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After a decade of lobbying and waiting, 9/11 first responders and survivors with uterine cancer can finally get the federal health coverage they’ve long been promised. On Wednesday, U.S. Health and Human Services (HHS) added uterine cancer to the list of conditions covered by the government program that monitors and treats those directly impacted by 9/11.

The decision comes after multiple stories from The Fuller Project and its partners about how women were systemically left out of the government’s World Trade Center Health Program (WTCHP).

Until now, uterine cancer was the only cancer that remained off the list of covered illnesses.

The reason cited was “insufficient evidence” that it was linked to 9/11. But stories run by The Fuller Project and its partners — including Reckon, The Star-Ledger and The Cut — revealed how the lack of data was due to the small number of women included in the early days of the program, which resulted in skewed research samples and excluded conditions that affect women.

“We’re relieved and feel like we can finally exhale, knowing many women will now receive the benefits they deserve,” said Tammy Kaminski, a chiropractor based in West Caldwell, N.J. who volunteered for months at Ground Zero and later developed uterine cancer in 2015. 

Following our reporting with Reckon and NJ.com last week, Rep. Frank Pallone (D-N.J.) sent a letter to HHS Secretary Xavier Becerra and WTCHP Administrator John Howard urging them to act. Pallone sits on the House Energy and Commerce Committee with jurisdiction over HHS, and also serves a district where many 9/11 survivors and first responders live. The Fuller Project had also previously covered efforts by Rep. Mikie Sherill, another New Jersey Democrat, to push for more robust coverage for women survivors and first responders. 

Shortly after Pallone’s letter, HHS released a final rule that uterine cancer patients could immediately apply for the program, noting that a “delayed effective date would defer the agency’s ability to provide life-saving treatment and result in less favorable treatment outcomes and survival rates for covered individuals.”

For covered illnesses, the WTCHP takes care of all preventive care, disease treatments and follow-ups, with its own physicians, records and insurance program. It estimates more than 200 women who receive coverage from them currently have uterine cancer but are not receiving treatment for the disease through the program. Statistical estimates based on the prevalence of uterine cancer in the country suggest thousands more could be eligible for coverage. 

The delay forced women first responders and survivors — anyone who lived, worked, or attended school in and around Ground Zero — to pay for their cancer treatment out of pocket if they didn’t have other insurance that covered it. It also locked them out of the federal health care “Clinical Centers of Excellence” that specialize in Ground Zero carcinogens. Those without federal health benefits were also left out of the linked 9/11 Victim Compensation Fund, which relies on WTCHP enrollment to verify compensation eligibility.

For some, the belated decision brought up mixed feelings. 

“I know I should be elated, but instead what came up was the fight to get here,” says Donna Malkentzos, a former New York Police Department detective who worked at the 9/11 debris dump on Staten Island for months, and later developed uterine cancer. “I kind of feel we may have won the battle, but we’re still at war.”

“For me, it took nine years to get here, but what about the women who didn’t have their own coverage? I had to spend a few thousand dollars, but I had it, others didn’t,” says Malketnzos, whose experience was profiled in our most recent story on the topic. “Instead of being happy and elated, it brought up how much we as women don’t have. I don’t want crumbs anymore, I want the whole freaking pound cake.”

Advocates for uterine cancer awareness say the news is an opportunity to spread the information about WTCHP enrollment, but also uterine cancer in general, which is often misdiagnosed or diagnosed late and leads to worse outcomes. 

“They were told the air was safe to breathe. They were told their cancer wasn’t caused by 9/11. Now these women can feel vindicated and can access free healthcare that is statistically more likely to extend their lives,” says Matthew Baione, a lawyer who has been one of the earliest advocates for the cancer’s inclusion.

Our story this week headlined “Somiland’s frankincense brings gold to companies. Its women pay the price” had impact even before publication in The Guardian. Our two-year investigation uncovered evidence that women in Somaliland working for Asli Maydi, a company supplying frankincense to the popular U.S. essential oils brand doTERRA, were underpaid and abused. As a result of our story and outreach to doTERRA, the company temporarily suspended operations and issued a statement which read, in part:

“At dōTERRA, our highest priority is the safety and proper treatment of each of our employees. Just as important is the safety and proper treatment of everyone in our global supplier network. All vendors are required to abide by our stringent Code of Conduct to ensure safe and healthy working conditions, fair and on-time payments and respectful and ethical conduct. We are committed to ensuring our Code of Conduct is followed thoroughly. If a supplier or its affiliates has committed a crime or wrongful act, we will take every appropriate action. This includes investigating the allegations of misconduct in Somaliland.” 

doTERRA said it provides regular audits of its global supply chain operations but has not done so in Somaliland since 2000 due to violence, and that it is working to engage a third party investigative team to supplement its efforts.

