a vaccine for HIV/AIDS on humans.

The approval from the Food and Drug Administration will lead to further tests that, if successful, could see a vaccine on the market in about five years, researchers from the University of Western Ontario said in announcing the milestone Tuesday morning at the campus in London. Ont.

The vaccine is the first based on a genetically modified, killed whole virus, following a line of research that successfully produced vaccines for polio, rabies and hepatitis A.

It is the only HIV vaccine currently under development in Canada, and one of only a few in the world, said the researchers.

Dr. Chil-Yong Kang and a team at the university, funded by pharmaceutical venture company Sumagen Canada, said approval by the American agency was crucial because its strict standards are generally regarded as a world standard.

A clinical trial on 40 HIV-positive volunteers will begin next month.

Those trials will be followed by tests on 6,600 HIV-negative but high-risk-category volunteers, testing immune responses and effectiveness of the vaccine in two more phases.

"I feel happy and comfortable with this human clinical trial," Kang told university and political leaders gathered for the announcement Tuesday.

Kang said the vaccine is being produced at special "bio-safety level 3" laboratories in Maryland and Colorado because there is no suitable lab in Canada.

Three earlier attempts at developing similar vaccines have failed since 2003.

Unlike other research, the Western team uses viruses it kills and genetically modifies to make them safe. Part of that process involves using white blood cells and the melittin protein from honeybees to help cultivate the vaccine.

Other attempts have used live viruses, because research found that route was successful in developing vaccines to combat mumps, measles and smallpox.

Kang said researchers in London had to conduct 230 different tests to satisfy the FDA, some involving primates, to ensure the vaccine would be safe to use on humans.

Sumagen Canada has secured patents to the vaccine in more than 70 countries.

HIV/AIDS has killed more than 28 million people worldwide, and more than 35 million people currently live with the virus that attacks the immune system. Since the virus was characterized in 1983, there have been numerous trials through pharmaceutical companies and academic institutions around the world to develop vaccines; however, no commercialized vaccine has been developed to date.

About the vaccine:

- Attempts to develop a vaccine in 2003, 2007 and 2009 failed.

- Western's is a new approach, similar to that used to develop vaccines for polio, influenza, rabies, hepatitis A, Japanese encephalitis for humans and 16 vaccines to prevent viral diseases in animals.

- The approach uses human immunodeficiency viruses that are killed, then genetically modified to be safe and cultivated with protein from honeybees.

Dr. Steven Schwartz had been waiting 14 years to make the phone call. As an eye doctor at the University of California, Los Angeles, Schwartz sees his share of patients with serious diseases that slowly rob them of their sight. Yet when a 12-year-old girl went to him complaining of vision problems, he had the difficult job of diagnosing her with Stargardt's, one of the more common forms of macular degeneration, in which the photoreceptor cells start to deteriorate. He had to tell her that the world she knew would gradually, pixel by pixel, fade into darkness and that there was nothing he could do to treat her impending blindness. He suggested she try visual aids and vitamins to keep any remaining cells functioning, but that was all he could offer. She and her family were interested in participating in research trials, however, so he promised that he would call if any new opportunities arose.

Nearly a decade and a half later, Schwartz kept that promise and phoned the patient he couldn't forget with some exciting news. He was getting ready to test the first embryonic-stem-cell therapy for Stargardt's and dry macular degeneration. Would she, he wondered, be interested in learning more?

Now 26 and legally blind, the young woman, who can't be identified until after her treatment because of informed-consent rules, immediately said yes. She is being evaluated as a potential pioneer to receive the first retinal pigment epithelium (RPE) cells generated from embryonic stem cells. If accepted, she will join a handful of other patients with macular degeneration who will have thousands of cells injected into their eyes to replace their destroyed RPE cells in the retina and, hopefully, rescue any remaining photoreceptor cells. They will help scientists answer a critical question: After all the controversy over embryonic stem cells, are therapies derived from them safe and ultimately effective?

Two patients with spinal-cord injuries have already received injections of another embryonic-stem-cell-based treatment — millions of specific cells that help neurons communicate with one another — in an effort to repair the shredded network of nerves that crisscross the spinal cord and extend out to the arms, legs, fingers and toes. While still a select group, together these patients represent the first wave of what doctors hope will be a new era in cell-based medicine. Instead of treating disease symptoms with drugs or surgery — regular insulin injections for diabetics, for instance, or medications to help break up the plaques that strangle nerve cells in the brains of Alzheimer's patients — they're hoping to replace damaged and no-longer-functioning cells with new, healthier versions that could eventually lead to a cure for countless chronic diseases, from macular degeneration to diabetes, heart disease and spinal-cord injury. And the key to generating these new cells will be stem cells.

"We are finally ready to break ground on this field with the first trials," says Dr. Robert Lanza, chief scientific officer at Advanced Cell Technology, the company that makes the RPE cells. "It's taken a decade of extensive research to get to this point."

In those 10 years, stem-cell scientists have had to address some tough questions about how realistic it would be to extract stem cells from a human embryo, coax those cells to develop into nerve and eye cells and then transplant them into patients. The burden on these vanguard trials is huge, and the questions they inspire are legion — and disturbing. Will the transplanted cells "take," escaping destruction by their new hosts' immune systems? The cells are, after all, made from embryos that were completely unrelated to the recipients. Will the fact that the cells were developed from embryonic stem cells lead them to form tumors? Embryonic stem cells are known for their ability to grow indefinitely. Left alone, such cells tend to form grotesque balls of different tissue types — bone, skin, tooth, hair, muscle — known as teratomas. And if the transplanted cells do survive and don't form tumors or teratomas, will they function properly? Will that function be enough to restore some feeling, in the case of the spinal-cord-injury patients, or some vision in the eye patients?

