9 Evidence-Based Health Benefits of Chestnuts
Chestnuts are the edible nuts of trees and shrubs that belong to the Castanea genus. They have a delicious, mildly sweet taste and are incredibly versatile. You can incorporate them into a variety of dishes like stuffings, salads, and soups.
There are many different types of chestnuts, and they share similar qualities. The most common types include the American chestnut, Chinese chestnut, Japanese or Korean chestnut, and European chestnut.
It's worth noting that they're not related to the water chestnut (Eleocharis dulcis), a type of aquatic vegetable popular in Asian cuisine.
Here are nine intriguing health benefits of chestnuts.
1. Packed with nutrients
Despite their small size, chestnuts are packed with a variety of nutrients.
A 10-kernel (84-gram) serving of roasted chestnuts provides the following:
Calories: 206
Protein: 2.7 grams
Fat: 1.9 grams
Carbs: 44.5 grams
Fiber: 4.3 grams, 15% of the daily value (DV)
Copper: 47% of the DV
Manganese: 43% of the DV
Vitamin B6: 25% of the DV
Vitamin C: 24% of the DV
Thiamine: 17% of the DV
Folate: 15% of the DV
Riboflavin: 11% of the DV
Potassium: 11% of the DV
Chestnuts are also a decent source of several other vitamins and minerals, including vitamins K, B5, and B3, as well as phosphorus and magnesium.
Compared with most other nuts, chestnuts contain fewer calories because they are low in fat. They are also higher in carbs than most nuts and contain a good amount of fiber, providing 15% of your daily needs in one serving.
2. Great source of antioxidants
Chestnuts contain a wide variety of antioxidants, which are important for your health.
These antioxidants include:
vitamin C
gallic acid
ellagic acid
tannins
alkaloids
various polyphenols
lutein
zeaxanthin
Lutein and zeaxanthin accumulate in the retinas of your eyes and protect them against damage from blue light.
Antioxidants are compounds that help protect your cells against damage from unstable molecules called free radicals.
High levels of free radicals may cause a state called oxidative stress. This can increase the risk of chronic diseases, such as heart disease, diabetes, and cancers.
In addition, studies have shown that various antioxidants found in chestnuts, such as gallic and ellagic acid, may help lower the risk of heart disease, reduce insulin resistance, and suppress the growth and spread of tumors.
3. May aid heart health
Chestnuts are a good source of nutrients that are great for your heart.
For starters, they contain antioxidants, such as gallic and ellagic acid. Studies have found that these antioxidants may help protect the heart against oxidative stress, a condition that may raise the risk of strokes and heart disease.
Chestnuts are also a good source of potassium, providing 11% of your daily needs. Potassium is important for a healthy heart and helps regulate your blood pressure.
In addition, research has found that consuming a potassium-rich diet may lower the risk of heart disease and strokes.
4. High in fiber
Chestnuts are a good source of fiber, which has many health benefits.
For one, fiber helps add bulk to your stools, which makes them easier to pass.
In addition, the fiber in your diet reaches your colon largely undigested, where it acts as a prebiotic. This means the fiber becomes a source of nourishment for the healthy bacteria in your gut that ferment fiber.
When gut bacteria ferment fiber, they produce various beneficial compounds, including short-chain fatty acids.
These short-chain fatty acids offer numerous benefits. Studies have shown they may aid gut health, reduce inflammation, and improve blood sugar control.
Lastly, because fiber passes through your body largely undigested, it contributes to feelings of fullness without adding calories to your diet. This may help with weight management.
5. May improve blood sugar control
Maintaining your blood sugar at a healthy level is important for your health, but especially important if you have prediabetes or diabetes.
Prolonged high blood sugar levels can raise the risk of health complications like damage to the blood vessels and organs.
Chestnuts have several intriguing properties that may aid blood sugar control.
Despite being higher in carbs than most nuts, chestnuts are a good source of fiber that can help prevent blood sugar spikes.
In addition, research has shown that chestnut antioxidants, such as gallic and ellagic acid, help manage blood sugar levels and may improve insulin sensitivity, making your cells more responsive to insulin.
However, chestnuts are still considered a higher carb nut. While eating a small to moderate quantity of chestnuts may offer these benefits, consuming too many chestnuts frequently may counter these health benefits.
6. May aid weight loss
Chestnuts have several properties that may aid weight loss.
The high proportion of fiber they contain can help you stay fuller for longer. This is because fiber can help slow down the time it takes for food to empty from the stomach into the intestines.
In addition, research has shown that high fiber intake can increase the production of hormones that help curb your appetite, such as peptide YY (PYY) and glucagon-like peptide-1 (GLP-1), while suppressing the hunger hormone ghrelin.
Furthermore, chestnuts contain fewer calories per gram than most other nuts. This is because they are low in fat, which is the most calorie-dense nutrient.
If you are looking to lose weight, you will need to create a calorie deficit to do so. Eating chestnuts may help you do this while also helping you feel full.
Interestingly, one 2020 animal study found that consuming chestnuts may help reduce cholesterol and belly fat. However, more research is needed to investigate these potential effects.
7. May lower inflammation
Inflammation is a natural process that helps the body heal and fight infections.
In some situations, inflammation may persist at a low level. This is known as chronic inflammation and is linked to numerous chronic conditions, such as heart disease, diabetes, and cancers.
The antioxidants chestnuts contain, such as vitamin C, gallic acid, ellagic acid, and various polyphenols, may help reduce inflammation. They neutralize free radicals, which are key drivers of chronic inflammation.
In addition, test-tube and animal studies have shown that chestnut antioxidants, such as tannins and flavonoids, can help suppress inflammatory signals like NF-κB and MAPK.
8. Potential anti-tumor properties
Lab research suggests that the antioxidants found in chestnuts may help suppress the growth and spread of cancer cells and stimulate cancer cell death.
Studies show that extracts from chestnuts suppressed the growth and spread of various types of cancer cells, such as prostate, breast, and colon cancers.
Research on chestnut antioxidants has found that they may also suppress the spread of tumor cells and stimulate tumor cell death. In particular, ellagic acid targets the PI3K signaling pathway, which regulates cell growth and survival.
However, more research is needed to understand how the compounds found in chestnuts may affect cancer cells in people.
9. Delicious and easy to add to your diet
Not only are chestnuts healthy, but they are also delicious and easy to add to your diet. They have a mildly sweet flavor and soft yet firm texture.
Although you can eat chestnuts raw, they are high in tannins, which may cause digestive issues or other complications in people sensitive to tannins.
They are easy to prepare. You can roast them in the oven on a baking sheet for 20 to 30 minutes at 400°F (200°C). Make sure to pierce the nuts' skin before roasting to prevent them from exploding in the oven.
