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HIV Infection Trial Offers Little Closure

Relatives of infected children furious at suspended sentences handed down to top health managers.
By Daur Dosybiev
A major trial of health professionals accused of allowing HIV-contaminated blood to be given in transfusions to young children in Kazakstan has left the parents of infected children angry because neither of the top officials charged in the case will serve prison terms.

Doctors lower down the ladder feel they are being blamed for the poor management endemic to the health sector, and say they are now afraid to carry out medical interventions for fear of being hauled up for malpractice.

The trial, which began in early January this year, saw 21 doctors and health service managers from the South Kazakstan region accused of professional negligence, as well as taking bribes and misappropriating funds. Among them were regional health chief Nursulu Tasmagambetova and Rysulbek Baykharashev, who headed the region’s committee that monitors the quality of medical services.

Tasmagambetova is Baykharashev’s wife and the sister of Imangali Tasmagambetov, a former prime minister who is now mayor of Almaty, Kazakstan’s commercial capital.

The case unfolded last year as large numbers of children in the region suddenly began to be diagnosed with HIV. That figure now stands at 133 people including 119 children, ten of whom have died.

The issue became a national scandal and the Kazak government sent in investigators to establish the origin of the infection, which proved to be a number of hospitals and health centres in and around the provincial centre, Shymkent. The investigation led to the resignations of Health Minister Yerbolat Dosaev and South Kazakstan regional governor Bolat Jylkishiev.

In its June 29 verdict, the court in Shymkent found that all 21 were guilty of professional negligence and three of them also of taking bribes. Judges handed down prison sentences of between two and eight years to 16 doctors.

However, all the officials who were charged – Tasmagambetova and Baykharashev plus three of their deputies – walked free after being given suspended sentences. Tasmagambetova has said she does not regard herself as guilty.

This decision infuriated parents and relatives of the children infected with the HIV virus while being treated in Shymkent.

“We are dissatisfied that the former health department head Tasmagambetova was given a suspended sentence,” said Sagdat Masaurov, whose grandchild was infected and who now heads a charity called Protecting Children From AIDS.

“When the verdict was delivered, some of the parents became hysterical; some even fainted. We are angry that [they] have avoided going to prison…. We will appeal, although we no longer hope for a fair verdict.”

Doctors in Shymkent dispute the official story that the virus was spread by reusable instruments contaminated by a small original amount of blood from an HIV-infected child who was treated at a city hospital in 2005. Many believe all the infections occurred from a contaminated consignment of donor blood.

“The most frightening thing is that the source and channels of the HIV virus infection have not been established,” said Shokan Baimukhamedov, a doctor at South Kazakstan’s regional hospital. “According to the official version, there were one or two HIV-infected doses of blood, and then doctors infected children in several hospitals simultaneously with reusable catheters and needles. But HIV is a very short-lived virus, and I don’t believe it is possible to infect [so many] people in this way.”

Journalist Yelena Yeliseyeva, who has written extensively about the case, sees a number of inconsistencies in the official account set out during the trial, which holds that infection via contamination of medical instruments took place at just three institutions – at South Kazakstan regional hospital in late 2995, and at two children’s hospitals in Shymkent in 2006.

Yeliseyeva believes that this story begins to look questionable when one considers that several of the infected children were treated at hospitals other than these three. She notes that during the trial, defendants complained about the official account on the grounds that it contained inaccurate information about where and when individual children were treated.

“This account is not proof, it is conjecture - and rather arbitrary conjecture at that – to the effect that the children infected each other via medical instruments,” said Yeliseyeva.

Meanwhile, doctors in South Kazakstan feel that their colleagues have been punished more severely than their superiors, and that the profession is being blamed for what, in their eyes, are failings of management.

About 300 of them signed an open letter to the government and international medical associations saying that the convicted doctors had been made the “scapegoats” for everything that it is wrong with Kazakstan’s healthcare system.

Dr Baimukhamedov says his colleagues are now reluctant to give blood transfusions, and many are moving away from Shymkent.

“There are virtually no emergency paediatric doctors left,” he said. “Three are in jail, and two more resigned when they saw how their colleagues were dealt with. Who will treat these children now?”

The head of the intensive care unit at one of the children’s hospitals named in the official account added, “I doubt I’ll work in intensive care or in medicine in general any more, although we have a serious shortage of specialists at the moment.”

At the end of last week, 80 doctors in South Kazakstan publicly handed in their resignations as a collective protest over the way the trial was handled.

Daur Dosybiev is an independent journalist in Almaty.

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