Stem-cell scientists certainly aren't expecting to answer all these questions with this first round of trials. In fact, the initial patients are part of important safety tests to determine if stem-cell-based tissues are safe and robust enough to live and grow in human patients. As in any situation involving a completely novel treatment with no precedent in medical history, the scientists are hoping for the best but bracing for the worst.

They have good reason to be cautious. Just eight months after it won approval from the Food and Drug Administration, the spinal-cord trial, led by Geron, was suspended for nearly a year after ongoing animal studies found that the transplanted nerve cells started to form odd clusters in the spines of the animals. Scientists eventually determined that the so-called rosettes weren't tumors and allowed the trial to continue, but the experience highlights the vigor and unpredictability of the cells. Learning from that incident, Lanza decided to take no chances and developed a test that would detect a single stray stem cell, with the potential of developing into a teratoma, that might have escaped into a preparation of over a million RPE cells. "Our cells are 99% to 100% pure," he says.

The retinal cells may have an advantage when it comes to immune rejection. The space beneath the retina where the cells are injected is generally free of the body's patrolling immune sentries. But in the patients in the trial, the RPE cells have been so damaged by disease that it's not clear whether they continue to maintain their immune-protected cocoon. So just to be safe, the volunteers will be taking drugs to suppress their immune system, in much the same way that patients receiving organ transplants from unrelated donors do.

Looking ahead, such immune protection may not be necessary. Researchers can now make embryo-like stem cells from a patient's own skin cells, which means that the concern about immune mismatch between donor and recipient cells may become moot. There's another benefit to these embryo-free stem cells, known as induced pluripotent stem cells, or iPS cells. Because they can be made from patients suffering from diseases like diabetes or Lou Gehrig's, scientists can watch how these cells develop and better understand how a motor neuron in a patient with such a disease starts to go awry.

So while a lot hangs on these first trials of embryonic-stem-cell therapies, they are, says Schwartz, only the beginning. Realistically, he doesn't anticipate that early participants will regain their vision completely, nor do the spinal-cord experts expect their patients to walk again after getting the treatments. But if the therapies are safe, then scientists can start figuring out when to intervene with the cells to do the most good. "We can start thinking about striking at diseases like macular degeneration before central vision is completely gone," says Schwartz. And that would indeed be something worth seeing.

At 12:33 p.m., the lunch bell rings at Los Angeles High School. Moments later comes the stampede. Kids — 2,000 of them — burst through the cafeteria doors, pushing and shoving, funneled through the serving area like ants in an ant farm.

Among them is Stephanie Hernandez. It's her first day here at the city's oldest public school. She is 17, pretty with long black hair, and as a junior enrolled in the math and science magnet program she spends the entire day on the third floor, away from "the kids who tag and the kids who ditch." The cafeteria, unfortunately, is on the first floor. By the time Hernandez hefts her books and races downstairs, the lunch line is enormous. By the time she gets within arm's reach of the food itself, the bell signaling the end of 30 minutes rings.

Lunch is over. Her empty stomach growls. That afternoon, she can't concentrate.

At home, her dad urges her to try again. He's a single father, an electrician, and his income qualifies her for a free, federally subsidized school lunch.

So she tries again ... and fails. Same the next day. And the next.

Her friend Jose Anaya doesn't even bother with the line. It's ridiculous. Besides, he won't eat the food.

"They're like lethal weapons," he says of the stiff, cold french fries. Like dozens of other kids, he buys contraband muffins from a Spanish teacher, Mercedes Salvador, who buys them in bulk from Costco and parcels them out for a buck, then reinvests the profits in more food.

It's against LAUSD rules to sell to students, and she's been warned. But if she stops, kids go hungry. She can't afford hungry, distracted students, since her teaching is being judged on test scores. It's a Sophie's Choice played out in snack foods.

Across town, at Wilson High School in El Sereno, 17-year-olds Xotchil Lopez andDinah Aruncion are trying to eat healthier. Though Aruncion wants to lose weight, she's looking at a Los Angeles Unified School District pepperoni pizza for lunch. It's actually a nutritionally modified pizza, 280 calories a slice. But Aruncion doesn't know that because the district doesn't tell kids the nutritional value of food. To her, it might as well be Domino's.

Lopez aspires to veganism but refuses the vegetarian sweet-and-sour meal that the district has painstakingly taste-tested some 30,000 times. The school district says it's one of the most popular items. But Lopez sees it as "disgusting."

This, then, is lunch in Los Angeles public schools: impossibly short lunch breaks, processed food, unappetizing meals. Even the nutritious items can look so unappealing that kids pass them up.

Seventy-five percent of the students in LAUSD come from homes with incomes below the federal poverty level. To many of them, any food — even school food — is better than nothing. Yet parents have long been irate over the quality of food at school breakfasts and lunch. Many have fought for years for improvements — and the district has made some big, worthwhile changes.

LAUSD administrators say other school districts look to Los Angeles with admiration, asking, "How do you do it?" How do you feed 671,648 kids 180 days a year — 121 million meals in all — for only 77 cents a meal? Truly, it's a Herculean task. But it has not been enough.

Critics continue to ask a simple question: Why can't the district provide appetizing, nutritional meals, cooked on-site, and give students enough time to eat? As Emily Ventura, social action chairwoman of Slow Food L.A., the nonprofit organization dedicated to promoting fair food production and consumption, says: "A protein, a vegetable, a carbohydrate, a piece of fruit and a glass of water. How hard is that?"

