JOHN YANG: Tonight on PBS News Weekend, Israel expands military operations in Gaza as health officials there claim more than 50,000 Palestinians have died since the start of the war.

Then, how the spread of misinformation online can fan the flames of conspiracy theories on both sides of the political aisle.

MAN: There's always been conspiracy theories.

They've existed as long as humans have recorded history.

But what we've seen, and particularly since the pandemic, is we've seen a supercharging of these.

JOHN YANG: And what Kenya is doing to try to create more open spaces for Africa's wildlife.

(BREAK) JOHN YANG: Good evening.

I'm John Yang.

Israeli forces are now carrying out ground operations in Gaza after days of bombardment from the air.

Israel is trying to pressure Hamas to free the remaining hostages.

Overnight, Israeli strikes across southern Gaza killed 26 people, including several women and children.

A senior leader of the political wing of Hamas is among the dead.

In Rafah, Israel ordered residents to evacuate as its ground forces moved into the city.

AMAL NASSAR, Diplaced Gazan (through translator): The shells are falling among us and the bullets are flying above us.

Injuries, killings, all the streets have filled up with people and children.

Where will we go?

How long will we remain in this suffering?

We have children.

Shame on them.

JOHN YANG: The Hamas run Gaza Health Ministry says the death toll in the 18 months since the war began has surpassed 50,000, nearly 700 of them since the ceasefire collapsed this past week.

Earlier, I spoke with UNICEF spokesperson Rosalia Bollen from Gaza.

ROSALIA BOLLEN, Spokesperson, UNICEF: The situation here continues really to deteriorate day by Day.

Since March 18, there have been hundreds of people killed, including at least 200 children, hundreds of children, more injured, including children with very severe injuries, burns all over their body.

And those attacks have been accompanied by displacement orders for notably northern Gaza, eastern Gaza and the south.

So families have been told to move yet again.

The vast majority of families had just returned to their homes a couple of weeks ago during the ceasefire, and now they're pushed out again and they are in urgent need of food assistance, clean water support with shelter.

We also have been facing an aid blockade since the beginning of March.

For three weeks now, UNICEF and other organizations, we haven't been able to pick up the life-saving assistance that we have right outside of Gaza.

I've been here for six months now, but when I drive around, I continue to be overwhelmed by just the sheer scale of devastation and destruction.

Like some areas look like a moon landscape with large craters.

Not a single building that is still standing.

It's rubble mixed with sand, debris, solid waste.

Everywhere you look, children live in the midst of the debris of the rubble.

There's unexploded ordnance, so there's bombs that have been dropped but that haven't gone off.

So it's a very dangerous place to be.

And children haven't been allowed to be children.

They're no longer children inside Gaza because of the exposure to violence, because they have to help their parents every day to survive.

It's become evident that every child in Gaza today is deeply traumatized, scarred and in need of urgent support, including mental help.

JOHN YANG: Had conditions been getting any better during the ceasefire before it broke down, before the aid blockade was put back in place?

ROSALIA BOLLEN: Yes.

So during the first six weeks of the ceasefire, we actually have been able not just to bring in considerably more life-saving assistance, but we have also been able to reach families throughout Gaza, wherever they were, and families had been able to move freely as well.

Unfortunately, we haven't been able to perform any miracles.

We're a couple of hundreds of humanitarian workers here inside Gaza, but the scale of devastation in Gaza is just impossible to undo.

Over a couple of weeks of times, we haven't been able to do any major rubble clearance to start rebuilding Gaza.

We've just been distributing as fast as we could this life saving assistance.

We've really been racing against the clock.

And we want to assist the population and we're ready to do that, but we need to be able to access our supplies.

JOHN YANG: The children and the families you've been dealing with, particularly in the last week, are there any that sort of stand out in your mind?

ROSALIA BOLLEN: The children I interviewed and the stories that I recorded made it evident that children were very acutely aware of the importance of the ceasefire negotiations.

They know the names of the countries who are involved, they're asking questions and they're talking about all the things that they want to do.

