For a bizarre real-life tale of medical cruelty, it’s hard to beat the sad sordid story of Luckner Cambronne. He rose from humble beginnings to head the hated Tontons Macoutes, or the secret police of Haiti, becoming second in power only to the hated Papa Doc Duvalier himself. But it was his activities as the part-owner of a short-lived biomedical firm that earned him the sobriquet “The Vampire of the Caribbean.”

Cambronne, a young man working as a bank teller, became part of the Papa Doc’s entourage. Starting out as a messenger and bag man, his star quickly rose. Papa Doc appointed him Minister of Public Works, and he set up the Movement for National Reconstruction, known by its French initials MRN. With the Tontons Macoutes acting as his enforcers, he extorted millions from anyone who had money – the wealthy and the merely middle-class alike. Even foreign diplomats were not immune to his depredations. The money was supposed to go for development and infrastructure, but virtually all of it ended up in the pockets of Papa Doc and his henchmen, while Haitians went without sufficient food or decent housing, roads, or schools.

Papa Doc died in April 1971 and was succeeded by his 19-year-old son, Baby Doc, as President-for-Life. Cambronne by then was already firmly entrenched as both Minister of the Interior and Minister of State. He had also diversified his business interests, becoming part-owner of Air Haiti and a travel agency, Ibo Tours, which specialized in quickie divorces. He enjoyed monopoly control over Haiti’s exports of coffee, fruit and timber, and owned a supermarket, several taxicabs, a fish-processing plant, a sisal plantation, an oil-exporting firm, and a company that imported used clothing.

In addition, Cambronne made money through drug trafficking and by selling cadavers to American medical schools. Some of the latter he purchased for three dollars apiece at the General Hospital at Port-au-Prince, but it was reportedly common for families to arrive for funerals to find that the coffins of their loved ones were empty. Still others may have met their ends at the hands of the Tontons Macoutes hit men.

But all this pales in comparison to Cambronne’s pivotal role in triggering the world-wide AIDS pandemic.

The genesis of that pandemic, and Cambronne’s role in bringing it about, are described in Doctor Jacques Pepin’s new book The Origins of AIDS. Pepin, an epidemiologist who spent four years working at a bush hospital in the Democratic Republic of Congo, notes that virtually all cases of AIDS outside of Africa and India are due to a viral strain known as subtype B, which originated in chimpanzees living between the Sanaga and Congo rivers in Africa. The epicenter of genetic diversity for subtype B in human subjects is found around Kinshasha (formerly Leopoldville), the capital of DROC, indicating that this is where the virus made its jump from chimpanzees to humans, sometime in the 1920’s.

When the Belgians pulled out of Congo abruptly in 1960, they left behind a huge vacuum which educated French-speaking professionals seeking travel and adventure from all over the world were happy to fill. Something like 4,500 Haitians answered the call. Virtually all HIV cases outside of Africa and India are believed to have arisen from a single infection that was brought from Congo to Haiti around 1966.

Cladogram showing the results of phylogenetic analysis based on sequences of two HIV gene sequences. As expected under the Haiti-first model, non-Haitian subtype-B strains are nested within an older and more extensive range of Haitian genetic variation, with Haitian lineages branching off closest to the subtype B ancestor.

The single case brought back to Haiti almost certainly would have died out without an amplifier.

Cambronne appears to have provided that amplifier.

Cambronne was part-owner of Hemocaribien, a plasmaphoresis center that he co-founded with Miami businessman and stockbroker Joseph Gorinstein. Plasmaphoresis refers to the process of separating red blood cells from the plasma, or the liquid part, so that the red blood cells can be re-infused back into the donor. While the blood volume lost during donation can be regained up in a day or so, it takes the body several weeks to replace the missing cells. Plasmaphoresis enables an individual to donate plasma once a week, or even more often, instead of having to wait eight weeks or more between donations.

Blood plasma can be used as is, to increase blood volume in patients whose blood pressure has dropped to dangerously low levels (e.g., after severe bleeding). It can also be profitably separated into its constituent proteins, including coagulation factors (to be administered to hemophiliac patients) and immunoglobulins (for use in making vaccines). The blood plasma of Haitians was especially prized, for a macabre reason – the nation’s infant mortality rate is so high, anyone who does make it to adulthood probably has lots of antibodies to lots of different diseases.

