After NRA Mocks Doctors, Physicians Reply: 'This Is Our Lane'

Doctors have been tweeting about their experiences treating victims of gun violence after the NRA mocked a position paper by the American College of Physicians. Above, the NRA logo in 2017 at an outdoor sports trade show in Harrisburg, Penn.

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Note: This story includes graphic imagery and language.

A mocking tweet from the National Rifle Association has stirred many physicians to post on social media about their tragically frequent experiences treating patients in the aftermath of gun violence.

“Someone should tell self-important anti-gun doctors to stay in their lane,” the NRA tweeted on Thursday. “Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves.”

Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves. https://t.co/oCR3uiLtS7

— NRA (@NRA) November 7, 2018

The NRA was criticizing the American College of Physicians’ (ACP) new position paper, in which the physicians’ group outlines its public health approach to reducing deaths and injuries from firearms.

“We are not anti-gun: we are anti-bullet holes in our patients,” Esther Choo, a doctor and professor of emergency medicine at Oregon Health & Science University, replied on Twitter. “Most upsetting, actually, is death and disability from gun violence that is unparalleled in the world.”

We are not self-important: we are important to the care of others
We are not anti-gun: we are anti-bullet holes in our patients
We consult with everyone but extremists
Most upsetting, actually, is death and disability from gun violence that is unparalleled in the world https://t.co/E8qz3lewK7

— Esther Choo MD MPH (@choo_ek) November 8, 2018

The NRA posted its tweet just hours before a man shot and killed 12 people at a country-western bar in Thousand Oaks, Calif.

“I would like to graciously extend the invitation to the author of this tweet and anyone else from the NRA to join me at the hospital the next time I care for a child who has been hurt or killed by a gun that wasn’t safely stored or was an innocent bystander,” tweeted Jeannie Moorjani, a pediatric doctor in Orlando.

More physicians weighed in, often using the hashtag #ThisIsOurLane.

“Do you have any idea how many bullets I pull out of corpses weekly? This isn’t just my lane. It’s my f****** highway,” wrote forensic pathologist Judy Melinek, in a tweet that has gone viral.

A trauma surgeon in Utah tweeted a photo of his blue scrubs covered in blood. “Can’t post a patient photo,” he wrote, “so this is a selfie. This is what it looks like to #stayinmylane.”

Can’t post a patient photo…. so this is a selfie.

This is what it looks like to #stayinmylane. @NRA @JosephSakran pic.twitter.com/bVPtXH9oXn

— Dave Morris (@traumadmo) November 10, 2018

Hey @NRA ! Wanna see my lane? Here’s the chair I sit in when I tell parents their kids are dead. How dare you tell me I can’t research evidence based solutions. #ThisISMyLane #ThisIsOurLane #thequietroom pic.twitter.com/y7tBAuje8O

— Stephanie Bonne (@scrubbedin) November 9, 2018

Good morning! Just a reminder @NRA : #ThisISMyLane #ThisISOurLane . She didn’t make it. pic.twitter.com/LMnev4bylF

— Stephanie Bonne (@scrubbedin) November 10, 2018

The NRA’s criticism of the physicians’ position paper hinges in part on research studies cited by the ACP.

“The problem is that the ACP cites ‘studies’ that wouldn’t qualify as ‘evidence’ in any other debate,” the gun advocacy organization argued in an article posted at the NRA Institute for Legislative Action. “One cited study was focused on a single rural county in Iowa. Another was of 106 outpatients at a single clinic. The authors acknowledge evidence is limited but cite their own belief there is ‘enough evidence’ or simply argue the policy should be enacted anyway. Inconclusive evidence is not ‘enough evidence.’ Applying narrow findings to a larger population is not ‘enough evidence.'”

The paper’s co-author, ACP Senior Vice President of Governmental Affairs and Public Policy Robert Doherty, responded to the NRA’s criticism in a series of tweets.

