I support EU ban on non-evidence-based medicine

Avaaz.org is an international organization which mounts civil pressure for causes regarded by its leadership as good. Some of them are good indeed, such as the no-fly zone in Libya. However, as often happens with activists, they also advocate things that anyone of the meanest understanding would call foolish at best. See what I found in my Inbox today:

"EU: 3 days to save herbal medicine!
Dear friends,
In 3 days, a new EU directive will ban much of herbal medicine, denying us safe remedies and feeding the profits of big pharma. Let's raise a massive outcry to push the Commission to fix the Directive, and our national governments to refuse to implement it. Let's get to 1 million voices to save herbal medicine:
In 3 days, the EU will ban much of herbal medicine, pressing more of us to take pharmaceutical drugs that drive the profits of big Pharma.
The EU Directive erects high barriers to any herbal remedy that hasn't been on the market for 30 years -- including virtually all Chinese, Ayurvedic, and African traditional medicine. It's a draconian move that helps drug companies and ignores thousands of years of medical knowledge...
It's hard to believe, but if a child is sick, and there is a safe and natural herbal remedy for that illness, it may be impossible to find that remedy.
On May 1st the Directive will create major barriers to manufactured herbal remedies, requiring enormous costs, years of effort, and endless expert processes to get each and every product approved. Pharmaceutical companies have the resources to jump through these hoops but hundreds of small- and medium-sized herbal medicine businesses, across Europe and worldwide, will go bust...
There are arguments for better regulation of natural medicine, but this draconian directive harms the ability of Europeans to make safe and healthy choices. Let's stand up for our health, and our right to choose safe herbal medicine."

I am omitting the lines directing the reader to the online petition. If you want to sign it, you can easily find it by a Web search.
I have bashed the EU bureaucracy on numeral occasions on this blog and elsewhere, but I support it whole-heartedly in this case. It is high time to stand for evidence-based medicine and to ban all snake oils being sold us under the label of "traditional medicine" in pharmacies. There is no such thing as "thousands of years of medical knowledge" - the threshold when medical knowledge advanced enough to bring more good than harm is probably the turn of the 20th century, and it was passed only in the West. If someone thinks that a particular "traditional" remedy works for a certain condition, he has to prove his case to the appropriate drug administration, as with any other proposed remedy. I do not care that the "small and medium-sized herbal medicine businesses" may not have the resources for this, and I do not think their lack of resources is an excuse to let them sell whatever snake oil they wish without proving its efficacy and even safety. If they cannot do their business properly, let them file for bankruptcy, the sooner the better. And please, if you want me to hate Big Pharma which has saved my life more than once, give me at least one rational reason why Big Pharma must be hated, except that it works for profit (as if the snake oil salesmen work pro bono publico).
There is a myth among foolish people that traditional, "natural" and particularly herbal medicine is both effective and safe. To begin with, a remedy that is both effective and safe is a Holy Grail. There are a number of placebos that are safe but not effective, plus a number of effective drugs that are generally not quite safe but, if properly used, have benefits far exceeding the risk. Traditional medicine generally relies on placebos. However, we should not assume that it is always safe. Numerous plants contain potent toxins (take just the fact that Socrates was executed by herbal poison). Some of these toxins have found their application in evidence-based medicine and are being sold by Big Pharma; for the rest, you have only the toxic effect without any proven therapeutic effect. To make things worse, for many traditional Eastern remedies the natural toxicity of plants is not enough and they contain also well-known chemical toxins such as heavy metals (Orac and Skeptico have blogged about this).
Some hardline supporter of individual freedom may argue that consumers should have the right to make choices, even if they are not "safe and healthy". I disagree. A consumer should not be forced to be on a permanent alert in order to avoid buying useless and dangerous things - at least not in civilized Europe. Moreover, while responsible adults could at least in theory make their choices, there is no way to prevent parents from pushing placebos and poisons down the throats of their poor defenceless children. The Avaaz letter particularly stresses the need to keep "safe and natural herbal remedies" available for sick children. I even know parents who treat their own illnesses by effective evidence-based drugs but, when their children are ill, give them traditional medicine because of concern about the side-effects of drugs.
So let's hope that the ban will be enforced and EU pharmacies in the future will sell us only remedies that actually help, according to the best available knowledge.

Quacks of the world, keep your dirty paws off autism!

The text below is a translation (omitting some minor parts) of what I posted on my Bulgarian blog on Jan. 11 as a reaction to the dangerous export of autism quackery to Bulgaria.

The problem of children with autism is that they look quite like the others. When there is inborn malformation, chromosomal disease, sensory disability or another quite obvious problem, parents and society eventually accept the fact that this child is different and will remain so. But the inpredictable time course of autism, its still mysterious nature and the normal appearence of autistics mislead parents to hope that they will somehow be able to bring their child to norm. In fact, today the diagnosis of autism is handed around like candy, often by people who are not competent to diagnose but know well how to "cure" the incurable condition of autism (you ask how? - by relieving parents of their too abundant money). Many of the alleged autistic children actually have only speech delay and eventually catch up spontaneously. But pronounced autism is another thing. In the framework of an unaccepting society, it is perceived by parents not as a part of their child's personality but as an enemy to be faught. And then the quacks wishing to separate them from their money lure them easily and catch them on a hook without even a bait.
The last "achievement" of this sort belongs to Tokuda Hospital in (the city of) Sofia... They organized a conference on autism on Jan. 8-9. A special guest who presented a lecture on this conference was Dr. Arthur Krigsman, (advertised as) "a world-renowned gastroenterologist" from the USA...
A minute's Google check shows that he is indeed world-renowned. Have you a page in Wikipedia? Has your child's doctor or the hospital's director such a page? No? Eh well, Dr. Krigsman has one. You can read in it that he is known for his controversial and widely-criticized research in which he attempted to prove that the MMR vaccine caused autism. I love this little English word "controversial". It is used e.g. for Jeremiah Wright - the US president's favourite minister known for his statement that the USA deserved the Sept. 11 attacks. When a doctor is called "controversial" by a restrained source like Wikipedia, you can be sure that he is a top quack already fired from everywhere and awaiting only the prosecutor's subpoena, if not having received it already. I guess the coming of such a high guest to Bulgaria must be a reaction to some call "Quacks of the world, unite!".
From the conference at Tokuda Hospital Dr. Krigsman went to the At a cup of coffee TV show aired on the Nova TV Channel, so that the entire Bulgarian nation could enjoy his blessings. I owe thanks to my mother in-law who heroically watched the program and then retold it to me (I could not see it personally). To sum up, Dr. Krigsman explained for an hour how the neurological disability known as autism is due either to the digestive system or to the immune system or to heavy metal poisoning, how vaccines are to blame, how autistic children must be subjected to colonoscopy and biopsy (an invasive and not quite safe procedure) and how his method provides a cure for autism, described in all medical textbooks as incurable. And at the end of this hour, the gentleman said, "We are not curing autism, we are curing gastrointestinal diseases!" Ha-ha-ha. Western quacks always include such a disclaimer in order to avoid the heavy grip of law. Dr. Krigsman was unaware that in our part of the world, rule of law is a bit sickly and everybody can lie as he wishes without any disclaimers at all.
Unfortunately, (TV show host) Gala - this pride of Bulgarian journalism, really succeeded in advertising the US quack doctor. You can see the discussion in BG-Mamma (the major Web forum of Bulgarian mothers). I could endure only a brief glance on the first page. It looks to me like a chorus from the circles of Hell where gullibility is reinforced by positive feedback as it is handed from one desperate soul to another. But those who are really in the circles of Hell are the children (and adults) with autism. Not because of the autism itself but because of our attitude.
What do I mean? Imagine that you have a disability - let's say, you are blind or your legs are paralyzed. Imagine that society does not wish to accommodate to your disability, refuses to give you Braille books or a wheelchair and instead wants you to start seeing or walking. It suggests to you that if you fail to achieve this, you have no value, you are not a complete human, it is not clear whether you are human at all. Now imagine that your family members, on whom you have to rely because of your disability and your tender age, are not interested in your real needs but instead wonder how to cure you. They put you on a diet without bread, dairy products and everything you like, and they swear that, thanks to this diet, you already distinguish light from darkness or have slightly moved your left toe. (I am referring to the notorious gluten-free casein-free diet that not only does not lessen autism traits a bit except for the placebo effect, but deprives children of calcium and so makes their bones thinner.) Moreover, your relations bring you to some quack to poison you allegedly to detoxicate you from heavy metals, endangering your life. They also bring you to another quack to puncture your intestines, again endangering your life. They subject you to all sorts of experiments that are not even included in a legal experimental medicine study. They repent for the vaccines that have allegedly contributed to your condition, and swear not to vaccinate your little sister - which you take as a message that they'd prefer her to die of measles than be like you.
Unfortunately, right now I have no time to write a serious text about autism, which seems to be necessary. For those who can read English, I recommend the sincere tale of Dr. James Laidler how he himself got involved in quackery because of his desperation after his two children were diagnosed with autism, and then the blog of "Prometheus" - a molecular biologist and father of an autistic child. Meanwhile, to all who care for children or adults with autism, I wish high spirit, health, physical and emotional strength - and act cleverly!
(In an update, I added that Gala's guest was not only Dr. Krigsman but also his pal Dr. Anju Usman, who has direct responsibility for the death of 5-yr-old Abubakar Nadama by referring him to Dr. Kerry to be "treated" with the poison EDTA that killed him.)

