Tripoli Six update: found guilty

Posted by Tara C. Smith on December 19, 2006
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Libya to execute HIV medics

(Previous posts on the topic)

A court convicted five Bulgarian nurses and a Palestinian doctor Tuesday of deliberately infecting 400 children with HIV and sentenced them to death, despite scientific evidence the youngsters had the virus before the medical workers came to Libya.

The United States and Europe reacted with outrage to the verdict, which prolongs a case that has hurt Libya’s ties to the West. The six co-defendants have already served seven years in jail.

The sentence brought cheers in Libya, where there is widespread public anger over the infections. The Libyan press has long depicted the medical workers as guilty.

After the sentence was pronounced, dozens of relatives outside the Tripoli court chanted “Execution! Execution!” Ibrahim Mohammed al-Aurabi, the father of an infected child, shouted, “God is great! Long live the Libyan judiciary!”

But the ruling stunned the defendants. They were convicted and sentenced to death a year ago, but the Libyan Supreme Court ordered a retrial after an international outcry that the first trial was unfair. The case now returns to the Supreme Court for an automatic appeal.

“This sentence was another blow, another shock for us,” Zdravko Georgiev, the husband of one of the nurses, Kristiana Valcheva, told the Associated Press in Bulgaria.


International reaction has gone against the decision, of course, but it seems tempered and lacking the outrage this verdict demands:

Secretary of State Condoleezza Rice, meeting with Bulgarian Foreign Minister Ivailo Kalfin in Washington, said the United States was “very disappointed with the outcome” and urged the medical workers be freed and “allowed to go home at the earliest possible date.”

In Bulgaria, President Georgi Parvanov and Prime Minister Sergei Stanishev called the ruling “absurd” and urged Libyan authorities “to intervene immediately” to reconsider it and free the medics.

The case was sent immediately to the Libyan Supreme Court for appeal, but it was not known when the court would rule. If it upholds the ruling, the case goes to the Judicial Board, which can uphold or annul it, Libyan Foreign Minister Abdel-Rahman Shalqam said.

An international legal observer, Francois Cantier of Lawyers Without Borders, criticized the retrial for failing to admit enough scientific evidence.

“We need scientific evidence. It is a medical issue, not only a judicial one,” Cantier said.

Declan Butler’s written a piece for Nature here; despite the sentence, this still isn’t over, though it looks grim…

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Comments

  1. #1 Texas reader
    December 20, 2006

    THIS IS HORRIBLE NEWS – IS SOMEONE ORGANIZING A CAMPAIGN TO PUSH OUR PRESIDENT TO MAKE AN EFFORT VIA THE UN OR DIRECTLY TO PREVENT THE DEATH OF THESE MEDICAL WORKERS?????

  2. #2 Ele
    December 20, 2006

    Below are links to two petitions. There are some more that have been started but I don’t have their links anymore.

    http://www.petitiononline.com/bulgaria/petition.html
    http://tashev.org/podpiska.cfm

  3. #3 icemonkey
    December 20, 2006

    witch-trials never go well for the accused.

    i hope someone does something. a counter-suit? accuse the host country of failing to adequately provide for the safety of international health care workers? if nothing far-reachingly positive can be done, the accused should just be *rescued*. that they sit there and end up executed for something trumped up by a bunch of morons is not acceptable.

    in the future, leaders of needy countries should be required to sign a binding ‘hold harmless’ agreement to be eligible for international health care aid of any kind. what *that* would do to benevolent activities of that nature worldwide, i hate to think. But what has happened to these people who gave up such a big chunk of their lives to live in a completely alien culture in order to offer their expertise to a lot of complete strangers, is absolutely unacceptable. that they could be *executed* in the end, is nearly unthinkable — and completely unbearable.

    if this happens, libya will be permanently stained. tainted.

  4. #4 pat
    December 20, 2006

    What if they did indeed conspire to infect all these children with HIV? I think we are blinded by our impression that Lybian justice is indeed flawed (because they are Arabs?). Why didn’t all the scientists dispatched to their aid admit that there is a very week corollation between HIV and AIDS? If HIV is transmissible by blood and there is CIRCUMSTANTIAL evidence of their guilt then why CAN’T they be held accountable?
    Texas reader, Ele and Icemonkey, how do you know they are not guilty of the crimes they are accused of? Do you have proof of their innocence?

  5. #5 JanieBelle
    December 21, 2006

    Y’know at first I was just going to ignore your comment, Pat, but it bugs me to leave it unanswered for the general public.