The statement went on to say that the company found the allegations of sexual misconduct the most troubling part of the report and that they “take any accusation of crimes or mistreatment against women very seriously.”  They said they encouraged Dr. DeCarlo, a scientist featured in the story who had previously raised allegations of rape against Asli Maydi owner Barkhad Hassan, to report the matter to law enforcement officials.

“As is company policy, we investigated the matter to the extent we could, however, we do not have the authority or investigative powers needed to fully investigate these allegations. We continue to encourage and support law enforcement’s efforts to fully investigate the allegations, as we would for any victim of alleged assault.”

The Fuller Project’s reporting drew attention for the first time to the exploitation of women sorters by a company that says it champions community investment and competitive wages. doTERRA markets to women, engages mostly female “wellness advocates” to sell their products, and counts among its influencers prominent female athletes and celebrities including singer/songwriter India Arie Simpson, professional tennis player Sloane Stephens, and Olympic Gold Medalist Jamie Anderson, according to their website. 

The early impact of The Fuller Project’s story, including doTERRA’s suspension of operations, statement and pledge to investigate, represents the most action the company has taken to date, either in response to DeCarlo’s allegations or a VICE documentary about male doTERRA harvesters who say they were never paid in full or were paid in food. Since then, sources say little has changed on the ground. 

While the VICE documentary focused mostly on men, The Fuller Project investigation took a different tack. DoTerra generates more than $2 billion in sales every year from mostly female clientele, and in Somaliland, it is primarily women who work for the company’s suppliers.  We told that story.  

We are continuing to follow the investigation.

For the thousands of women who lived and worked in lower Manhattan during the September 11 attacks — many of whom breathed dust from the towers for months afterward — the profound and sometimes fatal long-term impacts on their health remain understudied and undercovered. 

The federal World Trade Center Health Program (WTCHP), which was created to provide free medical monitoring and treatment for 9/11 survivors and responders, relied on initial research conducted overwhelmingly on male first responders to determine what treatments would qualify — which means some of the most common conditions for women survivors, such as breast cancer, went uncovered for years.

For The Fuller Project and The Cut, reporter Susan Rinkunas spent months speaking with women who had survived 9/11 to later be diagnosed with cancer, asthma, auto-immune or mental health disorders, who revealed what this critical lack of research on women survivors means for their health. 

When our story published, just ahead of the twentieth anniversary of the September 11 attacks, some of those women were battling uterine and endometrial cancers that were still not covered by the WTCHP; a hearing to discuss whether uterine cancer should qualify for coverage was scheduled for later that month. By November, an advisory committee unanimously approved a recommendation to include uterine cancer under the WTCHP. A final ruling is expected by mid-2022.

In partnership with The New York Times, The Fuller Project published the first in-depth examination of how domestic workers in the Middle East have turned to TikTok to share intimate details of their lives — and the consequences they could face for speaking out. Last August, a young Kenyan housekeeper, Brenda Dama, posted one such video from Saudi Arabia. As words like “freedom” and “respect” pop up on the screen, Dama, 26, swats them away one by one. A single day off? “Don’t got it.” A peaceful life without quarrels or insults? “Don’t got it.” One in a series posted by Ms. Dama, the video has amassed more than 900,000 views — her account gained nearly 5,000 followers in just two days after posting it.

Far from home and in unfamiliar settings, domestic workers in the Gulf — the vast majority of them women — have long used social media to keep in touch with friends and family. Our story documents how they have increasingly turned to TikTok after the platform’s popularity exploded last year, opening up about their lives and working conditions. Many of them say they are overworked, sexually harassed, discriminated against — and the pandemic has further diminished the minimal freedoms they once had.

To give our readers the context they needed to understand stories like Ms. Dama’s, The Fuller Project created an explainer video for social media, styled after TikTok’s platform. It allowed us to reach, inform and engage broad audiences beyond our normal remit — like the youth who are likely to be on TikTok themselves. The final product is The Fuller Project’s most-watched IGTV video to date.

Published in The New York Times online and in print, our story was widely shared among migrant rights and human rights groups, including The National Domestic Workers Alliance. It was covered by KTN, one of the largest news channels in Kenya, and reporter Louise Donovan discussed the implications of her reporting on NBC News Now and BBC’s Woman’s Hour — the second most popular daily podcast across BBC Radio, with 3.7 million weekly listeners. Several New York Times readers reached out to Brenda on TikTok after publication, engaging with her content and asking her to share more about her life as a foreign domestic worker.

The Fuller Project was among the first international newsrooms to capture scenes from the ground as India suffered the world’s most severe outbreak of COVID-19 this March. For weeks, our editors tracked the unfolding crisis in India as western journalists flew in to report for a few days — then left.