Drive carefully on Bulgarian killer roads

The translation below is from an Aug. 22, 2010 DarikNews report:

"Boy dies after car crash near Burgas
A 16-yr-old boy from Sofia died after a heavy car crash on the road Sofia - Burgas (Bourgas). His mother, 14-yr-old sister and the driver are hospitalized...
The crash happened 300 m east of the village of Venets, near the town of Karnobat... The driver, a 46-yr-old Cuban citizen living in France, attempted overtaking, although it was banned by traffic sign and road marking. She lost control over the vehicle and crashed frontally into a tree.
A 16-yr-old boy from Sofia travelling at the back seat died at the spot. His 14-yr-old sister is severely injured and her life is in danger..."

Readers have left the following comments:
"Oh, oh, this road between Karnobat and Venets - the stretch of death."
"Come on, overtake where overtaking is banned, like savages!"
"I knew the girl - may her rest in peace, and her brother also. I do know know what happened to the mother, may God keep her strong if she is alive..."
"I knew the boy, his name was Kaloyan. We attended the same school. He was always merry and was making merry all of us. He was an excellent friend and will remain forever in my heart, and in the hearts of all who knew him! I hope he and his sister are at a better place now! My condolescence to the parents..."

The victims are my neighbours' grandchildren. I vaguely remember the handsome boy with whom we exchanged greetings at the staircase of our apartment block. He often stayed with his grandparents because his school was in our district. Now, the obituaries of the two children with their smiling photos and attached flowers are facing us at the block's front door.
There are some inaccuracies in the DarikNews report. The boy was seating not at the back seat but at the front right seat, and this is why he died immediately when the right half of the car crashed into the tree. His sister was behind him. She died at the hospital 8 days later. The two adult women - the children's mother and her friend who was driving, were only slightly injured because they were sitting at the left side. The driver, presented in reports as Frenchwoman of Cuban origin, was in fact a Bulgarian living in France. Despite her long driving experience, she made the fatal mistake to drive on Bulgarian roads with a speed appropriate for a French highway, and to violate the overtaking ban.
Bulgaria has always been behind with its road infrastructure, but the situation became grotesque after 1989. As the emerging capitalism burdened our roads with unprecedented traffic, the domestic and EU money allocated for their construction and maintenance kept being stolen. I am not talking about "standard" corruption diverting 10-15% of funds yet allowing the road to be built. I am talking about Bulgarian corruption diverting 90-100% of funds. Millions have disappeared and we still have no roads. EU member Bulgaria does not yet possess a single finished highway - not one! With pain and peril, drivers navigate narrow roads full of turns, suitable for donkey cart travel between villages.
Through the years, every time when EU officials discovered that EU funds allocated for infrastructure had been stolen, they used a standard approach - to stop future transfers until appropriate anti-corruption measures are taken. I have very mixed feelings to this starvation policy. I admit that it is not too justified to enrich Bulgarian corrupt politicians with the money of European taxpayers. However, stopping the transfers deprived Bulgaria even of the small fraction that was used on purpose. What, exactly, are you hoping to achieve by depriving poor people of money? Possibly you are hoping that Bulgarians will behave as proper citizens and will keep their corrupt rulers responsible? But Bulgarians are not able to behave as proper citizens and to keep their rulers responsible, despite the superficially perfect multy-party representative democracy. This is actually the reason why Bulgarians, and also many other nations, are poor and stay poor. I would prefer EU to send Western companies with their equipment and workers to do the job, without any capital coming to Bulgaria in a convertible form.
Now, when beginning new constructions and opening road stretches finished with 15-20-yr delay, our rulers half-heartedly admit that the obsolete and poorly maintained roads take lives ("our goal is to diminish the number of car crash victims," said Prime Minister Borisov in 2009). It is good that they are talking like this, because talking about a problem is the first necessary step to solving it. However, it is not a sufficient step, and I don't yet see much deeds to back the words. No measures are taken even for places known to cause heavy crashes regularly, such as the Karnobat - Venets "stretch of death" which is narrow and has many turns.
Meanwhile, if you are a visitor to Bulgaria, your well-being and that of your fellow travellers depends on your successful navigations of Bulgarian killer roads. Be careful, do not speed and remember that there is no such thing as urgent business.
Keep your eyes open for potholes that "mine" Bulgarian roads. And for dangerous turns that are found at every kilometer. Because we are still using the old roads that connected towns and villages, you will pass through every single settlement on your way - speed down when you enter it. However, pedestrians and farm animals may appear on the road even when you are far from any settlement.
And please overtake as rarely as possible. All Bulgarian roads, if not 2-lane in their entire length, have long 2-lane stretches. You will soon find yourself behind some too-slow vehicle, and you will get nervous. Try to relax, rather than attempting a risky overtaking that may end in a frontal crash. And if overtaking is banned by signs, abide them even if you wonder why they are put there. Sometimes, such a sign marks a place where someone has died in attempted overtaking. So the sign may be an anonymous memorial to a previous victim, and it is not wise to neglect its warning.
Keep in mind also that Bulgaria is a poor country and if you are injured in a crash here, you may not receive state-of-the-art medical treatment. (This is not to imply that the Burgas doctors who tried to save the life of my neighbours' granddaughter have any responsibility for her death. She was injured very severely - I guess, beyond salvation.)
If you are travelling in winter, remember the risk of ice. Too little is done to make the roads usable after a snowfall, so you have to rely on yourself again. Personally, I always feel relieved when a winter car jouney comes to an uneventful end. It is January now and the most dangerous weeks for drivers are coming, as snow covers the roads where half a year ago two children were returning from their last sea vacation.

Blaming America by junk science

I have just read the March 4 BBC report Fallujah doctors report rise in birth defects, after following a link from the WIP site. I am quoting a part of it below:

"Doctors in the Iraqi city of Fallujah are reporting a high level of birth defects, with some blaming weapons used by the US after the Iraq invasion.
The city witnessed fierce fighting in 2004 as US forces carried out a major offensive against insurgents...
Doctors and parents believe the problem is the highly sophisticated weapons the US troops used in Fallujah six years ago.
British-based Iraqi researcher Malik Hamdan told the BBC's World Today programme that doctors in Fallujah were witnessing a "massive unprecedented number" of heart defects, and an increase in the number of nervous system defects.
She said that one doctor in the city had compared data about birth defects from before 2003 - when she saw about one case every two months - with the situation now, when, she saw cases every day.
Ms Hamdan said that based on data from January this year, the rate of congenital heart defects was 95 per 1,000 births - 13 times the rate found in Europe..."

A commenter has left the following remark at the WIP site: "Bloody warmongering U.S. commits war crimes with impunity. I am disgusted and ashamed. Sincerely."
I wrote, "Comparing the congenital heart defects incidence in Fallujah to that in Europe, rather than to that in the same city in earlier years, in other Iraqi cities or in other Mideast countries, should immediately raise the red flag. Hoffman et al. (2002) in their article "The incidence of congenital heart disease" (J Am Coll Cardiol, 2002; 39:1890-1900) point out that this incidence varies greatly depending on which defects you count, and that including all of them gives a rate of 75/1,000 live births - only a little less than reported here for Fallujah. Of course there may be true increase in birth defects causally linked to the US weapons; but so far, the data presented remind me the infamous "vaccines cause autism" speculation."
In fact, the 95/1,000 heart defects statistics is the only number cited in the BBC report. All other data are anecdotal, such as how many defects a doctor "saw" before and now (which could be due simply to her now seeing a larger total number of babies, or to her hospital acquiring better diagnostic equipment).
According to Hoffman et al., "there is no evidence for differences in incidence in different countries or times". I would add that even if there are significantly more birth defects in Fallujah than in Europe, the cause could be selective abortion of malformed fetuses after ultrasound diagnosis in Europe, higher prevalence of consanguineous marriages in Iraq, other genetic factors or environmental factors unrelated to the US-led war. Identifying correlation, let alone causation, is serious business. So far, the presented "data" seem to show only that the war has had psychological impact on Fallujah doctors and their patients.
Of course, we cannot exclude true increase in birth defects in Fallujah caused by the 2004 US operation. Weapons are not presumed or expected to be healthy. However, such an increase can be revealed only by research worth this name, preferably followed by publication(s) in peer-reviewed journal(s). I find it unfortunate that the BBC is so happy to embrace any piece of junk science (if not plain propaganda) as long as it makes the USA look bloody and warmongering.

Voice of a Haitian

Rose-Anne Clermont is a German journalist and blogger of Haitian origin. She contributes to Women's International Perspective and writes a blog titled Currents Between Shores. I like very much her writing and her personality, though we disagree on most issues. I advise you to visit her blog for an update about Haiti. Below I am copying most of her Jan. 13 post Helping Haiti:

"As many of you know, my mother runs a center for homeless boys in Jacmel, Haiti, my father's hometown. My mother's hometown, Port-au-Prince, lies in rubble... We are still awaiting news from the Clermont Center and we're hardly comforted by the devastating scenes of leveled buildings, half buried people and eerie absence of a casualty and mortality count.
But I, and I encourage those of you who would like to help, am trying not to dwell on the over abundance of negativity, which runs in a loop whenever mainstream news sources focus on Haiti: "one of the poorest countries in the world, people eat mud cakes, there was no infrastructure to begin with, hurricanes have already left the country crippled"... alright already.
Let's move forward. Let's move something.
For starters, you can help (whether it's donating money or supplies or time).
All major international relief organizations such as UNICEF... will be contributing to the relief effort. But remember also Doctors Without Borders, The Clermont Center for Homeless Adolescents and Yele... "Men anpil chay pa lou." Many hands make the load lighter."

