Someone must pay in HIV cases, Libya says

Nurses face execution as regime pressures Bulgaria over sick kids

Fellows Fall 2005

By David Michaels

June 03, 2009

BENGHAZI, Libya — In a room on a clinic's second floor, a young woman named Ferial lies on her side, wrapped in a red blanket with an IV in her arm. She once dreamed of being a doctor, but she has not gone to school in two years.

"She feels like she cannot face the other people," said Ferial's mother, Zakia Zoubi. "She feels like people look at her like she is sick or inferior."

Now 18, Ferial became HIV-positive in 1998, during a stay in Benghazi's Al-Fatah Children's Hospital. About 430 other children also have been infected with the virus – deliberately and at the hands of foreign nurses, many Libyans believe.

"We want punishment for the nurses and help for Ferial," Ms. Zoubi said.

Although the five nurses, all of them Bulgarian, remain in prison under a death sentence, Ferial's family and others might not get their wish. The Libyan government, which has promoted the conspiracy theory for more than five years, is trying to find a way out of the quandary.

Last month, Libya's Supreme Court delayed until Jan. 31 its decision on the appeal of the nurses' sentence, presumably to give Libya and other countries more time to negotiate a solution.

"The way the thing turned out was not unhelpful," said Anthony Layden, the British ambassador to Libya. "Efforts ... are being made to find a solution to this longstanding problem that will be acceptable to all parties."

The case has roiled Libya, which in 1998 had little experience with HIV and was at odds with Western countries. To deflect blame from Libya's own health-care failings, Col. Moammar Gadhafi, the country's leader, accused the CIA and Israeli intelligence of paying the nurses to infect the children.

Many Bulgarians and foreign diplomats consider the case against the nurses to be absurd, and they blame poor sanitary conditions in the hospital. A prominent French doctor who co-discovered the HIV virus concluded in 2002 that poorly trained staff and "systematic reuse" of needles probably caused the infections.

Still, the case has dragged on.

In an interview, Seif el-Islam Gadhafi, Col. Gadhafi's influential son, said Libya must find a way to resolve the situation without executing the nurses. The case against them "was manipulated by some people in order to create a plot or a story to blame those foreigners, and to make them a scapegoat," Mr. Gadhafi said.

But the families must be compensated because they have suffered so much, he said.

Libyan negotiators have asked Bulgaria to pay $10 million to each family, but Bulgaria has refused, saying a payment of "blood money" would make it appear as if the nurses are guilty.

"We have to have a decent solution for the children and to find an exit, because we are in a deadlock," Mr. Gadhafi said.

In Libya, a country where AIDS is widely misunderstood and treatment is uneven, many families view the infection as a death sentence. And many wish the same fate on the nurses.

"If [the options were] President Bush giving me $20 million or killing the nurses, I would choose to kill the nurses," said Khaled El Driwi, whose 7-year-old son is HIV-positive.

The families complain that America's and Europe's concern for the nurses has veiled their own suffering. Of 431 infected children, 51 have died, said doctors with the Benghazi Center for Infectious Diseases and Immunology.

The European Union is spending about $1.7 million to upgrade that center to international standards.

Salem El Gerabi, who treats young adults at the center, said Libya has enough anti-retroviral drugs, but physicians like him still have not been trained for cases that require specialized treatment.

"I don't have any qualifications in HIV, just my experience," Dr. El Gerabi said. "These are not all simple cases. There should be a team to treat these cases."

Benghazi also needs psychologists, Dr. El Gerabi said. Many of the HIV-positive teenagers are depressed because people have told them they cannot marry, he said.

"I am of the mind they can marry, but there is a social stigma in our society," he said. "A family is going to say you have to look for an HIV case like you."

Mr. Layden, the British ambassador, said his country has sent two psychiatrists to Benghazi to teach Libyan psychologists how to counsel the families and children.

Italy has accepted many of the children for free medical care. Mr. El Driwi said he has been to Italy so many times to seek treatment for his son that two of his other children were born there.

Another boy, Abdullah El Nuhely, is waiting to go to Italy. Lately, Abdullah has suffered from pneumonia and stomatitis, which has caused painful blisters around his mouth. He also suffers from growth failure. Dr. El Jhawi said he is 10 years old, but he looks no older than 4 or 5.

If Libya were to free the nurses, Mr. El Driwi would be very angry, he said. He would partly blame the United States, he said, because Mr. Bush has called for the nurses to be freed.

"The right judgment is death," Mr. El Driwi said. "Even now, the Bulgarian staff is living in the jails very nicely, with the best food. We feel the pain, as if we were in the prisons and they were free."

After last month's Supreme Court delay, dozens of angry Benghazi men threw rocks at foreign journalists and diplomats and burned the Bulgarian flag. Their signs read "Death for the Children Killers."

"We should have heard a decision by now," said Massoud Mufta, who said his daughter was infected when she was 9 months old. "We are tired and spend a lot of money to come here. Nobody pays for us. It is eight years of this."