France to stay in Mali until stability restored

BAMAKO/DUBAI (Reuters) - France pledged on Tuesday to keep troops in Mali until stability returned to the West African country, raising the specter of a long campaign against al Qaeda-linked rebels who held their ground despite a fifth day of air strikes.

Paris has poured hundreds of soldiers into Mali and carried out 50 bombing raids since Friday in the Islamist-controlled northern half of the country, which Western and regional states fear could become a base for terrorist attacks in Africa and Europe.

Defense Minister Jean-Yves Le Drian said that, despite French air support, Malian forces had not been able to dislodge Islamist fighters from the central Malian towns of Konna or Diabaly, just 350 km (220 miles) northeast of Bamako.

A column of French armored vehicles rolled northward from the dusty riverside capital of Bamako towards rebel lines on Tuesday, the first major northward deployment of ground troops. A military official declined to comment on their objective.

Thousands of African soldiers are due to take over the offensive. Regional armies are scrambling to accelerate an operation which was initially not expected until September and has been brought forward by France's surprise bombing campaign aimed at stopping a rebel advance on a strategic town last week.

President Francois Hollande, on a visit to the United Arab Emirates during which he sought Gulf states' financial backing for the African-led mission, suggested France would retain a major role in its former colony for months to come.

"We have one goal. To ensure that when we leave, when we end our intervention, Mali is safe, has legitimate authorities, an electoral process and there are no more terrorists threatening its territory," Hollande told a news conference.

Paris has said it plans to deploy 2,500 soldiers to bolster the Malian army and work with the intervention force provided by West African states.

AFRICAN TROOPS

West African Defense chiefs met in Bamako on Tuesday to approve plans for the swift deployment of 3,300 regional troops, foreseen in a United Nations-backed intervention plan. After failing to reach a final agreement, they adjourned their talks until Wednesday.

Nigeria pledged to deploy soldiers within 24 hours, and Belgium said it was sending transport planes and helicopters to help, but West Africa's armies need time to become operational.

Mali's north, a vast and inhospitable area of desert and rugged mountains the size of Texas, was seized last year by an Islamist alliance combining al Qaeda's north African wing AQIM with splinter group MUJWA and the home-grown Ansar Dine rebels.

Any delay in following up on the French air bombardments of Islamist bases and fuel depots with a ground offensive could allow the insurgents to slip away into the desert and mountains, regroup and counter-attack.

The rebels, who French officials say are mobile and well armed, have shown they can hit back, dislodging government forces from Diabaly on Monday.

Residents said the town was still under Islamist control on Tuesday despite a number of air strikes that shook houses.

An eye witness near Segou, to the south, told Reuters he had seen 20 French Special Forces soldiers driving toward Diabaly.

In Konna, whose seizure on Thursday sparked French involvement, residents said Islamist fighters were camped just outside town. Army troops had also withdrawn after entering the town on Saturday.

Malians have largely welcomed the French intervention, having seen their army suffer a series of defeats by the rebels.

"With the arrival of the French, we have started to see the situation on the front evolve in our favor," said Aba Sanare, a resident of Bamako.

QUESTIONS OVER READINESS

Aboudou Toure Cheaka, a senior regional official in Bamako, said the West African troops would be on the ground in a week.

The original timetable for the 3,300-strong U.N.-sanctioned African force - to be backed by western logistics, money and intelligence services - did not initially foresee full deployment before September due to logistical constraints.

Senegal, Burkina Faso, Niger, Nigeria and Guinea have all offered troops. Col. Mohammed Yerima, spokesman for Nigeria's Defense ministry, said the first 190 soldiers would be dispatched within 24 hours.

But Nigeria, which is due to lead the mission, has already cautioned that even if some troops arrive in Mali soon, their training and equipping will take more time.

Sub-Saharan Africa's top oil producer, which already has peacekeepers in Sudan's Darfur and is fighting a bloody and difficult insurgency at home against Islamist sect Boko Haram, could struggle to deliver on its troop commitment of 900 men.

