>> today on "earth focus"... coal ash. it's a toxic waste being dumped across the united states. some people living close to these dumps have unique health problems. is coal ash to blame? we look for answers, coming up, on "earth focus." in pennsylvania, 3 adjoining counties are the hot spot of a rare cancer. in juliette, georgia, radioactive water flows from the tap. these problems may seem unrelated, but with a closer look, these two communities share a common denominator--coal ash, and lots of it.

the discovery of coal in the united states dramatically shaped our energy future. today, there is no greater source of power than coal combustion. it's responsible for nearly 40% of our electricity. but burning coal generates waste. it's called coal ash, and every year in the u.s., 130 million tons of it is created. >> it's the largest industrial waste stream in america. you could fill the boxcars of a freight train that would stretch from new york city to melbourne, australia, with the coal ash that's generated every year in this country. >> the ash contains toxic metals. lead, arsenic, chromium, cadmium, others. and it even has radioactive substances. >> it's these pollutants, many of them known to cause cancer, that have people worried. and the big question is, where are all these toxins ending up?

>> there's fly ash and coal dust... we'll go on the front porch and do the same thing. >> you can see as you look up there the fresh ash. it's like an orangish color. when it's windy, it can get into their homes, it can get into their cars, and god forbid they're walking across the street or whatever, it actually gets into their lungs. >> in the united states, there are over 500 coal-fired power plants. and until recently, the dangers of coal ash have largely been hidden from public view. this is one of the largest

coal-fired power facilities in the country. called plant scherer, it's located in juliette, georgia, and is majority owned by georgia power. each year it produces 3 1/2 million kilowatts of electricity. generating that power requires a lot of coal. over 1,200 tons of coal are burned every hour at plant scherer, and in 2010, that resulted in 2,200 tons of coal ash. and it's all dumped into a 750-acre unlined pond, meaning nothing prevents toxins from entering the groundwater. >> they built this plant an area where there's no public water access. everyone within a 5-mile radius and maybe even further, drinking on private well water. >> that includes donna and phil welch. when they built their home n 2001, they thought they were moving into an ideal countryside home.

>> and we were so excited about moving to the country. um, fresh air, you know, kind of john denver-ish generation that we were from. and we were excited about bringing our children to the country. you know, building the home of our dreams. >> instead, like others in juliette, they got sick. >> several years after we moved in, i started developing some numbness in my feet. first in one foot, and then it just kept getting worse. and it just really was concerning. i would lose my balance. then, i had a stomachache for 3 weeks, really, really bad. i had been to the doctor, he drew blood, and he called me at work and said, your liver is almost in failure. he said, i've never seen liver enzymes as high as yours are. >> donna isn't the only one with severe health issues. mark goolsby, who once worked at the plant, doesn't believe it's safe to live here. >> there's been 12 people on

this road alone die with different kinds of cancer. my mother's probably a mile or less from the plant. my mother stays chronically ill with sinus infections. there's other families on this particular road, they have neurological problems, and all of this is documented through the local doctors. >> there was one article in our macon paper about a lady that lives maybe 2 miles from here. her husband had passed away, and he had had a rare form of cancer. before he died, she had both their hair tested, and it came up very high in some heavy metal elements. and so she had her water tested. we thought surely that's not our problem, but we might as well have it tested. >> donna sent her water here, to the university of georgia's water testing facility. using sophisticated instruments, technicians like jake mower are able to determine what elements are present in a water sample.