Two days later, Rose-Anne wrote that, fortunately, boys and staff at the Clermont Center are safe, though the building is damaged.

Playing the guilt game

A year ago, Prometheus published a post titled How they do the voodoo that they do so well - Part 2 ("they" are the alternative medicine practitioners). I am quoting it below:

"Eventually, even the most successful, charismatic “alternative” practitioner will have a patient who doesn’t improve enough... For those situations, there are a number of strategies that are typically used. (The first one is,) Did you follow my instructions to the letter? One of the oldest dodges in the “alternative” medicine “biz” is to prescribe a regimen of treatment that is too complicated for most patients to follow. If they get better (by chance), then it was due to the “treatment” – if they don’t get better….well, they didn’t follow all of the instructions exactly, did they?"

I wish to add that, unfortunately, some real doctors also like playing the guilt game and blaming any unfortunate outcome on the patient's non-compliance. Even when - especially when - the neglected bit of medical advice has been backed by about as much evidence as the typical alt-med "treatment".
(The events that inspired this post are too personal to be revealed here.)

AIDS is caused by HIV

When in the late 1990s an intrahospital epidemic in Benghazi, Libya resulted in infection of about 400 children with AIDS, I thought that I'd wish to popularize what we know about this disease and to devote these texts to the Benghazi victims. Since I started this blog, I have written many times to defend the Bulgarian medics accused in spreading the virus (see my posts with label "HIV trial in Libya", the latest of them here), but never to educate. I even thought that I need not write educational texts about AIDS because there are already many of them written by other, more competent authors. Now, however, I am going to write at least one such post.
These days, Indian journalist Rupa Chinai wrote on the WIP site a series of three articles about the AIDS situation in India. Intelectual honesty requires that I link directly to my opponent's writings, but I am unwilling, because I find their contradiction to the best available AIDS knowledge too dangerous if used by somebody as medical advice. Rupa has talent and compassion and presents real problems, such as the massive supply of bogus AIDS diagnostic tests giving false results and the inability of Indian health care system to control (and even monitor) properly the spread and progression of AIDS. However, she is also highly critical to science (which she calls "Western" science) and particularly to current scientific consensus about AIDS and the so-called by her "AIDS lobby" - a loose association of researchers, pharmaceutical companies and Western government agencies as well as international ones such as UNAIDS. Taken together, these convictions lead her to AIDS (HIV) denialism. Actually Rupa claims only to be unbiased observer of the debate between mainstream scientists and "the dissidents" (as denialists prefer to call themselves), but her preferences to the latter seem clear to me; and even if she was truly standing in the middle, this would be enough to me to regard her as belonging to the other camp, exactly as I regard Sarah Palin's wish to teach both creationism and Darwinism as indicative of her being a creationist, though she doesn't insist Darwinism to be thrown away from school.
Thinking what arguments to put forward in favour of the HIV causation of AIDS, I first wanted to point out that anti-retroviral drugs significantly increase the life span of infected patients. However, after reading Rupa's third (last) article, I was happy that I hadn't talked about the drugs, because it featured a group of HIV positive women who had lost their husbands to AIDS but remained in a reasonably good condition for many years by adhering to a healthy lifestyle, adequate (to their opinion) nutrition and "traditional" medicine. While I am glad that these women do so well, I think that they would do even better (and longer) on anti-retroviral drugs, and hope that nobody follows their example. Contrary to what these women, their so-called doctors and Rupa think, it is easy for the "AIDS lobby" to explain their cases: the "bright" period between encountering HIV and developing an AIDS-defining illness varies much between individuals and is 10 years on average. For the women in the report, this period has been so far 12-14 years, which doesn't differ dramatically from 10 years. So they seem just to have longer than average "bright" periods. I bet that other HIV-infected Indians have followed the same strategy but have had shorter than average bright periods, as the elementary calculus of mean values requires. These people, similarly to many Africans, have paid with their lives for the decision to be natural, traditional and non-Western and now aren't around to tell Rupa their stories.
I also wanted to refer Rupa to the Layperson's Guide to the Scientific Literature, published by Prometheus in three parts (1, 2, 3). However, it would hardly be of any use to her in this particular case, because AIDS denialists (similarly to other knights of anti-science and pseudo-science) are characterized by persistent absence of any works published in the peer-reviewed scientific literature; instead, they talk directly to the science-doubting lay public. I am sure that members of the public regard the poor scientific record of "dissidents" as proving not their incompetence but suppression of these good guys by the conspiring big bad "AIDS lobby". Turning one's own incompetence and professional impotence into virtue - what a feat! Why don't these people make careers as PR experts?
So let me return back to basics in my search for arguments. 19th century German microbiologist Robert Koch established four postulates for proving causal relationship between a particular microbe and a disease. Namely, the microbe must (1) be found in all organisms suffering from the disease, (2) be isolated from a diseased organism and grown in a pure culture, (3) cause disease when introduced from this culture to a healthy organism (typically an experimental animal) and (4) be isolated from the inoculated, diseased new host.
In the early years of AIDS research, scientists had problems with the 3rd and 4th postulate because HIV is highly host-specific and common experimental animals are resistant to it. In the late 1980s, three lab workers were infected with a pure, defined HIV strain by accident. They became HIV+ and developed AIDS. As Jon Cohen writes in top scientific journal Science in 1994, this incident alone means fulfilling Koch's postulates for HIV causation of AIDS. However, as noted in the same article, it failed to convince HIV denialists. Is anybody surprised? And can we expect any anti-scientist to change his theories when confronted by contradicting empirical data? After all, if anti-science people would allow their opinions to be influenced by facts, they wouldn't be anti-science, they would be pro-science.
Also in the 1990s, Koch's postulates were also proven using as experimental animal the chimpanzee, which is the natural host of HIV-1 (see Tim Teeter's article HIV Causes AIDS: Proof Derived from Koch's Postulates). Another animal model are immunodeficient mice "humanized" by grafting human immune cells. These mice are susceptible to HIV infection and special measures are needed to prevent them from dying within 1.5 months (Watanabe et al., 2007).
In his post Age of Unreason Prometheus wrote, "Much of “alternative” medicine encourages people to abandon scientific principles that have brought us in the West to a level of health and longevity that are unrivalled in human history. If we want to see what happens (when science is abandoned), we only have to look to those parts of the world where – for economic or philosophical reasons – scientific medicine is unavailable." Like Prometheus (and unlike Rupa), I think that "Western" science cannot be blamed for the poor life quality and short life span of people who are either prevented from accessing its fruits or, alas, reject them by deliberate choice.

On the stem cell controversy

Let me begin with a quote from Maria Rossbauer's report Unproven stem-cell therapy ban published in Nature journal on Aug. 20:
"The Bulgarian deputy minister for health has resigned over the country's decision to ban the use of a controversial stem-cell therapy to treat neurological disorders. The therapy, which since 2005 has been carried out on around 250 patients at St Ivan Rilski Hospital in Sofia, contravenes European Union regulations and is of unproven value, the Bulgarian health ministry ruled on 8 August."
Subscribers to Nature can read the whole text here.
I wasn't going to blog about the stem cell controversy, after it had a relatively happy ending, but on Oct. 3 our Faculty Board decided to "condemn the unethical and unscientific statements of members of our community (Prof. Bobev, Prof. Svinarov, Prof. Kremenski) in the campaign against the (Department of) Neurosurgery on the occasion of stem cells". Bulgarian readers can find the protocol of the Faculty Board session here. The three condemned professors apparently blew the whistle and this led to banning the therapy.
I am not a doctor, let alone a neurosurgeon, but let me share my thoughts on the subject.
First, bone marrow contains hematopoietic and mesenchymal stem cells. Both belong to the connective tissue, which isn't close to the nervous tissue, so I think it isn't very likely for these stem cells to "convert" and differentiate into neurons. Therefore, to my opinion, this low probability hardly justifies injecting bone marrow stem cells into the brain or the spinal cord, which is invasive and (I guess) not 100% safe procedure. At least not until the treatment has been shown to work in an animal model.
Second, after this experimental treatment has still been given a try, I think that after a reasonable number of treated patients (much fewer than 250) the results must have been submitted to a peer-reviewed journal for publication, no matter whether they have been negative or positive. The team claims positive results - improvement in as many as 50% of patients. However, without a publication it is unclear whether this improvement has been detected in a "blind" manner (i.e. by people unaware of the treatment) or by the treating doctors or even by the patients themselves. In the latter cases of course we cannot distinguish real improvement from placebo effect.
Third, what I disapprove most in the story is that the patients have paid for the therapy. I think that people undergoing experimental medical procedures must never pay (in some cases they may ever receive payments).
Still, I wouldn't like to condemn anybody because I want to believe in the good intentions of all people involved. However, I don't understand why the Faculty members haven't given such a benefit of the doubt to their opponents. So I wish to express solidarity with the three condemned professors.
Thanks to the colleague who informed me about the above cited documents (you know who you are).

I am skeptical about food additives - hyperactivity link

I've just read in Yahoo News that EU is urged to ban food additives over child hyperactivity fears. Quoting: "main consumer watchdog called Thursday for an EU-wide ban on six food colourings which a scientific study has linked to hyperactivity in children... A study published in September in the British science review, The Lancet, found that a cocktail of artificial colours and the commonly-used preservative sodium benzoate are linked to hyperactivity in children." The study mentioned is apparently the one by McCann et al., 2007, though the publication date given in PubMed is November, not September.


I am nobody to judge the study, but still I would like to recomment utmost caution about its results and any actions based on them. (And if you are not happy about what I am writing here, please keep in mind that this is my blog and I can write whatever I want.)


