Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.

Q: Paragraph: In its latest “report card,” the American College of Emergency Physicians said such reduced access earned the nation a “D+” — that’s down from the overall “C-“ grade from the group’s last report in 2009. Shortages and reduced hospital capacity make it more difficult to access emergency care, the group said. It also warned about the impact on disaster preparedness. While the report does not measure the actual quality of care provided, it does offer a snapshot of national and state policies affecting emergency medicine as seen by providers. Washington, D.C., was ranked the highest in the report, earning a “B-“ grade, while Wyoming ranked last and was the only state to earn an overall failing grade of “F.”  The group’s task force looked at scores of measure in five major categories — access to care, quality and patient safety, liability, injury prevention and disaster preparedness — and relied on data from the Centers for Disease Control and the Centers for Medicare and Medicaid Services, among others. The report comes just as the Affordable Care Act, known as Obamacare, comes into full effect this year. The 2010 law aims to expand access to health insurance and reduce the nation’s healthcare costs, but it has become a political flashpoint amid a troubled rollout of the federal insurance exchange website. While the physician’s report does not factor in all of the effects of the law — its grades are based on data from early 2013 — emergency rooms could be used even more as more Americans gain insurance coverage under Obamacare, it said. Some health experts have predicted that increasing the number of insured patients should reduce pressure on hospital emergency rooms because access to regular doctor care will improve, something that is hoped would prevent chronic conditions from spiraling out of control or help catch other problems before they worsen. But insurance coverage could also lead those who might have held off going to the emergency room to seek care, said Jon Mark Hirshon, an emergency medicine doctor and researcher at the University of Maryland who oversaw the group’s report card. Newly insured people also may have a hard time finding a regular doctor who accepts their plan, he said. “On top of that, emergency departments are open 24 hours a day, seven days a week. If I have a primary care provider but it’s 9 o’clock at night on a Friday and they’re closed, then people come to the emergency department,” Hirshon told Reuters. The group is asking for congressional hearings to probe whether the law puts “additional strains” on emergency rooms. Already, beds for patients have fallen from a rate of 358 per 100,000 people four years ago to about 330 beds per 100,000 people now, the report said. Wait times have increased to a median of 4.5 hours compared to four hours in 2009. Despite the dismal U.S. grade given by the group, it noted that policies and infrastructure varied widely by state. States with the best emergency care include Massachusetts, Maine, Nebraska and Colorado, while Kentucky, Montana, New Mexico and Arizona rounded out the bottom, just above Wyoming. States are also still grappling with the uninsured. By law, hospitals must provide emergency care regardless of patients’ ability to pay. Under Obamacare, states can expand access to Medicaid, the federal-state health insurance plan for the poor. Data shows that Medicaid patients use emergency rooms as much as other insured patients, but several recent studies have shown that Medicaid patients utilize them more than the uninsured. One study this month showed Oregon patients given Medicaid through a lottery increased their emergency room use by 40 percent compared to those not offered Medicaid. “We have to be leaner and more efficient, but it just becomes more and more challenging,” Hirshon said. Claim: Doctors say pressure on ERs may rise, give U.S. failing grade.

A: People seeking urgent medical could face longer wait times and other challenges as demand increases under Obamacare, U.S. emergency doctors said in a report on Thursday that gives the nation’s emergency infrastructure a near failing grade.
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Q: Paragraph: The power crisis is affecting health and sanitation - because sewage treatment plants can’t run, raw sewage is pouring into the Mediterranean - and now the elderly and sick are desperately trying to handle the heat. Plastic trays and scraps of cardboard are doubling as hand-held fans. Precious piped water is hosed over children and work animals. Those trying to sleep have abandoned clammy mattresses, preferring the relative cool of bare tiled floors. Hoping to pressure the Islamist Hamas group to relinquish control of Gaza, Palestinian President Mahmoud Abbas has reduced his administration’s payments to Israel for the electricity it supplies to Gaza. That has left the 2 million Palestinians there with only a few hours of power a day. Hospitals and other emergency facilities have made do with back-up generators. Few ordinary Palestinians have that option. A family excursion to the beach that might elsewhere have been a delight was, for Sabah Joudah, a forced decision, especially when having to put up with the sewage problems. “We came here to entertain the children, even though the sea is polluted,” she told Reuters as the dirty surf lapped close by. “It is summer and there is no electricity; no water and no fans are working in our homes. It is very tough, very tough.”   Environment officials say disruptions at sewage treatment facilities have meant more than 100,000 liters of untreated wastewater is discharged along the coast daily. Around 75 percent of the seawater is polluted. Swimming there frequently leaves children with skin inflammations and abdominal complaints, parents say. In the southern town of Khan Younis, a woman bathed her children in a bucket in the street, while a man doused his horse with water. One Khan Younis couple, the Abu Mehsens, both suffer from high blood pressure and said they were so beleaguered by the heat that simply fanning themselves could be too much effort. “When we get tired we rest for a bit before we start fanning again,” Jihan Abu Mehsen said. “We do so all day long.”    The situation has hurt Gaza’s meager retail sector, with vendors saying that sales of electrical appliances have tanked. One exception has been cheap rechargeable fans, which can be stored, with full batteries, in anticipation of the power cuts. “People have turned to alternative power, using batteries,” said appliance salesman Mahmoud Abu Hamda. “Sometimes they use trays and sometimes even the covers of kettles instead of electric fans. This has impacted us very much.” Claim: As temperatures soar, desperate Gazans try any means to beat heat.