>> donna welch and i have spoken many times. she had a--a very elevated amount of uranium in her well water. she also had radon in her water and radon in her home air. so her family was exposed to quite a bit of environmental toxicity. uranium will break down to radon, radium. they are classified as carcinogens. i think it would be very interesting to find out exactly what the source of the uranium contamination is, largely because her case was a little severe. i think it's a little unusual. >> now donna has no safe well water coming to her home and must rely on bottled water for everyday needs. >> you can imagine how many i go through and just the, um, you know, not being able to just have the simple convenience of running water in your home that's--that's safe. so it's a--

it's a chore. >> the story isn't much different in one tri-county area of pennsylvania. instead of one coal-fired power plant, there are 6. unlike plant scherer, which burns pure coal, these plants are burning coal waste left over by previous mining. coal waste, also called culm, can now be burned to generate power. but there are some downsides. not only is coal waste less efficient than regular coal, it also has higher concentrations of heavy metals. >> matter doesn't disappear. metals don't just disappear. they can't. and so when you burn waste coal, those metals, like lead and arsenic and cadmium, are left more concentrated than ever in the waste coal ash. 9- to 10 million tons of coal ash are dumped every year in pennsylvania. and a lot of it is happening right here in schuylkill county and

surrounding counties. >> john kolbush, a local resident and survivor of leukemia, has coal ash being dumped just minutes from his house. here at the northeastern power company in mcadoo, coal ash is trucked from the plant straight through the heart of town to an old mine site for dumping, bringing toxic coal ash ever closer to people. >> when--when the trucks are leaving and when they're fully loaded, the ashes is blowing out of the vehicles. and when they come through town here, empty, they don't have the tarps on, the ash just blows. if you see some of the houses, the sidings on the houses with the thick accumulation of soot and ash. a year and half ago, we came

through there, and it was a really windy day, it was like a smog going through it. none of the ash was covered and it's just--it was actually like driving through a fog. and it's just a--it's a crime. there's the one that we just followed down the road. he's dumping and you can see the ash there. this pit was approximately 300 feet deep. it's all filled with ashes. they run probably two dozen trucks continuous all day long, 6 days a week. >> tons of coal ash are dumped legally in unlined pits every year, even though the u.s. environmental protection agency acknowledges coal ash can cause serious health effects. coal ash

is also being used in creating products like roofing material, bricks, and concrete. the epa calls this "beneficial use," and members of the coal industry claim reusing coal ash provides an environmental benefit. >> there are a wide variety of things we can use coal ash for, rather than throw it away. the most prominent uses are, uh, using coal fly ash in concrete. every ton of fly ash we put into concrete is a ton of cement that doesn't need to be made, and not making that ton of cement has saved over 11 million tons of co2 emissions last year alone. used properly, coal ash is a safe material for beneficial use. the levels of metals in coal ash are comparable to the levels of metals in the dirt and rocks in your backyard. we believe the best solution to coal ash disposal problems is to quit throwing it away. in parts of the country, these historic coal mines have a tremendous problem with acid mine drainage.

you've seen the orange-colored creeks and those kind of things. coal ash can actually be used, uh, to modify the ph in those settings and relieve that acid mine drainage. so that's an example where you actually want to put the coal ash in contact with the water because it's-- it improves the water quality by doing that. >> but local people in pennsylvania disagree. >> this is actually the opening from the gilberton mineshaft. they have put 16 million tons of fly ash into the beaty mining and the owen gowen site to control acid mine drainage. and this is what's coming out from underneath them. and you can see on the rocks up there in the corner, you can see acid mine drainage. you can see the iron pyrite. right there's the ash, all the way back there. wow.

there's no liner. there's no nothing. it's just poured on the ground. underneath most of these sites, you have mine pools. there's more chemicals in there probably than you'd have in the average chemical factory. and it's all leaching into the ground to whatever mine pool is underneath, to god knows whose water supply where. >> we're talking about a quarter of a million people live here. now, people aren't drinking all that mine pool water. they're drinking reservoir water that the mine pool helps feed. the water that flows into those reservoirs comes from groundwater and from mine pools and from springs that come out of the sides of mountains. and the danger is if you contaminate too many of those sources, then you have a health threat. >> just as in juliette, georgia, people here are also getting sick. if you type in hazleton, it does come up cancer capital of pennsylvania. >> this is ground zero for the polycythemia vera cancer investigation.