The answer is that the lunch program of the nation's second-largest district has deep and intractable problems. Hunger and obesity coexist. Misperceptions abound — about what the district thinks kids won't eat, about what food advocates think the district thinks, about what parents believe kids are eating, about what kids actually will eat. School principals beg the district to stop sending them grapes because there aren't enough janitors to sweep the floor after lunch period is over. Well-meaning teachers violate district rules by selling food to hungry students for pennies on the dollar.

As David Binkle, deputy director of food services at LAUSD, says, "The school lunch program is the greatest hidden treasure in America. The problem is, it's broken."

And the problem is that there isn't just one problem. There are many.

Bad and Ugly

The national school lunch program was created after World War II to alleviate childhood hunger. Today, many school districts manage to provide meals that are both appetizing and nutritional, often cooked on-site. However, those meals are found mostly in school districts with more money to spend per meal than L.A. Unified has.

The current state of LAUSD's facilities makes the job of feeding kids especially onerous. Schools do not prepare meals from scratch on premises. Knives are not allowed in kitchens. Hot water is verboten. Cafeterias have only warming ovens and shelves with heat lamps.

To save money, in the late 1970s, the district began preparing meals at a central processing center. From there, the meals are sent out to schools where part-time cafeteria workers reheat and serve them. That is cheaper than hiring kitchen staffs at individual schools. Plus, most schools don't even have kitchens. At the 15 percent to 20 percent that do, the kitchens are old and aren't built to modern food-service code.

District officials argue that their meals are nutritional and, according to taste tests by students, appetizing. Sitting at a conference table on the 28th floor of LAUSD headquarters downtown, Food Services Director Dennis Barrett bristles at the idea that lunches aren't healthy. "Maybe somebody didn't heat it all the way through," he concedes. "But the nutritional content? We'll stand behind it 100 percent."

As required by federal law, L.A. Unified's meals do provide the recommended dietary allowances for specific nutrients: vitamins A and C, calcium, iron, and so on. The meals also comply with the U.S. Department of Agriculture's dietary guidelines, although not the current guidelines, issued last year. Instead, the district is following 2005 guidelines.

Yet the issue isn't as simple as meeting those minimums. Doing so does not ensure that food is healthy overall. Indeed, LAUSD's current menu is schizophrenic. The beef corn dog might be prim and proper with 6.2 grams of added sugar, but the orange chicken bowl with brown rice clocks in at a hefty 31.5 grams of sugar, almost as much as a can ofCoca-Cola.

Moreover, the district does not cap overall sugar content. High sugar consumption, we now know, is correlated with obesity. TheWorld Health Organization says no more than 10 percent of the day's calories should come from sugar; that means 50 grams total for a 2,000-calorie diet.

The wide variety in menu selections means LAUSD kids can easily select à la carte meals that blast past most definitions of healthy eating, assembling meals high in sugar and sodium without realizing it.

For instance, the coffee cake, a student breakfast favorite, packs 36 grams of added sugar. (Food Services' Binkle says, "We were practically lynched when we tried to take it off the menu.") Add in 29 grams of sugar from fruit punch, and kids are sucking down 65 grams of sugar in a single meal.

It's a similar grim tale with sodium. Six years ago, the USDA dietary guidelines advised a maximum 2,300 milligrams of sodium a day, averaged over a week. The agency has since cut the limit to 1,500 mg a day.

Here's how that applies in LAUSD. Over the course of five recent days, students at Los Angeles High School were given menu offerings of an orange chicken bowl (1,120 mg), followed the next day by a cheese sandwich with chicken noodle soup (2,226 mg), then by meat and cheese sauce (1,217 mg), then a deli turkey sub (958 mg) and, finally, a kung pao chicken bowl (602 mg). Wash each main dish down with two cartons of 1 percent white milk (150 mg each) and kids are consuming a daily average of 1,525 milligrams of sodium. For lunch alone.

Ventura, a former nutrition educator at LAUSD, says Binkle once told her: "You have to recognize the food they're getting at school is so much better than the food they're getting at the liquor stores, or fast food, or at home."

"You may be right, David," she replied, "but just because one thing is relatively better than the other doesn't mean it's good. If you want to be a nutritional leader, be a nutritional leader. Don't be slightly better than the worst."

To Jennie Cook, co-founder of nonprofit group Food for Lunch, which advocates fresh, whole foods at schools, the real devil is processing. "Processed food creates compulsive eaters," says Cook, a nutrition activist who started Food for Lunch with pediatricianRebecca Crane. "It creates sugar addictions. It creates allergies and histamine reactions."

In fairness, the district has been ahead of the curve in certain respects. In 2005, Los Angeles Unified made headlines by banning sodas and chips. This change — the single most important one in LAUSD's food quality in the past decade — was pushed through by then–board member Marlene Canter, who had spoken with a neighbor, pediatric endocrinologistFran Kaufman, author of the book Diabesity. Kaufman told Canter the district needed to stop selling sodas in school vending machines.

Since then, LAUSD also has eliminated many of the worst offenders in school food — MSG, palm oils, trans fats — and introduced whole wheat, brown rice and vegetarian entrées.

The district also has created healthy versions of some of the typically least healthy fast-food meals. A corn dog on LAUSD's menu isn't your average corn dog — even if few students know it. Burritos, chicken wings, hamburgers, even french fries have been nutritionally modified into healthier versions of traditionally unhealthy foods. Fast food, the rationale goes, is what kids crave. So give it to them. But sneak in the healthiness.

