South African doctor locked away in UAE prison 10 years after working for Canadian-managed hospital

Cyril Karabus is currently sitting in a prison in the United Arab Emirates. He passport has been seized. He has been denied bail four times.

The 77-year-old South African paediatric cancer specialist is being held on a charge of manslaughter, a charge he knew nothing about until he was detained during a stopover at Dubai International Airport on his way home from his son's Toronto wedding.

The court had sentenced Karabus, in absentia, to 3-and-a-half years in prison in connection with the death of one his patients he treated in 2002 while working for Toronto-based health company InterHealth Canada Ltd (ICL) in Abu Dhabi.

"What happened to Dr. Karabus underscores the perils of working overseas. Canadian employers with staff abroad often have professional liability insurance and indemnities to handle unforeseen legal hassles," the Globe and Mail's Tu Thanh Ha writes.

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While ICL offers malpractice insurance, it doesn't cover legal fees concerning criminal matters and told Karabus' family that it is not liable for the Karabus' current situation.

The hospital Karabus worked at in 2002 is no longer managed by ICL.

"At no time was ICL informed of any complaint in relation to Dr Karabus' performance of his clinical duties; no complaint was made against either ICL or [the hospital] and no claim was made under ICL's medical malpractice policy," InterHealth said in an e-mail to the Globe and Mail.

Karabus was filling in for another South African doctor, Lourens De Jager, at Sheikh Khalifa Medical City when he treated a girl with acute myeloblastic leukaemia. The girl died, and Karabus returned home shortly after.

The girl's father complained to police and had Karabus charged with manslaughter and falsifying documents, a lawyer for InterHealth says.

Karabus had already left the country. His family claims he was never warned about any charges.

InterHealth's lawyer, John Hyland, insists that De Jager contacted Karabus to stay away from the UAE.

De Jager, however, denies this, and wonders why InterHealth, the then-employer, didn't inform Karabus.

"That's definitely not correct. I never knew anything about the sentence, otherwise I would have warned him."

Karabus' next court date is October 11. At his previous hearing, authorities were granted extra time to find the medical files, all of which have gone missing.

"They can't even find the files to make the allegations," Karabus' lawyer, Michael Bagraim, told the Guardian. "They can't find the family of the deceased girl. They have nothing."

"He is probably one of the leading experts in paediatric oncology. He is telling the court, 'I have done nothing wrong and if I had to do it again, I would do the same thing'. This was acute leukaemia. The kid was going to die anyway. There was nothing he could do but make her comfortable."

The World Medical Association has written to the United Arab Emirates justice minister to express its "deep concern about Professor Karabus and the state of his health," dismay at the refusal to grant bail, and promised to follow any trial closely.

"We respect the laws of foreign countries when they are just, even if they are vastly different from our own laws," an open letter from the Treatment Action Campaign, a South African activist organization, stated. "However, by no modern principle of jurisprudence is it acceptable to try a foreign citizen in absentia without informing him or attempting to extradite him."

Karabus isn't the only employee who has experienced the perils of working abroad for a Canadian company.

Last spring, a New Brunswick farmer was released from a Lebanese jail after 373 days behind bars for allegedly tying to export rotten potatoes to Algeria.

Henk Tepper criticized the federal government for not doing enough to expedite his release.

"She said, 'We're going to make sure you're going to follow fair justice in Lebanon, fair extradition to Algeria, and be fairly judged and tried in Algeria,'" Tepper recalled a conversation with the Canadian ambassador to the Canadian Press. "I was really worried when she told me that."

He had been in the Middle East on a Potatoes Canada trade mission at the time of his arrest. He had no idea that he had been wanted since 2008.

Tepper was detained on an international arrest warrant alleging he exported rotten potatoes from Prince Edward Island and Quebec to Algeria in 2007.

Algerian officials received a report that the shipment contained ring rot and refused the shipment. All 310 tonnes of potatoes were eventually approved for human consumption and were sold to Syria.

Tepper was unaware that Algeria issued an Interpol warrant — charges carried a sentence of up to five years if convicted — and believes Canadian officials would have known about the Interpol notice and should have warned him to not travel outside of the country.

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While a spokesman for the general minister of state for foreign affairs insists that the Canadian government was working consistently on Tepper's behalf, Tepper insists that officials in Beirut didn't give him that impression.

"They never ever mentioned going back to Canada. They said they had their embassy in Algiers and that they would make sure that I was fairly tried in Algeria," he said. "As far as I'm concerned and what I know, they haven't done anything to bring me home. They wanted me to go to Algeria."

Upon his return, Tepper has had to deal with the financial burden of his farm in creditor protection under massive $11 million debt.

Pierrette Ringuette, the Liberal Senator for New Brunswick, called Tepper's treatment by the government as "borderline cruel."

"Having been on Parliament Hill for so long, I know full well that if we had a Canadian banker detained in Beirut without charge, he wouldn't be there more than 48 hours," Ringuette told the National Post following Tepper's release.

Under the Criminal Code's "duty of care," companies "must take 'reasonable steps' to protect workers, whether they are in Canada or working internationally," Foreign Affairs and International Trade Canada states. Failure to do so can result in being found criminally and financially liable under the Criminal Code.

John Proctor, the director of an independent information technology and business process services firm, recommends that companies take certain steps to ensure they've met this standard:

"Prevent a potential incident by tracking the traveller and informing him or her about changing events and circumstances," he lists on the government site.

Should this "duty of care" expand to after-the-fact incidents and include warning former employees of outstanding international warrants against them?

If not, here's the Canadian government's Guide for Canadians Imprisoned Abroad.