Teachers joined in birth, death

Two new mothers taught together, died days apart.

By Marie McCullough
Inquirer Staff Writer

In March, the staff, students and parents of Avon Elementary School threw a surprise baby shower for teachers Valerie Scythes and Melissa Farah.

Mere weeks later, both young women were dead.

They died, 15 days apart, after delivering by cesarean section at Underwood Memorial Hospital in Woodbury, Gloucester County. They left behind healthy infants - Isabella Rose Scythes and Grace Melissa Farah.

A combination of the unthinkable and the incredible, the deaths have turned two first-time fathers into widowers, shaken the tiny school and its close-knit borough of Barrington, and left myriad questions about what went wrong.

"It's just unbelievable," said Barrington Mayor John Rink, whose son Nolan was in Scythes' class last year.

Scythes, 35, died March 28. The cause is unclear, and final autopsy results are pending, said John Baldante, a Philadelphia lawyer representing the family.

Farah, 28, died April 12 of "shock, due to bleeding and anemia," according to her death certificate. The family's attorney, Todd Miller of Allentown, said he was awaiting an autopsy report.

Underwood Hospital spokesman Richard Bellamente said the women were "treated and transferred" to Hahnemann University Hospital and Cooper University Hospital - although he did not know which woman went where.

According to people who knew the women, Scythes was airlifted to Hahnemann University Hospital, while Farah was rushed to Cooper University Medical Center in Camden.

The New Jersey Department of Health and Senior Services, which investigates deadly medical errors, has not received reports or complaints regarding the care of the two women, department spokesman Nathan Rudy said.

Death during or around the time of childbirth, a common occurrence a century ago, is now extraordinarily rare in this country. In 2000, 396 women in this country died of obstetric complications of pregnancy or treatment of those complications - including incorrect treatment, federal statistics show. That's fewer than eight women per 100,000 births.

"It's like winning the lottery - a bad one," said Louis Weinstein, chair of obstetrics at Jefferson University Hospital.

The most common causes of such deaths are blood clots, a blood-pressure disorder called eclampsia, and a coagulation disorder triggered by, among other things, hemorrhage, said Robert Debbs, a high-risk obstetrician at Pennsylvania Hospital who also practices at Underwood and is familiar with the cases.

In Debbs' opinion, "the Underwood cases were both catastrophic complications that could have occurred anywhere in the country and were unpreventable," he wrote in an e-mail.

By all accounts, the poignancy of death so closely linked to birth has been compounded by the coincidence that Scythes and Farah were friends and colleagues in a small suburb. They were known to just about everyone with children in the two elementary schools that serve the 1.2-square-mile Camden County borough of 7,000.

Although Scythes came to the district four years before Farah, both were alumnae of Rowan University and loved working with special-education students.

Avon principal Anthony Arcodia, a 25-year veteran of the district, said he interviewed both and recommended they be hired. "They had a level of passion and enthusiasm. The last day I saw them, they still had it."

Scythes was known for giving her pupils individual, handmade Christmas ornaments. Both women were known for their love of all things Disney.

Daniel Farah, 29, a computer-information specialist who met his wife-to-be at Collingswood High School, recalled: "I proposed to her in front of the castle in Disney World after dinner at Cinderella's Castle. They had cleared everyone from in front of the castle for the fireworks show, and we were the only ones there."

The couple married in July 2005 and built a house in nearby Oaklyn.

"We started trying to have a baby on our first anniversary," he said. "I was a planner. She was a planner."

James Scythes, a college history professor who lived with his wife in Woodbury, declined to be interviewed. Baldante said his client wanted time to deal with the emotional trauma and questions surrounding his wife's death.

Underwood Hospital has about 1,100 deliveries a year, hospital billing records show. It is one of two hospitals with maternity units in Gloucester County.

Underwood has "never" had a maternal death, Bellamente said. He declined to discuss the cases, citing privacy rules. "Hospital policy and practice is to refrain from disclosing protected health information."

