Pharyngula

Go read Effect Measure on the recent events in the case of the Tripoli Six. This is the story of a team of health care workers who were blamed for an outbreak of HIV among young patients at a Libyan hospital—they’ve been tried in a kangaroo court and face very unpleasant prospects.

Now, in a powerful reply to the Libyan accusations, Nature has published the results of a detailed analysis of the viruses afflicting the children, and the story is clear: the cause of the outbreak was the poor hygiene present at the hospital before the six workers arrived. Here are the major conclusions of the paper:

In 1998, outbreaks of human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) infection were reported in children attending Al-Fateh Hospital in Benghazi, Libya. Here we use molecular phylogenetic techniques to analyse new virus sequences from these outbreaks. We find that the HIV-1 and HCV strains were already circulating and prevalent in this hospital and its environs before the arrival in March 1998 of the foreign medical staff (five Bulgarian nurses and a Palestinian doctor) who stand accused of transmitting the HIV strain to the children.

The strains present were also traceable to North Africa and at least one was prevalent in Egypt. They also found that the timing was off: the outbreak had begun before the workers had arrived.

We found that, irrespective of which model was used, the estimated date of the most common recent ancestor for each cluster pre-dated March 1998, sometimes by many years. In most analyses, the probability that the clusters from the Al-Fateh Hospital originated after that time was almost zero. For the three HCV clusters, the percentage of lineages already present before March 1998 was about 70%; the equivalent percentage for the HIV-1 cluster was estimated at about 40%.

Apparently, the scientific evidence which would have exonerated the accused was not allowed in the court. The Gaddafi government continues to live up to its reputation.

Comments

  1. #1 SEF
    December 6, 2006

    So when is Bush going to invade and rescue them? Libya is quite a bit closer to Dubya.

  2. #2 revere
    December 6, 2006

    PZ: Many thanks.

  3. #3 Reed A. Cartwright
    December 6, 2006

    Thank God for evolution.

  4. #4 E-gal
    December 6, 2006

    Intolerance, intolerance X intolerance = intolerance cubed = war and more intolerance.
    Ancient chinese and the freemasons were rational in their greetings to their neighbors when they said, ” I hope your exulted religion is serving you and your family well.”
    Here it is three thousand years later and all these people are predicating their lives on a book of early mideastern mythology. Is there something I am missing here?

  5. #5 Peter Barber
    December 7, 2006

    Reed, I wasn’t thinking quite the same as you (that tricky second word!) but otherwise – yes, that was my first reaction.

    I am now in cynical mode and waiting to see how long it will take for a known creationist to put their foot in their mouth by either: (a) pointing out how Real Science? gets results; (b) denying that phylogenetics has anything to do with evolutionary theory; (c) both (a) and (b); or (d) rejecting the Nature results and thereby aligning themselves with Muammar Gaddafi

    .

    Come on, Discovery peeps, we’re waiting for that press release!

  6. #6 Peter Barber
    December 7, 2006

    Bad full stop! Bad, bad full stop! You come back here right now!

  7. #7 Greg
    December 7, 2006

    Medical malpractice kills over a hundred thousand people EVERY year, according to the AMA.

    So the stats are probably even higher.

    No health care worker is innocent.

  8. #8 Fox1
    December 7, 2006

    Yeah, that’s what’s killing people in Libya. Medical Malpractice. Big problem in the third world, right up there with medical no-practice.
    Let’s get those people some chiropractors and colon-health supplements, stat!

  9. #9 Fernando Magyar
    December 7, 2006

    “Big problem in the third world, right up there with medical no-practice.”

    I guess there’s a rather large contingent of third world US citizens who just also happen to live in here in the US, about 40 million or so including women and children.

    As someone, who was born in a country that is often characterized as “third world”, every time I hear that expression voiced by someone living in the USA, really makes my blood boil. I have to wonder if they have traveled throughout this country, (New Orleans comes to mind) let alone lived anywhere else in the world? Yeah, lived, not just visited!

    Having said all that it is still nice to know that science has exonerated the accused health care workers. Now it remains to be seen the if the Libyans will accept the evidence.
    Not holding my breath.

  10. #10 Wes
    December 7, 2006

    From the Nature article:

    We studied HIV-1 gag gene sequences from
    44 affected children, plus 61 HCV E1E2 gene
    sequences that span the HCV hypervariable
    region (for methods, see supplementary information).
    By using these data in an evolutionary
    analysis
    , we could place a real timescale on
    the transmission history of the outbreaks.

    Sadly, I’d wager many of the Islamists in Libya are creationists and would reject this evidence the moment they saw that phrase. Shit, quite a few Americans would reject it as well.

  11. #11 Molly, NYC
    December 7, 2006

    . . . the Tripoli Six are innocent . . .

    Yeah, we really needed an HCV phylogenetic analysis to figure that one out.

    I’m not sure how much you can do for people who are intent on believing a lie. But as Lincoln pointed out, not everyone will buy it; and in a population as big as Libya, or even as big as a hospital staff, there must a great many Libyans who feel sick every time they think about this, about what it means about their health system, about the men running it, running their country, and the way those men value their egos over the welfare of their country’s citizens.