    You might start with the article in Nature which briefly mentions that the children’s infection began before the medical workers were even in the country.

    During the first trial, the Libyan government did ask Luc Montagnier, whose group at the Pasteur Institute in Paris discovered HIV, and Vittorio Colizzi, an AIDS researcher at Rome’s Tor Vergata University, to examine the scientific evidence. The researchers carried out a genetic analysis of viruses from the infected children, and concluded that many of them were infected long before the medics set foot in Libya in March 1998. Many of the children were also infected with hepatitis B and C, suggesting that the infections were spread by poor hospital hygiene. The infections were caused by subtypes of A/G HIV-1 — a recombinant strain common in central and west Africa, known to be highly infectious.

    You might then try Nick Matzke’s article at the Panda’s Thumb explaining the evidence in more detail.

    Basically, with molecular phylogenetics and statistical modelling, Rambaut and co. were able to prove that each of the various HIV-1 strains found in the Libyan children had a common ancestor that predated March 1998, the time when the foreign nurses arrived. More than that, all of the 95% confidence intervals for the estimated date of common ancestry of both the HIV-1 virus, and three strains of HCV (Hepatitis C), another blood-born pathogen which was co-infecting patients, all fall months-to-years before March 1998. This means that nosocomial (hospital-acquired) infections had been occuring for years.

    He also gives a link to the free .pdf of the actual science paper in Nature that backs up his statements.

    Andrea Bottaro even links to a documentary about the case if science papers aren’t your thing.

    As for your “HIV doesn’t cause AIDS”, I would suggest removal of your tinfoil hat, but that’s just me.

  6. #6 Peter Barber
    December 21, 2006

    pat said,

    Texas reader, Ele and Icemonkey, how do you know they are not guilty of the crimes they are accused of? Do you have proof of their innocence?

    IIRC you’re not a biologist, but do give this article in Nature a try. If you don’t feel like ploughing through the details (the language is inevitably quite technical), what the researchers did was roughly as follows:

    They looked at variation in an HIV gene between children who acquired HIV at Al-Fateh Hospital (AFH). They constructed “family tree” for the gene, and then calculated the most likely date of the most recent common ancestor (MRCA). I want to stress that these are thoroughly validated techniques and widely used in bioinformatics.

    For both genes, they found that the most likely date for the MRCAs predated the start of employment of the Bulgarian and Palestinian staff in March 1998, and that “[i]n most analyses the probability that the AFH clusters originated after March 1998 was practically zero.” The data also indicate that infections at AFH occurred over a longer period than the year during which the accused were employed there.

    There is a much simpler and more convincing explanation for the HIV outbreak – poor infection control. This explanation also has the attraction of not needing to explain what motive these six health workers would have had to conspire to infect hundreds of children.

    I hope that helps.

    BTW, please don’t ask me to explain what a “bayesian Markov chain Monte Carlo (MCMC) approach” is. I freely admit that I don’t understand it. I’m sure a bioinformatician or statistician can help us out here…

  7. #7 Peter Barber
    December 21, 2006

    Oh, and pat (this is probably going to appear before my other post because of those dastardly hyperlinks I used):

    What circumstantial evidence is there? I’m not aware of any.

  8. #8 JanieBelle
    December 22, 2006

    ditto. I commented yesterday, but I guess it got caught in the spam filter for the same reason.

    Several links in that one.

  9. #9 pat
    December 23, 2006

    “What circumstantial evidence is there? I’m not aware of any.”

    Just because you are not aware of any doesn’t mean there isn’t any.

    I am certain these nurses are innocent but for reasons some here find heretical (oh, and murderous deadly quackery before I forget!)

  10. #10 pat
    December 23, 2006

    “THIS IS HORRIBLE NEWS – IS SOMEONE ORGANIZING A CAMPAIGN TO PUSH OUR PRESIDENT TO MAKE AN EFFORT VIA THE UN OR DIRECTLY TO PREVENT THE DEATH OF THESE MEDICAL WORKERS?????”

    Right on! Let’d declare WAR !!!!!!!!!!!!!! Of course thousands of “Fuzzy Wuzzies” will perish but whats a “desert dweller” worth these days anyway?

    PS: “U.N.” is simply “U.S.” misspelled.

  11. #11 pat
    December 24, 2006

    “As for your “HIV doesn’t cause AIDS”, I would suggest removal of your tinfoil hat, but that’s just me.”