One senior government adviser in Nigeria said the Mali deployment was stretching the country's military.

"The whole thing's a mess. We don't have any troops with experience of those extreme conditions, even of how to keep all that sand from ruining your equipment. And we're facing battle-hardened guys who live in those dunes," said the adviser, who asked not to be named.

FRENCH LINING UP SUPPORT

France, which has repeatedly said it has abandoned its role as policeman of its former African colonies, said on Monday that the U.S., Canada, Denmark and Germany had also offered logistical support.

Fabius has said Gulf Arab states would help the Mali campaign, while Belgium said on Tuesday it would send two C130 transport planes and two medical helicopters following a request from Paris.

A meeting of donors for the operation was expected to be held in Addis Ababa at the end of January.

Security experts have warned that the multinational intervention in Mali, couched in terms of a campaign by governments against "terrorism", could provoke a jihadist backlash against France and the West, and African allies.

U.S. officials have warned of links between AQIM, Boko Haram in Nigeria and al Shabaab Islamic militants fighting in Somalia.

Al Shabaab, which foiled a French effort at the weekend to rescue a French secret agent it was holding hostage, urged Muslims around the world to rise up against what it called "Christian" attacks against Islam.

"Our brothers in Mali, show patience and tolerance and you will win. War planes never liberate a land," Sheikh Ali Mohamud Rage, al Shabaab's spokesman, said on a rebel-run website.

U.S. officials said Washington was sharing information with French forces in Mali and considering providing logistics, surveillance and airlift capability.

"We have made a commitment that al Qaeda is not going to find any place to hide," U.S. Defense Secretary Leon Panetta told reporters as he began a visit to Europe. Panetta later said the U.S. had no plans to send troops to Mali.

One U.S. military source said the haphazard nature of French involvement reminded him of the U.S. entry into Afghanistan.

"I don't know what the French endgame is for this," the source said. "Air strikes are fine, but pretty soon you run out of easy targets. Then what do you do? What do you do when they head up into the mountains?"

(Additional reporting by Elizabeth Pineau and Raissa Kasolowsky in Abu Dhabi, Felix Onuah in Abuja and Tim Cocks in Lagos, Abdi Sheikh in Mogadishu, Michelle Nichols and Louis Charbonneau at the United Nations,; Richard Valdmanis in Dakar, Joe Bavier in Abidjan, Jan Vermeylen in Brussels; Writing by Pascal Fletcher, Daniel Flynn and David Lewis; editing by Richard Valdmanis, Giles Elgood and Will Waterman)

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PAP's Koh Poh Koon describes himself as a man who wants to get things done

SINGAPORE: Someone who wants to get things done and done effectively.

That's how Dr Koh Poh Koon describes himself, believing these traits can help him contribute as the People's Action Party's (PAP) candidate for the Punggol East by-election.

Despite being a new face in the constituency, Dr Koh feels that many residents have warmed up to him.

Despite having only been introduced to Punggol East voters recently, Dr Koh already looks comfortable interacting with the residents. That's because he said, communicating with people comes as second nature given his profession as a surgeon.

"My job as a doctor has allowed me to really be connecting to strangers that just walk into my clinic and within five minutes we've established a rapport.

"They put their lives in my hands to operate for them so I think building up a rapport with people and gaining their trust is something that comes naturally to me because of my training and my profession.

"And I think my personality and disposition does make it easier as well. Be sincere, be yourself, never be a different person, life gets miserable when you put up a facade.

"Second thing, be sincere and ernest and I think people will be able to listen and they can feel it and that much I learned from my patients".

Dr Koh may have been a grassroots volunteer for the last 11 years. But a recent meeting with a low-income Punggol East resident convinced him that he has made the right choice to stand as a PAP candidate in this by-election.