The moment that the ceasefire is there.

It's just shattering really, to see that the fighting and the attacks have restarted.

JOHN YANG: UNICEF's Rosalia Bollen in Gaza, thank you very much and please stay safe.

ROSALIA BOLLEN: Thanks for having me.

JOHN YANG: In tonight's other news, a barrage of drone attacks threatens to complicate U.S.-mediated talks between Ukraine and Russia.

At least seven people were killed, including a five-year-old child, when Russian drones hit targets across the country.

And in the capital city of Kyiv, Ukrainian air defenses shot down nearly 100 drones, but that sent shrapnel and debris raining from the skies.

Russian, U.S. and Ukrainian officials are in Saudi Arabia to try to hammer out details of a partial ceasefire to halt strikes on energy and civilian infrastructure.

The arrested mayor of Istanbul has been suspended from his duties as a Turkish court ordered him jailed through his trial.

Ekrem Imamolu is charged with corruption.

The Interior Ministry calls the suspension a temporary measure.

His arrest is widely seen as a political move by President Recep Tayyip Erdogan to remove a likely challenger in the next presidential election.

Despite his detainment, Imamolu supporters voted for him in today's primary to choose their party's presidential candidate.

High winds and dry conditions are fueling wildfires in the Carolinas, where recovery efforts are still underway months after Hurricane Helene battered the area.

There are at least three active fires in Polk County, North Carolina, where mandatory evacuation orders have been issued.

Months old storm debris, downed trees and damaged roads are making a difficult job even harder.

The state public safety department warned residents to leave immediately to avoid being trapped by low visibility and blocked roads.

And Pope Francis has ended his weeks long hospital stay and is back at the Vatican to begin his recovery.

Before he left the hospital, the pontiff greeted the faithful from the balcony of his hospital room.

It was his first public appearance in five weeks.

Then, on his way back to the Vatican in the Pope Mobile, Francis made a surprise stop at the papal Basilica of St. Mary Major.

He's known to visit the site to pray after foreign trips.

Doctors have ordered the pontiff to rest for the next two months.

During that time, he'll have access to 24 hour medical care.

Still to come on PBS News Weekend, the strong allure of conspiracy theories online and what Kenya is doing to support its growing wildlife populations.

(BREAK) JOHN YANG: This past week saw the release of a trove of documents related to the assassination of John F. Kennedy, a subject that's long been fertile ground for conspiracy theories.

Other favorite topics include beliefs that the moon landing, the 9/11 attacks and the January 6th assault on the Capitol were all staged.

Podcaster Zach Mack wanted to see if conspiracy theorists could be shaken from their firm but unsubstantiated beliefs.

So he turned to someone he's debated about conspiracies for years, his father.

Mack tells what happened in a three part podcast from NPR called Alternate Realities.

This clip begins with Mack talking with members of his family about his father.

ZACH MACK, Podcaster: This is a story about my dad, but it's really a story about what he believes and how his beliefs are impacting our family.

WOMAN: We've been married 40 years.

It's very hard to walk away from.

I want him to fundamentally change who he is and be a different person.

MAN: How can I halfway believe what I believe?

JOHN YANG: Zach Mack joins us now along with David Robert Grimes.

He's a science writer.

He wrote a book called "Good Thinking: Why Flawed Logic Puts Us all at Risk and How Critical Thinking Could Save the World."

Zach, I want to play another clip of your father sharing his beliefs.

MAN: They're going to shut us down because of this emp.

All the supply lines are going to be disrupted.

So there will be a one world government with a one world currency.

I think the Biden has probably three or four maybe more body doubles.

Obama will be found guilty of treason.

JOHN YANG: Zach, has he always believed things like this for as long as you can remember?

ZACH MACK: Kind of not exactly.

It's been a long time coming.

He grew up in a household that was very distrusting of vaccines and really sort of skeptical of major institutions like education and the health, you know, health organizations.

And then in the last maybe four or five years, really since the pandemic, he's gotten really into like just really out there conspiracies.