School district food officials say their biggest challenge is to produce healthy food that is both cheap and appealing to students. Healthy meals do no one any good unless they are being eaten. One main element of the district's approach is to give students a number of menu choices each day.

To Cook, Ventura and others, those choices are a big part of the problem. Kids can mix and match, with the result being unhealthy meals. Ventura would rather see a single "grown-up" meal done well, and she could do without the "potato smiles," "cucumber coins," "breakfast surprises" and other items with gimmicky names.

To make processed food appetizing, school officials have an elaborate system for taste-testing, serving each dish to thousands of students and asking their opinions.

Take hummus. Studies show that kids will eat what they've been taught to eat and that it takes from 10 to 50 exposures before they'll accept a new food. Nutrition activist Matt Sharp of California Food Policy Advocates says that kids in Marin County, for instance, ask for hummus and lentils. It's what they're eating at home. It's what they've been eating since they were 3 or 4 years old.

LAUSD, however, didn't budge on hummus. "We've tested hummus six different times with children," Food Services Director Barrett says. "They've rejected it. We've even tried flavored hummus. They just don't like that texture in their mouth in Los Angeles."

Same with yogurt. "We brought up plain yogurt," Cook says of her last encounter with LAUSD administrators. "They looked at us like we wanted to serve cow eyeballs to the kids."

Ventura says the district could "make the plain yogurt work if you pair it with a fruit side, or granola. They were trying to put it with things that just won't work, like a hard-boiled egg. If you come into it with negative energy, like, 'Here's this gross plain yogurt,' they're not gonna like it. I could get them into plain yogurt, no problem. You have to have an enthusiastic person who's eating it with them."

Aside from that, many parents would like to see the district tell kids what they are eating, and educate them. As the argument goes, kids don't have to choose the unhealthy stuff. They might eat better if they were taught how to do it.

But the district does little to educate students. Signs on the wall above heating trays at Los Angeles High School proclaim: "Apples are made of 25 percent air, that is why they float," and "Most consumed vegetable in the U.S. = potato." That's not education, it's trivia.

Absent any attempt to inform students, the district is left to cater to their whims and often bad eating habits. "They're learning that french fries are served in school, therefore they must be good to eat," Sharp says. "They're not skipping one food one day to eat something else. They're just eating all of it all of the time."

Everyone who delves into the world of school food eventually hits upon a basic tension: Should the food reflect America, or lead America? LAUSD's menu of frozen, heat-and-serve meals is largely reflective of eating habits.

"In terms of the general dietary habit of pizza for lunch, or a 24-pack of nuggets at Mickey D's for dinner, LAUSD is not challenging the dominant eating culture," Sharp says.

77 Cents a Meal

The question most often asked by parents the Weekly spoke to for this story was this: "Why only 77 cents on food?" Why does the district spend just 77 cents per meal when the superintendent makes $275,000 a year with a company car and a driver? (NewSuperintendent John Deasy would have made $330,000 but he turned down the $55,000 raise from his old deputy position, given the district's dire financial straits.)

"Could the district choose to spend more on a meal?" asks Barrett. "Yes, they could. If they had it. They don't have it."

In truth, the district spends a total of $2.49 per meal — and is reimbursed for it by the federal government. The $2.49 is based on what USDA economists estimate a healthy meal costs. But of that amount, just 77 cents goes to food. Why? First, subtract $1.42 for labor and benefits. Subtract 12 cents for supplies. Subtract 18 cents for operating expenses.

That leaves 77 cents.

In a comparison with 49 other large districts, Los Angeles spends at the very top of the heap on labor — twice as much as it does on food.

How did this happen? One big reason is that in 2007, the school board voted to give its 2,300 part-time cafeteria employees a fourth hour of work each day, up from three. The purpose was to qualify them for full health benefits — family medical, vision and dental. It was a huge win for organized labor, but it cost the already cash-strapped district $105 million over three years. Every penny paid for benefits is a penny not available for food.

"It's a perfect illustration of an unfair choice," Sharp says.

LAUSD is projecting a $408 million budget shortfall for next year. It plans to lay off 5,000 teachers and 2,000 support personnel come June 30 if the district doesn't receive more money from the state. In the last two years, the district has laid off more than 2,700 teachers, nurses, mental health counselors and librarians.

In this climate, is it any wonder that food quality suffers?

Meals served at LAUSD schools are assembled in a factorylike plant called the Newman Center, located east of downtown near USC's medical campus. The scene there is not Upton Sinclair's The Jungle by any means. But it isn't Martha Stewart, either.

Taste-testing at Newman is what passes for field trips in LAUSD these days. A hundred kids are bused to the center daily. They sit at 10 little tables, three kids each, three shifts per day. Master of ceremonies chef Mark Baida — gregarious, animated, the Willy Wonka of this surreal factory — teaches kids about the flavor points on a tongue. Today they're rating his chicken posole. Each item is tested 30,000 times. Is it too salty? Too sweet? Too spicy? It's dangerous to serve food that kids won't eat. Imagine the horror of buying 100,000 burritos that don't get consumed — or reimbursed. Baida doesn't want to hear "eeeww" or "nasty" or even "good," he says. Can anybody tell him why?

"Because it doesn't do anything for you?" says one third-grade girl.

"Gold star," Baida says. "I need you to help me help you."

His posole — hand-chopped chicken breast, lime, cilantro, red bell peppers, no added sodium, hominy "so white and clean" — is a success. Out of 40 kids, only four give it the thumbs-down. Their responses will be input into a database. This is cooking by committee.

Newman was built to process 8,000 meals a day. Today, it pumps out a staggering 250,000. Consequently, space is cramped and the name of the game is speed. Automation. Heat and serve.