“All of our recommendations are supported by a comprehensive review of research on the causes of gun violence, & policies that could reduce it. Where the evidence is limited, we said so,” he wrote. “All of our recommendations were reviewed and approved by ACP physician-members who serve on our health policy committee, several of whom are gun owners.”

Doherty also noted that the paper calls for increased funding for research on gun violence.

For years, the NRA has lobbied to prevent the Centers for Disease Control and Prevention from conducting research on gun violence. A spending bill passed in March of this year notes that the CDC has the authority to do research on the “causes” of gun violence. But it doesn’t change the 1996 law that mandates “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention (CDC) may be used to advocate or promote gun control.” The rule has had a chilling effect on gun research in the U.S. ever since.

Which makes the NRA’s criticism about physicians not having adequate research particularly frustrating to doctors like Melinek.

“We aren’t against the second amendment,” she told The Guardian. “What we are against is not researching, not putting effort into researching, and not putting the funding into researching what can be used to prevent gun violence and death, whether it’s trigger locks, security, training or the idea of requiring insurance and having people have insurance in case their gun is used to kill someone else. We need to have the research and we need to have the data to back it up, and right now that’s not happening.”

“We need to do something, and telling doctors to say in their own lane is not the way to do it,” she told the newspaper. “We’re the ones who have to deal with the consequences. We’re the ones who have to testify in court about the wounds. We’re the ones who have to talk to the family members. It breaks my heart, and it’s just another day in America.”

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Reporting On Mass Shootings: A Familiar Heartbreaking Script

People gather to pray for the victims of a mass shooting during a candlelight vigil in Thousand Oaks, Calif., Thursday, Nov. 8, 2018. A gunman opened fire Wednesday evening inside a country music bar, killing multiple people, including a responding sheriff’s sergeant.

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Ringo H.W. Chiu/AP

This past week there was yet another tragic mass shooting, this time at the Borderline Bar and Grill in Thousand Oaks, Calif. Twelve people were killed before the gunman fatally turned the gun on himself. It’s an all too common scene. According to the Gun Violence Archive, which defines mass shootings as an incident in which four or more people are killed or injured, there was one almost every day of the past two weeks, another just Saturday in Tennessee.

And as journalists, we are now covering mass shootings not once, not twice but repeatedly as they happen more frequently across the country. And we’re finding people who’ve been through more than one in their lifetime.

Familiar and heartbreaking script

It starts with a phone call, usually in the middle of the night. You know without looking at the screen of your phone. You know that somewhere, someone has chosen to kill a lot of people. Now your job is to go bear witness. To try to tell the world why, speak to grieving families on the worst days of their lives so that millions of people can mourn with them and know the beautiful details of what makes a person special, what families and loved ones remember about their relatives who were killed.

This past week I learned about a college freshman who was beyond excited to vote for the first time, a navy veteran who loved line dancing, and the people who died because they stayed behind to help others live.

These days it feels like these shootings follow a familiar and heartbreaking script. First, the press conference where law enforcement officers tell their community what’s happened and reassure them that everything will be OK. Like Ventura County Sheriff Geoff Dean did this week before he retired. One of his own men was among the dead: Sgt. Ron Helus, who responded to the shooting first and died trying to stop it.

Then there are the families scrambling to find out if their loved ones lived or died. Like Marc Orfanos whose son Telemachus, already a survivor of the Las Vegas mass shooting, was at the bar. Marc got a phone call at 2 a.m. from a friend in New York who knew that his son, who the family calls Tel, frequents the bar. They rushed there. A friend said he thought Tel got out. But 10 hours later the Orfanos found out their 27-year-old son didn’t survive.

And now a video of his mother, Susan, has gone viral as she demands gun control. Inside this bar, Tel died the second time he was in the wrong place at the wrong time. Several other people at the bar that night had survived Las Vegas and now survived this. It was a shooting that I also covered. Maybe I met some of them when I talked to survivors then.