"He said doctor, we don't want handouts, help us get a breakthrough, break our poverty cycle and that really struck me that helping people really goes beyond giving handouts. It's about putting in place programmes that give people a break in life, giving people a future, that there's hope."

Connecting with the residents is of utmost importance to Dr Koh, prompting him to share his humble childhood experience.

"The way to understand a person is to know what he's made of, you need to know where he came from and that's the way of putting forward my life for residents to understand what makes me tick and I think that has achieved some resonance with the residents."

Dr Koh already has plans to provide new services such as daycare for the elderly and health screening programmes within a soon-to-be built community centre.

- CNA/ck

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Indian Army chief's statements "very hostile", says Pak foreign minister Hina Rabbani Khar

WASHINGTON: The disconnect between Pakistan's adrift and enfeebled civilian government and its out-of-control military was on show in the US last night when the country's foreign minister Hina Rabbani Khar insisted Islamabad wanted to resolve issues through dialogue rather than military actions despite the alleged depredations of its army resulting in the beheading of an Indian soldier.

The Indian leadership had to "catch up" with Pakistan in the matter of striving for peace with, Khar gratuitously told the Charlie Rose show, while presenting her country's version of what transpired at the LoC and denying the Indian account the soldier's beheading.

Khar arrived in the US to attend a special session of the UN Security Council of which Pakistan is the Chairman for the month of January even as her toxic country was imploding from a shadowy confrontation involving the judiciary, military, and clerical-political forces. But she presented the voice of sweet reason before American TV audience, maintaining that Islamabad was striving for peace and describing the Indian Army Chief's warning to Pakistan as "very hostile."

"After the comments by the army chief I am taken back by 20 years," Khar said on show aired on PBS.

Charlie Rose: What did he say?

Khar: Just very hostile comments.

The Indian Army Chief Gen Bikram Singh had warned Pakistan that India reserves the right to retaliate at the "time and place" of its choosing, suggesting that the border spat is not going to be buried anytime soon. India's political leadership too appeared to be responding with spine after initial timidity, following popular anger and media outcry.

Khar said Pakistan was "not very pleasantly surprised" by the comments it heard from India and gratuitously added "I think this is what has changed in Pakistan where India needs to catch up." Pakistan, she said, today presents a country "which is very clear in its head as to how it wants to operate with its neighbors."

"And the way we want to operate with our neighbors is to try and build on the trust to take care of and then build that trust enough to be able to build an environment in which we can take care of the disputes that we have on the dialogue table rather than through military statements and through military actions," she added.

While the Pakistan foreign minister's statements were mainly meant for western consumption, it is no great secret among analysts here that the country's civilian government has little control or leverage over the military, which plays by its own jihadi rule book both in its eastern and western front. There has been speculation in expert circles that the Pakistani military or sections of it could be turning up the heat on its eastern front with India to rein in and redirect some of the jihadi forces which are attacking the military.

On Tuesday, the regionalists were also riveted to the new power struggle in Islamabad with little attention paid to India's fulminations on the border incident.

In Khar's version of the border incident, it was Indian forces which came 400 meters inside Pakistani territory for an attack which resulted in the death of a Pakistani soldier. "Now just two days after that or three days after that, we had an allegation which was made that two Indian soldiers were killed by Pakistani fighting which we looked into and we could find no evidence that Pakistani troops had done that. And then of course, there were extremely conflicting statements that the heads were decapitated," Khar narrated, capitalizing on the initial mixed messages that came from India.

"The northern commander spokesperson who is the person on the ground said they weren't (beheaded). Others said they were," she added, suggesting that the issue had become embroiled in domestic politics.

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Risk to all ages: 100 kids die of flu each year

NEW YORK (AP) — How bad is this flu season, exactly? Look to the children.

Twenty flu-related deaths have been reported in kids so far this winter, one of the worst tolls this early in the year since the government started keeping track in 2004.