"This facility was supposed to be one of many throughout the city," Binkle says with a rueful smile. "They never built the other ones. They didn't have the money."

Cook, of Food for Lunch, has a somewhat different view: "Instead of whole foods, they still have this antiquated idea that they should be serving a hot meal for 77 cents for breakfast and lunch. Why would they even think that's possible? At 77 cents a meal?"

No Time

Back at lunch at Los Angeles High, Stephanie Hernandez has learned a few lessons. Keep your meal ticket hidden so bullies don't jack it. Make friends with those who will save you a place in line. Create a distraction so the monitors don't see you do it. Let other kids at the back of the line be the ones running out of time.

All's fair in war and lunch.

Each LAUSD school works out its own daily meal schedule. The only requirement is that the last child in line must have 20 minutes to eat. That's a pipe dream.

The district, which serves a meal on average every 10 seconds, is perfectly aware that students don't get enough time to eat. Everyone, really, is aware of it — district administrators, principals, teachers, cafeteria workers, parents, the kids themselves. Yet the situation persists.

"Everybody's pointing the finger at someone else," says CFPA nutrition policy advocateNicola Edwards.

"Kids get less time to eat because teachers want more time to teach," Binkle says. Teachers, Matt Sharp suspects, don't want to stay at school a minute longer than they already do.

Why doesn't LAUSD simply lengthen the school day to provide more time for students to eat?

"I've been asking that myself," Barrett says.

The district says the teachers union is responsible. "The length of the school day would need to be negotiated with the staff per their contract," explains Robert Alaniz, LAUSD director of communications. "Changing the length of the day changes their working conditions and is a negotiated item."

But the teachers union bounces responsibility right back to LAUSD: "This has nothing to do with the UTLA contract," counters A.J. Duffy, president of the United Teachers Los Angeles.

It's an endless game of pass-the-buck.

Here is another part of the problem: From 1992 to 2005, as a result of childbirth and immigration, the LAUSD school population increased by hundreds of thousands of students — to its current level of nearly 672,000.

Within such a system, things that should be simple become complicated.

Things like salad bars. What could be easier? Raw vegetables cut up. Dressings. Croutons. Serve yourself. But of the 1,092 LAUSD schools, kindergarten through 12th grade, only 35 have a salad bar.

"Salad bars sound wonderful," Binkle says. But to the district, they are a logistical nightmare. Kids touch the food, then put it back, causing contamination and sanitation issues.

Salad bars also require time — time for 1,000 kids in a line to make choices on each salad item, time to replenish the items, time to sit and chew. They might work somewhere like France, where kids get a minimum of an hour and a half for lunch — 30 minutes to eat, 30 minutes to play, then another 30 minutes to eat some more. Here in L.A., it's far easier to dole out a plastic-wrapped burrito you can hold with one hand and eat while walking down a hallway.

At one point, someone within the district created a handy Meal Period Calculator tool — anExcel spreadsheet, essentially. Type in the number of students at a school and it spits out how many windows and lunch periods the site should have. Currently, there is no requirement saying the tool should be used.

But imagine if each spring, when principals request approval for their next year's schedule, funding is denied unless the school uses the Meal Period Calculator to ensure kids have time to eat.

"We've been talking about this for four consecutive springs," Sharp says.

What has the response been?

"Well, the phone ain't ringing."

Angry Moms

A bunch of angry moms (and a few dads) are huddled together on a street corner downtown near LAUSD headquarters. It is Valentine's Day 2011. They are protesting sugary, flavored milk, which has been called "soda in drag."

Cook, Ventura, Sharp and others have carved an hour out of their Monday afternoon to storm the LAUSD Cafeteria Improvement Meeting. The district had asked Cook and Ventura to demonstrate parent support for removing sugar-laden strawberry and chocolate milk from menus — so here they are.

The women summon their network of angry moms. Maybe 50 show. However, celebrity chef Jamie Oliver, star of reality TV show Jamie Oliver's Food Revolution, arrives with cameras, which holds the promise of building more support.

"They say it's strawberry milk?" someone says. "Strawberries don't taste like that. We're teaching children that food should taste artificial. Why don't we give them real strawberries? And chocolate doesn't taste like that, either, by the way."

Cook grabs a plastic milk container and with a hearty "Get the jugs, people!" the group marches to LAUSD's front steps. One mom plays Def Leppard's "Pour Some Sugar on Me" on a boom box. Another mom, Diana Starr, passes around a photo of a typical LAUSD elementary school lunch — potato wedges, sweet-and-sour tofu chicken, frozen chocolate dessert, strawberry milk. Parents take turns getting indignant over it.

Their fury is for naught. The meeting can't be stormed. It's been canceled.

Such is the lot of the constantly rotating cast of angry parents trying to get answers and force changes in school meals. Parent after parent tells stories of banging on LAUSD's doors, eventually getting frustrated and giving up, only to be replaced by another generation of parents embarking on the same path.

A few days after the thwarted protest, the two head honchos of LAUSD Food Services, Binkle and Barrett, visited Starr's Lomita Magnet Elementary, where her 7-year-old son is a student and 57 percent of the students come from households with an income below the federal poverty level. Binkle and Barrett went to the school ostensibly to answer questions about the food. They showed up with a PowerPointpresentation.

"We could barely get a word in edgewise," Starr says.

After school, Starr and her friends are headed to McDonald's. The irony of the scene is rich: Moms sitting around a table at McDonald's, kvetching about lack of nutrition in school lunch.

