What is thrombocytopenia, the rare blood condition possibly linked to the AstraZeneca vaccine?

Shutterstock

Anthony Zulli, Victoria University; Maja Husaric, Victoria University; Maximilian de Courten, Victoria University, and Vasso Apostolopoulos, Victoria UniversityThe federal government has asked Australia’s medical and vaccine regulators to urgently consider the European Medicines Agency’s finding of a possible link between the Oxford/AstraZeneca COVID vaccine and rare blood clots.

This follows reports over recent weeks of blood clots in a small number of people around the world who had received the AstraZeneca vaccine, including one man who was hospitalised in Melbourne.

Scientists have termed the condition “vaccine induced prothrombotic immune thrombocytopenia” (VIPIT). But what does this actually mean, how significant is the risk, and what are the implications for Australia’s vaccine rollout — which is currently relying predominantly on the AstraZeneca jab?

A paucity of platelets

As indicated by its name, VIPIT is a form of something called thrombocytopenia.

Thrombocytopenia is a condition whereby the numbers of thrombocytes (very small blood particles, or platelets) are markedly reduced. Platelets form clots to stop bleeding, so when you don’t have enough platelets in your blood, your body can’t form clots. This can lead to excessive bleeding.

The condition has a genetic component, but can also arise from more than 300 common medicines, including penicillin and certain pain killers. Quinine, which is added to tonic water for flavour, can also very rarely cause thrombocytopenia.

The symptoms of VIPIT can include severe headaches, abdominal pain, seizures and visual changes. These are similar to the symptoms of thrombocytopenia unrelated to the vaccine.

In rare cases of thrombocytopenia, clots can develop in the vessels draining blood from the brain. The European Medicines Agency said it had received reports of 169 cases of brain blood clots in people who had been vaccinated with the AstraZeneca shot.

In severe cases, thrombocytopenia can be fatal. There have been deaths from blood clots reportedly associated with the AstraZeneca vaccine, including 19 in the United Kingdom.

---

Read more:
What can go wrong in the blood? A brief overview of bleeding, clotting and cancer

---

VIPIT appears to present 4-20 days after vaccination, and so far, the issue has been largely associated with women under the age of 65.

So how could this vaccine potentially cause thrombocytopenia? The “prothrombotic immune” part of the name denotes it’s caused by an over-activation of the immune system, which gives us a clue.

Platelets and COVID-19

The AstraZeneca vaccine prompts cells to make a specific part of SARS-CoV-2 (the virus that causes COVID-19), called the spike protein, which the virus uses to attach to cells when infecting us.

The vaccine stimulates our immune system to generate antibodies against the spike protein, which then primes the body to mount an immune response against SARS-CoV-2, if it encounters the virus in the future.

But in some people, the AstraZeneca vaccine seems to produce antibodies that react with platelets, making them stick together, leading the blood to clot. This in turn reduces circulating platelet numbers, and hence the thrombocytopenia.

These antibodies are similar to those found in some people on a blood thinning drug called heparin. The immune response to heparin generates antibodies that bind to platelets. This can lead to blood clots in some people, called heparin induced thrombocytopenia. As many as one in 20 patients receiving heparin develop thrombocytopenia.

Keeping in mind we’re yet to establish cause and effect, it’s a possibility that the biological mechanism by which we believe heparin leads to thrombocytopenia could be the same biological mechanism by which the AstraZeneca vaccine might.

How common is it?

Naturally occurring thrombocytopenia affects about one in 30,000 adults a year in the United States.

As for the suspected vaccine-induced kind, according to data collated by the Thrombosis and Haemostasis Society of Australia and New Zealand, VIPIT is as rare as one in 500,000 people. But the society notes the data are incomplete.

Different countries have reported different rates. Norway, for example, has so far reported one in 25,000 vaccinated adults under the age of 65 have experienced low platelet counts, bleeding, and widespread thromboses (blood clots).

Of course, the possibility that some of these cases of thrombocytopenia may have occurred regardless of the vaccine makes understanding vaccine-induced cases more complicated. But taken together, thrombocytopenia appears to be more common in the general population than among those who have been vaccinated.

As we continue to vaccinate the world, it’s likely small subsets of people will continue to experience this complication. Whether we can establish a causal link between the AstraZeneca vaccine and thrombocytopenia is subject to continued investigation.

---

Read more:
Politics with Michelle Grattan: Stephen Duckett on what’s gone wrong with the rollout

---

Be aware, but not alarmed

Amid this ongoing investigation, some countries, such as Norway, have paused their rollouts of the AstraZeneca vaccine. Others have restricted use of the vaccine in certain groups, like Canada, which is using it only for adults older than 55, who may have higher risks from COVID and lower risk of blood clots. Meanwhile, the UK has pledged to make other vaccine options available for younger people.