    That is thoroughly unimaginative Janie. Remove your bubble spectacles, you’re reading shit that ain’t there.

  12. #12 JanieBelle
    December 26, 2006

    That is thoroughly unimaginative Janie. Remove your bubble spectacles, you’re reading shit that ain’t there.

    O RLY?

    Why didn’t all the scientists dispatched to their aid admit that there is a very week corollation between HIV and AIDS?

    Looks there to me. Thats sounds a lot like standard “HIV doesn’t cause AIDS” crap.

    Is my sarcasm meter perhaps out of order? It’s so difficult to tell the real nutjobs from the parody, that I freely admit the possibility that I have missed the sarcasm.

    See, then I read from you -

    “What circumstantial evidence is there? I’m not aware of any.”

    Just because you are not aware of any doesn’t mean there isn’t any.

    I am certain these nurses are innocent but for reasons some here find heretical (oh, and murderous deadly quackery before I forget!)

    Nope, I’m thinking the ol’ sarcasm meter is working just fine.

    Real, actual scientists sans tinfoil hats have shown that the breakout of infection was occurring before these nurses were even in the country. Real, actual scientists sans tinfoil hats have shown HIV causes AIDS.

    Now, do I trust the thousands of real, actual scientists sans tinfoil hats, or do I trust some commenter named Pat?

    I’ll have to get back to you on that.

    not.

  13. #13 pat
    December 26, 2006

    Jeanie,
    To even point out that there is a real week corollation between HIV and AIDS is enough to be accused of deadly quackery and enough to suffer dumb comedic re-runs such as that thing with the tinfoil hats and you prove my point really well; you wrote “tinfoil hats” three times and even threw in “nut job” in your last post. I guess then according to you even Montagner wears one for he himself once said that HIV alone is insufficient to cause AIDS.
    I grant you that he was politically heavily leaned on for that one and ended up signing the Durban Declaration as HIV being the SOLE cause of AIDS. How do you know that he wasn’t leaned on again and sent to Tripoli to do a political clean up job again?

    One more thing…THOUSANDS HAVE BEEN SENT TO TRIPOLI TO PROVE THAT THIS INFECTION PREDATED THE NURSE’S ARRIVAL? REALLY?????????????????? who paid for the tickets? C’mon, you’re inventing your arguments as you go along (thousands! snickersniker). Science should be honest about their knowledge of HIV and admit that it is only a corollated hunch that has yet to be observed in nature. Let me give you an example of HIV/AIDS science:

    “Look, the sun rises here and sets over there therefor the Sun OBVIOUSLY, UNAMBIGUOUSLY and OVERWHEALMINGLY circles our planet!” (this, naturally, is AFTER the mainstream needed to be convinced that the world was indeed ROUND and not FLAT!)
    You may think I wear a tin hat but you may very well be the flat-earther here.
    Janie, you’re doing real well here at Tara’s “flameBlog” …good work!

  14. #14 Robster
    December 26, 2006

    Pat, the evidence is solid. Not weak. You either know that, or you deny the evidence. Poor Pat, nobody takes Pat seriously.

    THOUSANDS HAVE BEEN SENT TO TRIPOLI TO PROVE THAT THIS INFECTION PREDATED THE NURSE’S ARRIVAL? REALLY??????????????????

    Janie never said that thousands of anything had been sent to Tripoli. Thousands of scientists have studied the connection between HIV and AIDS. Some of these scientists have demonstrated that the Tripoli hospital strain was infecting patients prior to the arrival of the nurses and doctor.

    C’mon, you’re inventing your arguments as you go along (thousands! snickersniker).

    Pat, there’s a pot on the phone, asking for a kettle. I think its for you.

  15. #15 JanieBelle
    December 27, 2006

    Thank you, Robster.

    And Pat, Argumentum ad CAPSLOCKSIUM is cute…

    If you’re twelve.

  16. #16 pat
    December 27, 2006

    “And Pat, Argumentum ad CAPSLOCKSIUM is cute…

    If you’re twelve.”

    While the world waits for the elusive mechanism between HIV and AIDS to be demonstrated I’ll think you’re all very cute too. Janie, while we are on the topic of twelve year olds you said, like a twelve year old:

    “I’ll have to get back to you on that.
    not.”

    …and then you got back to me…like a twelve year old…

    PS: odd how you can see the address and lineage of a retrovirus but not see what it does; thats real cute.

    Guter Rutsch!