On the table in front of Starr is the photo of the sweet-and-sour meal she brought to the milk protest. Administrators say that dish is one of their most popular. But kids at Starr's son's school cry when they see it, she says. They must cry a lot: Vegetarian Sweet & Sour with Brown Rice is on the menu every single day in both the elementary and secondary schools.

"We were watching the kindergartners open their lunches," Starr says. "Here's this little boy, we're talking freshly 5. And he's struggling with the plastic, picking it out of his mouth, trying to get to the pizza. Now think about the plastic. They heat it up. It's gonna seep into the food. It's so scary."

Starr recalls a PTA president who found many gorgeous fresh bananas in trash cans, thrown there by young kids who didn't know how to peel them. Eating bananas might be easier with mom or dad's help, but the district doesn't allow parents to sit with their own children during school meals.

Starr and her husband moved here from Seattle. She used to laugh at the "granola moms" up there, with their organic beef and cruelty-free eggs. But then one day she poked her head into the cafeteria at her son's school in L.A. They were serving a breaded chicken patty on a bun. No condiments. Milk. And potato wedges. "I said where's the freaking vegetable. And they said that is the vegetable."

She stopped letting him buy school food.

Stay-at-home mom Carmen Joseph once visited a New Orleans school that blew her mind. Kindergartners sat at round tables, eating salads, with pitchers of water and cups in the middle, and a parent to guide them. "They were the quietest bunch of kids I've ever seen."

Ereida Garcia's kids go to Wilson, but they've attended other schools. In San Diego, they had a burrito stand, a burger stand, smoothies and a large salad bar with fruits and yogurt. InPortland, Ore., the cafeteria ladies whipped up fresh pancakes for breakfast. Garcia herself is a Class of '91 graduate of Pasadena High School, which is not part of LAUSD. She took her kids on a tour of its cafeteria, which they promptly fell in love with. "Why can't we have that here?" Garcia asks.

Garcia fought hard during her daughter's first two years at Wilson, and tried in vain with 80 other parents to get a salad bar. When that didn't happen, they sold mangoes, oranges and cucumbers for $1 a bag, reinvesting the proceeds into school field trips or equipment. When kids couldn't get through the cafeteria line, the parents sold tortas with tomatoes, potatoes and meat for lunch at the school Parent Center. Administrators told them to stop, saying the food was a health hazard.

Garcia, like many other frustrated parents, no longer bucks the system. "I gave up," she says.

What's more, the charter school movement siphoned some 100,000 students away from LAUSD in the past decade, stealing some of the best soldiers in the good-food movement. The students who departed were from some of the most organized households, with the most involved parents. They were precisely the people most likely to be able to fight for better school food.

Cook and Ventura attended meeting after meeting over 18 months. "We have a highly evolved food services director in David Binkle," Cook says. "He's working on the Berkeley Eco Literacy program. He's up there writing food nutrition policy for them. And then he comes down here and gives our kids frozen, processed dog food in a different container and calls it lunch?

"It's not OK."

LAUSD says it is all about transparency. That is true in some respects, false in others. Nutritional content for each menu item, for instance, can be found on the district's website. But sugar isn't listed. Neither is sodium. No information on either is readily available to the public.

Also, the district canceled the Cafeteria Improvement Committee meetings in recent months, taking away the public's one regular, guaranteed opportunity to be heard. The district's explanation? It plans to institute an ad hoc advisory group less encumbered by formal procedure. These will be better for stimulating dialogue, the district says.

"You get half of an answer that stops you for a while," says Carmen Joseph. "It's like you're drinking the Kool-Aid. Dennis Barrett did that to me once. I was, like, 'Oh, some of the kids aren't even getting their lunch? Well, that's terrible.' That's Dennis' technique. Feel sorry for us. And it's a good technique. It does work."

Small Changes

In the Riverside Unified School District, east of Los Angeles, Nutrition Services Director Rodney Taylor takes students to the school garden to pick lettuce. "Then they go into the cafeteria and say, 'You see that lettuce? I grew that,' " Cook recalls Taylor telling her. "He said, it doesn't matter what time of the year it is, they'll say that's my lettuce. Even if their lettuce is long gone. You create ownership, you create desire."

Taylor's district has 250 schools. All have salad bars.

How did you get a salad bar in every school, Cook asked?

"One school at a time," Taylor told her.

At LAUSD dependent charter Canyon Elementary School, Carmen Joseph works with second graders in the school garden. She says she has seen kids eat stuff that would shock their parents. They made black bean corn salad with kale, and pumpkin cornmeal muffins with pumpkins from the pumpkin patch.

But LAUSD does not allow them to serve the vegetables or fruits grown in the garden in the cafeteria because it would compete with participation in the lunch program.

At Los Angeles High, Jose Anaya isn't scoring illegal muffins from his Spanish teacher anymore. Teacher Salvador is no longer dealing. A student chucked a pear at her from the third floor while she was standing in the courtyard during lunch. The fruit hit her in the head and sent her to the hospital with concussion. No one knows who the culprit was, or if it was a piece of fruit the teacher herself sold.

After long deliberation and pressure from activists, Superintendent Deasy recommended that Los Angeles Unified's Board of Education stop serving the high-sugar chocolate and strawberry milk, effective fall 2011. Deasy made the announcement with a grinning Jamie Oliver on late-night TV show Jimmy Kimmel Live. The board voted 5-2 Tuesday to stop serving chocolate or strawberry flavored milk with added sugar.

There's also a new menu. It's the first one Binkle, Barrett and chef Mark Baida have had under their complete control, they say, without having to honor past contracts, which are sunsetting this year. The new menu, to debut in the fall, is undergoing taste-testing at the moment. Items are still in flux. Thus far, "potato smiles" and Tater Tots are returning. Chicken nuggets are not.

