once dreamed of being police officers, putting on uniforms, playing a glamorous real-life game of cops-and-robbers. Not anymore.

She lives three blocks from a funeral home and cups her ears when she hears sirens. Each time, she said, she whispers to herself: "Another dead one."

Mexico's feared band of hired guns takes a hit

By Carlos Martínez
Times Staff Writer

July 3, 2007

MEXICO CITY — Luis Reyes Enriquez was lying on the bed of a $13-per-night hotel room in a provincial town when federal troops came for him. Reyes, a leader in Mexico City of the infamous band of hit men known as the Zetas, was caught off guard: He was hung over from a wedding party the night before.

The arrest of the man also known as "Zeta 12" and "El Rex" was the latest in a series of blows in recent weeks to the Zetas, an organization born in the late 1990s when the Gulf cartel of drug traffickers began recruiting Mexican army deserters.

Reyes, 39, was an army deserter, as well as a former federal police officer who had once been assigned to work in the attorney general's office. As a well-trained gunman with an official pedigree, he was precisely the kind of man who helped build the Zetas' reputation as a paramilitary army at the service of drug traffickers.

Since taking office in December, President Felipe Calderon has declared an aggressive war on drugs and deployed thousands of federal troops throughout several Mexican states.

During the first seven months of his administration, authorities have arrested five Zeta leaders. A sixth Zeta was killed in an ambush with rivals. And the group's leader and founder, Osiel Cardenas, has been extradited to face drug-trafficking charges in the United States.

Three years ago, the Mexican attorney general's office had 44 members of the Zetas on its most-wanted list. As of May, with a growing number of Zetas in prison or dead in gun battles with authorities and rival traffickers, the number had declined to 27.

Analysts say Calderon's crackdown, along with a split in the Gulf cartel that is pitting old partners in crime against each other, is leading the Zetas to seek new avenues of income, such as kidnapping and extortion.

"There has been a clear effect on the Mexican drug market, which in turn has reduced the cash flow of these criminal groups and forced them to diversify their activities," said Erubiel Tirado, a security expert at the Ibero-American University here. "All of a sudden they're kidnapping businessmen. That's when they put themselves more at risk of getting caught."

A kidnapping scheme led to the arrest this year of Nabor Vargas, also a Zeta member.

Vargas, alias "El Debora," was captured in April when federal agents stormed a house in Ciudad del Carmen in the Gulf state of Campeche, looking for kidnapping victims and weapons. After a brief standoff, authorities rescued a prominent local businessman and arrested 19 people.

To the surprise of authorities, the kidnappers were being led by El Debora, one of the most-wanted criminals in Mexico and one of the first soldiers to desert and join the Zetas.

Vargas "was one of the founders of the Zetas and one of the few active members who was personally recruited by Osiel Cardenas," columnist Raymundo Riva Palacio wrote in the newspaper El Universal. For Vargas to be engaged in a kidnapping scheme illustrated a tremendous fall from power, Riva Palacio said.

It was an anonymous call that alerted police to the presence of Reyes in Atotonilco, a town in Hidalgo state, according to news reports. El Rex had attended a friend's wedding, and his heavily armed crew attracted the attention of residents.

In the early hours of June 24, after a night of partying, he headed to La Fuente Hotel to rest, unaware that he was under surveillance by dozens of soldiers and federal agents. He was arrested without incident. When authorities presented him to the media the next day in Mexico City, he was still dressed in a khaki suit and white dress shirt.

Not all arrests of Zetas are the result of the federal crackdown. Some are simply slip-ups by criminals known for their impulsive and reckless behavior.

Such was the case of Jose Ramon Davila Lopez, alias "El Cholo," who was arrested in February in the northern state of Tamaulipas.

According to the newspaper Reforma, El Cholo was cruising through the state capital, Ciudad Victoria, with his girlfriend when he caught a passerby staring at them. For a man considered one of Mexico's most dangerous criminals, this was apparently a grave insult.

El Cholo threw his car into reverse and called out: "What are you looking at?" A few seconds later he pulled a gun and opened fire, narrowly missing the man who had offended him.

The gunfire attracted local police. After a brief shootout, El Cholo was taken in. It took authorities six days to identify him as one of the Zetas.

Although it remains unclear how much power the Zetas still have, U.S. officials say the Mexican government is making important progress in many of the states where it has deployed troops to fight the drug trade.

"By going to places like Michoacan, Guerrero, Tamaulipas, Tabasco and Veracruz, you're able to knock many of these cells off their base of operations and circles of protection," said a senior U.S. official who asked not to be named. Mexican authorities are beginning to penetrate the "command-and-control structure" of several trafficking organizations, the official said.

Times staff writer Héctor Tobar contributed to this report.