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Guinea-Bissau demands extradition of doctor in Portugal

BMJ 2007; 335 doi: http://dx.doi.org/10.1136/bmj.39261.635220.DB (Published 05 July 2007) Cite this as: BMJ 2007;335:15
  1. Tiago Villanueva
  1. Lisbon

    The authorities of Guinea-Bissau are requesting the extradition of a Guinean anaesthetist and former director general of public health in Guinea-Bissau, who is based in Portugal. Guinea-Bissau is a former Portuguese colony in western Africa.

    Luís Nambanca, aged 45 years and born in Guinea-Bissau, later acquired Czech nationality through marriage. He was working as an anaesthetist in a hospital in the city of Beja, southern Portugal, when he was arrested by Portuguese police. An international arrest warrant had been issued by the military judiciary police of Guinea-Bissau, based on the decision of the regional court of Bissau, the capital of the country.

    The request was issued on the basis of an agreement between Portugal and Guinea-Bissau that was established in 1989.

    Dr Nambanca has been detained at Portugal's Beja penitentiary since 26 April.

    A Portuguese regional court is currently analysing the extradition request from the Guinean authorities.

    In 2001 Dr Nambanca, who worked at a private clinic in Bissau, was convicted of involuntary homicide caused by medical negligence, in an alleged case of induced abortion that his lawyer claims he never carried out.

    His Portuguese lawyer, Sofia Baptista, told the BMJ that the only thing Dr Nambanca did was to refer the patient to the clinic's gynaecologist. In 2001 a 25 year old woman admitted herself into his clinic one morning complaining of malaise. Dr Nambanca advised her to seek assistance at Bissau' Simão Mendes hospital because the clinical team was busy with a complex surgical case.

    The woman returned later the same day complaining of vaginal bleeding, and because he considered her case to be beyond his competence, he referred the woman to the gynaecologist Júlio Nafantche.

    After three days of caring for the patient, Dr Nafantche decided to operate. She died during the operation because of a ruptured uterus, supposedly caused by a clandestine abortion before her admission to the clinic.

    Ms Baptista says that the extradition request fail to conform to the European Convention on Human Rights. She also says that Dr Nambanca was convicted in absence because of his prior political and ethnic connections with a top Guinean minister, Artur Sanha, at the time when Dr Nambanca was director general of public health of Guinea-Bissau.

    Ms Baptista said that the legal battle was to do with tribal rivalries between the Balanta ethnic group, which was in power in 2001 and to which Dr Nambanca belongs, and the Fula ethnic group, which is the current political and ethnic force and is presently pursuing members of the rival Balanta group.

    After the incident, Dr Nambanca left the country and returned to Prague, in the Czech Republic, where he had studied medicine and specialised in anaesthesia. In 2005 he moved to Portugal for higher pay and because he spoke Portuguese, which is spoken in Guinea-Bissau. The region of southern Portugal to which he went also lacked anaesthetists.

    Meanwhile, while out of the country, Dr Nambanca was convicted and sentenced to four years imprisonment in Guinea-Bissau because the court thought his clinic was improperly equipped for emergencies and, in particular, lacked blood reserves that are necessary for surgical interventions. Also Dr Nafantche was sentenced to one and a half years imprisonment.

    The Guinean authorities considered Dr Nambanca an outlaw, even though he claims that the regional court of Bissau had always known his whereabouts.

    For the time being, Dr Nambanca's post in the Portuguese hospital has been suspended, and members of the hospital board have already declared willingness to testify as witnesses before the court if it is necessary.

    Sandra Linkensederova, consul at the Czech embassy in Lisbon, told the BMJ that the extradition is unlikely to succeed because it is counter to the European Convention on Human Rights and that Guinea-Bissau fails to meet international standards in terms of human rights, namely the independence of justice, the condition of prisons, and treatment of prisoners.

    Quintino Bedane, press officer at the Guinea-Bissau embassy in Lisbon, was aware of the situation, but didn't go into details. He told the BMJ, “We don't know if this whole situation is true or not, so it is complicated to make any comments about this case until it has been dealt with properly by justice.”

    Namuano Gomes, a lawyer and minister for justice in Guinea-Bissau until two months ago, told the BMJ, “The veracity of the facts in part has to do with medical negligence, but his problem was not having defended himself. If he had instructed his lawyer to defend him during the trial the conviction would have been attenuated. But a party that does not defend oneself stands little chance of winning, and he preferred to evade . . . justice, by not having appeared in court in Guinea-Bissau.

    “Furthermore, he must try to do a review of his case before five years elapse, which is the deadline for an appeal review, should he have any additional elements to add. The political and ethnic allegations don't have judicial value, albeit they have political value, as politicians take the opportunity to make noise.”