captioning sponsored by captioning sponsored by wnet stewart: on this edition for sunday april 17th, a powerful earthquake strikes ecuador. looking ahead to tuesday's new york presidential primary. in our signature segment, changing the way doctors are taught to treat pain. >> the amount of opioids that we're prescribing is way too much and the amount of education the average prescriber gets is way too little and that's a prescription for disaster. stewart: and, american country music resonates, in kenya. next on "pbs newshour weekend." >> pbs newshour weekend is made possible by: lewis b. and louise hirschfeld cullman. bernard and irene schwartz. judy and josh weston. the cheryl and philip milstein family.

the citi foundation. supporting innovation and enabling urban progress. the john and helen glessner family trust. supporting trustworthy journalism that informs and inspires. sue and edgar wachenheim, iii. corporate funding is provided by mutual of america-- designing customized individual and group retirement products. that's why we are your retirement company. additional support has been provided by: and by the corporation for public broadcasting, and by contributions to your pbs station from viewers like you. thank you. from the tisch wnet studios at lincoln center in new york, alison stewart. >> stewart: good evening and thanks for joining us. the small south american nation of ecuador is recovering from its most powerful earthquake in 40 years. last night's massive 7.8 magnitude quake was centered near the town of pedernales on ecuador's pacific coast.

but it could be felt in the nation's capital, quito, 105 miles away. the quake caused damage across the nation of 16-million people. the mayor of pedernales said, quote, "the entire town collapsed. there's nothing much we can do." ecuador's president, rafael correa, says at least 235 people have died in the quake, and 15- hundred more people were injured. thousands of police and troops have been mobilized to keep order and to help rescue people trapped in the rubble. venezuela, chile and mexico are sending relief workers and supplies, and u.s. military aircraft are assisting the mission. in japan, rescue efforts following powerful back-to-back earthquakes continued today amidst dozens of small aftershocks. authorities said eleven people were still missing after thursday's and friday's quakes on japan's southern island of kyushu. rescuers today pulled 10 college students from the rubble of a collapsed apartment building. more than 40 people died from both quakes. japan and ecuador both lie along the seismically-active pacific rim "ring of fire" but

geological officials say they doubt the quakes in both countries are linked. the presidential campaigns are homing in on their new york supporters with two days left before the empire state's delegate-rich primary. businessman donald trump held a rally today in new york city's most republican borough, staten island-- while ohio governor john kasich is set to appear in syracuse and albany tomorrow. after sweeping 14 delegates at the wyoming state convention yesterday, texas senator ted cruz trails trump by 185 total delegates in the race to 12- hundred-and-37 needed to win the nomination. kasich is more than 400 delegates behind cruz. on the democratic side, former secretary of state hillary clinton returned to new york city today after a weekend trip to california, which has the largest cache of delegates for both parties before this summer's national conventions. clinton leads vermont senator bernie sanders by more than 650 total delegates in their race to the 2,383 needed to win.

joining me now to talk about the boisterous new york campaign of the past two weeks is bob hardt, the political director for new york one, new york city's 24/7 news channel. >> bob you covered hillary clinton when she was rung for senate in 2000, and, she presented herself into i'm on a job interview and you should hire me. are there shades of that in this campaign? >> definitely. i'm having deja vu all over again. crisscrossing the state, also going upstate, reintroducing herself to voters, reminding them she was their senator for eight years, and also, they don't remember her when she was a senator because she left at 2008. there is a reintroduction to these younger voters who she's have desperately trying to steal away from the bernie sanders camp. >> bernie sanders has obviously had enthusiastic supporters in new york, we've seen rallies in washington square park and here