We will wait to see how the Australian experts respond. But for the general adult population, we agree with the current guidance from bodies including the European Medicines Agency and the World Health Organization that the benefits of the AstraZeneca vaccine outweigh the risks.

That said, it’s not unreasonable to be cautious. You should monitor for these symptoms up to 28 days after receiving the jab:

• breathlessness
• pain in the chest or stomach
• swelling or coldness in the leg
• severe or worsening headache
• blurred vision
• persistent bleeding
• multiple small bruises, reddish or purplish spots, or blood blisters under the skin.

If you’re experiencing any of these symptoms and you’re concerned, seek medical advice.

---

Read more:
Data suggest no increased risk of blood clots from the AstraZeneca vaccine. Australia shouldn’t pause its rollout

---

Anthony Zulli, Associate professor, Victoria University; Maja Husaric, Senior Lecturer; MD, Victoria University; Maximilian de Courten, Professor in Global Public Health and Director of the Mitchell Institute, Victoria University, and Vasso Apostolopoulos, Professor of Immunology and Associate Provost, Research Partnerships, Victoria University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Who pays compensation if a COVID-19 vaccine has rare side-effects? Here’s the little we know about Australia’s new deal

Shutterstock

Nicholas Wood, University of Sydney

In last week’s federal budget the Australian government announced it had given the suppliers of two COVID-19 vaccines indemnity against liability for rare side-effects.

Although details are unclear, it appears the government would foot the bill for compensation if a member of the public wins legal action against the drug company.

This is in contrast to 25 other countries with no-fault compensation schemes for rare vaccine side-effects.

Here’s the little we know about Australia’s latest indemnity deal and what we could be doing better.

What do we know about Australia’s new deal?

The deal relates to two vaccines the government had previously announced it would supply, should clinical trials prove successful.

These are the University of Oxford vaccine, from AstraZeneca, and the University of Queensland vaccine, from Seqirus (part of CSL).

However, it is not entirely clear what this indemnity deal means in practice. The budget papers say the government will cover:

certain liabilities that could result from the use of the vaccine.

The government considers further details “commercial in confidence”.

For instance, we don’t know how serious or disabling a side-effect would have to be to qualify or whether there is any cap on the amount of compensation.

We also don’t know what would happen if there were errors involved, or contaminants introduced, while manufacturing the vaccine. These would still be the company’s liability, but it may be hard to determine where boundaries lie.

---

Read more:
Putting our money on two COVID vaccines is better than one: why Australia’s latest vaccine deal makes sense

---

How unusual is this?

This deal is not entirely new or unexpected. The government has provided some indemnity to pharmaceutical companies that make vaccines against smallpox and influenza.

The governments of many other countries have also agreed to indemnify COVID-19 vaccine manufacturers, including governments in the UK, US and the European Union.

The manufacturers believe that as the use of their vaccine is for the benefit of society, they should not be held financially accountable for any consequences from a vaccine reaction.

---

Read more:
Big pharma’s safety pledge isn’t enough to build public confidence in COVID-19 vaccine – here’s what will

---

So what does this mean for the public?

If a person in Australia believes they have been injured by a vaccine, including future COVID-19 vaccines, they will need to pursue compensation through the legal system.

Under the latest agreement, it would appear the government, rather than the drug company, would pay that compensation, should the person win their case.

However this is not ideal. The person still has to engage with the legal system, which is both costly and complex, and there’s no guarantee of success.

Under the latest indemnity deal, it seems that people would still need to go through the legal system, with no guarantee of success.
www.shutterstock.com

Compensation may not even be possible via our legal system. That’s because in most cases, it will be difficult to show in court a serious side-effect was due to a fault in the vaccine composition or negligence in the way it was administered.

So in Australia, people with a vaccine injury, either COVID-19 or other vaccine, will likely bear the costs of their injury by themselves, and seek treatment by our publicly-funded or private health systems.

The National Disability Insurance Scheme helps fund therapies for people with a permanent and significant disability but does not cover temporary vaccine-related injuries.

Participants in COVID-19 vaccine clinical trials can be compensated for temporary and permanent vaccine injuries.

---

Read more:
The budget assumes a COVID-19 vaccine becomes available next year. Is this feasible?

---

What’s happening overseas?

In the US, people with a rare but serious reaction to a COVID-19 vaccine will be able to access a special compensation scheme. This is designed to provide compensation for the use of COVID-19 pandemic medications and vaccines.