But you've seen that slow ramp up.

JOHN YANG: David, you've written a lot about how people come to these false conclusions.

Tell us how that happens, how that works.

And we heard Zach's father, their conspiracy theories from the right.

Does it matter which where they come from, right or left?

DAVID ROBERT GRIMES, Author, "Good Thinking": Not necessarily.

What's, what's really interesting about this is it's a really good example of what the philosopher W.V.

Quine called "Our Web of Beliefs."

We find that with conspiracy theorists they tend to hold multiple, often conflicting beliefs.

And the idea of the web of belief is that if you pull on the thread of one belief, for example, if you find able to accept there's a big conspiracy about vaccination, which of course there is not.

But if you can accept that, it makes it easier to think that there's conspiracies about other things.

So beliefs pull onto beliefs.

That's a very common thing.

JOHN YANG: We see you talk about these sort of how these things start.

Does our current media environment contribute to that, do you think?

Do you think?

DAVID ROBERT GRIMES: Absolutely.

And, look, there's always been conspiracy theories.

They've existed as long as humans have recorded history.

But what we've seen, and particularly since the Pandemic is we've seen a supercharging of these many years ago.

If you walked in with a, an outlandish belief and you voice that in polite company, someone would probably challenge you on it.

Now, if I go online, I can find communities of people that not only validate my belief, they will amplify it.

At times when things are uncertain or people are afraid, conspiracy theories, they proliferate more wildly.

And the pandemic was the first thing, the first pandemic we'd ever had during the age of instant communication.

And I think we're still feeling the reverberations of that five years on.

JOHN YANG: Zach, I suspect a lot of families go through what you go through with your father, but they don't invite strangers to come in and listen.

How was doing this podcast?

How was it for you and for your family?

ZACH MACK: Yeah, for me, it was incredibly emotionally difficult.

I'm not going to lie to you about that.

I'm not used to documenting myself or my family, so that part was challenging.

But it was much easier because everyone in the family was on board.

Everyone gave their permission.

They pledged their full support.

They were at times really excited about the project.

So I did have their support.

But, yeah, it's just difficult to report on your family, especially as it's sort of falling apart in real time.

JOHN YANG: Falling apart.

But we heard you talking to your mother and your sister in the clip, in the introduction.

ZACH MACK: Yeah.

JOHN YANG: Has your father always been sort of a person alone on this in your family?

ZACH MACH: Yeah, yeah.

He's sort of the lone Christian conservative in our household.

My mother is like a very liberal Jewish woman.

We grew up in the Bay Area, so it's a pretty liberal place.

My sister and myself sort of fall along the lines.

We're much more like left leaning in our beliefs.

So he's always been a little bit of the odd man out.

And now that he's become increasingly interested in conspiracies, he's like really sort of isolated himself.

JOHN YANG: David, I want to play a little clip of an argument that Zach and his father had.

MAN: It's called denying us freedom of speech.

ZACH MACK: No, no.

MAN: It's called denying us freedom of speech.

ZACH MACH: It's misinformation.

MAN: No.

Who gets the right to label it misinformation?

JOHN YANG: Can people be shaken from their beliefs?

And how would you suggest people go about it?

DAVID ROBERT GRIMES: Yes, but there's a lot of caveats to that.

It partially, it's a function of how deep down the rabbit hole people have gone.

If people are, you know, very early in that stage as they've been exposed to material and maybe they have some questions, that's a very fruitful time for, you know, collaboration where you can have discussions.

And I always say discussions are far more important than debates.

You never change anyone else's mind.

You simply give them the tools to do it themselves.

And you rarely get that from a adversarial format.

But it's very frustrating and it's very easy to get sucked into that.

The other thing is people.

You have to understand why people have been drawn to their different beliefs.

For example, we know aversion to randomness and fear of the unknown and the lack of epistemic certainty.

These are things that draw people towards conspiracy theories.

They're trying to explain the world around them, in that case giving them a better alternative.

Explaining why scientists or experts think something different can be very useful.

