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Transplant Patient Dies from Receiving Cancerous Lungs; Congress to Merge Health-Care Bills; CNN Hero Helps Addicted, Homeless Veterans; Dow Hits 10,000 Briefly

Aired October 14, 2009 - 13:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

TONY HARRIS, CNN ANCHOR: We are pushing forward right now with the next hour of the CNN NEWSROOM with this lady, Kyra Phillips.

KYRA PHILLIPS, CNN ANCHOR: Can you tell I have all my notes and I'm trying to get organized?

HARRIS: That's because you've got a stacked show. That's why.

PHILLIPS: Tony, thank you so much.

Well, would you want the lungs of a heavy smoker? What if your own lungs were shot? We're pushing forward on the hidden dangers in donated organs.

Life and death in Medellin, the city that drugs built. Some people kill to live. Others live to kill. An incredible story you'll see only on CNN.

And London fighting drugs with drugs.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: ... procedure and this is medication.

(END VIDEO CLIP)

PHILLIPS: By any other name it's still heroin, and the British government is dealing.

Hello, everyone, I'm Kyra Phillips, live at the CNN world headquarters in Atlanta. You're live in the CNN NEWSROOM.

The president's war brain trust has met so many times now we're going to lose count. Meeting No. 5 has just wrapped up. A decision on sending more of our sons and daughters to Afghanistan, that's still on the war-room table. And we're waiting to hear what, if any, progress they have made.

How long have we been talking about all the talking? General Stanley McChrystal said back on August 30 that he needs more troops in Afghanistan. The 40,000 figure leaked out just a few weeks later, and the president says no increase until the mission is clear.

And as meeting number five is going on, the militants are getting bolder. Two of the most recent examples, fewer than two weeks ago. Eight U.S. soldiers were killed at a remote outpost in Afghanistan. Following that, a string of attacks in the heart of Afghanistan and Pakistan. They include a militant ambush on the Pakistani army headquarters.

Despite the dangers overseas, the Pentagon says all four branches of the U.S. military met their recruitment goals. The U.S. Army even topped its goal.

Now, to a story that could affect you, me, anyone, really. Organ transplants are modern miracles, and almost routine. They work so well, so often, that it's easy to overlook the risks. So, what if the new organs are diseased and nobody knows?

Listen to this. Last year a British soldier died after receiving the cancerous lungs of a person who smoked 50 cigarettes a day.

CNN's Elizabeth Cohen joins me now with what's really a very delicate balance.

Why don't we go ahead and talk about donated organs? They have to be screened, and so I guess the standards, I mean, where are they?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Well, in the U.K. what happened to Matthew Milington, which is the Iraqi veteran you were just mentioning, what happened to him was that a radiologist actually did some kind of an imaging, a CT scan or something like that, of the lungs and failed to find the tumor. And it wasn't discovered until the lungs were already in Milington. And as you said, that donor had been smoking 50 cigarettes a day.

So, in this case, it was -- it was a goof is what the hospital says. The hospital says, "We usually get this right."

PHILLIPS: So, could this happen in the United States? I think that's what a lot of people are wondering.

COHEN: Exactly. And you know what? I have to say that it could happen. Because they don't do imaging studies on every single organ that's donated.

PHILLIPS: Why not?

COHEN: Well, probably one reason is that it's a lot of resources, and your chances of catching a tumor are tiny.

Now, a doctor will do them at his discretion. For example, a smart doctor if they see that a set of lungs comes from a smoker, a smart doctor would do an imaging study and, hopefully, catch it.

But the reality is, is that they don't do it, and it's really up to each individual doctor. A lot of people say that really ought to change, and they ought to be forced to do an imaging study on every single organ.

PHILLIPS: OK. So if they don't do an imaging study on every single organ, what kind of tests do they do on organs? COHEN: Right. They do do certain kinds of screening. For example, they screen to see if an organ is from someone who had HIV or hepatitis or syphilis or some other diseases, and those they have to do.

And then there's some other kinds of screening that, again, the doctor can do at their discretion. For example, if this was a promiscuous person who's donating the organs, they might want to screen for more sexually-transmitted diseases.

PHILLIPS: Wow. OK. So, if this is a lung from a smoker, or let's even say someone needs a liver transplant. It's a liver from an alcoholic. Does the -- the doctor have to tell the recipient?

COHEN: No, they don't.

PHILLIPS: Really?

COHEN: And that's another thing that some people think ought to change.

So if a doctor knows that lungs are from a smoker or a liver is from someone who drank heavily for 50 years, they don't have to tell the recipient. And they can if they want to.