Alternatively, you can boil the chestnuts in a pot of water. Bring the pot to boil and then lower the heat to allow them to simmer for approximately 30 minutes. Again, make sure to pierce the skin of the chestnuts beforehand.
Once the chestnuts are cooked, their skin is easy to remove so you can enjoy them as a delicious snack. They are also incredibly versatile and you can incorporate them into salads, stuffings, soups, and desserts, such as tarts and pies.
Takeaway
Chestnuts are a popular nut that people enjoy around the world.
They are a good source of fiber, vitamin C, copper, B vitamins, manganese, and various antioxidants, which are linked to numerous health benefits.
Chestnuts and their nutrients may help improve heart health, blood sugar control, weight loss, inflammation, and digestive health, and may have potential anticancer properties.
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The Intercept
an hour ago
- The Intercept
Our Reporter Got Into Gaza. He Witnessed a Famine of Israel's Making.
It was Tuesday, June 10 when Khalil heard from neighbors that an aid truck had arrived a few kilometers from where he lived in Deir al Balah, Gaza. By then he had already lost about 45 pounds since the war began in 2023. With his brothers and a friend, Khalil set off on foot. On the walk over, the 26-year-old could hear intermittent shelling, but the promise of food, he felt, was worth the risk. 'Hunger has become stronger than fear,' said Khalil, who agreed to speak on the condition that his last name not be published. When they arrived around 6:30 a.m., a huge crowd was gathering at the aid point in Netzarim. 'People start heading there before sunrise because the lines get impossibly long,' Khalil said. Thousands had clearly gotten the same tip. The sheer amount of desperate, hungry people was overwhelming. Khalil said, 'I hadn't eaten properly in days. I was dizzy and weak.' The distribution site was run by a new aid provider active in Gaza for only a few weeks. Khalil quickly noticed military presence. 'We saw the Israeli soldiers in full military uniform standing next to their armored vehicles. We arrived knowing the place was dangerous. But, there was no clash, no threat to them,' Khalil said. (The Israeli Coordination of Government Activities in the Territories bureau did not respond to written requests for comment for this article.) 'I got closer to death that day than a piece of bread' He stood in line with hundreds of others. There were children, women, and elderly men. 'Some were barefoot, some had been waiting since the night before,' he recalled. As his group inched closer to the point where they hoped they would be able to grab a parcel of items, gunshots rang out. Khalil ran for his life. 'They began shooting directly at unarmed civilians,' he said. 'The bullets were chasing us as if we were targets on a shooting range, and not just hungry people. We scattered under a hail of bullets. I got closer to death that day than a piece of bread.' Khalil survived that quest for food — alive to starve another day instead. But at least 36 Palestinians did not, and 207 more were wounded, according to the Palestinian Health Ministry. Since Israel broke its ceasefire with Hamas in mid-March, more than 875 Palestinians have been killed while seeking food. Reporting from inside Gaza over the last few months, The Intercept observed a famine that is manufactured and an aid distribution system seemingly designed to cause more suffering and death. Amid the war, Israel has rendered Gaza inaccessible to the foreign press; American journalist Afeef Nessouli accessed the Strip by volunteering as an aid worker for a medical nonprofit and reporting in his off-hours. Usually during war, the distribution of medical care and food to a besieged population would not be administered by any party waging war against it, much less by an illegally occupying military. And in most situations, aid operations would closely involve established organizations already active in the area. But that's not the case in Gaza. Israel has effectively banned the biggest and longest-running aid group in the region: the United Nations Relief and Works Agency for Palestine Refugees in the Near East, or UNRWA. And by gutting the United States Agency for International Development, or USAID, a critical funding vehicle for aid groups including UNRWA, U.S. President Donald Trump has strangled international aid in Gaza. Israel and the U.S. have instead rolled out a new scheme centered around a fledgling U.S.-based nonprofit that operates alongside the same Israeli military responsible for killing more than 230 journalists, 1,400 health care workers, and 17,000 Palestinian children in the last two years. With a few small exceptions, all aid reaching Gaza since May has moved through the Gaza Humanitarian Foundation, which was established in Delaware in February. The organization has received tens of millions from the U.S. to distribute aid in Gaza — and, reportedly, some $100 million from an unnamed country. GHF did not respond to repeated requests for comment on this story. Since it started operations, the number of locations in Gaza where residents could receive aid has plummeted from around 400 to four sites. 'Sometimes only one hub is actually operating,' said Hanya Aljamal, the senior project coordinator at the aid group Action for Humanity, who is based in Deir al Balah. Sometimes, Aljamal said, the sites are closed for security reasons, other times for maintenance. Khalil corroborates this: 'I went a few days ago and it wasn't open.' He says now he checks the GHF's Facebook page, which informs people of the schedule. Aljamal says she believes 'they operate semi-daily for only two hours a day.' Arriving in Gaza in late March just as Israel broke the ceasefire, The Intercept witnessed firsthand what happened to Gaza's most vulnerable after the U.S. defunded USAID and UNRWA and turned those agencies' work over to the Israeli military and GHF. Famine has been a problem in Gaza since the early days of the war. But when Israel and Hamas announced a ceasefire on January 19, 2025, access to goods became easier. 'Meat, vegetables and chicken — and even snacks — were reachable, albeit at a slightly expensive price,' Aljamal said. 'But we had options.' When the holy month of Ramadan began on February 28, it wasn't hard to find a simple meal of rice or lentils for dinner, or labneh and za'atar for suhoor before fasting for the day. But on March 2, Israel cut off food imports to Gaza when it imposed a blockade. On March 18, Israel shattered the ceasefire when it restarted its campaign of airstrikes. Even after Eid, which marked the end of the Holy Month, one meal a day remained standard practice — if not a luxury. At the time, community kitchens like Shabab Gaza were running low on food. But they were still delivering what they could to areas the Israeli military referred to as 'red zones'— swaths of land Israel has evacuated and banned aid from entering, such as Khan Yunis. By spring, 70 percent of Gaza was considered a 'red zone.' Shabab Gaza, 'the youth of Gaza' in Arabic, was making meals of rice so people could break their fast at sundown. Inside a makeshift kitchen housed in a tent, the men, fasting themselves, worked in groups to cook the rice in vats. They packaged it quickly to deliver to the surrounding area, but neighbors also showed up with pots and pans, ready to grab the food for their families, or ready to eat themselves. The Shabab Gaza community kitchen in Al Qarara, Khan Yunis, Gaza, seen on June 1, 2025. Photo: Afeef Nessouli There were about 170 operational community kitchens before the crossings closed in early March. Just two months later, dozens had ceased operating. The blockade halted the entry of vital goods for months, resulting in scarcity and price hikes. It was made worse by the resumption of fighting between Israel and Hamas, which restricted access to domestic produce 'because of new evacuation orders from the north, Rafah, and areas in Khan Yunis where new crops were cultivated,' Aljamal said. At the market, produce was fresh but limited. Tomatoes, cucumbers, peppers, onions, and sometimes potatoes were for sale, grown on the shards of Gazan farmland remaining. The U.N. Office for the Coordination of Humanitarian Affairs, or OCHA, reported that Israel has destroyed 83 percent of Gaza's agricultural cropland and restricted access to some of what remains, rendering less than 5 percent of cropland 'available for cultivation.' 