WHEN Eric Van Dusen died of liver failure, it came as shock to his family. The 40-year-old Nova Scotia man had kept secret the fact that he was one of the thousands of victims of tainted blood.

After the funeral, three of his brothers, all hemophiliacs, learned they too had hepatitis C, a potentially debilitating liver disease that had killed their sibling. Unlike Eric, however, none had also contracted the AIDS virus.

While Eric Van Dusen received compensation of $30,000 a year for four years as part of a provincial lifetime compensation package for people who got HIV from a transfusion, his siblings have received nothing.

"All of us got tainted blood, but only one of us got compensation," Neil Van Dusen said. "I don't see how that's fair."

The estimated 60,000 Canadians who were infected with hepatitis C through transfusions and blood products are the forgotten victims of the tainted-blood tragedy.

There is no vaccine for hepatitis C and no cure. It is transmitted by blood, and the symptoms, which sometimes do not appear for up to 25 years, range from mild discomfort and fatigue to cirrhosis or cancer. As many as one in five people who are infected will die of it.

The case for compensating the thousands of Canadians who received blood contaminated with hepatitis C can be made with a single word: Fairness. But extending the "compassionate assistance" package to those with hepatitis C is something federal and provincial ministers of health have bitterly resisted for years and still cannot agree on. For them, the issue is money.

To date, the ministers have ignored the entreaties of everyone from Toronto Mayor Mel Lastman, who contracted hepatitis C during surgery in 1989, to Mr. Justice Horace Krever of the Ontario Court of Appeal, who spent more than four years looking into the tragedy.

But the ministers' hand may soon be forced by more than $3.5-billion in lawsuits launched by those who are infected, and by the results of the exhaustive Royal Commission of Inquiry on the Blood System in Canada.

In his final report in November, Judge Krever said the Red Cross, Ottawa and the provinces all played roles in the tainted-blood tragedy of the 1980s. He recommended that all victims, past and future, be compensated through a no-fault scheme, regardless of the etiology of their illness.

The health ministers postponed a meeting to discuss their response this week in Vancouver because they were nowhere close to a resolution. Some say it may take six or seven meetings -- months -- for them to agree on compensation, if in fact they can.

Neil Van Dusen, a Canada Post wicket clerk, is now too sick to work. He finds it frustrating when people call hepatitis C a minor affliction, and use that misconception to justify denying compensation. "When people say 'What are you looking for?' I say 'I want to go back to how I was before.'

Unfortunately, that isn't possible. So, all I want is a little help." He would use the compensation to move his family from Sydney to Halifax, where liver transplants are performed.

"Basically, they're waiting for me to deteriorate to the point where I am eligible for a transplant, so I have to prepare," Mr. Van Dusen said. He is particularly miffed at the behaviour of politicians in Nova Scotia, a province that took the lead in compensating victims of AIDS-tainted blood in April, 1993 -- right around the time his big brother died.

"I'm extremely disappointed they haven't picked up the ball on hep C," Mr. Van Dusen said. "At this point, we need another George Moody -- God love 'im."

The former Nova Scotia health minister was one of the few politicians to champion the cause of tainted-blood victims when most of his colleagues were ready to turn their backs for fear that compensation would be too expensive.

In 1993, after several emotional meetings with Randy Conners, a hemophiliac in Halifax who was infected with AIDS through tainted blood, and his wife Janet, Mr. Moody decided he would do everything he could to make sure the couple did not lose their family home because of monumental drug bills and lost income. He went to his cabinet and made a passionate presentation. They agreed something had to be done.

Mr. Moody angered the other health ministers in 1993 when he broke ranks and offered compensation. Many phoned to tell him not to do it. The deal, which was accepted by all 16 AIDS-infected tainted-blood victims in the province, provided $30,000 a year, free prescription drugs and other benefits.

Recipients had to sign a waiver agreeing not to sue the province. After Mr. Moody acted, all the other provinces eventually followed suit.

Today in opposition, Mr. Moody says he knows what will have to happen before the hepatitis C victims get justice. "It is going to take a politician with some heart, some feeling, who is willing to stand alone and do the right thing."

The 1993 Nova Scotia assistance package is not that different from what hepatitis C victims are looking for.

In addition to $30,000 a year (in exchange for agreeing not to sue the federal and provincial governments), they want additional payments for people who are ill and can no longer work, says Durhane Wong-Rieger, president of the Canadian Hemophilia Society.

Despite the possibility of avoiding expensive legal proceedings, politicians have resisted compensation because of fear of how much it will eventually cost: Many more Canadians contracted hepatitis C than HIV through the failings of the blood system.

About 2,000 Canadians contracted HIV from blood and blood products, and half of them received compensation. (The others died, most from the underlying causes that necessitated transfusions.)

About 60,000 people were infected with hepatitis C though tainted blood. According to the Krever report, 28,600 of them received contaminated blood between 1986 and 1990, and as many again before that period.

The time frame is important because from 1986 to 1990 U.S. authorities were using a substitute test to minimize hepatitis C infections. In Canada, the test was deemed inefficient, despite overwhelming evidence to the contrary. Judge Krever concluded that 85 per cent of infections during that time would have been prevented by substitute testing. In such tests, donors are checked for previous exposure to hepatitis B, a strong indication that the person was at risk of having hepatitis C.