However, applicants only have one year from the date they had the vaccine or medicine to request benefits.

The US already has a vaccine compensation scheme for vaccines other than COVID-19. This is an example of a no-fault compensation scheme. These compensate for specific vaccine reactions, without having to go to court to prove the vaccine manufacturer is liable.

Australia, in contrast to 25 countries including the US, UK and New Zealand, does not have a no-fault vaccine compensation scheme, and does not have the equivalent of the US COVID-19 vaccine compensation scheme.

How would a no-fault system work?

There are numerous benefits to a no-fault vaccine compensation system. These include simplified access to compensation, and avoiding a lengthy, costly and complex encounter with the legal system, with no guarantee of success.

Most are government funded. The US government funds it by a flat rate of US$0.75 for each disease prevented for each vaccine dose.

Finland and Sweden fund their programs via insurance payments from pharmaceutical companies marketing their products there.

The New Zealand scheme includes compensation for vaccine-related injuries, as well as for accidents and treatment injuries. This is funded through a combination of general taxation, and levies collected from employee earnings, businesses, vehicle licensing and fuel.

However, compensation awarded via such no-fault schemes is usually lower than you would receive after a successful liability lawsuit.

---

Read more:
We’re all at risk from scary medicine side effects, but we have to weigh the risks with the benefits

---

Where to next?

To encourage people to receive COVID-19 vaccines for the benefit of the entire community, we need compensation schemes to be in place if there is a rare but serious side-effect.

Should options to increase vaccine uptake include mandates or penalties — such as employment or travel restrictions if not vaccinated — this would make a no-fault vaccine compensation scheme even more essential.

Although it is important manufacturers receive indemnity for “certain liabilities”, we still need to look after our community. That means a compensation system the public can easily access and which provides appropriate support.

Nicholas Wood, Associate Professor, Discipline of Childhood and Adolescent Health, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Diarrhoea, stomach ache and nausea: the many ways COVID-19 can affect your gut

Shutterstock

Vincent Ho, Western Sydney University

Media reports earlier this week described a Queensland nurse with stomach pains who went on to test positive for COVID-19.

Could stomach pains be another symptom of COVID-19? And if you have stomach pains, should you get tested?

Although we might think of COVID-19 as a respiratory disease, we know it involves the gut. In fact SARS-CoV-2, the virus that causes COVID-19, enters our cells by latching onto protein receptors called ACE2. And the greatest numbers of ACE2 receptors are in the cells that line the gut.

COVID-19 patients with gut symptoms are also more likely to develop severe disease. That’s partly because even after the virus has been cleared from the respiratory system, it can persist in the gut of some patients for several days. That leads to a high level of virus and longer-lasting disease.

We also suspect the virus can be transmitted via the faecal-oral route. In other words, the virus can be shed in someone’s poo, and then transmitted to someone else if they handle it and touch their mouth.

---

Read more:
We don’t know for sure if coronavirus can spread through poo, but it’s possible

---

What type of gut symptoms are we talking about?

A review of more than 25,000 COVID-19 patients found about 18% had gastrointestinal symptoms. The most common was diarrhoea followed by nausea and vomiting. Abdominal pain was considered rare. In another study only about 2% of COVID-19 patients had abdominal pain.

Some people believe COVID-19 causes abdominal pain through inflammation of the nerves of the gut. This is a similar way to how gastroenteritis (gastro) causes abdominal pain.

Another explanation for the pain is that COVID-19 can lead to a sudden loss of blood supply to abdominal organs, such as the kidneys, resulting in tissue death (infarction).

Are gut symptoms recognised?

The US Centers for Disease Control has added diarrhoea, nausea and vomiting to its list of recognised COVID-19 symptoms.

However, the World Health Organisation still only lists diarrhoea as a gastrointestinal COVID-19 symptom.

In Australia, nausea, diarrhoea and vomiting are listed as other COVID-19 symptoms, alongside the classic ones (which include fever, cough, sore throat and shortness of breath). But abdominal pain is not listed.

Advice about symptoms that warrant testing may vary across states and territories.

How likely is it?

Doctors often use the concept of pre-test probability when working out if someone has a particular disease. This is the chance a person has the disease before we know the test result.

What makes it difficult to determine the pre-test probability for COVID-19 is we don’t know how many people in the community truly have the disease.

We do know, however, COVID-19 in Australia is much less common than in many other countries. This affects the way we view symptoms that aren’t typically associated with COVID-19.

It’s far more common for people’s abdominal pain to be caused by something other than COVID-19. For example, about a quarter of people at some point in their lives are known to suffer from dyspepsia (discomfort or pain in the upper abdomen). But the vast majority of people with dyspepsia do not have COVID-19.