Now, what some doctors would say is, "Look, these people are desperate for organs, and, yes, the person may have smoked a bit, but you know what? These are the only lungs available, and they're going to die if they don't get them."

So, it's basically kind of a balancing act.

Let's take a look at how many people are waiting for an organ in this country: 104,000 people are on the waiting list, and 18 people die every day while they're on that list. So you have this incredible need for organs, but then not every organ is perfect.

And, Kyra, some people are told, "This organ's not perfect," and they still want it, because it's better than nothing.

PHILLIPS: And that's an interesting point. OK, so, if you are waiting for an organ, what questions should you ask? I mean, not only beforehand but also when you find out you're getting an organ?

COHEN: Right. It is important to ask. And the reason is, as I said, doctors don't have to tell you everything. So, you might as well ask those questions, because you should really be in the know.

So, for example, a question that you want to ask is, "Was imaging done of this organ? Was there a CT scan? Did you look for tumors?"

Also, ask about the donor. They know the answers, or in many cases, they know the answers. Say, "Do you know if this donor was sexually promiscuous or was a smoker?" Ask those sorts of questions.

Also double-check, were the required screenings done for things like HIV and hepatitis?

PHILLIPS: All right, that's good information. Elizabeth, thank you so much.

COHEN: Thank you.

PHILLIPS: And now, after hearing about this story and what Elizabeth just told us, you know, she mentioned at least 18 people in the United States will die waiting for an organ transplant.

You know, this comes to us from the United Network for Organ Sharing. And right now, as Elizabeth mentioned, more than 104,000 people in the U.S. are actually on the waiting list, hoping for that one phone call that could possibly save their lives.

Now, more than 1,000 people need a lung. Nearly 82,000 people are hoping for a kidney donor. And more than 15,000 people are actually waiting for a liver.

Now, we found this Web site we wanted to tell you about. This is OrganDonor.gov. And you know, when you go to the DMV and you say you want to be an organ donor, and you check that off, and you have a little indication on your driver's license, that's great, but you can go a step further and actually go to this Web site and you can register.

So go to OrganDonor.gov. You see all this information here. You can actually go to "be an organ and tissue donor." Go ahead and bring that page up, and boom, right here you can register with your state donor registry. How to register to be a donor in your state. We went ahead and tapped on that. And there you go. Click onto your state. It tells you exactly what you need to do. You can give all your information.

And transplants -- you know, transplant basics, donation basics, how to reduce the risk for you and for someone that may be receiving your organ. Fantastic Web site. Once again, OrganDonor.gov.

All right, the next step in the long and complicated process of rewriting health care is set to begin next hour. Negotiations start in the office of the Senate majority leader, aimed at merging two very different bills. In the House, they're merging three bills.

CNN's Brianna Keilar reports that this may not take as long as it took to pass the bills in the first place, but it will be every bit as tough.

(BEGIN VIDEOTAPE)

BRIANNA KEILAR, CNN CONGRESSIONAL CORRESPONDENT (voice-over): With millions of eyes around the country watching, the call came down.

UNIDENTIFIED MALE: Fourteen ayes, 9 nays. The ayes have it.

KEILAR: The Senate Finance Committee's hotly-debated plan for health-care reform passed, thanks to 13 Democrats and one lone Republican, Olympia Snowe of Maine.

SEN. OLYMPIA SNOWE (R), MAINE: Is this bill all that I would want? Far from it. Is it all that it can be? No. But when history calls, history calls.

KEILAR: The plan has an $829 billion price tag. It prevents insurance companies from denying coverage based on pre-existing conditions and requires all Americans to have insurance. That would be done, in part, by expanding Medicaid and offering subsidies to people who can't afford it.

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: We are now closer than ever before to passing health reform. But we're not there yet. Now's not the time to pat ourselves on the back. Now's not the time to offer ourselves congratulations. Now's the time to dig in and work even harder to get this done.

KEILAR: And the road to getting health care done is still long and winding. The first hurdle: a government-run insurance plan, the so-called public option, isn't in the finance committee's bill, but it is in another Senate proposal. Those plans now have to be blended together, and lawmakers remain divided.

Another big sticking point: paying for reform by taxing high-end private insurance plans. Critics of that idea are already sounding off, including labor unions. Many of them gave up pay increases to get better health care in the first place. And this morning, less than 24 hours after the finance committee's vote, their opposition is in black and white in the morning papers.

(END VIDEOTAPE)

PHILLIPS: All right, Brianna joins us now live from Capitol Hill.