in new york city, one in 10 are attached somehow to the financial sector, going into all livelihoods,. >> exactly. like going into texas, and talking about oil as a net bad. some democratic voters agree with him. while the message might be a little dissonant to some new yorkers who do have jobs on wall street and there are democrats who do work on wallets, i don't think this hurtsdz him as much as this is a general election. it would be trouble then. >> stewart: down state new york and upstate new york are vastly dirchlt not in lob step. how is donald trump playing upstate? >> there is suburban new york city and upstate. upstate, he is playing very, very well, what we've seen in michigan is some industrial places upstate that no longer have the jobs so he's going there and saying, i'm going to

bring industry back, i'm going to go after the companies that have taken the jobs abroad. in the city, he hasn't done that many rallies, out on statten stn island. his are polls are doing well in the republican race but he is really resonating out there. >> you've written how this was for both primaries a very competitive race, something we haven't seen for a long time and led to weird campaigning. >> yes. >> what do you think you've seen? >> john kasich has eaten his way are is accredit new york. funny seeing ted cruz in a matso factory trying to court the jewish vote. we haven't had presidential candidates come here except to you fund-raise since 1992, when

bill clinton was trying to put away jerry brown, paul tsongas, you had michael de dukakis runng here, beautiful spring spring day, also haven't seen the candidates in the way we vjt seen them in 20 years. >> bob hardt, thank you for being here. >> great to be here. stewart: the abuse of heroin and prescription painkillers like oxycontin, vicodin, percocet, and methadone now causes almost 30,000 overdose deaths a year in the united states. about the same number of deaths as car accidents. a big factor in this american epidemic is the surge in painkiller prescriptions written by doctors to treat chronic pain. the food and drug administration recently announced it will require warning labels on painkiller bottles, and the centers for disease control and prevention has issued new

guidelines for limiting opioids. in line with those guidelines, more than 60 u.s. medical schools say beginning this fall they will require students to take some form of prescriber education. in tonight's signature segment, the newshour's christopher booker looks at what established doctors and doctors still in training are learning to curb the epidemic. >> along in here, any pain? >> no, but i did take my medicine this morning. >> reporter: lynn levine is one of tens of millions of americans diagnosed with chronic pain. after numerous surgeries for a range of health problems, levine has taken opioid painkillers for the last seven years. one medicine, morphine, in the morning. and i take an oxycodone at around noon or 1:00. and then i take a morphine late in the evening. they're long acting. >> reporter: where would you be, do you think, without the opioids? >> i think i would be laying in a bed most of the time. >> reporter: levine's doctor, joseph zebley, has been treating patients with cancer and chronic pain since the 1980s. he and levine recognize the risk of addiction in taking these potent drugs.

>> reporter: you have a very healthy fear of just how this opioid intake can get out of hand. >> it can. >> reporter: why? >> it can, because i know it can, because i've known lots of people who take it unnecessarily and take it for the high they supposedly get off of it. and i don't want to be in that position. >> reporter: as the number of u.s. prescriptions for opioids doubled over a 15 year period from 105 million in 1998 to 207 million in 2013. the number of fatal overdoses from the drugs soared almost fivefold, from 4,000 deaths a year in 1999 to nearly 19,000 in 2014. that includes people who illicitly used prescription opioids and those who overdosed on pills prescribed for them. as recently as the early 1990s, doctors were criticized for not prescribing enough painkillers, according to david thomas, a doctor who works for the national institute of drug abuse, known as "n.i.d.a." >> back then, there was a thing called opioid-phobia. a lot of healthcare professionals did not want to prescribe opiates at all, because they thought you give

the slightest amount, you turn your patients into addicts. and so even people with stage four cancer weren't being given opiates, they were left to suffer. >> reporter: doctor zebley says prescribing opioids wasn't a treatment option he even considered for chronic pain when he graduated from the university of maryland school of medicine 40 years ago. >> back then, if we wrote for even tylenol with codeine you would have a precept, or someone, looking over your shoulder and wondering why you were using a narcotic. i think there was a number of well meaning health care providers that said, "this is wrong. we have to take care of people in pain. and we have the means, we have opiates." instead of just using them to some degree to help people, they were starting to be used just as a replacement for comprehensive pain treatment. and then there was an entire movement and i have colleagues who were in pain medicine who were involved in this movement, who said that we had an unrecognized epidemic of pain in america. >> reporter: as the approach to treating pain evolved, pharmaceutical companies touted academic studies saying painkillers carried little risk of addiction.

