A joyous welcome for medics freed by Libya

For almost 8 1/2 years, they languished in a Libyan prison, condemned to death by military firing squad, convicted of a crime that was the antithesis of their careers in medicine.

Five Bulgarian nurses and a Palestinian doctor had deliberately infected more than 400 Libyan children with the virus that causes AIDS, a Libyan court had ruled. Why? First, it was supposedly part of a twisted plot to destabilize the government. Later, the Libyans claimed, the crime was a medical experiment gone horribly wrong.

The six health workers, their faces peering, year after year, through metal bars as an appalled but apparently impotent West looked on, proclaimed their innocence, and independent reports by experts backed them up. Their confessions were extracted through torture, they said; their supporters viewed them as pawns in an authoritarian regime’s quest to end its financially crippling isolation.

And then, on Tuesday, their ordeal came to a dramatic end.

It was a denouement brought about after months of negotiations leading to the payment of hundreds of millions of dollars for the infected children in Libya, which critics likened to ransom; the promise of new privileges for Libya’s government; and entreaties from the likes of the emir of Qatar and France’s new first lady.

Whisked out of their prison before dawn, the six were bundled onto a French presidential jet and flown to the Bulgarian capital. Minutes later, Bulgarian President Georgi Parvanov pardoned the nurses, Snezhana Dimitrova, Nasya Nenova, Valentina Siropulo, Valia Cherveniashka and Kristiana Valcheva, and the doctor, Ashraf Alhajouj, an Egyptian-born Palestinian who had been granted Bulgarian citizenship.

“I feel like I’ve been in a coma for eight years, and only now am I waking,” Dimitrova said, according to her son Ivaylo, who was among the jubilant, tearful relatives and friends and crowds of well-wishers who greeted the health workers at Sofia’s airport.

“I still can’t believe that I am standing on Bulgarian soil,” Valcheva told reporters. “I want my life to return to what it was before.”

The nurses, ages 41 to 54, had learned they were being freed only hours earlier. They stepped steadily but stiffly down the airplane’s staircase and began to shake hands with waiting officials and diplomats. But then relatives burst through and ran to the mothers and sisters they had not touched in years, nearly knocking them over in a blissful crush.

In Libya, while Col. Moammar Kadafi clearly parlayed the case into better trade, economic and political ties for his longtime pariah state with Europe, he did so at the expense of anger among the families of the 438 infected children, who did not want the health workers freed. Some of the children, who experts say were victims of unsanitary hospital conditions and practices, are now in their teens; more than 50 of those infected have died.

European officials, too, came under criticism for the perception that they had in essence paid ransom for the health workers.

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Delayed justice

“Science and diplomacy have righted a juridical abnormality,” said Dr. Vittorio Colizzi, an Italian virologist and one of the world’s foremost HIV/AIDS experts, who championed the Bulgarians’ cause. “But is it justice when it takes so many years to tell us what we already knew? This is very late.”

Several of the nurses said they were abused and tortured while incarcerated. They suffered broken bones and ill health. Their faces have become lined, their hair has grayed. One attempted suicide.

“The scars can still be seen on their bodies,” said Bulgarian Dr. Zdravko Georgiev, who is married to Valcheva and was imprisoned with the six but released earlier. However, he was not allowed to leave Libya until now.

“The electrical shocks were horrific,” he said, recalling his lengthy time in jail, during which he alternated between solitary confinement and overcrowded cells. “I could hear the girls screaming.”

Georgiev was flown home Tuesday with the rest of the group.

“I am trying to forget the horrors that I went through,” Dimitrova said, dark circles under her eyes. “I don’t want to tell anyone about it and tried to spare my children the stories.”

Asked what sustained her, Dimitrova, who turns 55 next month, said: “The best thing was I did not understand a word they said about me in court.”

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Soviet-era ties

For decades during the Cold War, the communist Balkan state of Bulgaria sent medical workers, engineers and other technicians abroad to ideologically like-minded nations such as Sandinista-led Nicaragua and Soviet ally Libya.

The tradition continued as Bulgaria shifted to democracy but remained poor. Professionals working abroad were able to send money for families back home. Dimitrova, Valcheva and the other nurses arrived in Libya in 1998 and most began work in the Al Fateh Children’s Hospital in the northeastern coastal city of Benghazi, where dozens of youngsters had been infected with HIV.

In 1999, a group of 23 medical staff members, mostly Bulgarians, was rounded up by police, blindfolded and taken into custody. The health workers were eventually released, except for the five nurses and Alhajouj, a Palestinian who had lived in Libya since 1971.

Libyan police claimed they found tainted blood in Valcheva’s home. Three of the nurses and Alhajouj said they were tortured with electrical shocks, beatings, drugs and menacing dogs to make them confess.

“During the shocks and torture they asked me where the AIDS came from and what is your role,” Valcheva said in a jailhouse interview with New York-based Human Rights Watch in 2005.

