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Married to a smartphone, this device can detect the Lao lao worm. Daniel A. Fletcher, UC Berkeley hide caption

itoggle caption Daniel A. Fletcher, UC Berkeley

Married to a smartphone, this device can detect the Lao lao worm.

Daniel A. Fletcher, UC Berkeley

Smartphones aren't simply an amazing convenience. In Africa they can be used to make a life-saving diagnosis. In fact, scientists are hoping to use a souped-up smartphone microscope to help them eradicate a devastating disease called river blindness.

Onchocerciasis, as the disease is also known, is caused by a parasite that's spread by flies. Thirty years ago, it was simply devastating in parts of Africa, like Mali.

"We went out to villages where 40 to 50 percent of the adults were blind," says Dr. Gary Weil, a parasitic disease specialist at the Washington University School of Medicine in St. Louis. Worldwide, 300,000 people are blind as a result of this parasite, according to the World Health Organization.

That situation changed dramatically when researchers discovered that a veterinary medicine called ivermectin could prevent river blindness in people. Since 1987, drug-maker Merck has donated more than a billion doses of this drug to fight river blindness and a related disease. The drug is given both as a preventive and after someone is diagnosed.

"The ivermectin has had an amazing effect," Weil says. There's a massive campaign under way to use the drug to eradicate river blindness entirely with an annual dose.

But there's a problem. In some areas, people are also infected by another parasite, a worm called Loa loa. And if someone has a raging Loa loa infection and you give them ivermectin, that can occasionally prove deadly.

The workaround has been to look for Loa loa worms in people before giving them the drug.

"The traditional way of making the measurement involves taking blood smears, looking at them under a conventional microscope by a trained individual, and counting [the worms] manually," says Daniel Fletcher, a bioengineering professor at the University of California, Berkeley. "And that's a far too laborious and long process to be used in a mass drug-administration program, which is what they were running."

Fletcher has been working on novel ways to use iPhones as the centerpiece of inexpensive, portable microscopes. One day he got a call from Dr. Thomas Nutman at the National Institute of Allergy and Infectious Diseases, asking Fletcher if he could develop a device that could quickly and reliably detect Loa loa in a drop of blood.

The worms don't make this job easy. They hide out in the lungs and "are only present in the bloodstream between 11 a.m. and 1 p.m.," Fletcher says. "The tests all have to be done during that time frame, so being quick is really important."

Fletcher's group at Berkeley set to work, and came up with way to detect the squirming motion of those worms when they emerge and circulate in the blood. They report their advance in the journal Science Translational Medicine.

"The phone does pretty much everything," Fletcher says. A health worker collects a pin-prick of blood in a small glass tube and pushes it into a compact and inexpensive microscope adapter that connects to the iPhone.

"You press one button, 'go,' and the phone controls the movement of the sample, controls taking of a video and controls analysis and reporting of the results."

In three minutes, start to finish, the process can tell the health worker whether it's safe to give the person ivermectin. But even producing an answer every three minutes still only translates to 40 results per day per phone, since the tests can only be run during a two-hour period. That's much faster than the conventional method, but the numbers are still daunting.

Weil says it seems useful on a smaller scale, but "I don't see it how it could be scaled up to the scale of tens of millions of people" who currently live in areas where both the Loa loa worm and the river blindness parasite live.

"And it wouldn't just be a one-time test," Weil adds, "since the treatment for river blindness is a once-a-year treatment, every year they would have to be tested."

The real solution, Weil says, is to find a drug that can safely kill both parasites at the same time. Researchers are working on that right now.

river blindness

smartphone

Pope Francis will canonize Spanish missionary Junipero Serra during his visit to the U.S. later this year, the Vatican says, affirming a plan that's drawn criticism over Serra's role in the California mission system of the 18th century.

After announcing his decision in January, Francis didn't wait for the traditional approval of a second miracle before moving ahead with canonizing Serra, whom the pope has praised for his zeal.

"I think it has to be seen from the viewpoint of a Latin American," NPR's Sylvia Poggioli reports from Rome. "A Vatican official told reporters that the canonization will give the United States its first Hispanic saint, and it will help counter what he called an 'Anglo-centric' view of history."

Sylvia adds, "But Native Americans accuse Serra of having helped wipe out their populations by spreading diseases, and they say he brutally imposed conversion."

As Jasmine Garsd reported for the Two-Way when the canonization plan was first announced in January:

"Serra, a Franciscan friar, founded the Mission of San Diego in 1769. As the Spanish army built fortresses nearby, he moved north, creating eight other missions all the way up to the San Francisco Bay.

"As the Spaniards pushed through California, so did diseases, which wiped out large numbers of the native population. Tribes were pushed to convert and to live in the missions, where they were taught to farm. Those who disobeyed were severely punished. It was not unheard of for someone to be whipped to death."

Sylvia reports, "with reference to charges that Serra used corporal punishment on Native Americans, an official of the saint-making office told reporters last month, 'It's not to be excluded, but it wasn't genocide.'"

Los Angeles Archbishop Jose H. Gomez recently defended Serra against his critics, suggesting that Serra's writings and other records "prove his efforts to defend the native peoples, particularly against the cruelty of the Spanish soldiers and governors," the Catholic News Service reports.

Serra died in 1784. Francis is scheduled to canonize him on Sept. 23, during the pope's visit to Washington, D.C., the Vatican says.

Junipero Serra

Pope Francis

Vatican

When Mike Huckabee ran for president eight years ago, he was a new face on the national scene, a fresh upstart former governor of Arkansas and a one-time Baptist preacher, who quickly became a favorite among evangelical voters.

He had an ease on the campaign trail, an openness with the media, and a quirkiness that made him seem like a breath of fresh air.