Let's compare the two plans that the Senate has come up with, Brianna, from the finance and health committees, if you don't mind, and we'll take it from there.

KEILAR: Yes, and it's interesting to look at this, because this is what key Democratic negotiators and White House officials are going to have to hash out here in days to come.

So, let's start with the similarities, because two the bills do have things in common. For instance, they would say to insurance companies, "You cannot deny coverage on the basis of pre-existing conditions. Also, you cannot cap benefits to a customer, a patient, either over the course of a year or over their lifetime."

And both of these bills include subsidies to help low-income and middle-class Americans buy health insurance.

But there are some pretty stark differences here, Kyra, that show you why the Senate Finance Committee bill is more conservative and why the Senate Health Committee bill is more liberal. Public option. There you go. Not in the finance committee bill, which has health co-ops. But the health committee bill does have a public option.

And then also check out this: the employer mandate. This is something that says employers have to contribute to the cost of health insurance for their employees. Not in the finance committee bill. It's in the health committee bill.

Should mention, though, in the finance committee bill, if businesses are of a certain size, and if those employees are getting subsidies, then there could be some penalties for those employers, Kyra.

PHILLIPS: Brianna Keilar, we'll keep tracking it. It's going to be a while, a number of months. That's for sure.

KEILAR: Yes.

PHILLIPS: Well, the first injectable H1N1 vaccines are showing up this week in doctors' offices, and folks with underlying health problems are strongly urged to show up, too.

But here's a surprising fact from the CDC. Almost half of the swine flu patients who had to be hospitalized so far, more than 45 percent, were otherwise healthy; no known pre-existing conditions. In the other group, asthma is a major complication in kids and grown-ups alike.

And should flu vaccines be mandatory? A nurse in New York is actually suing to block a state requirement that all health-care workers get immunized against both the swine and seasonal flus. A hearing is set for next hour in Manhattan, and we'll keep you posted.

Medellin, Colombia, nice place to visit, but you wouldn't want to be a homicide detective there. Drug dealers keeping the addicts high and the morgues full.

(COMMERCIAL BREAK)

PHILLIPS: Fighting cancer is bad enough. Fighting a power company to keep your electricity on, the electricity to help pump oxygen into your lungs? Well, that's an outrage.

(COMMERCIAL BREAK)

PHILLIPS: Coming under enemy fire, seeing comrades die. Realities of war can lead to very real trauma for America's vets. And often it's hard for them to get help. But new rules could change that.

The V.A. says that more than 134,000 vets from Iraq and Afghanistan have asked for help dealing with PTSD. Under proposed new rules, even the fear of hostile action would be sufficient for a diagnosis, as long as a V.A. psychologist or psychiatrist agreed. Today's "CNN Hero" knows the stresses of military life all too well. Roy Foster served his country proudly. He was in the Army for six years. But he was also battling demons within. He began drinking and using drugs. In civilian life, he ended up addicted, even homeless.

Ultimately, Foster was able to get help and turn his life around. But he didn't stop with himself. He ended up founding Stand-Down House, a charity that helps addicted and homeless veterans.

CNN top ten hero Roy Foster joining me live from Riviera Beach, Florida.

Great to see you, Roy.

ROY FOSTER, FOUNDER, STAND-DOWN HOUSE: Hello, Kyra, how are you?

PHILLIPS: I'll tell you what. I read your story, and it just brings tears to my eyes, to be quite honest with you. And to see what you've done and how you are giving back.

I mean, this has got to be working twofold for you: not only therapy for yourself, but for the men and women that are struggling right now just like you did when you came back.

FOSTER: Absolutely. And I think you nailed it on the head, for myself to be able to give back what I have to those that -- those service member (sic) is quite a reward. Very fulfilling.

PHILLIPS: What was it, Roy, that happened to you? Was it a certain moment while serving? Was it something personal that was going on? Was it a combination of both? I mean, so many people are trying to get inside of the heads of our vets, wondering why they are struggling so much with PTSD, with suicide, with depression, with homelessness.

FOSTER: I truly believe that we're a combination of things, even though I wasn't a combat veteran, my first trip overseas was to Germany. And it was one of those situations whereas this -- this young 18-year-old that's never left the small town of about 17,000, and I'm thrust into the middle of Germany, sitting at a train station for, like, six hours. Totally confused. Totally unaware of what was going on. And that separation in and of itself is a stressful situation.

PHILLIPS: So, what happened? What made it click that you had to deal with it? Was it a person? Was it a moment? Was it comrades? How -- how did you start to turn it around?