>> called pv for short, polycythemia vera is a rare form of blood cancer in most of the u.s. but here, there's a confirmed cluster of pv cases. >> in 2004, we learned that there were 67 diagnosed cases of polycythemia vera, which ultimately led to the--to the confirmation of a cancer cluster. since then, 130 cases of polycythemia vera have been reported to the pa cancer registry. >> people with pv, like debra trently and merle wertman, suffer from an overproduction of red blood cells. >> so the blood gets very thick, and it can cause, you know, blockages to smaller blood vessels that feed vital organs of our body. tissue death can occur anywhere in the body. it can occur in their brain, it can occur in their toe, it can occur in their liver. we've seen patients where they've developed infarctions to their feet, where they've had to have toes amputated. they have infarctions to their liver. they can have an infarction to their heart, much

like a heart attack. >> the way it works on you, you're so exhausted and tired, you have chronic pain everywhere. i have chronic fatigue. headaches, terrible. it affects your vision. i'll just wake up and have pains in my legs and my hands and my feet. it's vascular, so it goes through every part, every vein on your body, you're having a lot of pain, every direction. you don't know where to put yourself. >> for merle, who has been a sports fanatic all his life, pv has really changed his once active lifestyle. >> these are--some of these are pete rose. he's my favorite. steve carlton. he's a... sometimes i get moody and miserable, but i don't think i was always that way. they give me a phlebotomy. uh, they stick a 12-gauge needle in your arm and they draw all the blood out of you. usually 26 ounces they take out. when i first got this, it was, uh, i was getting it twice a month,

every two weeks. >> in the 22-square mile polycythemia vera research cluster area, uh, there's a number of environmental assaults. at least 6 known super-fund sites, 6 waste coal generators, and over 23 unlined waste coal ash pits, all surrounding our community's public water supplies and private well users. from a scientific perspective, it's known that polycythemia vera is an acquired cancer, meaning that it's likely of the environment. you're not born with it. so now we're looking at this very complex mystery of the environment and its potential link in causing p. vera. >> the search for answers began here, at the now silent home of betty and lester kester. >> what is happening here is not beautiful. it's not a pretty story. as beautiful as my parents' life was, and as many

wonderful things they had in it, the p. vera, it really affected their life in a dramatic way. both passed away in 2008. the p. vera took their lives within about 5 years from the time that they were diagnosed with it. >> ground zero for polycythemia vera in the free world, or in the world in general, was betty and lester kester. when betty kester died, she had decided to donate her body to science for the investigation. >> her body tissues eventually found their way here to dr. ronald hoffman's lab in mt. sinai hospital in new york city. he has spent nearly 40 years studying pv. >> there were too many patients with polycythemia vera in that-- in that area than one could account for. whether the environment or toxins in the environment lead to an increased risk of polycythemia vera is unknown. that's really an area

of research and also speculation. the problem is that there are multiple toxic compounds that are in the ground and also in the air in this area, and to prove a one-to-one relationship is going to be very, very tough. in this area, there were a lot of super-fund sites and coal mines. so, you know, they weren't here, they weren't there. they were here. and that was the concern. and that's the concern in my mind to this day. it's a question mark. i don't have the answer to this. i'm not a statistician, but intuitively it would seem to me more than chance that--that this would occur. >> while science continues to gather evidence, some people believe that politics and profit are outweighing the need to protect public health.

>> whether it's a democratic administration or a republican administration, coal talks. >> government agencies, in my opinion, have more been apt to represent the best interests of the polluters. they seem to have rights more so than what people do. >> georgia power, i think, is very effective in influencing, if not controlling, what gets voted on. they get what they want. i'm trying to figure out if they ever don't get what they want. >> there's no monitoring systems, there's no liner systems. there's a whole litany of things that just are absent, uh, from how we conduct our environmental business. >> in pennsylvania, two agencies, the state department of environmental protection and the federal agency for toxic substances and disease registry are obligated to protect public health. but they have both drawn criticism for not adequately addressing the contamination problem. >> the monitoring is overseen by the department of

