Sri Lanka: Happily Immune From AIDS?
AIDS was a mere speck on the horizon when the World AIDS Day was first observed in Sri Lanka in 1990. At the time there was a sense of complacency about AIDS in Sri Lanka. Though other South Asian countries were feeling the urgency of the scourge, Sri Lanka seemed to be happily immune.
However, by the middle of the nineties complacency began to give way to concern as a gradual increase in numbers of HIV infected persons began to emerge. A range of factors contributed to this increase. Chief among these was the burgeoning tourist trade and increasing incidence of homosexuality, growing number of sex workers in the areas where armed forces were stationed and in major transport routes. There was also the low use of condoms; high and growing number of sexually transmitted diseases (STDs); and high levels of mobility, displacement of population and sexual violence due to the ethnic conflict(1) and particular vulnerability of young women in the Free Trade Zones (FTZ).
Stigma
As official numbers increased, the possibility that infected persons were not coming forward for treatment due to the stigma and possible discrimination by family, community and at workplaces became a serious concern.
The government’s concern precipitated the formation of a special unit, the National STD/HIV/AIDS control program in the Ministry of Health.
According to this unit, the estimated figures stand today at 3 500 cases of HIV with 38 of these being new cases detected in the third quarter of 2005, a mirror to the rapid increase of numbers.
However, the actual figures of sufferers could be much higher as discrimination and stigmatization still keep patients away from hospitals and clinics. A landmark study by the Centre of Policy Alternatives (CPA) in July this year has shown that discrimination not only keeps patients away from seeking medical help, some have lost their jobs as a result of their status being made public. There have been a number of cases of discrimination in the health sector itself.
One of the tragic cases of discrimination concerns a respected pediatrician of the largest children’s hospital in Colombo, the Lady Ridgeway Children’s Hospital, who contracted HIV after a blood transfusion given to her when she was involved in a serious motor car accident(2). She had to leave her post as other medical personnel discriminated against her so much that no children were sent to her for treatment. Adding to this tragic tale is that her husband, a senior pediatric surgeon in the same hospital also had to resign his post as he could not carry on due to discrimination by colleagues.
This case received much publicity as the lady doctor, despite her illness, launched a program to create awareness among the general public about AIDS, to urge them to seek medical help and not be deterred by discrimination. During her lifetime her services to AIDS sufferers was so noteworthy that she received a Presidential Award for her courage.
Of course stigmatization is not only in high places. There are many instances where confidentiality has not been respected. The need to create awareness regarding HIV and AIDS and dispelling the myths surrounding these are urgent. Several studies have shown that many people living with AIDS who have faced stigma and discrimination due to their status, were unwilling to share information through fear of further repercussions. They have to deal with more than the trauma of being infected by an immune system destroying virus, they also have to face humiliation and ostracism.
“For example, many Sri Lankans regardless of their educational attainments, believe that merely touching a person infected with HIV can lead to it being contracted,” says the CPA study.
Being Proactive
Many Sri Lankans regardless of their educational attainments, believe that merely touching a person infected with HIV can lead to it being contracted—Centre of Policy Alternatives
Several Non-Governmental Organizations (NGOs) have awareness programs for people living with HIV/AIDS. Some have behavioral change interventions in addition to educational interventions. The Community Strength Development Foundation (CSDF) implements its program through 200 peer leaders who have to work against the serious situation of stigmatization by society.
They have found their work especially difficult when working with sex workers, drug users and homosexuals. There have been serious objections to their work, from neighbors and house owners as well as family members of those afflicted. However the CSDF project has had some luck specially in finding alternative employment to sex workers.
Discrimination and stigma have always acted tragically on women. Loss of employment, and forced separation from children have bedeviled the lives of many women. The Women’s Development Centre (WDC) operating in central Sri Lanka has played a significant role in changing women’s perception that AIDS is limited to drug users and others practicing “risk” behavior.
“We are working with sex workers, one of the most vulnerable groups as well as with poor girls and women forced into prostitution and untrained traditional birth attendants working in exposed environments and rehabilitate them so that they and their children will be spared the stigma of AIDS,” says Pearl Stephen, Director of WDC.
This NGO works with the staff of the University of Peradeniya, the police and religious leaders in the area to identify the nature of rehabilitation required and creating opportunities for HIV affected sex workers to live a normal everyday existence within the confines of the WDC hostels and try to bring up children of pregnant HIV positive women to save at least the next generation from the stigma of AIDS.
Among the several recommendations of a National Policy on HIV/AIDS which has been recently formulated and which is expected to be in place soon, is to seek the cooperation of religious leaders to “take an active role in promoting awareness about and working to reduce the stigma and discrimination related to HIV/AIDS.”
This is already happening in all religions(3). In the karmic context of both Buddhism and Hinduism, the suffering caused by disease or other misfortune including AIDS is the result of sins committed in previous births. The religious leaders assist the patient to alleviate his suffering and explain the karmic sequences to live a better life on the principle that, as in science, every action has a reaction. Many AIDS sufferers seek spiritual help from their religious leaders. In all religions the clergy plays an effective role in advocacy and awareness raising among the public to educate them in clean living; to avoid AIDS and other STDs; to refrain from “risk” behavior and practical know-how about how AIDS spreads. This helps dispel serious misconceptions people have about how AIDS is contracted. They do not take a strong public stand against homosexuality, lesbianism or other deviant sexual activity. However, in their advocacy role they all condemn stigmatization and discrimination against the AIDS afflicted in our society.
Vijita Fernando is a freelance Sri Lankan journalist with more than 25 years of experience. She is a member of the Sri Lanka Federation of University Women, Chairperson of the Centre for Family Services, which works with women and children victimized in local conflicts, and is a Board Member of a consortium of NGOs working in water and sanitation in poor rural communities. Your e-mails will be forwarded to her by contacting the editor at ScienceTech@islam-online.net.