FOSTER: That time is really one of those times in life that were -- it's very touching to me, even at this point in time. My grandmother -- my sister and I were raised by our grandmother. Our parents died at very early ages. Mother at 6 months and father at 7 years.

And during the point in time that I was in my addiction, my grandmother always labored with "am I OK?" And I real -- I found out she was hospitalized. And it was pretty much her -- at the end of her time. And when I did get there and visit her at the hospital, the one thing she said was, "I can go now. I can go. I see you're OK, and I can go."

And at that time, that was the -- that was the -- really the reinforcement that really, really kept me driving forward.

PHILLIPS: Wow.

FOSTER: That was the force.

PHILLIPS: What was your grandmother's name?

FOSTER: Gussie (ph).

PHILLIPS: Love it. I love it.

FOSTER: Yes.

PHILLIPS: All right, so, we're thinking about Gussie (ph) right now, her spirit, how she loved you. And now watching you love these vets.

Let's take a look at some of the video of your -- of your charity and how you've been interacting with these vets. Tell me what has been the most inspiring part of starting this charity and actually watching these men and women pull through?

FOSTER: I guess that some of the most inspiring times are when you see them walking back down the sidewalk, and you know that this is two years later, three years later, and they might have a wife with them, a child with them. And they just come back -- they're there.

And they're saying, "Mr. Foster, I just want to thank you again for all that you do." And, I mean, it's those moments that -- it's really undescribable [SIC], but those are the rewards. To know that they are carrying it on.

PHILLIPS: Wow, I think we're all feeling that right now. Roy Foster, congratulations. It's such an honor to talk to you. And thank God for Gussie (ph). She's still living on because of what you're doing.

FOSTER: Thank you.

PHILLIPS: Thanks, Roy.

FOSTER: Bye-bye.

PHILLIPS: Well, homelessness is just one issue that's facing America's vets. We've been talking about it a lot on this program. So, what is the Veterans Administration doing to help with PTSD and cut down on botched medical tests at V.A. hospitals? We're going to find out next hour from the first woman to serve on the Senate Veterans Affairs Committee, Patty Murray. Find out more about Roy Foster's veterans charity, please. Vote on our CNN Heroes. Just go to CNN.com/heroes. Plus, watch our all- star tribute that will be hosted by Anderson Cooper. That happens on thanksgiving, right here on CNN.

Top stories now.

Senator Olympia Snowe was the lone Republican supporting a sweeping health care reform bill. Now she could be getting some support from a colleague. Senator Susan Collins says she's open to passing responsible reform. But Collins says she's got serious concerns about the Democratic-sponsored bill that cleared the Senate Finance Committee.

And two former enemies teaming up on missile defense? Secretary of State Clinton is pushing for the U.S. and Russia to work together. Clinton is on a two-day visit to Moscow, but Iran's been the focus of her trip. Russia's president says that he's not ready to talk about punishing Iran for its nuclear program.

And is the accused Holocaust Museum shooter fit to stand trial? We'll know at the end of next month. At a hearing this morning in Washington, James Von Brunn's lawyer said that a competency report will be ready by then.

Von Brunn is charged with killing museum security guard Stephen Johns in a June killing rampage. Other guards returned fire, shooting Von Brunn square in the face.

Judge's orders: a teenage Christian convert is headed home. Months after running from her Muslim family, whom she says wants her dead.

(COMMERCIAL BREAK)

PHILLIPS: All right, Susan Lisovicz. The Dow hit 10,000 for a moment. And then it was gone.

LISOVICZ: But it was...

PHILLIPS: As quick as that bell.

LISOVICZ: It was a wonderful moment, though. There was a big whoop from the trading floor, because we have not seen that -- that level, Kyra, in a year. A year ago this month was the last time the Dow industrials were at 10,000.

And if you, I guess, remember the words of the great Yankee Yogi Berra, it's deja vu all over, because the Dow first closed over 10,000 ten years ago, and as proof of that, Kyra, I have a Dow 10,000 hat from ten years ago. And I have a new Dow 10,000 hat, 2.0. That was...

PHILLIPS: All right. Now, you need another one.

LISOVICZ: Yes, I do. I do need another one. And more importantly, what we need to see is the stock market continue to climb.

Why is that? The sense that things are getting better. It's a reflection of what's happening. We all feel better when we're buying stocks. That we believe in things.

And the latest optimism came from two big companies today: a financial company, JPMorgan Chase, and Intel, a big tech company, makes chips. Chips are used in everything. Both of them had pretty good earnings report, and the stock market took off. And hopefully, it will close over 10,000 and continue from there -- Kyra.