An Inquirer analysis of Underwood billing records shows that between 2001 and 2005, seven obstetric patients were transferred to other medical facilities.

In the Barrington school district, news of Scythes' death was shared by a letter sent home to parents. At the Avon school, which serves children in kindergarten through fifth grade, Melissa Farah was beyond grief-stricken.

"She said: 'Oh my God. Is this going to happen to me?,' " recalled parent-teacher association president Beth Cavallaro. "We tried to reassure her and said: 'No, no. It was just a freak thing.' "

On the Sunday night after Farah's death, the district's automated recording service called each Avon parent to alert them that an unspecified "tragedy" had occurred and that counselors would be available at the school to talk to the children.

Proposals for memorials to the teachers - and funds for their babies - are coming from all quarters, Arcodia said.

Already, the parent-teacher association has ordered plaques that will be unveiled at back-to-school night in September, Cavallaro said. The organization also plans to install a tree, a bench, and specially inscribed bricks in the new playground, to be built in August with $52,000 raised from Barrington parents and businesses.

Still, for most of those who knew the women, the double tragedy remains incomprehensible.

"Even if it was an act of God," said Daniel Farah, "the odds of two new mothers dying, then that those two people did the same thing for a living, that they worked together, that they went to one another's baby showers - the odds are astronomical."

For photos, obituaries and tributes to Valerie Scythes and Melissa Farah, go to http://go.philly.com/health

To Contribute

Funds have been set up for both of the babies.

For Melissa Farah's daughter:

Checks should be made to "Grace Melissa Farah UGMA Fund"

Pinnacle Food Group Inc.

6 Executive Campus

Suite 100

Cherry Hill, N.J. 08002

For Valerie Scythes' daughter:

Checks should be made to "Isabella Rose Scythes Trust Fund"

409 Mantua Ave.

Woodbury, N.J. 08096

Staff writers Josh Goldstein and John Sullivan contributed to this report.

Reach Sullivan at johnsullivan@phillynews.com or 215-854-2473.

Hail Caesarean: Such births rising in East Asia

This is scary! - AmyMc

BANGKOK: When the time came, the doctor stood over Suthasinee Santikanavin's bulging belly and said: "It's almost 9:19. We are going to pull the baby out."

The birth of Suthasinee's daughter was written in the stars, at least according to a Thai astrologer who helped pick the precise day, hour and minute that the infant should be extracted from her mother's womb by Caesarean section.

Suthasinee's husband, Mahakanasnan, an intelligence officer for the Thai Navy, stood anxiously beside the operating table and made sure the auspicious timing was respected. He programmed the alarms in both of his cellphones, one in each pocket, to vibrate silently at 9:19 a.m.

"The alarms went off," Mahakanasnan said, a tone of satisfaction in his voice. "And I heard the baby crying."

That baby's birth at a private hospital here on March 22 was part of a wider trend of what medical researchers are calling an epidemic of Caesareans across East Asia.

Once considered a procedure reserved for emergencies or high-risk pregnancies, Caesareans are now commonly planned for a variety of non-medical reasons, including fear of labor pain, convenience for the doctor and the patient, and astrology.

In a region that lives by time-is-money production schedules at footwear and computer chip factories, the elective Caesarean brings clockwork and clinical tidiness to one of humankind's most stubbornly unpredictable processes.

Meanwhile, medical advances that have made the procedure safer and more routine have also, paradoxically, helped reinforce age-old superstitions. Couples in Chinese-influenced cultures have long tried to time births for auspicious years. Now, many can refine their choice to the day and minute.

The World Health Organization estimates that under normal circumstances a country should not have a rate of Caesareans higher than 10 to 15 percent. That widely quoted benchmark was established two decades ago and was loosely based on the experiences of developed countries with the lowest infant and maternal mortality rates.

But while Caesareans have become increasingly commonplace in almost all countries outside Africa - they make up around 30 percent of all births in the United States, a quarter of births in Germany but less than 2 percent in Mali, Niger and Nigeria - rates have skyrocketed over the past 15 years in East Asia as the region has prospered.