'It used to be that three kilos of these onions were just $3,' an older woman said in her makeshift kitchen in eastern Khan Yunis. By April, an onion cost a dollar apiece. Flour became incredibly expensive, with a single bag selling for hundreds of dollars. Because nearly every bank branch and ATM remain inoperable in Gaza, people cannot find cash to pay for even a single bag of flour. They are reliant on an unregulated network of cash brokers to get money for daily life with commissions hovering around 40 percent. Even domesticated chickens have been laying fewer eggs than usual, one international aid worker said. 'Food isn't available for them, neither are supplements or animal feed that provide stuff like calcium, which is essential to egg production,' the worker said. And like humans, chickens also experience stress. The Israeli military's bombs and quadcopters are loud. As of July, OCHA reports that 100 percent of the population in Gaza was projected to face high levels of acute food insecurity. That includes 1 million people facing 'emergency' levels of food insecurity, and 470,000 facing 'catastrophic' levels of food insecurity. 'I have lost nearly 37 kilos,' said Basel, one of the men at Shabab Gaza's community kitchen. He showed pictures of himself from 2023, back when he used to weigh 247 pounds. Basel is bald with blue eyes, with a 6-foot, 2-inch frame. Now 165 pounds, he looks thin, his face gaunt. Several men showed pictures of this kind of transformation. They described the indignity of going hungry every day and how weakened they feel. 'Look at what they are doing to us. We are so tired,' Basel explained. 'By God, it has been almost two years, really we are so hungry,' he said. Basel on July 17, 2023, on the left, and on July 12, 2025 on the right. Photo: Courtesy of Basel Lehya Nessouli, the Intercept reporter, volunteered in Gaza with Glia, a medical nonprofit, from late March to early June. With other medical workers, he ate once per day — usually rice or lentils. Sometimes there would be tomatoes or peppers, occasionally canned tuna. During that time, he lost 12 pounds. People begging for food at the market, rushing international aid workers' cars on the seaside road, or even knocking on doors looking for flour became commonplace. 'Now we are reduced to one meal per day,' Aljamal, the aid worker, explained, which usually consists of 'a variation of the same thing: lentils.' Lentils can take the form of soup or falafel, be steamed, or cooked into a gravy. But sometimes, Aljamal said, the sole meal of the day consists of 'bread, plain bread.' UNRWA was set up in 1949 to provide humanitarian relief to Palestinians displaced by the 1948 Arab–Israeli War. Originally, it was intended to provide jobs on public works projects and direct relief. It grew to offer education, health care, and social services to wide swaths of Palestinian society, even serving more than 5 million registered Palestinian refugees and their descendants in the diaspora. The Palestinian Authority has been a recipient of UNRWA's services and support as it has governed the West Bank since 1993 and Gaza until the U.S.-monitored election of 2006, in which Hamas gained power. At its height, UNRWA employed over 30,000 staff, 99 percent of whom were Palestinian. Most of UNRWA's funding came from European countries and the United States, but this largely disappeared after Israel accused UNRWA employees of participating in the October 7 attacks. (A U.N. investigation cleared most of the accused UNRWA workers but found that nine of the 13,000 people who worked for the organization in Gaza may have participated in the attacks.) USAID also once provided financial support to the Palestinian people for various development and humanitarian projects. Since 1994, the United States has steered more than $5.2 billion in aid to Palestinians. This funding dried up after Secretary of State Marco Rubio promised in March to cut USAID's foreign grants by 83 percent before shuttering it entirely on July 1. Ending USAID, a Cold War tool of soft power founded in 1961 as 'an independent executive branch agency responsible for administering foreign aid and economic development assistance outside the US,' has been a signature policy of Trump's second administration. For decades, the agency has played a key role in treating HIV/AIDS and in providing lifesaving care to LGBTQ+ people, including in Gaza. One study estimates the USAID cuts will result in the deaths of 14 million people by 2030. Read our complete coverage Over the decades, most international aid to Gaza has been run through either UNRWA or USAID partners, though Qatar too has been a key funder, providing over $1 billion in reconstruction funds and stipends for poor Palestinians between 2014 and 2019. Much of the Strip's economic activity has been reliant on aid infrastructure, with UNRWA specifically playing a critical role in the distribution of food even before the war began. 'UNRWA has been the backbone that held Gazan society together,' Aljamal said. 'As a child I went to UNRWA schools and was offered the best possible education available with the smallest of resources. When me or any of my siblings got sick or needed medical attention, we rushed into subsidized UNRWA clinics that even provided us with the needed meds, too. When it comes to food, lots of refugee families relied on their three-month dry ration distributions,' which consisted of 'flour, cooking oil, sugar, rice, lentils, chickpeas per family member for three months.' For years, this program helped ensure food security in the region. 'We often held great pride in the fact that wherever you went and however bad it had gotten, you wouldn't possibly sleep without food,' she said. Community kitchens also played a critical role in aid distribution in Gaza. Glia's head of mission, Moureen Kaki, a Palestinian American, moved from Texas to Gaza more than a year ago to help; she never left. She also volunteers at Shabab Gaza in Khan Yunis. Kaki, who switches breezily throughout her day between Palestinian Arabic and English with a slight Texas lilt in her voice, notes that when she arrived, community kitchens across Gaza were producing 250,000 meals a day, feeding about 800,000 people — about 45 percent of the Strip's population. Back then, community kitchens were able to reliably source food via donations and USAID. But now, it is extremely difficult to operate. Today, community kitchens still exist, but their capacity has dropped from 250,000 meals a day to about 25,000, Kaki says, because they simply cannot source supplies. The current famine, she says, is 'the worst I have seen, hands down.' Moureen Kaki speaks to a man at Shabab Gaza community kitchen on June 1, 2025, in Al Qarara, Khan Yunis, Gaza. Photo: Afeef Nessouli World Central Kitchen — founded by chef José Andrés and one of the most recognized food distributors in Gaza, and whose workers were killed in a 2024 Israeli airstrike — ceased operations in May after it ran out of supplies; it resumed operations recently. Smaller mutual aid organizations like the Sameer Project have continued to churn out as many meals as they can, even after their camp coordinator Mosab Ali was killed. Shabab Gaza's capacity dropped from 15,000 meals a day to 3,000 in June — and by July had to stop operations because rice became too expensive. The group hopes to resume as soon as possible. As long-standing aid providers languish in Gaza, Israel and the United States have embraced a new approach: the Gaza Humanitarian Foundation. According to the New York Times, Israeli officials, military leaders, and businesspeople began discussing the concept of an Israeli-backed food distribution system in December 2023, and had brought a former CIA agent-turned-private security contractor on board by the summer of 2024. The new program was announced on May 19, 2025, as a U.S.