Similarly, irritable bowl syndrome affects about 9% of Australians, and causes diarrhoea. Again, the vast majority of people with irritable bowel syndrome do not have COVID-19.

So how about this latest case?

In the Queensland case, we know the nurse was worried he could have had COVID-19 because he was in close contact with COVID-19 patients.

As he seemed otherwise healthy before developing new abdominal symptoms, and considering he worked on a COVID ward, his pre-test probability was high. Doctors call this a “high index of suspicion” when there is a strong possibility someone may have symptoms due to a disease such as COVID-19.

What does this mean for me?

If you have new gastrointestinal symptoms and you’ve potentially been in contact with someone with COVID-19 or if you also have other classic COVID-19 symptoms (fever, cough, shortness of breath and sore throat) you should definitely get tested.

If you have just gastrointestinal symptoms, you may need to get tested if you’re in a “hotspot” area, or work in a high-risk occupation or industry.

If you have gastrointestinal symptoms alone, without any of these additional risk factors, there is no strong evidence to support testing.

---

Read more:
8 ways the coronavirus can affect your skin, from COVID toes, to rashes and hair loss

---

However, if COVID-19 becomes even more common in the community, these symptoms now regarded as uncommon for COVID-19 will become more common.

If you have concerns about any gastrointestinal symptoms, seeing your GP would be sensible. Your GP will provide a balanced assessment based on your medical history and risk profile.

---

Read more:
4 unusual things we’ve learned about the coronavirus since the start of the pandemic

---

Vincent Ho, Senior Lecturer and clinical academic gastroenterologist, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

What is autoinflammatory disease, the rare immune condition with waves of fever?

from www.shutterstock.com

John Silke, Walter and Eliza Hall Institute and Najoua Lalaoui, Walter and Eliza Hall Institute

Just over 20 years ago, people from three generations of an American family were referred to the National Institutes of Health (NIH) in Washington DC with an unknown disease.

They were ten to 82 years old and had symptoms including monthly episodes of unexplained high fevers (up to 41℃), lasting two to seven days.

They also had painful swollen lymph nodes, enlarged spleens and livers, abdominal pain, mouth ulcers, joint pain, and a patchwork of other symptoms.

The symptoms, which they’d had since shortly after birth, seemed like an inflammatory reaction. However, doctors could not trace the episodes to an infection.

---

Read more:
Explainer: what is inflammation and how does it cause disease?

---

We now know these symptoms are typical of autoinflammatory diseases – rare conditions with seemingly unprovoked episodes of fever and inflammation.

Because the inflammatory episodes occur regularly, the diseases are also known as “periodic fever syndromes”. In addition to being painful and debilitating, some of the conditions can damage vital organs, such as the heart and lungs.

What causes autoinflammatory disease?

Autoinflammatory diseases are caused by abnormal activation of the innate immune system, the body’s first-line defence against invading pathogens.

The innate immune system is a hard-wired response that can quickly mobilise to fight foreign invaders. Among its many roles is the release of cytokines.

These are immune messengers critical for alerting and recruiting other cells to the fight, increasing blood circulation and inducing fever. More about cytokines later.

However, in autoinflammatory diseases, invading microbes don’t cause the fever and inflammation. Instead, genetic changes (mutations) lead to the innate immune system being activated for what appears to be no reason, causing uncontrolled inflammation.

---

Read more:
Explainer: what is the immune system?

---

Autoinflammatory diseases typically begin in childhood, often from birth, and are lifelong conditions. The genetic mutations can be passed from parents to their children, leading to multiple cases of disease in an extended family.

Autoinflammatory diseases are different from autoimmune diseases, such as multiple sclerosis, which are caused by defects in the adaptive immune system, a different arm of the immune response.

---

Read more:
Explainer: what are autoimmune diseases?

---

There are a number of different autoinflammatory diseases, often caused by different genetic mutations.

How do we treat autoinflammatory disease?

Autoinflammatory diseases cannot be cured, and treatment is usually to relieve symptoms during an attack. Patients are often treated with high doses of corticosteroids, a broad-brush approach to suppress the immune system.

Autoinflammatory diseases are also quite rare, which in the past has made it difficult to develop specific treatments.

Because autoinflammatory diseases are typically associated with excess production of cytokines, they are sometimes treated with so-called biologics – antibodies that mop up these excess cytokines.

These are usually antibodies to the cytokines tumour necrosis factor (TNF) or interleukin-1.

However biologics are expensive, and can have significant side-effects.

Without knowing the cause of an inflammatory disease, treatment is a trial and error process; a drug that works for one person may not work for another.