As the identities of victims are revealed, the grieving begins, and the community comes together. There are the piles of teddy bears, crosses, letters, candles and tears. The vigils with different renditions of “Amazing Grace.” And in the back of your mind you know that it will happen, again and again and again.

Since returning to the United States in 2016 from reporting in the Middle East for more than a decade, I’ve covered three mass shootings in just over a year. I thought I’d left this type of violence behind me in war-torn countries like Iraq, Libya and Syria. But my stateside colleagues and I share the responsibilities of documenting these horrific incidents and the aftermath.

Like NPR’s Nate Rott, who’s covered eight mass shootings for NPR.

“The best word I can think to describe how I feel when I have to go cover one of these things, is just deflated,” he said. “You feel like you’re telling the same story over and over and over with different places and different names and maybe different reason. I think the hardest thing recently is this sense of inevitability that you hear from people. People aren’t necessarily surprised that it happened. There’s this sense, ‘Well, it was only a matter of time before it happened here,’ and as a human that’s really hard to hear.”

It makes me think of working in Iraq, which I did for many years. In the years between 2006 and 2010, the bombings were so common that we stopped reporting on incidents that took less than 10 lives. Think about that — 10 lives lost, and it wasn’t shocking anymore, wasn’t newsworthy. It was a terrifying but steady part of life. People grew numb to the carnage, they didn’t let it sink in, didn’t want to hear about the impact of loss. It was easier for people to stop paying attention.

Veronica Hartfield stands with her son Ayzayah Hartfield during a candlelight vigil for her husband, Las Vegas police officer Charleston Hartfield, Thursday, Oct. 5, 2017, in Las Vegas. Hartfield was killed during the shooting at the Route 91 Harvest country music festival.

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Gregory Bull/AP

“Why someone does something like this?”

As journalists, we also want to provide information that the public wants to know. I know as a human being, I always want to know why someone does something like this, decides to pick up a gun and steal precious lives from us.

Finding the answer to that question usually falls to people like my NPR colleague Martin Kaste. He covers law enforcement and typically is the reporter looking for all the information we can find about the shooter.

“I’m getting really worried about that. There is research showing that talking too much about the shooter, talking about his motives, can inspire other shooters,” Kaste said.

Of course, there is some journalistic value to looking at motive, a person might be driven by some ideology, racism, hatred of a specific group of people. But often, like the case was in Las Vegas, there is no why, and maybe we shouldn’t ask why.

“Well, I think we need to stop assuming there is something interesting to be said about why someone did this,” Kaste said. “I think a lot of times these are empty gestures of violence that we should not dignify with the assumption that there is a reason behind it that needs to be discussed and shared with millions of people.”

So we’ve started saying the shooter’s name as few times as possible, instead focusing our reporting on families, the stories of victims, on policy debates.

A helplessness to the work of bearing witness

There’s something else about covering these tragedies that makes them really difficult. I hate walking up to the door of a family who I know is mourning. Who I know has lost someone they loved so much in such a sudden and horrific way. But I knock on those doors, I have to knock. Because I want them to be able to tell their story to the world if they want the world to know it. Because I want to give them the option of a platform to talk about their family member, their concerns about violence. I want them to have an opportunity, but it sometimes feels wrong. And you never know if the person on the other side of that door will be enraged by you or if they’ve been waiting for someone to just ask them, ‘Tell me about your child, or partner, or parent.”

There’s a helplessness to this work of bearing witness to something so terrible. It’s something NPR’s Hansi Lo Wang and I have talked about many times.

“As a reporter, I wonder, does bearing witness and telling people around the country the hurt, the death, the destruction, is that enough?” he asked.

We all ask ourselves, is this our new normal, this inexcusable business of carnage? How do we keep witnessing these things without growing an impenetrable skin so that the horrors of what is happening can’t sink in? So that we don’t have to face grief head on. So that we as a society can be numb. But we need to fight against that numbness so that it never becomes normal, so that it doesn’t become a steady part of life. So that we still cry when we see pain, and we still ask how do we stop this?