But while such a tally is tragic, that does not mean this year will turn out to be unusually bad. Roughly 100 children die in an average flu season, and it's not yet clear the nation will reach that total.

The deaths this year have included a 6-year-old girl in Maine, a 15-year Michigan student who loved robotics, and 6-foot-4 Texas high school senior Max Schwolert, who grew sick in Wisconsin while visiting his grandparents for the holidays.

"He was kind of a gentle giant" whose death has had a huge impact on his hometown of Flower Mound, said Phil Schwolert, the Texas boy's uncle.

Health officials only started tracking pediatric flu deaths nine years ago, after media reports called attention to children's deaths. That was in 2003-04 when the primary flu germ was the same dangerous flu bug as the one dominating this year. It also was an earlier than normal flu season.

The government ultimately received reports of 153 flu-related deaths in children, from 40 states, and most of them had occurred by the beginning of January. But the reporting was scattershot. So in October 2004, the government started requiring all states to report flu-related deaths in kids.

Other things changed, most notably a broad expansion of who should get flu shots. During the terrible 2003-04 season, flu shots were only advised for children ages 6 months to 2 years.

That didn't help 4-year-old Amanda Kanowitz, who one day in late February 2004 came home from preschool with a cough and died less than three days later. Amanda was found dead in her bed that terrible Monday morning, by her mother.

"The worst day of our lives," said her father, Richard Kanowitz, a Manhattan attorney who went on to found a vaccine-promoting group called Families Fighting Flu.

The Centers for Disease Control and Prevention gradually expanded its flu shot guidance, and by 2008 all kids 6 months and older were urged to get the vaccine. As a result, the vaccination rate for kids grew from under 10 percent back then to around 40 percent today.

Flu vaccine is also much more plentiful. Roughly 130 million doses have been distributed this season, compared to 83 million back then. Public education seems to be better, too, Kanowitz observed.

The last unusually bad flu season for children, was 2009-10 — the year of the new swine flu, which hit young people especially hard. As of early January 2010, 236 flu-related deaths of kids had been reported since the previous August.

It's been difficult to compare the current flu season to those of other winters because this one started about a month earlier than usual.

Look at it this way: The nation is currently about five weeks into flu season, as measured by the first time flu case reports cross above a certain threshold. Two years ago, the nation wasn't five weeks into its flu season until early February, and at that point there were 30 pediatric flu deaths — or 10 more than have been reported at about the same point this year. That suggests that when the dust settles, this season may not be as bad as the one only two years ago.

But for some families, it will be remembered as the worst ever.

In Maine, 6-year-old Avery Lane — a first-grader in Benton who had recently received student-of-the-week honors — died in December following a case of the flu, according to press reports. She was Maine's first pediatric flu death in about two years, a Maine health official said.

In Michigan, 15-year-old Joshua Polehna died two weeks ago after suffering flu-like symptoms. The Lake Fenton High School student was the state's fourth pediatric flu death this year, according to published reports.

And in Texas, the town of Flower Mound mourned Schwolert, a healthy, lanky 17-year-old who loved to golf and taught Sunday school at the church where his father was a youth pastor.

Late last month, he and his family drove 16 hours to spend the holidays with his grandparents in Amery, Wis., a small town near the Minnesota state line. Max felt fluish on Christmas Eve, seemed better the next morning but grew worse that night. The family decided to postpone the drive home and took him to a local hospital. He was transferred to a medical center in St. Paul, Minn., where he died on Dec. 29.

He'd been accepted to Oklahoma State University before the Christmas trip. And an acceptance letter from the University of Minnesota arrived in Texas while Max was sick in Minnesota, his uncle said.

Nearly 1,400 people attended a memorial service for Max two weeks ago in Texas.

"He exuded care and love for other people," Phil Schwolert said.

"The bottom line is take care of your kids, be close to your kids," he said.

On average, an estimated 24,000 Americans die each flu season, according to the Centers for Disease Control and Prevention. People who are elderly and with certain chronic health conditions are generally at greatest risk from flu and its complications.