It is so tempting to pick an ubiquitous environmental factor that can be avoided only at an incredibly high cost (if at all) and blame on it some public health problem. Or a presumed problem - because I suspect that with today's unnatural child raising methods and paradigms, much of what is inside the normal range of childhood behaviour is stigmatized as hyperactivity.


Children's hyperactivity is sometimes blamed on another ubiquitous environmental factor - television. Not so far ago, a team led by an anti-television crusader published a study showing that television viewing in toddlers was associated with attention deficit at age 7. A skeptic immediately commented that "the message resonates in a society seemingly obsessed with public health villains", critisized the authors' methods and, with a language unusually sharp for a scientific journal, concluded that "the statistics are being used, in the words of Andrew Lang, "... as a drunken man uses lampposts—for support rather than illumination." " Later studies, e.g. this one, did not confirm the TV - attention deficit correlation. However, the jin had been let out of the bottle. The initial message reached the public while its disprovals, as usual, didn't. Just search the Google University and you'll find numerous pages warning you that you'll make your toddler ADHD if you let him in the same room with a TV. (Disclaimer: I am not saying that the best for a toddler is to let the TV babysit him.)


Returning to the main subject of this post, I ask myself - isn't it a bit suspicious that so many unrelated chemical substances in small doses are reported to have the same effect on behaviour?


Why didn't anybody try to conduct a study on animal models? At least, I cannot find such an article in PubMed. Animal studies are generally more standardized and hence more reliable than human ones. I know that in many countries it is easier to obtain a permit to experiment on humans than on animals, but still, why not get to the work seriously and do first the paperwork required and then the animal study itself?


Why was the study done only on children, after hyperactivity problems, when present, are thought to persist for life? Is it because adults are generally happy with their own flawed selves but demand perfection from their children, relentlessly drawing the little ones to some superhuman standards of intelligence and behaviour?


What are we going to do now? Consumers demand the culprit substances to be removed from food. While I don't like the presence in our food of so many chemical substances, often with unknown effects on human health, shall we now have to pay more for food protected from deterioration by methods more expensive than a preservative? Or we'll accept greenish food products and bacteria-caused food poisoning as a part of our lives?


Is it a minor issue to deprive kids of junk food? A person on the receiving end of this treatment testifies that it isn't. In conclusion: The sky won't fall on us if we postpone any action for several more years, so let's wait until independent research teams in other facilities confirm the study's findings, as the scientific method requires.


10 years ago, the same Lancet journal published an article (subsequently retracted by almost all of its authors) claiming that MMR vaccine caused regressive autism in children. Although subsequent studies disproved this work in entirety, the world still cannot recover from the enormous damage done by it. Why not learn from our past mistakes?


Update: At Quackwatch, there is a page titled Twenty-Five Ways to Spot Quacks and Vitamin Pushers, by S. Barrett and V. Herbert. Item No. 6 is: "They Claim That Diet Is a Major Factor in Behavior. Food quacks relate diet not only to disease but to behavior. Some claim that adverse reactions to additives and/or common foods cause hyperactivity in children and even criminal behavior in adolescents and adults. These claims are based on a combination of delusions, anecdotal evidence, and poorly designed research."


Update 2: Interverbal blogged about Feingold diet in 2007.

Vote for science

Copy-pasting Orac's March 6 post:

"There's an idiotic poll up at Larry King Live with the question: "Do you believe vaccines cause or contribute to autism?" Idiotic, because it's science that says whether or not vaccines cause or contribute to autism. Whether the public thinks they do or not is irrelevant to the biological, medical, and clinical science that say, to the best of our knowledge, they do not.
Even so, please go tell him the real science about vaccines and autism. The pseudoscientists have already stacked the deck, and clearly antivaccinationists are voting, as the numbers are running around 80% to 20% in favor of "yes" as of this posting.
Vote now, and bring some balance!"

I blogged about vaccines and autism on Jan. 14 , Feb. 1 and March 4.

Sen. McCain joined the ranks of celebrity idiots

As the US presidential campaign is gathering speed, we non-Americans are paying more and more attention to it. The show is good and, while we aren't entitled to cast votes, we at least can participate in the campaign (by our blogs).
Until now, the candidate I liked most was Sen. John McCain. However, I just read the following in the New York Times Web site:
"McCain Steps Into Debate Over Cause of Autism
By BENEDICT CAREY, published: March 3, 2008
“It’s indisputable that autism is on the rise among children,” Senator John McCain said while campaigning recently in Texas. “The question is what’s causing it. And we go back and forth and there’s strong evidence that indicates that it’s got to do with a preservative in vaccines.”"
I've already blogged on Jan. 14 and Feb. 1 about the vaccines-cause-autism theory disproved by science but still promoted by what another blogger called "celebrity idiots".
I wonder, why did Sen. McCain publicly make a statement on such a serious problem without first doing even the most basic homework? Did he really believe what he said, i.e. has he the same (low) level of intellectual skills as ageing porn star Jenny McCarthy? Or did he say it without really believing it, i.e. is he the sort of politician who in his hunt for votes would consciously and unscrupulously endanger the health and very lives of children?
Pick one of the two opportunities, dear Americans - I don't see a third one. And please think well whether to vote for such a person, whatever other virtues he may have.

Quacks want freedom of speech for themselves but deny it to opponents

Freedom of speech is definitely having a hard time. The relentless attacks of Islamists and their Western appeasers against it gave me material for 4 posts in last month alone (dated Jan. 11, 27, 29 and 30, respectively), and this without digging deeply into news and blogs. (Some Muslims seem to fear that their Allah, similarly to the gods of Terry Pratchett's Discworld, will cease to exist if enough people say He doesn't.) Crusaders of political correctness are banning every single word that could eventually offend anybody and so are transforming our languange into an euphemized and censored Newspeak. And now quack thugs try to silence people exposing their quackery.
Yes, I am not joking. On Jan. 23, Orac reported: "Three months ago, I wrote about vacuous legal threats issued by the Society of Homeopaths against one of the better skeptical bloggers, Le Canard Noir, who runs the excellent Quackometer Blog and created the infamous Quackometer, in order to intimidate him into silence. The attempt backfired spectacularly, as scores of bloggers reposted the article by Le Canard Noir that prompted the legal threats, in the face of which his ISP had caved. Now it looks like it might be time to do it all again, this time with a different twit who has issued abusive threats against Le Canard Noir. This time around, I learn from No Nonsense!, it is a man named Dr. Joseph Chikelue Obi (who bills himself as the "world's top expert in nutritional immunomudulation") who has threatened Le Canard Noir's webhost with a lawsuit, demanding a £1 million a day penalty unless pages about him and his highly dubious activities are removed from their server. Once again, given the U.K.'s exceedingly plaintiff-friendly libel laws, Le Canard Noir had little choice but to capitulate, as his ISP demanded that he take down the offending pages. Guess what? It's time for every blogger who supports freedom of speech and skepticism to repost the article, and I call on you to do just that. Here are my copies of the offending articles: Right Royal College of Pompous Quackery..."
However, knights of quackery are all for free speech when it comes to their "right" to give harmful advice to gullible public. Yesterday, Eli Stone soap opera went on air. Let me quote Wikipedia about it: "Eli Stone is an American television drama... Produced by ABC Studios..., the series... is airing as a mid-season replacement in 2008. It will also air on Channel Seven in Australia, CTV in Canada, and Antena 3 in Spain... The debut episode, dated 2008-01-31, attracted controversy due to its plot line, which depicts the theory that autism is caused by a mercury-based preservative formerly used in common childhood vaccines, and treats the theory as being credible and legally compelling. This theory is not supported by scientific evidence, but has contributed to decreased vaccination rates that endanger children. The American Academy of Pediatrics asked ABC to either cancel the episode or include a disclaimer emphasizing that mercury is not used in routine childhood vaccines, and that no scientific link exists between vaccines and autism. ABC instead decided to present a written notice and voice-over saying "The following story is fictional and does not portray any actual persons, companies, products or events", with a second card directing viewers to the autism web site of the Centers for Disease Control and Prevention."
When pediatricians raised their voices against the "drama", quacks cried censorship. A distinquished their representative, David Kirby, wrote a jewel titled Pediatricians, ABC and censorship: Facts are scarier than fiction. (No, don't expect a link from me here, find it yourself if you want to read it. I have written before about the vaccines-cause-autism myth on Jan. 14)
Kristina Chew cites Chicago Tribune columnist Julie Deardorff that "the show is not about whether vaccines cause autism. It’s about the redemptive powers of faith. What the episode’s conclusion really asks is: Which is the greater force in life: science or faith?... What people, and specifically parents of autistic children, believe, the scientific evidence that there is no link between vaccines and autism, or their own faith that one day their child was “normal” and the next, post-vaccination, autistic. “It won’t matter how many studies show there is no link between vaccines and autism,” writes Deardorff. “We all believe our own truths.” "
Cancel all science, all quest for The Truth. There is no objective Truth cognizable by reason, just individual truths revealed to us by faith. The Age of Unreason has come.
I want to end this post with a quote from Joey's Mom. I am pasting her entire Jan. 28 post, which is short and on target:
"ABC is airing a new show with a first episode that implies a link between autism and vaccines. The co-creators say they'd be upset if people stopped vaccinating because of the show... talk about waffle-waffle. If they were so concerned, they would never have written it. If they believe vaccines cause autism, why are they saying they are concerned? And if they don't pull it, guess who isn't going to buy any more Disney products?"