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World Leaders Warn Against Nationalism At World War I Remembrance Ceremony

President Trump, German Chancellor Angela Merkel and French President Emmanuel Macron took part in a ceremony Sunday to commemorate the end of World War I.

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At a ceremony in Paris on Sunday to commemorate the end of World War I, world leaders made impassioned pleas for global cooperation, with several making forceful denouncements against rising forces of nationalism.

In a speech at the Arc de Triomphe, French President Emmanuel Macron took aim at the style of nationalism that has been embraced by President Trump, warning a crowd of dignitaries and heads of state about how the splintering of multilateral institutions led to the first World War, and now threaten to divide the world once again.

“The traces of this war never went away,” Macron said, “The old demons are rising again.”

“Patriotism is the exact opposite of nationalism,” Macron continued. “Nationalism is a betrayal of patriotism. In saying ‘Our interests first, whatever happens to the others,’ you erase the most precious thing a nation can have, that which makes it live, that which causes it to be great and that which is most important: Its moral values.”

Among the dozens of world leaders in attendance were President Trump, Canadian Prime Minister Justin Trudeau, President Recep Tayyip Erdogan of Turkey and Israeli Prime Minister Benjamin Netanyahu.

Most of the world leaders attending the Armistice Day event were transported to the ceremony site in buses, and then marched together down the Champs-Elysees towards the Arc de Triomphe. President Trump and Russian President Vladimir Putin each arrived to the commemoration separately, citing security reasons.

LIVE – #WWI armistice centennial: World leaders walk toward the #ArcdeTriomphe as the commemoration ceremony starts in #Paris

Watch our live coverage here 🔽🔽https://t.co/u9ano6yR14 pic.twitter.com/OE5GbMlqvw

— FRANCE 24 English (@France24_en) November 11, 2018

Putin greeted Trump with a thumbs up at the ceremony. According to the Associated Press, Putin told Russian broadcaster RT he didn’t speak with President Trump in Paris, but said the two will meet on the sidelines of the Group of 20 summit in Argentina later this month.

Putin said he and Trump decided “not to interrupt the schedule” of the World War I events with a separate meeting.

France’s President Macron leads ceremony at Arc de Triomphe in Paris where 70 world leaders mark centenary of end of World War One #ArmisticeDay100

Live coverage: https://t.co/SgpOE8V2ca #LestWeForget pic.twitter.com/30DwAic3vs

— BBC News (World) (@BBCWorld) November 11, 2018

Later on Sunday, Macron convened a Paris Peace Forum, which he said would give world leaders an opportunity to discuss the miscalculations that led to World War I and promote concrete actions toward peace.

Celia Belin, a visiting fellow at the Brookings Institution, wrote that the forum was part of a broader effort by the international community to find “new approaches to save global cooperation.” According to Belin:

France—and Macron—are taking the lead to empower a global “resistance” of multilateralists hoping to salvage, or rebuild, a dwindling rules-based order. The question remains open whether the multilateralists can do that without U.S. leadership.

At the forum German Chancellor Angela Merkel warned against taking peace for granted, saying, “We have to work for it.”

United Nations Secretary General Antonio Guterres also spoke at the forum, and “warned of ‘parallels’ between the present day and the unstable and dangerous 1930s as he marked the centenary of World War I in a speech in Paris,” according to a report by RFI.

“‘As I see it, several elements today have many parallels with both the start of the twentieth century and the 1930s, giving us grounds to fear that an unpredictable chain of events could ensue,'” Guterres said at the forum, according to RFI.

President Trump did not attend the forum, instead visiting the Suresnes American Cemetery and Memorial outside of Paris before returning to Washington.

