JOHN YANG: Tonight on PBS News Weekend, what the Biden administration's expansion of healthcare, privacy, means for people seeking abortions, then concerns about security and stability in Africa as American troops leave Chad and Niger and one Ukrainian family lost everything in the Russian invasion.
Now they're rebuilding their life in America.
WOMAN (through translator): I will always feel this pain for him because I had normal life and now he has different life.
(BREAK) JOHN YANG: Good evening.
I'm John Yang.
Almost from the very beginning of the Israel Hamas war, seven months ago next week, aid groups have been warning that Gaza was a humanitarian crisis in the making.
And now Cindy McCain, head of the U.N.'s World Food Programme, tells NBC's Meet the Press the situation has reached a perilous phase.
CINDY MCCAIN, World Food Programme: What I can explain to you is that there is famine, full blown famine in the north, and it's moving its way south.
KRISTEN WELKER, NBC News White House correspondent: I just want to be very clear, because what you're saying is significant, and I believe it's the first time we've heard it.
You're saying there is full blown famine.
CINDY MCCAIN: Yes.
KRISTEN WELKER: In northern Gaza.
CINDY MCCAIN: I am.
Yes, I am.
KRISTEN WELKER: And there has not been an official declaration that there is known.
But you are saying that based on what you've seen.
CINDY MCCAIN: Yes, it is based on what we've seen and what we've experienced on the ground.
Yes.
KRISTEN WELKER: Which is?
CINDY MCCAIN: It's horror.
It's so hard to look at and it's so hard to hear.
JOHN YANG: Also in southern Gaza today, an Israeli airstrike sent plumes of smoke into the skies.
Report said six people were killed in two different locations.
As all this was going on, efforts to negotiate a deal between Israel and Hamas for a hostage release and a truce were said to be intensifying.
A Hamas delegation arrived in Cairo today, but Israel has not yet sent a team of negotiators.
As the college commencement season gets into full swing, tensions on campuses remain high due to anti-war protests.
At the University of Virginia this afternoon, police arrested several protesters at a pro-Palestinian encampment on campus saying it was an unlawful assembly.
And at the University of Michigan, there was a brief disturbance when protesters waved Palestinian flags and chanted anti-war messages.
About 50 people took part.
Today also marked the 54th anniversary of the death of four students at Kent State University in Ohio during a Vietnam War protest.
Last night, there was a candlelight vigil commemorating the day Ohio National Guard troops opened fire on protesters.
In Ukraine, new drone footage reveals the damage Russia has inflicted on a village in the eastern Donetsk region.
No building appears untouched, many looking damaged beyond repair.
Residents have fled, and Ukraine's military acknowledges that Russia has gained a foothold as troops advance against Ukraine's depleted defenses.
In Kharkiv to the north, Russia stepped up attacks overnight.
Exploding drones set fire to two buildings in an industrial area.
Russia has increasingly targeted Ukraine's second largest city, which is only 25 miles from the Russian border.
And around Houston, more 400 people have been rescued from their homes after fierce storms left neighborhoods flooded.
And officials say more rain forecasts for tonight could make the situation even worse.
In a 24 hours period, more than eleven inches of rain fell, inundating roads and homes and forcing a number of high water rescues.
Authorities urged residents of low lying areas to evacuate ahead of tonight's rains.
Still to come on PBS News, the potential consequences of American troops pulling out of two African nations.
And after fleeing the war, a Ukrainian family begins to rebuild in America.
(BREAK) JOHN YANG: Late last month, the Biden administration issued new rules designed to keep prosecutors from getting the medical records of patients seeking legal abortions.
The expansion of the 30 year old health privacy law, known as HIPAA, prohibits the disclosure of health information to state officials who are conducting a criminal investigation.
The idea is to prevent it from being used to prosecute an instance where a pregnant person goes out of state for a legal abortion.
The rules are to take effect in late June.
Carmel Shachar heads the Health Law and Policy Clinic at Harvard University.
Carmel, I think there are a lot of people have misperceptions about HIPAA.
They think that their medical information goes locked into a vault almost behind an impenetrable wall.
So why are these new rules needed?
CARMEL SHACHAR, Faculty Director, Health Law and Policy Clinic: So I wish that HIPAA was that kind of lockbox.
The truth is that HIPAA is a little bit more like a pasta strainer, so it keeps some information protected.