Antibodies against the molecule TNF (above) can be used to treat excess inflammation.
from www.shutterstock.com/StudioMolekuul

Can genetic testing help?

The discovery of mutations in genes causing autoinflammatory diseases has led to the development of genetic tests to help diagnosis.

However, some people with autoinflammatory disease do not have a change in one of the known disease-causing genes.

So our researchers have established the Australian Autoinflammatory Disease Registry to help identify other genetic causes of autoinflammatory diseases.

How we found out about the underlying mechanism

While the NIH researchers were looking for a cause of the American family’s disease, another strand of the story was playing out in Australia.

We were looking at the role of the master cytokine TNF, which controls many aspects of the body’s inflammatory response, and its partner RIPK1.

Usually, the body has many checks and balances to ensure these molecules are tightly controlled.

But we worked with the US scientists who found a critical mutation in the gene coding for RIPK1. We found this mutation, leading to changes in just one amino acid, was enough to supercharge its partner TNF into an elite killer.

This is what triggered the uncontrolled inflammation behind the American family’s disease.

Our team named this condition CRIA syndrome (cleavage-resistant RIPK1-induced autoinflammatory syndrome).

So what does this mean?

Understanding the molecular mechanism by which CRIA syndrome causes inflammation gives us an opportunity to get to the root of the problem, and to offer an alternative to existing treatments.

For this American family, treatment with an agent that inhibits the faulty RIPK1 might be a tailored option.

Lastly, the discovery of CRIA syndrome now confirms RIPK1 can play an important role in regulating inflammation in humans. So it may also play a role in far more common human illnesses, such as colitis (inflammation of the colon), rheumatoid arthritis and the skin condition psoriasis.

---

Read more:
What is rheumatoid arthritis, the condition tennis champion Caroline Wozniacki lives with?

---

John Silke, Leader, Infection, Inflammation and Immunity theme, Walter and Eliza Hall Institute and Najoua Lalaoui, Postdoctoral research fellow, Inflammation Division, Walter and Eliza Hall Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Pakistan: Good News

The link below is to an article reporting on some rare good news from Pakistan.

For more visit:
http://www.persecution.org/2013/04/04/christian-on-death-row-for-blasphemy-acquitted-by-pakistani-court/

Church ministry in Syria treads carefully after shut down

The spiritual climate in Syria is a changing one. While Syria’s Christian minority is generally respected, conversions to Christianity from Islam are rare and sometimes met with opposition, reports MNN.

Voice of the Martyrs reports that evangelizing is legal, but visas are not granted for missionary work. And while there is freedom to worship, any activity that could threaten communal harmony is suspect, making it difficult to spread the Gospel.

Despite the challenges, Reach Global in the Middle East and North Africa (MENA) began in 2008. The team working in the area is focused on holistic ministry: meeting physical and emotional needs as well as the spiritual needs of an individual.

They have been working together with churches, national partners, and collaborating with like-minded ministry organizations in order to reach the Syrians with the hope of Christ, and there has been success. A church has been planted.

This June however, the Syrian government closed the doors of that evangelical church. The group is still hoping to meet for worship and Bible study, but they are praying for wisdom and discernment on how to do that and still remain within the law.

Report from the Christian Telegraph

Could I live Without a Car for a Year?

I have already lived without a car for a year – in fact it is now over two years. I had a car accident that almost killed me and the car was written off as a consequence of the accident.

How have I got by? Well during that time I have ‘car pooled’ of sorts – because I haven’t got a car, I have been a passenger in the cars of others. I have also traveled via public transport. I have moved around locally on a bicycle and also walked.

So do I need a car? I would say, probably not. I can get by without one. On the rare occasions that i would like a car, I can rent one. I get on the bus and travel to the rental place (about an hour’s drive away) and rent one for a short time. So that’s how I get by without a car.

China Moves Uyghur Christian Prisoner, Allows Family Visit

Court rejects appeal of 15-year sentence for Alimjan Yimit.

DUBLIN, April 29 (CDN) — Authorities in Xinjiang Province recently moved Uyghur Christian Alimjan Yimit from a prison in Kashgar to a prison in the provincial capital Urumqi and allowed the first visit from family members since his arrest in January 2008, sources told Compass.

Alimjan (Alimujiang Yimiti in Chinese) was noticeably thinner but in good spirits, the family told friends after their brief visit to him in Xinjiang No. 3 prison on April 20, one source told Compass. They were allowed only 15 minutes to speak with Alimjan via telephone through a glass barrier, the source said.