In Bangkok's private hospitals, which typically cater to wealthier patients, Caesareans now make up about 65 percent of births, up from 40 percent in 1990, hospital administrators said. In Hong Kong, where the notion of scheduling a birth dovetails with the city's palpable ethos of efficiency, 59 percent of all babies born in private hospitals came into the world under the knife in 2005, compared with 31 percent two decades ago, according to the Department of Health.

Cesareans involve slicing through layers of skin and fat and stretching apart abdominal muscles to reach in and pull out the baby. They take about an hour to perform and are safer than ever; in the West, the rate of maternal or infant mortality from the procedure is well below one percent for both mother and child.

Yet the growing use of elective Caesareans is controversial. Because it entails major surgery, there is always the potential for complications, even as the technology improves.

Still, the procedure's popularity is growing and is having a sociological impact. Increasingly, birthdays occur by appointment.

Whether astrologers or doctors decide, there is often haggling over the appropriate day and time.

Bumrungrad Hospital in Bangkok, a large private facility that caters to wealthy Thais and foreigners, bars parents from scheduling Caesareans during the inconvenient hours of 9 p.m. to 7 a.m. The hospital delivers about 180 babies a month, 65 percent by Caesarean.

At St. Paul's hospital in Hong Kong, where the Caesarean rate is about 70 percent, couples are charged extra if they select a time of birth between midnight and 7:30 a.m.

Noppadol Saropala, an obstetrician at Bumrungrad, says about one third to half of all his Thai patients who choose Caesareans want to set their own date and time. But there are limits: A patient must be close to the average gestation period of 40 weeks.

"I will not do a Caesarean if they're less than 38 weeks," Noppadol said.

If labor drags into a Friday evening, doctors may be tempted to speed things along, said Monir Islam, director of the WHO's Making Pregnancy Safer program. "They will go for a Caesarean section so that they don't have to be called over the weekend," Islam said.

Caesarean rates have been known to spike on the eve of major holidays. One recent example was April 12, the day before the start of Thailand's Songkran festival, a time of family gatherings, which this year amounted to five days off. At Phayathai 3, a private hospital in Bangkok, the number of Caesareans rose to eight, compared with the usual rate of three or four a day, said Supakorn Phawanna, a hospital spokesman. Supakorn said patients chose Caesareans because they wanted to "have relatives and friends visit their baby during the long holiday."

Doctors and hospitals alike have a financial incentive to perform Caesareans, especially at private hospitals. At Phayathai 3, a "Caesarean package" - four days and three nights in a private hospital room - costs 41,900 baht, or about $1,200. That is 40 percent more expensive than the typical vaginal birth.

Elective Caesareans are not covered by Thailand's universal health care system, reinforcing the notion that this is a procedure for the rich. In Thailand's government-run hospitals, which serve the country's have-nots, only 20 percent of births are Caesarean.

One of the women who chose April 12 to give birth was influenced less by the holiday schedule than astrology.

Apinya Jirupansawat, a 34-year-old employee of a stock brokerage, was told by a Chinese astrologer that she had three choices: April 12, 18 or 24.

After cross-checking with Thai and Western astrology books, Apinya settled on the first day. As she explained, according to Chinese astrology, a child born then "would support his parents and be easy to raise."

Some days of the week are luckier than others, said Pinyo Pongcharoen, the astrologer who helped time Suthasinee's daughter's birth.

This year, according to Thai beliefs, Sunday and Monday are generally auspicious, he said, while Saturday and Wednesday are not.

Doctors sometimes have trouble timing Caesarean operations so that the baby is extracted at the astrologically correct hour, Pinyo said, but ideally the birth should take place within 10 or 20 minutes of the time he selects as most compatible with stellar and planetary alignments.

"Sometimes we give them many dates," Pinyo said in the classroom at a Buddhist temple where he lectures fellow astrologers. "It's up to the doctors and the parents to choose which one is most convenient."

Pinyo's colleague, Sompong Winworanat, says the lucky time should be planned for the baby's first cry.

