Sunday Times (London), October 3, 1993, Sunday

HEADLINE: The plague that never was

BYLINE: Neville Hodgkinson

BODY: Philippe and Evelyne Krynen had come to Africa with a
quest: their mission was to help children in the direst need.
After being told they could have no children of their own, the
French charity workers had determined they would dedicate the
rest of their lives to Third World orphans.

In January 1989 they found the ideal opportunity. A three-day
journey through Tanzania by bus, train and boat took the couple

to the remote Kagera province, a pocket of land west of Lake
Victoria and bordering Uganda, Rwanda and Burundi, where Africa's
first cases of Aids had been diagnosed as far back as 1983.

Now the region was an epicentre of the disease, according to
a local Lutheran bishop who took them on a tour of the worst-hit
places. Whole villages were being destroyed, people were dying
continuously in and around the main township of Bukoba, and HIV
testing suggested that up to half the sexually active population
was infected.

Philippe, 50, a former pilot, and Evelyne, 42, a teacher,
prepared an illustrated report on their findings, Voyage des
Krynen en Tanzanie, which they sent back to France. It was to
prove a catalyst for world interest in the social impact of the
pandemic of Aids in the continent.

Their journal presented a dramatic picture: children alone in
houses emptied of adults, or abandoned into the care of
grandparents; a football team destroyed by the disease; old
people sitting alone with their dead; black crosses painted at
the entrances of Aids-stricken homes.

"Here, Aids does not choose its victims among marginal
groups," they wrote. "It touches the entire sexually active
population, men and women alike. Extreme sexual liberty, a weak
sense of hygiene and a lack of medical and social support have
made the populations of these parts a particularly homogeneous
risk group."

It was a message that Western medical and charitable
agencies, urgently wanting to alert people to the perceived
dangers of HIV and Aids, were more than ready to hear. French and
Belgian newspapers, magazines and television stations took up the
story and aspects of it are still being quoted around the world
by Aids organisations.

In common with many other Westerners who had seen the Aids
epidemic as a call to arms against the perils of ignorance and
promiscuity, the couple had felt it was almost impossible to
overstate the dangers it posed.

They helped one young villager write a letter to
schoolchildren. It said so many of his team-mates had died that
"we can't play football any more so behave, and you won't get the
disease like we did here". The letter featured in pamphlets
prepared by a European Community Aids prevention project and was
distributed widely to schools in west Africa.

"When we came here we had the textbook knowledge of Aids in
our minds," Philippe says. "That it is a sexually transmitted
disease; that it would be very easily transmitted in Africa
because other STDs are rampant; that many Africans are HIV-
positive and would get full-blown Aids after one or two years,
faster than in Europe; and that the virus was passed from mother
to child, affecting 50% of children.

"This was what we had learned from our medical studies. And
the people who showed me what was happening here reinforced this
belief. What I wrote in my journal was with 100% bonne
conscience."

Four years later the couple recognise their understanding of
the situation was utterly wrong.

IN THE late 1980s, medical workers almost without exception
believed the disease first seen destroying the immune systems and
lives of homosexual men in San Francisco and New York was a new
or mutant virus, HIV, which posed a threat to the sexually-active
population of the entire world.

A diagnostic test had been developed which purported to be
able to identify antibodies to HIV in the blood of infected
people. Most Aids patients seemed to have these antibodies in
their blood, and on the basis of that link various forms of the
test were rushed on to the market.

They rapidly became big business. Doctors believed the test
could identify infected people and thus help predict people at
risk of developing Aids.

It was also widely believed that because of its similarity
with certain viruses found in African monkeys, HIV had come from
Africa. The viruses were harmless to monkeys except in abnormal
laboratory circumstances; but if HIV had recently crossed the
species barrier into humans, that might be why it could be so
devastating in its new hosts.

When Western scientists began to look for Aids in Africa,
their tests showed that millions already seemed to be infected
with HIV, confirming the theory that this was where the virus had
originated.

Furthermore, strange deaths had been reported which carried
the hallmarks of Aids. In particular, an unexpected collapse of
immune system defences in young adults had allowed fungal and
other infections to run wild. A few such deaths had been seen in
two of Kagera's villages, Kashenye and Bukwali, in the early
1980s.

The number of cases was tiny relative to the apparent spread
of HIV, but because the virus was thought to take anything from
two to 10 years to cause the immune system to fail, Aids doctors
came to believe the continent was already in the grip of a
terrible disaster.