-led initiative, with U.S. Ambassador to Israel Mike Huckabee saying it was 'wholly inaccurate' to characterize it as an Israeli plan. By June, Israeli Prime Minister Benjamin Netanyahu stated that the initiative had in fact originated in Israel. Unlike prior aid distribution systems, GHF planned to use a small number of distribution hubs in southern Gaza that would be secured by private U.S.-backed contractors, with the Israeli military keeping watch 'at a distance.' The aid would be prepackaged, filled with a hygiene kit, medical supplies, and food rations. Each meal was budgeted to cost only around $1.30 each. Soon after it launched, officials said the GHF system would attempt to screen people for involvement with Hamas by using facial recognition or biometric technology, violating a core tenet of addressing hunger: that no political litmus test can be imposed for access to human rights like food and water. The United Nations rejected the new U.S.-backed distribution plan and sayings that it did not meet its long-held principles of 'impartiality, neutrality and independence.' The U.N. aid chief said the new system would force further displacement, expose people to harm, and restrict aid to one part of Gaza. Oxfam and 240 other nongovernmental organizations called for immediate action to end the Israeli distribution scheme. In late June, Israeli soldiers corroborated what Palestinians had been claiming about the GHF aid distribution sites: Commanders explicitly ordered soldiers to shoot unarmed civilians. Massacres were a result of soldiers doing what they were told to do. Video obtained by Afeef Nessouli One video shows thousands of people crowded all around at GHF distribution site in Rafah, according to Al Jazeera. The phone camera pans to the left, and the sound of gunshots hitting a mound of earth about 200 meters in front of the crowd is piercing. The video shows sand kicking up in a whirl upward from the bullets as people crawl on their knees trying to dodge the gunfire. 'Imagine if Toronto was starving,' Dorotea Gucciardo hypothesized at a press conference at the Canadian Parliament in June. Gucciardo is the director of Glia, the NGO Nessouli volunteered with in Gaza, and with whom he and reporter Steven Thrasher have also worked to deliver antiretroviral medication into Gaza since reporting on AIDS in the Strip in January. In this Canadian analogy, Gucciardo said, 'The U.N. system would deploy over 1,300 distribution sites. The GHF model? Ten. In Montreal, the U.N. would open 850 sites, while GHF's version? Six.' 'And in Gaza, the UN. .had a well-maintained system of 400 aid sites,' she said. 'GHF has replaced those with only three.' Glia was founded in 2015 with a focus on providing low-cost medical supplies using 3D printing technology, beginning with a stethoscope design. Over the years, its services have expanded. Since 2017, the group has rotated doctors, nurses, and other personnel into Gaza to support local health care workers. 'Aid is distributed by gunpoint by American mercenaries.' Glia doctors operating in Gaza's incredibly damaged health care system have been treating malnourished patients throughout the war. Since GHF began operating on May 26, '20 to 50 Palestinians have been killed per day at the aid distribution sites,' Gucciardo explains. They are treating an ever-rising number of malnourished patients injured waiting for food. 'Everybody my medical team treats is skin and bones,' Gucciardo said. Gucciardo called the switch to the GHF program an engineered starvation. 'Aid is distributed by gunpoint by American mercenaries. It is inhumane, degrading, dangerous, and it violates every principle of humanitarian law,' she says. The AP has reported that GHF contractors have shot live ammo at aid sites, allegations that GHF denies. GHF has also denied that multiple violent incidents have even occurred near their aid distribution sites, regularly blames outside agitators for the incidents it does acknowledge, and stated that 'GHF remains focused on its mission: to safely, quickly and effectively feed as many people as possible, every day.' When GHF's original executive director, American veteran and entrepreneur Jake Wood, announced he was stepping down after just a couple of months, one reason he cited was because it was impossible to fulfill GHF's 'plan while also strictly adhering to the humanitarian principles of humanity, neutrality, impartiality, and independence, which I will not abandon.' 'From the outset, they were placed in active red zones — especially in southern Gaza, in Rafah,' said Majed Jaber, a Palestinian volunteer emergency room doctor who has worked at several hospitals in the southern part of Gaza. 'We saw far too many headshots to ever call it random.' 'At Nasser and the Red Crescent hospitals, where I worked during those distributions, we regularly received 50 to 100 wounded people in a single day. Dozens arrived already dead or died shortly after,' he said. 'Every other day, the number would spike. The injuries were horrific. Limbs blown off by high-caliber bullets. Vital organs pierced — hearts, aortas, lungs. We saw far too many headshots to ever call it random.' Tarek Loubani, a Canadian doctor in Gaza and the medical director of Glia, observed a similar pattern of wounds in those killed or injured at GHF distribution sites. 'Today, I saw patients with gunshots to the head, gunshots to the neck … the gunshots to the head and neck are almost always targeted. Usually shot by snipers,' he said. When there are shots to other parts of the body, Loubani explained, it's usually from 'a machine gun being used to shoot on the crowd.' For its part, GHF acknowledges the dangerous proximity of the Israeli military to its distribution centers, writing on Facebook, 'Our dear precious residents of Gaza, We ask you not to be near our centers between 7 p.m. and 6 a.m., for your safety, due to the possibility of the IDF conducting military operations in the area.' [newsetter][/newsletter] Amal, a trans woman who lives in Gaza City, sent The Intercept a picture of her bandaged arm on WhatsApp in early June. Amal gave The Intercept a pseudonym for safety. 'Do you see what happened to me?' Amal said in her voice note. Her voice was trembling and angry, but still soft. 'Yesterday, I went to the GHF distribution point to pick up some aid to get a bag of flour,' she said. 'I finally got a bag after a really hard time, I was exhausted. And then after all of that, thieves stole my bag and stabbed me with a knife.' Hunger is painful, Amal said. She complained of joint pain, stomach pain, and a lack of concentration. 'I faint and fall,' said Amal, who stands 6 feet tall and weighs just 119 pounds. 'I do not want anything, I only want to eat.' Despite the Trump administration axing thousands of USAID awards (and firing the accompanying officers who managed these funds), GHF does not seem to lack for funds. Earlier this month, Reuters reported that the State Department is considering giving GHF an additional $500 million. Zeteo reported that GHF requested $30 million dollars from USAID. The group's social media accounts regularly publish accusations against international aid groups and journalists. GHF has denounced the U.N. and Oxfam for standing 'by helplessly while their aid is looted,' and allege that The Associated Press's 'Middle East bureau has sadly devolved into a propaganda vehicle — amplifying unverified claims, omitting critical context, and publishing narratives that serve a designated terrorist group.' Its belligerent posts have a Trumpian quality, down to the use of all caps ('let's go through the history of how we got here in the first place. … HAMAS IS A TERRORIST ORGANIZATION WITH AN ACTIVE PROPAGANDA ARM') and are marked with denial of any problems with their approach ('Scenes like this prove the GHF model is working'). 