But there's a lot of exceptions.
And one of the exceptions that has been there from the start is if law enforcement goes to your medical provider and says, hey, we need these patients medical records for an investigation.
And ever since Dobbs undid the constitutional protections for abortion, people are afraid that police law enforcement in states that have banned abortion will use that exception to get patients medical records.
JOHN YANG: Do cities and states collect information about people who have abortion procedures that is not protected?
CARMEL SHACHAR: Yes, a lot of states have had abortion and abortion complication reporting requirements for many years.
Those reports nominally don't include people's names.
It's supposed to be okay, who's providing abortions?
What are the outcomes of the abortions?
But then there are also concerns over prosecution of people who are seeking abortions.
JOHN YANG: And would this also cover someone who was going online, say, to seek to try abortion medication from a pharmacy or a provider in another state?
CARMEL SHACHAR: Yeah, so that is a big concern.
I mean Dobbs undid Roe, but we're not back in 1973, before there was a constitutional right to abortion.
So a lot of people are getting abortion care and abortion information over the Internet, where a patient might be sitting in Alabama, but the physician is sitting in Massachusetts, the state that allows abortions.
JOHN YANG: Are there other loopholes or ways that these rules fall short in your view, do you wish they had gone farther?
CARMEL SHACHAR: I do wish that they had gone farther, although I understand the Biden administration's concern with how much can we put out there before we're going to open ourselves to legal challenges?
So one of the issues is telehealth abortions, as you raised, are those lawful under this rule and protected, or are those unlawful because the patient is in a state that has banned abortion?
The other concerns are this rule is really focused on reproductive health information, but there's a lot of other kind of health information that is increasingly becoming criminalized, such as gender affirming care.
This rule doesn't protect that kind of information.
It doesn't protect HIV status as well.
I think there's also going to be some challenges because right now you have a rule that says, okay, records about abortion need to be protected in physicians hospitals.
If somebody asks you for those records, you have to say no.
Otherwise, you're going to get some serious penalties under HIPAA, which is a big deal for hospitals.
But state law is going to say, hey, aiding and abetting an abortion.
And that could mean just talking about, okay, patient, are you going out of state for a lawful abortion is a crime.
We need to get information from you in order to prosecute crimes that are properly put on the books in terms of being enacted.
And so I think it's going to create a real conflict between federal and state law, and I think physicians and patients are going to be in the middle of it.
JOHN YANG: You know, continuing on thought, former President Trump spelled out his stand on abortion in an interview published in Time magazine this past week.
He said, I'm leaving everything up to the states.
He was asked specifically about tracking pregnancies.
He said, they might do that.
Again, you'll have to speak to the individual states.
Now, this is an administrative rule.
Could a new administration come in and wipe it out?
CARMEL SHACHAR: So I think this rule is somewhat fragile.
The good news is it was passed early enough that Congress can't simply repeal it under the Congressional Review Act when there's a change of administration, if there will be a change in administration.
But as we've seen in other rules in the healthcare space, most notably around anti-discrimination protections, we saw that the Obama administration put out one rule, the Trump administration put out another rule, walking it back.
And then the Biden administration put out a rule restoring the Obama administration's protection.
So you could see a lot of flip flopping.
I think that is going to be really concerning for patients.
We know that in the first half of 2023, about 92,000 people traveled from an abortion restrictive state to a state with legalized abortion in order to receive that care.
And we've heard officials like the Mississippi attorney general say that the state maybe has an interest in preventing these people, mostly women, from traveling across state borders.
That feels alarming that people's ability to travel would be restricted depending on their pregnancy status.
JOHN YANG: Carmel Shachar from Harvard University, thank you very much.
CARMEL SHACHAR: Thank you.
JOHN YANG: The African nations of Niger and Chad have both been key partners with the United States in combating terrorist groups in the region.
But as Ali Rogin tells us, that cooperation is in question now that both countries are ruled by military regimes.
ALI ROGIN: The American presence in Niger and Chad gave us troops eyes in the sky and boots on the ground in the region known as the Sahel.
Stronghold for Islamist groups like ISIS and al Qaeda.
The Sahel accounts for nearly half of all terrorism deaths worldwide.
Niger has been hosting nearly 1,000 American military personnel and an airbase from which the U.S. launched drone operations and special operations forces had also been stationed in Chad's capital.