That was the climate of medical and scientific opinion in
which the Krynens arrived in Kagera four and a half years ago.

Backed by Partage, a charity which arranges sponsorship among
French families and institutions to help Third World children,
they soon found themselves heading the first and largest Aids
organisation for children in Tanzania.

In preparation for their new life helping people in
developing countries, the couple had abandoned their previous
careers to train as nurses specialising in tropical medicine.

Today, Partage Tanzanie has 230 full-time employees who are
helping 7,000 children in 15 of Kagera's villages. The charity
has an income of more than Pounds 50,000 a year, a fortune in a
country desperate for foreign currency. The staff includes 20
nurses, a doctor, a pharmacist, a laboratory technician, office
staff and teachers. There are also scores of field workers who
get to know the children, caring for them at day centres,
monitoring their health and ensuring they are well fed.

The couple's first intimation that there might be something
wrong with the standard medical model of HIV and Aids came when
they started to try to organise help for children in the border
villages. "Our aim was to help the people help their children,"
says Evelyne. "But in some of the villages we found nobody was
interested in the future, or in the kids, any more.

"One reason, we thought, was that they had been told 40-50%
were infected and were going to die, and this in a context where
people were indeed dying a lot, because of poverty and an upsurge
in malaria. The young people were convinced they were going to
die anyway, so why should they think of the children or the
future.

"We said that even if 50% are infected, 50% are not, so let
us find out which are which. Then those who are free of the virus
can think about the future again."

A pilot study offering HIV tests to their own staff provided
the next shock: only 5% were positive, although almost all were
young and sexually active. Perhaps they were unrepresentative,
the Krynens thought, because their level of education was above
average.

So last year, they proposed a mass testing programme to the
villagers of Bukwali. Encouraged by the promise that a clinic
would be established to give free treatment to anyone testing
positive, about 850 people agreed to take part almost the entire
population aged between 18 and 60. This time, 13.7% were found to
be HIV-positive still much lower than the villagers had been led
to believe.

The Krynens have found that one positive test cannot be
relied upon for a HIV diagnosis, even though in many African
countries a single test is all that can be afforded. A wide
variety of parasitical and other infections can trigger a false
positive result and repeated testing frequently shows the same
patient to be negative.

The villagers may have shown a higher rate of HIV-positives
simply because they were older, with an average age of about 42,
compared with 24 in the staff study. They had been exposed for
longer to "whatever it is in Africa that can so readily cause the
blood to test positive", says Evelyne.

"We have noticed that with the women, the more children they
have, the more likely they are to be positive. We have five HIV-
positive women on our staff, and all have children but a stable
life.

"It could be because being more in contact with doctors and
hospitals, and taking more drugs, or even just giving birth,
causes you to accumulate reactivity to the test. It may not have
anything to do with a virus."

Even more dramatically, the Krynens' studies have shown no
connection between HIV-positivity and risk of illness. Fifty-four
villagers were ill with complaints such as pneumonia and fungal
infections that might have contributed to an Aids diagnosis, but
just as many of these were HIV-negative (29) as positive (25).
When they were given appropriate treatment, most recovered.

"All of a sudden you put all you have been told about the
disease in the garbage can, and try to reconsider," Evelyne says.
"Once you know HIV means nothing any more, once you know it is
not true there is an epidemic, you doubt everything you believed
before.

"The 15 villages we have looked at are in the most affected
area of a region that is supposed to be at the epicentre of Aids
in Africa.

"When you listen to the people, you find they had been
shocked by some deaths where the effects on the body were very
visual, with fungus infections and skin rashes. But these can be
secondary effects of antibiotics, and the people who died with
these conditions had all been treated before for conditions such
as bronchitis. Nothing is sure; everything is just wind."

Most of the first deaths reported as Aids were in young men
trading in black-market goods in the aftermath of the Ugandan
war. "It started at the border, where people were dealing in
drugs as well as other goods," says Philippe.

"It's true this group had money and was affected with immune
suppression and a wasting syndrome. But it was not because they
had sex like rabbits that they died. This is what was put in
people's minds by missionaries and other people, but whatever
killed them was not sexually transmitted, because they have not
killed their partners. They have not killed the prostitutes they
were using; these girls are still prostitutes in the same place.

"Was it a special booze? Was it an amphetamine or
aphrodisiac? It is difficult to give more than hints, but when
you listen to the people's descriptions of those first affected,
you find they were saying they had been poisoned. If the local
people said that, for two or three years before the word Aids
came to the region, why don't we believe them a bit, and look at
what could have poisoned them?"