PHILLIPS: Good news. Thanks, Susan.

LISOVICZ: You're welcome.

PHILLIPS: Well, not such good news, pretty soggy mess across parts of the U.S. today. So, when is the sun going to shine again, Chad Myers?

(WEATHER REPORT)

CHAD MYERS, AMS METEOROLOGIST: And then for the rainfall for the big cities, Napa, San Francisco, all the way down to Sacramento, that's a lot of rain. They don't like this much rain when the grapes are about ready to be harvested, because then they get all plump. They want them nice and small when they don't have a lot of juice, and all that juice is nice and concentrated to make the wine, Kyra. So we'll have to see what happens to the wine prices in Napa.

PHILLIPS: Now people are paying attention.

MYERS: I know.

PHILLIPS: Everyone is seeing the numbers.

MYERS: It will all be jug wine now.

PHILLIPS: Wait a minute, did you just say that wine prices are increasing? All right. More on that with Chad Myers, straight from the winery in about two minutes. Thanks, Chad.

MYERS: All right.

PHILLIPS: If you heard her story and saw her tears, could you do it? Could you actually cut off a Stage 4 cancer patient's electricity? Or could you cut her some slack?

(COMMERCIAL BREAK)

PHILLIPS: Quick check of the headlines now. Another long strategy session today for President Obama and his national security team. The nagging question? What should be America's next step in Afghanistan? Stay and fight or draw down? Decision appears to be weeks away.

Better care for America's fighting men and women. The big talking points for Veterans Affairs Secretary Eric Shinseki testifying on Capitol Hill. Meantime, the V.A. is looking for ways to cut the red tape and make it easier for vets to get disability money.

Oh, the power of of outrage. A cancer patient is about to die. At the same time she's been told her electricity is about to be cut off. Yes, this caught our attention. And now the Public Utility Commission of Texas is paying attention, too. It's reviewing the facts, because apparently someone at the commission saw the story that you're about to see, and couldn't turn the other way.

Rucks Russell with our Houston affiliate KHO reports on the outrage.

(BEGIN VIDEOTAPE)

RUCKS RUSSELL, KHOU-TV CORRESPONDENT (voice-over): It's just an oxygen machine.

MABLE RANDON, CANCER PATIENT: It help me breathe better.

RUSSELL: But to Mable Randon, it's a lifeline.

RANDON: I'm in stage 4, the last stage of cancer.

RUSSELL: She's living on borrowed time and borrowed electricity.

RANDON: I'm up and down all night. And that's because I'm kind of worried about whether the lights will be on when I wake up.

RUSSELL: This cutoff notice from her power provider heightens those fears. She got it after falling behind on her bill.

RANDON: I'm on a set income, and my husband lost his job. And he find a little work every now and then, but it's been hard.

RUSSELL: Hard, but not impossible, she thought, to work out a deal. So she applied to CenterPoint Energy's Critical Care Customer program, which tries to maintain service for people who depend on electrically operated life support systems.

RANDON: I'm fighting for my life.

RUSSELL: But the power company rejected the application.

RANDON: I'm baffled, and I'm angry.

RUSSELL: We asked CenterPoint for an explanation. A spokesperson told us Mable Randon didn't meet the criteria for critical care because she could buy a battery-powered alternative oxygen machine. The spokesperson added, quote, "This program is a communication program, not a guarantee of uninterrupted power, even to customers who are on the list."

But to Mabel Randon, this power meter seems like an hourglass...

(on camera): ... measuring the time she has left to breathe. And the time she has left to live.

RANDON: What am I to do? What am I going to do?

RUSSELL: For the time being, she's just gasping for air and help.

(END VIDEOTAPE)

PHILLIPS: That was Rucks Russell with KHOU out of Houston, Texas. The station has been getting a lot of calls as far away as Connecticut on this story, and, again, the Public Utility Commission of Texas says it will not allow a cancer patient's electricity to be cut off until it's reviewed all the facts.

The energy company tells us it hasn't gotten a disconnect notice from the power company. The power company, well, we still haven't heard from them.

Same eyes, same smile, same Jaycee. The world's getting its first look at Jaycee Dugard 18 years after she was kidnapped on her way to school. People.com posted the photo this morning. The magazine also doing an interview with Dugard, now 29 years old.

She was 11 when she disappeared in 1991. Suspects Phillip and Nancy Garrido have pleaded not guilty to kidnapping and sex crimes.

She converted from Islam to Christianity and says her father will kill her if she goes back home. Now a judge says she's got to go back.