The authority problem in the Age of Unreason illustrated by "celebrity idiots"

(Warning: long post.)
Age of Unreason is the title of a post by one of my favourite bloggers, Prometheus. He writes in it, "After centuries of slow but steady progress against the forces of unreason, a single generation is trying to send us back to the Dark Ages. After centuries of scientific progress in medicine, a single generation brings back homeopathy, naturopathy and introduces any number of new variations on shamanism... Much of “alternative” medicine encourages people to abandon scientific principles that have brought us in the West to a level of health and longevity that are unrivalled in human history. If we want to see what happens when that happens, we only have to look to those parts of the world where – for economic or philosophical reasons – scientific medicine is unavailable."
Let me begin with Oprah Winfrey. She is described by Wikipedia as "the American multiple-Emmy Award winning host of The Oprah Winfrey Show, the highest-rated talk show in television history... an influential book critic, an Academy Award-nominated actress, and a magazine publisher. She has been ranked the richest African American of the 20th century... She is also, according to some assessments, the most influential woman in the world."
Personally, I've held a low opinion about Ms. Winfrey ever since I learned that she supports Palestinian terror (see details e.g. at CAMERA and Garbanzo Toons). And, to return to the subject of this post, she clearly belongs to the Age of Unreason. Wikipedia again: "Recently, Winfrey has been accused by magician and skeptic James Randi of being deliberately deceptive and uncritical in how she handles paranormal claims on her show. In 2007, Winfrey began to endorse the controversial self-help program The Secret. It claims that people can change their lives through positive thoughts, which will then cause vibrations that result in good things happening to them." Last September, Oprah invited to her show Jenny McCarthy... but if you belong to my target group of readers, you are likely to ask, "Who the hell Jenny McCarthy is?"
Wikipedia describes McCarthy as "a model, comedian, actress and author. She first appeared in Playboy magazine in October 1993 and was named Playmate of the Year in its June 1994 issue. She later began a career in television and film and has recently started writing books... Though McCarthy initially rose to fame because of her sexual image, a frequent source of her celebrity derives from toilet humor... In 1993, McCarthy underwent breast augmentation to enhance her look as a model for Playboy. McCarthy had the implants down-sized in 1998... (Her) son, Evan Joseph, (was) born on May 18, 2002... In May 2007 McCarthy announced that her son was diagnosed with autism in 2005... In June, 2007, Talk About Curing Autism (TACA) named McCarthy as its spokesperson. Her stated goal is to educate the public that autism is treatable... (Her book) Louder than Words: A Mother's Journey in Healing Autism was published Sept. 17, 2007. McCarthy told Oprah that her son was developing normally until he received his measles, mumps and rubella vaccine (at 15 months of age). She has stated in her book, and on her appearance on the Oprah Winfrey Show that her husband was unable to deal with their son's autism, which led to their divorce." (I have changed the order of some of the above pasted sequences - M.M.)
Now, I may be a puritan and an extreme feminist, but I admit I have little respect for women who photograph themselves undressed for money. Of course anybody is free to produce and publish any pictures (as long as the people photographed are consenting and over 18), but I think that magazines like Playboy and women contributing to them perpetuate the worst sexist stereotypes. If we, the other women, meet obstacles in our careers because of being women, or if men discuss our appearance when we try to explain our views, I think this is partly "thanks" to ladies like Ms. McCarthy. So, if a woman has appeared in Playboy, I put on her the entire burden to prove that she can be something more than a mere sexual object. And if, without providing any such proof, the lady becomes "an author" and begins "writing books" on serious subjects such as parenting and autism, my reaction is, Save us God! (Representative pictures of Jenny here, unfortunately I cannot paste one because they seem to be all copyrighted.)
The Oprah site has a page about Jenny McCarthy but it contains a narrative rather than the actual interview that took place in the talk show. So I'll rely on reports and commentaries by people who have watched the show. At Left Brain/Right Brain site, the phenomenon is described as New McCarthy-ism (as far as I know, this post introduced the term): "Step aside, people: Jenny McCarthy is armed with Google, and she’s not afraid to use it... No joke: McCarthy was cheered lustily by the studio audience for announcing that, after her son was diagnosed, she typed the word “autism” into the Google search engine, launching a courageous and audacious search for the truth. And what came up? Why, story after story about remedies and recoveries and other amazing stuff your pediatrician is paid handsomely by the CDC (the US Centre for Disease Control - M.M.) not to tell you about... McCarthy spoke particularly of clicking on a link “up in the corner” (I believe those are what are known as “advertisements”) and learning about the wonders of biomed... (Here, "biomed" refers to the quack "biomedical treatments" of autism widely advertised to parents of autistic kids by snake oil salesmen - M.M.) There was something chilling about the way she described getting an employee of a play gym fired for suggesting her son might have a “brain problem”... Oprah also cooed approvingly when McCarthy defended biomed by saying, “Well, chemotherapy doesn’t work for everybody either”... And naturally, vaccines had to come up. McCarthy said she had invoked what she calls her “mommy instinct” to finger the MMR in the case of her son. Then Oprah read a response she had received from the CDC (at least she took a stab at social responsibility by contacting the agency) that talked about the lack of scientific support for the idea that thimerosal triggers autism. McCarthy scoffed and said, speaking of her son: “He is my science.”"
Science blogger Orac discusses the show under the title Jenny McCarthy and Oprah Winfery: Two Crappy Tastes that Taste Crappy Together on Autism. He writes, "Jenny McCarthy... was apparently quite susceptible to woo. Indeed, she once ran a website for "Indigo Moms." The website was apparently taken down shortly before the release of McCarthy's book, perhaps to take away an obvious bit of evidence of her New Age credulity..., but Joseph points to a source that tells us a bit about "Indigo Kids": "Jenny, who runs IndigoMoms.com, is of the belief that Evan is a 'crystal child,' and she herself is an 'adult indigo.' This belief suggests that 'indigo/crystal phenomenon is the next step in our evolution as a human species.' Proponents also suggest that many indigo and crystal children are wrongly diagnosed with ADD, ADHD, and autism." There's more about what "indigo children" are here, and McCarthy herself has written about it here. In addition, Kristina Chew also discussed some of the woo found on the IndigoMoms website before it was shut down around the time McCarthy's book was released. I think McCarthy's involvement with the "indigo children" movement shows all you need to know about her critical thinking skills. Of course, if she really thinks she is an "indigo adult" and thus part of the next step in human evolution, she probably has a very inflated view of her own reasoning abilities."
After the Oprah show, Jenny McCarthy was also invited and interviewed by Larry King. Prometheus commented on Not Mercury's blog, "Why is it that "everybody" (i.e. Oprah, Larry King...) is willing to take as Gospel the opinions of a woman who - by her own admission - believed a total stranger who stopped her on the street and told her that her son was a "Crystal" or "Indigo" or whatever (I can't keep that sort of nonsense straight)? Isn't it much more likely that her latest "revelation" is as fanciful as the previous one(s)? Is there an epidemic of gullibility going on?"
On Steve's blog, commenters wrote, "Jenny McCarthy appeals to parents by being just like them except with a porn star appearance. She doesn't particularly pretend to be smart or educated. She says "I'm just like you. We're in this together. We know things those smartypants scientists can't figure out with all their numbers." People enjoy identifying with glamorous porn stars (God/FSM help America)"; "The US has a strong tradition of anti-intellectualism. Keep in mind that, for example, the majority of Americans do not believe in evolution. If something is said by a scientist, that makes in suspect in and of itself."
There are many more good texts about Jenny on the Autism Hub, I am sorry that I cannot mention all of them. Outside the Hub, Debbie Schlussel writes about Bimbo Science: "Doctor" Jenny McCarthy & The New McCarthyism: "You've heard of "junk science." Now there's a new form, which I call "Bimbo Science." The latest (and maybe the first of many such bims to come) "scientist" to come along and dismiss accepted, proven medicine is former Playboy model, Playboy video star, and all around blow-up doll Jenny McCarthy. She's parading around all the usual shows that welcome Bimbo Science--Oprah, The View, etc.--claiming that vaccines caused her son's autism. But while the "New McCarthyist" has a medical degree from the University of Google, Dr. Ari Brown, a Medical Doctor, pediatrician, and fellow of the American Academy of Pediatrics exposes McCarthy's many lies and idiocy in one of the best Wall Street Journal op-eds I've read in a while... Dr. Brown refers to Jenny McCarthy as an "actress." That's being charitable. But who knew America would actually be taking medical advice from this bim?... While life often imitates art, it's sad that the world of "Idiocracy" is already this dominant."
Knudsen also has an excellent post titled Jenny McCarthy to Host Autism Symposium: "Los Angeles, CA-A meeting of the world's foremost experts on neurodevelopmental disorders and vaccine science, moderated by autism authority and former co-host of MTV's Singled Out Jenny McCarthy, will be held today at UCLA's Schoenberg Auditorium. "For years now, the scientific community has lagged behind the overwhelming anecdotal evidence that has been collected and compiled in places like Google and YouTube," Dr. McCarthy explained..."
Now, after criticizing two female celebrities, let me add a gentleman to the list. Citing Autism Street's post Where Is Trump's Science Team: "I was really beginning to think that Jenny McCarthy would be an extremely popular candidate for being considered the “celebrity idiot of the year” by many scientific thinkers in the autism blogging community. I suppose I should have known better about claims to the singular, where the plural is not only possible, but likely. Jenny apparently has company... (Quote from) the Palm Beach Politics blog: "Trump: Autism linked to child vaccinations... In an interview with Palm Beach Politics, Donald Trump offered a controversial opinion on a new topic: autism. The New York-Palm Beach real estate mogul is no doctor, but he said he thinks the rising prevalence of autism is related to vaccinations given to children at a young age."... Mr. Trump, do you have any science to go with this nonsense?"