Evelyne adds: "There is not a trace of evidence for it being
sexually transmitted. I will spend a night with an HIV-positive
person, if he's handsome enough I'll do it to prove it."

Studies elsewhere in Africa have shown a close correlation
between HIV-positivity and risk of illness, but the Krynens think
this may be a consequence of health workers and patients giving
up hope in the face of an HIV "death sentence".

"If you look at the sick people only, and test them, you may
find many who are positive," Philippe said. "If you do the
contrary, and test the whole population of a village, you seize
an instant picture of a real state.

"We have fewer casualties, proportionately, in those who test
positive than in those who are negative. That may be because they
are able to report to our clinic where they are treated free.
They have a little flu, a backache, a boil, and they get a nurse,
a smile, and do much better than the poor fellow who tested
negative."

The couple tried from the start to play down the significance
of a positive test result. Today they are continuing to use the
HIV test, "just to prove that we have to stop doing this, that it
has nothing to do with Aids". They are training their field
workers not to mention HIV or Aids, but instead to deal with any
known disease they encounter with the best treatment available,
regardless of the patient's HIV status.

"It is not known whether HIV causes Aids," they say in a
pamphlet produced for the team. "It is time to come back to
science and abandon magic thinking."

Philippe now declares: "There is no Aids. It is something
that has been invented. There are no epidemiological grounds for
it; it doesn't exist for us."

IF KAGERA is not, after all, in the grip of an epidemic of
"HIV disease", and if there is no Aids, where have the thousands
of orphans come from?

The answer, say the Krynens, is that most of the children are
not orphans at all. Their final disillusionment was to discover
that although many children are raised by their grandparents,
that is a long-standing cultural feature of the region.

"The parents expatriate themselves a lot. They move away from
the region, sending a little money, returning little or never,
but still have many children in the village," Philippe explains.
"They are outwardly orphans, but raised by the grandmother or
grandfather. It has always been like this here; they may need
help, but it has nothing to do with Aids.

"Polygamy is also rampant here and they don't raise all the
children. They select very few and the others are just made and
abandoned." Other children were born to prostitutes.

"You come as a European and ask: 'Who has no mother or
father?' They produce all these children, even though they have a
mother or father in another place.

"We have been shown false orphans since the beginning
children who have parents who never died, but who will not show
up any more. And when the parent has died, nobody has been asking
why. It has nothing to do with an epidemic.

"Families just bring them as orphans, and if you ask how the
parents died they will say Aids. It is fashionable nowadays to
say that, because it brings money and support.

"If you say your father has died in a car accident it is bad
luck, but if he has died from Aids there is an agency to help
you. The local people have seen so many agencies coming, called
Aids support programmes, that they want to join this group of
victims. Everybody claims to be a victim of Aids nowadays. And
local people working for Aids agencies have become rich. They
have built homes in Dar es Salaam, they have their motorbikes;
they have benefited a lot."

The children usually thrive once they are properly fed and
cared for, although some are so poorly from birth, regardless of
"HIV", that they remain vulnerable to infections.

Philippe says: "In all the children we have lost there was a
very well designated reason, an illness we could not cope with
because we hadn't the means to do it: heart failure, TB treated
too late, cerebral malaria, acute hepatitis probably caused by a
drug taken for the wrong reasons. You have no right to call any
of these deaths Aids. I can't tell you of a single child I have
followed who has died of a so-called Aids-related illness."

The Krynens have an adopted Tanzanian son, Joseph, 5, whose
one-time diarrhoea, coughing and wasting were said at a local
hospital to be untreatable because of HIV. Today he is cheerful,
in near-normal health and vigorously active.

"Joseph is what people call an Aids baby, but he is living
well," says Philippe. "He is a sample of the manufactured Aids
you can have in this region.

"We put him on anti-fungal drugs for his diarrhoea, and sent
him to France in January this year for bronchial washing and now
look at the kid.

"Whenever I have been able to follow people reported to have
Aids for any length of time, I have seen them to be cured. When
you really look into it, they are not Aids cases. So where are
these cases? Always in the hands of other people hospitals,
reporters, photographers.

"A 65-year-old who tested HIV-positive had been getting sick,
suffering stomach troubles and losing weight. I explained to him
that HIV and Aids were very different things, that we could not
really make a link between them. The other day I heard that the
fellow is not sick any more. He doesn't believe he is going to
get Aids. He has regained four kilos and is doing very well. This
type of resuscitation is very common in our programme.