>> i think i, like many others, were fooled into at least partially believing that and starting to write prescriptions more liberally. >> reporter: how much responsibility do the doctor have in our opioid epidemic? >> i think we all share some responsibility. but i would put a lot more and this may be controversial, on the pharmaceutical industry. i won't name the names of certain companies but they were in my office 15, 20 years ago promoting long-acting narcotics with articles in their defense saying that these were less addicting. >> reporter: in the late 1990s, purdue pharma, the maker of oxycontin, which earned billion of dollars in revenue for the company, promoted the painkiller as having a low risk for addiction. but in 2007 the company admitted those claims were fraudulent and paid 600-million dollars in fines. since 2010, purdue says, it has "reformulated oxycontin with

abuse-deterrent properties." and it now refers physicians to new guidelines for opioid- prescribing from the centers for disease control. when releasing the guidelines in march, director tom frieden of the c.d.c. stated: "the science of opioids for chronic pain is clear: for the vast majority of patients, the known, serious, and too-often-fatal risks far outweigh the unproven and transient benefits." >> i wouldn't be able to stop 'em right away. that's for sure. because i'm physically addicted, not, you know, not addicted where i take more than the dose that they order. but i'm physically dependent on them. and that would mean a lot to me if they were to just, you know, stop the doses all of the sudden. >> there's a certain amount of anger on the part of physicians who feel trapped. we have a large cohort now of patients who are taking these medications long term, and on the other hand we're being told, "well, you guys are at fault because you're writing all these opioids." well, what are we to do? >> reporter: one answer to that question has been for medical schools to reexamine how their students are taught to treat pain. a 2011 study found that during four years of training, a

typical u.s. medical student spends only nine hours learning about pain. that's, like, one long day at work. the amount of opioids that we're prescribing is way too much and the amount of education that the average prescriber gets is way too little. and that's a prescription for disaster. >> the challenge is there's only so much time in the day and medical students have to learn about lots of things. you doing ok? >> reporter: doctor antje barreveld is a pain specialist and assistant professor at tufts university school of medicine outside boston. barreveld says that tufts currently has no formalized program on pain. right now she teaches roughly 5o students a year about pain, for one hour. >> she told the nurse that she ran out of oxycodone. i think that a lot of the students still feel that managing pain is very mysterious. they still just don't have a real handle on the basics of it. >> reporter: so barreveld has developed a new "pain education class" as part of a program by

"n.i.d.a." and the national institutes of health. they're making 50 to 100 interactive pain patient case studies, accessible online, so other medical schools can use them too. this case study shows a re- enactment of barreveld assessing a patient with a history of chronic pain and substance abuse. the students then meet with her to think creatively about treatment options, including physical and behavioral therapies as well as opioids, if appropriate, at low doses, and with caution. can you get "hooked" on buprenorphine? absolutely. it's an opioid. >> reporter: tufts third-year medical student olivia pezulo took barreveld's class and says it was most comprehensive pain training she's had. >> you have a lot of exposure to patients and pain, but you don't get the exposure to the treatment side of it. >> reporter: so then what was different here? >> first of all just addressing this is problem, this is real. and then coming up with-- multiple options, which-- and some are options. i've never seen before and not

really heard of before. >> we get to have perspectives from different disciplines. a nurse treats pain very differently from a doctor or a dentist or a pharmacist. but we all together can come up with some excellent strategies that complement each other. it's real. your pain is real. but you've made so much progress. this is why i have tissue boxes here. pain isn't necessarily that simple. and there aren't easy answers to treating it. and it often takes a special kind of person to take the time to really listen to the patient. so modeling that for students, of course, is the ultimate goal. >> reporter: what more do you think medical schools should be doing? >> so finally someone is recognizing that this is important. i'm hoping that it's not just gonna be an opioid-centric education. i think this needs to be about human beings as a whole and the human that suffers. >> reporter: this holistic approach is something the university of maryland school of medicine is trying with its by month-long elective dedicated to alternatives to medication for treating pain.