'People have been comparing it to 'Squid Game' or 'Hunger Games.'' On June 17, reports emerged that Israeli tanks had killed over 50 Palestinians as they were waiting for aid trucks in Khan Yunis in the southern part of the Strip. On July 16, over 20 Palestinians were killed at a GHF distribution site in southern Gaza. Most of the victims were reported to have died in a stampede. Many Palestinians in Gaza who have limited supplies refuse to go to the new aid sites. 'We don't go to GHF aid points because they're death traps,' says E.S, a 28-year-old restrained to a walker because of complications due to his HIV status. 'I can't fight through the crowds because of my disability plus we all know the whole situation is messy,' he continues. 'There is no line and there is no distribution method at all, they offload everything into a big arena, in fact, people have been comparing it to 'Squid Game' or 'Hunger Games,'' E.S explains. 'It becomes a battle because everyone is desperate for food.' The number of people reportedly killed by Israeli gunfire at GHF aid distribution sites continues to climb, as the people of Gaza face starvation. The Gaza Health Ministry has counted 1,021 people killed and another 6,511 wounded at GHF sites since the program was put in place, including at least 38 killed by Israeli fire this past weekend. A newborn baby died of malnutrition at Al-Shifa Hospital in Gaza City on Saturday, and Palestinian journalists have been posting image after image of people dying of starvation. More than 20 countries, including the U.K., France and Canada, released a statement Monday saying that 'the suffering of civilians has reached new depths,' and calling for the war in Gaza to end now. 'The Israeli government's aid delivery model is dangerous, fuels instability and deprives Gazans of human dignity,' the statement continued. 'We condemn the drip feeding of aid and the inhumane killing of civilians, including children, seeking to meet their most basic needs of water and food.' On Monday morning, Israel also began a new military invasion of Deir al Balah, where Nessouli was based in June. As Israeli tanks moved into the dense area, packed with many thousands of displaced people, an Israeli airstrike destroyed a water desalination plant, killing five more people in the blast.
Associated Press
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- Associated Press
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SINGAPORE - July 21, 2025 ( NEWMEDIAWIRE ) - On July 15 2025, to mark the successful secondary listing of China Medical System Holdings Limited ('CMS' or the 'Group') on the Main Board of the Singapore Exchange ('SGX'), SGX and CMS co-hosted the 'Singapore and Emerging Markets Pharmaceutical Industry Growth Forum & CMS SGX Secondary Listing Appreciation Dinner'. Held in a grand fashion, the event was held at the Group's CDMO manufacturing facility, PharmaGend, which is located in Tuas, Singapore. The event brought together about 150 representatives from local government agencies, multinational pharmaceutical companies, innovative biotech companies, leading investment institutions, and the KOLs in the pharmaceutical industry. Through a series of insightful keynote speeches and panel discussions, guests engaged in in-depth exchanges and shared ideas on various topics, such as the pharmaceutical industry's development in Singapore and emerging markets across the Asia-Pacific region, the breakthroughs and overseas expansion of Chinese innovative drugs, the globalization strategies, commercialization pathways, as well as ecosystem collaboration of innovative pharmaceutical companies. The forum began with opening remarks by Ms. Caihan Chia, Head of Greater China Capital Markets and Chief Representative of Beijing Representative Office at SGX, and Ms. Louise Ho, Assistant Vice President of Healthcare Division and China Desk at the Singapore Economic Development Board. These were followed by keynote addresses from Mr. Siang Sheng Foo, Head of Investment Banking at Singapore CGS International Securities, Mr. Shriharsha Sarkar, Partner for Asia Healthcare at L.E.K. Consulting, and Ms. Kah Yean Neo, Senior Director at Singapore's Agency for Science, Technology and Research (A*STAR). Ms. Caihan Chia stated that in recent years, SGX has become increasingly attractive to Chinese enterprises through policy refinements, including tax incentives, capital support from the secondary market, and streamlined regulatory procedures. The successful listing of CMS showcases the growing interest among Chinese companies in the Singapore market. As one of leading healthcare companies, CMS's listing highlights the growing demand for medical innovation and medical service accessibility across Asia. With CMS seeking to expand its business in Southeast Asia, its listing on SGX will serve as a strategic springboard to connect with international investors and further reinforce Singapore's role as a vital capital hub. Emerging Markets: A New Growth Engine for the Global Pharmaceutical Industry Emerging markets, such as Southeast Asia and the Middle East, are becoming new growth drivers for the global pharmaceutical industry. A combination of factors, including large populations, early signs of ageing, the rise of the middle class, growing health awareness, and the increasing burden of chronic diseases, is driving higher demand for medicines and improved accessibility. According to IQVIA, by 2028, the combined pharmaceutical market size of four major emerging regions - Asia-Pacific, India, Africa & the Middle East, and Latin America - is expected to reach USD 336 - 384 billion, comparable to the USD 410 billion market size projected for Western Europe. Singapore possesses geographical and institutional advantages for accessing Southeast Asia, the Middle East, and other emerging markets. With its robust financial system, open and inclusive policy environment, and thriving pharmaceutical industry, Singapore is increasingly becoming a global hub for capital and innovation. It has also become the preferred location for regional headquarters for many Chinese enterprises expanding into Southeast Asia. Seizing Opportunity: Strategic Pathways for Chinese Innovative Pharma to Expand into Emerging Markets In Southeast Asia's six major economies (SEA6), limited healthcare coverage means that out-of-pocket payments constitute the primary source of drug expenditure. While generics dominate, branded originator drugs continue to hold significant market share in private hospitals, retail pharmacies, and clinics. Patient demand for biologics and biosimilars continues to grow. In terms of commercialization models, traditional distribution model, which relies on third-party logistics (3PL), is gradually giving way to models with stronger commercial capabilities and strategic licensing partnerships. To achieve sustainable success in Southeast Asia, pharmaceutical companies must build competitive product portfolios, leverage experienced local sales teams, and consider establishing localized manufacturing capabilities, widely seen as key strategic advantages. The CMS's Approach: Building Dual Hubs in China and Singapore to Drive End-to-End Innovation With over 30 years of experience in the Chinese market, CMS has accumulated a differentiated product portfolio and mature commercialization capabilities. Today, the Group is expanding its strategic vision across the Asia-Pacific region, using China as a foundation and Singapore as its regional hub. Through an end-to-end value chain of 'R&D–manufacturing–commercialization–investment', CMS is driving innovation to deliver high-quality