In his remarks at the cemetery, Trump said, “The American and French patriots of World War I embody the timeless virtues of our two republics.”

The president was widely criticized for not visiting the Aisne-Marne American Cemetery on Saturday, where 1,800 American soldiers were killed during World War I.

An armistice marked the official end of World War I at exactly 11:00am, 100 years ago. The global conflict originated in Europe, killing an estimated 8.5 million soldiers, and injuring 21 million more.

Countries around the world commemorated the armistice on Sunday, with New Zealand holding a 100-gun salute; planes dropping thousands of red paper poppies in Australia, and hundreds of bagpipers across the United Kingdom playing a lament at 6 a.m.

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Archaeologists Discover Dozens Of Cat Mummies, 100 Cat Statues In Ancient Tomb

Men carry mummified cats from a tomb at the Saqqara necropolis in Egypt on Saturday.

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Mohamed Abd El Ghany/Reuters

The more archaeologists continue to explore the tombs of ancient Egypt, the more evidence mounts that ancient Egyptians admired cats — and loved mummifying them.

Egypt’s Ministry of Antiquities announced Saturday that a team of Egyptian archeologists excavating a 4,500-year-old tomb near Cairo has found dozens of mummified cats. Also in the tomb were 100 gilded, wooden cat statues, as well as a bronze statue of Bastet, the goddess of cats.

The discoveries were made at a newly discovered tomb in Saqqara, the site of a necropolis used by the ancient city of Memphis. The tomb dates from the Fifth Dynasty of the Old Kingdom, and archaeologists have found another one nearby with its door still sealed – raising the possibility that its contents are untouched.

The Ministry of Antiquities was clear about its goals in announcing the discoveries: attracting visitors back to Egypt’s heritage sites, as the country has experienced a significant drop in tourists since the 2011 mass protests that overthrew dictatorial president Hosni Mubarak.

The ministry tweeted photos of the findings. Smartly, pictures of the cat statues took front and center – with the ancient felines looking proud and cool, like an upscale, 4,500-year-old version of what a cat fancier today might try to commission.

#Tens of #cats #mummies were unearthed in #Saqqara #necropolis along with 100 wooden #gilded #statues of #cats and a bronze one dedicated to the cat #goddess #bastet. pic.twitter.com/g0oSQPBhL8

— Ministry of Antiquities-Arab Republic of Egypt (@AntiquitiesOf) November 10, 2018

The mummified cats themselves – well, those images are more unsettling, though they offer incontrovertible evidence that mummification is highly effective.

#mummies of #cats #discoverd in #Saqqara (#Discovery pic.twitter.com/AFRNERfHBn

— Ministry of Antiquities-Arab Republic of Egypt (@AntiquitiesOf) November 10, 2018

While ancient Egyptians saw cats as divine, they didn’t exactly worship them, Antonietta Catanzariti, curator of the exhibit Divine Felines: Cats of Ancient Egypt, told NPR last year.

“What they did is to observe their behavior,” she said, and create gods and goddesses in their image – much as they did with other animals, including dogs, crocodiles, snakes, and bulls.

And while cat mummies are fascinating, Catanzariti said they were also pretty common in ancient Egypt, where cats were bred for the purpose. “In the 1890s, people from England went to Egypt and they collected all these mummies. One cargo was 180,000 of them.”

An Egyptian archaeologist cleans mummified cats in the necropolis at Saqqara, south of Cairo, on Saturday.

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Khaled Desouki/AFP/Getty Images

Perhaps, that’s why the antiquities ministry made a bigger deal about something else they found in the tomb: mummified scarab beetles. Two large specimens were found wrapped in linen, and apparently in very good condition. They were found inside sarcophagi decorated with drawings of scarabs.