    I can relate. I feel the same way about the Bush administration.

  12. #12 suirauqa
    December 7, 2006

    Fernando, I am from a so-called “Third World” country, and I agree completely – I repeat, completely – with your sentiments regarding the medical practice there.

    However, that said, I think Fox1 meant his/her remarks to be sarcastic, in response to Greg’s blanket assertion that “No health care worker is innocent.” Quite a tall claim, that! I wonder if Greg has evidence to support that horrific claim, or he is just trolling around here.

    Fox1 could perhaps have worded the comments better. “Third World” is an expansive term. If you consider medical practices in parts of South and South-East Asia (and I am talking about modern medicine), many of them have established medical education and public health care systems working somewhat along old British system. And I must say that some are even better than the levels of medical care available in parts of the United States.

    If, on the other hand, you consider parts of Africa, you’d see that even saying ‘medical no-practice’ is saying more that what is available there. Voluntary organizations, such as Médecins Sans Frontières, and random groups of socially conscious doctors from different countries (including US) have worked there from time to time, but that’s about it. The health care situation across vast stretches in Africa is really, really pathetic and subhuman.

  13. #13 Peter Barber
    December 7, 2006

    Greg said:

    No health care worker is innocent.

    Better sack them all then. I’ll just go and march my wife down to the police station for you, shall I?

  14. #14 Warren
    December 7, 2006

    Apparently, the scientific evidence which would have exonerated the accused was not allowed in the court. The Gaddafi government continues to live up to its reputation.

    Wow, a government that refuses to take science seriously. Good thing It Can Never Happen Here, huh?

    Seriously, though, I was thinking about this today — how upside-down the fiasco is. The medical practitioners shouldn’t have to be proving their innocence; proving a negative is pretty hard to manage, and besides, the accusation is heinous.

    I mean, how effed-up does a society have to be to believe that physicians or nurses are in the business of killing children?

    Oh … wait, yeah.

  15. #15 Warren
    December 7, 2006

    FWIW, PZ, I expanded a little on my above comment. Thanks for the pointer to the story.

  16. #16 Kristine
    December 7, 2006

    Is there something else that we can do for the accused, those of us who have written letters and blogged? Should we try again to get more letters written or take some other action?

    Also, I am wondering how much of the “HIV doesn’t cause AIDS in heterosexuals/children” blather from Jonathan Wells and his ilk has enabled this stance by the Libyan government. Maybe there’s no connection at all, or maybe there is. It simultaneously angers and frightens me. Can’t they see how this crap destroys lives?

  17. #17 Warren
    December 7, 2006

    Kristine:

    Can’t they see how this crap destroys lives?

    They can, but they don’t care. Or, more accurately, they believe those who suffer from AIDS deserve it. Let me see if I can explain how these people see it.

    When you’re a right-wing fanatic, there’s basically you (plus God) versus the world (which is ruled by Satan). Anyone who refuses to side with God is, by default, on the side of The Enemy; and particularly those who choose to “defile” themselves in some way or another are acting in a way that is supposed to be in direct opposition to God’s design.

    This may even be due to demonic possession; but that can’t happen by accident. You have to deliberately ask Satan into your life and reject the sacrifice of Jesus before The Enemy can infest you with demons.

    Thus, anyone with AIDS has been acting well outside of God’s grace for years, might be demonically possessed, and in any case is surely a sinner, either a drug-user, a pervert, a fag or possibly all of these things. It’s obvious that anyone who lives cleanly and uprighteously in the eyes of God cannot have this disease.

    (Bill Maher once remarked that to fanatics, there are no gays; there are only straight people who commit sexual sins. This perfectly sums up the right-wing attitude toward homosexuality.)

    Maybe the children are being visited with the illness for the same reasons that Pharaoh saw Egypt plagued; maybe God is trying to warn Lybians to turn from the false idolatry of Mohammed and toward the beacon of the One True Cross.

    In any case, yes, they see the results of their preaching; but they don’t have to feel responsible for it, since with God all things are possible, and since those who suffer are doing something to make them deserve it.

    They really believe this, and you have every reason to be infuriated and frightened by this stunningly backward attitude.

  18. #18 Fox1
    December 7, 2006

    Yes, thank you suirauqa, I was being extremely, extremely sarcastic. I will attempt to take the admonishments over my careless use of the term “third world” to heart (I think that’s what Fernando was objecting to? I’m having a bit of a hard time parsing it).

    That said, even within the areas you point out, I would be surprised if medical malpractice was even in the top half of the list, as far as public health concerns go, but I suppose I speak from less than perfect knowledge.

    (Can we not do the whole reflexive assumptions about where people have been and lived, and what they are thus “allowed” to comment on thing, though? That gets old and imprecise in a hurry)

  19. #19 Fernando Magyar
    December 7, 2006

    Fox1 and suirauqa, I take your points, my reaction may have been more a bit more from the gut and a little less from the mind. I actually do get the sarcasm as well. Cheers!