“My confession was all in Arabic without translation,” she said, adding that Libyan interrogators attached electrodes to her breasts and genitals. “We were ready to sign anything just to stop the torture.”

Armed with the false confessions, Libyan prosecutors indicted the six, initially alleging that they had given HIV-tainted blood to the children on orders from the CIA and the Israeli intelligence agency, Mossad.

Later, the prosecutors claimed the health workers were infecting the children as part of an experiment to develop a vaccine against HIV/AIDS.

As outlandish as those claims might appear, hearings before the People’s Court started in 2000, and the following year Kadafi himself lashed out at the defendants in a speech at an African AIDS conference. For their “odious crime,” he said, they would receive a trial “like Lockerbie.”

He was alluding to the prosecution of two Libyan agents in the 1988 bombing of Pan Am Flight 103 over Lockerbie, Scotland -- and underscoring the political nature of the proceedings.

Kadafi’s influential son, Seif Islam, eventually stepped in to help resolve the case. In 2002, he invited two of the world’s leading experts on AIDS to study the Benghazi outbreak. Dr. Luc Montagnier of France, the co-discoverer of HIV, and Colizzi, the Italian expert, concluded that poor hygiene and reuse of needles at ill-equipped Libyan hospitals were the most likely culprits.

Colizzi and Montagnier testified to the court for hours. “I still remember how much they [the defendants] smiled when they heard for the first time that they were innocent and could not have caused this,” Colizzi said Tuesday in an interview in Rome.

The doctors performed genetic analyses on the blood of the infected children and determined that the first cases dated to 1996-97, a year or more before the Bulgarian nurses arrived in Benghazi. The strain of HIV, they said, matched that found in central and western Africa and was probably brought to Libya by an immigrant from one of those neighboring regions. Furthermore, incidence of the virus among the children was often combined with hepatitis, pointing to the use of unsterilized needles.

But the court ignored the findings and sentenced the six defendants to death in 2004; appeals in 2006 and again this year were rejected.

However, diplomatic efforts that had proceeded in fits and starts were finally moving to a new level.

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Newfound clout

Bulgaria this year joined the European Union, and now had a powerful 27-nation group to support it. And the interests of the EU, which seeks Libya’s oil and its cooperation against terrorism and illegal immigration, converged with those of Tripoli, which wants to end its international isolation and gain access to Western markets.

Several European countries agreed weeks ago to pay money into a fund to help the infected children; the family of each victim would receive about $1 million. With that, Libyan authorities commuted the death sentences to life in prison.

But the famously mercurial Kadafi apparently decided that was not enough. A deal was struck after tense negotiations over the last two weeks, and with the surprise participation of Cecilia Sarkozy, the wife of the French president, who personally beseeched Kadafi.

The EU agreed to a slate of concessions, including a quick opening of trade and diplomatic links, lifting of restrictions on Libyan agricultural exports, and a more flexible visa regime for Libyans, said Salah Abdel Salam, director of the Kadafi Foundation, which has been helping the children’s families.

The Europeans also agreed to pay for the children’s treatment, equip a children’s hospital and finance a national anti-AIDS campaign in Libya, he said in an interview.

Jose Manuel Barroso, president of the European Commission, said he spent hours on the phone explaining to Kadafi that detention of the medical personnel was a permanent obstacle to improved ties but that removing it would bring rewards.

“I assured him of our wish to normalize relations,” Barroso said in Brussels.

The United States, which has been gradually thawing its relations with Libya, had also called for the six health professionals’ release.

Some EU officials could not conceal their resentment at what they felt was upstaging by Cecilia and Nicolas Sarkozy. The unusual participation of a first lady in high-stakes diplomacy stirred debate Tuesday in France, as well.

“One needs to ask if Mr. Sarkozy decided to make his wife the new foreign affairs minister,” said opposition politician Noel Mamere of the Green Party. “At the head of our country we have not only a president but a couple. Is that a republic?”

President Sarkozy dismissed the criticisms, saying the results, not the methods, are what count.

“The nurses, in my heart, were French,” he said in a news conference. “They were French because they were unjustly accused and because they suffered and because we had to get them out of there.”

The deal is not without risks for Kadafi as well, but he probably calculated that the economic benefits outweighed domestic wrath, analysts said.

“By releasing them, Libya lost one point; however, it would have lost 10 points had it kept them,” said Abu Qassem Smida, a Cairo-based Libyan political analyst.

National debate is also percolating in Bulgaria, where many Bulgarians, including some of the freed nurses, said their government did not do enough to end their torment.

“Besides the physical suffering and the pain, the psychological hardship was the most difficult thing,” Georgiev said. “The destruction of your self-esteem as a human being. They have accused us of the most horrible of all crimes -- to have killed children.”

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wilkinson@latimes.com

Special correspondent Damianova reported from Sofia and Times staff writer Wilkinson from Rome. Noha El Hennawy of The Times’ Cairo Bureau and Achrene Sicakyuz of the Paris Bureau contributed to this report.