CNN national correspondent Susan Candiotti has the latest on an Ohio teen who tried to run away to Florida.

(BEGIN VIDEOTAPE)

SUSAN CANDIOTTI, CNN NATIONAL CORRESPONDENT: This is a partial victory for the 17-year-old's parents whose daughter ran away to a Florida minister and his wife after someone bought her a bus ticket to move to their Florida home. Now, a Florida judge says it's time to send runaway teen Rifqa Bary and her case back to Ohio, where her family lives.

The ruling came during a hearing in Florida. And in that courtroom, Rifqa and her attorney, and on the phone in Ohio, another judge, Rifqa's parents and in both states, child welfare agencies.

JUDGE DANIEL DAWSON, ORANGE COUNTY, FLORIDA CIRCUIT COURT: It's this court's opinion that the sooner that these parties get into one courtroom in front of one judge who's going to have jurisdiction for the remainder of the case, that that...

CANDIOTTI: But before Rifqa can be sent back, a judge is demanding two things: proof that Rifqa is in the U.S. legally, something her parents have so far failed to provide, and a guarantee that the 17-year-old can continue taking classes online once she leaves Florida. If those conditions are met, Rifqa will be sent back to Ohio in state custody, not back to her parents, who Rifqa insists want to kill her for converting from Islam to Christianity.

RIFQA BARY, CONVERTED TO CHRISTIANITY: They have to kill me. My blood is now halal, which means that because I am now a Christian, I'm from a Muslim background, it's an honor. If they love God more than me, they have to do this. And I'm fighting for my life. You guys don't understand. I -- they don't understand.

CANDIOTTI: But a Florida Department of Law Enforcement investigation has found no credible threats to Rifqa. And when I spoke with her parents last month, they said they love their daughter and would never hurt her.

MOHAMED BARY, RIFQA'S FATHER: We did not fight over it. We just asked, and then that's it.

CANDIOTTI: Your daughter says at one point you held up a laptop and said, I'm going to kill you.

M. BARY: It's not at all true. It's not at all true.

CANDIOTTI: The family moved to the U.S. in 2000 from Sri Lanka to get medical care for Rifqa. As part of the court ruling, Rifqa and her family will all undergo psychological testing and counseling. Until then, Rifqa will remain in counseling in Florida, and that won't change in Ohio until everything is all sorted out.

Susan Candiotti, CNN, New York.

(END VIDEOTAPE)

PHILLIPS: Her voice is getting out, but she's not. Cuba clamps down on a prolific blogger. She's been voted one of the most influential people in the world, but she can't get a ticket out.

(COMMERCIAL BREAK)

PHILLIPS: Cuba's newest blockade, designed to keep a controversial journalist and her story from getting out. I'm talking about Yoani Sanchez, a Cuban blogger who will receive a prestigious journalism award tonight in absentia.

Here's CNN's Shasta Darlington.

(BEGIN VIDEOTAPE)

SHASTA DARLINGTON, CNN INTERNATIONAL CORRESPONDENT (voice-over): Armed with a laptop and a flash drive, Cuban blogger Yoani Sanchez is breaking down barriers. Her feisty and often courageous blog, Generacion Y, gets more than a million hits from around the globe every month.

YOANI SANCHEZ, BLOGGER (through translator): I think the goal is to express myself, and that expression is the biggest hammer against the wall.

DARLINGTON: Last year, "Time" magazine named her one the 100 most influential people in the world, but she does run up against obstacles. Cuba has blocked access to her blog. And this week, the government denied Sanchez permission to travel to New York to receive a journalism prize from Columbia University.

LEE C. BOLLINGER, PRESIDENT, COLUMBIA UNIVERSITY: That's very unfortunate. Unfortunate for her, because she deserves to be recognized, but also unfortunate for the world, because it's freedom of the press that's going to really give us the information we need to be able to think about the great issues of global society.

DARLINGTON: Sanchez isn't bitter.

SANCHEZ (through translator): I don't let things drive me crazy. I can't be at the ceremony, but I travel virtually every day. I'll celebrate it with friends.

DARLINGTON: Sanchez pens wry commentaries on life in communist Cuba, shedding light on taboo topics like police harassment and the thriving black market. She's openly critical of the government. In one recent entry, she complains she can't find detergent in stores, despite warnings about the spread of swine flu.

(on camera): Sanchez was a pioneer. Now, despite restricted access to Internet, there are dozens of independent Cuban bloggers. They send posts into cyberspace and use flash drives and CDs to share entries at home.

(voice-over): Their voices resonate in the country where all mainstream media is controlled by the state.