environmental protection. we have one site where a public water supply has been contaminated with arsenic. the epa's toxic release inventory indicates that high levels of arsenic was found in much of the ash that was dumped at this site. all right? so, you know, simply from the standpoint of the waste stream, the quality of the waste stream and what has happened to the public water supply, indicates an adequate study should have been done to determine if there is a connection between the disposal site and the well. this never did occur. the public have been simply brushed off and told, don't worry, trust us. you are adequately protected. but once again, this is being done without any adequate data to give to the public. and consequently the public is saying, should we trust the people that are supposed to protect us? >> for the last 20 years, these federal and state agencies, the same ones that have been

investigating this problem, have been promoting this process of dumping the coal ash without any safeguards. for them to now, uh, admit that they think that the coal ash is causing these cancers would be to admit that they caused this whole problem in the first place. >> while families wait for answers, toxic ash continues to pile up. back in georgia, people aren't just frustrated about poor regulation, they're claiming that georgia power is trying to hide the problem. georgia power will tell you the 750-acre unlined pond poses no threat to local residents. but behind this good-neighbor disguise, some company actions suggest that they know there is a problem. in the last decade, georgia power bought several homes from residents with particularly poor health. >> my aunt, she was bought out last july. she had been out here since 1976. and her concrete

driveway starting turning black. her brick started to turning. she would go out in the yard and have severe nosebleeds. then she developed breast cancer. when my aunt's house was purchased, they hired a contractor to come in. they filled the well, they filled the septic tank, tore her house down, tore up the concrete driveway, planted pine trees, like there's nothin' ever been there. put up a fence and posted signs. but we feel kind of like david going up against goliath, you know. it's, uh, to me, to buy out one person on this road that complained about it, go 5 miles down the road, buy out another family, but yet leave people close to the plant that's in harm's way, i say, uh, to have to breathe in this coal dust and this fly ash, they're trying to hide something. and i think georgia power has known all along that there's been a problem. >> mark isn't the only one who shares that opinion. local lawyer brian adams, who grew up near the plant, now represents over 100 juliette

residents who are suing the plant for environmental contamination. >> there have been deaths that we attribute that are related to the toxins that are coming from the plant. linking everything together is certainly one of the scientific issues that we're working on, but we-- we know that there were bad things, bad contaminants that are coming from the plant that are getting to the people in the community that are causing health problems. we do have liver cancer, kidney cancer, stomach cancer, all that we are afraid is attributed to the contaminations. i think as people realize that maybe georgia power has known that some of this stuff is not good and not good for the area, and they never said anything, instead encouraged people to be in that area, that's where the anger really starts to get in, because, again, they feel like they've been lied to. the thing is, georgia power does do some good things for the community. they help people in the community, they give back, they give to good causes. a lot of people in that community, they do work there. but it's in part to cover up these callous and cruel things

that they know they've done. they've know this stuff is gonna cause problems, and it appears that they don't really care. a lot of our claims are based on some common law claims that say, look, you can't do something and harm your neighbor. and that's what they're doing. they're harming their neighbor. and that is a violation of the law. >> as litigation in georgia slowly plays out, coal ash dumps across the u.s. continue to be regulated at the state level, resulting in a patchwork of standards. many states, like georgia and pennsylvania, exempt coal ash from hazardous waste regulation. at the federal level, debate over coal ash regulation has dragged on for decades. and despite recent coal ash spills in north carolina, coal ash has yet to receive federal regulation. >> garbage disposal and trash is probably more regulated than coal ash is. without any question, we need

a national regulation to establish a bar that every state has to meet. and this is how we're going to protect the public. >> the government has been sued to demand that they do something about this. the problem is that the power companies have known since the seventies and probably longer than that that this coal ash is such a massive, huge amount of waste that they don't know what to do with. they have fought for years and years and years to make sure that the regulations don't make it difficult for them to get rid of this stuff. >> the message for the communities are you have to defend yourself and know that your government that you are financing is not adequately defending your health, safety, and welfare, nor your rights to clean air, clean land, and clean water. >> the people who live around coal ash dump sites believe they are being shrugged off as collateral damage, by both corporate interests and slow-moving government agencies. more than anyone, they know what's at stake. >> i've lived 55 years.