#Discovery Unique #Discovery in #Saqqara #Giza #Egypt #mummies of #scarabs #AncientEgypt pic.twitter.com/FkCA9HxY5P

— Ministry of Antiquities-Arab Republic of Egypt (@AntiquitiesOf) November 10, 2018

“The (mummified) scarab is something really unique. It is something really a bit rare,” Mostafa Waziri, secretary-general of Egypt’s Supreme Council of Antiquities, told outlets including Reuters.

“A couple of days ago, when we discovered those coffins, they were sealed coffins with drawings of scarabs. I never heard about them before.”

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On 'SNL,' Lil Wayne And Future Address Consent

Lil Wayne, left, with Future during the sketch “Booty Anthem,” from the Nov. 10, 2018 episode of Saturday Night Live.

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NBC/Rosalind O’Connor/NBC

It took an elaborate satire for two of hip-hop’s biggest acts to address the elephant in the room of rap.

Last night on SNL, musical guest Lil Wayne performed two songs from his recently released LP The Carter V. He brought out pop singer Halsey for backing vocals on “Can’t Be Broken,” and producer Swizz Beatz to perform their song “Uproar” for his second segment. But the real highlight was Wayne’s collaborative appearance, along with the rapper Future, in a skit on sexual consent.

In “Booty Kings,” SNL players Chris Redd and Kenan Thompson starred as The Booty Kings, two flamboyant rappers — “the kings of that booty music” — who rock oversize Time’s Up lapel pendants next to their glaring, gold Booty Kings chains. The skit flips mainstream rap’s penchant for misogynistic content that objectifies women by featuring the duo, along with Uncle Butt (Pete Davidson), as rappers who prioritize consent first. Far from “conscience emcees,” they’re hilariously hellbent on navigating the learning curve.

YouTube

In the mock music video, The Booty Kings’ oversexed appeals to women in the club come with awkward shows of respect for the objects of their desire: “I’m on a mission for that a**, but first I need permission,” as the refrain goes. “Lights, camera, action / Video vixen / Hendrix steal yo’ girl / But only with her permission,” Future raps in a surprise appearance that parodies the popular, but played-out, conceit of rappers endlessly bragging about stealing their adversaries’ girls.

The irony, of course, is that the comedic skit is likely the closest any major rap stars have come to engaging in a conversation about consent in the year of #MeToo. An SNL spoof is about as progressive as it gets in 2018.

While major players across the spectrum of film, television, journalism and comedy have been put on time out for such alleged abuses, hip-hop and the music industry at large have gone mostly unchecked. Despite a campaign to #MuteRKelly, the R&B singer has yet to face any real consequences for the litany of sexual abuse and coercion allegations made against him, which he continues to deny. Hip-hop mogul Russell Simmons stepped away from the spotlight, and many of his businesses, after a long list of women alleged being victims of rape and of having abusive encounters with him over the years.

Meanwhile the careers of contemporary artists, including XXXTentacion, who faced felony domestic assault charges for beating his pregnant former girlfriend before he was murdered earlier this year, and Tekashi 6ix9ine, recently sentenced to four years probation for a 2015 sexual misconduct charge with a minor, have continued to thrive on the Billboard charts.

As for the music itself, the creative challenge hip-hop has yet to face is how to respect the growing culture of consent when so much misogyny is baked into commercial rap’s cake. For his sake, Lil Wayne, whose been known for his lascivious lyrics over the years, attempts to clean up his act in the Booty Kings skit when he raps: “Respect is the game / And booty is the scrimmage / And I play good defense if that booty get offended.”

It’s not the most delicately-worded dance, but one long overdue.

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Iran And Trading Partners Will Find Ways To Skirt Sanctions, Analysts Say

Part of the Pardis petrochemical complex facilities in Assaluyeh, on the northern coast of the Persian Gulf, Iran. The United States has reimposed sanctions targeting Iran’s economy.

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Iranian Presidency Office via AP

The Trump administration hopes the sweeping sanctions it has imposed on Iran’s oil, shipping and banking industries will cripple its economy and force it to negotiate a new nuclear deal.