The current vaccine is about 60 percent effective, and is considered the best protection available. Max Schwolert had not been vaccinated, nor had the majority of the other pediatric deaths.

Even if kids are vaccinated, parents should be watchful for unusually severe symptoms, said Lyn Finelli of the CDC.

"If they have influenza-like illness and are lethargic, or not eating, or look punky — or if a parent's intuition is the kid doesn't look right and they're alarmed — they need to call the doctor and take them to the doctor," she advised.

___

CDC advice on kids: http://www.cdc.gov/flu/protect/children.htm

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NY Passes Nation's Toughest Gun Law

Today New York became the first state to pass a gun control law -- the toughest in the nation -- since the Sandy Hook Elementary School shooting massacre last month.

Acting one month and a day since the rampage killing that left 20 first-graders and six educators dead, Gov. Andrew Cuomo signed the bill into law shortly after 5 p.m.

Called the New York Safe Act, the law includes a tougher assault weapons ban that broadens the definition of what constitutes an assault weapon, and limits the capacity of magazines to seven bullets, down from 10. The law also requires background checks of ammunition and gun buyers, even in private sales, imposes tougher penalties for illegal gun use, a one-state check on all firearms purchases, and programs to cut gun violence in high-crime neighborhoods.

As he signed the bill into law, Cuomo said it was not only "the first bill" but the "best bill."

"I'm proud to be a New Yorker, because New York is doing something, because we are fighting back, because, yes, we've had tragedies, and yes, we've had too many innocent people lose their lives, and yes, it's unfortunate that it took those tragedies to get us to this point, but let's at least learn from what's happened, let's at least be able to say to people, yes, we went through terrible situations, but we saw, we learned, we responded, and we acted, and we are doing something about it," Cuomo said. "We are not victims.

NYC Mayor Michael Bloomberg on 'Epidemic of Gun Violence' Watch Video

'The View' on NRA Shooting App: Think It Out Watch Video

"You can overpower the extremists with intelligence and with reason and with commonsense," Cuomo continued, "and you can make this state a safer state."

New York's law also aims to keep guns out of the hands of those will mental illness. The law gives judges the power to require those who pose a threat to themselves or others get outpatient care. The law also requires that when a mental health professional determines a gun owner is likely to do harm, the risk must be reported and the gun removed by law enforcement.

The legislation also includes what is called a "Webster provision," named for the two firefighters ambushed on Christmas Eve in Webster, N.Y. The measure would mandate a life sentence with no chance of parole for anyone who kills a first responder.

The National Rifle Association issued a statement after the bill's signing, saying it was "outraged at the draconian gun control bill that was rushed through ... late Monday evening."

"Gov. Andrew Cuomo and the New York State Legislature orchestrated a secretive end-run around the legislative and democratic process and passed sweeping anti-gun measures with no committee hearings and no public input," the statement read. "These gun control schemes have failed in the past and will have no impact on public safety and crime. Sadly, the New York Legislature gave no consideration to that reality. While lawmakers could have taken a step toward strengthening mental health reporting and focusing on criminals, they opted for trampling the rights of law-abiding gun owners in New York, and they did it under a veil of secrecy in the dark of night. The legislature caved to the political demands of a governor and helped fuel his personal political aspirations."

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West African army chiefs to approve Mali troops plan

BAMAKO (Reuters) - West African defense chiefs will on Tuesday approve plans to speed up the deployment of African troops against Islamist rebels in northern Mali, with some regional soldiers seen arriving next week.

France has already poured hundreds of troops into Mali and carried out days of air strikes in a vast desert area seized last year by an Islamist alliance that combines al Qaeda's north African wing AQIM with Mali's home-grown MUJWA and Ansar Dine rebel groups.

Western and regional powers are concerned the insurgents will use Mali's north as a launchpad for international attacks.

