In May 2003, I began an investigation of the Incarnation Children's Center (ICC), an orphanage in New York City's Washington Heights that was being used by government (N.I.H.) and pharmaceutical companies as a test center for the standard AIDS drugs AZT and its analogues, Nevirapine, and the various protease inhibitors. ICC received funding from both government and corporate sponsors to enroll its wards, primarily abandoned children of drug (crack cocaine and heroin) abusers, in NIH clinical trials (1).
What follows are five excerpts from my October, 2003 interview with ICC's medical director Dr. Katherine Painter. In the interview, Dr. Painter provides information about:
1. Who gets into ICC and why.
2. The backdoor through which ICC's wards were used in government/pharma-sponsored Clinical Trials.
3. The measures taken to enforce "adherence" to the drug regimen.
4. And a hint of the toxicity of the drugs (ie. their ability to "suppress" bone marrow and cause anemia).
On a personal note, I found it very uncomfortable to talk with the doctor, and to listen to her, as she seemed totally removed from what she was saying; dissociated, in a real sense; inured against the horror of what she was describing, of what she was participating in. Three and a half years later, I still find it almost impossible listen to.
PRIMARY CARE PHYSICIAN
Here Dr. Painter describes the role of ICC, as a referral foster home for children being treated in hospitals in the major metropolitan area. She explains her role as the primary physician at ICC, and also hints at the primary reason that children are remanded to ICC - failure to adhere to the drug regimen.
Dr. Painter explains the backdoor through which ICC's population is entered into drug trials. Even though ICC wasn't listed as an NIH recipient as of 2002, their wards were able to be used in government/pharmaceutical drug trials.
The children in ICC got to the orphanage through referrals from the major hospitals in the New York Metropolitan Area (Columbia Presbyterian, St. Mary's, SUNY, Roosevelt, etc.), and so it is at these hospitals that the children are enrolled in drug studies. The study drugs are then maintained and enforced at the ICC, by their medical and nursing staff.
When I began investigating the ICC, I found 27 studied listed at the government clinical trial database (2) with about 7 or 8 listed as "currently recruiting". (3, 4) That number dropped after media coverage increased following my first expose.
After the BBC film was released in Europe in late 2004 (5, 6), that number dropped further. I noted two studies "still recruiting" in early 2005. The page now lists no studies recruiting specifically at the ICC.
As of January, 2006, the total number of studies specifically listing ICC as a participant stands at 36 (1), nine more than the 2003 listing. But the backdoor use of enrolling children at Columbia Presbyterian, Harlem and neighboring hospitals, as described in the previous section, no doubt contributes significantly to the increase.
Dr. Painter tended to view the inclusion of these orphans in government/pharma drug trials as a positive event, and used terms like "expanded" and "progressive action programs" as euphamisms for "human drug trial", or "experiments with extraordinarily toxic synthetic chemicals in abandoned drug orphans", which I think more accurately describe the situation at ICC.
Dr. Painter describes the importance of "adherence" to the drug regimen, and the lengths she and the ICC medical staff go to enforce it. She explains that the growing cause for being in the orphanage is not illness, but refusal to take the various AIDS drugs.
Resistance to the drugs was strong in many children, because, according to the childcare workers, nurses and former ICC residents I interviewed from 2003 through 2005, (2, 3) the drugs made many children immediately ill; severe nausea, vomiting and diarrhea were the predictable after-effects of ingesting the various chemicals.
Failure to take or enforce the drugs was and remains sufficient reason for the state to remove children from parental custody and remand them to the ICC, or to a foster home. This was not only the case with the mothers and guardians I have interviewed in New York, but also in Canada, California, and Europe.
In this segment, Dr. Painter describes the chief problem of the drugs as their "significant, lingering bitter aftertaste". This was clearly code for what was described to me by patients, nurses, child care workers as the daily and hourly vomiting, nausea and diarrhea, that occurred after taking the drugs. (This is the same description offered by many adult gay men who are on the drugs).
Dr. Painter clearly explains the processes of forcing "adherence" in children who are reluctant, or unable, to swallow the medicines. The "first intervention", as she called it, is an "N.G. Tube", tube inserted through the nose, and pushed down the throat into the stomach, through which the ground pills are given.
For continued refusal, a "G-Tube" is considered appropriate. In this, a child undergoes a surgery in which a tube is inserted through the abdominal wall directly into the stomach. From then on, the ground drugs are pushed, by syringe, into the stomach. "Do not refuse", seems to be the message (4).
VIRAL LOAD, T-CELLS AND AZT
In this section, Dr. Painter offers the justification for the practice of forced and surgical drugging. It is based on T-cell and viral load determinations, which Dr. Painter describes as based on an "evolving understanding".
Dr. Painter at first deflects the idea that the primary drug used in AIDSs patients, AZT, is extremely toxic, but then states that one of the problems it causes is "bone marrow suppression". That is, it destroys your blood-producing tissue (5).
In case of AZT toxicity, she suggests lowering the dose, or giving additional drugs to try to replace the missing neutrophils (protective white blood cells) and red bloods cells destroyed by the drug.
Liam Scheff is a writer and journalist on politics, history, race, class and culture.