LIBYA'S COGNITIVE DISSONANCE: HIV AWARENESS PROGRAMMING AND

C O N F I D E N T I A L SECTION 01 OF 03 TRIPOLI 000169 DEPARTMENT FOR NEA/MAG E.O. 12958: DECL: 2/16/2017 TAGS: SOCI KHIV LY SUBJECT: LIBYA'S COGNITIVE DISSONANCE: HIV AWARENESS PROGRAMMING AND CONTINUING BLAME ON OUTSIDERS FOR AIDS OUTBREAK TRIPOLI 00000169 001.2 OF 003 CLASSIFIED BY: Elizabeth Fritschle, Pol/Econ Chief, Embassy Tripoli, Department of State. REASON: 1.4 (b),(d) ¶1. (C) SUMMARY: The Libyan government continues to move forward with its own unique form of education awareness of HIV and AIDs. There is some basic level of educational programming in Libyan schools in conjunction with the UNDP office in Tripoli and the government has also held additional activities including a World AIDS day event in December 2006. Given the plight of the Bulgarian nurses and Palestinian doctor found guilty in Libyan courts of deliberately injecting children with the HIV virus, despite conclusive scientific evidence from renowned international experts that the infections spread in a manner that precluded premeditated criminal intent, it is noteworthy that Libyan medical professionals are still making public statements claiming that the HIV outbreak in Benghazi was deliberate and not the result of poor hospital hygiene or other causes. The Libyan press has continued over the last two weeks to print articles claiming that "foreign intelligence services" are responsible for the outbreak, most recently claiming that Bulgarian intelligence and Israeli intelligence were responsible for the "crime". While some Libyans will privately admit that they know the medics did not deliberately inject the Benghazi children with HIV virus, most Libyans, despite their belief that the Libyan medical system is unsafe, reflexively blame outsiders for the disease outbreak. The cognitive dissonance on HIV awareness makes it extremely difficult to manage public opinion that prevents a quick solution in the Medics case. END SUMMARY. ¶2. (C) After months of failed attempts to meet with managers of the Watassimo Foundation for Charitable Activities headed by Dr. Aisha Muammar Qadhafi, a government-sanctioned, quasi-NGO in Libya, about its work in AIDs awareness education, Embassy was invited to a World Aids Day held at the Tripoli General People's Congress Hall on December 2 that was jointly sponsored by UNDP and Watassimo. Aisha Qadhafi did not attend, but was idolized in a slide show that depicted her in halo'ed photographs attending committee meetings and giving speeches. ¶3. (C) The sparsely-attended event had about 50 "boy scouts" and 30 "girl guides" in the audience, along with a dozen public health officials and the family members of the children performing a skit as part of the program. In the lobby, head-scarf covered women from Watassimo handed out promotional materials for a Quran memorization contest sponsored by Aisha Qadhafi, along with some basic informational materials about AIDS. The General People's Congress Hall, one of the largest government structures in Tripoli, features a large auditorium that could hold several hundred people on both the main and upper level seating areas. The building is decorated with two large murals - one is an outline of all the Arabic-speaking countries painted in green with the caption "All Arab Countries are One." On the opposite wall is an outline of the African continent in black, with only the Libyan territory highlighted in green, along with the caption, "Africa isn't just an entity, it is a message of future civilization." ¶4. (C) After a blessing from an Imam and introduction by the head of the Libyan Infectious Diseases Center (LIDC),Secretary of the General People's Committee for Health Dr. Mohamed Abu-Ujaylah Rashed gave an address that broadly outlined the scope of AIDS in a global context, but also commented in his remarks that children in Benghazi were deliberately infected with the AIDs virus. He told the audience that there were 7023 cases of AIDS in Libya and 6707 were Libyan citizens. ¶5. (C) There was also a brief presentation by a man, currently under treatment for AIDS, who urged the crowd to accept those with the illness and also called for the government to create a special center to provide free treatment and support for all people with AIDs. The man, wearing very conservative Islamic dress including a white robe, crocheted white skullcap, and facial hair worn by devout religious clerics, conveyed a sense of repentance for past misdeeds in his remarks. The audience reaction to the remarks was polite and reflective. ¶6. (C) More than half of the program was a play enacted by young schoolgirls describing how viruses (using the example of avian influenza, not HIV) could attack the body. The play explained the role of good nutrition in heath, and also the function of red and white blood cells in the body's immune TRIPOLI 00000169 002.2 OF 003 system. The schoolgirls representing white blood cells (the defender's of health) were dressed in copies of the white military uniform Colonel Qadhafi usually wears on Revolution Day, complete with gold-fringed