"On January 15, the committee of Chiefs of Defense Staff will meet in Bamako to approve the contingency plan," the mission head of the ECOWAS grouping of West African states, Aboudou Toure Cheaka, told Reuters.

"I can tell you that in one week, the troops will effectively be on the ground," he said, adding their immediate mission would be to help stop the rebel advance while preparations for a full intervention plan continued.

He did not say how many soldiers would arrive.

The original timetable for the 3,300-strong U.N.-sanctioned African force - backed by western logistics, money and intelligence services - did not initially foresee full deployment before September due to logistical constraints.

Senegal, Burkina Faso, Niger, Nigeria and Guinea have all offered troops. But regional powerhouse Nigeria, which is due to lead the mission, has cautioned that even if some troops arrive in Mali soon, training will take more time.

The plan is being fast-tracked after France rushed to respond to a plea for help by Mali's government after mobile columns of Islamist fighters last week threatened the central garrison towns of Mopti and Sevare, with its key airport.

The French defense ministry said on Monday it aimed to deploy some 2,500 soldiers to Mali to bolster the Malian army and the eventual West African force.

"SAFEGUARD MALI"

French Prime Minister Jean-Marc Ayrault said France's goals were to stop the Islamist rebels, to "safeguard the existence of Mali" and pave the way for the African-led military operation.

U.S. officials said Washington was sharing information with French forces in Mali and considering providing logistics, surveillance and airlift capability.

"We have made a commitment that al Qaeda is not going to find anyplace to hide," U.S. Defense Secretary Leon Panetta told reporters as he began a visit to Europe.

As French aircraft bombarded mobile columns of Islamist fighters, other insurgents launched a counter-attack further to the south, dislodging government forces from the town of Diabaly, 350 km (220 miles) from Bamako.

French intervention has raised the threat for eight French hostages held by al Qaeda allies in the Sahara and for 30,000 French expatriates living in neighboring, mostly Muslim states. Concerned about reprisals at home, France has tightened security at public buildings and on public transport.

The U.N. said an estimated 30,000 people had fled the latest fighting in Mali, joining more than 200,000 already displaced.

U.N. Secretary-General Ban Ki-moon on Monday welcomed the French-led military intervention in Mali and voiced the hope that it would halt the Islamist assault.

Amnesty International said at least six civilians were killed in recent fighting in the town of Konna, where French aircraft had earlier bombarded rebel positions, and called on both sides to spare non-combatants.

France, which has repeatedly said it has abandoned its role as the policeman of its former African colonies, is among the toughest proponents of a speedier deployment of the African troops, and convened a U.N. Security Council meeting Monday to discuss the crisis.

French U.N. Ambassador Gerard Araud told reporters after the meeting that the U.S., Canada, Belgium, Denmark and Germany had also offered logistical support for France's Mali operation.

"I felt that all the members of the Security Council were expressing their support (for) and understanding of the French decision," Araud told reporters.

No Europeans or other African Union members will be allowed in the defense chiefs meeting in Bamako on Tuesday, a western diplomat told Reuters, requesting not to be named.

"They don't want any French pressure at the meeting," the diplomat said.

(Reporting by Bate Felix; Additional reporting by Michelle Nichols and Louis Charbonneau at the United Nations Richard Valdmanis in Dakar, Brian Love in Paris and David Alexander in Lisbon; Editing by Richard Valdmanis and Giles Elgood)

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Tennis: Ice-cool Murray crushes Haase at Australian Open

MELBOURNE: Andy Murray brushed aside Dutchman Robin Haase in a clinical display to progress smoothly to the second round of the Australian Open.

The third-seeded Scot had few problems with the 53rd-ranked Haase, winning 6-3, 6-1, 6-3 in 1hr 37min in warming temperatures on Rod Laver Arena.

Murray, who broke through for his first Grand Slam title at last year's US Open, was always in charge of his opening match breaking Haase's service eight times in a dominant display.