A: As Middle East summer temperatures soar above 35 degrees Celsius (95 Fahrenheit), Gazans are struggling to stay cool amid a power crisis, with less than four hours of electricity a day and little chance to run fans and air-conditioners.
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Q: Paragraph: Yet nothing prepared residents of its oldest town, Graaff-Reinet, for their worst drought in more than a century. As the dry spell entered its fourth year, tap water turned brown and smelled like rotting fish. When the water behind the Nqweba Dam dried up, depositing tens of thousands of dead fish onto cracked earth, queues began forming at municipal bore holes and farm animals died in their hundreds. The bleak choices facing millions of people in drought-stricken southern Africa - whether to flush toilets or not, or to keep animals alive or let them die - could soon be faced by other places on a warming planet with shrinking water supplies. “This area is dry but our taps have never been completely empty. Never,” said Bukelwa Booysen, who has had to send staff in search of borehole water for her school for disabled children, and send the kids home when they can’t find any. An abnormally hot summer with rainfall 75% below average, according to the U.S. National Oceanic and Atmospheric Administration, has struck the whole region. The United Nations says 45 million people in southern Africa face hunger. Bushes and trees clinging to the Karoo’s rocky ravines are withered and grey - even hardy acacia thorns are dying. Signs mark rivers that are now dry beds. At one farm, Gerrie Snyman, 65, was feeding grain to sheep and goats that couldn’t find pasture. More than a third of his couple-thousand goats and sheep had either died or been sold this year. His 80 cows were now 15. He loaded a calf that was starving - its mother had stopped producing milk - onto his truck to take home and shoot. A friend had shot himself dead after his animals died of thirst. “We are grateful to the Almighty for our borehole water,” he said. “We don’t know what we’ll do when it runs out.”   When Cape Town’s reservoir nearly ran dry 18 months ago, it made international headlines and authorities rationed water. Yet Karoo is long past water rationing. For Valentia Esho, 45, an unemployed mother of seven in the township of Umazisakhe, it means letting her toilet fill up  instead of flushing, never washing clothes and only washing plates that stink. Water is just for drinking. “The house is really smelling,” she said, inside her one-room brick-and-tin home. “Everyone is paining from stomach aches and diarrhoea.”   In another township, Asherville, where wind kicked up dust devils, school headmaster Basil Vaaltyn was overseeing water distribution from a truck. He’d done everything to cut down on his usage: “I’m down to a minute showering instead of two.” His wife saves dirty dishwater to fill the cistern. A spokesman for the municipality said it was drilling boreholes, installing pipelines and building an 18-million-litre reservoir, adding: “Usage of water is still very high. The community is requested to use water sparingly.”  With municipal authorities overwhelmed, South African charity Gift of the Givers is trucking water to townships and drilling boreholes. Gideon Groenewald, a geohydrologist for the charity, uses science and spirituality to look for groundwater. When he was growing up on a farm, he used to dowse with wet twigs. Nowadays he prefers magnetic detectors. “I open Google maps and look for the lines of trees. I ask God in prayer which lines hold water, then I go down to that GPS location,” he said while a forked stick turned in his hand over an arid patch of shrubs. “You see the stick moving where the magnetic field is? There’s water here,” he continued. “It’s pure science.”  The charity has drilled 1,800 boreholes in the past three years, Groenewald said, only a third of them dry. But Louise Stafford, water director for the Nature Conservancy in South Africa, urged caution with boreholes, because groundwater is a finite resource. Water-intensive agriculture like citrus farms can make droughts worse, she said, and leaky pipes are losing a billion litres a year - problems Water Minister Lindiwe Sisulu pledged to tackle in a new water masterplan she delivered on Thursday. One Sunday, as clouds formed over Graaff-Reinet, its Assembly Church prayed. The clouds spat but didn’t pour. “We pray for God to open heaven and send rain,” Pastor Dolan Cochrane said. The congregation bowed. “Lord,” Cochrane continued. “We know that, in your time, you will come to our rescue.” Claim: South Africa's Karoo drills and prays as taps run dry.

A:
South Africa’s Karoo region has always been parched - it means land of thirst in the language of its earliest inhabitants, the Khoisan hunter gatherers.
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