Now he's back for a second try at the nomination. But this time he'll have to contend with a new crop of young Republican hopefuls.

Even as he sizes up this year's GOP field — including rising Republican superstars like Ted Cruz, Marco Rubio, Rand Paul and Scott Walker — his campaign kickoff Thursday felt like a nod to an earlier time, one of decades past.

There was Tony Orlando on stage, emceeing the event and singing his No. 1 hit — from 40 years ago, "Whoa, tie a yellow ribbon around the old oak tree, it's been three long years, do you still want me?"

The move is already being lampooned by some:

But Huckabee, who took the stage in his hometown of Hope, Ark. — the same town where Bill Clinton grew up — spoke of the values he was taught as a child. They're values he believes the nation needs to fully embrace today.

"It was here in Hope that I learned how to swim, how to ride a bike, how to read, how to work, and how to play fair," Huckabee said. "I learned the difference between right and wrong. I learned that God loves me as much as He loves anyone, but that He doesn't love some more than others."

Huckabee won the Iowa caucuses in 2008 and seven other states' nominating contests, thanks, in large measure, to conservative Christian voters. He is again reaching out to them.

"We prayed at the start of each day," Huckabee said, "and we prayed again before lunch, and I learned that this exceptional country could only be explained by the providence of almighty God."

Huckabee added that he believes the country has lost its way morally. He pointed to the U.S. Supreme Court's pending decision on same-sex marriage.

"My friends, the Supreme Court is not the Supreme Being," he said, "and they can't overturn the laws of nature or of nature's God."

Many in the crowd were sympathetic and came away impressed, but they weren't all sure he would have as easy a time as 2008 coalescing evangelicals around his bid.

"You know, I think he still can do a good job among the evangelical voters, but it's just some people may want that young face — that young politician," said 31-year-old youth pastor Jonathan Montgomery, who was just 23 the last time Huckabee ran. "And so he's going to have his work cut out for him, I believe."

As Huckabee embarks on another race, in which he finds new competition for the evangelical voters he did so well with last time, he also faces a test of whether his old-fashioned personality fits with the times.

Orlando's song is about an ex-convict coming home from prison and is unsure if his girlfriend will still want him after the time away. He anxiously awaits as the prison bus pulls into town, and he looks for whether there is a yellow ribbon tied for him, signifying that he is welcome back.

Orlando could have changed the words from a "three-long-years'" wait to "eight," and it would have been a metaphor for Huckabee's campaign.

(The song pushed yellow ribbons into pop culture and became a symbol not of prisoners returning home but as a way to show support for American hostages in Iran and then later, in the 1990s, of U.S. troops fighting overseas in the first Gulf War.)

Huckabee will find out soon enough if those Iowa evangelicals he was so popular with are going to be tying yellow ribbons for him.

2016 Presidential Race

Mike Huckabee

Republicans

President Obama says he wants consumers around the world buying more products stamped, "Made in the U.S.A."

That's one reason he's pushing a controversial Asian trade deal known as the Trans-Pacific Partnership.

Obama has chosen a curious setting to make his pitch for the trade agreement this week. He'll be speaking Friday at the Beaverton, Ore. headquarters of the Nike Corporation.

"All of their footwear, all of their clothing is produced in contract factories in places like Vietnam and Indonesia and China," said Scott Nova, executive director of the Worker Rights Consortium, a watchdog group that monitors overseas factories.

"Nike is one of the companies that helped perfect the sourcing model that now defines production in footwear and garments and other major light manufacturing sectors. And it's a model based on cheap labor and poor working conditions," Nova said.

Nike, which had $28 billion in sales last year, did not respond to telephone and email requests for comment.

After a burst of bad publicity in the 1990s, Nike tried to clean up factory abuses such as child labor. But the company's most recent report on "sustainable business performance" acknowledges nearly a third of the factories making its products fall short of Nike's own standards. Hours and wages are the most common complaints.

That raises eyebrows of critics who ask why the president would choose such a setting to make the case for his Asia-Pacific trade deal. The administration says the proposed agreement is designed to raise labor standards in the twelve participating countries including Vietnam, the number one source for Nike shoes.

"The president believes that by raising labor standards and raising environmental standards throughout the Asia-Pacific region, that will level the playing field for American businesses," said White House spokesman Josh Earnest. "No longer will companies be able to gain an unfair advantage by capitalizing on low labor standards."

When Nike first blazed the trail of offshore manufacturing in the 1960s, more than 90 percent of the shoes Americans wore were still made domestically. But since then, nearly every other American shoemaker has followed Nike's path, and today more than 99 percent of our shoes are imported, mostly from China, Vietnam, and Indonesia.

Oregon Sen. Ron Wyden, who represents Nike's home state of Oregon, is one of the leading supporters of the trade deal. He wrote a letter two years ago arguing there's no justification for the tariffs levied on imported shoes, now that there's virtually no domestic manufacturing left to protect. Shoe tariffs totaled $2.7 billion last year, of which about $460 million was for shoes from countries covered by the Trans-Pacific Partnership.

Supporters say lowering those tariffs would give a boost to the shoe design and marketing jobs that are still located in the United States.

"It will help us design more shoes. It will help us sell more shoes. And when we're selling more shoes, we're creating more jobs throughout the supply chain," said Matt Priest, president of the Footwear Distributors and Retailers of America, an industry trade group.

Indeed, the Asia-Pacific trade deal is less about defending labor-intensive manufacturing than promoting intellectual property, services, and agriculture sectors where the U.S. has a competitive advantage. But that raises a question: Why doesn't the president's West Coast pitch for the trade deal take him to a movie studio or a rice farm ... businesses where the products still say "Made in the U.S.A."