"It was a good start and it was nice to win in straight sets, it was the hottest day of the tournament so far," Murray said at courtside.

"It took a little while to get used to that and the court was playing much quicker because of it."

Murray, 25, has twice been runner-up at the Australian Open. He is drawn to face 17-time Grand Slam champion Roger Federer in the semi-finals and possibly defending champion Novak Djokovic in the final.

The Scot hit 25 winners mixed with 20 unforced errors, while Haase gave up 35 unforced errors.

Murray broke the erratic Dutchman's serve three times to take the opening set in 41 minutes helped by his superior accuracy. Meanwhile Haase frequently over-hit his volleys and failed to put consistent pressure on the third seed.

Murray was broken as he attempted to serve out for the set, putting a weak sliced backhand into the net, but it was only a temporary setback as the Scot broke Haase's serve next game for the set.

Murray, with an iced towel around his neck at changeovers to cope with the heat, took a grip on the match and he raced through the second set in 26 minutes with two more service breaks, conceding just 12 points.

And the third seed broke the wilting Dutchman's opening service game in the final set as he surged towards victory.

Murray reeled off another break in the fifth game, but lost his own serve for only the second time in the match at 4-2. But he again broke Haase's serve to take the match when the Dutchman overhit a forehand.

- AFP/ck

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National Conference may induct Congress MLAs in J&K Cabinet

NEW DELHI: Jammu and Kashmir chief minister Omar Abdullah can expand and reshuffle his ministry on Tuesday following a prod from AICC president Sonia Gandhi on Sunday evening. Congress leaders like Saifuddin Soz have been asking for more representation from their party in the Omar-led National Conference coalition government.

Abdullah had dropped two Congress ministers, G A Saroori and Peerzada Mohammad Sayeed, on charges of corruption. Saroori, a Congress MLA from Kishtwar, was charged for an impersonation fraud in the medical entrance test that his daughter gave and Peerzada was accused of helping his step-son copy in Class X exams. They were exonerated by the CBI and a state-level investigation team.

Sonia asked for the inclusion of more Congress legislators in the J&K House. State governor NN Vohra rushed to Jammu from New Delhi to make arrangements for the oath ceremony of new ministers at 4pm on Tuesday. Soz and Ghulam Nabi Azad had briefed Sonia about the unrest in the Congress camp after berths meant for them were not filled.

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Hospitals crack down on workers refusing flu shots

CHICAGO (AP) — Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal.

"Where does it say that I am no longer a patient if I'm a nurse," wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.

Hospitals' get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.

Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.

In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.

Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.

Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.

"We would all like to see stronger data," she said. But other evidence shows flu vaccination "significantly decreases" flu cases, she said. "It should work the same in a health care worker versus somebody out in the community."

Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly "a personal thing." She's among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body."

Medical ethicist Art Caplan says health care workers' ethical obligation to protect patients trumps their individual rights.

"If you don't want to do it, you shouldn't work in that environment," said Caplan, medical ethics chief at New York University's Langone Medical Center. "Patients should demand that their health care provider gets flu shots — and they should ask them."

For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.

A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.

At Calhoun's hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, "I'm wearing the mask for your safety," Calhoun says. She says that's discriminatory and may make patients want to avoid "the dirty nurse" with the mask.

The hospital justified its vaccination policy in an email, citing the CDC's warning that this year's flu outbreak was "expected to be among the worst in a decade" and noted that Illinois has already been hit especially hard. The mandatory vaccine policy "is consistent with our health system's mission to provide the safest environment possible."

The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.

According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That's up from previous years, but the government wants 90 percent coverage of health care workers by 2020.

The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.

Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.

Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.

Starting this year, the government's Centers for Medicare & Medicaid Services is requiring hospitals to report employees' flu vaccination rates as a means to boost the rates, the CDC's Bridges said. Eventually the data will be posted on the agency's "Hospital Compare" website.

Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they're adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.

Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work — partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.