There have been two hypotheses linking vaccines to autism causation: one implicating the mercury-containing preservative thimerosal which was widely present in vaccines in the recent past, and another one implicating the live viruses in the measles, mumps and rubella (MMR) vaccine. If you, dear reader, want to know what science says about the vaccine-autism link, let me inform you: it's disproved. In fact, it was never considered very plausible because autism symptoms don't resemble symptoms of known vaccine complications or of actual mercury poisoning. Populations with known exposure to mercury haven't higher prevalence of autism. Epidemiological studies showed that removing thimerosal from mandatory childhood vaccines, as well as skipping the MMR vaccine, does not curb autism prevalence a bit. And attempts to induce an autism-like condition in animal models by vaccine components have been unsuccessful. Of course many people still think that their child's autism has been caused by vaccines. They are likely to remain that way; in fact, some of them openly say that no scientific evidence will ever succeed to shake their belief.
The three celebrity idiots discussed above illustrate the deeper problem present-day societies have with authority. Here, by "authority" I mean a person to whom we voluntarily transfer our decision-making power, such as a doctor when we have care for our health or a Member of Parliament when we vote. Some American commenters cited above were highly critical of their own society and described the problem as specific for the USA. It is beyond doubt present in the USA - just compare the Founding Fathers to the people populating the American political landscape in recent decades. However, it is not restricted to the USA. It is a global problem.
What have Oprah Winfrey, Jenny McCarthy and Donald Trump in common? They have all succeeded to become rich and well-known people. It seems that in today's Western world, the ability to earn money has remained the single attribute of authority.
The ability to become rich requires some specific intelligence and skills, but isn't correlated with ability or expertise in any other field. It isn't even necessarily accompanied by high general intelligence. Anybody who has been around rich people, especially if he has tried to educate them, is likely to agree with me. It is understandable that the rich themselves tend to mistake their income for actual intelligence. But why do other people do the same?
After the Oprah's show with Jenny McCarthy, some my online friends - autistics and parents of autistic children, suggested writing to Oprah and explaining to her why the show had wronged autistic people. (And it wronged them in many other ways besides the vaccine thing, it will become tomorrow if I try to explain in debth.) I disagreed. I wrote, "I've repeatedly observed that (1) few individuals can do more harm than popular TV show hosts and (2) glorious career and earning millions are quite compatible with moral and intellectual qualities far below the average. The question is, why people let themselves be influenced by celebrities instead of thinking with their own heads? I don't think writing Oprah would be to any avail. Do it, it will do no harm either. But people like her are very pompous and consider themselves very good and smart. They think they make no mistakes and even if they make one, it cannot be noted and should not be pointed out by mere mortals."
Because celebrity idiots parasitize on society's backwardness, they cannot be expected to work for the cause of enlightenment. So it's no use to try and recruit them as our allies; they are our natural enemies. If we manage to bring enlightenment, it will be despite them. Let them keep their damn money, but not the undeserved respect and authority they enjoy now. Authority must be given to people based on their expertise, intelligence, record of decent life and loyal service to society and adherence to solid moral principles even in situations when this is unpopular.
Isn't it a bit scary that the last sentence sounds so old-fashioned?
Update: Jenny McCarthy was Larry's guest again and here is how Gawker reports it (hattip Kev): "Larry King had noted medical expert/softcore video star Jenny McCarthy on the program last night to talk about AUTISM. Specifically, how it’s caused by VACCINATING YOUR CHILDREN. This is patent conspiratorial nonsense, but it’s very popular conspiratorial nonsense. Of course, in a battle between concerned, credulous parents and medical experts, the media will generally frame it as, say, Debate Rages Anew on Vaccine-Autism Link. Faced with a panel of three trained pediatricians, Ms. McCarthy shouted “BULLSHIT” twice."

Pharmacies for pharmacists only! Air companies for pilots only!

Our district traditionally has had one pharmacy. About a year ago, another one was opened. However, it was closed three or four months ago. I thought, apparently the consumer demand for pharmacy products in our districts isn't high enough to allow a second pharmacy.
However, when I went to the pharmacy yesterday to buy cold remedies for my husband and saw that it was closed, too, I understood something else was going on.
Bulgarian business in general is burdened by a myriad of regulations, rates and taxes. For pharmacies, there are even more of them because here buraucrats find it easy to claim that they are thinking about the patients' well-being. However, the predictable net result is that Bulgarian patients buy drugs at higher prices than patients in other European countries with much higher incomes. And keep in mind that in Bulgaria, unlike other countries, you typically pay out of your pocket 100% of the drug's price even if it is prescribed by a doctor and you have a perfect medical insurance. Worse, many drugs, including life-saving ones, aren't available in Bulgaria at all because the regulations and taxes make it impossible for manufacturers and pharmacists to profit from them, or simply because the manufacturer cannot cope with the grotesque paperwork required for the drug to be allowed for sale.
Right now, pharmacists are protesting about the latest attack on their profits by government (you can read details at Novinite). They complain they will be driven out of business and officials reply that this would be no disaster because Bulgaria now has more pharmacies per capita than other European countries. Eh well, I suppose other European countries have also fewer grocery stores and supermarkets, because the majority of people use their cars when shopping and prefer fewer but bigger shops. However, in a country where most people have no cars and will not have them in the foreseeable future, you just cannot say that it is OK if shops supplying an entire district go bankrupt. This enormously affects quality of life.
Now, the nearest pharmacy is located at about 1.5 km from my home. This is quite a long distance when the weather is bad or you have to walk through snow, as now. Worse, you have to walk through an underpass with stares which has no accessibility accommodations. I hate going there with the baby pram (just think about wheelchair users - it is absolutely impossible for them to climb down and up the stairs). So I decided not to do the journey.
In the evening, I told my mother in-law that the pharmacy has closed. She said, "I know. This happened three weeks ago, you just haven't mentioned until now. The owner has no Master degree in pharmacy, just a Bachelor degree. So the regulations ban him from owning a pharmacy. The same problem had the owner of the other pharmacy that was opened in the district last year. He also had to close."
Arrrrrgh! Indeed, one of the myriad regulations about pharmacies is that only Masters of Pharmacy can own them. Capital weekly commented that following the same logic, you must allow only pilots to own air companies! The regulation in question must have been introduced because of lobbying by pharmacists with Master degree.
I would say that these people are stupid and have the inability to think long-term that is typical for stupid people. They may be happy now for driving their competitors out of business, but as years pass, time will come for them to hand the business to their children. And then they may not be so happy, because not all children of Masters of Pharmacy will also succeed to acquire the degree!
Buraucrats give the usual explanation: "This is the practice in other countries." Why must we import every illogical thing that is practiced in other countries? I agree that the people who supply the drugs to the pharmacy and sell them to the patients should be pharmacists. But why the owner also? Master of Pharmacy degree needed to fill the tax forms?
The result, as we see, will be - many poorer people left without access to any pharmacy.

End of life in pediatric intensive care unit in Plovdiv, Bulgaria

"End of life" is an euphemism for passive euthanasia and means termination of life support for a patient in an intensive care unit. In pediatric units, end of life means that a premature baby is let to die because he seems unable ever to survive without life support, or will have too severe disabilities to be considered a valuable person by the society. However, the case in Plovdiv was different. Translating from Netinfo (http://news.netinfo.bg/?tid=40&oid=1106939):
"A blackout occurred after 9 pm on Saturday in the Multiprofile Hospital in the city of Plovdiv and endangered the lives of seven premature babies. The equipment keeping the babies warm and supplying them with oxygen, food and medications depended on electricity. The hospital has its own power generator only for the lighting. The personnel on duty wanted to ask when power supply would be resumed but nobody answered the emergency phone number of the electricity company EVN that was given to them. The blackout lasted for 1 hour 35 minutes. The patient in most critical condition was a newborn girl weighing only 800 grams who was on artificial ventilation. Six hours later, the baby died. The other six babies in the intensive care unit survived by a hair's breadth. The electricity company said that the blackout was caused by a damaged electric cable near the hospital. They also said they have new emergency phone numbers that can be found in Internet."

The HIV trial in Libya, part 6 (last): Why most Libyans believed the official story

This image, which I copied from AngloLibyan's blog, seems to be very popular in Libya. At http://lonehighlander.blogspot.com/2005/04/case-441999-story-of-bulgarian-medics.html, Highlander shows it being used by demonstrating HIV-infected Libyan children. The author and copyright status of the image are unknown to me. I'll be grateful to any reader who informs me about these details, so that I could give credit and ask for permission. UPDATE: The author is Mohammed Izwawa (thanks to Suliman who informed me, see his comment to this post; the name seems to be spelled also Ezwawi). I cannot find Mr. Izwawa's e-mail; if he is reading this and disagrees with his work being shown here, he can post a comment or e-mail me (mayamarkov at gmail dot com) and I'll remove it.