But Alimjan’s lawyers, Li Baiguang and Liu Peifu, were prohibited from meeting with him, despite gaining permission from the Xinjiang Bureau of Prison Management, the China Aid Association (CAA) reported on Saturday (April 24).

Officials have now granted Alimjan’s wife Gulnur (Chinese spelling Gulinuer) and other close family members permission to visit him once a month.

Alimjan and Gulnur pastored a Uyghur ethnic house church in Xinjiang prior to his arrest in January 2008.

Attorney Li told Radio Free Asia earlier this month that while the initial charges against Alimjan were both “instigating separatism” and “leaking state secrets” to foreign organizations, his actual offense was talking to visiting Christians from the United States.

The Kashgar Intermediate Court found Alimjan guilty of “leaking state secrets” on Oct. 27, 2009 and gave him a 15-year sentence. His lawyers appealed the sentence, but the People’s High Court of Xinjiang upheld the original verdict on March 16.

“This decision is illegal and void because it never succeeded in showing how Alimjan supplied state secrets to people overseas,” Li said, according to Radio Free Asia.

“Religion lies at the heart of this case,” fellow legal advocate Li Dunyong, who was effectively disbarred at the end of May 2008 when Chinese authorities turned down an annual application to renew his law license, told Radio Free Asia.

Zhang Kai, another Beijing lawyer who had defended Alimjan, suffered the same fate. (See “China Refuses to Renew Licenses for Human Rights Lawyers,” June 11, 2009.)

Alimjan’s legal team now plans to appeal to the Beijing Supreme Court, according to CAA.

Court Irregularities

Officials initially interrogated Alimjan during his employment by two foreign-owned companies and forbade him to discuss the questioning with anyone. In September 2007 they closed the business he then worked for and accused him of using it as a cover for “preaching Christianity” among the Uyghurs.

Kashgar police then detained Alimjan on Jan. 11, 2008 on charges of endangering state security before formally re-arresting him on Feb. 20, 2008 for allegedly “inciting secession” and “leaking state secrets.”

He was then held for more than a year at the Kashgar Municipal Detention Center without facing trial.

After an initial closed hearing in the Kashgar Intermediate Court on May 27, 2008, court officials returned Alimjan’s case to state prosecutors citing lack of evidence. During a second secret hearing in July 2008 the charge of “inciting secession” was dropped. After further investigation the case was returned to court officials for consideration in mid-October 2008.

On Mar. 30, 2009, just one week after a rare prison visit from his lawyer, prison officials transferred Alimjan to a hospital in Kashgar. Alimjan called out to onlookers, “I’m sick. Tell my lawyer to come quickly to see me,” according to a CAA report. Compass sources confirmed that Alimjan had been beaten in prison. (See “Detained Uyghur Christian Taken to Hospital,” April 16, 2009.)

Last October, authorities finally sentenced Alimjan to 15 years in prison for “leaking state secrets” to foreign organizations.

“It is the maximum penalty for this charge … which requires Alimjan’s actions to be defined as having caused irreparable, grave national damage,” Li Dunyong said in a CAA press statement announcing the verdict.

The United Nations Working Group on Arbitrary Detention has ruled the arrest and detention of Alimjan to be arbitrary and in violation of international law, according to CAA.

Report from Compass Direct News 

Christians in Ethiopian Town Hit by Unexpected Attack

Orthodox church members strike two evangelical worship buildings, beat evangelist unconscious.

NAIROBI, Kenya, April 15 (CDN) — Evangelical Christians in an area of Ethiopia unaccustomed to anti-Christian hostility have come under attack from Ethiopian Orthodox Church (EOC) members threatened by their existence, Christian leaders said.

In Olenkomi, about 65 kilometers (40 miles) west of the Ethiopian capital of Addis Ababa, two church buildings were attacked by an EOC mob in Olenkomi town, Oromia Region, on Jan. 27 – leaving one evangelist unconscious and other Christians fearful of Orthodox hostility. Area Christians fear the assailants will not face justice due to the EOC’s powerful presence and impending elections.

A Mekane Yesus Church building was destroyed in the assault, while a Brethren Church structure suffered damages.

Attacks against evangelicals in the area are rare, but recently Christians have come under immense pressure as they face isolation and verbal threats, church leaders said. Located in the West Shoa Zone of Oromia Region, Olenkomi is a small town where most people there and in surrounding areas belong to the EOC. All officials in government are EOC members, and evangelical Christians encounter difficulties obtaining land for church buildings, church leaders said.

The attack followed an accidental fire from liturgical candles that burned an EOC building. EOC members blamed evangelicals, and in the ensuing assault evangelist Abera Ongeremu was so badly beaten the mob left him for dead. Another three Christians also sustained minor injuries.