Hemocaribien operated out of Port-au-Prince from May 1971 through November 1972, draining blood from the poorest residents of the poorest nation in the Western Hemisphere and paying them three dollars plus a bottle of soda pop for a liter of plasma. A January 1972 article in the New York Times noted that the company was exporting 5,000-6,000 liters of plasma a month for further processing at biomedical firms in the United States, Germany, and Sweden. The article quoted Werner Thill, an Austrian national serving as the company’s technical director, who stated that he was not concerned if some donors with venereal diseases or malaria slipped through the screening process, claiming the freezing process used on the plasma “kills those bacteria.”

The article also quoted Joseph Gorinstein, who stated that his company’s product was “a hell of a lot cleaner than that which comes from the slums of some American cities.”

It may not have been as clean as he thought. The combination of desperate donors willing to sell their plasma repeatedly, along with venal owners determined to squeeze out as much profit as possible, creates ideal conditions for the spread of the AIDS virus. Re-use of needles, syringes, tubing, and even pooling of red blood cells from multiple donors before re-introducing them into the body (thereby ensuring any pathogen brought in by one donor will be brought out by all of them) – all of dubious practices these have been reported in plasmaphoresis centers in other countries. Any one of them could do the trick. Outbreaks of HIV have occurred at plasmaphoresis centers in Mexico, Spain, India, and most notably China, where a quarter of a million plasma donors came down with AIDS in the early 1990’s. It seems unlikely that Hemocaribien, operating in an era before anyone had heard of AIDS, was any more scrupulous about protecting the health of its donors.

In November 1972, a team of six Haitian doctors inspected Hemocaribien’s two clinics and, in a report to the Minister of Health, detailed the shocking conditions they found:

“It is beyond doubt that the criteria used by Hemocaribien were not sufficient to evaluate the state of the donors... [Hemocaribien] is a commercial venture that takes twice the medically safe amount of plasma…The diet of these donors, the inadequate way they are selected, taken together with the unfavorable conditions in these centers, create a grave situation.”

The report added the clinics had no facilities to treat an accident, no consultation room, no emergency room, not even an oxygen tank. Donors who suffered complications were taken to a poorly ventilated room where, it was hoped, they would recover on their own. In addition, the report claimed that donors were threatened and even beaten by guards armed with “huge clubs.”

A few days later, Baby Doc, at the urging of his older sister Marie-Denise, sacked Cambronne from his post and ordered Hemocaribien be closed. Wisely, Cambronne took refuge in the Colombian embassy.

Was Baby Doc motivated by a tender concern for the Haitians being bled for cash, or for the wealthy first-world consumers of their blood products? Subsequent events answer that question well enough. A few months later, Hemocaribien changed its name to “Life Services” and hired two prominent Washington DC lawyers, Joseph Sharlitt and Milton Barall (former US Deputy Chief of Mission in Haiti) to represent them. Sharlitt and Barall arranged for Haitian officials to meet with Representative Dante Fascell (Chairman of the House Subcommittee on Inter-American Relations) and D.C. delegate Walter Fauntroy. Afterwards, Sharlitt wrote to the Haitian Ambassador, suggesting he could arrange for Haiti to be praised on the floor of Congress if the blood operation were resumed, adding “The impact of such a statement on potential US investors in Haiti would be most salutary.”

Sharlitt also promised to launch a massive public relations program to promote American investment in Haiti and prevent adverse publicity. The program would “seek to identify the origin of attacks [against the blood program], most probably the political opposition to the government.”

These negotiations were the subject of a column by the legendary Jack Anderson. Sharlitt protested, alleging that Anderson had told "roughly 50% of the truth." Anderson's reply was to leak the contents of the report of the six doctors, and nothing was ever heard on the matter again.  

Meanwhile, from Haiti, the pandemic spread to America. Pepin notes that thousands of American gay men flocked to Haiti for fun and frolic in the 1970’s and early 1980’s. The Spartacus international travel guide for gay men informed readers that “your partners will expect to be paid for their services but charges are nominal” and further characterized Haitian men as “handsome, very well endowed, highly sexed, uninhibited, and affectionate.” The first cases of what was soon to be known as “Gay Related Immune Disorder” were noted in Los Angeles in 1981.

And the rest, as they say, is history. The world-wide death toll from AIDS today stands at 29 million and counting. No doubt many more would have perished had Jack Anderson not blown the whistle on the behind-the-scenes efforts to revive the corpse of Hemocaribien.

Cambronne eventually made his way to Miami, where he lived quietly until his death from natural causes in 2006.

Cladogram via National Academy of Sciences

Blood smear photo via Wikimedia Commons