"A woman of about 40, with two daughters, was dying of
chronic diarrhoea and chest infections, said to be HIV-related.
Her husband was said to have died of Aids, although nobody has
been able to tell me precisely what killed him.

"We admitted one of the daughters to our day-care centre,
supported the other at school with books and meals, and treated
the mother with rifampicin, a drug normally reserved for TB which
we have found to be very effective in such cases. After a month
she did not have diarrhoea any more, she was able to go to the
fields again and has started to gain weight. I can swear to you
that this woman will not be sick for a long time, as long as she
knows we are supporting her. We have stolen another Aids case
from the statistics.

"It is good to know that this epidemic which was going to
wipe out Africa is just a big bubble of soap."

POSTERS warning of the dangers of ukimwi (Aids) adorn the
cabins of the Victoria, a steamer that ferries passengers on the
nine-hour journey from Mwanza, on the southern shore of Lake
Victoria, to Bukoba.

When the Krynens first made the journey they found a small
town with only a handful of foreigners and few cars. Despite the
concern of doctors over an apparently high rate of HIV-
positivity, Aids had not become a topic of widespread attention.

Today, as the ferry arrives the tiny port seizes up with
vehicles, including several white Land-Rovers and Toyotas
characteristic of the numerous Aids agencies that have flourished
in much of central Africa.

"We have everybody coming here now the World Bank, the
churches, the Red Cross, the UN Development Programme, the
African Medical Research Foundation about 17 organisations
reportedly doing something for Aids in Kagera," says Philippe.
"It brings jobs, cars the day there is no more Aids, a lot of
development is going to go away."

The Krynens work hard. They keep files on all their donor
families and careful records of how the money is spent. Their
home, a modest bungalow on a hillside overlooking Lake Victoria,
is the hub of the project, with its own HIV-testing laboratory.
All day a stream of workers comes by to give feedback and take
directions. A few children who have nowhere else to go live in an
adjoining building.

When direct, practical help is given to suffering people,
perhaps it doesn't matter too much whether the children are Aids
orphans or not. But the Krynens are angry because false
information continues to be fed to Africa and the world.

"Africa is a market for many things, an experimental ground
for many organisations and a 'good conscience' ground for many
charities," Philippe says.

"It is very easy to 'do good' in Africa. It is so
disorganised that the one who is doing the good is also the one
reporting the good he is doing. So it is a perfect field for
charity the fake charity which is 99% of the charity in Africa,
charity which benefits the benefactors."

They speak especially strongly about this because of their
own involvement in triggering an invasion of Aids agencies to
Kagera. They now know that the stories they told, of houses and
villages abandoned because of Aids, were untrue.

"Not one such village can be witnessed by a team of
journalists led by me," Philippe says. "The houses that were
empty were closed because they were the second or third homes of
someone in Dar es Salaam. I learned this later.

"I have never seen a village with no adults, where children
are like wolves in the forest. You know who is responsible for
these stories? Partly, Partage. We said that if we did not do
something very quickly, these villages would be emptied of adults
and children would be like wild animals. The stories have been
printed and reprinted, without the 'if'.

"My medical studies led me to believe that Aids was
devastating and the people who showed me the situation here
reinforced this belief. I jumped into this, and made others
believe it. And now I know it was not true. But I know many more
things that were not true. Nothing was true.

"It is terrible to consider you have done so many things you
thought worthwhile, when in fact you were misled. It is difficult
to adjust afterwards. Nobody knows who is responsible for the
first misinterpretation, but as time passes it gets bigger and
bigger.

"These ideas were not based on any studies; they were just
fashion. But when you are here, and you have to witness the
reality of what happens in the field, you cannot agree with any
of the statements they are making in Europe about Aids in Africa.
We discovered we were in a full-blown lie about Aids. Everybody
participates in this lie, willingly or not. No individual is
responsible, but it is a big scandal.

"The world has been brainwashed about Aids. It has become a
disease in itself, without the necessity of having sick people
any more. You don't need Aids patients to have an Aids epidemic
nowadays, because what is wrong doesn't need to be proved. Nobody
checks; Aids exists by itself.

"We came here to help orphans of Aids. Now we are facing a
situation where there are no orphans and no Aids.

"We are in the heart of Aids country. You are talking to
people who 'discovered' Aids here, and who now say it is a lie.
We expect to have to pay for what we say. It will be the price of
truth."

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