But analysts point out that while such economic penalties can be persuasive, there are also ways to circumvent them.

“There will always be both overt and covert activities to work around sanctions, to dodge sanctions or evade them,” says Dan Wager, a global sanctions expert at the consulting firm LexisNexis Risk Solutions. “That’s something that’s gone on for a very long time.”

Iran endured global sanctions for years until 2016, when an agreement with the U.S. and other world powers gave the country economic relief in exchange for limiting Tehran’s nuclear program. President Trump unilaterally pulled out of that multination deal and placed a raft of U.S. sanctions back on Iran.

Wager says many of the techniques to skirt sanctions are also used for money laundering, including the use of shell companies, freight forwarding companies or other intermediaries to hide the origin or destination of goods. He points to Iran’s efforts to procure aircraft parts and components — something Iran critically needs to keep its aging airplanes working.

“There’s a vast network of individuals who are out there that will go to a company that provides aircraft components, engine parts, landing gear parts, avionics and electronics, and they will procure them and represent that those goods are being shipped to and paid for by someone in a country where it is allowed,” he says. “Once the goods are shipped to there, they are further transshipped onward to Iran.”

It’s trickier to work around oil sanctions because the crude has to be transported by large tankers on open waters. But Iran still found ways to do it under past rounds of international sanctions, according to Peter Harrell, an adjunct senior fellow with the Center for a New American Security, a think tank in Washington, D.C.

“You saw Iran have its oil tankers turn off the tracking information. They’d kind of take these very convoluted shipping routes to try to disguise that they were Iranian tankers. They change their flag and they change their name … tactics that a ship can use to disguise its origin,” he says.

Nowadays, says Harrell, who worked on sanctions at the State Department during the Obama administration, it’s getting easier to track Iranian oil tankers with the help of satellites.

The U.S. government can also look at financial transactions around the world to identify Iranian oil deals. Elizabeth Rosenberg, a former sanctions official at the Treasury Department, says that will help track down — and penalize — any company or country doing business with the Iranians, not just the oil buyers.

“They could also go after the refiners,” Rosenberg says. “Who else do those refiners supply with oil, who are their partners and creditors? The shipping companies, the shipping lines, the brokers, who touches them. The web is very broad here,” she adds.

Iran exported an average of 2.5 million oil barrels per day before the U.S. pulled out of the agreement in May. U.S. officials say that figure has been cut nearly by half.

The Trump administration wants Iran’s oil exports — the country’s vital economic engine and tax revenue source — down to zero and says it will punish any country or company that continues to trade with Iran.

The other signatories on the Iran nuclear deal include China, France, Germany, Russia and the United Kingdom. Many of those and other nations want to keep the agreement going.

Earlier this month, the U.S. granted temporary waivers to China, India, Italy, Greece, Japan, South Korea, Taiwan and Turkey, allowing them to continue buying Iranian oil without consequences for six months.

Harrell says energy-hungry nations are willing to risk sanctions that could reduce their access to U.S. markets. He says the countries can use small companies or banks to do the transactions.

“So, you could see countries such as China that’s importing oil — instead of the oil being purchased by a great big Chinese company that has lots of business in the United States, it will be purchased by some small company that doesn’t really do any business in the U.S. and if it is sanctioned, so what,” he says.

Some methods of evading sanctions fall into a gray zone, such as holding payments in an escrow account, something India did the last time Iran was sanctioned. India and China were also involved in a bartering agreement where Iranian oil could be exchanged for industrial machinery, for example.

The European Union is also looking at creating a system for buying Iranian oil that doesn’t use U.S. dollars or run through the American banking system. The Special Purpose Vehicle has yet to take shape because large European companies are afraid to run afoul of the Trump administration, says Wager, with LexisNexis Risk Solutions.

“It is certain that anyone from there that willfully violates these sanctions will be targeted by U.S. enforcement agencies,” Wager says.

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