Our newsroom saw the urgent need for timely reporting by Indian journalists living through the surge themselves. Setting aside the long-form reporting that typically defines The Fuller Project’s work, we aimed instead to cover as much of one of the world’s largest and most densely populated countries as quickly as possible. We issued a call out on Twitter to reporters on the ground who could capture the sensory experience of the outbreak, receiving dozens of pitches from parts of the country beyond New Delhi and Mumbai, allowing us to cover areas most Western journalists could not gain access to in their brief reporting trips.

The resulting series exclusively features the work of journalists from India and India-administered Kashmir — most of them women. Their reporting centers the voices of India’s most marginalized: women and transgender people, particularly those also oppressed on the basis of religion, caste and class. In Kashmir, fisherwoman Fazi Begum navigated a new economic reality as her clients dwindled; in Manipur, where the Indian army has special powers and an outsized presence, a transgender woman named Lulu experienced heightened anxiety; in Tamil Nadu, construction worker Devi made frantic calls for jobs; in the Rajasthani desert, Taramani relayed her trials as a three-time survivor of COVID-19; in New Delhi, a nurse named Rakhi navigated professional trauma and personal loss.

The Fuller Project newsroom and its contributors worked around the clock to thread women’s narratives into a living archive, highlighting their humanity in their own words. “Gasping for Breath” revealed that content exclusive to our own site can draw a wide native audience — in April and May, the stories were the top read on the site— showing that these voices were clearly missing from the wider media landscape and that audiences all over the world were hungry for them. NBC Asian America took notice of our work, asking to partner as we gathered more stories from the ground. Together, we put out a call to the South Asian diaspora in the United States for tributes to the women they knew in their home countries battling COVID-19 on the front lines — or fighting to survive themselves.

Reporters Louise Donovan and Refiloe Makhaba Nkune spent eight months investigating sexual, verbal and physical harassment at Hippo Knitting, a Lesotho- based factory that supplies Kate Hudson’s Fabletics activewear brand. Interviews with more than 40 employees revealed a network of abuse stretching back years.

Producing garments for prominent U.S. brands has become the backbone of Lesotho’s economy in recent years. But sexual violence at the factories — and the government’s tepid response to the abuse — threatens the livelihoods of thousands of garment workers, ninety percent of whom are women. Thirteen of the workers we spoke to said their underwear and vulvas were often exposed during routine daily searches by supervisors. Another said a male supervisor tried to pressure her into a sexual relationship, and three allege sexual assault by male supervisors. Workers said they were forced to crawl on the floor as punishment and often humiliated and verbally abused by management. In one instance, a woman said she urinated on herself because she was prevented from accessing the bathroom.

The resulting story had impact before it was even published: after Donovan and Nkune reached out to Fabletics for comment, the brand vowed to do “everything in [their] power” to remedy the situation. Fabletics immediately suspended all operations with the factory, flew a “senior leader” to Lesotho within days to conduct an investigation and promised to keep providing workers’ full pay during this period. The owners of Hippo Knitting launched an independent audit and internal investigation, placing the factory’s HR manager on administrative leave — she has since been let go.

The investigation was published in print and online in partnership with TIME, shared widely on social media by workers’ rights groups and covered by global media outlets including The Daily Mail, InStyle, MSN, People, Yahoo and Fox. A version of the story also ran in print in the Lesotho Times, the country’s most widely read newspaper.

Since publication, police say they’re investigating at least three cases of sexual offense and public indecency at Hippo Knitting. “There are more allegations,” a police spokesperson told The Fuller Project, “though the victims are skeptical about reporting in fear of losing their jobs.” At least 12 more employees have stepped forward about abuses, according to unions on the ground in Lesotho — one union, IDUL, says it was our reporting that made these workers feel safe enough to speak up.

In response to our reporting, Hippo Knitting, Fabletics and IDUL have now announced a formal plan to combat gender-based violence at the factory. It includes career development and management opportunities for women, their representation in factory committees and trade union structures, a toll-free number workers can call for assistance and a memorandum of understanding signed with both the Ministry of Labour and Employment and the Ministry of Foreign Affairs and International Relations. Actor Kate Hudson was asked about the findings of our investigation with TIME in a June CNBC interview, responding that the allegations were under investigation, “unacceptable and horrendous.

Hippo Knitting and Fabletics have also launched a corrective action plan for the factory that includes a new grievance procedure for reporting workplace violations, a new anti-intimidation and anti-retaliation policy, and a new process for non-invasive searches that includes dedicated privacy screening areas. Staff from the human rights organization Africa Rising will be on-site during all working hours at the factory when Hippo Knitting resumes production to oversee the corrective action plan.

Lifestyle influencer Melanie Murphy, a former brand ambassador for Fabletics, contacted the brand after our story published for the results of their investigation into Hippo Knitting. In a wardrobe-decluttering video on YouTube this January, she revealed that she stopped working for Fabletics because they never responded — she no longer feels comfortable representing the brand.