pharmaceutical products and services to patients worldwide. Mr. Lam Kong, Chairman, Chief Executive and President of CMS, delivered a keynote speech titled 'New CMS, New Ascent: Three Strategies to Drive the Second Growth Curve.' He shared that since launching its 'New CMS' transformation strategy in 2018, the Group has propelled growth through three engines - product innovation, commercial transformation, and international expansion. This has enabled the Group's transition from 'China's largest CSO' to 'a pharmaceutical company in transformation,' and finally, to 'an end-to-end innovative pharmaceutical enterprise', with a sustainable second growth curve. In product innovation, driven by a three-dimensional approach of 'Licensing, Strategic partnerships, and in-house R&D', the Group has built a pipeline of nearly 40 FIC/BIC innovative drugs, five of which have been approved in China and are in large-scale clinical use. In the area of commercialization, CMS remains focused on cardio-cerebrovascular, gastroenterology, ophthalmology, and skin health specialties, while enhancing anti-cyclical resilience through a diversified ecosystem of 'New retail, E-commerce, and Consumer healthcare'. Its skin health subsidiary, Dermavon, has become a niche market leader in China and is now progressing toward a spin-off for an independent listing on the Hong Kong Stock Exchange. In the area of globalization, CMS is creating a dual-track model centred in China and Singapore, using a strategy of 'bringing in' to accelerate overseas product launches in China, and a strategy of 'moving outward' to establish an end-to-end presence in emerging markets. The successful listing on SGX will enhance its regional synergy and close the loop in the 'R&D – Manufacturing - Commercialization – Investment' global value chain, unlocking growth from emerging markets and creating a multi-regional growth framework. CMS formally launched its industrial globalization strategy in 2022. At this event, CMS's international business clusters made their debut, showcasing its forward-looking, full industry chain layout and leadership in setting a new paradigm for Chinese pharmaceutical companies expanding overseas. PharmaGend Established in 2023, PharmaGend aims to become Southeast Asia's largest and most reliable CMO/CDMO. It has a site spanning 30,000 square meters and is capable of manufacturing dosage forms such as tablets and capsules, which has been certified by the FDA and HSA, demonstrating its high-standard pharmaceutical manufacturing capabilities for global export. It has future plans to expand production lines for injections, ointments, and nasal sprays. Rxilient Established in 2021, Rxilient operates by a professional and experienced localized team, and has fully established BD, registration, marketing, and commercialization capabilities. Leveraging its unique local expertise and advantages, Rxilient can bring innovative drugs to emerging markets led by Southeast Asia and the Middle East. It has submitted marketing applications for nearly 20 drugs and medical devices across Southeast Asia, the Middle East, and regions such as Hong Kong, Macao, and Taiwan, covering the therapeutic areas of dermatology, ophthalmology, oncology, autoimmune, and central nervous system. As more drugs receive regulatory approval in these countries, Rxilient anticipates sustained and significant revenue growth. CMS R&D Established in Singapore in 2024, CMS R&D has been working on more than 10 early-stage innovative drug projects. Leveraging China's mature early-stage R&D and clinical resources, it aims to synchronize China speed with global standards to advance more Chinese innovative drugs toward globalization. HiGend Established in 2025, HiGend is a global early-stage bio-pharma incubation platform which uses a 'hub-and-spoke' model, integrating China's innovation capabilities to accelerate global R&D and commercialization. Subsequently, three panel discussions were held in succession, which facilitated an in-depth exchange between industry and capital, driving the forum to its climax. Distinguished guests from various parties freely shared insights on the continuous development and diversification of the pharmaceutical ecosystem, and jointly explored the future of pharmaceutical expansion into emerging markets. Panel Discussion 1 - Challenges and Breakthroughs: The Enduring Power of Organizational and Strategic Long-Term Vision The emerging markets of today share numerous similarities with China's pharmaceutical landscape twenty years ago, which are currently experiencing a critical period of accelerated demand release for pharmaceuticals, constituting medium- to long-term structural opportunities. Undoubtedly, these markets are diverse and complex - each country has its own unique characteristics in terms of drug regulation, healthcare insurance mechanisms, and market acceptance. However, CMS's core strength lies in its systematic commercialization capabilities, which it is now extending to emerging markets. CMS's senior management team, alongside its business partners, jointly reviewed and discussed the key factors contributing to its commercial excellence, as well as the pathways driving the Group's second growth curve. The first panel discussion was moderated by Mr. Brian Yang, Vice President for Business Development at Rxilient. Participants included Mr. Karl Luschmann, Managing Director of Pharma Stulln GmbH, and Ms. Linlang Wang (formerly the first product manager of the Augentropfen Stulln Mono Eye Drops ('Stulln') in China), General Manager of CMS's ophthalmology business, CMS Vision, among others. Collectively, they reviewed the core strategies behind the rapid, year-on-year growth of Stulln in the Chinese market- a focus on clinical value and continuous innovation in commercialization models. CMS adhered to prioritizing clinical efficacy, amassing substantial evidence to demonstrate the clinical value of Stulln in treating asthenopia, and leveraging medical advancements to drive product commercialization. Meanwhile, CMS also continuously revamped its commercialization model by establishing a full-channel retail system that integrates in-hospital and out-of-hospital sales, developing an 'online + offline' omnichannel marketing system, and adopting a diversified product portfolio strategy in consumer attributes. These concerted efforts facilitated the sustained, rapid growth and wide recognition of Stulln within the Chinese market. Mr. Victor Yin, Country Manager of Incyte Bioscience China, Mr. Huang Anjun, CEO of Dermavon (CMS's skin health business), and Mr. Lawrence He, CEO of Rxilient, jointly retraced the entire journey of launching ruxolitinib cream - a blockbuster prescription drug with consumer attributes. From the signing of the collaboration agreement and pilot launch in Hainan Boao Lecheng pilot zone, to marketing approvals in Macao, followed by Hong Kong, introduction into designated hospitals in the Greater Bay Area in China, and the NDA has been submitted in China, Singapore, and other countries or regions. Leveraging mature clinical development experience and capabilities, proven commercialization competence, a compliant operational system, and efficient execution, the group earned high recognition and trust from Mr. Victor Yin. Together, the parties have helped bring new hope to vitiligo patients in both China and Southeast Asia simultaneously. These successful commercialization experiences not only provide valuable business model references for international pharmaceutical companies entering the Chinese market, but also offer significant insights for Chinese pharmaceutical companies looking to expand into emerging markets overseas. Panel Discussion 2 - Breaking Through: Diverse Explorations for Chinese Innovative Pharmaceutical Companies to Expand into Emerging Markets Over the past three years, Chinese pharmaceutical companies have secured over USD 10 billion in upfront payments through