"It's not the time when the woman's stomach is cut," Sompong said. "It's when the baby first screams: Waaaaaa!"

While there is little public debate about soaring Caesarean rates in East Asia, there are early signs of a backlash.

Concerned by a national Caesarean rate of 40.5 percent in 2001, doctors in South Korea managed to bring it down by three percentage points by 2005, according to Joo Hyun Nam, the chairman of the Korean Society of Obstetrics and Gynecology.

In Japan, the overall Caesarean rate has risen sharply, but was well below its neighbors at 21.4 percent in 2005, up from 11.2 percent in 1990. The rate in Taiwan is 35.4 percent, according to a study published last year in the medical journal Birth.

If some see the burgeoning resort to Caesareans in Asia as a problem, it is overshadowed by more pressing issues related to the application of medical technology to engineer a culturally desirable outcome in childbirth, such as the growing use of ultrasound and abortion to determine a child's sex, said one international health official who asked not to be named because she is not authorized to speak for her institution.

When compared to such practices, she said, "I don't see such a big, big tragedy in terms of all babies being born on a Saturday."

Pornnapa Wongakanit contributed from Bangkok.

Placental problems in mums who have had a previous caesarean section

New research to be published in BJOG: An International Journal of Obstetrics and Gynaecology shows a link between the development of placenta praevia and placental abruption during the subsequent pregnancies of women who previously had a caesarean section.

Placental praevia is defined as the implantation of the placenta over or near the internal opening of the cervix. Placenta abruption is the premature separation of the placenta from the uterus. Both result in bleeding during the pregnancy, which could spell danger for mother and baby.

This study was undertaken to examine the risk of placenta praevia and placental abruption in singleton, second pregnancies after a caesarean delivery in the first pregnancy.

Data provided by the US National Centre for Health Statistics, Centres for Disease Control and Prevention was examined by a team of Canadian researchers. A total of 5, 146 742 pregnancies were analysed over 1995 – 2000. This is the largest population-based study of its kind to date.

Researchers found that women who previously delivered by caesarean section had a 47% increased risk of developing placenta praevia and a 40% increased risk of placental abruption in the following pregnancy.

The authors believe that caesarean sections cause scarring inside the womb which may affect placental attachment in future pregnancies. The ligation of the uterine vessels during caesarean sections could also da mage the lining of the womb, resulting in the low implantation of the placenta in the next pregnancy.

Dr Qiuying Yang of the Ottawa Health Research Institute and University of Ottawa said, “Our paper, which is the largest study to date, shows an important association between caesarean sections and the subsequent pregnancy complications of placenta praevia and placental abruption.”

“More than 1% of pregnancies with a prior Caesarean section had one of these events which had a 50% increase compared to women without previous Caesarean section. This has important implications on the management of these pregnancies. It also introduces new and important evidence in the debate on the risks of caesarean sections ‘on demand’.”

Professor Philip Steer, BJOG editor-in-chief, said “The caesarean section rate in the UK is one of the highest in the world. This isn’t because, in some cases, women are ‘too posh to push’, but rather, complications occur during the pregnancy or birth which make normal delivery impossible.”

“Women need to be informed of the possible risks that can happen throughout the pregnancy and it is important to have their scheduled ultrasound scans to detect if the baby is developing safely. Should a woman encounter unusual bleeding during her pregnancy, it is best if she sees the doctor immediately.”

(Last updated on Wednesday, May 9, 2007, and first posted on Tuesday, May 8, 2007)

A few more minutes of maternal attachment may reduce anemia in children

In the past, the newborns' umbilical cord was not clamped right after birth, thus allowing the blood flow to stop naturally. This practice, known as "late clamping", was replaced by "early clamping", that is, cutting the cord immediately after the infant is expelled. However, this new practice lacks studies corroborating its benefits. In fact, recent studies on the importance of when clamping should be done have shown contradictory results.