Part two of our two-part series with The Telegraph & Kenya’s Daily Nation

During the coronavirus outbreak, Kenya saw another uptick in the number of aborted fetuses and abandoned babies, according to service providers in direct contact with women on the ground. Kabale and Donovan wrote a second, follow-up story digging into the spike. The reasons were varied: schools closures leaving some 13 million students idle for seven months, restrictions on movement hindering access to contraceptives and reproductive health information, as well as global medical supply chains still causing knock-on delays and shortages of contraceptives for some clinics in Kenya.

They told the story through the experience of Ashura Mciteka, a health volunteer who was dealing with aborted fetuses after they’d been abandoned in her local area. After a community landlord read the story, he offered Ashura an office space for one year free of charge. Using this space, she has been able to hold one-day trainings about the dangers of unsafe abortions with pregnant girls.

When COVID-19 first shuttered schools in Washington, DC, and around the country, Fuller Project Co-Founder and CEO Dr. Xanthe Scharff immediately penned an OpEd in TIME noting that the pandemic would quickly become a gender and equity issue, and focusing on the impact of the most vulnerable women workers. The piece forecasted that job losses would be disproportionately shouldered by women and that women with jobs in industries with poor workplace protections would be doubly impacted. With widespread and lengthy school closures looming, a majority of mothers would be forced to miss work, as they are ten times more likely than men to stay home with children. Single working parents, who are four times more likely to be women than men in the United States, would struggle to keep their jobs. The piece also underscored the heightened strain on those without a social support system and how the increase in economic hardships could make women more susceptible to domestic violence. This article drew important attention to the trends which have since defined the “Shecession.” 

After this OpEd, Dr. Scharff and Fuller Project contributor Sarah Ryley followed with rigorous, data-backed reporting based on exclusive statistics from 17 states that showed women were the majority of unemployment seekers. The analysis showed that federal data would not reveal this trend for another month – precious time while trillions of dollars of pandemic aid were being legislated. 

Dr. Scharff and Ryley provided individual and group briefings on the data to dozens of reporters the Wednesday evening before the Jobs Report release. As a result at least 12 news outlets, ranging from The New York Times to Iowa Watch, covered the story and cited the data. This widely published data underpinned a national conversation in April about the stark gender trends in unemployment three weeks ahead of a federal release of data that showed the same trend. Following the data requests, two states, New York and Oregon, began to release weekly unemployment statistics disaggregated by gender. Building on this investigation, Ryley analyzed the U.S. Bureau of Labor Statistics’ May employment report, finding that women lost 11.7 million nonfarm payroll jobs compared to an estimated 9.6 million for men. Dr. Scharff and Susan Smith Richardson co-authored an OpEd in the Boston Globe calling for the U.S. government to address the shortcomings in federal data releases with regards to disaggregated information related to race and gender. Dr. Scharff has briefed over 80 policymakers, journalists and philanthropists on these findings to date.

Fuller Project reporter Jenna Krajeski profiled Dr. Lubab al-Quraishi, an Iraqi surgical pathologist and a refugee, who was helping the US in its COVID-19 response by administering tests to elderly residents in nursing homes in Staten Island, Queens and Brooklyn. When the lab director at the pathology lab where she works asked for volunteers, she was the first to step up, despite the risk of infection. “We are from Baghdad, we know how to handle difficult situations,” she told Krajeski. 

Following our reporting, New Jersey Governor Phil Murphy called Dr. Al-Quraishi directly to thank her for her service and pledged to help extend her temporary medical license. Advocacy groups cited the reporting as having raised awareness about licensure barriers. Al-Quraishi has been invited to speak on the issue, and she penned an open letter to then-incoming President Biden asking him to help refugee medical professionals practice in their fields of expertise.

For Marie Claire Magazine, Fuller Project contributor Colleen Hagerty reported on homeless and housing insecure moms struggling to find safe places to shelter their families during the coronavirus crisis.

Hagerty featured a homeless mother, Martha Escudero, who along with her two daughters was looking for shelter in Los Angeles while advocating for abandoned properties to be used to house families. 

Escudero is part of “Reclaiming Our Homes,” a group that demanded California Governor Gavin Newsom open up all vacant properties in the state for occupancy during the initial coronavirus outbreak. She called it “immoral” for so many houses to sit empty as thousands are on the streets during a public health crisis. “If the government’s not doing their job and finding solutions fast enough, then we need to take the steps and sometimes break their laws,” she said.

Following this reporting, activists successfully negotiated with the city to use vacant properties. Escudero and her two daughters moved into a blue bungalow in El Sereno, one of more than 100 vacant, state-owned properties in East Los Angeles.  Since she and other “Reclaimers” have cultivated a community garden, a community maintenance team and community storage space, according to Reclaiming Our Homes.


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