Ongeremu was visiting from Neqemite, 260 kilometers (161 miles) away. After the mob stoned the Brethren Church, they next targeted Mekane Yesus Church, where Ongeremu was staying in guest quarters. A member of the mob took a Bible from his guest room and told him to burn it.

“How can I burn the book that showed me life?” the shocked Ongeremu asked.

He said that he told the mob that they could do anything they wanted, but he was not going to burn the Holy Bible. The attackers tied his hands and legs together and threw him back into the room, sprinkling diesel on the walls and roof and locking him in before setting it on fire, he said.

“I thought it was my last,” Ongeremu said. “I now understand nothing will happen to you without the will of God. That was not the day God allowed for me to die.”

Some of the assailants argued that Ongeremu should not die by burning, but by beating. Two of them dragged him out of the room and continuously beat him, covering his face in blood. He sustained wounds on his skull and right arm.

“After repeated beatings I lost consciousness,” he said. “I didn’t know how and when they left me. I only recall they argued about how to kill me.”

Premeditated?

Federal police were summoned from Ambo – the nearest town some 50 kilometers (31 miles) away – to disperse the mob, but too late to avert the injuries and damages after their rugged journey of nearly three hours.

Prior to the attacks, according to church leaders, there was no substantial build-up of tension between the two groups, though EOC priests had expressed anger about the expansion of evangelical churches and had questioned why teachers from evangelical backgrounds were prevalent in the high school in Olenkomi.

Most of the teachers at Olenkomi Secondary High School are evangelical Christians, according to church leaders, who said this circumstance was solely coincidental. Although teachers of evangelical faith are prevalent in the school, they are forbidden by law to promote their faith in class.

The EOC members had been constructing a building for a church in Olenkomi, but because of funding shortfalls they revised the plan and built a temporary structure. Evangelical church leaders said EOC priests had seized the land without formal process, but sources said the EOC’s strong presence in the area kept evangelical church officials from protesting brazen construction efforts.

The EOC’s small structure was being used for liturgical purposes.

“The shelter-like house has faced fire disaster in various incidents,” said a church leader in Olenkomi. “The materials used to build it, and the curtains they hung on walls exposed the shelter to several fire incidents. The [candle and lantern] lights the priests used for liturgy were causing problems. We heard that a number of times the fire had lit curtains, and the priests stopped before it spread.”

Such a fire broke out on the day of the attack, this time out-pacing the frantic efforts of the priests. The fire consumed curtains inside the house and spread to roofs and walls. To douse it the priests went to a nearby government-owned water tank operated by an evangelical woman. She granted them water, and the structure did not burn entirely.

When they later returned to wash, however, they put their hands inside the tank and sullied the public water source. When the operator objected, the EOC members  spoke derogatorily of her as a “Pente” and began to spread the rumor that she was responsible for the burnt structure, church leaders said.

EOC members quickly formed into groups of various sizes, sources said, and rolled into town chanting, “This is the day to destroy Pentecostals and their churches!” They first went to the Brethren Church, located by the side of a highway that stretches through Olenkomi to western Ethiopia.

“When we first heard stones falling on the roof, we thought the wind was tearing up iron sheets,” said one evangelist. “We also heard a loud noise from outside. It was around 12:30 p.m. I opened the main door to check what was happening. The whole compound was filled by men and women who carried stones and sticks. It was a very scary sight.”

They were stoning the church building, forcing the praying believers to escape through a back door. The assailants continued breaking doors and windows, thinking worshippers were trapped inside.

Local police arrived, the evangelist said, but they failed to disperse the violent mob.

“Despite firing into the air, the officers didn’t do anything serious to stop the mob,” he said. “They later said it is beyond their capacity and would call Federal Police from Ambo town. The anti-riot police arrived two and half hours later, practically after the mob effectively carried out all the destruction.”

Of the attack on Mekane Yesus Church, one church leader said the mob broke in and set fire on everything they found.

“They gathered benches, office chairs and tables, documents, musical instruments, public address system, choir uniforms and other materials and set them on fire,” he said. “They also lit fire to the church building, which reduced it to ashes.”

The mob was not finished. They proceeded to the high school, where they attacked Christian teachers as students rushed to defend them. Church leaders said the targeting of the school was evidence that the attack had been planned before with well-considered aims.

With Ethiopia scheduled to hold parliamentary elections on May 23, government officials don’t want to upset voters by punishing those behind the attacks, church leaders said. It is likely that officials would pressure church leaders from both camps to settle for the sake of stability, but Christians fear that in doing so their complaints will be overlooked.