And U.S. soldiers have trained local armed forces in both countries.
But the majority of forces in Niger are now on their way out.
Those in Chad will follow suit while talks continue to possibly keep troops in the country.
As U.S. forces withdraw, us adversaries are looking to fill the void.
Russia has sent military instructors to Niger, and Russian President Vladimir Putin hosted Chad's junta leader in Moscow this year.
Jay Peter Pham is former us ambassador and special envoy for the Sahel region and a distinguished fellow with the Atlantic Council.
Peter, thank you so much for being here.
J. PETER PHAM, Former U.S. Special Envoy for the Sahel Region: Pleasure to be with you, Ali.
ALI ROGIN: how significant are these departures?
J. PETER PHAM: Well, in particular, the departure and the loss of the two air bases, one in Agadez and one in Niame in Niger, are significant.
It took a decade to build these facilities up, to train local forces with which we operated, and to carry out operations, not just in Niger and not just in the Sahel, but actually, these bases were useful for operations, really, across a wide part of Africa.
So, it's going to be a significant loss, a setback.
There's no sugar coating in time.
Substitute facilities may be found, but it's going to take time to build up the capacity and the partnerships that are being lost.
ALI ROGIN: Could this have been avoided?
What could the U.S. have done differently?
J. PETER PHAM: I think we could have been more attuned to the fact that winds of change were sweeping across Africa.
Political elites are widely discredited in many of these Sahelian countries.
Just because there's an extra constitutional overthrow of a government doesn't mean that what came before was necessarily a Jeffersonian democracy.
And also, quite frankly, our French friends and allies, their old partners, but they've got a lot of baggage in this region, and they were the first kick out.
There's widespread unrest about them and there's been some tainting by association.
So, we could have been, probably managed the situation much better in terms of being attuned to what was happening, the dynamics, and also engagement with the regimes that have emerged.
ALI ROGIN: And, of course, what was happening are eight military coups in west and Central Africa since 2020.
Why have they swept the region like they have?
J. PETER PHAM: I think part of it was with what came before, there were elections, but they weren't necessarily legitimate elections.
And even where they were democratic elections, these were young democracies where governments were failing.
When I was special envoy, I kept repeating that the region had a crisis of state legitimacy, that governments were not providing basic goods, services and protection to their people.
And so what people want is protection, security.
And I'm not saying military guys are the solution, but they present an easy, credible solution compared with some of the civilian leaderships that came before.
ALI ROGIN: What does it say about these junta leaders that they've all been shunning leaders from the west, the United States, also many colonial powers, including France?
J. PETER PHAM: Well, I think the one big mistake we make is to try to make them, force them to choose us or the other guy.
And I'm not by any stretch of the -- anyone who knows me knows I carry very little water or any for our Chinese or Russian friends, but they're offering facile solutions.
And when we tell them, us or them very often, because they can deliver quickly and immediately, that becomes the easy one for the juntas or other leaders to opt for, we have to figure a way to maintain our conversations, maintain our strategic objectives, while at the same time not betraying our values.
And it's a tough balancing act.
ALI ROGIN: Niger, this decision does seem final.
The troops are leaving.
But in Chad, though, is there a little more wiggle room there?
There are talks going on.
Could these troops actually come back to the region?
J. PETER PHAM: Well, I think the Chadians raise in their note a legitimate question.
What are our forces doing in Chad?
It's been several years since we've had direct military to military training assistance of the normal kind that one has troops stationed these countries for.
And part of it has to do with the nature of the regime and Chad events that have occurred.
I'm not trying to be an apologist for, but at the same time they have a question asked.
They're also going through an election period right now, which is a period of a little bit of turbulence.
I think once they get through that, I think there's some serious frank conversations that have to be had and we'll see what comes out of it.
Hopefully, we don't get pushed out of yet another country in the region and especially a country like Chad, which, of course is really at the fulcrum of not just the Sahel but also Libya to its north, Sudan to its east.
But it's been several years since Congress and the administration have given military assistance or training to the Chadians.
Now, part of that is due to the nature of regime transition in that country.
But at the same time, the Chadians have a right to ask, well, if you're not here to train us, what are you here to do?
And the answer to that, of course, is, as we all know, also help our French partners in some of their counterterrorism operations.
But raises a legitimate question from the Chadian point of view, and again, we end up associated with a former colonial power that has baggage in the region.