This amateur psychological "study" is the last part of my sequel about the trial in Libya; the previous parts are, respectively, at http://mayas-corner.blogspot.com/2006/09/hiv-trial-in-libya-part-1-infection.html, http://mayas-corner.blogspot.com/2006/09/hiv-trial-in-libya-part-2-victims.html, http://mayas-corner.blogspot.com/2007/03/hiv-trial-in-libya-part-3-tale-of-two.html, http://mayas-corner.blogspot.com/2007/03/hiv-trial-in-libya-part-4-how-infection.html and http://mayas-corner.blogspot.com/2007/04/hiv-trial-in-libya-part-5-discussing.html.
This part was the most difficult for me to write. Remember Diogenes who took a lantern to search for The Human? Anyone who tries to explore the hidden spaces of human mind needs a lantern, for he is likely to find little light where he is going. Moreover, because I am not a Libyan and my people differs from the Libyans in many respects, the intended recipients of my message will most probably dismiss it as mere bigotry. I have even considered omitting this part and letting Libyans, one day after they set aside their more serious problems, to search their souls themselves. However, such a bright future seems unlikely to come, so I'll end my sequel as planned. I won't try to make this post concise - let it be as long as it gets.
Why do most Libyans agree with the official version that the AIDS epidemic in Benghazi was caused intentionally? I think some really believe it while others only claim to believe. So we have two groups to consider.
1) Libyans sincerely believing in intentional infection
The official story that the infection was deliberately spread, especially in its original CIA-Mossad version, seemed so absurd to me that I wondered how could any sane adult believe in it. Even a 12-yr old, I thought, would laugh and say this is a good idea for a video game. However, we must remember what Einstein said, "Two things are infinite: the universe and human stupidity; and I'm not sure about the universe." Recently, one of my relations said to me she believed cures for AIDS, plus all types of cancer, were discovered but drug companies were hiding them in order to sell their current expensive and inefficient products. At the same time, a popular TV host (Milen Tsvetkov, for Bulgarian readers) was launching a hysterical campaign against immunizations because of the rare but severe complications of some vaccines (I wish him to see the video at http://www.kevinleitch.co.uk/wp/?p=538). So stupidity is by no means a Libyan patent. However, in a normal society different views are freely expressed and so you have many different types of stupidity, instead of one dominating. The situation is different in a dictatorship, where you are brainwashed round the clock by the official propaganda and have very limited access to alternative information sources. Of course nobody knows better that the Libyans that the TV speaker's "Good evening" is the only part of the news likely to be true, but humans cannot live in informational vacuum, so most of them finally succumb to propaganda. In this context, it is noteworthy that Qaddafi's version isn't very popular among Libyan expatriates who live in normal informational environment. To cite some examples, Hannu, Suliman, 7mada and Smokey Spice reject it.
Let me give a small sample of official Libyan propaganda. As Suliman mentioned in a comment to my earlier post, Libyan sources, without giving the full text of Dr. Montagnier's in-court testimony, claim that it "was damning to the case of the accused" (http://mayas-corner.blogspot.com/2007/01/what-made-libya-at-end-of-2006-similar.html). (This reminds me of the joke about Napoleon who said in his afterlife, "Soviet propaganda is a great thing. If I had it, nobody would ever know I had lost the Waterloo battle.") An even more fruitful approach is using the infected children and their families. Remembering how useful was for the anti-Vietnam war propaganda the image of a single napalm-burned child, you can figure out what can be done with more than 400 young victims. An example can be found at http://anglolibyan.blogspot.com/2007/03/wisams-story.html. The mother of an infected boy claims that "Sanjaka the Bulgarian old nurse" (presumably Snezhana Dimitrova) has given him an unauthorized shot: "I saw with my own eyes Sanjaka injecting a syringe in to my son's drip, when the nurse noticed that I was looking she got scared and quickly hid the syringe, I asked her what was that medicine for and told her that he is not supposed to have any medications at this time... Yes I saw her inject my son with my own eyes." I'll duscuss later the families' claims and their reflection on other Libyans, let me now just mention that if the story is true, this woman should be telling it not in a newspaper but in the court. As should be expected if the defendants are picked randomly, the evidence linking them to the infected children is very thin. It is in fact so thin that a mother who could testify to have actually seen nurse Valya Chervenyashka inject her child was a key witness and it was a blow for the prosecution when she died of AIDS. (It is another question that only in the twisted reality of totalitarian Libya a nurse in a children's hospital can be charged with giving shots to children - what actually was she expected to do to earn her salary?)
Another reason for Libyans to believe in intentional infection is that they regard the Benghazi epidemic as a world precedent. It seems that the intra-hospital infections in other countries and the importance of unsafe transfusions and injections for spreading the disease are still unknown to most Libyans. Indeed it is in human nature, when something awful happens to us, to think we are the first and only ones in the world hit by it (and realizing that thousands or millions other people have suffered the same is an important part of recovery). But in this case, the propaganda also helps. See e.g. http://anglolibyan.blogspot.com/2007/02/unite-for-children-unite-against-aids.html. At the top of a continent devastated by AIDS for decades, Libyans are being told that theirs is "a real tragedy that the world never experienced before", "no crime ever committed was as horrible as this crime that was committed against our children", "there is no crime worse than this crime". And once you believe that the Libyan epidemic is unique, you will require a unique explanation. Only if you are outside Libya, the question "how bad is this case in comparison to the AIDS disaster in Africa as a whole" may come to your head (Suliman's comment to the same post).
I think that, despite my conviction that unwanted behaviour mustn't be excused in order not to be encouraged, I have almost excused the Libyans for believing the unbelievable. However, a seemingly small but very important detail remains: the personalities of the accused. One day, when the Q-man's rule will be just a painful past, the Libyans will have to deal with the question, "Why did our dictator choose exactly this story to sell to us? He implicated CIA because he knew we hated America; logically, the Americans had bombed us. He implicated Mossad because he knew we were anti-Semites; well, almost everybody was at that time. But why did he choose as scapegoats foreigners, mostly white, mostly women? Did he think we were sexists, racists and xenophobes? And was he right, after we believed him so easily?"
I think it isn't a coincidence that of the seven accused medics, five are women and the only one acquitted is one of the two men (Dr. Zdravko Georgiev). Witchhunts in Europe also targeted mainly women. It seems that cultures repressing sexuality tend to see something satanic in women. This applies not only to young attractive women but also to others who aren't much of a temptation, so this phenomenon is puzzling to me. Possibly someone else could try to clarify it.
The impact of racism and xenophobia is easier to explain. They had been inherent to human even before he evolved into human proper and although restrained today, they are still here and raise their ugly heads every time when something bad happens. Earlier this year, Atanas Predov, a Bulgarian guest worker in Spain, died of methanol intoxication. His relations didn't believe this to be the cause and requested an autopsy which revealed that both kidneys were missing. It was concluded they had been taken for illegal transplantation and this had caused the man's death (source e.g. http://www.sofiadnes.com/modules.php?m=news&nid=24783 in Bulgarian, http://p083.ezboard.com/Bulgarian-Victim-of-Criminal-Organ-Removal-in-Spain/fbalkansfrm11.showMessage?topicID=1325.topic in English). Significantly, no one of the Bulgarian comments I've seen questions the idea that Spanish doctors kidnap Bulgarians from the street and kill them by removing their kidneys for transplantation. In the early 1990s, many Bulgarians objected foreign adoptions out of fear that the children would be used as organ donors. A Bulgarian journalist, mentioning that such fears are popular in many countries despite the absence of proven cases, described this is a modern technological version of an immortal myth - that our children are kidnapped or killed by foreigners. Indeed, the parents of at least two missing Bulgarian children believe, without any serious reason, that the children have been kidnapped and taken abroad (you can read about one of the victims at http://savestin.exactpages.com/).
Taking the above into account, imagine how bad could the situation be in Libya, where the Others are all the time demonized by the official religion. Indeed, one of the reasons why I hate Islam is that it uses, and enhances in order to use, every single built-in defect of human nature. To help the demonization, Libyan prosecutors have accused the Bulgarians also in illicit sexual relationships, distilling alcohol, drinking alcohol in public and illegally transacting in foreign currency. To the Western mind, it seems absurd that additional minor charges are allowed to obscure such a grave case. However, within the if-it-moves-forbid-it Koranic philosophy these charges are not minor. As an anonymous commentor explained at http://mayas-corner.blogspot.com/2006/11/alfa-roma.html, a woman wishing to have sex with a man other than her husband is not a human sinner but a monster able to do a first-degree child murder or any other outrage without even hesitating. The currency transaction seems to imply a violation of the Koranic ban on interest and prove that the accused are extremely greedy people able to do everything for money.
The belief of so many Libyans that the accused medics deliberately infected their patients does more than moving the anger away from Qaddafi's health care establishment. It affects the collective Libyan psyche. Without this belief, the siblings and classmates of the infected children would vow to become AIDS researchers and find a cure; instead, now parents are vowing to join al-Qaeda and seek revenge. Such pledges reveal what is going on in people's heads and for that reason, although very unlikely to be fulfilled, may help us predict the future.
2) Libyans trying/pretending to believe
While many Libyans sincerely believe the official story about the Benghazi epidemic, many others just try to convince others, and usually also themselves, that they believe it. Of course, trying to accept something you don't really think means personality split. I've mentioned that not only patients with schizophrenia but also most of the so-called normal people are a combination of two or more incompatible personalities. You don't agree? Haven't you asked yourself why you so often cannot predict how a well-known person will behave in a certain situation? This is because, even if you have been around him for 20 years, you have no way to know which of his personalities you'll be dealing with. But let's return to the question why Libyans claim and try to believe in intentional infection.