and i know that it's a tough economy and people have to make tough decisions. um, i do think that power and money and greed is a big--is a big part of it. >> i do believe that we need energy. i do believe that we-- i'm not against coal. the thing that i would like to see is, um, not shutting the company down or anything like that. i just do not want these contaminants seeping into the underground water. >> if we could just let people have clean water and clean air to breathe. and just get back to the business of living and not worried about dying. >> burning coal to generate power isn't going away anytime soon. but there is a changing climate in the energy sector. >> the way we produce power in this country is changing, and it will continue to change. at the end of the day, i think we're all realizing that you cannot make a coal plant as safe as you

can make other energy production. >> and while we rely heavily on coal now, that does not excuse the coal industry from its obligation to operate safely. that, too, is a cost of doing business. gg99ññwçça7guc

>> a few years ago, costa rica set itself an ambitious goal to fight climate change. the small central american country said it wants to have a carbon neutral economy by 2021. how far has it got? more on that in a bit. but first, a warm welcome to "global 3000." i'm amrita cheema. coming up in the show -- the click business -- buying online friends from bangladesh. underage marriage in mozambique-- robbing girls of their childhood

and future. and, old and lonely? senior citizens in japan find ways to cope. most of us can't imagine a world without social media anymore. it has become a part of our lives. how big a part, of course, varies. facebook, twitter, and similar sites have changed the way we communicate, but they are also influencing the way business is done. companies big and small are using these platforms to gain access to consumers. the more friends and likes they get for their products, the more customers they can expect. the hunt for more fans to boost a company's online image has led to the creation of what are known as click farms. we visited one site in bangladesh to see how it works. >> likes are the new currency on the internet. dhaka, the capital of

bangladesh. it's also the global capital of click farms. the country is one of the poorest in the world, yet it's also home to a young, upwardly mobile middle class that uses digital media on smartphones and computers. boosting fan numbers on commission is a booming business. we contacted 18 click farms, but only one of the companies agreed to let us film there. we set off to look for it, but it wasn't easy. few streets here have names. finally, we find it, at the end of a small street on the outskirts of dhaka, where rents and wages are cheap. the zaman it company is in a narrow, six-story building. we meet the owner, masud rana, a 29-year-old with a university degree in computer science.

he employs 20 people, who click their way to their commissions. the boss shows us how easy it is. >> if i want to see, we click like. just click on it. >> the company uses thousands of real facebook accounts owned by people willing to exchange their passwords for a small fee. >> i started my business from 2008, and now my clients are almost 2,500 plus. on average, we can create 1,000 clicks per day. and if a client's requirements are from per day 100,000 clicks, we hire more people to click more. >> the clients are largely online retailers in europe and north america. companies are increasingly hoping more social media likes will result in a better image, more attention, and therefore

more sales. 1,000 likes cost them two euros. and the employees have to put in a lot of time to get them. >> it's no problem for me. it's a good first job after getting my degree, and the work is fine. >> the employees earn 60 euros a month. they work in two shifts for round-the-clock clicking, six days a week. >> clicking is a totally normal job. i have no qualms about it. >> company owner masud rana doesn't either and his clients certainly don't. rana shows us an especially blatant example of a bangladeshi businessman who hopes to get into politics. >> we just got for him 50,499 likes. >> there are no laws in bangladesh against click farming, and the promise of

quick cash is leading to many new companies being started. >> in our country, there are 5,000 students graduating in computer science and computer engineering. they have not such a job in the market. they want an outsourcing business for their income. >> these computer science students, all in their 20s, have also discovered click farming as a source of income. they're doing it to pay for their studies. we meet them in a private home. they used to use an automatic computer program. >> 1000 likes in five or three minutes. >> they demonstrate using a facebook page for a german news program. a few keystrokes, and the number of likes rises. but this kind of fraud is easy to uncover. facebook deleted the automatically added numbers the