While not 100 percent effective, this year's vaccine is a good match, the CDC's Bridges said.

Several states have laws or regulations requiring flu vaccination for health care workers but only three — Arkansas, Maine and Rhode Island — spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policy and co-author of a study appearing this month in the journal Vaccine.

Rhode Island's regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.

Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.

"We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole," but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.

Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.

Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.

Calhoun, the Illinois nurse, says she is unsure of her options.

"Most of the hospitals in my area are all implementing these policies," she said. "This conflict could end the career I have dedicated myself to."

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Online:

R.I. union lawsuit against mandatory vaccines: http://www.seiu1199ne.org/files/2013/01/FluLawsuitRI.pdf

CDC: http://www.cdc.gov

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Armstrong Admits Doping in Tour, Sources Say

Lance Armstrong today admitted to Oprah Winfrey that he used performance enhancing drugs to win the Tour de France, sources told ABC News.

A goverment source tells ABC News that Armstrong is now talking with authorities about paying back some of the US Postal Service money from sponsoring his team. He is also talking to authorities about confessing and naming names, giving up others involved in illegal doping. This could result in a reduction of his lifetime ban, according to the source, if Armstrong provides substantial and meaningful information.

Armstrong made the admission in what sources describe as an emotional interview with Winfrey to air on "Oprah's Next Chapter" on Jan. 17.

The 90-minute interview at his home in Austin, Texas, was Armstrong's first since officials stripped him of his world cycling titles in response to doping allegations.

Word of Armstrong's admission comes after a Livestrong official said that Armstrong apologized today to the foundation's staff ahead of his interview.

The disgraced cyclist gathered with about 100 Livestrong Foundation staffers at their Austin headquarters for a meeting that included social workers who deal directly with patients as part of the group's mission to support cancer victims.

Armstrong's "sincere and heartfelt apology" generated lots of tears, spokeswoman Katherine McLane said, adding that he "took responsibility" for the trouble he has caused the foundation.

Riccardo S. Savi/Getty Images|Ray Tamarra/Getty Images

Lance Armstrong Stripped of Tour de France Titles Watch Video

Lance Armstrong Doping Charges: Secret Tapes Watch Video

McLane declined to say whether Armstrong's comments included an admission of doping, just that the cyclist wanted the staff to hear from him in person rather than rely on second-hand accounts.

Armstrong then took questions from the staff.

Armstrong's story has never changed. In front of cameras, microphones, fans, sponsors, cancer survivors -- even under oath -- Lance Armstrong hasn't just denied ever using performance enhancing drugs, he has done so in an indignant, even threatening way.

Armstrong, 41, was stripped of his seven Tour de France titles and banned from the sport for life by the U.S. Anti-Doping Agency in October 2012, after allegations that he benefited from years of systematic doping, using banned substances and receiving illicit blood transfusions.

"Lance Armstrong has no place in cycling and he deserves to be forgotten in cycling," Pat McQuaid, the president of the International Cycling Union, said at a news conference in Switzerland announcing the decision. "This is a landmark day for cycling."

The U.S. Anti-Doping Agency issued a 200-page report Oct. 10 after a wide-scale investigation into Armstrong's alleged use of performance-enhancing substances.

Armstrong won the Tour de France from 1999 to 2005.

According to a source, speaking to ABC News, a representative of Armstrong's once offered to make a donation estimated around $250,000 to the agency, as "60 Minutes Sports" on Showtime first reported.

Lance Armstrong's attorney Tim Herman denied it. "No truth to that story," Herman said. "First Lance heard of it was today. He never made any such contribution or suggestion."

Armstrong, who himself recovered from testicular cancer, created the Lance Armstrong Foundation (now known as the LIVESTRONG Foundation) to help people with cancer cope, as well as foster a community for cancer awareness. Armstrong resigned late last year as chairman of the LIVESTRONG Foundation, which raised millions of dollars in the fight against cancer.

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