Some suspects have been identified, but church leaders don’t expect they will be punished.

“It is like hitting a fire ball,” said a church leader from Brethren Church. “When you hit the fire, it would round back to you. It can even burn you. You may also distribute the fire to new places.”

In spite of the violence, evangelical Christians have engaged in “fervent witnessing ministry and prayer,” he said.

“It awakens us to think, pray and unite,” he said. “There is no good in persecution. But God turned it around for the good of us. The persecution was intended to destroy our commitment, but it rather built our faith.”

As election day draws closer, said the leader, EOC priests could easily motivate followers to attack.

“That would be bad times for believers,” he said. “Let’s pray for people in Olenkomi to know the will of God and repent from evil from which they assume to serve God.”

Report from Compass Direct News 

Vietnam’s Temporary Release of Priest Goes against Trend

Government granting leave to Father Ly is said to be tightening control overall.

DUBLIN, March 30 (CDN) — Vietnamese officials have in recent months tightened control over those they regard as dissidents, and the temporary release of Catholic priest Thadeus Nguyen van Ly on March 15 was a rare exception, according to Amnesty International (AI).

Officials on March 15 released Ly, now 63, from prison for one year so that he could receive medical treatment.

An outspoken advocate for religious freedom, Ly was sentenced to eight years in prison in March 2007 for “spreading propaganda” against the state. He had previously received 10- and 15-year sentences on similar charges.

“The release of Father Ly appears to be a one-off, related to his health,” Brittis Edman, Asia researcher for AI, told Compass by phone.

Human rights lawyer Le Thi Cong Nhan was released on March 6 after serving a three years in prison.  Officials have sentenced 16 other “perceived dissidents” since last September.

“Those 16 are people whose names are in the public domain,” Edman added. “There are probably others we’re not aware of.”

Edman confirmed that Ly was recently diagnosed with a brain tumor, although few details are available on the prognosis or the availability of treatment. Fellow priests told the Union of Catholic Asian News (UCAN) that Ly had suffered three strokes in May, September and November of last year, partially paralyzing his right arm and leg and making it difficult for him to walk, write or feed himself.

Following urgent requests from diocesan priests and family members, officials on March 14 granted Ly one year’s reprieve from his jail sentence. On March 15 they transported him by ambulance from Ba Sao prison camp in northern Ha Nam province to a home for retired priests in Hue, central Vietnam.

Under pressure from international advocacy groups including AI, the government may have granted Ly’s release to ward off potential embarrassment should he die in prison, Edman said.

“He’s a very public figure, and the Vietnamese government is not comfortable with being criticized.”

Religious Rights Campaigner

Ly was first jailed for one year in 1977 when he distributed a Church statement decrying the arrest of Buddhist monks and the treatment of Catholics in Vietnam, according to an AI report.

This was followed in December 1983 by a 10-year sentence served from the time of his arrest in May 1983 until his early release in July 1992. Prior to his arrest, Ly wrote a seven-point document urging officials to cease harassing Christians and announced that he was willing to be martyred for his faith.

In November 1994 Ly issued a “Ten Point Statement on the State of the Catholic Church in the Hue Diocese,” criticizing the lack of adequate training for would-be priests, the state’s interference in church teachings and its appropriation of church property.

He also became an advisory board member of the U.S.-based Committee for Religious Freedom in Vietnam (CRFV), according to AI.

In 1999, authorities objected when Ly coordinated relief projects for flood victims in partnership with CRFV. In November 2000, while U.S. President Bill Clinton and a CRFV delegation were in Vietnam, Ly reissued his ten-point statement and later made further appeals for religious freedom.

The United States Commission on International Religious Freedom in February 2001 invited Ly to address a hearing on Vietnam. Though unable to attend, Ly submitted written testimony stating that the Vietnamese government had “stripped all churches of their independence and freedom” and urging that the U.S. Congress not ratify a long-negotiated U.S.-Vietnam Bilateral Trade Agreement.

State-owned media then accused Ly of inviting “foreign hostile forces to intervene in Vietnam’s internal affairs” and inciting Catholic followers against the state.

Officials in May 2001 seized Ly during a church service and sentenced him to 15 years in prison for allegedly spreading anti-government propaganda. He was released under house arrest in February 2005 but arrested again in February 2007 and sentenced to eight years for organizing a pro-democracy event.

When the government released over 5,000 prisoners to mark Vietnam’s National Day last Sept. 2, Ly was omitted from the list despite vigorous international campaigns for his release. In a state media report quoted by UCAN, Vice Minister of Public Security Le The Tiem declared that the priest was “still in good enough health to serve his sentence.”

Report from Compass Direct News