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Medical Students in Limbo as Young Immigrant Program Ends

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Zarna Patel poses for a portrait at the Loyola University Medical
Zarna Patel poses for a portrait at the Loyola University Medical School in Maywood, Ill, Patel, a third year student
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Chicago, October 21: Medical students such as Alejandra Duran  Arreola are trying to shape the debate, and they have the backing of influential medical groups, including the American Medical Association.

Arreola dreams of becoming an OB-GYN in her home state of Georgia, where there’s a shortage of doctors and one of the highest maternal mortality rates in the U.S.

But the 26-year-old Mexican immigrant’s goal is now trapped in the debate over a program protecting hundreds of thousands of immigrants like her from deportation. Whether she becomes a doctor depends on whether Congress finds an alternative to the Deferred Action for Childhood Arrivals program that President Donald Trump phased out last month.

Arreola, who was brought to the U.S. illegally at age 14, is among about 100 medical students nationwide who are enrolled in DACA, and many have become a powerful voice in the immigration debate. Their stories have resonated with leaders in Washington. Having excelled in school and gained admission into competitive medical schools, they’re on the verge of starting residencies to treat patients, a move experts say could help address the nation’s worsening doctor shortage.

“It’s mostly a tragedy of wasted talent and resources,” said Mark Kuczewski, who leads the medical education department at Loyola University’s medical school, where Arreola is in her second year. “Our country will have said, ‘You cannot go treat patients.’”

The Chicago-area medical school was the first to openly accept DACA students and has the largest concentration nationwide at 32. California and New York also have significant populations, according to the Association of American Medical Colleges.

DACA gives protection to about 800,000 immigrants who were brought to the U.S. as children and who otherwise would lack legal permission to be in the country. The immigrants must meet strict criteria to receive two-year permits that shield them from deportation and allow them to work.

Then-President Barack Obama created DACA in 2012. Critics call it an illegal amnesty program that is taking jobs from U.S. citizens. In rescinding it last month, Trump gave lawmakers until March to come up with a replacement.

Public support for DACA is wide. A recent poll by The Associated Press-NORC Center for Public Affairs Research showed that just 1 in 5 Americans want to deport DACA recipients.

Arreola took a break from her studies last month to travel to Washington with fellow Loyola medical students and DACA recipient Cesar Montelongo Hernandez to talk to stakeholders. In their meetings with lawmakers, they framed the program as a medical necessity but also want a solution for others with DACA.

A 2017 report by the Association of American Medical Colleges predicts a shortfall of between about 35,000 and 83,000 doctors in 2025. That shortage is expected to increase with population growth and aging.

Hernandez, a 28-year-old from Mexico simultaneously pursuing a Ph.D., wants to focus his research on early detection of diseases. His work permit expires next September, and he’s worried he won’t qualify for scientific research funding without the program.

“I’ve shown I deserve to be here,” said Hernandez, who met with Illinois Sen. Dick Durbin, a Democrat who’s called for Congress to quickly pass a replacement for DACA.

For Arreola it’s about returning to the state she’s called home since she was 14 and giving back to areas in need of doctors.

“My family is from there; I know those people,” Arreola said. “Those are the people that inspired to really give this a push.”

Among those Arreola met with were policy staff for Georgia Republican Sen. Johnny Isakson, who believes the Obama program was “an overreach of executive power” but also wants Congress to write a plan to protect DACA recipients.

Medical school administrators say the immigrant medical students stand out even among their accomplished peers: They’re often bilingual and bicultural, have overcome adversity and are more likely to work with underserved populations or rural areas.

“They come with a cultural competency for how to best treat the individuals from their background, whether immigrants or different races and ethnicities,” said Matthew Shick, a government relations director for the Association of American Medical Colleges. “That gets translated over to their peers in education and training.”

Zarna Patel, 24, is a third-year student at Loyola who was brought to the U.S. from India as a 3-year-old without any legal documents. Her DACA permit expires in January, and she’s trying to renew it so she can continue medical school rotations that require clinical work. If she’s able to work in U.S., Patel will work in disadvantaged areas of Illinois for four years, part of her agreement to get school loans.

“Growing up, I didn’t have insurance,” she said. “I knew what that felt like, being locked out of the whole system.”

For others, there’s added worry of being stuck with debt they can’t repay.

Marcela Zhou, who was born in Mexico after her family moved there from China, is in her third year at the University of California at Los Angeles’ medical school. She wants to work in public health.

“Can I even afford to finish medical school?” said Zhou, who was 12 when she came to the U.S. on a visitor visa that eventually expired. “It’s sort of hard sometimes to keep going.”(VOA)

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Hurricane: Development of Beachfront areas Not Safe in US

US Beach Building Persists Despite Nature’s Grip

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FILE - Homes severely damaged by Superstorm Sandy are seen along the beach in Mantoloking, N.J., April 25, 2013. Mantoloking and Ocean City, N.J., planned to go to court to seize control of narrow strips of beachfront land from property owners blocking a desperately needed protective dune system along New Jersey's 127-mile coast. (VOA)

When a hurricane comes ashore, few images are more iconic than a million-dollar beach house collapsing into the sea.