epaulets just like the "Leader's" outfits. In keeping with the revolutionary mindset of the Jamahiriya (an Arabic word that translates as "the state of the masses"),the play included air raid sirens when the system was under attack by the virus, and the girls used toy rifles and handguns to attack back, accompanied by background sound effects simulating machine-gun fire. ¶7. (C) After the program, P/E Chief spoke with a doctor who lived in the U.S. for seven years and did post-graduate work in medicine at Tulane University. She now runs public health programs at the LIDC. Asked to confirm P/E Chief's understanding of the Health Secretary's remarks in Arabic, she said that yes, the children had been deliberately infected. Asked how she, as a health professional, knew the infections were deliberate, she said that the Libyan health authorities had conducted studies that proved the crime of the accused Bulgarians and Palestinian. She was not aware that the Libyan courts had rejected expert testimony from leading AIDS researchers from outside Libya. While earlier in the conversation, the doctor complained about Libya's abysmal state of public health, health education and service, when it came to the AIDS investigation, she insisted that Libyan doctors and equipment were world-class and capable of conducting a thorough investigation. ¶8. (C) Similarly, the head of the Tuberculosis prevention program for the General People's Committee of Health, a doctor who lived and studied in Budapest for seven years before returning to Libya also said he believed the Benghazi HIV infections were deliberate. When P/E Chief ran through a list of medical reports issued by internationally-recognized experts, including Libyan expatriate medical specialists, and offered other explanations for the outbreak, the doctor was not receptive to any citations of scientific studies. ¶9. (C) Last year P/E Chief had dinner in Benghazi with a working-class family with one son in medical school. Asked about the case and local Benghazi opinion, the future doctor said that "everyone" in Benghazi knew the infections were deliberate and that if the medics were released it was a sign that the government was corrupt and bowing to pressure from the West. ¶10. (C) In late November the charge had a conversation with a Libyan doctor now living outside Libya but who returns from time to time to provide consultative services to the government. The doctor gave many examples of the declining quality of the education available in Libya's medical schools, and cited the absence of quality control in the educational system. He then told the charge that he had been asked to write a report about AIDS and its treatment, with reference to the Benghazi problem. At first his interlocutors had been reluctant to provide him requested data, and remained vague as to whether the report was to be read by specialists or by laymen or someone in between. After persistent questioning the doctor finally ascertained that the report was to be prepared for Muammar Qadhafi. The doctor concluded that Qadhafi was intensely interested in this technical issue and was following the Benghazi case closely. The doctor made it clear to the charge that he did not believe the Bulgarian nurses were guilty of intentionally infecting the children but it was not clear how much of this conclusion was conveyed in the report he wrote. ¶11. (C) COMMENT: The disconnect between the public rhetoric of health policy officials and the often privately-acknowledged admittance that the HIV infection was not a deliberate criminal act by the medics reflects the deep threat felt by the authoritarian regime. There are a number of factors influencing the government's current stance that outsiders are to blame for the HIV infections in Libya. Religious, social and cultural stigmas make it very difficult to admit that behaviors or practices that contribute to the spread of HIV may exist in Libya. The government also, given Benghazi perceptions that it receives less than a fair share of state resources, has to manage public opinion. It is not willing to accept responsibility for the lack of basic hygiene, sanitation, equipment or adequately trained staff in state-run facilities. The government's image problems became even more tangled after its initial attempts to blame the outbreak on outsiders, (at one time claiming U.S. and Israeli intelligence services were behind TRIPOLI 00000169 003.2 OF 003 a plot to kill Libyan children). After 8 years of blaming outsiders, now the government also faces heavy criticism from oppositionist forces, especially conservative Islamic groups, who decry the government falling under the influence of western forces. While some Libyan officials acknowledge privately and confidentially that they know the HIV outbreak was not a deliberate, criminal conspiracy they have not found a way to manage the situation in a way that protects the Libyan regime from damaging criticism. The cognitive dissonance on HIV awareness makes it extremely difficult to manage public opinion that prevents a quick solution in the Medics case. CECIL