SANCHEZ (through translator): The blogger phenomenon is there pushing against the wall, which isn't going to be brought down by kilowatts or posts, but it helps.

DARLINGTON: Sanchez writes her blog at home, saves it on a flash drive or laptop and then wanders Havana trying to get into a cybercafe or hotel business center. One way or another, she gets her message out.

Shasta Darlington, CNN, Havana.

(END VIDEOTAPE)

PHILLIPS: Top stories now. Time to up the ante or fold the hand. That's what President Obama and his national security team are dealing with. They're meeting yet again on war strategy in Afghanistan. A decision could be weeks away.

British Prime Minister Gordon Brown pledges to send more troops to Afghanistan, but there is a but -- only if other allies send more troops, too.

Folks in southern California breathing a little easier as the number of flash-flood advisories are lifted. There were plenty of fears that heavy rains would pave the way for mudslides in fire- scorched areas. Drivers had a heck of a time with the weather, but no mudslides.

It's a scene that would make the late Pablo Escobar proud, and if you're making Pablo proud, you're putting cocaine up noses and bodies on the sidewalk.

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PHILLIPS: Pushing forward to the next hour of CNN NEWSROOM, it's been a rough year for the V.A., but so much rougher for the vets that they're meant to serve. A backlog of mental health cases, medical malpractice, well, the list goes on. Reforming the Department of Veterans Affairs, talk about a tough mission.

The country's nursing homes already strapped for cash. How will health care reform affect them and their care of patients -- or parents, rather, and grandparents?

Plus, treating heroin addicts, with heroin. And the government's the dealer. You won't believe how much it costs.

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PHILLIPS: You want to see some mean streets? Medellin's are brutal mean streets and morbid sidewalks as young bodies for the Colombian city's drug war pile up. This is not pleasant stuff or new stuff, just to warn you as a viewer.

But imagine what it's like to see the carnage every day as a homicide detective. Here's an exclusive, an incredible report from our Karl Penhaul.

(BEGIN VIDEOTAPE)

UNIDENTIFIED FEMALE (through translator): I heard the shots, and that was it.

KARL PENHAUL, CNN VIDEO CORRESPONDENT (voice-over): This is the headquarters of CSI Medellin, the rapid reaction unit of the city's crime scene investigators, known here as CTI.

UNIDENTIFIED FEMALE (through translator): Have you got a murder up there? Can you confirm the location?

PENHAUL (on camera): So, that report that's just come through is of a street killing in an area the investigators are calling a hot zone. They say that one of the last times they came up there, they came under fire from one of the gangs, so they told us to stay close and be exceptionally careful.

(voice-over): It's got all of the hallmarks of a gang slaying, the latest victim in a war that erupted when cocaine bosses in Medellin's main cartel fell out. Investigators chart the progress of that war with close-up photos of bullet wounds and precise measurements of where the victim fell. Neighbors young and old stand and stare. None will give evidence. DORA SALDARRIAGA, MEDELLIN CTI (through translator): We have a witness, but he won't speak because he lives in the neighborhood. If he talks, he's afraid the next corpse will be his.

PENHAUL: The 23-year-old is tagged and bagged. The body is carried away through narrow alleys, followed by a procession of women lamenting another untimely death.

MARIA TERESA RODRIGUEZ, GRANDMOTHER OF MURDER VICTIM (through translator): I heard the shots, and then a man came to my door and told me Darwin (ph) had been shot.

PENHAUL: So, afternoon shift becomes a nighttime killing spree. A teenager gunned down with a .38 revolver on a sidewalk in a western neighborhood. Another man in his 30s, killed as he tried to flee a lone gunman. He made it as far as this evangelical prayer house just before worshippers were due to hold a celebration.

OMAR GOMEZ, EVANGELICAL PREACHER (through translator): We thought it was balloons bursting, but then we saw it was a guy pumping bullet into another.

PENHAUL: As investigators gather up 9-millimeter bullet fragments and shell casings, the walkie-talkie crackles with reports of another shooting.

PABLO CASTANO, MEDILLIN CTI (through translator): We're going for the fifth body, and we're only an hour and 45 minutes into our shift.

PENHAUL: By the time dawn breaks, they'll have recovered 12 corpses, all apparently victims of the cartel war. But that's far from unusual. Over a single weekend in August, CSI teams were called out to 47 drug-related murders.

They need more equipment and more personnel. But more than anything, they need the killing to stop.

Fabio Osorio is head of the Rabid Reaction Squad.

