Libyan Case Draws To A Close
Six Convicted Health Professionals May Be Given Reprieve
Compensation to the families of children infected with HIV may mean six convicted health professionals escape the death penalty.
A case that has been embroiled in controversy and debate may be finally drawing to a close. Following the outbreak of an AIDS epidemic in the El-Fath Children’s Hospital in Benghazi, Libya, five Bulgarian nurses and one Palestinian physician were arrested and charged with deliberately infecting 426 children with the HIV virus. Since the outbreak in 1998, over 50 of the infected children have died. When the AIDS epidemic came to light in Libya, public outrage led to the arrest of the six health professionals. They have since been convicted and sentenced to death.
However, in a new turn of events, the convicted may be given a reprieve or allowed to serve jail time instead of being executed, because of a deal that will give compensation to the victims of the families. Under Islamic law, the families of murder victims have the choice of receiving compensation for loss and suffering in lieu of the death penalty. This may be the best possible outcome given the strong international opposition to the convictions and Libya’s desire to strengthen its foreign ties.
The scientific evidence linking the accused to the infections has been under attack. In a report done by the external scientific experts, Dr. Luc Montagnier and Dr. Vittorio Colizzi, unhygienic practices at the hospital were cited as the cause of the epidemic. The epidemic can be traced back to an HIV-positive child admitted before the accused even began working at the hospital. In fact, 7 of the 426 children were already HIV-positive before the accused started working at the facility and new infections continued after the accused were jailed and no longer at the hospital. The reuse of syringes and the use of indwelling intravenous catheters for injection were cited as possible sources of transmission. As well, Montagnier and Colizzi noted that the strain of HIV is particularly virulent and pathogenic leading to the rapid spread of HIV within the hospital.
A Libyan committee of scientific experts refuted Montagnier and Colizzi’s report. This panel stated that in fact, indwelling catheters were not widely used and disposable syringes were not reused. The panel also cites the fact that the AIDS outbreak only occurred in that one hospital and only in certain departments within the hospital. These departments, when risk factors were assessed, should have had lower rates of HIV-infection than other departments, which were relatively untouched by HIV.
Regardless of where the truth lies, the case brings many issues to the forefront which can impact how the spread of AIDS is curtailed. One important point is the role of international health professionals. The foreign health professionals who were convicted in Libya are seen by the international community as scapegoats for an epidemic seen to be caused by system failures. The majority of the six convicted were recruited to come work in Libya indicating a possible shortage of health professionals in Libya. However, if there is the fear among health professionals that they may be held responsible for issues that arise from poor infrastructure and a lack of adherence to guidelines, developing countries may find it even more difficult to recruit foreign health professionals. Another issue is the mistrust and suspicion with which locals look at the motives and actions of foreigners. Although, with the advent of humanitarian imperialism, this suspicion is not entirely unearned, the reality is that in the field of health care, trust is paramount between health professionals and the communities which they serve if they are to be effective.