Compassion is a burden for the soul. Therefore, if a person is suffering and we cannot (easily) help him, we tend to brush compassion off by convincing ourselves that he brought it upon himself. In other words, we are inclined to blame the victim. E.g. when some years ago in my city a 16-yr old girl was shot dead by a policeman as she was leaving a bar with her boyfriend, a surprising number of people reacted by saying that good girls don't go to bars. In the Libyan HIV case, I am sure that if the infected patients were adults, much more time would pass before linking them to the hospital. Everybody would think they had contracted the disease by illegal sex or drug use. But because children are infected, and infected not by HIV-positive promiscuous mothers but by medical procedures, the Libyan society has to feel compassion for the children and their families. This is already a burden. It would be too much of a burden to pity, apart from the children, also a bunch of tortured and gravely accused foreigners. So people feel better to think that the defendants are guilty. And logically, the more abuse and undue imprisonment the medics are forced to endure, the stronger will be the psychological need of ordinary Libyans to consider them guilty.
In fact, subjects of a dictatorship tend to blame every victim of the regime. When the Communist rule in Bulgaria was dismantled in 1989 and we first enjoyed freedom of speech, I was surprised to see how many Bulgarians believed in the guilt of political prisoners. (In fact, there had never been a strong anti-Communist opposition in Bulgaria and most "political prisoners" were jailed for offences such as wearing a wrong kind of clothes, speaking Western languages, listening to the BBC, telling quite innocent jokes about the regime and the dictator, or for nothing at all.) My friend explained this widespread opinion. She said, "People just feel compelled, after not entreating for the prisoners, to believe in their guilt." I replied, "But who would dare to entreat? We had justified fears for our own safety!" My friend said, "Few can think like you, because people hate regarding themselves as cowards." I call this phenomenon "survivor syndrome". It surely helps people to live under a dictator without feeling depressed all the time, but slows recovery after the dictator is toppled. The survivor syndrome means that the more atrocities a dictator does, the stronger will be the motivation for his (surviving) people to whitewash him and blame his victims. We are observing this very clearly in Iraq.
There is also another, more noble reason for Libyans to convince themselves in the medics' guilt. This is the sense of solidarity with the parents of the infected children and the wish to believe everything they say. Let me discuss this important issue in more detail. The initial article in the La magazine cited a number of parents who accused the hospital staff in rudeness and incompetence but expressed no suspicion of malicious intent, neither pointed to medics of a particular nationality. Of course the parents, most of whom had accompanied their children at the hospital, shouldn't believe very easily in the official version. E.g. some of them are likely to know that their children haven't been treated by any of the accused medics (the defense team revealed that such infected children exist by simply comparing the dates when the patients were treated at the hospital and the dates when the defendants were on duty). However, at a later stage the parents very actively supported the version of intentional infection and called for death penalty and huge compensations. Of course some of them, desperately needing somebody(anybody) to blame for their tragedy, found relief in seeking revenge against the accused, while others, even if not quite believing, would want the Bulgarians sentenced in order to receive compensations from Bulgaria (or its Western allies). These parents have every reason to think that Qaddafi will not agree to give money for their children and they have more chance to get the sums needed for treatment from a foreign source. They cannot think too much of justice and abstract truth and so on, the need of their infected child comes first.
After a court session last August when none of the defense witnesses appeared (I've blogged about this at http://mayas-corner.blogspot.com/2006/09/nothing-new-in-libya.html), Idris Laga, father of an infected child and chairman of an association of parents of the infected children, was delighted about the witnesses' absence and said it proved the prosecution thesis was correct. A more sophisticated person would express regret that the witnesses hadn't appeared to say their phony testimony and have it disproved, but we must be glad that Mr. Laga said what he said, because his words show us something important: the parents of the infected children aren't interested in fair trial and disclosing the truth, on the contrary, they will make every effort to obscure it. After de Oliveira et al. published their article in Nature claiming that the epidemic started before the defendants arrived to the hospital, Mr. Laga stated that the scientists "were not authorized by the kids' legal guardians to obtain samples" (Suliman's comment at http://mayas-corner.blogspot.com/2007/01/what-made-libya-at-end-of-2006-similar.html). With other words, we won't allow blood samples to be taken from our children because their analysis could prove somebody not guilty and so make his execution more difficult!
The cynic would also mention that the guardians (most likely the parents) seem too well informed about their rights for people fresh out of a dictatorship, so hasn't anybody instructed them? Indeed, in the above lines, I portrayed the parents as free people acting on their own free will, which is hardly justified. Remember the mother who allegedly saw nurse "Sanjaka" inject her boy (http://anglolibyan.blogspot.com/2007/03/wisams-story.html)? Let me cite the comment of Libyan-American Hannu, mother of four: "I am very skeptical of the story and the extent of truth in it. First, the fact that it was published in a Libyan newspaper takes away from its credibility. I got to the part "... when I saw with my own eyes Sanjaka injecting a syringe in to my son's drip..." and that's where I realized the Libyan propaganda behind the story... It is a fact that some of those families are being coaxed by the Libyan authorities to lie and distort things in exchange of false never-fulfilled promises. Who's to blame them!" Mickey Grant, who made a video about the case, has first-hand information that the families are indeed coaxed: "No journalist I know of has ever been allowed to do real interviews with the families of the children. I went to Rome where many of the children were being treated for that purpose and I found that the only way the families could participate in an interview was if a Libyan Agent was present and they were too scared to do that." (http://anglolibyan.blogspot.com/2007/05/what-is-real-number-of-libyas-aids.html; there you can see the video, too).
Some Libyans may think that while it is unfortunate that innocent people have been abused by the Libyan state the way they were, it is a good thing to force the West to pay for the children's treatment (especially after the Libyan government seems reluctant to pay). Indeed, demanding ransom after taking hostages is a much more reliable way to obtain money than appealing to people's humane feelings. However, what might benefit the families (because, while much of the money will surely go astray, some will serve its purpose) is a long-term PR disaster for Libya. I don't think that in our globalizing world somebody can afford not to care what others think of him. "How many Arabs does it take to change a light bulb? None. Arabs just sit in the dark and blame it on the Jews. Same thing with the HIV infection, but this time they blame foreign medics." This is the best of several samples of the "war declared on Libyans on the Internet", cited by AngloLibyan (http://anglolibyan.blogspot.com/2007/02/who-is-michael-sheilds.html). What should be more worrying for Libyans than these Web insults (apparently work of Bulgarian teenagers) is what adults are thinking, typically without saying it in public. The whole affair reinforced one of the worst steretypes about Arab Muslims - that they contact Westerners mainly in order to extort money from them at any cost. I advise Libyans always to stick to the claim that the demand to Bulgaria/West to pay for the children's treatment is solely Q-man's policy never approved by the majority of Libyans. Without true opinion polls, nobody can ever prove the opposite. Those who make voluntary fund-raising campaigns for the children should never imply that the West has any responsibility for the children's plight, either by conspiracy to infect them or by sanctions. Instead, a point should be made that these children are innocent victims of Qaddafi's health care system which, after allowing them to be infected in the first place, now refuses them adequate treatment, although Libya has enough money to afford it (esp. after lifting the sanctions).
And last, after discussing the most noble reason for Libyans to claim to believe Qaddafi's story, let me mention the least noble one: Islamism, i.e. taking to heart the Koran's demand to force Islam down the throats of non-Muslims. While Islam makes a person prone to sincerely believing bad things about the Others, Islamism includes deliberate lying in an effort to denigrate the enemies and so obscure their evident moral superiority. After the Islamists blame the West for their own crimes (Sept. 11) and for natural disasters (the tsunami), how could they resist to blame it for a man-made AIDS epidemic? Among the Libyan diaspora, I've observed almost 100% correlation between expressing firm belief in the medics' guilt and being Islamist (I prefer not to give links, because the aim of this post is not to attack my opponents personally). Within Libya, Islamism doesn't seem very popular... with one important exception: the city of Benghazi.
As I mentioned before in Part 2, strong feelings against the Qaddafi's regime existed in Benghazi even before the epidemic and were reinforced by it. However, the Q-man handled the crisis in a way I reluctantly admire. Knowing well the Islamists' minds, he knew that they were hating him but were hating much more the white infidels, especially the women (similarly to the Iraqi Islamists who, while disliking Saddam, love to hate America and its supporters). All he needed to do was to divert the anger and hate to appropriate objects. After that, interviewed ordinary Benghazeeans praised the Leader for helping the infected children receive justice and not caving in under Western pressure. Of course they couldn't say in front of the camera that they hate Qaddafi, but I had the feeling that the praise was at least 70% sincere.
This is why I am angry at the Benghazi residents. Unwilling or unable to use properly their brains because of heavy Islamist prejudice, they wasted their courage in vain and achieved less than nothing. Instead of being real danger or at least a thorn in the ass for Qaddafi, they became useful pawns in his game. When criticized by Westerners, he can always point at them and say, "You may dislike me but do you see the alternative? People ready to torch buildings because of a cartoon, people whose most cherished dream is to resurrect the 7th century." In the case of the AIDS outbreak, Qaddafi is responsible (though indirectly) but he manipulated the Benghazeeans so successfully that now he is more popular among them than before! Like an Iraqi who admires Saddam despite having a brother killed by the regime (linked and discussed by Sandmonkey at http://www.sandmonkey.org/2007/02/02/lmao/), Benghazi residents now admire the true murderer of their children. Indeed, Qaddafi gained so much from the whole affair that some Libyan expatriates, following the "Who benefits from this?" logic useful in disclosing many crimes, suspect that he caused the Benghazi epidemic intentionally, with or without the accused medics' participation!
I wouldn't want to end this post with such a bleak picture, but so be it, for even the worst truth is better than false hopes. In conclusion, I'd advise Libyans, when going to a hospital for intravenous injections, to ask what syringes and needles they'll need and buy them beforehand. And of course also to use condoms when making unauthorized love.