That means some 24,000 Canadians have a claim -- and probably a strong claim -- to compensation for a harm suffered. Activists, however, are concentrating on getting help for those who are sick. (Hepatitis C has a long incubation period, and about 20 per cent of those infected will develop cirrhosis or liver cancer.)

Because the blood products they used were manufactured from pools of up to 20,000 blood donations, hemophiliacs are the first and the hardest hit when blood-borne diseases surface, so their infection rate is high. About 43 per cent of hemophiliacs in Canada contracted HIV from tainted blood, but 75 per cent got hepatitis C.

Today, hepatitis C is the No. 1 killer of hemophiliacs, and the lack of a compensation program has created hardship and bitterness.

Michael McCarthy, 38, of Sebringville, Ont., thought he was lucky because he did not get HIV, but now he is suffering the effects of hepatitis.

"I escaped the quick killer," he said, "but I'm stuck with the slow, agonizing one."

The only approved treatment for hepatitis C is interferon, a powerful drug that often has debilitating side effects. When he took a course of the drug, Mr. McCarthy lost 50 pounds and developed an auto-immune disorder that leaves him susceptible to all manner of infections -- much like those infected with HIV.

Because they are so physically weak, the political fight for compensation has not been easy for the women and men infected with hepatitis C. In October of 1996, Jeremy Beaty and Alan Powell, two early leaders of what would become the Hepatitis C Society of Canada, went to Parliament Hill for the first time to lobby for compensation. They looked tired and haggard, and had to sit frequently. The best audience they could muster was a small group of MPs.

Both were infected through transfusions, and they asked those MPs the question they are still asking politicians today: Is it fair to compensate Canadians who were infected with AIDS through tainted blood and not those who were infected with hepatitis C?

Emboldened by Judge Krever's report, hepatitis C groups are becoming far more aggressive. On Thursday, they held a news conference in Toronto to accuse the government of Ontario of holding up the talks on compensation, although a spokesman for the province's Health Minister denied their accusations.

Former Ontario health minister Jim Wilson angered the groups by suggesting last year that they should go to court if they want compensation. (Most of those infected say they will sue if they have to, but would rather settle out of court because they don't have the energy or the money for protracted litigation.)

The new Health Minister, Elizabeth Witmer, has yet to say whether she disagrees with Mr. Wilson.

Mr. Beaty says that Ontario, Alberta and New Brunswick are the holdouts. Quebec and Saskatchewan are pushing for compensation, and the others seem willing to go along, he says. Ontario and Alberta, key to a settlement because of their size and wealth, have not yet even met with tainted-blood victims.

Saskatchewan Health Minister Clay Serby dodged questions about the negotiations in an interview this week. Mr. Serby, who is the chairman of the federal-provincial health ministers' meetings this year, would say only that they are still looking "to find a mechanism."

Key issues remain to be resolved, including who should be covered. Some provinces argue that only those infected from 1986 to 1990 -- when the subsitute test was available -- should be compensated.

The federal government and the provinces are also wrangling over how to share the costs of compensation, with some provinces arguing the health care they provide to those who are infected should count.

This is not a new debate.

In the late eighties the federal health minister, Perrin Beatty, tried to get the provinces to agree to a compensation package for those who had been infected with HIV through the blood system. The provinces are largely responsible for the administration of the blood system in Canada, and he felt they should be willing to pay their fair share.

Then, as now, they couldn't agree, so Mr. Beatty decided that the federal government would offer $120,000 to each person tax-free over four years. Mr. Beatty had been advised by his department that if the victims went to court, the average settlement would likely be around $3-million, adding up to $1-billion in total if Ottawa lost all the cases.

Today, Ottawa and the provinces are again facing billions of dollars in potential court settlements. But so far, Health Minister Allan Rock has shown no sign that he is prepared to break with the provinces and offer a federal package.

"It is still our preference to come forward with a package that includes all the provinces; we think that is the best result for people who are victims of tainted blood," his spokesman, Cyrus Reporter, said yesterday. The ministers are scheduled to meet in several weeks in Toronto, although there is no guarantee they will reach an agreement.

Another bit of unfinished business for the health ministers is dealing with the claims of the so-called secondarily infected, the spouses and children of victims of tainted blood who also contracted the AIDS virus. There are about 100 of these cases nation-wide so far.

In his final report on the tragedy, Judge Krever noted that you can tell a lot about a society by how it deals with people such as the tainted-blood victims.

"The compassion of a society," he wrote, "can be judged by the measures it takes to reduce the impact of tragedy on its members."

No cure

Hepatitis C is a potentially debilitating liver disease for which there is no cure.

It was identified in 1989. Before that, it was known as as non-A, non-B hepatitis.

Transmitted by blood, the symptoms range from mild discomfort to cirrhosis or liver cancer. As many as one in five people who are infected will die as a result of the disease.

Mr. Justice Horace Krever estimated in his final report on the tainted-blood tragedy that as many as 60,000 Canadians may have been infected with the virus through tainted blood, which means as many as 12,000 could die as a result of blood-borne hepatitis.

So far, only a fraction of that number have come forward to declare their infection. That is because hepatitis C has a long incubation period, and it can take up to 25 years before severe symptoms become obvious. About half of people who have major surgery (the biggest users of blood) die of the underlying causes that necessitated the transfusion within a couple of years.

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