HIV Scare at Children's Hospitals in South Kazakstan

Southern Kazakstan has been rocked by news that 15 small children have been found to be infected with the HIV virus at two hospitals. The government has moved fast to find the source of the infection, but nothing has come to light yet.



Prosecutors in the South Kazakstan region launched a criminal investigation on July 14 after doctors at three paediatric hospitals found 15 children under three years of age who tested HIV-positive.



Apart from the fact that young children are involved, these cases also amount to a huge spike in the incidence of HIV in South Kazakstan. They take the total number of new cases since the beginning of the year to 78, compared with 44 for the same period of 2005.



Such is the seriousness with which the authorities are treating the matter that a government commission led by Kazakstan’s chief doctor Anatoly Belonog and National AIDS Centre director Isidora Erasylova was sent in to look into the cases, and a regional-level health commission is conducting its own investigation.



Despite this activity, the authorities are remaining tight-lipped about how the children were infected, and officials have been reluctant to talk to the media.



Doctors cannot say for certain what the source of infection was, and warn that more cases may yet emerge.



The deputy director of the regional health department, Nagima Joldasova, said all the children affected had been treated at least once and had received blood transfusions at the hospitals – two located in the provincial centre Shymkent and one elsewhere in the region.



Hospital blood stocks, donors, and the children’s parents have all been tested, but nothing has come to light, she said.



The health department’s director Nursulu Tasmagambetova agrees with her deputy’s assessment, but suspects that the parents may eventually be found to be the source.



“I have data from infectious disease doctors in Russia showing that HIV-infected women may remain in a so-called negative grey zone for a long time – up to 10 years. When they’re examined, no infection is found, but they may still be carriers,” she said.



Dr Belonog and his commission have not come up with definitive conclusions yet, but they appear to believe the hospitals are to blame.



“In the hospitals we’ve looked at, we found a lack of control over the use of sterile medical instruments, and cases where the sterilisation regulations had been broken,” he said. “These children were probably infected by donor blood, or as a result of non-sterile medical instruments being used.”



The commission’s findings to date have led to three senior health officials being sacked: Tashmukhan Taibekov, head doctor at the regional children’s hospital in Shymkent; Kelesbai Jumagulov, chief doctor at the regional AIDS centre; and Shora Seidinov, the head doctor at the regional blood centre. The head doctors of children’s hospitals in Shymkent have received formal reprimands.



Seidinov is unhappy with what he seeks as a knee-jerk reaction, and intends to appeal against his dismissal. He points out that Belonog’s commission did not find fault with the blood centre.



“Of the 91 donors whose blood was given to recipients, all have undergone repeat testing, except one who was away, out in the steppes working as a beekeeper. And I’m sure this man is not the source of the infection, as he’s been examined several times in the past,” said Seidinov.



He noted that a recommendation made by the commission for blood plasma to be quarantined for six months has been enforced since January, but only for ten or 15 per cent of the blood in stock since his centre does not have the 130,000 US dollars it needs to buy the 35 extra refrigerator units required. “I reported to my superiors that neither the money nor the equipment had been provided,” he said.



There is some disagreement about the number of donors involved. While Seidinov spoke of 91, of whom one had not yet been tested again after the HIV scare, regional health officials said three of them had not undergone repeat tests. Meanwhile, a national health ministry official, Ualikhan Akhmetov, told reporters that all the donors had been checked, but that there were 105 of them.



This contradictory information has only added to the rising sense of panic among Shymkent resident.



A health officials who asked not to be named said there are more and more cases where people refusing are refusing medical assistance and hospitalisation, especially when it comes to their children. The number of children visiting doctors at Shymkent clinics has halved. Many parents are taking their children out of hospital even though their course of treatment has not ended, the official said.



“After this outrageous incident, how can you trust doctors to look after your child?” asked one mother with a five-year-old son. “If my child falls ill, then I will try to go to a doctor I know personally, and he will be treated at home. I don’t trust hospitals at all.”



The majority of doctors interviewed by IWPR were doubtful that the 15 children had been infected while in hospital. But one senior doctor with 24 years’ experience said the possibility could not be ruled out for certain.



“I fear that the official information we’ve received is just the tip of the iceberg, and we’ll never know how many children actually received this fatal infection,” he said. “It’s also possible we’re dealing with ‘professional terrorism’ here - in other words, some medical staff member is intentionally infecting people.”



As parents watch and wait nervously, the regional health department has taken action to reassure the public. A July 25 instruction requires all medical staff whose work has any connection with blood to undergo HIV testing. All children who have received medical treatment this year will also be tested.



Olga Dosybieva and Daur Dosybiev are independent journalists and regular IWPR contributors in Shymkent.