next day. now the students use the real facebook accounts of their friends. >> i save a lot of the money i'm earning because i want to start my own company after getting my degree. >> that hope for a better life also drives masud rana. he still lives with his parents and siblings in a small apartment, eight people crammed into 50 square meters. >> i want to buy a flat first because i am in a rent now. but i have a flat, my satisfaction will increase, you know? that's the main fact. and my other plan is that i want to buy an exclusive bmw car. >> for the time being, rana still rides a motorcycle. but judging by the demand for click farms, he'll be able to upgrade soon. >> there is general consensus worldwide about the urgency of dealing with the impact of climate change.

but as we have seen at various international conferences, sharp divisions remain on how we should go about it. the central american nation of costa rica has come up with its own strategy. a quarter of the country has been designated a nature reserve to protect the region's bio- diversity and reduce environmental degradation. various initiatives have brought progress, but as we hear, it is sometimes tough to find the right balance between economic and environmental interests. >> it's night-time on this beach on costa rica's southern pacific coast. a female sea turtle buries her eggs in the sand, watched over by police officers who see wildlife protection as national duty. once the turtle has disappeared back into the sea, they gather the eggs. >> she made a nest, but there's

a risk that the waves will wash it away. so, we're taking the eggs out and putting them in an incubator. >> this is a city administration initiative, and for this german expert, it's a model for the future. michael schlönvoigt is looking for ways to help protect costa rica's biodiversity. the landscape here is changing, sometimes very quickly. here, for instance, several meters of coastline have disappeared in the past three months, after a large river altered its flow. >> this is in part a result of climate change. there's an increase in rainfall intensity. but it's also a result of human intervention. if you look, you can see there are a lot of tree trunks moving in the river. deforestation in higher areas, in the highlands, has increased the speed of the river's flow,

and then the river floods more easily when it rains. >> predicting changes to the landscape and advising politicians is michael schlönvoigt's job. today, he's in the capital san josé to consult with costa rican authorities. his task is to help draw up guidelines for conservation areas, with a special focus on climate change. >> thanks to a gap analysis, we discovered that certain conservation areas are too small. they're not big enough to be able to adapt to the effects of climate change. >> in order to protect the country's biodiversity, some of the conservation areas are to be connected with others, and the areas redrawn. so, where should the new borders be, and how can conservation be carried out? >> it all depends on the relationships we have to the fishermen and the local authorities.

it's up to them whether we'll be able to expand these zones or not. >> a coral reef in the marino ballena national park. these corals look the way they're supposed to. the marine biologist is satisfied. >> what a beautiful place. the reef is in very good shape, really, really nice. the corals look really good, the surface is perfect and there are a lot of fish. >> one of the reasons is that there are very strict rules in the national park. snorkeling and looking is allowed. touching is strictly forbidden. schlönvoigt points to the marino ballena national park as a good example. here, authorities were able to get local residents on board years ago, but only after dealing with angry protests.

the fishermen were worried about their livelihoods. >> a guard station was burned down in 1994. we don't know who did it. maybe it was because of a conflict of interest. but today, the fishermen from the 1990's work as tour guides. >> there are only a few fishing boats now, out along the edge of the national park. most of the fishermen have retrained as tour guides and their new careers have changed the way they think. >> it used to be that the national park meant that we weren't allowed to fish. but later, and thanks to the training, we changed our minds. we now look at nature in a new way. >> by taking tourists on whale watches, the former fisherman now earns three times as much as he used to.