A doctoral thesis carried out at the Department of Obstetrics and Gynecology at the University of Granada (Universidad de Granada [http://www.ugr.es]) by Catalina de Paco Matallana shows that the clamping of the umbilical cord of newborns from full-term pregnancies (that is, infants born after a nine-month pregnancy) two minutes after the infant is expelled from the womb makes no difference to hematocrit or hemoglobin levels of the umbilical cord vein compared to clamping the cord within 20 seconds. Thus, the study shows that early clamping (which is widely performed) is not justified.

Analysis of 151 umbilical cords

The doctoral thesis Repercusiones clínicas y fisicoquímicas del tiempo de ligadura del cordón umbilical en recién nacidos a término (Clinical and Physiochemical Repercussions of Clamping Time of the Umbilical Cord of Newborns from Full-Term Pregnancies) analyzed a total of 151 umbilical cords of newborns from full-term pregnancies. In 79 cases, the umbilical cord was cut within 20 seconds, and in 72 cases it was clamped two minutes after the infant was expelled.

The study found that the partial pressure of oxygen in the umbilical artery of the newborn babies who had late clamping had risen, while there was a lesser need of oxygenotherapy after birth. There were no differences in the removal time of the placenta and the mother's bleeding after birth - one of the reasons why early clamping of the umbilical cord started to be practiced.

De Paco Matallana also analyzed the melatonin concentration (one of the strongest and most currently studied antioxidants), finding differences between the melatonin concentration (aMT) in the umbilical vein and the umbilical artery, the latter being where the concentration is significantly higher. "This suggests that the fetus not only receives melatonin from the mother via the umbilical vein because it crosses the placental barrier, but also that it is produced in stressful situations such as during labor," says de Paco Matallana. Thus, high melatonin concentrations in the umbilical cord, together with the arterial and vein differences according to type of birth, suggest that the pineal gland is used by the fetus and that it can respond during birth.

Preventing anemia in children

As for the concentration of the triacylglycerols (TAG) analyzed in the umbilical vein of both groups, this study found statistically significant differences, as there is a higher concentration of TAG in the group of early clamping. The same is applied to the umbilical artery, where there are also statistically significant differences, with higher a concentration of TAG in the group of early clamping. However, there are no studies corroborating these findings, so more research is needed, although many other studies recommend late clamping "especially because of the beneficial effect on the prevention of anemia in children," says de Paco Matallana.

The author points out that the results of her thesis "show that there are no differences in the hemogram or the general biochemical profile in the umbilical vein in the cases of early and late clamping". Moreover, there were no differences in the viscosity or the melatonin in the umbilical artery and vein, which have traditionally been variables related to early clamping. From a clinical point of view, there were no differences in either group with umbilical clamping at birth.

"This study has not found any scientific evidence to suggest that the practice of early clamping is advisable or to justify the abandonment of late clamping in newborns from full-term pregnancies," says de Paco Matallana. "There are convincing findings for and against the two different types of clamping analyzed in this study, which shows not only the complexity of the problem, but also that research in this field may not be controlled enough or designed correctly."

(Last updated on Wednesday, May 9, 2007, and first posted on Wednesday, May 9, 2007)

Modern Milk

The milk we drink today may not be nature’s perfect food,” says Ganmaa Davaasambuu, a Mongolian physician who is a fellow this year at the Radcliffe Institute for Advanced Study. Even as the scientific community has become interested in the effects of the bioactive substances found in pesticides, says Ganmaa, not much attention has been paid to the naturally occurring estrogens found in food, which are both far more abundant and more biologically available than environmental estrogens. In fact, she is concerned that the high levels of hormones found in commercially produced milk may be harmful to human health. Estrogens and other growth factors have been implicated in the development of hormone-dependent cancers: those affecting the prostate, testes, ovaries, breasts, and uterus.

Skeptics note that humans have been drinking milk without apparent harm for millennia, she says. But modern milk is different. Her concern stems not from the use of bovine growth hormone (she excluded BGH-fed cows from her studies), but from the fact that milk-producing cows in commercial dairies, through use of artificial insemination and high-quality winter feed, are kept pregnant and lactating 300 days a year. “Cows are like humans,” she explains. “When they get pregnant, the estrogen levels in their blood, milk, and urine increase. [Human pregnancy tests detect similar increases.] This made me wonder—since the cows are pregnant all the time, the hormone levels in their milk should be really high.”