license-out deals. However, the majority of these transactions remain concentrated in mature markets led by Europe and the United States. Looking ahead, the next engine of growth may shift toward emerging markets such as Southeast Asia, the Middle East, and Latin America - regions with a combined population of approximately 1.8 billion and per capita healthcare spending is merely one-fifth that of Western markets. While pharmaceutical demand is accelerating in these areas, challenges persist, including limited payment capacity and significant differences in regulatory systems. Whether Chinese pharmaceutical companies can effectively replicate and localize their domestic development and innovation models in these blue ocean markets, will determine the scale and sustainability of their second growth curve. The second panel discussion, moderated by Mr. Brian Yang, featured esteemed representatives from leading Chinese innovative pharmaceutical companies that are closely collaborating with CMS, including Tibet Nordicon Pharma, NeuroDawn Pharmaceutical (Ningdan Pharmaceutical), Mabgeek Biotech, and Jingze BioPharmaceutical. Using examples such as XinHuoSu (for acute decompensated heart failure), Y-3 for Injection (under development for stroke treatment), ABP-671 (under development for gout) etc., participants held in-depth discussions on topics, including 'What constitutes truly clinically valuable innovation' and 'How to implement commercialization pathways within emerging markets.' True innovation value stems from professionalism and dedicated focus. It requires researchers to remain committed to a specific field over the long term, and to validate new targets and drug structures through reverse translational research, thereby identifying their potential clinical value. Since China officially joined the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH) in 2017 and became a member of its steering committee, the quality of Chinese innovative pharmaceutical products has improved rapidly and has gradually gained global recognition. In addition to entering mature markets led by Europe and the U.S., Chinese innovators are increasingly turning their attention to emerging blue ocean markets such as Southeast Asia, actively exploring parallel regulatory filings in both emerging and mature markets. For innovative pharmaceutical companies, globalization strategies should be integrated into the early stages of pipeline development cycles and macro-level strategy. It is also crucial to seek out a business partner that possesses the entire value-chain capabilities - including experienced local clinical registration teams, manufacturing capacity, and commercialization operations - in order to drive efficient product launches and expand access to high-quality medical solutions across a broader range of geographies. Panel Discussion 3 – Setting Sail: Pharmaceutical Expansion into Emerging Markets The third panel discussion was moderated by Mr. Frank Hong, Managing Director of Legend Capital, engaging multiple leading pharmaceutical analysts from renowned investment banks and representatives from investment institutions in an insightful sharing and in-depth discussion on the international expansion of innovative drug products and pharmaceutical industry globalization. Participants pointed out that China's pharmaceutical industry is currently at a strategic inflection point for global expansion. The Intellectual Property (IP) licensing model has preliminarily demonstrated the global competitiveness of Chinese innovation. However, for most domestic pharmaceutical companies, this process remains in the 'isolatedbreakthrough' phase. To achieve the transition from a practice of 'one-time licensing' to 'sustained global engagement,' Chinese pharmaceutical companies must look to multinational pharmaceutical giants as a benchmark - internationalizing their commercialization, manufacturing, and R&D capabilities to build a replicable, scalable, and sustainable global industrial ecosystem. Achieving this goal is no easy task. While many Chinese pharmaceutical companies have begun exploring emerging markets, they often face challenges such as fragmented distribution channels and difficulty in standardizing operational systems. Only by maintaining conviction and building a fully integrated, internationalized ecosystem across the entire value chain can companies transform one-off licensing revenues into long-term brand equity and control of the value chain, ultimately earning a sustained voice and competitive edge in the global arena. Though the forum's spotlight has dimmed, the consensus reached continues to shine like a beacon: Southeast Asia, the Middle East, and other emerging markets are quickly becoming the next major destinations for the global pharmaceutical industry. CMS's fully localized framework covering 'Research, Manufacturing, Commercialization, and Investment' has paved the way for industrial expansion overseas, constructing a bridge to globalization. With an open and win-win attitude, the Group welcomes innovators, regulators, and capital from around the world to work together in bringing more Chinese and global innovative drugs to emerging markets, fostering international growth. CMS sincerely invites partners across all sectors to seize the growth opportunities of the Asia-Pacific region and jointly promote innovation in the pharmaceutical industry across emerging markets, so that more innovative therapies may benefit patients around the world. Media Contact: Company: China Medical System Holdings Ltd. Contact: CMS Investor Relations Email: [email protected] Website: Source: China Medical System Holdings Ltd. View the original release on
Los Angeles Times
5 hours ago
- Los Angeles Times
As Trump's raids ramp up, a Texas region's residents stay inside — even when they need medical care
WESLACO, Texas — These days, Juanita says a prayer every time she steps off the driveway of her modest rural home. The 41-year-old mother, who crossed into the United States from Mexico more than two decades ago and married an American carpenter, fears federal agents may be on the hunt for her. As she was about to leave for the pharmacy late last month, her husband called with a frantic warning: Immigration enforcement officers were swarming the store's parking lot. Juanita, who is prediabetic, skipped filling medications that treat her nutrient deficiencies. She also couldn't risk being detained because she has to care for her 17-year-old daughter, who has Down syndrome. 'If I am caught, who's going to help my daughter?' Juanita asks in Spanish, through an interpreter. Some people quoted in this story insisted that the Associated Press publish only their first names because of concerns over their immigration status. As the Trump administration intensifies deportation activity around the country, some immigrants — including many who have lived in Texas's southern tip for decades — are unwilling to leave their homes, even for necessary medical care. Tucked behind the freeway strip malls, roadside taquerias and vast citrus groves that span this 160-mile stretch of the Rio Grande Valley are people like Juanita, who need critical medical care in one of the nation's poorest and unhealthiest regions. For generations, Mexican families have harmoniously settled — some legally, some not — in this predominately Latino community where immigration status was once hardly top of mind. White House officials have directed federal agents to leave no location unchecked, including hospitals and churches, in their drive to remove 1 million immigrants by year's end. Those agents are even combing through the federal government's largest medical record databases to search for immigrants who may be in the United States illegally. Deportations and tougher restrictions will come with consequences, says Mark Krikorian, the director of the Center for Immigration Studies, a think tank that favors restrictive immigration policies. 