Instead of processed reconstituted meat, there will be whole chicken breast served with dark green veggies and brown rice. Kids can expect to eat chef Baida's Vietnamese bánh mì. Quinoa and Israeli couscous and lentils are on the agenda, too.

And yes, even hummus.

Following this week's state workplace health meeting on requiring condoms in porn, adult stars spoke out against the proposed practice.

An interesting theme among some of the women:

It's a reproductive rights issue.

"Keep your laws off my body," former Penthouse Pet Ryan Keely said in a statement sent out to the media today (which happens to be 6/9, if anyone cares).

As Tuesday's meeting made clear, California's Division of Occupational Health and Safety (Cal/OSHA) is moving toward a rule that would specifically require condom use at porn shoots in the state.

ryankeely.com

Keely.

​

As it stands, Cal/OSHA officials say condoms are already required via federal rules that seek to protect workers from exposure to bloodborne pathogens.

But state officials have said they don't have the resources to fully enforce the rules. So big producers like Larry Flynt's Hustler video get raided and cited occasionally, and they seem to chalk it up to the price of doing business.

A rule specifically naming adult video and condoms wouldn't seem to change this situation.

Still, porn stars are pissed. While industry leaders say the requirement, if enforced, would push production out of state and underground -- into even less-safe terrain -- performers say they don't want California all up in their genitals.

Porn star Ela Darling says the industry's system of having performers regularly tested works:

darlingela.com

Ela Darling.

​

As an individual and as a performer, I would rather have unprotected sex with someone whom I know for sure has been tested for HIV, Gonorrhea and Chlamydia in the past thirty days, than have barrier-protected sex with someone whose STD status is either unknown or positive.

Lily Cade:

lilycade.com

Lily Cade.

​

These proposed regulations are so absurd that, if actually enforced, they would drive the porn industry out of California. Taking my job away doesn't make me safer - it makes me unemployed. I absolutely, unequivocally, love what I do, and I do not want that taken away from me because of misguided concerns about my safety. We are not a hazmat team. We are not radioactive. We are fucking, something almost everyone does, and almost no one encases themselves in plastic wrap to do.

And last, but certainly not least, Justine Joli (who calls herself a "girl-on-girl performer"):

justinejoli.com

Justine Joli.

Being required to use dental dams, plastic over labia, gloves and goggles instead of testing wont make me safer. It will only take my job away.

• By Maryn McKenna

This Sunday — June 5, 2011 — marks what public health considers the 30th anniversary of the international epidemic of HIV-AIDS.

If you’d like a summation of the past 30 years, Larry Altman, the retired senior medical writer of the New York Times, did an excellent job last Tuesday. And the Centers for Disease Control and Prevention summed up, in a paper released at noon ET, the state of the epidemic today.

I was not yet a reporter when the plague began, so my memories of that time are not professional memories, but personal. I was a student, studying mostly theatre, and almost all my friends were gay. And suddenly my friends were dying. People who remember will know what I mean. We got used to seeing people we worked and drank with looking, abruptly, like famine victims. We grew battlefield-numb bringing meals, and attending memorials, and calling people’s mothers on their death anniversaries. We knew when the multi-drug cocktails that changed the course of the epidemic had arrived, not because we read the journal articles, but because suddenly we could take our florists off our speed-dial.

I worry, in the complacency that has settled now around HIV as an almost-chronic illness, that the stunning initial impact of this disease that changed the planet has been somehow forgotten. So for my next three posts, I’m going to take you back to those days.

A few years ago, I wrote a book chronicling the history of the Epidemic Intelligence Service, the young disease-detective corps of the CDC. EIS officers, as they’re called, were in on every major disease event of the last half of the 20th century: the end of smallpox, the beginning of the end of polio. And though his name was never well-known and has been almost forgotten, one of them alerted the world to the first known cases of AIDS.

His name was Wayne X. Shandera, and the anniversary that we’ll mark on Sunday is actually the 30th anniversary of the publication of his urgent bulletin, the first in any medical journal to describe a case of HIV.

Below is Chapter 6 of Beating Back the Devil. We begin in California, in the winter of 1980, where Wayne Shandera is contemplating his options for his 2-year stint in the EIS.

AIDS: 1981, Los Angeles (Part One)

Los Angeles was just about the last place Wayne X. Shandera wanted to end up.

The wiry-haired physician had gone to college at Rice University in Houston, crossed the country to medical school at Johns Hopkins University in Baltimore, and then crossed back for residency at Stanford University outside San Francisco. Now he was wondering whether to pack up again. He had been admitted to the Epidemic Intelligence Service, and the group had asked him to list his preferences for an assignment.

Shandera was 29 years old, a devout Catholic who read three languages and was an accomplished organist. He loved living in the Bay Area; he liked the climate and the architecture, and he felt at home in the left-leaning discourse that simmered in its bookstores and coffee shops. Shandera had moved to San Francisco in 1977, the year that activist Harvey Milk was elected to the city’s board of supervisors. Milk was the first openly gay man to win a popular election anywhere in America. When he was murdered a year later, gay men poured into the city, transforming its colorful, casual decadence into a nexus of sexual flamboyance and political fury. But Shandera had little contact with gay San Francisco. Heterosexual, socially conservative and somewhat shy, he would rather have gone to a chamber music concert than a Pride parade.

At the moment, he was unsure where to go. Conventional CDC wisdom held that headquarters offered the best EIS assignments. Atlanta made personal sense as well. Shandera’s father was ill with colon cancer in San Antonio, and he had left the promising beginnings of a relationship behind in Baltimore three years before. In Atlanta, he thought, he would have easy airplane access in both directions.