While earning her doctorate in environmental health in Japan, Ganmaa began investigating the prevalence and effects of these naturally occurring hormones. In her native Mongolia, traditional patterns of milking—the same as those used in Westernized countries until the 1920s—are still followed: pasture-fed cows are milked only through the first three months of a new pregnancy. Their raw milk had only one-tenth the progesterone that she and her colleagues found in commercially produced milk in Japan.

Mongolian physician Ganmaa Davaasambuu has linked increased tumor formation and growth in laboratory animals with chemically induced cancer to high levels of hormones in commercial milk. Seasonal milking practices among Mongolian nomads ensure that cows produce milk only during the first three months of a new pregnancy, when hormone levels are low. Because modern dairies, on the other hand, milk cows well into their next pregnancy, commercial milk often contains much higher levels of biologically active hormones.

In a 2002 study of cancer and diet in 42 countries, Ganmaa and colleagues found that countries with the highest consumption of dairy products suffered the highest rates of prostatic and testicular cancer. (A similar study Ganmaa did in 2005 showed much the same results for breast, ovarian, and uterine cancers.) In 2003, the group focused on the relationship between rising rates of these cancers and increased dairy consumption in Japan. Prior to World War II, the Japanese consumed very little milk, and rates of these cancers were low. But in the 1950s, a school-lunch program that included milk was instituted nationwide. Since that time, the intake of milk has increased twentyfold, and the incidence of prostrate cancer has increased twenty-five-fold.

Still, such epidemiological evidence is circumstantial. But in a 2004 study that used rats in which mammary cancer had been induced, she and her colleagues found that rats fed low-fat milk (1 percent) were more likely to develop tumors, and in greater numbers and of larger size, than rats fed water or artificial milk. In a 2006 study, also in rats, she proved that the hormones in milk are biologically active in animals. Both adult and immature milk-fed rats showed increased uterine weight—the gold standard for measuring the estrogen activity of food and other substances.

During her time at Harvard, which began with a year as a research fellow at the School of Public Health under Stare professor of epidemiology and nutrition Walter Willett, she and her colleagues have conducted two pilot studies. The first compared American milk (whole, whole organic, skim, and “shelf-stable” ultra-high temperature milk) to milk from Mongolia. Levels of hormones and growth factors were low in both American skim milk (hormones are carried in the milk fat) and Mongolian milk. In a subsequent study, Mongolian third-graders were fed U.S. commercial milk for a month. The good news was that a number of the children who had been vitamin D-deficient when the study began saw those deficiencies corrected. “Milk is a complex food that contains many good things, such as vitamin B, vitamin D, and calcium,” Ganmaa notes. But the Mongolian schoolchildren’s growth- hormone levels shot up 40 percent; and the children grew, on average, one centimeter during the month—a statistically significant increase, according to Ganmaa. “But we don’t know if it will be sustained in the long term, whether it will affect their sexual maturation or their age at puberty,” she says. “One month is too short.” She and her Harvard colleagues are now seeking funding for a two-year study.

Based on what she has found so far, Ganmaa believes that cows in late pregnancy should not be milked—or, at least, that such milk should be labeled to indicate that it comes from a pregnant cow. In the meantime, it is reassuring to know that skim milk from the United States has low levels of hormones, just like the traditional stuff from Mongolia.

~Jonathan Shaw

Ganmaa Davaasambuu e-mail address: gdavaasa@hsph.harvard.edu

Lag Ba'omer bonfires 'ecological disaster'

Reform rabbi slams ritual lighting of bonfires during holiday that causes massive air pollution each year, calls on haredi rabbis to issue clear instructions on matter

Kobi Nahshoni

Published:

05.07.07, 03:12 / Israel Jewish Scene

"This is an ecological disaster, it's virtually rabbi-sanctioned vandalism," Reform Rabbi Levi Weinman Kalman said Sunday, referring to the Lag Ba'omer bonfires that were lit across Israel Saturday night and caused massive air pollution throughout the country.