FABIO OSORIO, HEAD, CTI RABID REACTION SQUAD (through translator): This is not like another country where you maybe have two murders a week. Here we have 15 or 20 murders a day or every two days.

PENHAUL: So, who are the men pulling the trigger? Through trusted intermediaries, I meet two long-serving cartel hitmen. One who calls himself Red says he went through assassin training school at 14. He confirms police reports that the current wave of violence has been sparked by cartel infighting, but says poverty is at the core.

"RED," CARTEL HITMAN (through translator): People need to eat and there's a lot of hunger. We don't just want the crumbs. There's a lot of idle hands around here, and many people think they have a chance if they have a gun in their hand.

PENHAUL: In the current conflict, a hired gun can make a financial killing.

"C," CARTEL HITMAN (through translator): If you're talking about a contract hit right now, you can earn maybe $2,500 to kill some idiot slimeball. Then of course, there's bigger hits, where you can earn $10,000 depending on the patient (ph).

PENHAUL: "C" claims all his targets are involved in cocaine trafficking or gangs, and that none is innocent.

"C," CARTEL HITMAN (through translator): Sometimes I go to the funeral and see people crying, and I know it's my fault. But sometimes you kill people to stop them killing you. It's not about conscience, it's a question of kill or be killed.

PENHAUL: These young women are crying tonight for their uncle. Investigators say the victim was a gang member who had done prison time for murder. Riddled with 15 bullets at close range as he walked with his wife and son.

OSORIO (through translator): If they start doing dirty work, then you can be sure that sooner or later they'll end up like this. But young kids want to join a gang that gives them money and power.

PENHAUL: It may be a local war, but the victors will claim a bigger share of the international cocaine trade. It's the multibillion-dollar income from global trafficking that's bankrolled in Colombia's carnage. Chaos theory in practice. As someone in London or Los Angeles gets high on coke, a young man in Medellin gets pumped with bullets.

OSORIO (through translator): Maybe these youngsters live until they're 20. They'll grab what they can until 20. If they survive longer, it's a bonus. And if they die, then they always knew that was the risk.

PENHAUL: It's the lure of easy money and a chance to escape poverty, leading another generation to its death.

(END VIDEOTAPE)

PHILLIPS: Karl now joining us live from Bogota. And Karl, you know, we can't forget. We've got to put it in perspective. Every person here in United States who's snorting coke is supporting that violence right there in Medellin.

PENHAUL: Well, absolutely. According to the DEA, there's about 20 million cocaine users, at least, in the U.S. That's based on their survey. The real figure could be more.

What we've seen over the last few months is, according to the DEA, the price of a gram of cocaine on the streets of the U.S. is now up to an average of about $90 a gram. That's an average. Now, that's up from about $60 a gram.

What that means, according to the DEA, is that they're having greater success in clamping down on shipments of cocaine from South America to the U.S. But as they clamp down on those shipments, quite obviously, the cocaine gangs are getting much more desperate. They're also getting smarter.

And so, from Colombia, you see the cartels putting multiton shipments, up to eight and 10 tons of cocaine a time, into submarines. Now, they ship that through Central America, and that of course is generating all that violence that we've seen in Central America and in Mexico.

But because the end user, the users in the United States and in Europe, are still snorting this stuff, there's still a demand. There's still multibillion-dollar profits to be made. One of those narco submarines with an eight-ton load, that value on the streets of the U.S. could be up to half a billion dollars.

Half a billion dollars buys a lot of bullets. Half a billion dollars of U.S. consumers' money buys a lot of guns, a lot of bullets, whether that's here in Colombia or there in Mexico. And if you get that violence in Mexico, that's spilling across the border. But it's all Colombian cocaine. The source is here -- Kyra.

PHILLIPS: Karl Penhaul, incredible reporting. Appreciate it.

CNN's Christiane Amanpour also sat down with Cesar Gaviria. He was Colombia's president when Pablo Escobar, the king of the kingpins, seemed to control that country. Gaviria suggested that a key to curbing drug violence in Latin America is to curb drug dependence in the U.S.

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CESAR GAVIRIA, FORMER PRESIDENT OF COLOMBIA: If the U.S. doesn't make an extraordinary effort to reduce consumption, moving more resources from the jail system and the judicial system to treatment and to deal with the problem with education and campaigns, instead of putting so many people in jail, it's going to be very difficult. I mean, the Mexicans probably in a few years will be able to deal a little better with the problems of security, but the problem of drugs will keep growing.

(END VIDEO CLIP)

PHILLIPS: Well, you can see more interviews like that every Sunday, 3:00 p.m. Eastern. "AMANPOUR" is only on CNN.