but in a nearby mangrove swamp, things aren't looking so good. there are dead trees marring the idyll. >> why are these trees here so bare? what happened? >> it's mainly from chemicals. they're sprayed on pineapple plantations here in the area. rice paddies, too. and on the oil palm tree plantations here in front of us. >> the problem is that agriculture is creeping too close to the conservation area. but there's no money to enforce laws and compensate local residents. but schlönvoigt has an idea. >> we've found out that up to 400 tons of co2 per hectare can be absorbed. and here, we have a total of 16,000 hectares of connected rainforest or mangrove swamp. so, there's a huge capacity for absorbing co2. we're now conducting a study to

see if we can get the mangrove swamp into a redd process. we're very optimistic that it will happen. >> redd stands for "reducing emissions from deforestation and forest degradation" and is a kind of co2 offset scheme. the credits could be used to preserve the mangrove swamp. businesses are also being asked to do their part. the hotels depend on tourists who also come for the natural beauty. so here, an international hotel chain is sponsoring an initiative where children help reforest a section of the coastline. the trees will give shade and help fight erosion. it's an exemplary project, but many more are needed. >> we assume that currently, under-financing of the entire conservation area system is at 100%. we have a budget of maybe $50 million to $60 million a year provided by the conservation area authority. but we really need around $100 million to manage everything

properly. >> in order to find the funds needed, the experts on the ground still need a lot more good ideas. >> there is increasing concern about the high number of child marriages in the world. globally, an estimated 14 million girls are married off annually before they turn 18. in most cases, without their consent. these girls are deprived of their childhood, their right to education and opportunities according to unicef, in over 70% of marriages in niger, the girls are underage. in chad and bangladesh, it's over 60% and in mozambique, more than 50% of girls are married off before they turn 18. child marriage also has a very detrimental affect on the health of girls, who often become mothers at a young age. we take a closer look at this

problem in mozambique. >> ilse guambe is 15 years old and a mother. that's nothing unusual in rural mozambique, where half of all girls are married before they're of legal age. one in five is married before the age of 15. their husbands' families generally just see them as cheap labor. >> after i had my baby, my parents sent me to my in-laws. all they did was insult me. i wasn't welcome there. >> and ilse was one of the lucky ones. she and her child are healthy. essita muhlanga lives far away from the nearest hospital. >> it happened during the birth. when it was over, i was incontinent. >> her husband works in south africa. just 14, essita was alone when she went into labor. her baby was too big, and the birth took several days. the pressure from the baby cut off blood flow in her pelvis,

causing tissue damage and tearing. >> after the birth, my baby was very weak and died. i was very sad. then i noticed that i could hardly walk anymore. >> the world health organization says some 3.5 million women around the world suffer this kind of injury, called obstetric fistula. it's rare in industrialized nations, where caesarean deliveries are carried out in complicated cases. essita's going to have surgery at the hospital in muzrisi, which specializes in treating fistulas. it's supported by the un's population fund. dr. michaque tembe says pregnancies among young girls are one of the biggest problems in rural mozambique. >> these child weddings are a terrible thing. the girls aren't ready for pregnancy yet, and not only physically. the children should not have to be responsible yet for their own children.

>> but it's not only about giving the young mothers medical care, it's also about education. actors have come to this actors have come to this village, putting the suffering of child brides on stage. the play is meant to convince the elders, the decision-makers in the village. the legal marriage age in mozambique is actually 16. and after today, no one in the village can say they didn't know that. salmina cumbane, who herself was a child bride, thinks the campaign is working. >> when the play started, most of the village elders here thought it was fine to force a girl to marry against her will.

but i think that the longer they watched, the better they understood that you shouldn't force children to marry. they should go to school and then decide themselves whom they want to marry. >> going back to school offers the girls a chance to determine the course of their own lives. >> all i want is to go back to school. i don't want to go back to my husband. i suffered so much, too much. when i finish school, then i can get job training and earn my own money. >> for the young mothers, childhood is over. but perhaps their daughters can look forward to a better future. >> from girls robbed of their health and of opportunities in mozambique to a rapidly aging population in japan. falling fertility rates in countries like germany are

contributing to what is called a graying population. but it's less well known that the problem is equally acute in japan, where almost a quarter of the population is over 65 years of age. senior citizens living in small towns and villages often face an isolated and lonely future. we take a look at some innovative ways to help them cope. >> tomo choki begins the day with a prayer of thanks and offerings on the home altar. she believes she'd no longer be alive without divine help. >> thank you for letting me wake up healthy again. please let me spend the day without any problems. >> a day like any other, spent alone with nothing but photographs for company. her father. her mother and her husband, who died three years ago. since then, the 86-year-old widow has lived by herself. >> in the evening, when it gets dark outside, it's difficult for me. i shut the windows, draw the curtains, and turn all the lamps on, so it's really bright.