Weinman-Kalman, head of the Kol Haneshama congregation in Jerusalem, is a staunch opponent of the ritual Lag Ba'omer celebration, and claims that the "Bal tashchit" prohibition, which bans destroying anything that is of value to man, is a prominent mitzvah that applies in this case.

The rabbi, along with environmental organizations, does not expect Israelis to refrain from lighting the traditional bonfire on the holiday, but recommends to light less bonfires.

"Nowadays there is competition between yeshivas and families on who has the biggest bonfire. The rabbis should issue a clear instruction to those who celebrate that it is quality – not quantity – that matters," he stated.

Regardless of Lag Ba'omer, the rabbi believes that the concern for the environment can lead to rare cooperation between rabbis, including haredi ones, and the green organizations. For instance, he suggests to declare one Shabbat a month as a "car-free day".

"A car-free day and such cooperation certainly seem far-fetched, but creative thinking can lead to cooperation between sectors who usually don't meet," he stated.

Rabbi Aviner: Green organizations exaggerate

In response to Rabbi Weinman-Kalman's suggestion, Rabbi Shlomo Aviner, the rabbi of the Beit El settlement and head of the Ateret Kohanim yeshiva told Ynet that rabbis were aware of damages to the environment.

"Not everything we do gets media attention, and therefore I warn again of 'Bal tashchit' and of damages that may be caused to people and the environment," he said.

However, Rabbi Aviner said that as a former scientist, he knew that green organizations usually exaggerate the importance of ecological issues.

"It's true that we only have one planet Earth, and that without it there would be no Eretz Israel, Torah and mitzvot, but the damage caused

to it is minor… The money and resources that go into preserving the environment should be invested in more important things," he said.

Rabbi Aviner said that he believes that in the war for the environment, the consideration of gain versus loss should be kept in mind. "Disposable diapers are also bad for the environment, but no one thinks of returning to cloth diapers, because there are other needs as well," he explained.

According to the rabbi, although bonfires have no religious justification, if they meet the need for stress relief, entrainment or even pyromania, then they are legitimate.

The Home School option

August 20, 2001: 10:38 a.m. ET Why a growing number of parents are educating their children at home By Kamala Nair