The other thing is you have a distrust of authority, which I think Zach's father would have shown for some time, where people who are inherently distrustful of certain forms of authority can be very easily brought to distrust further forms of authority or find an alternative belief system or authority system.

So understanding where people are coming from is really, really important, but really, really difficult.

JOHN YANG: Zach Mack and David Robert Grimes, thank you both very much.

ZACH MACK: Thanks for having me.

DAVID ROBERT GRIMES: Thank you for having me.

JOHN YANG: Millions of American women use some form of contraception to prevent pregnancy and help with medical issues.

One of the most popular forms is an intrauterine device, or IUD.

It's a T shaped contraption slightly larger than a quarter, and it's inserted into the uterus.

Lately, IUDs have been going viral, not because of their popularity, but because of the pain associated with getting them.

Patients have been posting videos on TikTok and other platforms to show how traumatic it can be.

WOMAN: Didn't you let the lidocaine kick in?

WOMAN: It's kicked in already.

How's your pain?

WOMAN: Bad.

Bad.

Oh, I don't like that.

WOMAN: I don't like that.

WOMAN: It literally felt like I was being ripped open.

JOHN YANG: Following a surge in these videos, the CDC issued new recommendations about how doctors can better treat the pain.

Ali Rogin recently spoke with Yale School of Medicine Professor Dr. Aaron Lazorwitz.

ALI ROGIN: Dr. Aaon Lazorwitz, thank you so much for joining us.

Before we talk about these new CDC guidelines, can you tell me about your understanding of the types of pain that people can experience when getting IUDs inserted.

DR. AARON LAZORWITZ, Yale School of Medicine: There's a couple different types of pain and different time points during the IUD insertion where patients can experience pain.

Some patients have discomfort and pain just with the insertion of the speculum.

And then there's an instrument we place onto the cervix for insertion of the IUD called a tenaculum.

And placement of that instrument can also be painful.

And then the IUD insertion itself can also be painful.

All of these experiences differ quite a bit from patient to patient, with some having minimal pain and some having quite severe pain with some of these steps of the process.

ALI ROGIN: And then tell me about the spectrum of pain management that is available to doctors to use in these circumstances, whether or not they actually use them.

AARON LAZORWITZ: So right now we unfortunately have very limited options of pain management options that actually work.

You know, we all give non-steroidal anti-inflammatory drugs beforehand, like ibuprofen.

Does that really help?

Maybe, you know, but in terms of actual reliable medications or things we can do to reduce that pain, as the CDC guideline says, there's only a couple things that may help, and that includes lidocaine injections, which I do offer to my patients, but with the caveat of it may not help with the process.

ALI ROGIN: And it's my understanding that you do sometimes offer anesthesia to patients.

What are those conversations like before you might offer that option?

AARON LAZORWITZ: Yeah, I want to make sure my patients have the full spectrum of options, including going to the operating room with anesthesia if needed.

And so we have a discussion of what that entails.

That's a full day process for a lot of patients.

Could take four to five hours.

They have to fast beforehand, then they're going to have to recover.

It's a much more involved process.

But there are patients where that's necessary for them to be comfortable getting an IUD.

And that's OK. And that's something I talk with them about.

Of the risk, benefits, there's additional risks to anesthesia with the clear benefit of reduced pain.

ALI ROGIN: It does seem though like there's no happy medium here between taking an Advil before insertion and then going immediately to a much more intensive process of going under anesthesia.

What does that say about the way that medicine science treats the pain of women and other people with uteruses?

AARON LAZORWITZ: It underplays that for too long, we have been ignoring the pain that patients who need IUDs have been experiencing with these procedures.

You know, though, a lot of us in the complex family planning field have been trying to research ways to deal with this pain and make it better.

And there hasn't been widespread notice or care taken to make these things better for the patients, to improve that process, to find that middle ground, as you said.

And that's really where we've lacked the development of new methods for pain control that are sorely needed, not only for IUD insertions, but all the gynecological procedures that we do in the office that can all be painful.