the techniques range from chiropractic methods, to guided imagery techniques that incorporate meditation. and even-- tai chi. fourth year medical student kevin o'malley took the class. >> after taking this rotation, i feel much more comfortable and prepared for treating chronic pain in patients. because i've been exposed to so many different therapies, i think it can be easy to think, "well, you know, someone's in pain, they experience it like anyone else does. and it's more complicated than that. >> reporter: o'malley plans to become a family doctor. just like maryland alumnus joseph zebley. seasoned physicians like him are taking steps to update their training. maryland is one of at least 20 states where doctors are required to take a class in pain management, opioid prescribing, or substance abuse in order to be re-licensed. >> don't ever think you know your patient even if they show up once a week for something. you don't. i think it's a reasonable first step. but it's nowhere near sufficient to really have doctors slow down the use of opioids. >> reporter: at least 12 states also require doctors to check

databases listing who has been prescribed opioid painkillers. before issuing the first opioid prescription to a patient. but none regularly check to see if prescribers are actually using the database. >> has anyone talked to you about weaning? >> reporter: zebley still faces the challenge of managing opioid dependent patients like lynn levine. he says he's vigilant in looking for signs of abuse and avoids prescribing opioids unless it's absolutely necessary. >> reporter: how hard is it for you, in that position, and for doctors to change this, being like what i was taught was wrong? >> well, first you have to have some humility. that's hard right there. and then one has to change. but we've changed how we use antibiotics. we've changed what we do for high blood pressure. so if you have science that backs you up then you change. it may be difficult. >> stewart: learn more about how the opioid epidemic is affecting pregnant women and their babies.

american co "inside kenya," correspondent nick schiffrin has this look and listen at kenya's country music scene. ♪ if you're looking for some love tonight ♪ then i might just have enough >> reporter: on a wednesday night in kenya's capital, the music is flowing. we're six thousand miles from tennessee. but tonight nairobi looks, and sounds, a lot like nashville. ♪ i've been thinking about it all day long ♪ never had a feeling quite this strong >> every time i get on stage, i live in the moment. when i feel the music in that depth, they feel it. ♪ it ain't no use to sit and wonder why, baby. >> reporter: elvis otieno, that's his real name, was born in 1977, the same year elvis

presley died. otieno's parents named him after the king, sealing his fate. ♪ you're the reason why i'm traveling on >> i tried everything i could in my life to be an engineer, an aeronautical engineer. but it was never to be, because i think music was my calling. ♪ my hometown's coming in sight if you think i'm happy, you're ♪ right >> reporter: he's now known as "sir elvis." he thought about becoming a rock musician. but he identified more with country. >> it's down home stories that i resonate with. ♪ listen to the radio >> reporter: when he started performing 10 years ago, he was the first kenyan to sound like the original artists. >> if you're playing beethoven, you have to sound authentically beethoven. if i sing jim reeves, it has to

have a silky velvet way of it. ♪ i love you because you're understanding ♪ i love you because you're understanding >> he's original. his voice. it's out of this world. >> reporter: he's as genuine as the music. because you can't do this stuff if you don't believe in it. >> howdy, folks. hi there and welcome to the strings of country interview. >> reporter: david kimotho hosts a weekly show called strings of country. sir elvis is his best known guest. >> there are a lot of guys who want to play like him. they want to sing like him. so he is actually, you know, growing the industry. ♪ because i'm in love with this pretty little girl >> reporter: kenyans have been listening to country for 50 years, ever since kenya gained independence from britain. >> even though we were colonized by the brits, you know, what we were exposed to was american music. it resonates because of the