ALI ROGIN: In terms of the countries filling the vacuum, we saw that Russia has already made its way into Niger.
What are the possible consequences of countries like Russia and China filling the void that we're leaving?
J. PETER PHAM: In the short term, they provide what some of these new regimes, military regimes, think is a security blanket because they're interested in regime survival.
Now, whether what they provide is actually useful to that end, that's a different question.
But in the long term, are they capable of providing the military assistance, the training which was very effective in Niger that the U.S. and our European friends have provided?
Are they capable of providing the economic and development assistance that the U.S. and our European friends have provided for the decades?
And the answer seems to be no.
In the short term, the juntas may benefit.
In the long term, it's the people of Niger, Mali, Burkina Faso, of Chad, countries in the Sahel who ultimately may pay the price for short term decisions.
ALI ROGIN: J. Peter Pham, former U.S. ambassador and special envoy for the Sahel region and now a distinguished fellow with the Atlantic Council, thank you so much.
J. PETER PHAM: Thank you for having me, Ali.
JOHN YANG: Since Russia invaded Ukraine more than two years ago, about 6.5 million Ukrainians have left the country, including hundreds of thousands who've come to the United States.
One of them is ten year old Artem Fedorenko.
Just days after the war began, he lost part of his arm in a Russian bombing that killed his father and brother.
A Minnesota group that helps Ukrainians who've lost limbs brought Artem to America for a prosthetic arm.
And today, he and his mother Oksana, are rebuilding their lives in suburban Minneapolis.
This story comes to us from Minnesota Public Radio News.
INNA KARPENKO: Yeah, sure.
Okay, so this is our kitchen.
We like it.
Very nice.
Table for our big family.
Nice deck and big yard.
OKSANA SHPAKOVYCH: My name is Oksana.
I live Ukraine, Kyiv.
INNA KARPENKO: My name is Inna Karpenko.
We became big friendly family.
Here we are.
We have each other, and it's wonderful.
We are very grateful.
VERONIKA KRAVCHENKO: I have really good friends here, and everybody is so nice.
I don't know why, but I drew like rainbow.
I like to draw that smile.
My name is Nika and I am eight.
ARTEM FEDORENKO: Artem, nine years, almost 10.
VERONIKA KRAVCHENKO: He likes his class, teachers, food.
That is his first.
Yeah.
OKSANA SHPAKOVYCH: Oh, my son.
INNA KARPENKO: He's a good example for all of us.
How he can enjoy life and do everything he wants, even without his own arm.
It happened on February 26.
They were scared and they decided to run away from Kyiv to save their lives.
They thought it would be safer.
That was big mistake.
Russian soldiers came into her ex-husband's cabin.
He saw how he died.
She's very grateful that his father put his son life first than his own.
I will always feel this pain for him because it's better that happened to me then to him, because I had normal life and now he has different life.
YAKOV GRADINAR, Chief Medical Officer, Protez Foundation: We started to work with Artem.
He's quite a character.
He's very active, active person.
Right now we have 1,500 people on our list that wants to get prosthetics.
In Ukrainian, protez means prosthetics.
So we named it protest foundation.
Seeing people with lost limbs due to stupid war, that should never happen.
But when you put prosthetic on and person can start doing first steps, that makes my day.
WOMAN: What game would you like to play, Artem?
ARTEM FEDORENKO: Heads up.
Seven up.
WOMAN: All right.
He's very confident, likes the spotlight, Really does like the spotlight.
There will be some times when he's sharing and he might just go into the whole thing about how I miss my dad and but if it weren't for him, I wouldn't be here right now.
Okay, Artem, favorite part of your day.
Tell us.
ARTEM FEDORENKO: Gym and soccer.
You play soccer now?
MAN: You can do that, right?
ARTEM FEDORENKO: Zip.
Okay, Fred.
JOHN YANG: Now online cicada season is in full swing.
As the soil in several states reaches 64 degrees Fahrenheit, billions of cicadas will emerge to start off their adult life in the world above ground.
All that and more is on our website, pbs.org/newshour.
And that is PBS News weekend for this Saturday.
On Sunday, how some students and administrators are diffusing tensions over pro-Palestinian protests on campuses.
I'm John Yang.
For all of my colleagues, thanks for joining us.
See you tomorrow.