On the other hand, he had just finished three years of caring for patients. He had not had a course in statistics or epidemiology since his second year of medical school, and he was weak in the necessary skills of sleuthing out the details of outbreaks and writing coherent narratives about them. He might, he thought, get more practice in a city or state health department. EIS matching lets candidates list up to 10 choices. Shandera studied the list of possible postings and put the Louisiana health department first, followed by eight jobs in Atlanta, and the Los Angeles County health department dead last. It was a low probability, he thought; the matchers never worked their way that far down a candidate’s list.

In June 1980, the notice arrived: After training in Atlanta, Shandera was to pack up his Stanford apartment and move south to Los Angeles.

He was horrified. His colleagues were dismissive.

“You’re not going to find anything to work on there,” his cardiology professor said. “Except for a bunch of sexually transmitted diseases.”

He had no idea how prophetic a statement that was.

-  -  -

It looked, at first, as though Shandera’s derisive professor had been wrong. There were plenty of diseases in Los Angeles. There was a cluster of miscarriages in Long Beach; two outbreaks of diarrhea, one in a day care center and one spread throughout the city; a set of hepatitis cases among women who donated blood plasma; and a puzzling outbreak of epidemic neuromyasthenia, a syndrome of headache, fever and muscle weakness, among patients of a neurologist in Pacific Palisades.

He did not solve all of the outbreaks, though they kept him busy. He worked hard, but he was unhappy. Nothing he was doing seemed novel, and he had been attracted to the EIS by the hope that he could help identify new health problems.

Twice in the past five years, the group’s members had helped identify previously unrecognized diseases. In the summer of 1976, they had scrambled to an epidemic of pneumonia that sickened 221 people and killed 34 at an American Legion convention in a hotel in Philadelphia; by the end of the year, CDC scientists had identified the pathogen causing it, dubbed it Legionnaires’ disease, and exposed it as the cause of two other, never-solved outbreaks in 1965 and 1968. Two months before Shandera joined the EIS, in May 1980, the CDC had linked 55 severe cases of fever, rash and Group A Streptococcusinfection, a constellation of symptoms dubbed toxic shock syndrome, to women’s use of high-absorbency tampons. Nothing that he was seeing in Los Angeles promised the excitement of those discoveries.

He worried, too, that he wasn’t learning enough epidemiology. He missed the intense supervision of residency. He had chosen public health, to start with, out of a sense that he wanted to make more of a difference than he would working one-on-one with patients in a hospital. In Los Angeles, he couldn’t see any evidence that he was making much of a difference at all.

The clincher was that he loathed the place. In San Francisco, he had biked everywhere; now he owned an old Mustang and was immersed every day in the city’s desperate traffic. The air quality was very bad that year — “Some days we couldn’t see across the street,” said Frank Sorvillo, an epidemiologist who shared a cubicle with him — and the frank materialism of the city grated on Shandera’s sensibilities.

“In one day, I would see 20 migrant workers living in a garage in East L.A., and then have to drive through Bel Air and be staggered by the contrasts,” he said. “It was disturbing, and hard to work in. I was at odds with the city most of the time.”

In the spring, Shandera asked the corps to transfer him. They offered him a job in Atlanta, starting in a few months: late July 1981. He accepted.

-  -  -

There was something percolating through Southern California that spring.

Some of the health department’s epidemiologists heard reports from doctors they knew, that patients in practices in the San Fernando Valley were complaining of swollen lymph nodes and stubborn low-grade fevers. There was no obvious diagnosis. Those symptoms could signal the start of lymphoma, a cancer of the immune system that attacks a particular type of white blood cell, but tests were finding no trace of cancer.

Most of the patients, the doctors said, were men.

At about the same time, a pathologist at the University of Southern California called Shandera’s cubicle-mate Frank Sorvillo. He had evidence of cancers in a cluster of six male patients. But there was something odd about what he was seeing through the microscope; the pathology of these lymphomas was like nothing he knew.

One of the patients was still in the hospital, and Shandera and Sorvillo went to interview him. The man was a drug addict, but there was nothing else extraordinary about him, nothing that would predispose him to an unusual lymphatic cancer. They let the case go.

At University of California-Los Angeles, anomalous cases were showing up as well. They were finding their way to Dr. Michael S. Gottlieb, an assistant professor of immunology who had joined the medical school staff in the summer of 1980. Like Shandera, Gottlieb had come from Stanford and they had known each other there slightly. Gottlieb was four years older, and had been a research fellow when Shandera rotated through immunology as a resident; he had gone over cases and journal articles with the younger doctor.

Gottlieb’s specialty was the immunology of organ transplantation. At Stanford, he had looked for ways to persuade the body to accept transplants without using drugs to suppress the immune system, the only way known to keep organs from being rejected as foreign. Unlike Shandera, Gottlieb liked Los Angeles. While at Stanford, he spent some time at UCLA studying bone-marrow transplants, and the university invited him to move south and open an immunologic research lab.

Gottlieb was one of the attending physicians — senior doctors who supervise the training of younger ones — on the immunology service of the UCLA School of Medicine. On a slow day in March 1981, he asked Dr. Howard Schanker, a fellow, to patrol the hospital for patients whose cases might present teaching opportunities.

Gottlieb’s office was in the hospital basement. Schanker left for the upper floors. Very shortly afterward, he came back.

“He had a quizzical look on his face,” Gottlieb said. “He said, ‘There is a guy upstairs whose infections are really kind of strange.’”