'We shouldn't have let it get out of hand the way we did,' Krikorian says of the previous administration's immigration policies. 'Some businesses are going to have difficulties. Some communities are going to face difficulties.' Federal agents' raids began reaching deeper into everyday life across the Rio Grande Valley in June, just as the area's 1.4 million residents began their summer ritual of enduring the suffocating heat. This working-class stretch of Texas solidly backed Trump in the 2024 election, despite campaign promises to ruthlessly pursue mass deportations. People here, who once moved regularly from the U.S. to Mexico to visit relatives or get cheap dental care, say they didn't realize his deportation campaign would focus on their neighbors. But in recent weeks, restaurant workers have been escorted out mid-shift and farmers have suddenly lost field workers. Schoolchildren talk openly about friends who lost a parent in raids. More than a dozen were arrested last month at local flea markets, according to local news reports and Border Patrol officials. Immigrants are staying shut inside their mobiles homes and shacks that make up the 'colonias,' zoning-free neighborhoods that sometimes don't have access to running water or electricity, says Sandra de la Cruz-Yarrison, who runs the Holy Family Services, Inc. clinic in Weslaco, Texas. 'People are not going to risk it,' de la Cruz-Yarrison says. 'People are being stripped from their families.' Yet people here are among the most medically needy in the country. Nearly half the population is obese. Women are more likely to be diagnosed with cervical cancer and elderly people are more likely to develop dementia. Bladder cancers can be more aggressive. One out of every four people lives with diabetes. As much as a third of the population doesn't have health insurance to cover those ailments. And a quarter of people live in poverty, more than double the national average. Now, many in this region are on a path to develop worse health outcomes as they skip doctor appointments out of fear, says Dr. Stanley Fisch, a pediatrician who helped open Driscoll Children's Hospital in the region last year. 'We've always had, unfortunately, people who have gone with untreated diabetes for a long time and now it's compounded with these other issues at the moment,' Fisch says. 'This is a very dangerous situation for people. The population is suffering accordingly.' Elvia was the unlucky — and unsuspecting — patient who sat down for the finger prick the clinic offers everyone during its monthly educational meeting for community members. As blood oozed out of her finger, the monitor registered a 194 glucose level, indicating she is prediabetic. She balked at the idea of writing down her address for regular care at Holy Family Services' clinic. Nor did she want to enroll in Medicaid, the federal and state funded program that provides health care coverage to the poorest Americans. Although she is a legal resident, some people living in her house do not have legal status. Fewer people have come to Holy Family Services' clinic with coverage in recent months, says billing coordinator Elizabeth Reta. Over decades, the clinic's midwifery staff has helped birth thousands of babies in bathtubs or on cozy beds in birthing houses situated throughout the campus. But now, Reta says, some parents are too scared to sign those children up for health insurance because they do not want to share too much information with the government. 'Even people I personally know that used to have Medicaid for their children that were born here — that are legally here, but the parents are not — they stopped requesting Medicaid,' Reta says. Their worry is well-founded. An Associated Press investigation last week revealed that U.S. Immigration and Customs Enforcement officials have gained access to personal health data — including addresses — of the nation's 79 million Medicaid and Children's Health Insurance Program enrollees. The disclosure will allow ICE officials to receive 'identity and location information of aliens,' documents obtained by the AP say. In Texas, the governor started requiring emergency room staff to ask patients about their legal status, a move that doctors have argued will dissuade immigrants from seeking needed care. State officials have said the data will show how much money is spent on care for immigrants who may not be here legally. Federal law requires emergency rooms to treat any patients who come to the doors. Visits to Holy Family Services' mobile clinic have stopped altogether since Trump took office. The van, which once offered checkups at the doorsteps in the colonias, now sits running on idle. Its constant hum is heard throughout the clinic's campus, to keep medical supplies fresh in the 100-degree temperatures. 'These were hard-hit communities that really needed the services,' de la Cruz-Yarrison says. 'People were just not coming after the administration changed.' Immigrants were less likely to seek medical care during Trump's first term, multiple studies concluded. A 2023 study of well-child visits in Boston, Minneapolis and Little Rock, Arkansas, noted a 5% drop for children who were born to immigrant mothers after Trump was elected in 2016. The study also noted declines in visits when news about Trump's plans to tighten immigration rules broke throughout his first term. 'It's a really high-anxiety environment where they're afraid to talk to the pediatrician, go to school or bring their kids to child care,' says Stephanie Ettinger de Cuba, a Boston University researcher who oversaw the study. A delayed trip to the doctor almost cost 82-year-old Maria Isabel de Perez her son this spring. He refused to seek help for his intense and constant stomach pains for weeks, instead popping Tylenol daily so he could still labor in the farm fields of Arkansas, she says. He put off going to the hospital as rumors swirled that immigration enforcement officials were outside of the hospital. 'He waited and waited because he felt the pain but was too scared to go to the hospital,' she explains in Spanish through an interpreter. 'He couldn't go until the appendix exploded.' Her son is still recovering after surgery and has not been able to return to work, she says. Perez is a permanent resident who has lived in the United States for 40 years. But all of her children were born in Mexico, and, because she is a green card holder, she cannot sponsor them for citizenship. Maria, meanwhile, only leaves her house to volunteer at a local food bank. She's skipped work on nearby farms. And after last month's arrests, she won't sell clothes for money at the flea market anymore. So she stuffs cardboard boxes with loaves of bread, potatoes, peppers and beans that will be handed out to the hungry. Before the raids began, about 130 people would drive up to collect a box of food from Maria. But on this sweltering June day, only 68 people show up for food. She brings home a box weekly to her children, ages 16, 11 and 4, who are spending the summer shut inside. Her 16-year-old daughter has skipped the checkup she needs to refill her depression medication. The teenager, who checks in on friends whose parents have been arrested in immigration raids through a text group chat, insists she is 'doing OK.' Maria left Mexico years ago because dangerous gangs rule her hometown, she explains. She's married now to an American truck driver. 'We're not bad people,' Maria says from her dining room table, where her 4-year-old son happily eats a lime green popsicle. 'We just want to have a better future for our children.' Juanita, the prediabetic mother who hasn't filled her prescriptions out of fear, was not sure when she would brave the pharmacy again. But with a cross hanging around her neck, the devout Catholic says she will say three invocations before she does. Explains her 15-year-old son, Jose: 'We always pray before we leave.' Seitz and Martin write for the Associated Press.