then i turn on the tv, so i don't feel so lonely. >> her three children left their home in southern japan and now live in cities. they call their mother often, but they don't want to move back. and tomo doesn't want to move in with one of them. she says someone has to look after the house, that's the tradition. she lives in a valley on the japanese island of kyushu, where rice paddies shimmer in the sunlight. the soil has always provided food for the people here. but many no longer want to live here. abandoned houses, places that have been uninhabited for years, their owners dead, the children moved away. in some villages, 70% of the population is of retirement age. tomo choki doesn't often have visitors. sometimes masayoshi kiyohara from the neighborhood committee comes by. his main concern is that old

people could die alone in their homes, helpless. so, the villagers have come up with a solution. every morning, they put up a yellow flag in front of their houses. >> we put the flag out in the morning, and bring it in again at night. everyone in the village has to participate, and then it works. when we see the flag, then everyone knows the people inside are fine. >> if the flag fails to appear, the house is immediately visited by a neighbor, and medical help provided when needed. the idea has spread to many neighboring villages, too. but it doesn't solve the fundamental problem. no pitter-patter of tiny feet here in this schoolyard. an exercise class is taking place in the former school cafeteria. people who come to this school

in the small town of kunisaki want to learn how to stay mobile. a social services provider has taken over the building. but the original rooms were too big for their new uses. >> this used to be one big classroom. we turned it into four separate rooms for resident care. the windows stayed as they are, and the tables are from the school. each resident has one. >> once, this school had 400 pupils. there were five children in the last graduating class. in 2008, the school was closed. what the town now needs is effective senior care. that's the case all over japan, not just in remote areas. this is a trade fair for nursing products in tokyo. the demographic shift in japan has also opened up a huge new market for things like adult diapers with a suction device, meaning they can be changed less

often. the nursing products industry has seen the writing on the wall. this is a bed that can monitor a patient's heartbeat and send the information to doctors or family members. many of the innovative products have one goal -- helping seniors to live independently. there's a device that helps you stand up, and robot modules make climbing stairs easier. and for emotional needs, a robot made to look like a baby seal. it has a sensor that reacts to touch and kind words. the modern generation of robots doesn't avoid physical contact. just the opposite. they're meant to help where human contact is lacking. "i'm palro" it says, "i'm responsible for the entertainment here. i'll try to do my best, so be kind to me! a round of applause!"

there's not much that palro can't do. >> palro can entertain an audience at a nursing home for 20 minutes. it asks quiz questions, dances, and plays with people. the reaction to it is positive. it's also used in day centers. the clients enjoy going there when they hear, "palro is here!" >> here among the rice paddies in kyushu, there are no robots. instead, the neighbors look after one other. that's a help to tomo choki, but it can't replace what once was. >> when my children were small, the house was full of life and noise. they were always running around.

those days are gone. now my children have families of their own. i have ten great-grandchildren. they like me, and when they call out, "grandma, grandma!", it makes me very happy. >> happiness is when the children come home. if only they came more often, her yellow flag wouldn't be such a lifeline. >> the challenges of an aging society -- not just confined to western nations but also a growing problem in asia. that's it for now. don't forget you can go to our website for more information on those and other stories. from me, amrita cheema, and the "global 3000" team here in berlin, thanks for being with us. michaela küfner will be back with you next week. be sure to join us. until then, goodbye. captioned by the national captioning institute --www.ncicap.org--gg99ññwçça7gx