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Medicine Politics

Libya’s miscarriage of justice

Declan Butler of Nature has issued a call for help from the scientific and medical blogosphere in protesting and raising awareness about an utter travesty of justice, a vile and utterly vicious miscarriage of justice. This is one that I can’t help but throw the paltry weight of my own blog behind. Here’s the story:

Lawyers defending six medical workers who risk execution by firing squad in Libya have called for the international scientific community to support a bid to prove the medics’ innocence. The six are charged with deliberately infecting more than 400 children with HIV at the al-Fateh Hospital in Benghazi in 1998, so far causing the deaths of at least 40 of them.

On 28 August, when the prosecution was scheduled to close its case, the Libyan prosecutor called for the five Bulgarian nurses and a Palestinian doctor to be sentenced to death. Attorneys from Lawyers Without Borders, who are handling the defence of the six, have responded by calling for the international community to request that the court order an independent scientific assessment, by international AIDS experts, of how the children became infected.

The medics were condemned to death in May 2004, but the Supreme Court quashed their convictions last December, following international protests that the first trial had been unfair. It ordered a retrial, which has run intermittently since 11 May at the Criminal Court of Benghazi, based in Tripoli. A verdict is expected within weeks.

But the scientific community has so far shown relatively little interest in the case, says Emmanuel Altit, a member of the Paris bar and a volunteer with Lawyers Without Borders, who has in the past defended inmates at Guantanamo Bay. “We have knocked on a lot of doors, but we have not had much help; we hope this will change.”

One reason for the lack of interest, he says, is the widespread notion that the trial is a sideshow, and that the “real decisions” will be made by diplomats (see page 245). Altit argues that diplomacy has so far failed to secure results, and that the medics’ release will only be secured by using scientific evidence to fight the case in the Tripoli courtroom. He hopes that exposing the “emptiness” of the prosecution case will ramp up enough international pressure to force governments to take action.


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We can only hope, but, as the accompanying editorial in Nature makes plain, that very well may not happen:

Despite the medics’ plight, the United States agreed in May to re-establish diplomatic relations with Libya, 18 years after the bombing of an airliner over Lockerbie in Scotland that killed 270 civilians. Many observers had expected a resolution of the medics’ case to be part of the deal. And the European Union has given Muammar Gaddafi, the Libyan leader, red-carpet treatment at the European Commission in Brussels.

International diplomacy, dealing as it does with geopolitical and economic realpolitik, by necessity often involves turning a blind eye. But its lack of progress in response to the medics’ case in Libya is an affront to the basic democratic principles that the United States and the European Union espouse. Diplomacy has lamentably failed to deliver.

The principles of law and science have the common aim of discovering the truth. A previous assessment of the case by two prominent AIDS researchers, Luc Montagnier and Vittorio Colizzi, concluded that the charges are false, that the medics are innocent, and that the infections resulted from poor hygiene in Libya’s hospitals. It was not a plot orchestrated by the CIA and Israel’s Mossad, as President Gaddafi alleged in 2001 — an allegation that has driven a popular thirst for vengeance in Libya.

The case is politically embarrassing for Gaddafi. Finding a scapegoat is easier than having to admit that the infection of the children was an accidental tragedy. But the most likely diplomatic compromise — that the medics will be condemned to death, with this being commuted to a life sentence — is unacceptable. They are innocent, and the law and science can prove it, if they get the belated opportunity.

There are five Bulgarians and one Palestinian citizens at serious risk of being executed for a trumped up crime, all as scapegoats for the real problem, the unsanitary conditions in the Libyan hospital. Prior to being sentenced to death by firing squad, they spent five years in appalling conditions in a Libyan prison, with credibile allegations that their confessions were obtained under torture,

“I confessed during torture with electricity. They put small wires on my toes and on my thumbs. Sometimes they put one on my thumb and another on either my tongue, neck or ear,” Valentina Siropulo, one of the Bulgarian defendants, told Human Rights Watch. “They had two kinds of machines, one with a crank and one with buttons.”

Another Bulgarian defendant, Kristiana Valceva, said interrogators used a small machine with cables and a handle that produced electricity.

“During the shocks and torture they asked me where the AIDS came from and what is your role�” she told Human Rights Watch. She said that Libyan interrogators subjected her to electric shocks on her breasts and genitals.

“My confession was all in Arabic without translation,” she said. “We were ready to sign anything just to stop the torture.”

The five Bulgarian nurses are being held in a special wing of Jadida prison, where they now get regular visits from their lawyers and Bulgarian officials. The Palestinian doctor, Ashraf Ahmad Jum’a, is in the men’s section of the prison by himself in the wing for those on death row.

“We had barbaric, sadistic torture for a crime we didn’t do,” Jum’a told Human Rights Watch during an interview conducted in the presence of a prison guard. “They used electric shocks, drugs, beatings, police dogs, sleep prevention.”

“The confession was like multiple choice, and when I gave a wrong answer they shocked me,” he said. He claimed that the defendants were also forced to shock each other.

In addition, the relatives of the infected children demand their blood every time news reports suggest that they might be released. Indeed, because of the prevailing ignorance in Libya about how HIV is transmitted, the charges that foreigners infected Libyan children with HIV seems plausible to the average Libyan. Gaddafi may have put on a kinder, gentler face in the recent past, but clearly the old tendency towards utter unconcern for justice and human rights is still there. Now, he appears to be trying to extort $5.5 billion as the price for their release.

Paul Haviland put it well in the British Medical Journal:

While the “Benghazi Six” languish in a Libyan prison (often deprived of food and water, and some in a worrying state of health), those who should be putting pressure on the Libyan regime are acting with exaggerated caution. The mercurial Colonel Gaddafi is being treated with kid gloves as he seeks to renew friendly ties with the West; “quiet diplomacy” is being urged on the Bulgarian government, for fear of alienating the Libyan authorities (nothing to do with the skyrocketing price of oil, of course); human rights organisations are preoccupied with Iraq, Afghanistan, and Sudan. And those death sentences are under appeal–which, in Libya, seems to be yet another form of judicial limbo.

This article was written two years ago, and in essence, little has changed–except that now the Benghazi Six (a.k.a. the Tripoli Six) face execution. They are still in legal limbo, but their fate will likely be decided, and not for the better, within weeks. If international pressure is to do anything, now is the time to start putting pressure on the President, your Senator, and your Congressional representative. You can also use this link to send a letter to Libyan President Muammar al-Gaddafi and other Libyan officials. You can also contribute to Lawyers Without Borders, which is helping with the defense of the Benghazi Six.

The liberal and conservative blogosphere flex their muscles about issues all the time. Now it’s time to see if the medical and scientific blogosphere can rally support to save six health care workers whose only crime was trying to help.

Other blogs with commentary:

Declan Butler’s blog
Effect Measure
Pharyngula
Stranger Fruit
Gene Expression

What now?
Maya’s corner
Libyan Writers’ Club
Pure Pedantry
Dr. Joan Bushwell’s Chimpanzee Refuge
Adventures in Ethics and Science

Deltoid
A Blog Around the Clock
Saratoga Spirit
Thoughts in a Haystack
Aetiology
Terra Sigillata
Open Reading Frame
Daily Kos
Firedoglake
Secular Blasphemy

Sisyphus Shrugged
Science Ripsaw
World’s Fair
Thoughts from Kansas
Uncertain Principles

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

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