Undermined by the ferocity of water, shifting sands and sometimes bad construction, waterfront development takes a beating each time a powerful storm barrels into the Eastern Seaboard.

So why do people keep building on the beach?

“Development of beachfront areas is controversial,” writes Florence Duarte of Georgia State University in the report Responsible Beachfront Development. “On one side, a growing human population demands the use of such areas for recreation and work. On the other, environmentalists and biologists hope to preserve these habitats.”

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Sandbags surround homes on North Topsail Beach, N.C., Sept. 12, 2018, as Hurricane Florence threatens the coast. (VOA)

A balance

The balance between the human desire to work and play on the water — and developing the waterfront responsibly — often is tested during hurricane and storm season. Despite increased intensity and frequency of storms, rising sea levels and other weather catastrophes, the beach remains the most desirable of destinations: The U.S. Environmental Protection Agency reports that more than half the U.S. population lives along a coast, and 180 million people visit each year.

Housing and rental prices along East Coast beaches in Florida, South Carolina, North Carolina, Virginia, Maryland, New Jersey, New York’s Long Island and Cape Cod in Massachusetts exceed the national average because of the views, fresh air and access to water activities. The point of sitting for hours in traffic on a hot, summer Friday is to get away from developed, urban, asphalt centers for the weekend.

Development tapped out

But many resort destinations are reaching maximum development.

In Ocean City, Maryland, a 14-kilometer-long barrier island that is home to about 7,000 permanent residents in the off-season, swells to more than 300,000 vacationers in the summer and on holidays.

“The development has pretty much tapped out,” said J.D. Wells, a Realtor and lifelong Ocean City resident. “The oceanfront is completely developed. Any new construction being done is replacing a tear-down that was already there.”

Properties that sit along the waterfront or have a view of the ocean can fetch more than double equivalent properties inland, Wells said.

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FILE – People walk along a beach near damaged beachfront homes, March 11, 2018, in Marshfield, Mass. The Northeast is bracing for its third nor’easter in fewer than two weeks. (VOA)

Views and taxes

Towns and cities collect substantial tax revenue from those waterfront and water-view properties, sometimes charging homeowners tens of thousands of dollars more in taxes for the luxury of owning beachfront property. In many areas that have seasonal ebbs and flows, tax revenue from those properties can fill municipal coffers that benefit permanent residents, many of whom cannot afford the waterfront prices of seasonal residents.

“Over the past few decades, society’s wealth, attitude and desires have shifted and floodplains are now being developed in more upscale ways,” said Andy Coburn, associate director for the Study of Developed Shorelines at Western Carolina University in Cullowhee, North Carolina.

“We can’t overlook the demand for coastal land, no matter how vulnerable or risky,” he added.

To protect beachfront properties, some towns have pushed back on nature by replacing sand stolen by storms. And while beach replenishment is expensive — Virginia Beach, Virginia, set aside $10 million for six years of sand replenishment — it is not permanent. The ocean is supposed to pound away at the beach, dragging it back out to sea.

In New Jersey, the state earmarked $1.2 billion for projects that reduce hurricane and storm damage, manage coastal storm risk and replenish the beaches that generate nearly half of the state’s $45.4 billion in annual tourism dollars.

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FILE – The remnants of a home leveled by Hurricane Matthew sit along the beachfront as Chief of Police George Brothers talks on the radio after Hurricane Matthew hit Edisto Beach, S.C., Oct. 8, 2016. (VOA)

Building codes for new construction require windows and doors that can withstand high winds and hold back flooding. Wells explained that seawalls and sand dunes are erected as barriers. But nature is mighty.

Powerful even on a normal day, the Atlantic Ocean, when combined with the energy of an extreme storm, can cut through solid land. Residents of Ocean City, Maryland, wandered out after a storm in 1933 to find that a 15-meter wide, 2.5-meter-deep inlet had been sliced into the south end of their barrier island, opening a convenient channel for fishing and pleasure craft between the ocean and the bay.

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Likewise, the ocean created an inlet in Chatham, Massachusetts, on Cape Cod, while snatching vintage, brown-shingled cottages into the sea in 2009, according to the Boston Globe newspaper.

“A compromise needs to be found that is responsible to both demands. Rational, sustainable usage of these areas is possible if people are willing to spend time and money in planning,” Duarte wrote.

“Bounded by water, coastal and waterfront communities are challenged to make the best use of limited land while protecting critical natural resources from the potentially damaging effects of growth,” says the National Oceanic and Atmospheric Administration (NOAA) in its SmartGrowth report. “These communities must consider a common set of overarching issues when managing growth and development.” (VOA)