ALI ROGIN: These CDC recommendations have two main components.

They recommend the use of lidocaine as a numbing spray, and they recommend against the use of misoprostol to help the cervix dilate.

What is the impact of these CDC recommendations?

AARON LAZORWITZ: So I'm a big proponent of these guidelines coming out because gives widespread attention to things that we've been doing in our field for a while, that we know that offering more pain management options is patient centered that discussion of either injectable lidocaine or topical lidocaine is something that we should be talking with our patients and that the misoprosto really is something that we should not be doing for everyone because it can definitely increase the pain.

And so it's great that now this is becoming a more widespread conversation because, you know, patients have been suffering and really attention needs to be paid.

ALI ROGIN: And what has the impact of these videos on TikTok and other social media sources been on the CDC putting out this guideline, but going way beyond that, just the general more attention being put on this issue.

AARON LAZORWITZ: I think what's actually good is the CDC coming out these TikTok videos is empowering patients to ask for more, to not accept when a clinician or whoever's doing the IUD or another procedure says, oh, this is fine, you're not going to feel any pain, that's not OK. And that's how we get this conversation going.

And that's how we put more pressure on the development of more pain management options when patients demand it.

And I have patients that come in and say, I want to talk about the pain management.

I'm like, great, let's talk about the options we have and the limitations thereof.

But I hope this encourages patients, wherever they go for their iud, to ask and empower themselves and be their own advocate, to say, hey, what do you offer for pain management?

ALI ROGIN: Dr. Aaron Lazorwitz, professor of obstetrics, gynecology and reproductive science at the Yale School of Medicine.

Thank you so much for joining us.

AARON LAZORWITZ: Of course.

Thank you so much, Ali.

JOHN YANG: And finally tonight, the populations of some of Africa's most iconic animals have been bouncing back thanks to decades of conservation efforts.

But activists are warning that climate change and human activity are shrinking their habitats.

Now a nature preserve in central Kenya is pushing to set aside more land to connect with other preserves to allow wild animals to roam freely.

JOHN YANG (voice-over): At the Lewa Wildlife Conservancy, it takes planes, Jeeps, binoculars and a lot of patience to count the animals by hand.

Dominic Marenga is Lewa's head of conservation.

Each year, his team conducts a census of the 60,000 acre sanctuary.

DOMINIC MARINGA, Lewa Wildlife Conservancy: All this is an effort to ensure that we undertake responsibility of accounting for every species that is found on Lewa, especially the most critically endangered ones, the threatened ones.

And we make sure it is a full census.

JOHN YANG (voice-over): A full census to track the growing population, including elephants.

Their pregnancies last nearly two years, the longest of any living mammal.

In 2014, there were 350.

By 2024, their population had grown to 450.

There's been a similar increase in rhinos.

In fact, the sanctuary is home to 14 percent of all black rhinos in Kenya.

It reflects a nationwide wildlife comeback.

In the 1980s, Kenya's elephant population was around 16,000.

By last year, their numbers had climbed to 37,000.

But habitats are shrinking.

Among the causes, climate change and urbanization, both spurred by a human population boom.

Now Kenyan wildlife officials are encouraging conservancies to create more of what they call wildlife corridors, protected strips of land connecting large habitats like Lewa with other rangelands that would otherwise be separated by human activity.

They allow animals to move freely, reduce chances of human interaction, support wildlife population growth and boost tourism, which generates billions of dollars a year.

Lewa plans to add more corridors to the ones they've already created.

DOMINIC MARINGA: If you are in an enclosed ecosystem, the population will have to filter out one way or the other.

And who are they going to meet outside?

The farms, you know, retaliatory attacks.

So you think ahead.

Open new corridors.

Connect your conservancy with others.

JOHN YANG (voice-over): The Lewa Conservancy hopes that would help animals that have existed for millions billions of years thrive alongside humans for millennia to come.

JOHN YANG: And that is PBS News Weekend for this Sunday.

I'm John Yang.

For all of my colleagues, thanks for joining us.

Have a good week.