NEW YORK (CNNfn) - Deanna Busch runs a tight ship. Classes start at 6:30 a.m. – those who are not in their seat by then receive detention. Like other teachers, Busch does not allow gum chewing. She requires homework to be finished on time and tests to be taken in silence. The only difference is: Her students call her "mom." Like most military families, the Busch's lifestyle takes them all over the world. When her husband was posted in Korea, Deanna Bush had a chance to preview schools for her six young children. Unsatisfied with the quality of education offered by the Department of Defense, she decided to take her children's education into her own hands. She began researching the home schooling concept, reading books such as "The Big Book of Home Learning," by Mary Pride, which recommends curriculum and lesson manuals. She attended home school conventions, which are held annually in every state, where she visited exhibits displaying a variety of useful books and curriculum. Within a year, she added "teacher" to her list of qualifications, and turned their home into a classroom. A growing contingent According to the ERIC Clearinghouse on Educational Management, the Busch family is not alone. The home schooling population has grown from 10,000-to-15,000 children in the late 1960s to well over 1 million today. The most common tools parents use when beginning to home educate their children are annual conventions, the Web, and correspondence programs, which test children and design curriculum for their specific needs. About 20 percent of home schoolers belong to these programs, which also keep records of academic history and issue diplomas upon graduation. While currently only about one-third of parents educate their children at home beyond the elementary level, Chris Klicka, senior council at the Home School Legal Defense Association (HSLDA), estimated that roughly 80 percent of new home schooling parents plan to educate their children through high school. In such cases, parents themselves issue their children transcripts and diplomas. Research conducted by the HSLDA indicates that since home education families are not dependent on public, tax-funded resources, they save United States taxpayers more than $7.5 million a year. However, parents who school children at home pay the same amount in property taxes as everyone else. Parents pay about $450 annually to teach one child at home, about $6,000 to send a child to public school, and anywhere from $1,000 to more than $6,000 to send a child to private school. Busch said her costs have increased as her children grow older, reaching around $800 per year for her 7th and 8th graders, because she sends their assignments to certified teachers through a correspondence course, who provide grades and transcripts. Busch emphasized that fusing the roles of parent and teacher can be a big sacrifice for parents. Because they are generally one-income households, money is often an important factor, especially for military families who don't earn a large income. "But the sacrifice and hard work pay off," asserted Busch, who will be sending her oldest son on a $1,000 scholarship to begin high school at a prestigious parochial school in Washington, D.C. Home schooling, which once was outlawed in most states, is now legal throughout the United States, and its popularity has grown steadily over the past several decades. While the Department of Education does not impose any federal restrictions on home education, each state has its own policies regarding the issue. South Carolina, for example, requires a parent to enroll with the local school district or with an accountability association. The parent must have at least a GED or a high school diploma, must teach for 180 days out of the year, and keep records and samples of their children's work. Other states, such as Arizona or Kansas, simply require parents who home educate to register with the state, but do not monitor the children's progress as closely. According to ERIC, while home schooling families come from all major ethnic and income groups, the typical family tends to be large, religious (Christian), conservative, and white. They are also generally middle-class, better educated, and more likely to be part of a two-parent family. About 10 percent of these families belong to the military as well, since many parents feel that forcing their children to migrate from one school to the next is harmful to their development. "My oldest son has been to the same grade school even though we have moved so often. Our house and our friends change continuously, but his education has stayed constant," said Busch. Brian Ray, president of the National Home Education Research Institute (NHERI), said the most commonly stated reasons that parents give for home schooling their kids include: teaching them specific philosophical and religious values; controlling their social interactions; developing close family bonds; and promoting high-level academics. At the same time, he said, many parents feel that schools today are breeding grounds for morally corrupt behavior and attitudes. "Parents do not want their kids to be exposed to all the violence in schools these days," said Gloria Ferber, of the Grace Home School Association, based in South Carolina. Academic and social implications In fact, advocates argue that educating children at home not only protects them from moral corruption, but that it also leads to increased maturity and a higher level of academic achievement. Through a nationwide study conducted by NHERI, Ray discovered home educated students to be scoring, on average, at or above the 80th percentile in all areas on standardized achievement tests. That is well above the national average, which is in the 50th percentile. According to ERIC, college admission statistics are also a measure of success. Home school graduates have reported admission to more than 1,000 different colleges and universities, at last check. While there is no conclusive research suggesting that additional time with peers is preferable to more time with individuals of varying ages, parents who choose to educate their children at home say that the increased exposure to people of all ages they receive through community activities and involvement with support groups, increases their self-confidence and maturity. "Kids should not be learning what's right and wrong from other kids – they should be learning from adults," said Busch. Although home schoolers are an ever-growing contingent, the practice still remains controversial. Organizations such as the national Parent-Teacher Association and the National Association of Elementary School Principals oppose this mode of education, and the National Education Association has called for more rigorous regulation of home schooling. Conversely, groups such as the American Civil Liberties Union believe that parents have a constitutional right to teach their own children. The majority of Americans, while they don't necessarily promote the institution, believe in a parent's right to take charge of their children's education, and many state legislatures have amended their laws to provide greater flexibility for home schooling. Klicka, of the HSLDA, acknowledged the limitations that home education poses to children, in terms of access to labs and athletics. However, he firmly believes the individual attention and disciplined learning environment it provides outweighs the cons. "Home schooling parents feel their children need to be educated based on the values this country was founded upon," he explained. "A lot of people are concerned that their kids will become an academic or social statistic. They want their kids to be literate and to be able to have the necessary skills to succeed."