message. we can identify with the stories. >> reporter: country was especially popular in kenya's farming areas. ♪ because i am just a country boy. ♪ money have i none. >> reporter: elvis says his life is a little bit country. he lived in a farming area near the end of a rail line. >> in kenya, people to work so hard to get the harvests. when they came to realize that there is a style of music that actually goes along with this kind of lifestyle, they embraced it. ♪ when your rooster's a-crowin' at the break of dawn >> reporter: is there one song in particular that kenyans always ask for? >> yes. "you're my best friend" by don williams. ♪ you're my anchor in love's ocean ♪ but most of all, you're my best friend

>> reporter: the homegrown country music industry here has a long way to go. even elvis has not recorded any his own original songs-- yet. >> i'm so excited about it, because this is going to be my first single. mansion built paradise on the prairies just a bit of the song that i wrote! ♪ wasted away again in margaritaville. >> reporter: sir elvis believes in a famous saying: country music is "nothing but three chords and the truth." >> sometimes life is sad. sometimes life is happy. but we always keep the joy of the music. ♪ some of god's greatest gifts are unanswered prayers. >> yeah.

>> this is pbs newshour weekend, sunday. stewart: what's hoped will be the final push to eradicate polio around the world began today. led by the united nations' world health organization, the complex and costly effort involves getting 155 countries & territories to switch to a new kind of polio vaccine by may 1st. yesterday, i spoke with doctor steven koch-ee from the centers for disease control and prevention about the effort. prevention, about the effort. why polio, why now? >> this initiative started back in 1988. and at that point in time there were 350,000 cases of polio per year in 125 countries. if we fast-forward we're now down to only ten case he of pole -- cases of polio in this calendar year so we are on the

verge of completely finishing the job of erad yo eradicating . amazon what is the vaccine that this one doesn't do? >> it is a three in one vaccine it contains cms each of the three it is types of polio virus. now we are at a point where the type 2 poem yoa virus no longer exists in the world -- polio virus no lodger exists in the world. this louse us to remove the type 2 from the oral vaccine. the type 2 virus in fact all these vac sooner viruses very rarely can mutate and cause polio that is indistinguishable from the naturally occurring polio. so because there is no type 2 polio occurring in the world we can remove the type 2 virus from the vaccine and we will no longer have to worry about these very rare cases of polio coughed

by the oral polio vaccine. >> finally, the latest round of united nations brokered peace talks of the war in yemen start tomorrow in kuwait. finally ending the year long conflict that has killed 6,000 people. any tensions between saudi arabia and iran who back rival sides in the fighting. tomorrow the supreme court hears arguments on president obama' obama's.proposal to allow citizen immigrants to remain in the country. that's all for pbs newshour weekend, i'm alison stewart, good night. captioning sponsored by wnet captioned by media access group at wgbh access.wgbh.org >> pbs newshour weekend is made

possible by: cullman.and louise hirschfeld bernard and irene schwartz. judy and josh weston. the cheryl and philip milstein family. the citi foundation. supporting innovation and enabling urban progress. the john and helen glessner family trust. supporting trustworthy journalism that informs and inspires. sue and edgar wachenheim, iii. corporate funding is provided by mutual of america-- designing customized individual and group retirement products. that's why we are your additional support has been provided by: and by the corporation for public broadcasting, and by contributions to your pbs station from viewers like you. thank you.

announcer: explore new worlds and new ideas through programs like this, made available for everyone through contributions to your pbs station from viewers like you. thank you. ♪ ow ♪ i feel good announcer: tonight, the legends of rhythm, blues, and soul unite for an event 40 years in the making to benefit public television. ♪ when a man loves a woman ♪ i'm a soul man ♪ everybody, sing ladies and gentlemen, from heinz hall in pittsburgh, pennsylvania, r&b legends dionne warwick and jerry butler! [applause] jerry butler: well, dionne, have we got a show for 'em tonight. that's what ed sullivan used to say.